Funding Lags for Older Adult Services

 

By Ann Hardie

For two hours a week, a respite worker comes to Nancy Downes’ home in Winder, 45 miles east of downtown Atlanta. While that isn’t a lot of time, it’s enough to let Downes run to the grocery store, take a hot shower—and even catch her breath.

The rest of the time Downes, 61, is the sole caregiver for her mother, Mildred Tripp, 87, who has advanced Alzheimer’s disease and lives with Downes. “Even standing in the line at the grocery store is too much for my mother,” Downes said. “Any time I get to myself is extremely important. I know I am a better caregiver because of it.”

Respite care and other state-funded services that keep older Georgians living in the community and out of nursing homes not only benefit families, but also save taxpayers. Older Georgians and their advocates, including AARP Georgia, will underscore that point when they urge state lawmakers in January to designate $10 million in additional funds for services to help frail and vulnerable older adults. Since 2009, annual state funding of older adult services has been cut by more than $12 million.

Less expensive option
Advocates will emphasize that Medicaid, the federal-state health care program for the poor, pays the bill for 80 percent of Georgia’s nursing home residents, at an average annual cost to the program of about $31,000 each. Meanwhile, the state pays around $1,900 per resident per year for home- and community-based services such as the respite care Downes receives, delivered meals and rides to medical appointments.

By 2030, the number of state residents 60 and older is expected to increase by 66 percent; those 85 and older will almost double.

“We have a booming senior population. It just makes economic sense to keep people at home,” said Kathryn Fowler, outgoing executive director of the Georgia Council on Aging. “Instead of fighting for little toeholds, we are going for the ‘big ask.’ ”

Older Georgians and their advocates want $6 million to help whittle down a waiting list of about 11,200 people who do not qualify for Medicaid but can’t afford services including respite and adult day care, home-delivered meals, transportation and minor home repair. Eight of 10 of those currently on the list are eligible for nursing home care, and if they were to go that route, the government’s tab would skyrocket. That would increase spending for home- and community-based services roughly 8 percent.

The remaining $4 million would be used to shore up efforts to safeguard Georgians at risk of being neglected, abused or ripped off­­—roughly a 25 percent increase.

These efforts include:

• Hiring more staff at Adult Protective Services, the program that investigates reports of abuse and neglect of older Georgians living at home. New investigations have increased almost a third over the past three years while funding for protective services has been cut by more than $1 million.
• Training volunteers and providing computers and other technology for the Long-Term Care Ombudsman, a federally mandated watchdog program for residents of assisted living facilities and nursing and personal care homes. The state has not increased its share of money to match the federal contribution since about 2005.
• Providing state support for a hot-line that provides free legal ser­vices to older adults who fall victim to physical and financial abuse. A three-year federal grant for the toll-free hotline (888-257-9519) expired in October, but the service has continued through support from the Atlanta Legal Aid Society.
• Providing emergency placements for older adults who need to be removed from abusive or unsafe domestic situations.

Following a handful of tough budget years, older Georgians have reason to be optimistic, said Kathy Floyd, AARP Georgia advocacy director. Gov. Nathan Deal (R) has included $693,000 in the budget to fund 11 Adult Protective Services positions.

“We will continue to push for the $10 million, because after a lifetime of paying in, seniors deserve better,” Floyd said.

Downes certainly hopes so. In 2009, she closed her consignment shop for children to care for her mother full time. Initially, the two went bowling, to church and on other outings. As the Alzheimer’s progressed, they ventured out less and less.

She isn’t complaining. “As long as I can make caring for Mom at home work, I think this is what I am supposed to be doing,” Downes said. “I just wish the government understood how much caregivers are struggling.”—Ann Hardie is a writer based in Atlanta.