(C) Iowa Capital Dispatch
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Lawmakers asked again to raise monthly allowance of nursing home residents • Iowa Capital Dispatch [1]
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Date: 2025-03-05
Iowa’s Long-Term Care Ombudsman is again asking state lawmakers to increase the monthly allowance that nursing home residents collect through Medicaid for personal living expenses.
For the past three years, the ombudsman’s office has called for an increase in the so-called “personal needs allowance” that Medicaid beneficiaries receive while in nursing homes.
The allowance is typically used by residents to pay for personal items that care facilities often don’t provide — such as hairdressing, cable TV, snacks, greeting cards or gifts for family members, clothing and cellphone service.
For 24 years, Iowa has provided nursing home residents with the same amount of money for a personal needs allowance: $50 per month. Had the allowance been increased to keep pace with inflation, it would now be just under $90.
In 2023, the ombudsman and other advocates for seniors proposed an increase to $85 per month, but the legislation failed to advance. Last year, the request was reduced to $65 per month with regular cost-of-living adjustments, but it, too, failed to gain traction with legislators. This year’s proposal mirrors the 2024 proposal of a $65 monthly allowance with cost-of-living adjustments beginning in 2026.
The Senate version of this year’s bill, Senate File 476, advanced out of committee earlier this week. The House version, House File 225, hasn’t advanced since it was introduced and referred to that chamber’s Health and Human Services Committee in early February.
I tell you, I feel like the lowest thing on the face of the earth when I can’t buy a simple ten-dollar birthday gift for my grandkids. – Greg, an Iowa nursing home resident, speaking at a virtual town hall event.
When Iowa’s 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.
In years past, the Office of the Iowa Long-Term Care Ombudsman has argued that increasing the personal needs allowance is a way lawmakers can have a direct, positive impact on nursing home residents’ quality of life without adding to industry-opposed oversight and regulation.
At a virtual town hall meeting last year, Melanie Kempf of the ombudsman’s office told a gathering of seniors that an increase is overdue.
“In our state we haven’t seen an increase since 2021,” Kemp said. “Since then, there have been no increases to keep up with the cost of inflation, and we know prices today have certainly almost doubled.”
A senior who identified himself as Greg told Kempf, “I tell you, I feel like the lowest thing on the face of the earth when I can’t buy a simple ten-dollar birthday gift for my grandkids. I can’t go to the store and get energy drinks. I haven’t had one of those in three or four months. Fifty dollars just doesn’t do anything … How about a magazine? I can’t afford that.”
When a Grundy Center senior asked Kempf why the office was backing an increase to only $65, Kemp noted that the 2023 bill that called for an increase to $85 “did not move anywhere” in the Iowa Legislature, and so a less costly request was proposed last year and this year.
Nationally, more than half the states provide their nursing home residents with a higher allowance than Iowa, including some of the states surrounding Iowa:
Nebraska: $75
Minnesota: $128
Illinois: $60
Missouri: $50
Kansas: $62
South Dakota: $100
Only 10 states have a personal needs allowance of less than $50 per month, according to the American Council on Aging. Two states, Alabama and South Carolina, continue to pay out only the federally mandated minimum allowance, established in 1987, of $30 per month.
Federal regulations require nursing homes to provide residents, at no additional cost, basic personal hygiene items, such as a toothbrush, toothpaste, dental floss, denture adhesive and cleaner, shampoo, bath soap, deodorant, moisturizing lotion, comb, razors, incontinence supplies, and tissues. But if a resident needs or wants a specific brand that isn’t provided by the nursing home, they can use their personal needs allowance for such items.
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