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Legislature Passes Wee-Hours Budget, Boosts Nursing Home Medicaid Reimbursement 10%

To beat the impending blizzard, the Legislature convened just after midnight, passed a 4.9-billion-dollar budget that most of them had not read, and adjourned at 3 a.m.

Budgets at 3 a.m.—yeah, that makes for thoughtful lawmaking.

Seventeen legislators—16% of the body—missed the biggest vote of the Session: Representatives Bordeaux, Deutsch, Frye-Mueller, Howard, Johns, Livermont, Marty, Milstead, Olson, Pourier, and Saba and Senators Curd, DiSanto, Foster, Jensen (Phil), Schoenbeck, and Wismer.

Senator Stace Nelson (R-19/Fulton) protested, as usual, that the budget was being passed with insufficient scrutiny. The Senate, as usual, ignored Senator Nelson’s protest; only Nelson’s pal Senator Lance Russell (R-30/Hot Springs) voted against the budget with Nelson.

Sarah Mearhoff reports that, with the passage of Senate Bill 191, the Legislature finally did something about nursing homes:

Nursing homes emerged as the clear winners of budget negotiations. After weeks of discussion among legislators about the state’s nursing home crisis, legislators granted nursing homes the most substantial funding boost percentage-wise.

State Medicaid reimbursement rates for nursing home providers will increase by 10 percent under the approved Fiscal 2020 budget.

Additionally, the Legislature passed Senate Bill 180, amending appropriations for the remainder of Fiscal Year 2019. Thus, nursing homes will start seeing increased reimbursement rates as soon as April.

…The boost doesn’t close the gap completely. Nursing homes still won’t be reimbursed 100 percent for their Medicaid patients, but they will be closer to full reimbursement.

“Is (the increase) going to solve the problem entirely?” Joint Committee on Appropriations Co-Chair Sen. John Wiik, R-Big Stone City, said on the floor Wednesday. “No, but it’s a good start” [Sarah Mearhoff, “Nursing Homes Emerge as Winners in 2020 Budget Passed by SD Legislature,” Mitchell Daily Republic, 2019.03.13].

Once again, in South Dakota, “winning” means going from doing nothing to doing something. “Winning” means getting an incomplete solution.

Governor Noem had proposed only a 5% increase in the Medicaid reimbursement rate to nursing homes. The Legislature found the cash to double that increase and still submit a total budget burning up $2.80 million less in general funds than Noem recommended in January. The total budget passed these wee hours spends $3.66 million less than Noem recommended. It also provides for one half of an employee more than Noem asked for. The 14,013.2 FTEs in the FY2020 budget represent a 91.3-person, 0.66% increase in the state staff budgeted for in FY2019.

9 Comments

  1. Eve Fisher 2019-03-13 15:54

    Still trying to figure out exactly where nursing home residents are supposed to come up with the money to fill in the Medicaid gap. Organ donation? Blood donation? Or is this all a subtle plan to make sure that no poor old people end up in nursing homes, but die in the snow, the way they did in the good old days?

  2. Debbo 2019-03-13 16:11

    Eve, I think it’s the latter.

  3. Senator Stace Nelson (R-Fulton) 2019-03-13 17:33

    Mr H, You miss the mark. I received the brand new SB191 at 1:16 AM with 34 pages of $4.9+ BILLION in spending. We then also received new amendments on Senate bills 172, 180, 3 bills, for a total of 46 NEW pages! $4.9+ Billion in spending pushed through 01:16-2:30AM in both chambers with little discussion, 75(?) minutes total in both chambers? Most important & expensive bills.

    Curious when my colleagues, who voted for these bills, had the time to read all 46 pages of those complicated documents, pay attention and participate, and vote in several floor proceedings, participate in the debates on those 3 bills, and vote to MASSIVELY expand government by $152++ Million and 96.3 new FTE… in 75 minutes.. Especially when many of the House members were hanging out in the Senate..

    The games, back room deals, and frustrations at the budget process being highjacked over SB176 and being held hostage over that bill? Worst budget process of the 7 miserable ones I have been a part of.

    I haven’t heard, did the Governor veto SB191? It clearly blows up one of her 4-pillar campaign promises, the pillar of protecting South Dakotans from government growth..

  4. grudznick 2019-03-13 18:27

    Mr. Nelson, had you not the opportunity to stop going to free lunches and dinners and attend the meetings of the legislatures where they talked about the budgets for weeks and weeks?

    Why do you wait until the middle of the night before you try to read these law bills?

    Did they not drop this law bill on you early in the sessions and talk about it for months and months?

    Did not you read the budgets given to you months ago?

    I feel you just don’t understand the maths for the fellows in your district, or don’t want to put the effort into anything except complaining. grudznick shakes his head at you with disdain. Probably Rhoden is laughing. Rhoden laughing.

  5. Jenny 2019-03-13 18:48

    Leave Stace alone, he’s a lot better man then you’ll ever be!
    You’re just a pathetic POS lobbyist, Murphy, riding on your daddy’s coattails.
    Stace, grudz’s real name is Jeremiah Murphy and I’m sure you’ve seen the slimy weasel around the Capital.

  6. grudznick 2019-03-13 19:11

    It is good that Mr. Nelson, apparently a snowflake requiring Ms. Jenny’s protection, cannot spell “Capitol” correctly, as it further discredits her with the intellectual high-brows that Mr. Nelson is eating dinner with tonight.

  7. grudznick 2019-03-13 19:22

    I believe I was unclear. Let me clarify:

    Ms. Jenny thinks Mr. Nelson is a snowflake.
    Mr. Nelson is eating dinner tonight, being paid for by lobbists and other grubbers who are buying his votes.
    Mr. Nelson remains the most ineffective in the legislatures and the lobbists who buy him dinner are throwing money away.

    I just felt grudznick should be more clear, since Ms. Jenny doesn’t even understand what the Capitol is or how it must work. Not unlike Mr. Nelson.

  8. Jenny 2019-03-13 19:47

    FYI, the word capital popped up and I automatically highlighted it and didn’t proofread. It may drive you crazy But really a simple mistake.

  9. Cory Allen Heidelberger Post author | 2019-03-13 20:29

    Senator Nelson makes a reasonable point about government growth and the collapse of another pillar of the protections Kristi Noem promised us when she wanted our vote.

    But come on—nobody believed her to start with, did they? She’s like Trump: her people aren’t voting for rational or consistent policy positions; they’re voting to make themselves feel better, to affirm their self-image. The same farmers who voted for her last year whom she’s screwing over now with her hemp veto will put on their seed caps (just like hers) and go out and vote for her again in 2022, because she makes them feel good when she plays farmer on top.

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