Nestled at the very edge of the East Campus, and hidden behind a grove of trees, lies the stately and sprawling residence of the Long Island State Veterans Home. Although within walking distance of the well known University Hospital, and located on the aptly named Patriots Road, the Veterans Home remains a secret to a large majority of students and visitors at Stony Brook. But last Tuesday, Mar. 6, the Veterans Home rose to the occasion, along with the rest of the campus population, to participate in the annual SB Day in Albany.
Since the Veterans Home’s establishment in October of 1991, care and assistance has been provided to over 2,000 veterans, spouses and parents of gold star soldiers. The Veterans Home at SB is one out of a 150 state veterans home across the country, but it is the only state veterans home located on an academic institution and affiliated with a major medical center. It has a 350 bed nursing facility located on 25 wooded acres of land, operated under the auspices of the Health Sciences Center and overseen by Dr. Richard Fine, the Dean of the School of Medicine.
Residents at the Veterans Home receive a federal benefit per-diem, which is $65 per day towards the cost of care in a NY state veterans home. This per-diem provides for about 28 percent of the total $240 cost of care at the Veterans Home compared to the $380 average cost of care of nursing homes on Long Island. These seemingly costly rates are ameliorated by Medicaid and Medicare reimbursements by the federal government.
Most of the veterans at the home are severely ill with terminal illnesses. According to Jonathan Spier, the Director of Community Relations at the L.I. Veterans Home, ‘our residents are pretty ill by the time they enter the nursing home’hellip;our typical [patient] is an 84 year old male with 10 to 12 chronic diseases such as CSF, cardiac, diabetes, and a little bit of Alzheimer dementia.’
Over 80 percent of these residents rely on Medicaid to pay for their stay. However, this may change if New York State Governor Eliot Spitzer’s Budget Proposal is passed and Medicaid reforms are set into effect. This is the prevailing concern of the L.I. Veterans home as well as many other nursing homes and hospitals around the state.
Governor Spitzer’s $120.6 billion budget proposal would increase overall spending by 6.3 percent, about twice the rate of inflation and cut $1.2 billion from the existing health care programs. His proposals would also freeze reimbursement rates to hospitals and nursing homes, lower reimbursements to pharmacies and overhaul payments to hospitals to help them increase salaries. Spitzer is confronting the costly Medicaid program, one riddled with problems, but many opponents fear that his proposals would do more harm than good. As quoted in the New York Times, Kenneth E. Raske, the President of the Greater New York Hospital Association, said that ‘he cuts us and we have to cut into the operations of the hospitals, particularly since no one has helped us by putting a freeze on our cost of doing business.’
According to Spier, NY nursing homes lose about $25 per day from the payment Medicaid provides for patients opposed to the actual cost of care in NY. Spitzer’s reforms would result in a $450 million cut to the already stagnant industry. In particular, the L.I. State Veterans Home would be impacted by a $2.8 million deficit per year. ‘Many nursing homes on Long Island and in NY are barely surviving’hellip;We understand that Medicaid is definitely a broken system and needs some changes, but we don’t think that it should be at the expense of our veterans here.’
The L.I. State Veterans Home has a turnover rate of about 200 out of the 300 beds per year with a 20 to 30 person waiting list on the average day. Most of the residents who enter the nursing home do so because their families are no longer able to provide for the daily living activities such as bathing, feeding, toileting and transferring.
‘When families can no longer take care of mom and pop-that’s when they enter the nursing homes,’ explained Spier. Since many of these residents are very ill by the time they enter the veterans home, a large component of the Veterans Home is spent on palliative and hospice care. The L.I. Veterans home also works with Good Shepherd hospice to provide a ‘good death’ for the residents here. As Spier explained, ‘we can’t cure them because death is unavoidable’hellip;.but we strive for a painless and comfortable death.’
If the budget reforms are passed, the Veteran’s Home would be negatively affected and eventually cuts would have to be made. The Veterans Home is a state facility and different from the federally operated Veterans Administration health care system, which has different regulations and criteria for patients.
In addition, the L.I. Veterans Home does not receive any state funding; instead it runs through Medicaid dollars. The only funding it receives is through its VA Construction Grant Program, which is a partnership between the federal and state government. The program matches any construction costs with the federal government paying two-thirds and the state paying one-third of the total costs. ‘If these cuts are sustained for a number of years, we will have to reevaluate the budget and implement cost containing measures’hellip;At the end of the day we are running a business and taking caring of our veterans,’ said Spier.
According to Spier, Senator John Flanagan and Assemblyman Steven Englebright have been great supporters of the L.I. Veterans Home. Senator Hillary Rodham Clinton helped co-sponsor last year’s VA per-diem bill, which has resulted in more efficient care for the veterans.
Spier continued to explain that ‘Stony Brook’s Day in Albany is a perfect opportunity for our voices to be heard and to make sure legislators know that we need their assistance.’ Albany Day also served as a forum for other groups and students on campus to voice their concerns to legislators as well as the opportunity to become more aware of the different organizations on campus. ‘I didn’t even realize we had a Veteran’s Home on campus until I went to Albany Day,’ said Amy Young, a Junior at SB.
The Senate and Assembly have both introduced variations to the budget, with the Senate’s proposal to restore most of the $1.3 billion in state and federal health care spending the Governor cut from his budget, while the Assembly proposed restoring $483 million in state health care cuts.
