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A brief roundup of recent direct-care worker state news:

Court Rules That Missouri Home Care Workers Can Unionize

A state appeals court ruled May 1 that Missouri home care workers can unionize, ending their three-year battle to gain legal recognition as a union in the eyes of the state.

In 2009 and 2010, Missouri’s 13,000 home-care workers voted — by overwhelming margins — in favor of unionization. Both times, however, the votes were thrown out in court after anti-union activists challenged the results, alleging procedural flaws in the voting process.

Last week, however, a Missouri appeals court ruled that the state had to validate the 2010 election, thus clearing a path to the creation of a union for home-care workers.

The newly formed union, Missouri Home Care Union, is a partnership between SEIU and AFSCME.

Minnesota PCAs Temporarily Spared Wage Cuts

Proposed wage cuts to thousands of personal care aides (PCAs) in Minnesota were left out of the state’s latest Health and Human Services (HHS) budget, which Governor Mark Dayton (D) signed into law April 30.

The original HHS budget bill would have reduced state spending on PCAs by nearly $6 million. The cuts would have affected as many as 7,000 family caregivers who serve as PCAs to low-income relatives and receive payment through Medicaid.

The controversial cuts were deemed legal by a district judge in March after being challenged in court by eight Minnesota home care agencies. Despite the judge’s ruling, however, the legislature removed the cuts from the final budget sent to the governor.

Additionally, the budget bill postpones a $20.6 million rate cut to long-term care facilities. The postponement could give Minnesota enough time to negotiate a deal with the federal government, rendering the cut unnecessary.

Alabama Gov. Pushes for More Medicaid Funding

Alabama Governor Robert Bentley (R) vowed on May 2 that he would veto any General Fund budget bill that allots less than $602 million for Medicaid.

The governor’s announcement was a response to an early FY 13 budget proposal from state lawmakers that would have set aside just $400 million in Medicaid spending, 30 percent less than the FY 12 Medicaid allotment.

On May 8, a State Senate committee approved a budget bill that would devote $418 million of the General Fund to Medicaid, with the remaining $184 million to come from a line of credit from a state trust fund.

The credit line can only be created through a constitutional amendment, however. The state legislature is currently considering the amendment; if it passes, it will have to be approved by Alabama voters.

– by Matthew Ozga

The Alabama House of Representatives passed a Fiscal Year 2013 Budget on April 10 that slashes the Medicaid program by 30 percent — $175 million — which would result in a Medicaid budget of $400 million if the proposal is signed into law.

More than 900,000 Alabamians depend on Medicaid for their health care coverage, including many direct-care workers.

Don Williamson, M.D., who heads up the Alabama Department of Public Health and has been charged with overseeing a Medicaid Task Force, said that “the agency may be forced to reduce payments to doctors, hospitals, and other health providers that serve Medicaid patients.”

Williamson is seeking ways to cut Medicaid programs while at the same time complying with federal Medicaid requirements. However, he has been reported to say that the “proposed budget would not only lead to cuts to optional services, but cuts to programs mandated by the federal government.”

For every $1 that Alabama spends on Medicaid, the federal government matches it with $2, compounding the state’s Medicaid budget loss.

“I don’t think there’s any way in the world any human being can make this budget work at $400 million without serious cuts to someone,” Williamson said.

Will Mean Job Losses

“If nursing homes and other medical-related facilities are forced to make cuts, that will mean job losses,” SalLee Sasser-Williams, an Alabama nursing home owner, told the Andalusia Star-News.

In the meantime, the Star-News reports that Williams is “looking for small cuts that don’t affect patient care” and depending on volunteers to take on tasks such as resident activities, which “frees our activities director to do other things.”

The Alabama Nursing Home Association issued a statement saying that, “We agree with Dr. Williamson that current budget figures for the next fiscal year will make it virtually impossible to avoid serious cuts in the access to care and the quality of care delivered. As Dr. Williamson observed, some of the cuts we may face could mean life or death for many.”

Alabama Governor Robert Bentley (R), a physician, is opposed to raising taxes or other revenue, including increasing the cigarette tax, a measure supported by the House Democrats.

The proposed cuts come on top of a recent 10.6 percent across-the-board budget cut to the state’s General Fund this fiscal year.

“Medicaid cuts this severe will hurt families, health care workers, and many direct-care employers at a time when families are already hurting economically,” said Carol Regan, PHI director of government affairs. “Advocates at the state and national level must continue to protect American families and fight for a strong safety net.”

– by Deane Beebe

Wall Street Journal's Rundown of LTC Cuts

Health care stakeholders hoped this week the lame-duck session of Congress would examine a stimulus package that includes an increase to the federal medical assistance percentage (FMAP), the federal matching funds that states receive to fund their Medicaid programs.

Many states, such as New York, are threatening to cut Medicaid to make up for budget shortfalls.

According to a recent Wall Street Journal story, at least 15 states, including Alabama, Virginia and Massachusetts, are targeting funding for programs that allow low-income direct-care consumers to receive personal care in their own homes.

The story says the cutbacks are exacerbating the already long waiting lists for home-care support services in many states. With forced reductions due to state budget shortfalls, the low-income elderly and disabled may be forced into nursing homes.

Read the full story