Senior care reduced in three-county area after cut

Services down for one client by more than 40 hours per month; aging agency sees few alternatives

By Marcus Clem, July 30, 2016

Since his partial stroke earlier this year, Bob Anderson, 79, has tried to avoid stress and be positive. In June, he got a notice he said makes this difficult.

The 11 hours per week of in-home care he obtains with assistance from the Jayhawk Area Agency on Aging (JAAA) would be reduced, according to Anderson and the agency.

If the change had not been made, Anderson would have received more than 50 hours of care in July with JAAA’s help. Instead, he received five hours.

Anderson, who retired 10 years ago, has tried to focus on doing what he can on his own at home in Topeka. But the worries haven’t gone away.

“The situation is really going to pot,” he said. “Us old people, you know, we worked and contributed until we couldn’t anymore. Now it seems like we’re just a piece of trash someone just wants to throw out the window. I really don’t want to say that, but I feel like it is how people think.”

According to the Kansas Department for Aging and Disability Services, distribution through the Senior Care Act to JAAA dropped from $560,441 in fiscal year 2015 to $333,343 for 2017. That’s about 40 percent over the two years.

JAAA Executive Director Jocelyn Lyons said the 172 clients her agency serves in Jefferson, Shawnee and Douglas counties depend on a three-tier support system enabled by Senior Care Act funds.

These are emergency medical lifeline support, at-residence attendant care and at-residence homemakers.

Roxanne McNeil, 65, of Topeka, said she’s a little younger and needs less day-to-day care than many seniors in the area, but a workplace shoulder injury she suffered in 2008 has rendered her permanently disabled.

She said it’s difficult to keep her apartment clean and organized with only one healthy arm and hand. Anything she is not able to pick up, lift or carry has to be done by a helper. Her hours per month of assistance have varied at times, typically more than 10, but she is now reduced to five. Like Anderson, her primary income is Social Security.

Anderson said he wants to express his frustration without seeming political. McNeil has no such objection.

“I think Gov. (Sam) Brownback is pretty close to becoming a senior,” she said. “If the man, like me, had a devastating accident that changed his whole life, right now, and he became 100 percent handicapped in some way, and his financial situation dropped out ... he would be lucky to be as I am, to find the friends and support I’ve had at Jayhawk.

“And now he’s pulled the rug out from under us. This is a thorn in my side. A very deep thorn. The public needs to know.”

Angela de Rocha, director of communications for KDADS, expressed surprise at Anderson’s case and said she did not believe such a large cut was necessary, based on the funding JAAA is slated to receive.

“I don’t understand why they would tell him he’s going to go down to five hours,” she said. “That’s (JAAA’s) decision, not ours.”

De Rocha said that in her view, the numbers to justify the cut don’t add up.

“They’re reducing him like 80 percent after we reduced JAAA by 30 percent,” she said.

She added that infirm seniors who don’t qualify for Medicaid and are not getting enough support at the state level should apply for the Medicaid Frail Elderly Waiver to obtain the help they need.

“If he’s on Social Security only, I would bet anything he qualifies for the waiver,” she said.

According to files shared with Anderson’s consent by his JAAA case manager, Theresa Foster, Anderson’s income is $1,152 per month.

His JAAA assistance co-pay is $110 per month, 10 percent of the total cost of about $1,100, Foster said.

She said Anderson may qualify for the Medicaid waiver, but she expects his application would be affected by a significant backlog.

If approved, she said, JAAA estimates his monthly cost for services comparable to what he had before would nearly quadruple to $405.

That creates a difficult situation, Foster said. Either Anderson must learn to live with only five hours per month of in-home attendant care, move into a nursing home or pay a much larger share of his capped income.

“It’s not practical to stay on five hours,” she said. “Bob — well, not just Bob, but most of our clients — have certain needs. He’s been in a nursing home before. He has heart issues, trouble with his balance; he’s very frail.

“The 11 hours per week he had were appropriate for his needs. With five hours per month, his safety and recovery are impeded.”

Foster emphasized that Anderson’s case is similar to those of many JAAA clients.

“He’s just the worst example,” she said. “Most of our clients need between 20 and 30 hours of in-home care per month. They’re all down to five now.”

When informed of this information, de Rocha expressed frustration and skepticism.

“We can’t do anything about these cuts. The policy is in place,” she said. “Let me tell you what the result of this story is going to be: People will post ad hominem insults about me (online), not the policy. I’m sick and tired of getting insulted gratuitously ... It makes me want to scream.”

McNeil said that while she worries about her own needs, which she predicts will increase at the same time public aid decreases, she’s also concerned about those employed in public-good agencies from all sectors.

“My God, look at the employees that the agencies have hired to do these services for you, and they’re all being cut too,” she said. “And the business owners and directors who are specialized in helping us, they’ve lost that revenue, and their employees have lost their paychecks. It’s thousands of people in this state.”

Anderson has no children, but several of his nieces and nephews live in the region. He discounts what he said are suggestions that cutbacks could be replaced by family support.

“Some of them work full time plus part time, if not double full time,” he said. “And they have kids of their own. They can’t do it. I would be happy if the family could help me out more, but they just can’t. And I can’t expect my family members to change their whole lives for me. I’d rather just go terminate in a nursing home.”

Contact the Jayhawk Area Agency on Aging at (785) 235-1367. To find out more about Kansas Senior Care Act programs, as well as the Medicaid Frail Elderly Waiver, go to www.payingforseniorcare.com/medicaid-waivers/ks-hcbs-frail-and-elderly.html.

Marcus Clem can be reached at (785) 295-1192 or marcus.clem@cjonline.com.
Follow Marcus on Twitter @ClemoSeDice.

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