Opinion: Pay attention to health and human services cuts

There’s a growing concern over what will happen to care for the elderly if the state legislators significantly cut the health and human services budget.

The state sets the rates nursing homes can charge that determine the level of service providers can give the elderly. It also funds waiver programs that enable seniors to live in their own homes and assisted living facilities.

Stakes are high for state-funded health care, because it’s being suggested that a billion dollars be cut from the health and human services budget for fiscal years 2011 and 2012.

Adding to the problem, stimulus funds that flowed through federal Medicaid will expire. Where the federal government now is providing 62 percent of Medicaid funding including stimulus dollars, that match is likely to drop to 50-50.

Up to now, the Legislature has been able to provide state funding necessary to care for the elderly, but that could change with the state facing a $6.2 billion deficit. If funding for K–12 education is protected, the Legislature must look at cutting health and human services funding.

Rep. James Abeler of Anoka, who is the new chair of the Health and Human Services Committee, says programs for the disabled and nursing home care residents will be protected.

He says, however, that programs for able-bodied people may lose some funding in next year’s budget.

Abeler agrees that $1 billion will be cut from the human services general fund, but he adds that there is $1.5 billion projected growth for the biennium – from $10.5 billion to $12 billion. The $12 billion is the state’s share of the $24 billion health and human services biennium general fund, the other half being federal money.

This biennium, the total Health and Human Services Department budget is $23.5 billion, of which $8.8 billion is the state’s share. The budget for elderly programs from those amounts is $3.5 billion, of which the state’s share is $1.4 billion.

One thrust of human services is to keep seniors living in their own homes longer. To that end, the state funds programs to provide services in private homes for elderly residents who are at risk of going into nursing homes.

Such a program is cost effective because the state on average pays $9,000 a month through Medicaid funds to provide nursing home care. (About 60 percent of patients in nursing homes receive state and federal assistance.)

The big cut could come in the elderly waiver programs that enable the elderly to live in their homes longer.

Abeler, however, believes that eliminating unnecessary Medicaid-funded treatments and cutting other costs can save $1 billion, while protecting the programs for the disabled and nursing home patients.

The alternative to cutting spending for health care for the elderly and disabled is to raise revenues, something Republican legislators who control both houses oppose.

Even by reducing the health and human services budget to single-digit increases, Abeler says Minnesota will continue to be more generous than surrounding states in providing health and human services.

Meanwhile, seniors should pay attention to where cuts are being proposed for the health and human services programs and let their legislators know they are concerned.— Don Heinzman, ECM Publishers

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