by Jay Luxenberg, MD

Today is March 1, and at the time this article is being written it is uncertain but looking more likely that we will experience the “sequester”- the dreaded across-the-board $85 billion in spending cuts between March 1 and the end of the fiscal year on Sept. 30. In case you notice a “Mad Max” scenario on your drive home today, with the dissolution of civilization as we have known it, it probably can be attributed to the remarkably dysfunctional legislators who could not work out a compromise that would allow a more logical allocation of cuts rather than this blunderbuss approach. As usual, our fragile elderly patients are likely to suffer disproportionately from such cuts.

Further cuts to providers inevitably will lead to less access to choice, and less access to the services that can allow an elderly person to remain safely in the community of their choice. If nursing home placement is their best option, there will be fewer resources to support the sort of high-quality, person-centered care that CALTCM champions.

Even if we are spared the “sequester,” we can anticipate an environment with multiple fiscally driven changes, and our patients are at risk of being harmed during the process of change. Under such circumstances, we as health care and social service providers must stay educated about the nature of changes that are coming, and we must be up-to-date on every strategy available for improving our efficiency and quality to mitigate the effect of cuts and drastic changes. Even with the tightened finances we will all find ourselves in, attending meetings like the upcoming CALTCM annual meeting is more important than ever. Certainly the WAVE will be making every effort to keep you informed. Meanwhile, realize that we are all in this together, so please consider submitting an article on your own experiences for the WAVE, or a poster or presentation to a state or national meeting.