By Diane C. Lade, South Florida Sun-Sentinel
More than a thousand South Florida seniors are waiting for in-home services, like home-delivered meals and personal care aides, that are financed through the federal Older Americans Act. But Holocaust survivors could get priority when slots become open in those programs under a bill recently introduced in Congress by local lawmakers.
The timing may make its passage sticky, however, as the automatic sequestration budget cuts snipped almost 6 percent out of local Older Americans programs earlier this year. And there could be more cutbacks in 2014.
The legislation provides no new funding, which would leave local service agencies responsible for figuring out how to fairly divide a shrinking pie. There already are 4,175 seniors on the wait list in a five-county service area including Palm Beach County, and 131 in Broward.
While other recent measures to update the 1965 act have foundered, the Holocaust bill has supporters on both sides of the political aisle, giving it a better shot at success.
“Generally speaking, bipartisan bills have a better chance of surviving the political negotiations that are part of the process,” said Aaron Tax, director of federal government relations for Services & Advocacy for GLBT Elders. His group is pushing for act changes benefiting gay and lesbian seniors.
South Florida programs financed through the Older Americans Act include hot lunch sites, van rides to doctor appointments and senior center activities. The demand is highest for at-home services, which often have a waiting list: home-delivered meals, help with bathing and dressing, light housekeeping.
Advocates for Jewish seniors and the bill sponsors say aging survivors should be given preference, because care allowing them to remain at home is critical. Institutional settings like nursing homes can trigger painful memories of being imprisoned in concentration camps.
“Something as simple as being taken to the shower can be traumatic,” said Danielle Hartman, president and CEO of Ruth Rales Jewish Family Service in Boca Raton.
Studies also have shown survivors are more likely to have chronic medical conditions or mental health problems stemming from the trauma they endured 70 years ago, and tend to have lower incomes.
“We have a moral obligation to acknowledge the plight and uphold the dignity of Holocaust survivors to ensure their well-being,” said House bill sponsor Rep. Debbie Wasserman Schultz, D-Weston. Rep. Ileana Ros-Lehtinen, R-Miami, was the House co-sponsor of the Responding to the Urgent Needs of Survivors of the Holocaust (RUSH) Act, which also was introduced in the Senate.
South Florida is home to 17,000 of the 120,000 survivors worldwide still living. Their numbers are declining rapidly, as they now are in their late 80s or 90s.
Many other special interest groups, however, have started insisting their seniors are at risk, too, and need special attention. Separate bills have been filed in recent years seeking federal priority status for LGBT seniors, those with HIV or Alzheimer’s disease, and veterans.
They’re looking to tap into a clause of the Older Americans Act stating that while these programs are open to anyone age 60 and older, preference must be given to those who have the greatest “social and economic” need. Currently, that list includes seniors with low incomes, particularly if they are minorities; those who speak little or no English; and residents of rural communities.
Part of a bill that would reauthorize and strengthen the act, introduced by Vermont Sen. Bernie Sanders about two weeks ago, suggests greatly expanding the priority category. It includes Holocaust survivors along with veterans, Alzheimer’s patients, LGBT seniors, abuse and exploitation victims, and seniors with physical and mental disabilities.
But the legislation so far has no Republican sponsors. Tax said it’s considered a “starting point for negotiations.”
Broward received $6.4 million in Older Americans Act money this calendar year, with the five-county area including Palm Beach County receiving $7.8 million.
Service providers said seniors already enrolled in Older Americans programs won’t be dropped and replaced with priority applicants even when there is a waiting list. But agencies do consider priority status when a program spot opens, providers said, along with using a state ranking system that looks at frailty, if the senior is living alone and other such factors. And Older American dollars may be more likely to be funneled to new programs targeting priority populations, they said.
The more priority groups there are, the harder it will be to make those choices, said Mark Adler, executive director of Broward Meals on Wheels. “You end up weighing the needs of different populations against each other,” he said.
Organizations serving other populations vying for priority designation point out that while Holocaust survivors have pressing needs, so do their seniors — and fairness debates are bound to come up.
Mary Barnes, president and CEO of Alzheimer’s Community Care, said there are far many more Alzheimer’s patients in South Florida than Holocaust survivors, with the fatal untreatable neurological disorder taking a high toll on community resources as well as families. Her West Palm Beach-based service agency, whose clients include Holocaust survivors, last year had requested Older Americans money for a caregiver and staff training program but was turned down.
“When you start singling out special groups, it takes away from the larger picture of what’s best for society,” she said.
Jewish social service agencies hope that if the bill passes, they’ll be able to create new initiatives as more survivors are coming to them for help as they age. Many of them are alone, having lost most of their immediate family in the Holocaust.
Jewish Family Service of Broward County provides services ranging from emergency payments for rent and utilities to mental health counseling for about 600 survivors through a $3.5 million grant from the Conference on Jewish Material Claims Against Germany. But CEO Kenneth Moskowitz is concerned that survivors will land on home care wait lists, and be more likely to end up in nursing homes.
“For me, the focus of the bill is to help survivors stay in their homes as long as possible,” he said.