Guest opinion: Sequester hurts the most vulnerable

The 618 Area Agencies on Aging (AAAs) across the nation have been at the forefront of building local community service networks that provide the necessary long-term services and support so critical for older adults to be able to remain at home and in their communities as they age. The Older Americans Act (OAA), first passed by Congress in 1965, has been a key funding source to build and maintain these services through a network of local providers.

But Congress recently dealt AAAs and their community partners a serious blow to their efforts by allowing sequestration, under the Budget Control Act of 2011, to proceed. In doing so, Congress also dealt a serious blow to frail, vulnerable older adults with chronic illnesses who rely on a home-delivered meal, a ride to a medical appointment, heat for their home or respite care to give family members a brief break from their 24/7 caregiving responsibilities.

During the next 15-20 years, the growth in the number of older Americans will increase faster than at any other time in our nation’s history. A key mission for AAAs now and into the future is preparing communities all across the nation for this “age wave.” AAAs leverage federal, state and local funding to develop cost-effective services that provide viable alternatives to nursing home care – and at a fraction of the cost.

The services offered depend on the needs of that older adult or family: It could be a nutritious meal in the home or at a community center; help managing one’s own personal care to be able to stay independent; a class on preventing falls; transportation to medical appointments; or even just minor home repairs.

We do whatever is needed to help an older adult successfully remain in their home and community, thereby preserving their independence and dignity while saving dollars for the system as a whole.

But now, nationwide, the sequester will cut OAA by approximately $87 million in the first year alone. And coming on the heels of years of stagnant funding, that average of approximately 5 percent really hurts the very people we are trying so hard to help.

For the five-county area served by Aging and Long Term Care of Eastern Washington (ALTCEW), Older Americans Act funding will be cut by $153,523 due to sequestration.  Unless Congress acts to repeal or modify the cutbacks, this loss in funding will lead to reductions in services.  For example, we estimate a loss of 14,600 home-delivered meals and 8,800 congregate meals annually.  Funding for van and volunteer transportation will be reduced, and 1,750 fewer rides for medical services will be available.

The ALTCEW governing board recently approved supplemental funding to reduce the impact of sequestration cuts for this year, but the agency does not have the resources to do this next year.

Funding cuts are hitting just as rising populations of seniors and disabled create a “tidal wave” of need for services that help keep families, friends and neighbors in their own homes and out of much more expensive nursing facilities.

Given the high cost of nursing home care, which averages $72,000 a year, compared to the much lower costs of in-home and community-based care, estimated to be one-third of the cost of institutional care, you might think it is a no-brainer to exempt the OAA from the sequester. But no, Congress did not, and the result beginning now and continuing for nine more years if the sequester isn’t turned off is that these critical services and supports will be available to even fewer vulnerable older adults.

Even those who would like to see reasonable reductions in government spending should look closely at what the sequester will actually do. Cuts to critical programs provided through the OAA will lead to a rise in the number of frail older adults with chronic illnesses who are cut off from in-home supports and services. More older adults will suffer from poorer health due to lack of nutrition and preventive services, leading to greater Medicare and Medicaid spending as well as reduced independence. Ironically, the consequences of sequestration may be more expensive than the savings it generates.

Sequestration represents a meat ax approach to budget planning and public policy. We call upon Congress to change course and reach a better compromise that: makes investments, not cuts, in cost-effective home and community-based services and supports; and provides for flexibility, not a one-size-fits-all approach to funding cuts. The current and future well-being of our nation’s growing older population hangs in the balance.

Nick Beamer is the president of the National Association of Area Agencies on Aging, and executive director of Aging and Long Term Care of Eastern Washington.

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