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On the Ballot: To Lock In or Lock Up Care for Elderly?

On Nov. 4, Louisiana voters are being asked — as they were in 2012 — to decide whether to protect nursing homes from future budget cuts.

“We’re caring for the sickest of the sick, and the oldest of the old,” says Louisiana Nursing Home Association director Joe Donchess, by way of explaining why nursing homes are asking voters to lock in health care dollars for the elderly and profoundly disabled.

“It’s so vitally important that the state establish a stable funding source for not only the current number of elderly but for those into the near future,” Donchess notes, adding that aging baby boomers are expected to swell the demand for nursing home care by 40 percent within the next 16 years.

The fall ballot’s Constitutional Amendment 1 would set up a dedicated fund for nursing homes, supported by existing fees self-imposed by the industry.

Home health care providers, disability advocates, Councils on Aging, and hospice service providers oppose this amendment. They fear that by locking up the funding stream, Louisiana will end up locking away its elderly and severely disabled — only in nursing homes.

“That’s at the exclusion of home and community-based services for the elderly, and people with disabilities,” Louisiana Budget Project director Jan Moller says of the nursing home fund this constitutional amendment would create. And, he says, that’s not what senior citizens need or want.

“Every survey I’ve ever seen shows people want to stay at home as long as possible when they get older and more infirm,” Moller says.

The nursing home industry, which has a substantial lobby in the Louisiana legislature, is spending more than a few dollars to run media ads pushing for passage of this amendment. The groups in opposition--home health care, disability services, hospice care and Councils on Aging—are using free resources, like social media, emails and newspaper letters to the editor--to let their concerns be known.

And if this entire debate sounds familiar, that’s because this is take two. Voters approved a similar fund in 2012, but that one — the Medicaid Trust Fund for the Elderly — wasn’t as tightly protected as what’s in this current proposal. The previous fund has been used for home health care and disability services, and has been raided to fill other state budget holes. It is now nearly empty.