Effort  to avoid cuts to hospice

Advocate staff photo by BRYAN TUCK State Sen. Fred Mills, R-New Iberia, standing, participates in a forum Wednesday at Hospice of Acadiana in Lafayette on Medicaid funding cuts to hospice programs. From left are Hospice of Acadiana Board President Janice Beyt, state Rep. Terry Landry, D-New Iberia, and state Sen. Page Cortez, R-Lafayette. Show caption
Advocate staff photo by BRYAN TUCK State Sen. Fred Mills, R-New Iberia, standing, participates in a forum Wednesday at Hospice of Acadiana in Lafayette on Medicaid funding cuts to hospice programs. From left are Hospice of Acadiana Board President Janice Beyt, state Rep. Terry Landry, D-New Iberia, and state Sen. Page Cortez, R-Lafayette.

A contingent of legislators and medical professionals are hoping to restore midyear state budget cuts that will end most Medicaid payments for hospice care.

The cuts, scheduled to go into effect Feb. 1, will not affect Medicaid payments for those already receiving hospice care and will not apply to patients younger than 21.

Gov. Bobby Jindal’s administration has argued that ending most hospice coverage will help deal with a $166 million shortfall in this fiscal year’s $25 billion budget.

“It does not appear to be the right strategic cut to make,” said state Sen. Fred Mills, R-Parks.

No specific plan of action was developed on Wednesday to fight the cuts, but Mills said the administration seems open to some form of compromise.

“They are not totally closing the door on this,” he said.

Mills spoke Wednesday at the nonprofit Hospice of Acadiana in Lafayette.

He was joined by state Sen. Page Cortez, R-Lafayette; state Rep. Terry Landry, D-Lafayette; state Rep. Vincent Pierre, D-Lafayette; and state Rep. Stephen Ortego, D-Carencro.

They heard from hospice providers who argued that hospice care saves health care dollars that might otherwise be spent on unnecessary trips to the emergency room, ambulance fees and costly in-patient care in a hospital.

“The costs come up. They bubble up somewhere else,” Hospice of Acadiana Medical Director Dr. Glen Mire said.

Also on Wednesday, state Sen. Dan Claitor, R-Baton Rouge, asked legislators to consider rejecting the Jindal administration’s proposed cut.

Claitor asked state Senate President John Alario, R-Westwego, to select a committee to consider the matter.

“If you are lucky enough to be diagnosed and enrolled under the proper criteria in advance of two weeks from now, then you are in (the terminally sinking) lifeboat. After February 1, 2013, you are adrift, if there is no social, religious or private safety net for you or your loved one to die in,” Claitor wrote Alario.

Claitor said Wednesday that the smart solution would be to rework the decision to allow Medicaid patients dying at home to receive hospice care.

Hospice care is offered to terminally ill patients approaching death and involves a team of nurses, social workers, home health workers and religious figures providing spiritual support.

The Medicaid cuts would not affect payments for prescription drugs and many other health care services for dying patients, but a comprehensive hospice program would not be covered.

“We not only take care of the patient, we also take care of the family,” Hospice of Acadiana CEO Louis “Buzzy” Hebert said.

Ortego said hospice care is just as much about dying in peace as it is about conventional medical treatment.

“I can’t think of many more things as precious as making sure people have dignity when they die,” he said.

More than 1,700 terminally ill patients in Louisiana received hospice care under Medicaid in 2012, according to figures from the Louisiana-Mississippi Hospice and Palliative Care Organization.

Medicare payments for hospice care — available to those 65 and older — are not affected by the cuts that are scheduled to take effect Feb. 1.

Hebert said Hospice of Acadiana will continue to provide care for the low-income patients served by the state-managed Medicaid program but will have to rely more heavily on outside fundraising to cover the expenses.

“It will be a strain, but this is part of our mission,” he said.

The Alliance for the Advancement of End-of-Life Care has scheduled a Jan. 23 candlelight event from 4 p.m. to 6:30 p.m. on the steps of the State Capitol to protest the Medicaid cut.

The Alliance said in a news release that a study based on 2010 Medicaid figures found the average savings in Louisiana was estimated at $17,601 per patient for hospice care compared with a terminally ill patient who was hospitalized as he neared death.

Arizona had made a similar cut to hospice care but recently renewed coverage after Medicaid costs rose by nearly 5 percent, according to the Alliance.