Last-minute budget cut axes program helping older adults avoid RI nursing homes
A nonprofit is sounding the alarm over a last-minute funding cut from Gov. Dan McKee’s proposed budget that would eliminate a program designed to help older adults avoid costly nursing home stays after getting discharged from hospitals.
McKee officials insist the cut is necessary because the program is no longer eligible for matching federal funding amid increased scrutiny over what services are covered by Medicaid under the Trump administration.
The services are provided by the nonprofit RIPIN. Its executive director, Sam Salganik, said he disagrees with the state’s assessment and called on lawmakers to restore the funding with general revenue.
“If any of you have helped an aging loved one at hospital discharge time you know that sometimes the nursing home is the path of least resistance,” Salganik said during a hearing last week. “But nursing home care is very expensive and it’s often on a long-term basis, not what families wish for.”
The Hospital Care Transition initiative was cut from the governor’s tax-and-spending plan in a budget amendment sent to the General Assembly on May 15. The $500,000-per-year program serves 500 older adults per year, and about 75% of them make it home from the hospital within a week of discharge, according to Salganik.
The nonprofit embeds employees with hospital discharge teams at Rhode Island, Miriam, Kent and South County hospitals. The goal is to help those families come up with a plan and access other services that allow them to get home quickly rather than stay at a nursing home, sometimes for months on end.
Salganik estimated long-term nursing home stays end up costing the state about $70,000 per patient, telling House lawmakers, “you don’t need to avoid very many of these to have it be a good investment.”
State Rep. Teresa Tanzi, a Narragansett Democrat, echoed that concern, saying individual interventions are often what end up saving the state far more money in the long term.
“It’s these interventions on an individual level that actually keep our system flowing,” she said, drawing on personal experience that setting up older adults at home is complicated and tough on families. “Honestly, it saves our state a significant amount of money.”
John Bonin, deputy director of the state Medicaid program, said Rhode Island is under increased scrutiny across all of its contracts not to use administrative claims for services.
He said the hospital discharge initiative could technically be built out and billed appropriately through other programs, such as community health workers. No program currently exists elsewhere, according to Salganik.
Salganik said his nonprofit didn’t know about the planned cut until the budget amendment on May 15, giving them little time to rework the contract to ensure it was compliant with federal regulations.
He also disagreed with the state’s assessment on eligibility, providing lawmakers with documentation that showed the contract followed rules and regulations pulled directly from Medicaid.
He said Bonin’s remarks were the most the organization had received from the administration, which he suggested wasn’t communicating clearly with its partners.