When Pennsylvania Secretary of Welfare Gary Alexander cut reimbursement rates to Area Agencies on Aging, he may have wanted to save the state money, but it's unlikely that he did.
Cuts to in-home care will send more of the elderly to nursing homes, which can cost more than three times as much. Alexander was also shortsighted in cutting back on supervision of seniors by nurses and social workers. That could lead to health and hunger problems going unnoticed for months, which will only make the ailments worse and more expensive to treat.
The funding decisions come from the same administration that dumped 89,000 children from Medicaid, leading federal regulators to question whether the benefits were properly terminated, or just eliminated because of bureaucratic ineptitude. The department also tossed 70,000 adults from a temporary-assistance program, which could force them into homelessness.
These cruel cuts have been made in part under Act 22, which became law in 2011. The act gave the secretary overly broad powers to cut payments to service providers and change eligibility requirements without legislative or administrative input. The act was designed to cut costs, but reducing reasonable oversight has already caused too much pain for recipients.
In June, the welfare department unilaterally changed the way it reimburses the state's aging agencies, resulting in about a 30 percent cut. It also limited how often nurses and social workers could visit seniors. As a result, the Philadelphia Corporation for Aging laid off 25 nurses, each of whom used to make 18 home visits each a week. Now the agency has two staff nurses who manage care from the office. Aging agencies around the state have also cut services.
Advocates say taxpayers ultimately will wind up spending more. The average cost of in-home services for a senior citizen in Philadelphia is $30,000 a year. Care can range from regular visits from a nurse or social worker to bringing in aides who help seniors clean, cook, go to the bathroom, and bathe. The professionals also evaluate whether a patient's physical and mental health is declining. They can call for treatment soon enough to stabilize the senior. Unless they have a knowledgable person check on them, seniors can deteriorate rapidly and wind up in a nursing home, costing about $100,000 yearly.
There is such a high demand for in-home care that the waiting list in Philadelphia, Montgomery, Bucks, Delaware and Chester counties has swelled to 1,500 since the summer, with no indication that people on the list will get the help they need anytime soon.