Sagging economy affects state-supported options for seniors

MIDDLEBURY — Growing older doesn’t just bring decisions about personal care for the elderly and their families. When people leave the workforce, many also encounter new financial worries.
As the Baby Boomer generation ages into the country’s elder care systems and the economy continues to struggle, seniors are finding it harder and harder to get financial help for the amount of professional care that they need, or the levels of comfort that they hope for.
According to the U.S. Census Bureau, 13.8 percent of Vermont’s population was over the age of 65 in the year 2008, compared to 12.8 percent nationally — meaning that a significant portion of the state’s population is thinking about how they are going to pay for care for themselves or for an aging relative.
Growing senior population in county needs more care
Sagging economy affects state-supported options for seniors
Adult children face tough decisions in care for aging parents
Resources on aging in Addison County and Vermont
Vermont Department of Disabilities, Aging and Independent Living
Champlain Valley Agency on Aging
Elderly Services
Addison County Home Health and Hospice
Joanne Corbett, the executive director of Elderly Services Inc. in Middlebury, said that she’s seen financial struggles taking a toll on the people who attend Project Independence, ESI’s adult daycare program.
“What we have seen in the last year and a half is a very big rise in the number of families that we have to offer financial aid to,” said Corbett. “And enrollment is going down.”
Project Independence receives funding from 17 sources, and more than half of those are through the government. All of these — including Medicaid, federal school lunch programs and the Veteran’s Administration (VA) — have experienced budget cuts in recent years.
And some funding sources have been frozen: Funds that seniors received through the Vermont Department of Disabilities, Aging and Independent Living (DAIL) and the VA have stopped accepting new applicants, paying only for those who were grandfathered in on the programs.
Corbett said the high of between $14,000 and $15,000 per month that Project Independence received from participants funded by the VA has dropped to about $7,000, as people leave the program for more intensive care and no new ones are funded.
“As participants leave the program who were on state funding, people are coming in with much lower payment rates,” said Corbett. “Our revenue is going down as an organization.”
To add to the financial struggles, Medicaid, which funds more than half of the participants at Project Independence, in fiscal year 2010  cut the rates it pays to Elderly Services by 2 percent.
So the number of people who are applying directly to Elderly Services for help paying the $16 per hour price tag on care at Project Independence is rising, enrollment in the program is falling for those who simply can’t afford it, and the organization’s revenue is falling.
Corbett reported that in fiscal year 2009 her organization saw an average decrease in revenue of about $5,000 a month. Since then, monthly revenue has declined steadily — in May, the organization saw a $30,000 decrease.
These hits on the organization’s finances have decreased its spending from $2.2 million in the 2009 fiscal year to $2.1 million in the fiscal year that ended last week. And Corbett said that spending in fiscal year 2011, which began July 1, will likely drop to $1.9 million.
“We’ll definitely be facing an operating deficit (in the current fiscal year),” Corbett said. “We’re trying to reduce costs for the coming year.
“It’s the government’s financial struggles that are hitting us,” she added. “And families are suffering because they can’t get the funding.”
Corbett said funding cuts are proving to be especially hard on the wallets of the middle class.
“Those who have almost no resources can get Medicaid,” she said. “Those who have a large savings can do private pay. Those with modest incomes were helped a lot by the state’s Moderate Needs program.”
Choices for Care is a broad program, administered by DAIL and funded by Medicaid, that works to provide flexible care for aging and disabled Vermonters with low and moderate incomes, keeping them in their homes and out of institutional care situations for as long as possible. The program breaks down into three brackets: the Highest, High and Moderate Needs groups.
In November of 2009 the state put a freeze on new applicants to the Moderate Needs group, leaving many seniors out in the cold.
Stacey Ayotte of Bristol has been caring for her 89-year-old mother, Mary Stephens, for three years. For much of that time, the state’s Moderate Needs funding program covered Stephens for the three days each week she spent at Project Independence. That time in adult daycare has made a difference, Ayotte said.
“She has a lot of social interaction,” Ayotte said. “Her dementia has slowed down.”
Last September, however, Stephens fell and broke her hip, and spent 110 days at Helen Porter nursing home. In that time, her coverage under the Moderate Needs program was terminated by the state to make way for other applicants. Once Stephens had fully recuperated and returned home, DAIL had frozen the Moderate Needs program to new applicants, and she was put on the waiting list.
Now, said Ayotte, there is little chance of getting back onto the program.
Ayotte said her mother is among the lucky — she has a modest pension and good health insurance from her career as an accountant at Bristol-Myers Squibb in Syracuse, N.Y., as well as Social Security and Medicare. Plus Ayotte is able to offer her mother a rent-free apartment, food and financial help.
And Stephens is still able to attend Project Independence with the help of financial aid and a small Addison County Home Health and Hospice grant to cover transportation.
But this is just not enough, said Ayotte.
“I wish I could say she has lots of money in the bank,” said Ayotte. “But (if she didn’t live here) she would probably end up in some sort of home health situation, which she could not afford on her income, because it’s very little.”
Now the family is waiting for Stephens’ Medicaid application to go through. If it does, she will be covered more extensively in the event of hospitalization and other medical bills, and the fund would also pay her tuition to Project Independence.
In the application process, Ayotte has seen firsthand just how overburdened the Medicaid office is — if she hadn’t adopted a strategy of calling twice a week and contacting legislators, she suspects she would have no information on how far along in the process her mother’s application is.
“You have to be persistent,” she said. “The squeaky wheel gets the grease.”
For now, it’s a waiting game.
But Stephens’s struggle and that of others like her in Addison County isn’t unique. This year is the first year that seniors saw no cost-of-living increase in their already meager Social Security checks.
“Social Security doesn’t come close to covering home care or the cost of living,” said John Barbour, executive director of the Champlain Valley Agency on Aging.
Barbour said that seniors throughout the nation are having more difficulty finding financial help, and the waitlists for many of these programs are expanding.
“People get less help in-home, there are higher premiums and co-pays, and seniors themselves are paying more out of pocket,” said Barbour.
He said that most human service programs funded by the state are facing significant cuts. In part, he said, this is due to Challenges for Change, the Legislature’s cost-cutting initiative. It has targeted DAIL for a cut of $5 million to $7 million in spending in the current fiscal year.
According to the Agency on Human Services’ Challenges for Change progress report submitted to the Legislature in March, DAIL hopes to achieve a savings of approximately $7.5 million by further emphasizing independent living and home care options, keeping the elderly out of the more costly institutional care facilities — an integral part of which is the Choices for Care program, with a focus on the neediest cases.
But Mary Gerdt, the DAIL long-term care coordinator for Addison County, said her office has seen a significant increase in people searching for financial assistance, and they haven’t only been low-income applicants. Those who are looking for help applying for Choices for Care programs, food stamps, fuel assistance and other aid are in middle-income brackets as well.
“We’re busier,” she said. “It seems to be hitting everybody.”
Barbour said that the news hasn’t been all bad, though.
“In a time when people are looking for work … they’ve found it easier to recruit home caregivers,” he said.
Barbour said that one of his hopes for the future of paying for elder care is on the federal level. The recent health care reforms included the Community Living Assistance Service and Supports Act, which will set up a public, long-term care insurance model.
And Ayotte, for one, is glad that her mother is with her in Vermont. Despite financial struggles, she’s found the resources available to be remarkably extensive.
“I have to say Vermont, especially Addison County, is magnificent to their elderly,” she said.
Reporter Andrea Suozzo is at [email protected].

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