GOVERNOR SHIFTS TO REPUBLICAN POSITION ON LONG-TERM CARE REFORM
NASHVILLE, TN – Gov. Phil Bredesen’s decision to embrace long-term care reform, after five years of inaction on the issue, is welcomed by Tennessee Republicans who have long pushed for giving Tennessee’s elderly alternatives to nursing home care.
Bredesen announced today at the Tennessee Press Association meeting in Nashville that he will soon propose legislation called the “Long Term Care Community Choices Act,” which would begin to shift TennCare nursing home dollars to home-based care for elderly and disabled people on TennCare who would prefer it.
Bredesen said home-based care is less costly, and more preferable for most elderly people. “People simply need more choices,” Bredesen said. “In the months ahead we’re going to fundamentally restructure how our state deals with long-term care in the TennCare program.”
Under the current system, 98 percent of state dollars for elderly care go to nursing home care, which, Bredesen says, ends up “forcing people into nursing homes who would prefer to remain in their own homes.”
Bredesen is absolutely correct.
“The Tennessee Republican Party is glad Gov. Bredesen has embraced this Republican policy proposal, however long it took him to make the shift,” said Bill Hobbs, communications director for the Tennessee Republican Party. “The Bredesen administration’s shut-down in recent months of numerous nursing homes shows that alternatives are desperately needed – and alternatives to nursing home care such as home-based care are not only desired by many patients, they are more economical for taxpayers too.
The Bredesen administration has closed 37 nursing homes across the state since 2005, affecting hundreds of patients and their families. Current federal Medicaid law forces the elderly to “spend down” their assets before qualifying for nursing home care under TennCare, meaning that many elderly patients who lost their nursing home space in the wave of nursing home shutdowns had few options and few resources to pay for them.
Home and Community-Based Services (HCBS) is universally acknowledged to be much less expensive than nursing home care - but under Bredesen’s watch less than 2 percent of the more than $1 billion that Tennessee spends (including federal dollars) on long-term care for the poor, elderly and disabled goes to HCBS. That’s the lowest rate of any state in the country.
The rest goes to nursing homes - the most expensive form of care. None goes to assisted-living, which is an intermediate step between HCBS care and nursing home, and costs less than nursing home care.
Republican state Sen. Diane Black of Gallatin has been the leading voice in the state legislature for long-term care reform, and has been championing reform legislation for three years.
This week, the state Senate has moved passage of two key health care bills this week aimed at helping elderly or disabled Tennesseans receive more options in their health care, including staying in their homes for as long as possible. The long term care legislation is part of a series of bills aiming to help citizens “age in place.”
Just this week, the full Senate passed Sen. Black’s legislation SB 2614, which will help provide more options for elderly and disabled citizens by broadening the definition of assisted living to include hospice services. This bill would make it clear that any assisted-care living facility resident who qualifies for hospice care under Medicare can continue those services and also receive reimbursement for assisted living services.
Also, the Senate General Welfare, Health and Human Services Committee passed SB 1157, which calls for a pilot program for a “self-directed care program” where individual patients get the opportunity to choose services they think they need and who provides them. If SB 1157 becomes law, eligible patients would receive a monthly budget based on their needs, and could use this money to hire personal assistant services, make home modifications, and more.
“Tennessee has been last in the nation for too long in the number of healthcare choices for elderly and disabled citizens on Medicaid-supported services, a problem that has kept them from being able to stay in their homes and age with dignity,” said Senator Diane Black, sponsor of the legislation. “I know from speaking with citizens in my district that this is an issue that concerns many of them, and I can sympathize with their lack of options.”
Senators approve key bills to help elderly and disabled “age in place” – Feb. 14, 2008
Bill Hobbs
Communications Director
Tennessee Republican Party
2424 21st Avenue, Suite 200
Nashville, Tennessee 37212
Phone: (615) 269-4260
Email: billhobbs@tngop.org
