Please, lawmakers: attitudes, not platitudes about stalled Farm Bill

The election’s over, and even the introduction of the gang of flying monkeys nominated for cabinet posts is getting tedious (if terrible for the country).

Also maybe tiresome: The Farm Bill hasn’t progressed; people who eat and grow food must be interested and wonder, “More politicking?!” There are more than 2,600 farms in the Tri-County area, the USDA says – 72,000 in Illinois, the Number-5 state for exporting ag products.

The bill’s temporary extension expired Sept. 30; its Supplemental Nutrition Assistance Program (SNAP) ends Dec. 20. (Merry Christmas!); if nothing’s done, U.S. agriculture will revert to a pricing model from before the first Farm Bill, in 1933.

Meanwhile, this summer Illinois Congressman Darin LaHood (R-16^th) responded to a reporter’s question about the Farm Bill by saying, “It is vitally important we have a Farm Bill that helps protect our farmers.”

Ah.

After House Ag Committee deliberations of the massive Farm, Food and National Security Act of 2024, U.S. Rep. Eric Sorensen (D-17^th) said, “The substantial increase in reference prices for Southern states does nothing to help my farmers back home. We need to level the playing field for Midwestern producers who are more susceptible to drought, flash flood and heat.”

Still, Sorensen’s didn’t vote against the measure, which passed committee 33-21 in May.

U.S. Rep. Nikki Budzinski (13^th Dist.) seems like a lawmaker who doesn’t just posture but gets into the weeds of the Farm Bill, votes against proposals, and explains why. One of three Illinois Democrats on the Ag Committee, along with Sorensen and Jonathan Jackson (1^st), plus Illinois Republicans Mike Bost (12^th) and Mary Miller (15^th), the Peoria native has continued to campaign to restore and improve the Farm Bill.

Enacted about every five years, Farm Bills affect how the nation farms and eats, and how we use and protect the land and rural America. The last Farm Bill had assistance for rural development and farm-loan aid plus four entitlements: income and price-support subsidies for farmers; crop insurance for disasters, conservation, and nutrition (including SNAP, formerly food stamps).

“SNAP is the only social benefits program available to all low-income Americans,” writes Northwestern University economist Dianne Whitmore Schanzenbach.

The House measure contains “important provisions regarding the Rural Energy Savings Program, funding and updates that support Illinois’ flourishing bioeconomy, a definition for sustainable aviation fuel, increased research facilities funding, a new Specialty Crop Advisory Committee and doubled funding for the Market Access Program and the Foreign Market Development Program,” Budzinski conceded. “But what sticks with me is that these strides are made alongside concerning changes to our farm safety net, and they come at the expense of hungry families and our climate.”

One beneficial change could be incentivizing crop-insurance policy writing in areas with high loss ratios.

“Unfortunately,’ Budzinski said, “they’ve decided to arbitrarily cut Illinois and four other Midwestern states out of these improvements,” but not Southern cotton, peanut and rice growers.

“I want to make sure that our corn and soybean farmers [are] getting their fair share,” she continued.

“I’m deeply disappointed that the Farm Bill released by Committee Republicans fails by harming our ability to respond to emergencies and deepening regional disparities in our safety net,” she added. “We’ve established safety net programs in the event of things like drought, natural disasters and trade instability. These aren't the only safety net programs weakened in this Farm Bill, [which] privatizes SNAP, pulling back nearly $30 billion from the program over the next 10 years.”

The House version also would seize $14 billion in Inflation Reduction Act conservation funding to transfer elsewhere.

The League of Conservation Voters also blasted the House bill, commenting, “House Agriculture Committee Chair GT Thompson caved to the demands of extreme MAGA Republicans.”

Indeed, the House Republican Study Committee, whose members include LaHood, also has recommended additional cuts: removing SNAP, eliminating “duplicative” crop insurance programs, stop funding National School Lunch Standards, eliminate the Rural Water and Waste Disposal Program account, and dismantle the bipartisan Bob Dole/George McGovern Food for Education program.

Budzinski, who last month won her second term on Capitol Hill, seems determined.

“I want to make sure family farmers have a seat at that table when the Farm Bill is being negotiated,” she said.

“Any farm bill that has passed over the last few decades has been done on a bipartisan basis,” she said. “That’s what I think we need to get to: coming back to the table, negotiating these sticking points and getting the bill done.”

Nursing homes and residents cope with staffing shortages, fiscal woes

For months, greater Peoria has seen headlines about Petersen Health Care, 830 W. Trailcreek Dr. in Peoria, which has faced foreclosures and bankruptcy due to hundreds of millions of dollars of unpaid debt. Petersen’s holdings include nursing homes in Iowa, Missouri and Illinois.

