ST. PAUL -- Mitch Jasper worries about the fate of his small town and others like it, should state lawmakers cut spending to nursing homes and other care facilities.
Nursing homes often are the largest employer in a small town, said Jasper, mayor of Jackson in southwestern Minnesota. The mayor said rural towns cannot afford to see their nursing homes suffer financially or, in some cases, face closure.
"The community stability of rural Minnesota depends upon the availability of stable, local jobs and the ability for seniors to find access to the care they need locally," Jasper said.
Elderly citizens and nursing home officials filled the State Capitol rotunda Tuesday to advocate for state aid for long-term care facilities. Lawmakers are considering funding cuts to long-term care programs as they try to solve a $4.6 billion deficit. That is after federal stimulus funds soften the blow of a projected $6.4 billion shortfall.
The Capitol rally came one day after the House and Senate passed major health and human services spending packages, delaying state aid increases that nursing homes planned to receive during the next two-year budget period, beginning July.
The Senate also proposes cutting some nursing homes' reimbursement rates, while the House avoids a reimbursement cut for nursing homes.
Other long-term care facilities, such as those treating people with developmental disabilities, would see reductions in their state reimbursements.
A roughly nine-hour House debate concluded late Monday with the bill passing 85-49, following the Senate's 40-23 passage of its version
The House bill won the support of all local Democrats, while Rep. Larry Howes, R-Walker, opposed it. On the Senate side, Sen. Mary Olson, DFL-Bemidji, voted against the bill while Sen. Rod Skoe, DFL-Clearbrook, voted for it.
Rep. Tom Huntley, the House health finance chairman, warned that the spending cuts could get worse.
"This bill is the best-case scenario you're going to see," Huntley, DFL-Duluth, said late Monday of his bill that cuts $400 million from what human services programs are expected to cost in the next budget period.
Nursing home administrators said they are planning for state spending cuts.
Mark Anderson of the Knute Nelson care facility in Alexandria said his center is not in jeopardy of closing, but said that could be the case for nursing homes in tiny rural towns.
If those rural facilities close, local residents will have to travel farther for care, added Angie Urman, Knute Nelson's vice president of clinical operations.
A plan to change how nursing homes receive state aid, which is expected to provide increased state payments to many facilities, is on hold under the state budget proposals.
That delay is problematic, Anderson said, because that is intended to help nursing homes for the long term. That delay would occur as the number of older adults needing care increases.
Delayed - or decreased - state funding may make it impossible for some nursing homes to give their employees pay increases or even health insurance, said Austin Blilie, the administrator at Frazee Care Center in northwestern Minnesota.
That makes it difficult to retain health care workers, who may be forced to leave for more lucrative job offers elsewhere, added Katie Lundmark, who oversees Lake Park's Sunnyside Care Center.
Staff turnover ultimately affects nursing home residents, she said.
Nursing homes report losing around $25 a day per resident who is enrolled in government health programs. The planned increases in nursing home reimbursements were supposed to help close that gap, but that will not happen if the payment change is delayed.
"That's just going to widen the gap," said Randy Wanek, administrator at Pelican Valley Health Center in Pelican Rapids.
Top lawmakers offered House Speaker Margaret Anderson Kelliher and Minority Leader Marty Seifert told nursing home officials that legislators support elderly care funding, but they made no promises that state aid to long-term care facilities will go unharmed.
"The best we can probably hope for is no reduction," said Gordon Hormann, the administrator at Good Samaritan Center in Jackson.
Hormann said his facility lost $33,000 in the first two months of the year, and a 2 percent cut in state aid to his nursing home would result in a $58,000 loss.
Scott Wente works for Forum Communications Co., which owns the Bemidji Pioneer.