Cecily O'Connor
RedwoodAge.com
As states wrestle with budget shortfalls, transportation, home-delivered meals and other programs for older adults are suffering.
At least 70 percent of states will start cutting these services in 2009, according to a survey by the National Association of State Units on Aging. That means states could restrict the duration of services, reduce eligibility, increase cost-sharing and cut cash assistance.
The Older Americans Act programs, disability programs, Medicaid, and home and community-based supports are among services likely to be most affected by the cuts.
"These programs are the critical lifeline that keeps many older Americans across the country self-sufficient, rather than in institutional settings, where the costs are significantly higher," said association president Patricia Polansky, who is also assistant commissioner of the New Jersey Division of Aging & Community Services.
The situation is troubling, given that the number of older adults needing services is expected to rise with boomer retirements. State agencies are urging legislators to consider small investments in aging programs to keep them afloat.
However, aging organizations realize they need to be more resourceful and collaborate with other agencies because funding is scarce. Sixty-seven percent of states expect a budget shortfall in 2009, and the majority see additional cuts the following year. California, for example, is forecasting a deficit of over $40 billion - roughly 40 percent of the state's entire general fund budget.
Deficits represent more than a fiscal challenge, however. They also test state's social and health services offerings.
Rising Demand
Given the down economy, older adults are relying on community-based aging
services more than ever. The survey, conducted among state aging directors in
late November, found that nearly 85 percent of states are experiencing more
requests for transportation and home-delivered meals.
As winter approaches, 63 percent of states are hearing increased calls for home-heating assistance. Meanwhile, Medicaid services also are in high demand, with over 50 percent of states receiving more requests for elderly Medicaid waiver programs.
As states grapple with meeting needs, many are forced to start wait lists, especially for meal services.
States rely on a number of financing strategies to deliver their services, according to the association. In addition to Medicaid waivers, states combine funding from the Older Americans Act, Social Services Block Grant, the Low-Income Home Energy Assistance Program, the Community Services Block Grant, and other federal sources to deliver a package of benefits for their eligible seniors and individuals with disabilities. Some funding for programming that is solely financed by the state.
At the city level, communities also are bracing for tough times, given that some of their primary funding sources - sales and property tax revenue - are down sharply.
For some of the states surveyed, 2009 represents the fourth year in a row that their budgets have been slashed. Administrative cuts is one coping mechanism. About 90 percent of states are anticipating hiring freezes, nearly half expect staff cuts and a large majority anticipate reductions in training.
'Human Suffering'
Amid legislator's difficult funding choices, the association is urging Congress
to consider a "moderate investment" in state-based programs.
In the meantime, state aging directors said they'll review the current delivery methods for home-delivered food. Some states anticipate switching to a regionally based model instead of a county-based system. Other states plan to cut back the number of times meals will be delivered to individuals. For example, instead of delivering meals five days a week, states may switch to a system of delivering five meals once a week.
Several states indicated that they are working aggressively with their area agencies on aging to develop stronger partnerships in the community and better business plans.
