State funding not keeping pace with Montco's senior population

Montgomery County already has one of the "oldest" populations in Pennsylvania, and officials say its continued growth is straining the safety net.

A recent study out of Temple University projected that the county's senior population would grow 44 percent in the next 20 years. But state funding for senior and disabled services has been flat for seven years, leaving a waiting list of nearly 200 people needing care.

The county Office of Aging and Adult Services serves about 45,000 residents a year, with a primary goal of supporting independent living.  Services include in-home care, senior centers, long-term care assessment, information and assistance, caregiver support, transportation, nursing homes and adult-day centers, and protective services.

With more than 225,000 senior residents, Montco has the highest median age in the five-county region. And compared to the county's younger residents, those over 65 are more likely to live in a lower-income household, according to an AAS report.

In 2011, the office began conducting surveys and hearings with constituents, employees and service recipients to draft a four-year plan.  At a hearing Wednesday, AAS staff and Advisory Council members provided an update on the plan's goals and progress, and listened to constituents' and care providers' concerns.

Chief among them is state funding, which declined 12.5 percent last year.

In 2012, the state's Aging Waiver Program eliminated registered nurse visits and translation services for non-English-speakers. Program oversight was shifted from the county to the state level; several Montco AAS workers were laid off as a result.

The state also reduced waiver reimbursement rates to a level that several in-home care providers said is unsustainable.  The state now pays $19.12 an hour, with no reimbursement for mileage or other expenses – which can be substantial in large counties like Montco.  After administrative costs, that leaves care providers paying wages that "compete with McDonald's and Wal-Mart," said Samuel Cordisco of VNA Community Services.

Joanne Kline, executive director of Montco AAS, said they aren't yet running short of care providers, but she worries that quality of care is declining.

"We have a lot of providers that are new to us, and the state is now responsible for the oversight as opposed to local," Kline said Wednesday.

Kline and the county's Aging Advisory Council are optimistic that the proposed 2013-2014 state budget includes a $50 million increase for county aging services agencies.  Now, they're lobbying lawmakers to make sure the line item doesn't get reduced or eliminated before the June 30 deadline.

The extra $50 million would come from a $187 million surplus in the state's Lottery Fund, which is earmarked to benefit "Older Pennsylvanians."  In 2007, the state started using lottery funds for Medicaid-eligible nursing home care, which used to come out of the general fund, according to the Philadelphia Corporation for Aging.

Last year, that diversion of lottery funds totaled $309 million – "nearly as much as all of the funding for services to seniors in the community," PCA wrote.

The $50 million would be split up as follows: