Tuesday, November 30, 2010

Years after Katrina, one federal program still misses the mark

Today ends the 2010 hurricane season, and thankfully no major storms impacted Florida or the United States this year. It’s hard to believe, however, that five years ago, Hurricane Katrina pounded the shores of the Gulf Coast, leaving destruction and devastation in its path and forcing a record number of people out of their homes. While the massive storm revealed several shortcomings of the federal government’s disaster response, the restoring and rebuilding effort continues today. However, several disparities remain. One of these disparities affects Florida’s most vulnerable population — seniors and individuals with developmental disabilities.

One would assume that emergency federal aid is distributed to all those in need, without regard to the classification of their living environment. Sadly, this is not the case. Current federal law has long prohibited aid to nearly three-quarters of our nation’s post-acute care, long term care, and assisted living providers who care for some of the country’s most vulnerable citizens. This assistance, which is provided in accordance with the Stafford Act, is designed to address the immediate needs of those affected by a disaster, including evacuation, shelter, and nutrition. Unfortunately, it precludes access for for-profit long term care providers including “medical, rehabilitation, and temporary or permanent custodial care facilities… for the aged and disabled,” from accessing these resources.

Disasters like Hurricane Katrina wreak havoc indiscriminately, impacting individuals whether they live in a for-profit or not-for-profit facility. Florida’s nearly 700 long term care facilities must cope with the same results with limited physical, financial and human resources. Caring for individuals who are frail, elderly or have a disability can be challenging even under the best of circumstances. When disaster strikes, those challenges are magnified and limited resources only makes matters worse.

Just like not-for-profit providers, for-profit providers of long term and post acute care play a critical role in caring for Florida’s nearly 71,000 long term care residents. This is all the more important, given that Florida’s nursing and rehabilitation facilities have evolved to meet the special demands and needs of our aging population, including a greater focus on post-acute care. About 80 percent of Florida’s Medicaid recipients receive care in for-profit facilities. These residents have a number of special needs and require 24-hour care, 7 days a week. It’s important that their care is not interrupted by denial of access to critical aid during a disaster.

FHCA is confident that, despite such limitations, facilities have contingency plans in place to ensure critical health care services are continually provided during an emergency. In fact, since Hurricane Katrina, the Association has developed a number of resources to assist facilities with emergency preparedness, thanks to partnerships with such groups as the John A. Hartford Foundation, Florida Department of Health, University of South Florida and Florida Power & Light. These include the Emergency Management Guide for Nursing Homes and the accompanying software, the Nursing Home Incident Command System and other online resources which can be found on the FHCA website at http://www.fhca.org/.

Given Florida’s Medicaid budget and the more than $16 billion in federal Medicare cuts to skilled nursing care over the next decade, we do not have the same confidence about the economic stability, which is necessary for facilities to implement such plans.

While the Stafford Act shows good intent, it misses the mark in providing emergency disaster relief to all nursing facility patients. A bill sponsored by Representative Ron Paul (R-TX) would rectify this inherent disparity in federal law, ensuring all long term care providers have access to disaster relief funding when needed to protect vulnerable patients and residents during a disaster. We hope Congress will do its part to ensure that the mistakes of the past do not repeat in the future by passing this bill to ensure that all providers of long term and post acute care to Florida’s most vulnerable citizens have access to critical aid when they most need it.

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