State Sen. Fred Mills Jr., a Republican, told United Press International the restored funding of $1.1 million to provide end-of-life care for those in a hospice facility or provided hospice care in the home, allowed the state five months to work for alternative solutions because the same budget cut is scheduled for the next fiscal year.
On Dec. 14, 2012, state officials said a lack of anticipated state revenue from income taxes, corporate taxes and sales taxes coupled with a several tax cuts including a $1.1 billion tax cut over five years resulted in notification that the state faced a budget deficit of more than $130 million in July.
As a result, the Louisiana Department of Health and Hospitals said the state decided to eliminate Medicaid hospice care on Feb. 1 of this year to help avoid the shortfall in July.
The state has already made many budget cuts, but there are few optional programs under Medicaid and hospice is considered an optional program so hospice was included in the cuts, Mills said.
However, out of all of the proposed cuts by Gov. Bobby Jindal, a Republican, the cut to hospice drew the most notice and angered many.
At the time, Jindal said eliminating Medicaid hospice care would save the state money and non-profits and faith-based organizations could be called upon to help pick up the slack, but Mills said there were several presentations pointing out eliminating indigent hospice care was neither a wise fiscal move nor a humane one.
Mills, a licensed pharmacist, said dying patients with cancer who would have to moved from hospice care to another facility might have a harder time because prescribing pain medication for the dying or frail is a skill developed over time and physicians in the other facilities might not be attuned to the dying patient's needs compared to those who have worked in hospice for a long time.
The Louisiana-Mississippi Hospice and Palliative Care Organization said when hospice is not an option, people will go in and out of emergency rooms and ICUs, costing the state at least four times more than hospice care.
For example, when Arizona eliminated hospice care for the poorest of the poor, they were sent to more expensive hospitals and nursing facilities and the cost increased by approximately 4.4 percent to provide the same services, the state of Arizona said in a letter in 2010.
However, at the end of January during a candlelight vigil protesting the move, Bruce D. Greenstein, secretary of Louisiana's Department of Health and Hospitals announced plans to reform the Medicaid Hospice Program, with a focus on providing services in the community.
He said his department secured bridge funding from existing grants to continue the current hospice program until July.
"I'm certain from the discussions we're had with doctors, nurses, patients, hospice administrations that hospice is the most cost effective way to provide end-of-life care, prevent unnecessary hospital emergency room visits and ICU stays and provide patients with choices," Mills told UPI.
"I have always said we are all one tragedy away from needing hospice -- if it doesn't affect us directly, it affects someone we know."
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