Support for: (1) Medicaid reimbursements which are sufficient to cover the cost of care; (2) continued development of suitable community alternatives to nursing home care; (3) professional development to upgrade the staffing of nursing homes, in particular, training for aides in community educational facilities; and (4) other specific changes in state licensing requirements. 

The League supports adequate Medicaid rates for nursing home residents to make it economically feasible for administrators to accept Medicaid patients. League supports increases in Medicaid rates to cover costs of care but not to allow for excessive profits as well as a reclassification of patients according to both the level of skill and the amount of personal care needed by individual patients and reflected in the rates paid by Medicaid. 
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League members strongly supported the concept of keeping people in their homes when possible and providing for their medical, personal, and social needs through the use of other community services. 
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Members support training of administrators and provision for physical and occupational therapy and dietary evaluation. They support the use of "consulting" specialists such as VNA services, aide training and nutritional consultants, field placement of trainees in related nursing home services, etc. 
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Areas where decided improvement in regulation is desired are as follows: 

1. Inservice training. One hour per month is not adequate; all personnel would benefit from the training.

2. Aides. (a) Regulations should establish a minimum personnel/patient ratio based on the amount of care required by individual patients. (b) There should be general upgrading of aide training to allow more professional status and better pay achieved through vocational education programs in high schools, junior college programs, and continuing education programs. For those under 18 years of age, successful completion of such training would eliminate the present age requirement.
 
Community services considered by League members which would help implement this goal are as follows: (a) Establioshment of a day care center for the elderly; (b) Expansion of existing projects such as Meals on Wheels, VNA services, mursing and personel care, homemaker services, and physical therapy; (c) Council on Aging's planned programs: transportation, information, and administrative center.
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Historical Note 

In 1967 a study of nursing homes in Douglas County was included in a larger study of the Douglas County Welfare Department. Renewed interest in nursing homes in the League resulted from a 1972 report of the Douglas County Comprehensive Health Planning Council which revealed many of the problems of 1967 were still prevalent in 1972 despite many changes in nursing home services in the county since 1967. In 1972-73 the Lawrence League reviewed the nursing home section only of the 1967 study, considering substantially the same questions that were taken up previously.

Initial League action included sending the survey and consensus to related professional and volunteer services in the community, governmental agencies at the local and state levels. The consensus was sent to state agencies with the approval of the Kansas LWV and with the explanation that it covered only our community. Since then, the League has supported, with letters, the recommendation of the Comprehensive Health Planning Council for the provision of training for aides, and certification of nursing home administrators. The League has also supported funding for home nursing services as a regular part of the County Health Department services.

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