Lawmaker riled over hospice care cuts

A Baton Rouge legislator angrily accused the Jindal administration Thursday of misleading her and other lawmakers about the extent of budget cuts to hospice care.

State Rep. Patricia Smith, D-Baton Rouge, said agency leaders need to be reminded to tell the truth when addressing legislative committees.

“That was totally one that did not give us the right information on hospice care,” Smith said.

At issue is the impact of mid-year state budget cuts on dying patients relying on hospice services through the Medicaid program.

As part of a bid to erase a $166 million shortfall in the current $25 billion budget year, the Jindal administration announced that hospice care “provided outside of nursing homes” to Medicaid recipients would be eliminated beginning in February. Recipients already receiving care will continue to get the services.

Under the Medicaid program that treats the poor, hospice care is an optional service that states can eliminate. Nearly 6,000 Medicaid recipients in Louisiana got hospice care during the fiscal year that ended June 30.

Legislators thought the cuts meant patients dying at home would no longer receive hospice care, but that patients nearing the end of their lives in nursing homes would. Instead, the entire program is being eliminated.

“It may just be our obtuse choice of words. We are no longer offering that benefit,” state Department of Health and Hospitals Secretary Bruce Greenstein said Thursday.

Greenstein said people in nursing homes already have access to pain management and clergy visits so his main concern was what would happen to people in the community without the same infrastructure.

He said the Jindal administration had no other choice but to cut hospice after weak sales and personal income tax collections forced economists to lower their state revenue projections.

“We have had all optional services on our reduction list over the years. This is one of the benefits that is an optional service ... We don’t have the funding to continue funding optional services and so this is what we decided to reduce,” Greenstein said.

He said Medicaid recipients can turn to nonprofit or faith-based organizations for services.

Jamey Boudreaux, executive director of the New Orleans-based Louisiana-Mississippi Hospice and Palliative Care Organization, said hospice saves money by providing services outside a hospital.

He said patients will end up in emergency rooms, costing the state even more money.

The goal of hospice, Boudreaux said, is to make patients as comfortable as possible, usually at home, in the final weeks of their lives. “They’re going to be left to fend for themselves,” he said.

Hospice of Acadiana is a nonprofit organization that provides medical care, counseling and spiritual direction to people with life-threatening conditions.

The organization’s director, Louis “Buzzy” Hebert, said he is dismayed that the Jindal administration chose to cut hospice care through the Medicaid program. Now, he said, his organization will be forced to see patients for free and provide nursing, chaplain, social work and bereavement services.

“We’ve got to make a living ourselves. We can’t afford to be in the business to lose money,” Hebert said.

Boudreaux said other states looked at cutting hospice services only to shelve the proposal or reenact the care.

He said his fear is that dying patients won’t receive hospice care at all.

“They’re not going to have emotional support,” Boudreaux said.