MacIver News Service | June 4, 2019
By M.D. Kittle
MADISON, Wis. — Gov. Tony Evers calls his rate increase for Wisconsin nursing homes the largest in over a decade.
That would make sense. The Democrat has proposed a massive $84.2 billion biennial budget, proposing dramatic spending hikes for everything from public education to welfare programs.
But a closer look at the numbers shows Evers’ proposed 2.5 percent general rate increase for nursing homes isn’t technically even the largest funding jump in the past three years.
In fact, thanks to Medicaid’s woeful reimbursement rates, the governor’s budget delivers about $40 million less when compared to the base year.
John Sauer, president and CEO of LeadingAge Wisconsin, which represents nursing homes in the state and serves as a leading advocate for seniors and the disabled, said even with a 2.5 percent increase on Medicaid fee-for services, funding for nursing homes would go down “compared to where we are now.”
“In the governor’s budget, that’s about $40 million less … on the Medicaid fee-for-service portion of the Medicaid program,” Sauer said, pointing to projections showing a continued decline in Medicaid patients, which equals less Medicaid funding.
More than 30 nursing homes have closed since 2016, buckling under the weight of low Medicaid payments and a consumer shift to assisted-living facilities. Wisconsin’s 350-plus nursing centers also are facing a worker shortage crisis driven in large part by low Medicaid payments, advocates say.
Evers’ budget proposal calls for $8.7 million in fiscal year 2020 and $17.8 million the following year, amounting to a combined 2.5 percent increase. Like much of the Democrat’s budget plan, the funding increases are tied to Wisconsin accepting the federal Medicaid expansion and the expensive “free money” that goes along with it. Evers would spend another $2.8 annually to expand the dementia care specialists program to all aging and disability resource centers in the state, equating to 30 new Aging and Disability Resource Center positions, according to the administration.
The current budget signed by former Gov. Scott Walker increased payment rates by 2 percent, but the spending plan also increased by $5 million annually payments specifically for care of behaviorally challenged residents. Factoring in the increased funding, the current budget comes closer to a 3 percent increase, at least in the first year of the biennium, Sauer said.
Ultimately, the single-digit increases amount to a few dollars more per Medicaid patient.
Despite Evers’ budget rhetoric, though, even a governor not shy about spending taxpayer money can’t keep up with what nursing home care advocates describe as a funding crisis.
“We appreciate the increases but that level of increase is not really enough to reverse the trend happening in closures and the difficulty in attracting staff,” Sauer said.The Legislature’s budget-writing committee takes up the governor’s Department of Health Services budget Tuesday afternoon in what promises to be a contentious day, particularly on the Medicaid front. #wiright #wibudget #wiright Click To Tweet
LeadingAge Wisconsin has called for $83 million in state general purpose revenue over the biennium, about a 10 percent increase in daily Medicaid rates.
The Legislature’s budget-writing committee takes up the governor’s Department of Health Services budget Tuesday afternoon in what promises to be a contentious day, particularly on the Medicaid front.
“We’re hoping people will say this is crisis time and that we need to have good nursing facilities available in every corner of the state,” Sauer said. “My concern is if we don’t invest in nursing facilities there won’t be community nursing homes available to many of the people who need them most.”