Illinois has almost 700 nursing homes and related facilities, with 61 in Peoria, Tazewell and Woodford Counties, according to the Illinois Department of Public Health (IDPH), which licenses, regulates and examines facilities’ documents for compliance.

Few face bankruptcy, but most cope with fiscal challenges affecting budgets, staffing and residents’ care.

“It’s all about staffing,” said Charlene Harrington, professor emeritus at the University of California, San Francisco, who specializes in long-term care research. “If you don’t have adequate staffing, you just can’t do the job.”

It’s daunting, according to a February report.

“Monumental and ongoing staffing shortages” and worker burnout have created a crisis, said the inspector general’s office at the U.S. Dept. of Health and Human Services. Its Centers for Medicare & Medicaid Services (CMS) supervises 1.2 million nursing homes where care is underwritten by federal funds.

This spring, the Biden administration sought to guarantee adequate staffing with tougher standards, and issued the first federal rules on minimum staffing for long-term care facilities. They could require many homes to boost staffing. Intended to “significantly reduce the risk of residents receiving unsafe and low-quality care,” the total nurse staffing standard will be 3.48 hours per resident day (the total number of hours worked by each type of staff divided by the total number of residents) and 2.45 hours per resident day of direct nurse aide care.

“But putting a law on the books is no guarantee of better staffing,” said Jordan Rau of KFF Health News. “Many nursing homes operated with fewer workers than required, often with the permission of regulators or with no consequences at all.”

Less than 20% of Illinois nursing homes meet the new federal criteria, according to CMS data analyzed by Chicago public media’s WTTW-TV 11. Failure to comply can lead to progressive penalties, from orders correcting violations to fines and even termination of licenses (although Illinois last year delayed fines tied to the state’s minimum staffing requirement until July 2025).

Some states also set minimum staffing levels, and Illinois mandates slightly more than the new federal standards.

Since January 1, 2014, the Illinois’ Nursing Home Care Act says, “The minimum staffing ratios shall be 3.8 hours of nursing and personal care each day for a resident needing skilled care and 2.5 hours of nursing and personal care each day for a resident needing intermediate care. A minimum of 25% of nursing and personal care time shall be provided by licensed nurses, with at least 10% of nursing and personal care time provided by Registered Nurses.

“Compliance shall be determined quarterly by comparing the number of hours provided per resident per day using the Centers for Medicare and Medicaid Services' payroll-based journal and the facility's daily census.”

However, the IDPH has had its own staffing shortage, with too few employees assigned to inspect the facilities’ self-documented records.

In part, the staffing shortage stems from the industry’s inability to keep workers, Harrington added. 

In Illinois, the average percentage of total nursing staff turnover was about 52% this summer.

“They’re able to hire, but they’re not retaining people, and then they don’t really want to retain because every time you bring a new staff person in, they bring them in at the minimum wage at the bottom of the wage scale,” Harrington said. “They don’t value their workforce.”

Another factor could be how the nursing home owners use their revenue.

The mostly for-profit nursing home industry blames financial woes on reimbursement rates from Medicaid, the federal/state program that covers most nursing home residents’ costs. But studies and lawsuits show that owners and investors often generate huge profits.

“Some researchers, lawyers and state authorities argue that they could reinvest more of the money they make into their facilities,” said Rau. “Pay remains so low — nursing assistants earn $19 an hour on average — that homes frequently lose workers to retail stores and fast-food restaurants that pay as well or better and offer jobs that are far less grueling.

“Average turnover in nursing homes is extraordinarily high: Federal records show half of employees leave their jobs each year.”

The effects of for-profit ownership aren’t new.

“At the height of the pandemic, lavish payments flowed into real estate, management and staffing companies financially linked to nursing home owners throughout New York,” Rau continued. “Nearly half the state’s 600-plus nursing homes hired companies run or controlled by their owners, frequently paying them well above the cost of services, a KHN analysis found, while the federal government was giving the facilities hundreds of millions in fiscal relief.

“In 2020, these affiliated corporations collectively amassed profits of $269 million, yielding average [profit] margins of 27%, while the nursing homes that hired them were strained by staff shortages, harrowing injuries, and mounting COVID deaths, state records reveal.”

Whether by changing management or strengthening enforcement and penalties, reforming the nursing home industry could be critical in the next decade. By 2034, the U.S. population will have 77 million people 65 years and older compared to 76.5 million under the age of 18, according to the Census Bureau.

It may take regular Americans pressuring companies or lawmakers.

What’s needed is the political will to address the crisis, according to Elizabeth White, RN, a professor at Brown University School of Public Health and a long-term-care expert.

“The pandemic helped highlight the challenges facing nursing homes, but it’s still the elephant in the room,” she said. “The financing system is broken, and the problem is just so enormous that it’s very hard to get the political motivation to do anything about it.”

 

For related information, go to the “Nursing Home Inspect” tool-

http://projects.propublica.org/nursing-homes/