PA's Plan to Balance Budget? Cut Nursing Home Care.

By Stacy Brown | PA Independent

HARRISBURG — Gov. Tom Corbett wants to cut $161 million from nursing home care through the state's medical assistance program to help balance this year's proposed $27 billion budget.

But, some say the funds are needed, because Pennsylvania’s senior population is among the largest in the nation — and rising — putting nursing-home care in high demand.

The cuts proposed would affect nursing homes and care provided by nurses in the private homes of senior citizens. The latter generally includes providing two or more hot meals per day, laundry, cleaning, housekeeping and other incidental care.

"We understand that the administration is facing real revenue challenges, while at the same time the senior population in the state is growing exponentially, which means there is an even greater need," said Vicki Hoak, CEO of the Pennsylvania Homecare Association, or PHA, a state trade association representing more than 400 organizations that provide care and support to individuals in their own homes.

Of Pennsylvania's more than 12.5 million residents, about 2 million are older than age 65, according to 2010 U.S. Census Bureau data. The state ranks third in the country for this senior population, following Florida and West Virginia.

Pennsylvania also ranks fourth in the nation for its residents aged 85 and older, who are the most intensive users of nursing-home care, according to PHA.

Further, the state could see a boom in nursing-home construction by 2020, said Paul Bach, an executive with Chester County-based Genesis Healthcare Corp., which provides long-term, nursing-care facilities in 13 states.

Pennsylvania has about 725 nursing homes with almost 90,000 beds, according to Genesis numbers.

Research by the company showed those facilities are filled to more than 90 percent capacity, Bach said. As the aging population grows, extra capacity will be required within the next 10 years, if not sooner, Bach said.

"We need to preserve funding for programs that allow our seniors to remain in their own homes, where they want to be, for as long as they want to be there," Hoak, of the PHA, said.

Messages left for Corbett spokesman Kevin Harley was not returned Tuesday.

Corbett's Budget Secretary Charles Zogby defended the governor's proposal to redirect the funds to the general fund and said the administration is "proposing those as permanent redirections."

Pennsylvania's Constitution requires a balanced operating, or general fund, budget. The expenditures covered through the general fund include public education, transportation, public assistance and Medicaid.

Other fund redirections proposed by Corbett include:

• $20.5 million in state cigarette tax earmarked for the Agricultural Conservation Easement Fund, which enables the state to pay farmers for agreeing to limit the use of their land to agricultural production, commercial equine activities and certain other uses, diverted tο the general fund.
• $38.6 million frοm the Keystone, Recreation, Park and Conservation Easement Fund, which funds nature preserves and wildlife habitats and improvements to and expansion of state parks, community parks and recreation facilities, historic sites, zoos, and public libraries, tο the general fund.
• $71.6 million frοm the Lottery Fund that supports long-term care programs to the general fund.
• $69 million frοm the Oil and Gas Lease Fund, which is used to purchase land for many of Pennsylvania’s state parks, tο the state Department οf Conservation and Natural Resources.
• $6.5 million frοm the Alternative Fuels Incentive Grant Fund, which helps to create new markets for alternative fuels, tο the general fund.

Nathan Benefield, director of policy analysis for the Commonwealth Foundation, an independent conservative think tank here, described the shift in funds as a “principled move.”

For instance, Benefield said, subsidizing the horse racing industry is not a core function of government. Using funds for other programs would not be so much as raiding other funds as prioritizing how taxpayer dollars are spent, he said.

"However, we caution against temporary shifts or using excess fund balances for one-time revenue, as that sort of spending is unsustainable," Benefield said.