Florida Puts More Money Into Community Care for the Elderly

By Diane C. Lade, Orlando Sentinel

Finally, there has been a state funding increase for Florida’s Community Care for the Elderly, one of the first programs in the country focused on keeping seniors at home and out of more expensive nursing facilities.

The extra $1 million approved this last legislative session, which brings the total to $41.5 million, is the first raise Community Care has received in 10 years. But South Florida agencies serving seniors say it won’t go far in whittling down the more than 26,000 people on the waiting list statewide as of July 25.

They predict demand for the program will remain high as the 85-plus population has become one of South Florida’s fastest-growing age groups, according to the U.S. Census.

Community Care provides personal care, delivered meals and other assistance for disabled or frail elders age 60 or older living at home. The average client is 81 years old with multiple serious medical conditions. About half have lost their spouses, and one-third have dementia.

They are people who often live on Social Security checks, struggling to pay for prescriptions and medical treatments, said Robert Beck, a consultant for Florida’s regional aging planning agencies. But their incomes aren’t low enough to qualify them for Medicaid, the health care program for the poor that also pays for in-home help.

“The funding increase will help — a little,” said Linda Rosa, vice president at the Mae Volen Senior Center in Boca Raton, which handles the Community Care program for south Palm Beach County. “But we have so many people waiting for services.”

Case workers say they have seen seniors unable to afford home care or transportation, some who are living alone or are seriously ill, die before their turn came. Jaime Estremera-Fitzgerald, CEO of the Area Agency on Aging of Palm Beach/Treasure Coast, said the need has climbed as longevity has increased along with South Florida’s cost of living.

“These are people who have paid their bills and been responsible. But they didn’t expect to live this long and now they don’t have any extra income,” he said.

There are about 4,000 in Palm Beach County and 1,100 in Broward lined up for Community Care slots. The funding increase will take about 200 people statewide off the list, officials say.

The extra dollars, appropriated by state legislators, are earmarked for those who are the most disabled, isolated and sick. The district serving Miami-Dade and Monroe counties will receive the largest share, about $358,000. The single-county Broward district will get about $35,000, and the five-county district including Palm Beach County, about $84,500.

Created about 30 years ago, Community Care soon became one of Florida’s signature elder services for its then-novel approach: spending public dollars on in-home care to save taxpayers from footing costly bills later, when seniors depleted their savings. The home-based services cost $5,340 per person annually in 2011, compared with $58,056 for nursing home placement, according to the state Department of Elder Affairs, which manages Community Care.

To qualify for service, seniors must be evaluated and determined to have serious physical or mental conditions that put them at risk for living at home. They pay for part of their care based on income.

Despite Community Care’s popularity, legislators rarely increased its funding. Instead, they invested in new Medicaid programs offering similar services as the federal government matched the state’s contribution slightly more than dollar per dollar.

That move shut out tens of thousands of middle-class elders who weren’t impoverished but had limited finances. Most Medicaid programs allow an individual to have $2,000 in assets and about $1,100 in total monthly income.

The Community Care appropriation in fiscal year 2007-08 was $43.4 million. This past fiscal year, before the increase, it was $40.5 million. In the same time period, Medicaid’s Aged and Disabled Waiver appropriation grew from $85.4 million to $103.8 million.

Sen. Nan Rich, who sponsored the amendment authorizing the Community Care increase, said Florida needs to up spending on measures helping seniors age in place if they are able. Not only will it save Florida millions on its share of Medicaid nursing home costs, it will allow elders to “preserve their dignity and independence,” said Rich, D-Weston.

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