During a hearing with the Texas Human Services Committee this week, nursing home residents urged lawmakers to pass a bill to increase the Medicaid Personal Needs Allowance (PNA).
Democrat state Rep. Senfronia Thompson introduced HB 54, which would raise the PNA from $60 to $85 monthly if passed. (pdf) PNA is the income nursing home residents receive to pay for items not covered by Medicaid, such as haircuts, clothing, vitamins, books, and vending machine snacks.
A 60-year-old woman told the nine-member committee that she was healthy and independent a few years ago, but she became sick with COVID-19, suffered strokes, and a coma, sending her into a long-term facility.
“My PNA is mostly used to provide food I need to supplement or replace the food that is provided,” the woman said during Tuesday’s hearing in Austin, Texas. She added that the “institutional food” the facility provides is a lot of potatoes, pasta, and rice, which is not ideal for her health condition.
The woman, who was sitting in a wheelchair, told lawmakers that she is working to regain her independence and prefers to wear pull-up style incontinence underwear that allows her to take them on and off without assistance.
But Medicaid will only allow facilities to supply residents with tab-style diapers, similar to infant diapers.
“So we have to provide them out of the monies we get,” the woman continued. “Twenty-five dollars doesn’t seem like a lot, but to someone who’s working with $60 now, $25 is a big improvement.
“And I really hope you will push this bill out and, hopefully, through the House and Senate this time.”
The Supplemental Security Act of 1972, enacted in 1974, requires Medicaid-funded nursing home residents to receive PNA. The mandate was set at $25 monthly. In 1988, the amount was increased to $30. It has not increased since then; however, each state can allow up to $200 a month.
The last time Texas hiked its PNA rate was Jan. 1, 2006, when it went from $45 to $60.
Alaska is the only state that provides a $200 PNA to its nursing home residents. Alabama, Illinois, and South Carolina pay the lowest amount at $30 monthly, according to the American Council on Aging.
Long-term care (LTC) ombudsman Alexa Shoeman also attended the hearing, asking lawmakers to pass HB 54. LTC ombudsmen are advocates for residents’ rights and work to protect the quality of life and care of those living in nursing homes or assisted living facilities.
Residents living in these facilities lose “much of their freedom and autonomy,” Shoeman told the committee, adding that LTC ombudsmen have collected hundreds of letters from nursing facility residents across the state about the items they purchase with their allowance. The letters are being forwarded to the lawmakers on the committee.
“A person’s own spending money in a nursing facility is one of the last things they feel they have control over,” she said.
If a resident wants a non-institutional brand of shampoo or even a candy bar, they must buy it with their PNA.
“Even without inflation, $2 a day doesn’t go far, and the rising cost of items has affected nursing home facility residents just like everyone else,” Shoeman added. “As you’ve heard, $25 a month may not sound like a lot to many of us, but it will make a huge difference in the lives of nursing home residents.”
The Texas Human Services committee will meet to decide whether the bill will be considered on the floor. The committee is chaired by Republican Rep. James Frank, and Democrat Rep. Toni Rose is the vice chair.