by Carmella Gutierrez, Californians for Patient Care, 5/1/2013
Many of us know what it’s like to see a loved one grow older. We see the joys that a grandparent experiences, but also the hardships that come with health issues and becoming more dependent on others. Often, we ride the “roller coaster of health” with them. As we do, it can be difficult to know how to best help our loved ones continue to live long, healthy and fulfilling lives.
The answer often lies in finding the best care close to home and family. And identifying the right doctor, nursing facility or hospital is a big decision — one that takes time. Family members who live nearby often lend support during this process, not to mention providing other help like running errands and companionship.
That’s why we are concerned about pending state budget cuts in MediCal reimbursements to certain skilled nursing facilities, including those in Plumas County. These reductions could force many of them to close, displacing our most vulnerable patients who depend on nearby family members. The cuts would impact thousands of Californians cared for annually in these facilities, along with the lives of relatives who help them daily.
For example, close to home here in Plumas County, the pending cuts could shutter several nearby facilities, including the immediate closure of Eastern Plumas Health Care’s Loyalton skilled nursing facility. EPHC’s Portola skilled nursing facility, which already has stopped accepting MediCal patients, would close completely within six months.
In addition, if EPHC closes its skilled nursing facilities and is faced with a $2.4 million retroactive payment, EPHC’s four rural health clinics and critical access hospital — including emergency room, ambulance and medical services — will be in danger of closing. Residents in rural Eastern Plumas and Sierra counties, particularly the elderly, would be left with a critical lack of access to necessary services.
As we near Mother’s Day, we want to draw your attention to the fact that the cuts would have a particularly devastating effect on our grandmothers, mothers, great-aunts and other elderly women in our families. Primarily because women outlive men, two out of three nursing facility residents are women; and 82 percent of nursing facility residents in California are 65 or older.
For our loved ones who need more care beyond what is provided through assisted living or regular nursing homes, skilled nursing facilities provide the medically necessary and appropriate care. For example, if the parent we love has been in the hospital, a skilled nursing facility can help her regain the health and independence she needs to transition back home to her community.
For people living in rural areas, hospital-based skilled nursing facilities are often the only place where elderly and disabled patients can access the complex physical and behavioral care they need.
Of the patients who receive care from these types of facilities, nearly 80 percent are MediCal beneficiaries. These individuals would be hit hardest, as the pending cuts — 25 percent in today’s dollars — target health care facilities that provide care to them.
Already, more than 40 hospital-based skilled nursing facilities have closed in the last five years, due to inadequate reimbursements that don’t cover the cost of caring for patients. If these cuts go into effect, 58 more would be impacted, affecting all patients and their families who rely on these facilities. In some cases, the nearest available facility is hundreds of miles away.
There is another way for California to move forward. While the changes to health care are creating some unknown variables, we can still safeguard the well-being of our older family members.
Assembly Bill 900,authored by AssemblymanLuis Alejo(D-Salinas),and Senate Bill 640, authored by Sen. Ricardo Lara (D-Bell Gardens), for example, would prevent these devastating cuts. These bills would help maintain theseand otherfacilities, providinghealth care for our loved ones and keepingmore patients close to their families.
As millions of California’s baby boomers age into their 70s and 80s, the viability of adequate community facilities will take on even greater importance. Hundreds of thousands of elderly patients statewide will need this type of specialized medical care. California cannot afford to lose any more of these facilities.
We can work collaboratively to make sure the women and men who raised so many of us are not neglected in their time of need. They deserve proper facilities and health professionals to care for them and help them maintain a quality of life as they age. Our efforts can improve the long-term health and well-being of hundreds of thousands of people we love today, and future generations.
Our state budget should not forsake our mothers, grandmothers, great-aunts and other loved ones. We do not want to displace them from the health care facilities close to family when they most need that care and support. For their sake, and for the next generation that will need care, let’s find solutions to create more access to health care, not less, closer to home.
Carmella Gutierrez is president of Californians for Patient Care, a nonprofit organization dedicated to protecting the interests of patients and ensuring all California consumers have fair and equitable access to high-quality health care.

(Also printed in the Portola Reporter & other Feather Pub. newspapers Regional section)
http://www.plumasnews.com/index.php?option=com_content&view=article&id=10941:our-elderly-relatives-deserve-quality-care-close-to-home&catid=82:opinion&Itemid=76