| Perspectives on Texas

Do not cast me off in the time of old age; forsake me not when my strength is spent.

— Psalm 71:9

What does it take to become a priority in the Texas Legislature?

As someone who provides nursing home care for the state’s frail and elderly, I often wonder why my residents and their caregivers never seem to be a priority of our legislators.

About two out of every three Texas nursing home residents rely on Medicaid to pay for their care. That rate is set by the Texas Legislature. Our Legislature has set a rate that is one of the lowest in the nation. It does not even come close to meeting the cost of caring for Medicaid residents — by the state’s own estimates.

The result is that nursing homes struggle to ensure that when your loved ones call for help, someone who is qualified and compassionate will be there quickly to help them. The fact that nursing homes are not able to offer competitive wages makes it hard to recruit good, quality nurses and nurse assistants, and is why our annual staff turnover statewide averages more than 90 percent. 

It also makes it very hard to upgrade older facilities or offer some of the extra amenities that can brighten the lives of our residents, such as improved dining, better activities programs and telemedicine and wellness programs to further prepare residents for return to home.

But the Legislature has been reluctant to fund increases to assist with this care. In 2015, despite entering the session with a $7.5 billion budget surplus, Texas nursing homes received no increase from state lawmakers.

This session, with a much tighter state budget, providers did not ask for state funding. Instead, we asked the Legislature to allow us to pull down federal funds — without expanding Medicaid — through a program that has been used to help nursing homes in 43 other states. We even supported requiring that 50 percent of those dollars not be available to nursing homes unless we earned them by demonstrating improvement in the quality of care.

You would think legislators would jump at the chance to get funding back to an industry that everyone seems to agree is badly underfunded and needs to improve, especially with a program that would not add to state spending.

Some of them did. Rep. J.D. Sheffield, R-Gatesville, and Sen. Juan “Chuy” Hinojosa, D-McAllen, filed legislation to authorize it. Several legislators, including Appropriations Committee Chairman John Zerwas, R-Richmond, helped in this effort.

But others still could not see their way to assist this struggling sector of health care. They thought people might accuse them of voting for a “granny tax” and that certain political groups might attack them for not being conservative enough.

I am a lifelong conservative Republican, as are many who supported this proposal. I believe conservatism is about taking care of your responsibilities, including helping those who truly are unable to help themselves, and using taxpayer dollars wisely and only where they will have the most positive impact.

Fears among legislators were not sufficient to prevent 97 of the 150 members of the House and six of the nine members of the Senate Health and Human Services Committee from voting for the bill. But fear did result in the bill failing to get the vote it deserved and the support it needed to be considered on the Senate floor before a key legislative deadline.

I love caring for nursing home residents because of the opportunity it brings to do something that truly matters and positively affects the lives of so many people. I enjoy their stories about the Texas they remember. I am always moved by the love they show for their families and often for other residents and staff.

I want them to feel happy and cherished even as their health fails them. I want their final years to be filled with purpose and the dignity and respect they deserve.

What will it take for legislators to share this commitment, rise up above political rhetoric and fear, and prioritize care of our elderly? Unfortunately, the answer may be seen in Child Protective Services, where the state has only stepped up its efforts and funding when tragedies and intolerable situations receive media coverage.

Texans must demand more.

We cannot wait for our elderly to suffer the way our children have before our legislators jump to action.

Disclosure: The Texas Health Care Association has been a financial supporter of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here.