Massachusetts Democrats scrap “bed holds” for seniors, the disabled

By John Marion
20 June 2011

The Democratic Party-controlled Massachusetts state Senate has voted to eliminate, as of July 8, a program that pays nursing homes to hold beds for up to 10 days when residents leave for hospital care, family visits, and other short-term absences.

The 25-12 Senate vote to cut $9 million in funding for the program demonstrates the ruthless manner in which state Democrats are using the fiscal year 2012 budget debate to force policy changes that attack the basic rights of workers and the poor.

Such “bed hold” or “leave of absence” payments are common in state Medicaid programs. In Massachusetts, Medicaid is administered through the MassHealth program. Without these payments, nursing homes could kick out residents who are absent for more than 10 days in a row, even if the absence is for hospitalization.

The cuts would affect those suffering from Alzheimer’s and other diseases as well as young people in nursing homes. The Boston Globe reported on the case of a 31-year-old man who needs 24-hour care after being permanently disabled by a car accident. Without the “bed hold” funds, he would be unable to attend a summer camp for the disabled without losing his place.

In 2010, the benefit was used 28,854 times in Massachusetts. Many elderly residents will be severely impacted if they have to abandon friends and familiar routines along with their beds.

As Democratic Governor Deval Patrick, along with the Democrat-controlled state legislature, work to finalize a budget for the year beginning July 1, they are estimating total cuts of between $1.5 billion and $1.9 billion. The relatively small size of the “bed hold” cut, when compared to the total state deficit, demonstrates that the budget shortfall is being used as a pretext to implement particularly cruel and vindictive social cuts.

The bed hold program makes up at most 0.6 percent of this amount. Cuts on a similar scale—devastating to working people but representing small change in the state budget—have been proposed for other programs, such as the WIC nutrition supplements ($2.16 million) and suicide prevention ($1 million).

State Democrats have ruled out any increases in corporate taxes, with Governor Patrick boasting at the beginning of the year that, “CNBC has moved our state up to the fifth best place in America to do business,” and Speaker of the House Robert DeLeo writing in his budget cover letter that “our budget also includes several provisions designed to…improve the business climate in the Commonwealth.”

On June 10, the Division of Medical Assistance of the Massachusetts Department of Health and Human Services held a public hearing on the issue of the elimination of the bed hold program. Health and Human Services made a point in its public meeting announcement to consider the well being of the businesses that run the homes.

“Compliance with the proposed regulation is likely to have a negligible impact on the administrative costs of nursing facility providers,” it stated, while expressing no such concern for the elderly and disabled who stand to suffer. Indeed, such companies will turn more of a profit if they are able to replace Medicaid recipients with wealthier clients.

The Code of Massachusetts Regulations limits the leave of absence nursing home payments to $80.10 per day. Even if paid every day for a full year, this amount would cost the state slightly more than $29,000 for one bed, which is about half the salary of an “accounting technician” in the National Guard. Thousands of Massachusetts National Guard troops have been deployed to both Iraq and Afghanistan over the past decade.

While the $9 million “bed hold” cut is not specifically spelled out in the proposed budgets of Governor Patrick or the state House of Representatives, it is part of a larger budget account for MassHealth Nursing Home Supplemental Rates that is funded at the same level in all the proposed budgets. Therefore it is to be assumed that the House and Governor will go along with the Senate’s decision.

Jennifer Kritz, a state Health and Human Services spokesperson, told the Globe last week that “we continue to face the effects of an unprecedented budget crisis and are committed to spending taxpayer dollars wisely and to support vital services for our members.’’

Apparently the taxpayers for whom Kritz expresses such concern do not include the elderly who paid taxes during their working lives. Kritz herself has a long career as a Democratic Party operative, having worked on John Kerry’s 2004 political campaign and as a constituent liaison in Hillary Clinton’s US Senate office.