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Thursday, April 21, 2005 06:36 am

Why is Illinois so stingy to its oldsters?


I now have to travel the 30-or-so miles to Girard to take flowers to my friend Elizabeth Brown, who’s living at the Pleasant Hill Village nursing home. She was organist at our church for many years, and though she likes the care she’s getting and the facility in which she lives, she always talks about how much she misses the church in Springfield. Until now she’s lived her entire 92 years in Springfield, except for the time she served in England and France with the Women’s Army Corps during World War II. Elizabeth is one of many in the “greatest generation” whose later years are made more difficult by bad public policy on nursing-home funding.

Like several nursing homes in Springfield, the facility in which Elizabeth lived until recently won’t accept government Medicaid payments for care. Though she’s still paying her own way, as she has throughout her life, her assets are dwindling. It would bother her to know she may have to accept public aid soon. Her family decided to move her now, before the money runs out, to a place that will still care for her when she is no longer classified as “private pay.” The family learned that some Springfield nursing homes that will keep patients after they convert to Medicaid still ask brusquely how many years they’ll be on private pay. Some homes were downright rude when the possibility of Medicaid was brought up. Others, where most patients are on Medicaid, offered undesirable facilities or care.

“We’re in trouble as a society,” says Mary Link of Springfield, Elizabeth Brown’s younger sister, who has served as a nursing-home ombudsman for the Department on Aging. “We don’t take care of our old people. What have these people done wrong? Why are we punishing them for taking care of themselves so well that they live a long time?”

The reason many facilities shun Medicaid reimbursement — and Elizabeth Brown along with it — is that the government simply doesn’t pay enough to cover the cost of nursing-home care. At Pleasant Hill Village, the nonprofit Church of the Brethren home on whose board I serve, the basic “private pay” rate is $99 a day, and many area facilities charge considerably more. But Medicaid pays only $69.52 a day, a sum that will buy a modest hotel room but which no one believes is adequate to cover costs of 24-hour nursing care and meals. Also, low Medicaid rates sometimes force nursing homes to increase their private rates, which in turn hastens the day on which a patient’s assets will be exhausted.

Medicaid is a joint federal-state program, and nursing-home reimbursement is a problem all over the country. But reimbursement rates are largely set by states, and Illinois is particularly stingy, ranking 47th among the states in the average rate paid to nursing homes, even though it is the ninth-wealthiest state. The average daily Medicaid rate for Illinois nursing homes is $96.99, compared with Indiana’s $107.27 and Minnesota’s $135.

Many of the nursing homes that labor to provide care under these conditions are faith-based nonprofits that already go the extra mile to care for the needy in their charge. Rather than protest or make demands, they designated April 12 a “Day of Reflection,” on which some 35,000 nursing home residents, staff members, and family members prayed that legislators and Gov. Rod Blagojevich would do their moral duty by adequately funding care for the elderly. Life Services Network, the statewide association for nonprofit homes, credits last year’s Day of Reflection with helping persuade legislators to restore the 5.9 percent Medicaid cut made in 2002. So far this year the prayer has been lost on the governor, who clings stubbornly to his pledge to absorb deficits without increasing sales or income taxes.

The governor could use a day of reflection. We couldn’t help but notice that he arrived late for and left early from Sunday’s interfaith worship service in Springfield to dedicate the new museum. We know that the governor is a busy man, and TV cameras beckoned. But he would do well to sit still and pray about his moral obligations. Better yet, he should visit Elizabeth Brown, thank her for her service to her country and community, and try to explain to her why this wealthy state can’t afford adequate funding for her care.

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