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Point of View: Legislators could positively impact nursing home care

Nico Gomez
Nico Gomez

As we age, many of us will become frail, or sick, or unable to take care of ourselves for whatever reason.

Some of us will be able to rely on family for care. Others will be able to live at home, semi-independently, with the help of supportive services. But a significant portion of our aging population will require the kind of around-the-clock, specialized care offered in skilled nursing facilities. This need will continue to grow as the Baby Boomers age and live longer.

This greater demand for eldercare services is on a collision course in Oklahoma with inadequate, unstable funding. In most medical fields, the primary form of payment is private insurance, which pays relatively well. In the world of skilled nursing care, however, the primary form of payment is Medicaid, which, in Oklahoma, pays much less than the cost of care.

More than 70 percent of Oklahoma nursing home residents are on Medicaid. Oklahoma has one of the three lowest Medicaid reimbursement rates for nursing services in the nation. In fact, the cost of providing care to Oklahoma’s Medicaid residents is greater than the amount reimbursed, meaning each Medicaid recipient represents a net financial loss.

Our long-term care infrastructure is challenged and providing high-quality care for our seniors is becoming increasingly difficult. This year, however, an unprecedented coalition of eldercare advocates is working on a permanent solution. It's called the Nursing Home Quality Assurance Initiative, and it exists in two identical bills: House Bill 1902 and Senate Bill 280.

The concept is simple: Invest funds for critical nursing services to compensate the cost of providing high-quality care, which equates to about a $23 per day, per person increase in the Medicaid reimbursement rate. As a result, nursing homes will be required to deliver on the largest quality improvement plan in generations: increased direct care staffing, additional mandatory training, and documented improvements in quality measures.

Both bills have passed in their respective chambers with unanimous support. That is great news, but it's an empty victory without funding, which will come only in a final budget agreement. If the budget bill signed by Gov. Stitt includes an extra $9 million to $13 million to fully fund this plan, our lawmakers will have delivered a historic win for seniors. If it doesn't, we will face a crisis, knowing we let the solution slip between our fingers. Passing and implementing the Nursing Home Quality Assurance Initiative is a rare opportunity for all Oklahomans to tell our seniors their quality of care and quality of life matter.

Gomez is president and CEO of Care Providers Oklahoma.