Long Term Care programs to feel pinch of budget cuts


A recent announcement by the Department of Social and Health Services detailed a Washington State budget cut of $40 million from senior services including Long Term Care programs. According to area officials that also means an even greater amount of matching federal money will be lost.

The cuts to the Senior Citizen's Services Act begins Dec. 10. This effects programs including Senior Meals on Wheels and Congregate Meals, Adult Day Care, Senior Transportation, Information and Assistance and mobility programs such as foot care.

At the area office of Aging and Long Term Care program coordinator Mary Cleveland said these cuts will save money in the short term but the real effect will be to increase expenses in the long run. According to Cleveland programs that provide preventative care help keep people in their homes, deferring or delaying the need for more intensive options, such as placement in a facility and delaying entry to Medicaid, all of which saves money longer term.

Cleveland said because the state revenue for fiscal 2011 is below projections Gov. Christine Gregoire has initiated across the board budget cuts of all state agencies. According to Cleveland, DSHS is the largest part of the state budget and has already gone through a series of reductions, including lay offs and not filling open positions. Cleveland said this round of cuts will involve changes in services and concerns are being expressed by both providers and clients.

Betty Keller, RN and Foot Care provider in Columbia and Garfield counties said she does many sessions with people needing care such as foot care teaching, for diabetics, people with arthritis and vision impairment

"If these things are not taken care of, especially for diabetics, lack of foot care can lead to losing a limb, that would be more dollars lost (in addition to the person's suffering.)"

According to Howard Ostby, director of the Senior Round Table, providing home delivered meals helps save money in the long run; a little bit of help now saves a client from needing much more help later. "Eating right, in your own home, taking preventative measures is a lot better." He estimated cost of a facility as about $6,600 a month and said, "You can get a heck of a lot of in home service for that. The meal delivery helps them from being forced out of their homes and it prevents hospital stays. Then the government, we as individuals, will end up paying much more. Don't be penny wise and pound foolish, as the saying goes. The home delivered meals can delay a person going into an institution and keep costs down. We utilize volunteers for meals on wheels; and lots and lots of volunteers are cheaper than institutions."

Cleveland added that the volunteers see the clients five days a week and can check on them to make sure they are alright. If they're not, Ostby said, the volunteer calls the family or 911. Cleveland again stressed the importance of catching things early to prevent worse.

Ostby said, "By spending money for these in home services you don't end up spending a lot more later." And they both agreed that people generally do better in their own homes.

Cleveland said the cuts "will impact all of our long term care clients and impact our caregivers income. It will have an impact on wage earners."

"In 1995 we went from an institutional model to a home and community based model," Howard Ostby said. "This made Washington state one of the leaders in the U.S. not only because of its benevolent delivery system, but because it is estimated this helped save $300 million a year. If you extrapolate that over a 15 year period that is a $4.5 billion savings to the Medicaid budget and to the State of Washington."

A former volunteer with Meals on Wheels, Ron Grassi, is now a recipient. "Clients are very happy to receive the meals. It's great to see those folks coming. They receive a hot balanced meal and there's a lot of effort put into that, from the kitchen to the delivery. Please don't take away our meals."

John Rupp of Home Care Services said that adding these cuts to those experienced last year probably means it's very unlikely many agencies will still be in business in a year.

Mary Cleveland added, "We're already having trouble finding placement for people in facilities. We're not sure we can maintain our services. We're basically walking away from a very good model. If the system devolves there's not going to be a place for these people to go. They're going to end up in the emergency rooms. A lot more of care giving responsibilities will fall back on the families."

Cleveland and Ostby said there's a huge potential for the domino effect, making small preventable problems into larger, life threatening and very costly events. In addition, the timing couldn't be worse due to the large baby boomer generation reaching their senior years, meaning an increase in need as the services available decrease.

John Rupp added, "These cuts will have impacts on clients and their families and it will have a ripple effect in communities."

Karlene Ponti can be reached by calling 509-526-8324 or by e-mail at karleneponti@wwub.com.


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