Grumet: Extra dollars make a difference for nursing home residents

Sep 07, 2023

At some nursing homes in Texas, the most popular bingo prizes are bottles of shampoo or lotion.

Basic toiletries.

"Many don't realize that (nursing home) residents need to buy a lot of basic necessities" out of their own pockets, Alexa Schoeman, deputy state ombudsman for long-term care, told a Senate committee earlier this month.

It's not just personal hygiene items. Also, haircuts. Pajamas. Glasses. Cellphone service. A magazine or a book. A snack or a soda from the vending machine. Even a stamp to send a letter.

Nearly two-thirds of Texas nursing home residents — those whose care is covered by Medicaid — get just $60 a month of personal spending money, a figure that hadn't changed since 2006, even as the cost of everything has gone up.

Finally, some good news: Texas lawmakers voted to bump up that personal needs allowance to $75 a month, a small victory for nearly 57,000 nursing home residents and, in my view, one of the brightest silver linings of the regular legislative session that just ended.

The extra $15 a month supports an element of autonomy and respect for residents who eat mass-produced food, who get one kind of soap to use for their hair and body, and who might want to buy something special for themselves or someone they care about.

"It's those moments of dignity where you’ve got your own spending cash that really have a huge impact on your sense of still being an adult who gets to make choices with your life," Patty Ducayet, the state's long-term care ombudsman, told me.

Some lawmakers going as far back as 2009 have tried to raise the personal needs allowance, and Rep. Senfronia Thompson, D-Houston, led the push in the past few sessions. She got House Bill 54 across the finish line this year with the help of Senate sponsor Sen. Judith Zaffirini, D-Laredo; hundreds of nursing home residents who sent letters to lawmakers; and the dogged work of the Texas Silver-Haired Legislature, which made this issue its top priority this session.

The Texas Silver-Haired Legislature, a nonpartisan group of volunteers aged 60-plus who study and push for policies to help older Texans, originally called for an increase to $85 a month, what the allowance would be if it had kept up with inflation. Thompson's bill also sought $85 a month, which got knocked down to $75 a month in negotiations with the Senate.

The state will pay about $5 million a year, and use federal matching funds, to provide the extra spending money.

"It's heartwarming and rewarding and exciting, all at the same time," said Scott Christensen, one of the Texas Silver-Haired Legislature members who worked on the issue.

He noted that a fellow advocate who championed this cause for years, 92-year-old Jetta Roberts of El Paso, died just a few days before the House and Senate reached a deal in the closing days of the regular session.

"It's unfortunate that she passed before this happened, but I kind of like to think that this, in part, was accomplished in her memory," Christensen told me.

As I noted Sunday, this legislative session missed the mark on some important issues for many Texans, from education to health care to gun violence. But there were victories for Texans on some other issues I’ve written about:

Bags for foster kids: Both chambers passed House Bill 3765 to ensure foster kids receive a duffel bag or a backpack — not a trash bag — for their belongings when they’re removed from a home. As it is now, if a bag donated by a kind-hearted stranger isn't available, some children have received a garbage bag, which sends a terrible message about how they are valued.

Assistance for relatives caring for foster kids: About a third of the children in state custody are living with grandparents or other relatives instead of a foster home — a good thing — yet as I reported in January, their "kinship caregivers" receive about $13 a day for those children's needs, while foster homes run by strangers receive about $27 a day per child. A budget rider directs the state to develop a streamlined process for kinship caregivers to become licensed, which would allow them to receive better compensation.

Updating food stamp eligibility. Most Texans seeking food stamp must work at least 30 hours a week. Oftentimes, people need a car to do that. But under eligibility requirements that hadn't been adjusted in decades, a food stamp recipient's car couldn't be worth more than $15,000, and a second car in the household couldn't be worth more than $4,650. HB 1287, which is headed to the governor's desk, updates the values to $22,500 for the first car and $8,700 for a second car, ensuring more people who need temporary aid can get it.

Often these issues don't make headlines. The financial implications are rounding errors in a state with a two-year, $321.3 billion budget.

But these issues reflect our state's attitude toward some of the most vulnerable people in our communities. Lawmakers saw that Texas can do more to help. And for the folks on the receiving end of these efforts, life can get a little better.

Grumet is the Statesman's Metro columnist. Her column, ATX in Context, contains her opinions. Share yours via email at [email protected] or via Twitter at @bgrumet. Find her previous work at statesman.com/news/columns.