Old age should burn and rave at close of day;
Rage, rage against the dying of the light." ~Dylan Thomas
PO Box 94004
Baton Rouge, LA 70804-9004
Phone: 225-342-7015 or 866-366-1121 (Toll Free)
Commentary by Sherrill Phelps, RN, administrator of Christus Cabrini Hospice and the president-elect of the Louisiana-Mississippi Hospice and Palliative Care Organization
"Death is an uncomfortable topic for almost everyone. We know it happens to all of us, eventually, and we realize that for some it will be unexpected, while for others, the end of a long journey.
But is the emergency room or intensive care unit the best option? Is it what the patient or family wants? Is it the cheapest option for the payor (Medicare, Medicaid, insurance or family)? Louisiana Gov. Bobby Jindal has directed the state Department of Health and Hospitals to eliminate the hospice benefit for Medicaid patients, effective Feb. 1, 2013.
While the intent of the directive is to save costs, research and the experience of other states show that hospice actually costs less while providing better and more appropriate care for dying patients. Hospice Analytics released a study based on 2010 Medicaid figures.
According to Louisiana’s health department, Medicaid patients can receive medical care through home health and long-term personal care services. Of course, home health eligibility requires patients to make “progress to goals.” And the personal care services have a current waiting list of several years.
The health department goes on to say that community nonprofit and faith-based organizations can provide medical social support services. What specific organizations are those in Central Louisiana? I am unaware of any medical social support services for the dying available through an organization other than a hospice organization licensed and certified by state licensure. Christus Cabrini Hospice is the only faith-based, nonprofit hospice in Central Louisiana. We serve about 6 percent of our patients as free care and an additional 9 percent as Medicaid. Several of the investor-owned hospice companies (for-profit) have already stated that they will not provide free care.
While the Christus mission is “to extend the healing ministry of Jesus Christ,” Bishop Dubuis famously stated, “No money, no mission.” The approximately half-million dollars in Medicaid patient care will not be possible to provide without a massive fundraising effort. We want to continue providing services for those who need us after Feb. 1. The question is, how long can we serve without funding? As always, it is the poorest and sickest who will suffer the most. The cuts have no impact on those with Medicare or private insurance.
If you are disturbed by the decision to eliminate hospice care for Medicaid patients, I urge you to contact your legislators and Gov. Jindal. Time is running out."