AGING SERVICES PROVIDED TO MEET THE UNMET NEED
In my last Threescore article, I reported that advocacy efforts were needed to encourage state legislators to vote for the additional aging funding recommended in the Governor’s Executive Budget. I am extremely happy to report that our advocacy efforts have succeeded. Effective April 1, 2019, NY State legislators enacted the 2019/20 state budget. An additional $15 million dollars was approved in the state aging budget to help provide services to seniors that are waiting for services.
As the population ages, the service needs continue to grow. Local aging agencies are hard pressed to keep up with the demand. Frequently seniors have to wait for services to become available. With the provision of these additional funds more seniors will receive the necessary preventative services to help them remain at home as long as safely possible and to prevent or postpone more expensive institutional long term care (nursing homes).
Aging agencies report the unmet service needs to the state annually. The primary services identified as an unmet need are: personal care assistance (light housekeeping and personal care), case management, home delivered meals, transportation, Personal Emergency Response Services (PERS), and legal services.
Prior to the approval of this additional funding, Wayne County Department of Aging and Youth had made a concentrated effort to reduce or eliminate our waiting lists for the core services listed above.
Personal Emergency Response Services – PERS, the pendant/unit we provide eligible seniors to alert if the senior requires emergency services. Last year, through our advocacy efforts, aging agencies were awarded additional Community Services for the Elderly (CSE) funds. With those extra resources, we were able to eliminate our PERS waiting list. Over the past several years our department had only been able to serve 160 clients with PERS units. With the increased CSE funding, we were able to serve the extra 40 seniors on the waiting list by the end of 2018.
Home Delivered Meals– This waiting list has also been eliminated. More eligible seniors are being provided meals due to the reduced home delivered meal cost provided by our new contractor, ARC of Wayne. Meals to seniors have increased from 36,000 to 42,000 annually without any additional county cost.
Case Management no longer has a waiting list. Each case worker carries a caseload of approximately of 50 clients. In 2018, we served 146 eligible seniors and had a wait list of 11 clients.
Legal Services– Our agency was able to increase the funding by 25% last year to better meet the demand. Last year we were able to serve all 60 seniors seeking legal services.
Personal Care Assistance Level I (light housekeeping) fortunately, our office has been able to keep up the demand for the housekeeping services by contracting with a second vendor, Home Instead. The Home Instead contract was able to fill the surplus demand for housekeeping services.
Transportation –our agency provides limited transportation to medical appointments and to our Lunch Club 60s. In 2018, we teamed up with Wayne CAP’s RSVP program which coordinates volunteers to drive seniors to medical appointments. With Bullis Foundation grant funding, we were able to assist Wayne CAP in providing a full mileage reimbursement to their drivers and performing background checks. We also assisted them with recruiting drivers. In 2018 we offered 61 senior riders almost 2000 rides and through our partnership with Wayne CAP, were able to support an additional 126 senior riders for an additional 1342 rides. Transportation will always remain an issue in a rural county.
The primary service that we still struggle to meet the demand is for:
Personal Care Assistance- Level II– (showering, feeding, transfers to chair/bed/toilet and grooming).
Our agency has attempted numerous strategies to increase the availability of PCA level II aides in Wayne County. The issue is not necessarily the lack of funding but the shortage of available personnel to provide this critical service. PCA aide shortage is not just a county problem but a national dilemma.
Currently our department has a significant wait list for PCA Level II services. There is only one provider in Wayne County that currently provides this service to multiple agencies. Out of the 143 seniors receiving aide services approximately 30 active clients are assessed eligible for PCA level II services but are still on a waiting list.
In 2018, there were 8 people on the waitlist for a year or more in the hard to serve areas in Wayne County. The average length of time waiting for level II aides is approximately 6 months. Unfortunately, 14 of the 30 clients were closed to services prior to ever even receiving PCA service (2 died, 4 went into nursing homes or on hospice, 5 made other arrangements with family or hiring privately, 3 applied for Medicaid and Managed Long Term Care Services). About 6-8 people lost their aide service as a result of going in to the hospital and having their aide reassigned and no aide being available when they were discharged.
The Department of Aging and Youth is currently collaborating with the Department of Social Services and Wayne County Public Health Department to develop strategies to address the shortage. Next month we will be exploring possible options to address the workforce shortage with the Board of Supervisors. I will update the results of our recommendation in the next issue of the Threescore.