Senate plan to boost Alzheimer’s program could affect other services for aging residents

tgoldsmith@newsobserver.comMay 31, 2013 

  • What $2.9 million buys

    A state Senate budget proposal would cut $2.9 million from the Home and Community Care Block Grant, a fund that pays for services for aging people across North Carolina. Republican budget writers note that the money cut would go to higher funding at Project CARE, a nonprofit that gives a break to people looking after friends or relatives with dementia. Respite care is one of the services covered by Home and Community Care Block grants, so the cut would be partially restored by Project CARE, Sen. Ralph Hise said.

    According to the state Division of Aging and Adult Services, a $2.9 million trim for the budget year could mean:

    • 900 seniors could lose 135,000 home delivered meals.

    • 600 seniors could lose 48,000 trips.

    • 430 seniors could lose 71,000 in-home aide hours.

    • 75 people could lose 7,500 days of adult day care/day health care.

    • Other services will also take cuts. Additionally, 1,500 older people are expected to lose services because of federal funds sequestration.

The Alzheimer’s respite program known as Project CARE has gained broad support for its work of providing a break to caregivers for people with dementia.

But many aging advocates say that a state Senate budget proposal to increase funding for Project CARE from $500,000 to $2.9 million would come at the expense of more than 20 other services for older North Carolinians – from home-delivered meals to adult day care to rides for people with medical appointments.

More than 15,000 people are on waiting lists for those services across the state. Counties take the lead in picking the services that residents need most among those supported by the Home and Community Care Block Grant, which is composed of state, federal and local funds.

In Wake County, the block grant cut of $300,000 in state funds – along with an ongoing $100,000 decrease because of federal sequestration policies – would mean a loss of about 32,000 home-delivered meals in the fiscal year beginning July 1, said Alan Winstead, executive director at Meals on Wheels of Wake County.

“Some of our people call, and they have a very short-term and immediate need – they’re having surgery and are unable to drive,” Winstead said. “Those people will have to look for other services.”

Though other agencies can offer food to clients, there’s no other source for home-delivered, prepared meals, he said.

Visits from one of the many Meals on Wheels volunteers in Wake provide significant regular nutrition and check-in for more than 1,200 clients, such as Raleigh resident Hattie Thorpe, 78.

“They’re so nice and sweet,” Thorpe said. “They come every day, except on the weekends.”

Support for Project CARE

Senate budget writers say the $2.9 million decrease in the block-grant fund will allow a fivefold increase in Project CARE, for Caregivers Running on Empty.

Sen. Ralph Hise, a Spruce Pine Republican, said expanding the respite program will allow it to serve caregivers across the state instead of those in the about 25 Project CARE counties. Respite services are available in some other counties through other programs.

“Our point of view on putting money in the budget is that we’re prioritizing for services being used statewide,” Hise said. “There are counties that do not provide respite care.”

Mary Bethel, a lobbyist for AARP in North Carolina, said aging-advocacy groups fully support Project CARE, but they don’t want it to be funded through money that’s needed for a range of other services.

Hise pointed out that the state would still pitch more than $26 million into the total $60 million block grant fund. Planners want to make sure services are equitably provided, he said.

Although it could have a stark impact on older people seeking to live independent of institutional care, the dispute over how to fund social services represents a relatively small piece of the negotiations over next year’s budget among House and Senate budget writers and Gov. Pat McCrory.

McCrory’s budget set aside $500,000 from sources other than the block grant to continue Project CARE, with plans for future expansion in the works at the Division of Aging and Adult Services.

Advocates for older North Carolinians met Thursday with state Rep. Marilyn Avila, a Wake County Republican, to urge her to work to restore the money that Senate budget writers set aside from the fund. Efforts to reach Avila for comment were unsuccessful.

‘More resources are needed’

David Cottengim is president of Resources for Seniors, the agency responsible for providing many of the Wake County services, as well as co-chairman of the GOLD Coalition, another nonprofit advocacy group.

“Aging advocacy groups support increased funding for both the home and community care block grant and for Project CARE,” Cottengim and GOLD Coalition co-chair Liz Scott said this week in a letter to The News & Observer. “With the increase in the older adult population in the state – the population of those 65-plus will almost double in the next 20 years from 1.3 to 2.3 million – and the continuing rise in the cost of delivering services, more resources are needed to help those who need assistance.”

State figures show that 7,000 fewer people get help from the block grant with home care, transportation, adult day care and other services than did 10 years ago.

Goldsmith: 919-829-8929

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