One of my readers accused me of going off half-cocked with my blog post yesterday about how the Legislature ended up giving nursing homes more money after it became apparent there would be no tax referendum to restore budget cuts to nursing homes.

He said it was based on thin evidence. It was thin. Yesterday, I didn't yet have the other main component -- that is, how much money did the Legislature restore to the cuts it was going to make to hospitals?

Today, I do.

The final budget restored $36.5 million to the amount of money that was going to cut from state payments to hospitals for inpatient and outpatient, the biggest component.

When the House and Senate came out with their original budgets March 30-31, BOTH of them were going to cut hospital funding by $157.6 million in 2009-11. The final budget cut funding by only $121.1 million.

That's not a case of the two chambers having different amounts and then compromising on an amount somewhere in between the two. I suspect state budget-writers decided to lessen the blow to hospitals because there wasn't enough support to put a 0.3 percent sales tax hike on the ballot. That meant, there was no chance to raise $1.1 billion over 3 years. And that meant there was no way to buy back cuts to health care programs, mainly to hospitals and nursing homes. (If you'll recall, the hospitals and nursing homes, along with the Service Employees International Union locals 775 and 1199, were the driving forces behind the tax package. Well, and House Speaker Frank Chopp.)

But as my critical reader says, I'm just looking for conspiracies. And I am. One reason this is important is because I asked -- before the final budget came out and before the tax referendum went into the tax -- if the budget would be revised if there were no tax measure on the ballot. And key House leaders told me, "No."

And yet, it does appear the budget was redone to soften the blow to hospitals and nursing homes. That's my conspiracy theory and I'm sticking to it.

But Here's Adam Glickman's take on my last post (with his permission).

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From: Adam Glickman [mailto:Adam.Glickman@seiu775.org]
Sent: Monday, May 11, 2009 5:02 PM
To: Turner, Joe - Tacoma
Subject: nursing homes

Your little conspiracy theory doesn’t make any sense, and is based on incredibly weak evidence, which anyone who knows anything about the budget could have told you if you had bothered asking before doing your blog.

The legislature did not substantially reduce the long-term care cuts overall in the 2010-2011 budget after the referendum went down. Adult day health was still cut by 70%. Home care was cut based on the higher House level than the lower Senate level. Nursing homes was cut somewhere in the middle of the house/senate/Gov levels as you note.

The only thing that was significantly modified was the supplemental budget, which wasn’t what was prevented as a “people will die” budget. And the revenue referendum was never tied to the supplemental budget, only to the biennial operating budget.

The supplemental budget cut wouldn’t have affected the revenue referendum, or the final nursing home rate. The 2010-2011 rate, as you note, is well below what the proposed supplemental budget reduce rate would have been. The supplemental would have just cut it temporarily to $163.72, and the final budget cuts it much deeper in 2010-2011 to $159 or so. The revenue referendum would just have restored the rate STARTING IN JANUARY to $168 or so, which is what it would have been without any cuts. The referendum would not have retroactively refunded the supplemental cut.

The supplemental cut was reversed primarily because it was a huge short-term cut that didn’t save all that much money overall but could have led to a lot of nursing homes having to close down because it was concentrating a big cut in a short time-frame. The nursing homes successfully argued that they were the only long-term care entity taking a massive cut in the supplemental, and convinced budget writers it was unfair.

But way to go off half-cocked and make outrageous accusations!

Adam

Adam Glickman-Flora
Vice-President and
Director of Public Affairs
SEIU Healthcare 775NW
adam.glickman@seiu775.org