Rally calls for hike in Medicaid reimbursement

Photo by Eric Tichy Lisa Haglund, Heritage Ministries CEO, is pictured Tuesday at Christ First United Methodist Church in Jamestown. She was among a handful who called for an increase in the Medicaid reimbursement rate.

About 14 years ago, William Disbro started becoming concerned with the behaviors of his beloved wife, Andrea. The pair would later sell their home and move into an independent living campus, where they resided for a decade.

Andrea was diagnosed with Alzheimer’s disease about five years ago.

“It was a slow process for me to realize what was happening to my wife as I assumed more and more duties of 24-hour care,” Disbro said. “As the disease progressed, I struggled with the realization that my wife was leaving me.”

Andrea was moved to an assisted living facility at Orchard Grove, part of Heritage Ministries. After six weeks it was deemed necessary to place her in a secure nursing home at Heritage Green.

“Andrea has always been a pleasing soul with a gentle personality and industrious capabilities typical of a successful artist, but now she requires assistance getting dressed, showering, cutting up her food, pouring milk from the carton into a glass,” Disbro said in comments provided to The Post-Journal. “All this assistance requires time and dedicated staff and Andrea is not the only resident to need this one-on-one assistance.”

In sharing his story, Disbro implored New York state to raise the Medicaid reimbursement rate. He said his wife is cared for at a cost of about $500 a day; however, Medicaid only reimburses Heritage about $135 per day.

“This is a difference of about $365 per day, which results in a financial loss to Heritage of almost $11,000 a month,” Disbro said.

About two dozen people were present at a rally Tuesday outside Christ First United Methodist Church in Jamestown. The gathering coincided with a rally taking place in Albany, where thousands of caregivers called for the governor and state lawmakers to reverse cuts in health care and to close the Medicaid coverage gap.

Speakers in Jamestown included Lisa Haglund, Heritage CEO; Don Peterson, a longtime Heritage resident; MaryAnn Spanos, county Office for the Aging director; and Mayor Eddie Sundquist.

Haglund said Heritage has about 800 employees serving 1,200 residents locally. She alluded to a statewide shortage of nurses, certified nursing assistants and doctors and the need for New York to raise the Medicaid reimbursement rate to desperate facilities.

“We’re losing over $100 per day for every resident we take care of,” she said. “And we continue to do that and operate at a financial loss as a not-for-profit because our community needs us.”

Spanos said Tuesday’s event was indeed necessary, stating that “for far too long” a dynamic has been set up for long-term health care that is not sustainable.

Spanos worked in nursing homes about 16 years ago; even then, she said, the Medicaid rate was paid below cost for nursing home care.

In the past, she said, stays at nursing homes could be paid for out of pocket. At present, more people are now living on Social Security and have less than $50,000 in the bank.

Spanos said the current reimbursement rate is not sustainable for nursing homes and assisted living facilities that handle far more residents on Medicaid. “We’re going to see this problem throughout,” she said.

Sundquist said the city has passed American Rescue Plan Act funding to “support over $2 million for seniors for housing.” He said it’s important that long-term and assisted living facilities are just as inviting as being at home.

“The fact that the state continues to undercut this for our seniors, the fact that we are not raising the amount of funding to the level that we need to sustain it is truly a problem,” Sundquist said. “I appreciate all of you here raising awareness to it, but also telling the state, ‘Enough is enough.'”


Today's breaking news and more in your inbox

I'm interested in (please check all that apply)
Are you a paying subscriber to the newspaper? *

Starting at $2.99/week.

Subscribe Today