Care facility residents call on state lawmakers to increase monthly allowance

Iowa’s Medicaid-dependent nursing home residents are asking state lawmakers to raise the monthly allowance they collect for personal living expenses.

The Iowa Long-Term Care Ombudsman’s Office is leading a statewide effort to raise the Personal Needs Allowance for Medicaid beneficiaries in care facilities from $50 per month to $85 per month. The allowance is used by residents to pay for personal items that care facilities typically don’t provide — such as hairdressing, cable TV, snacks, greeting cards for family members, clothing, cellphone service and cigarettes.

One nursing home resident who has joined the effort to increase the allowance is Brian, a former businessman who now resides in an Iowa City nursing home. In a video distributed by the ombudsman’s office, Brian describes the $50 allowance as “kind of pathetic” and says an increase is overdue.

“I was an account executive for a Fortune 500 company,” he says. “I worked hard my whole life and earned some decent money. And then I got sick and had to come here. And I went from being a good contributor to society to having to live off $50 per month. I can’t afford toiletries – body wash, good shampoo, anything. I can’t buy decent clothes anymore. Fifty dollars per month just doesn’t do it.”’

Another care facility resident, Jody, recorded a similar plea directed at state lawmakers. The ombudsman’s office has not returned messages seeking to verify the residents’ last names.

“I’ve lived here for six and a half years and I just can’t make it,” she says. “We need extra groceries like a can of soda, or a can of Spam and some cheese and crackers. You know, add some shampoo and conditioner and, before you know it, the $50 is gone.”

Recently, the ombudsman sent all lawmakers a one-page fact sheet on the issue and encouraged care facilities to circulate petitions so residents can have the option of joining the effort to secure an increase. One online petition has so far collected 470 signatures.

For 22 years, Iowa has provided the same amount of money for a Personal Needs Allowance: $50 per month. During that time, inflation has dramatically reduced the buying power of that stipend. For example, cigarettes that cost $6 per pack in 2001 now cost $19.36. Haircuts that cost $22.50 in 2001 now cost $38.29, and the cost of food and beverages has increased from $15 to $26.21.

Overall, products that cost $50 in 2001 now cost $82.64.

The Office of the Iowa Long-Term Care Ombudsman argues that increasing the Personal Needs Allowance is a way lawmakers can have a direct, positive impact on nursing home residents’ quality of life.

Nationally, more than half the states provide more than Iowa for a monthly Personal Needs Allowance, including some of the states surrounding Iowa:

Nebraska: $60

Minnesota: $121

Illinois: $30

Missouri: $50

Kansas: $62

South Dakota: $60

So far, however, there has been very little discussion of the proposed increase at the Statehouse, and several members of the Senate Health and Human Services Committee said last week they were unaware of the proposal.

It’s expected now that the latest revenue estimates for the coming fiscal year are finalized, the budget subcommittees for health and human services will at least consider factoring the proposed increase into the Iowa Department of Health and Human Services’ annual budget. The subcommittee chairmen did not return messages seeking comment.

When the Personal Needs Allowance was last raised, from $30 to $50 in 2001, lawmakers were told the cost would entail an additional $3.6 million in government spending, but only $1.4 million of that would have to be paid by the state.