Demand for home services for elderly continues to climb
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Gov. Tom Corbett wants the Pennsylvania Lottery's management privatized under a contract that he says could provide an additional $50 million annually to expand home services for the state's growing elderly population.
Democrats and advocates for older adults in Harrisburg say that thanks to a thriving lottery, the money exists to enhance senior services no matter who's running the numbers game.
And those responsible for lining up the home care locally don't care where the money comes from or how -- they just know there's a growing need to serve a population that's better able to avoid costly nursing home placements when it receives subsidized assistance at home.
"I'm not an expert in the lottery, so I don't know if privatization is a good idea, but I do know there are significant unmet needs in our senior community," said Beverly Sullivan, administrator of the Beaver County Office on Aging, which has a waiting list that didn't exist a year ago for its services.
Her office has reduced its spending on home modifications, legal help, eyeglasses and hearing aids for clients to stretch its dollars further for basic home services such as sending a personal care aide to assist with bathing, dressing and meal preparation, Ms. Sullivan said.
Even so, Beaver County has 30 adults age 60 and older awaiting the chance to get those subsidized services under what's known as the Options program, and that's only a small number compared to the 438 on Allegheny County's growing waiting list. The waiting list of 5,400 among county aging agencies statewide is more than twice the number of two years ago.
Officials say funding of home help for seniors in recent years has failed to keep up with growing costs and demand, based on demographics of Pennsylvania's aging population. The governor's $50 million in proposed new funding breaks down as follows:
• $20 million to reduce the Options waiting list of 5,400 people who would qualify for subsidized visits from home aides, home-delivered meals and other services -- similar to some 27,000 other people in the state -- if more funds were available. The Options budget has been given minimal or no increases from lottery proceeds for at least five years, which has reduced the overall number being served, due to higher costs.
• $21 million to add 1,550 individuals to what's known as the Aging Waiver program, which provides even more extensive home services than Options for people who qualify because of frail health and modest income. Paid for by a combination of state and federal funds, the Aging Waiver has seen steady budget growth in recent years, unlike most human services programs.
• $5 million in increased funding to the 52 Area Agencies on Aging statewide for general costs of running programs, after years with no increase.
• $2 million for senior center modernization projects, the first new funding for that purpose in at least five years.
• $2 million to cover services for people with disabilities turning age 60 and shifting into aging programs.
In all, it would represent the biggest boost to home and community services for the frail elderly in at least a decade, state officials say; the big question, though, is whether the $50 million will actually materialize in the 2013-14 budget.
The governor's office is wrestling with whether to file a court challenge to Attorney General Kathleen Kane's finding that privatizing lottery management, as Mr. Corbett wanted to do with a British firm, would be illegal. The governor had tied his proposal to expand home and community services to the ability to complete the deal in which Camelot Global Services would guarantee new money to the state with revenue from expanded gambling opportunities, such as adding keno as a lottery game.
Some advocates for the elderly say the new home services funding is so essential it shouldn't be dependent on the lottery contract. The lottery had a record year in 2011-12, generating more than $1 billion in revenue for the state, and is on pace to exceed that this year. The governor's 2013-14 budget proposal calls for maintaining a balance and reserve of more than $200 million in unspent lottery funds, to cover program costs in the event of a lottery downturn.
"Gov. Corbett is using Pennsylvania seniors as pawns in his scheme to outsource our lottery to a foreign corporation," House Democratic Whip Mike Hanna of Clinton County said this month when House Democrats unveiled legislation that would mandate use of the surplus lottery funds to cover the $50 million in new spending proposed by the governor, plus add $70 million more for the same purposes.
The governor has not said what would happen to his $50 million proposal if the contract does not go through. His budget spokesman, Jay Pagni, said Friday that the administration's position is that the lottery, while successful now, does not provide reliable year-to-year profits that should be tapped for expansion of home services. From 2006 to 2009, the lottery encountered declining revenue in three successive years.
But if the privatization plan is not possible, Mr. Pagni said, the governor would discuss with the Legislature what funding, if any, to make available for additional home services.
"Over the next several months, I'm sure we will have several discussions over this topic as well as others," he said, "and work with them to develop a contingency, if need be."
The neediest group among the elderly population, those 85 and older, is in the process of growing from about 325,000 Pennsylvanians in 2010 to an estimated 355,000 by 2015, according to state projections.
"When you look at the demographics, we know the cost of delivering services goes up and demand continues to go up," state Aging Secretary Brian Duke said. "We have a need that has to be met, and the need is growing."
Aside from growth of the senior population, advocates for their funding note the societal shift that makes their adult children less available to help them than for prior generations -- because of distance or careers -- at the same time that everyone seems to prefer avoiding nursing home care until there's no other choice.
Referring to the 438 people awaiting home help in Allegheny County's Options area, administrator Mildred Morrison of the Area Agency on Aging said, "I don't know that it's a broad community crisis, but it's an issue of prevention, of providing the little bit of help that keeps them from needing a lot of help later on."
First Published February 25, 2013 12:00 am