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By M. PAUL JACKSON
michaelj@leader.net
Wednesday, March 12, 2003     Page: 1C

The governor’s new budget is coming. But some health-care officials wish
it would just go away.
   
Governor Rendell’s proposed 2003-2004 budget could include up to $600
million in cuts to the state’s Medicaid program, sapping services from
hospitals, behavioral health facilities and nursing homes, health advocates
said.
    And, the budget could include an increased “tax” on nursing facilities,
forcing some nursing home residents to pay more for their treatment.
   
“I am hopeful the Legislature will decline the opportunity to tax” nursing
home residents, Ron Barth, president of the Pennsylvania Association of Non
Profit Senior Services, said of Rendell’s budget.
   
The budget, introduced March 4, includes about $1.6 billion in budget cuts.
It is intended to reduce the state’s $2.4 billion deficit.
   
The $21 billion budget has been approved by the House. It could be approved
by the Senate today.
   
In the past, “hospitals have been on a razor-thin edge,” said Carolyn
Scanlan, president of the state’s Hospital and Healthsystem Association. “This
is going to put some very deep in a hole.”
   
The budget includes about $35 million in cuts to hospitals’ medical
education programs, as well as the elimination of drug and alcohol treatment
funds. The total Medicare cuts could equal about $600 million, according to
the association.
   
Hospitals already struggling with inadequate Medicare reimbursement and
rising liability insurance payments cannot afford the additional cuts, she
said.
   
State officials have called the cuts necessary to ease Pennsylvania’s
revenue shortage.
   
“The state has (such) a large deficit that we need to provide a balanced
budget,” said Jay Pagni, spokesman for the state Department of Public Welfare.
   
Medicaid is a state-run program that provides funds for low-income
patients.
   
Without the cuts, the government would have had to cut more Medicaid
programs, including payments for chiropractic and pharmacy services, Pagni
said.
   
It is not clear if Rendell will veto his own budget if the Senate approves
it. He is scheduled to present the rest of his budget later this month.
   
Nursing homes and local hospitals are already beginning to assess their
potential losses.
   
Rendell’s budget also includes a “revenue assessment” for all non-Medicare
nursing homes. Those nursing homes would have to pay about $1,825 per-bed
annually to the government.
   
According to state officials, the assessment plan which has not yet been
finalized would bring in about $145 million in revenue, but Barth said the
costs would be passed on to residents who pay for their own care.
   
“These are not rich people,” he said of the state’s elderly.
   
Jeff Retner, administrator for Riverstreet Manor in Wilkes-Barre, could not
immediately say how much the manor could lose in Medicaid cuts, or the new
assessment plan.
   
The facility has about 122 residents. About 75 percent are on Medicaid, he
said.
   
“I’m not happy to hear that they are looking at reduced reimbursement,” he
said. For nursing homes, “its the darkest time in the 17 years I’ve been an
administrator.”
   
And the Wyoming Valley Health Care System’s behavioral health programs
including its drug rehabilitation and transitional care programs could lose
about $275,000 annually, said spokesman Jim Schilling.
   
The system operates Heritage House, an assisted living facility. Schilling
estimated the facility’s transitional care program could lose about $150,000
in assessment payments.
   
The cuts to its medical education programs could cost an additional
$125,000 he said.
   
Schilling could not immediately say what the loss percentage would be from
the system’s bottom line. But “the potential exists that there could be more
losses,” he said.
   
The cuts, if they come, have left some health-care advocates believing the
state’s elderly have been overlooked.
   
Few state politicians “seem to be able to address any of these issues,”
Retner said. “Because, primarily, the elderly have no voice. They are a
voiceless constituency that is easily ignored.”
   
Scanlan, president of the hospital association, said the lobbying group
would move to convince the Senate to enact amendments to the law. “We’re going
to make a lot noise.”
   
M. Paul Jackson, a Times Leader staff writer, may be reached at 829-7134.