Putting it hard to seniors, students

BY ART CULLEN

It was only a matter of time. North Lake Manor will close in March because of a poorly conceived and badly managed privatization of Medicaid by Gov. Terry Branstad last spring. The facility was down to just 17 residents with some 30 employees and was among the first to close because of the changes. Residents will be welcomed to a nursing home in Pocahontas owned by the same company or they may choose facilities elsewhere — if they can find them.

“With the privatization of Medicaid it’s become harder to operate these smaller facilities,” said Matt Neimeier of J.P. Senior Health Care of Sioux City, which owns North Lake Manor.

Health care providers and nursing homes have been complaining all year that they are not getting paid on time or they are getting paid less. Three private insurance companies have taken over management of Medicaid for the state, and they are losing bundles of money in the process.

The governor, who is on his way out the door, says everything is fine.

But it’s not.

North Lake Manor has fallen by the wayside.

You could say that it wasn’t the government but the management. We never heard our friends who live there and work there talk poorly of it. Our friends said they were happy. Their families felt they were cared for well. That much we know.

Operating a nursing home is a difficult business. There’s not a lot of money in it, despite what you might think when you pay the rent. The basic stream of revenue comes from the government, and it keeps getting restrained or cut back. Branstad put the issue over the edge when he turned it over to the insurance companies, who themselves cannot figure out how to make this thing work.

The governor says that he is all about economic development and creating jobs. Well, here are 30 jobs lost in Storm Lake. They are not among the highest-paying. They are not the easiest. But they are the most important jobs: cleaning our elderly and frail, feeding them, listening to them and caring for them. As a people we are saying that they can just get by on less or not at all. That is exactly the message that the nursing home industry is getting.

There is no changing it. The die is cast. Democrats are baying at the moon. More nursing homes will close. No doubt, Methodist Manor will find choppy waters ahead as it seeks to serve its clients better. Storm Lake will be without a secondary care facility. That’s a shame, because it didn’t need to happen.

If we cannot afford to provide a basic framework of care to working people who have aged out, then we must examine what business we are about in this state. Moving people to Pocahontas who have lived their entire lives in Storm Lake — who may have lived for decades undisturbed and happy at affordable North Lake Manor — seems cruel. That’s the way things are in Iowa these days. We did not have this problem when Medicaid was run by the state for the people it served.

AS IF EVICTING old people weren’t enough, Gov. Branstad this year is calling for nearly $35 million in cuts to higher education next fiscal year — $25.5 million to the three Regents universities and $8.7 million to the community colleges. That means higher tuition yet at Northern Iowa, Iowa State and Iowa. Iowa Central Community College President Dan Kinney said it means a 10% tuition increase next year, following increases in previous years of 4.5% and 3.5%. These tuition increases are far outside the rate of inflation and are unsustainable.

Thank goodness Branstad set aside 2% growth for K-12 public schools. We can hope legislators share his prudence and quickly adopt the governor’s recommendation.

As for higher education, we would remind the governor that he loves to talk about creating jobs and training workers. He loves to talk about doing a better job teaching science, technology, math and engineering. Then he turns around and whacks the institutions that are delivering on his demand: community colleges. They are delivering STEM education to welding and nursing students. They are training maintenance technicians trying to climb the ladder to higher wages at Tyson. And, yes, they are teaching remedial English to adults so they can learn science and math.

We could fill the hole by eliminating corporate welfare with grants, tax credits and the like delivered to companies that would be here anyway, like meatpackers and fertilizer companies.

Or, we could save $100 million by having the state assume control of Medicaid again.

Or, Democrats suggest drawing down the ending fund balance to cover the necessary expenses. That’s the lamest idea, but that’s why Democrats are in the minority.

The governor could solve Medicaid and education funding problems by repeal and replacement of Branstad’s fatal Medicaid reform or by eliminating corporate welfare for Egyptian and European companies. He could defer giving $10 million in water quality money to the agri-chemical complex. That’s a start. Just by using his head with a few pen swipes he could put this state in the black and never raise tuition. But like we said, Branstad is leaving. Lesser figures remain in his wake.