The Bush Administration is proposing cuts to programs that benefit or protect long term care beneficiaries, including almost $25 billion from Medicaid over the next five years and $1 million from the long term care ombudsman program. The Administration’s FY 2008 budget proposal also asks Congress to cut Medicare rate increases for skilled nursing facilities by $10 billion over five years! These cuts will result in further reductions of already inadequate levels of staffing and limit state supervision.
State ombudsman programs would lose $1 million under the proposal. The programs’ caseload grew by 32 percent between 2000 and 2005, while their capacity to investigate complaints decreased. Ombudsmen currently are handling about 300,000 complaints a year, and their caseload is expanding with the rapid growth of assisted living.
State survey and certification programs are already having difficulty hiring and retaining qualified surveyors because of noncompetitive salaries and heavy workloads. The President’s budget proposal would reduce federal matching funds for administration of survey and certification from 75 percent to 50 percent, costing states almost a billion dollars a year. With the cuts, states would have even less ability to hire surveyors with the clinical skills and regulatory knowledge necessary to conduct inspections and investigate complaints.
State Medicaid fraud control units, which prosecute nursing home neglect and abuse, would also have their federal matching funds for administration cut from 75 percent to 50 percent. Legal services offices, which often are on the front lines providing free legal representation for long term care residents, would lose almost 5 percent of their overall funding.
The new Democratic majority in Congress is not likely to embrace the President’s budget with open arms. However, the risk is real and it is important that concerned citizens call their Senators and Representatives’ offices (202/224-3121) and ask them to oppose the President’s budget proposal. The budget cuts will only hurt nursing home residents!