Columbus Dispatch. September 15, 2022.
Editorial: Low Medicaid reimbursement for adult day care is hindering recovery
From the start, we were told the effects of the COVID-19 pandemic would continue far into the future. We are seeing evidence of that in many areas, including supply chain issues that have contributed to global inflation.
But each day, it seems, we learn of other areas where the pandemic has caused harm.
According to a Mississippi Today report, the pandemic has played a contributing role to a decline in the availability of adult day care centers. According to the report about 30 percent of the state’s 126 adult day care centers closed during the height of the pandemic and never reopened.
Most of these day care facilities serve poor and elderly who rely on Medicaid. It’s a godsend for these people and their caregivers. For the elderly, the daycare provided allows them to remain in their homes. For their caregivers, having a place where their loved one can be attended to during the day allows them to work or attend to other duties.
The pandemic did not create the crisis facing adult daycare centers, but it certainly exacerbated it.
The problem with this system is that reimbursement rates have stagnated while costs have continued to rise, meaning only those who bring in a high number of participants can break even. Currently, adult daycares receive a maximum reimbursement of $60 per person each day from Medicaid. They can only bill for up to four hours of care, though they’re required to be open for eight.
The bulk of those overhead costs come from staffing, which includes a family nurse practitioner and social worker, along with seven other required positions. Under quality assurance standards set by the Mississippi Division of Medicaid, each facility must maintain a minimum staff-to-participant ratio of one-to-six, or one-to-four in a facility that serves a high percentage of people who are severely impaired.
Every year since 2015, the state legislature has considered raising the compensation to $125 per person. Each time, the legislation has either died in committee or in conference when the Senate and House were unable to reach a compromise.
Failing to raise the compensation is short-sided.
Even at $125 per day, adult daycare centers are a bargain, far cheaper than nursing home costs or, in some cases, lengthy hospital stays.
For those who benefit from these services and those who care for them, increasing the compensation means happier, healthier lives.
We encourage our legislative delegation to support raising the compensation.
It’s the compassionate thing to do.
Greenwood Commonwealth. September 17, 2022.
Editorial: State Has Interest In Jackson’s Water
As we have said before, all of Mississippi has a stake in the well-being of the state’s capital city.
Jackson is the only municipality in this state of any size. North Mississippi may be able to piggyback off of Memphis, but for the rest of the state, how well it does depends in part on how well Jackson does.
American population trends in recent years have shown a clear preference for urban areas, especially by people in their 20s through 40s. Think of all the young adults from this community who, after graduating from college, have settled in Nashville, Birmingham or Atlanta. If Mississippi is going to reverse this “brain drain,” Jackson will be a critical piece in the process.
Thus, the rest of Mississippi cannot ignore Jackson’s problems, whether that be its high murder rate, its potholed streets or, most recently, its water crisis. Nor can the rest of Mississippi just retreat to Jackson’s suburbs. It must be invested with its attention and, to some degree, with its tax dollars if this state is going to catch up with other areas of the South that are growing.
Jackson’s water problems, while thankfully no longer in a crisis stage, have not been solved. Water is flowing again and it’s been judged safe for most people to drink after 45 days of the city being under a boiled water notice. This a short-term fix, though, that has resulted from state intervention and major outside help.
To avoid another massive failure the next time the treatment plants are short-staffed or there’s a hard freeze is going to require a substantial investment of money. Probably not the billion dollars that Jackson’s mayor, Chokwe Antar Lumumba, has estimated, but possibly several hundred million dollars to get the entire leaky and dilapidated infrastructure back up to snuff. Federal dollars already received and those promised will help, but it’s also going to take a state investment. Thankfully, with the surpluses the state has been running the last couple of years, it’s in a better position to help now than it has been in some time.
If the Legislature, however, is going to do more for Jackson than the matching funds it’s already offering to all cities and counties to repair or upgrade their water infrastructure, the state should also have a say in how Jackson’s water system operates going forward.
Past indifference from the Legislature admittedly contributed to the water crisis, but the main fault lies with the incompetence of the Jackson administration. If you don’t collect the water bills, if you don’t do preventive maintenance, if you don’t hire enough people with knowledge about operating a sophisticated wastewater and drinking water system, it’s bound to crash. No one should feel confident that the water system won’t crash again if turned back to the city to operate.
Gov. Tate Reeves, who stepped in when Jackson’s dry taps created a health emergency, has said there will not be a return to the status quo. What might replace the Jackson mayor’s control is uncertain. Among the governance ideas floated has been a state or federal takeover, the creation of an independent utility district, even turning it over to a private operator.
Whatever the alternative, it’s a better option than going back to a city-run operation that couldn’t keep the water flowing or drinkable.