Louisiana Gov. Bobby Jindal's administration scrapped plans Wednesday to shutter the state's Medicaid hospice program in February, meaning the state will continue to provide end-of-life care to people on their death beds who can't afford private insurance.
Health and Hospitals Secretary Bruce Greenstein announced the reversal as hospice program supporters were gathering for a candlelight vigil on the state capitol steps to protest the cut. Greenstein said his department will use federal grant funding to continue the services for the poor and terminally ill.
Cheers went up across the small crowd of people gathered in what they expected to be a somber vigil. Instead, they celebrated.
"I got goose bumps," certified grief counselor and nurse Sue deRada said as she heard the program would be spared.
"End-of-life care is just so vital for everybody. It's sacred. It's one of the most sacred times in people's life next to being born. Why would we abandon people at such a critical time?" said deRada, who works for a hospice service in St. Tammany Parish, 40 miles north of New Orleans.
The cut would have made Louisiana one of only two states that don't pay for hospice care through its Medicaid program, and the plan faced strong resistance from state senators, who were seeking ways to avoid shuttering hospice to new adult recipients on Feb. 1.
Sen. Fred Mills, vice chairman of the Senate Health and Welfare Committee, walked into the vigil crowd to deliver the news that the Jindal administration had backed away from plans to close the program.
"The good Lord took care of us today, so we got a fix," Mills, R-Breaux Bridge, told Rhonda Johnson, who works for a Baton Rouge-based hospice provider.
Johnson said cutting the program would have been "throwing away poor people."
"The thought of ever eliminating hospice for poor people is just unreal," she said. "This is a huge victory."
Oklahoma is the only state that doesn't offer hospice care to adults through Medicaid, according to the nonpartisan Kaiser Family Foundation.
Jindal made a series of budget reductions in mid-December to help close a nearly $166 million deficit in the current fiscal year that ends June 30. Many of the cuts fell on the Department of Health and Hospitals.
Greenstein said when cuts are required to the Medicaid program, only a few optional benefits can be reduced without violating requirements for the state's participation in the program it runs with the federal government. Hospice is an optional program the health department said has been available since 2002.
By using the grant funding, DHH will keep the program running while still saving $1.1 million in state funding this year and an estimated $3.1 million in state funding for the 2013-14 budget year.
The health department intends to make changes to the hospice services to shrink the costs of the care and improve the program, Greenstein said.
"Just turning it back on didn't make sense," he said. "This is going to be something that we're proud of because this going to be more efficient and effective."
More than 5,800 people received hospice services through Louisiana's Medicaid program in the last budget year, according to the health department. Many of those, however, were eligible to receive the end-of-life care through Medicare. About 1,400 received the services in their homes and wouldn't have been eligible through Medicare.
Among the planned changes is a focus on community-based, at-home care, Greenstein said. Nursing home residents will not be eligible for hospice care through Medicaid, though most can get it through Medicare, he said.