Area Agencies on Aging (AAA) across Missouri and the nation will see many changes over the course of the next few years as they try to accommodate increased budget cuts while serving an expanding population of elderly.
Northwest Missouri AAA Executive Director Rebecca Flaherty, Albany, explained how the agency has seen a decline in funding over the past several years and shared how the future will hold even bigger decreases in state and federal monies.
She stated that neither state nor federal funding have kept up with inflation over the years. Of the 24 services funded by the Northwest AAA, only two, home-delivered meals and transportation, receive significant funding from the state.
The federal budget for discretionary spending, including funds for the AAAs, was cut by one percent last year, two percent this year and will be cut another three percent next year. USDA and Family Caregiver monies received additional cuts this year and social service block grants were slated for elimination in the federal 2018 budget.
In 2008, under Obama’s stimulus program, Missouri used stimulus money to replace $1.9 million of the $2.9 million in general revenue reductions for AAA’s home-delivered meals programs. After the stimulus payments ended, the state did not reinstate the general funds. The current funding for home-delivered meals is still below the 2009 level.
Monies are distributed from the federal and state governments by an intra-state funding formula based on demographics targeted by the Older American’s Act. The state and the AAAs receive funding based on the percentage of elderly population in the service delivery areas.
Missouri loses capital each year because other states have a bigger elderly population percentage. Missouri’s Northwest Region AAA sees additional cuts due to a smaller elderly population compared to other regions in the state.
On July 1, the state government changed qualification requirements for Medicaid. Seniors who no longer qualified were referred to the AAA for services, resulting in an influx of clients.
Medicaid also cut the rates distributed for services, further hurting the AAA reimbursements. Flaherty stated that both federal and state governments are looking for ways to cap the Medicaid monies.
One way is to block grant Medicaid. According to Flaherty, the state government currently has to raise the Medicaid budget more than once a year to keep up with the federal money match. Block granting Medicaid would greatly impact the AAA and other service providers.
“There are so many people and so many needs with a finite pot of money. The 40-year model won’t work going forward,” Flaherty said.
Senior centers take up business models
She believes senior centers will need to start functioning as businesses in order to survive because government funding will not be enough.
She explained that other areas in the state are seeing an increase in for-profit service providers moving in and offering services to seniors for a fee, making “lots of money.” As a result, the higher-income seniors have moved to the private companies, leaving the senior centers and AAAs with poorer clients.
These companies have moved north through the state, are in Kansas City and have started moving into the St. Joseph area. By working under a business model, a non-profit organization like a senior center could take the money raised through services or memberships and invest it back into serving those who can’t afford to pay.
“If we don’t get a jump on this, we are going to be in trouble and our people are going to be in trouble. If you don’t have the contributions and donations and volunteers of one group, you serve a lot fewer of this group,” Flaherty said.
She believes these for-profit companies will eventually eliminate local senior centers. The original intent of the Older American’s Act was for individuals with the resources of time and money to help support those with less.
“Across the nation, senior centers are closing every year. In Missouri, the number of senior centers has decreased by seven percent in the last four years. There’s not enough money. We are trying very hard to be proactive up here. People’s expectations and wants are not necessarily what we can fund with government resources,” Flaherty said.
AAA directors across the state have implemented pilot programs to bring costs down. Missouri’s central region went to all frozen meals for home-delivered meals several years ago, and after working out the challenges, they saw success.
The Nodaway County Senior Center will start two new pilot programs in September. See story below.
“People will go hungry if we don’t do something. It takes making those hard decisions. Our goal as an agency is to make sure people don’t go hungry,” Flaherty said.