The Sierra and Plumas Republicans have asked the Plumas and Sierra Democrats’ help to prevent closing of our skilled nursing facilities. An invitation and agenda is HERE with details for the Feb 25th meeting in Sierraville. This issue is affecting rural Skilled Nursing Facilities (SNF) all over the state, with Medi-Cal cuts of 25%. No one can absorb that kind of cut and the retroactive provision makes it even more impossible. Even worse is the affect it will have on those seniors in the SNFs that will be moved, some hundreds of miles away from their families.
Background — Governor Brown’s 2013-2014 budget includes $488.4 million in cuts (10%) to Medi-Cal reimbursements. The 10% cut was passed in 2011. It has been stalled by court cases since then, but recently a three-judge panel of the Ninth Circuit Court paved the way for the cuts to proceed. The cuts are being appealed to the full Ninth Circuit Court; the case may or may not be successful.
What does this mean for your rural hospital?
First, the state government may ask for reimbursement of payments back to mid-2011, which would amount to several hundred thousand dollars or more for each hospital. Rates had already been reduced on June 30, 2011 by 10%. However, based on the newly proposed rates for DP/SNFs (reducing 2008 rates rather than current rates), this would result in a 30% reduction for many facilities.
Second, reimbursements will be lower in the future (which will affect the long-term care facilities, among other hospital services).
In addition, due to other factors, the hospital districts will be moving to a “managed care” type payment system – a lump sum per person enrolled in the system rather than being paid based on cost. Due to the high proportion of seniors in many rural counties, this means it will be even harder for rural Districts to cover the cost of services.
The California Department of Health Care Services has indicated they plan to move forward with recouping funds for claims with dates of service beginning June 1, 2011. The recoupment is planned for this spring. Further, the significant reduction in Medi-Cal reimbursement is not sustainable for District Hospitals. Many Districts will have to shift beds and/or close entire units. This will result in many Medi-Cal beneficiaries being forced to transfer to different skilled nursing facilities, most likely outside their community. Statistics show that 30% of patients relocated in this way die shortly after the move. For District Hospitals, these measures will severely burden rural residents as well as have severe impacts on the local hospital and the local economy.
This is not a partisan issue and Sierra and Plumas County political parties are joining forces with other partners to solve it.
GO to the meeting
Call your friends and forward this email
Sign this online petition: Stop Medi-Cal Cuts to Most Vulnerable Rural Skilled Nursing Facilities
Make your government care about the people who need care.
This excellent article in the Plumas News explains the local problem we’re facing.
Contact Cindy Ellsmore if you’d like to help: 530-862-1379 or firstname.lastname@example.org OR call Pat Whitley 530-993-1258