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Arizona Daily Star
Posted: Monday, February 1, 2010 12:00 am
State legislators, in an attempt to balance the budget, have cut care options for some terminally ill Arizonans, and hospices may have to repay the state for services already provided.
A footnote in the Legislature's 2007 General Appropriation Act allowed the Arizona Health Care Cost Containment System to match federal funds for hospice services needed by acute-care patients. It was a one-year appropriation that was renewed in 2008, but not for the fiscal year that began on July 1, 2009. Even though legislators approved the budget in July, AHCCCS continued authorizing hospice payments for another six months.
Last month, AHCCCS sent a letter to providers telling them that the funding had been eliminated, and it suggested they would have to repay the state.
Because of the state's budget crisis, the end of the legislative session was "a confusing time," said Monica Coury, a spokeswoman for AHCCCS. "Normally we might have been able to provide notification sooner. We didn't provide it as soon as we would have liked to."
AHCCCS members enrolled in the agency's long-term-care program retain their hospice benefits, but other patients likely will end up in hospital emergency rooms without the hospice benefit. The average hospice stay is 20 days, according to the National Hospice and Palliative Care Organization.
"Typically in the hospice world, individuals are not seeking aggressive treatment anymore; they are seeking comfort care," said Agnes Poore, chief clinical officer and co-founder of Casa de la Luz Hospice. "But typically in the hospital, they might do diagnostic tests. If you need pain management, they might admit you to the hospital. Emergency room and hospital costs are enormous compared to what you would pay for hospice care."
Last year, 541 acute-care hospice patients were enrolled in AHCCCS. Those same patients would not be eligible for AHCCCS-funded hospice benefits today.
Read more here.
