Iowa Legislature To Spend Funds on Nursing Homes, Rather than Community-based Care

The Iowa Legislature has approved the use of $24.7 million from the state's Senior Living Trust Fund to make Medicaid payments to nursing homes, draining funding away from "less costly" nursing home alternatives such as home- and community-based services, the Des Moines Register reports. The Senior Living Trust Fund was established in 2000 with $98 million from federal sources to finance "a new system of making Medicaid payments" to nursing homes and alternatives to traditional institutional care. Home care providers oppose using "so much trust fund money for nursing home care because it would leave less money to pay for home care." Larry Breeding of the Iowa Association for Home Care said, "The state is saying, 'We support home- and community-based services, but we're going to take money from them. To turn around and rob ... and use the money for the very facilities the fund was intended to keep people out of, that just doesn't sound like good government policy." However, Steve Ackerson of the Iowa Health Care Association, which represents nursing homes and other long term care facilities, said nursing homes need the funding "to compensate for the state's long history of 'underfunding' nursing homes through low Medicaid payment rates." The money will be used to implement a new system in which Medicaid payments would be tied to the needs of residents, rather than "the amount of money spent meeting those needs" (Kauffman, Des Moines Register, 5/4).