• previous post
• next post

•  RSS, Disability Field News
•  RSS, Hope House News

As budgets are slashed, many people with disabilities worry about services

July 21st, 2010

By John Leland, The New York Times

As states face severe budget shortfalls, many have cut home-care services for the elderly or the disabled, programs that have been shown to save states money in the long run because they keep people out of nursing homes.

Since the start of the recession, at least 25 states and the District of Columbia have curtailed programs that include meal deliveries, housekeeping aid and assistance for family caregivers, according to the Center on Budget and Policy Priorities, a research organization. That threatens to reverse a long-term trend of enabling people to stay in their homes longer.

For Afton England, who lives in a trailer home here, the news came in a letter last week: Oregon, facing a $577 million deficit, was cutting home aides to more than 4,500 low-income residents, including her. Ms. England, 65, has diabetes, spinal stenosis, degenerative disc disease, arthritis and other health problems that prevent her from walking or standing for more than a few minutes at a time.

Through a state program, she has received 45 hours of assistance a month to help her bathe, prepare meals, clean her house and shop. The program had helped make Oregon a model for helping older and disabled people remain in their homes.

But state legislators say home care is a service the state can no longer afford. Cuts affecting an additional 10,500 people are scheduled for Oct. 1.

“They yanked the rug out from underneath us,” said Ms. England, who lives on $802 a month from Social Security. “I’m scared. I’m petrified. I can’t function on my own. I took care of my husband for eight years. Already I’ve given up many of my freedoms. Now they’ve taken our dignity. I’d like them to try living in my body for a week.”

Her case manager, Brandi Lemke, shook her head. “This is not saving any money,” she said.

Ms. Lemke said she feared that Ms. England would “end up in the hospital because of the diabetes” and be in assisted living by the end of the year. “If she takes a fall,” Ms. Lemke said, “she may require more than assisted living can handle.”

Nursing homes here cost the state an average of $5,900 a month; home and community-based services cost $1,500 a month.

Other states have made similar cuts:

• Florida placed 69,000 people on waiting lists for home or community services last year, and more than 5,700 of them ended up in Medicaid nursing homes.
• Alabama cut housekeeping services — useful for people who can no longer do some cleaning tasks — for more than 1,000 elderly residents.
• Arizona sliced independent living supports and respite programs for family caregivers.
• Kansas, with a $131 million shortfall, will cut independent-living services for 2,800 people with disabilities in the next year.
• In Illinois, providers of Meals on Wheels have stopped adding clients because the state was not reimbursing them.

“I’m not getting a cost-of-living adjustment, and now I’m not getting food,” said Joyce Plennert, 83, who is on a waiting list for Meals on Wheels in Palatine, Ill. “Now I’m worried my home services will be cut. Without that, I’d be in a nursing home, if I could find one with room.”

Colorado, Mississippi, Missouri, Nevada, New Jersey, New York and Texas have all made cuts or frozen spending at a time when the elderly population — and the need for services — is growing.

In California, which faces a budget shortfall of $19.1 billion for the 2010-11 fiscal year, Gov. Arnold Schwarzenegger’s office proposed eliminating adult day health care centers that serve 45,000 people and in-home supportive services that help more than 400,000 elderly, disabled or blind residents. The Legislature rejected these cuts but has not yet produced an alternative budget. The state already cut Alzheimer’s day care centers and assistance for caregivers.

Because Medicaid regulations require states to provide nursing home care to receive federal Medicaid money, legislators often have more leeway to cut from home services. Advocates for the elderly and the disabled worry that these cuts are just the beginning, because state ledgers tend to recover more slowly than the national economy.

“The situation is grim, and it’s safe to say that present trends are expected to continue,” said JoAnn Lamphere, the director of state government relations for health and long-term care for AARP. “Nearly every state has proposed cuts of some sort to Medicaid. Some might seem small, but it’s death by a thousand slashes.”

Read the rest of the article.