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Now that the sequester cuts are starting to take effect, health care and social service providers are waiting for the other shoe to drop. This is the first in an occasional series highlighting a variety of people who would be affected by cuts generated by sequestration.
By Rose Hoban
Millie Veasey remembers being in London on the day World War II ended in Europe. She was a clerk, part of one of the first African-American support units sent to Europe near the end of the war.
“We were standing below Big Ben, they were ringing the bells, everyone was out on the street, crying, singing,” Veasey remembers.
Now, at 95, her life is less exciting; she lives alone in Raleigh, in the house she bought 45 years ago. But for the last five years, every weekday, she’s looked forward to the volunteer from Meals-On-Wheels who brings a hot lunch to her side door.
“I can get breakfast,” Veasey said. “Breakfast food is not too bad, and I can pick up various things that you can stick in the oven.… But the Meals-On-Wheels gets me the meat, and generally it’s a good vegetable that you have here. I’m able to manage that way.”
Veasey is one of 1,250 low-income seniors in Wake County who get meals from the program. But with the federal budget cuts called “sequestration,” at least 50 of those people will lose access to the program, said Alan Winstead, head of the county program.
Many are people like Veasey, he said.
Cuts and cuts and cuts
About 45 percent of the Wake County Meals-On-Wheels program comes from public dollars – federal, state and county money. Of that, the federal portion is the largest, coming from the Home and Community Care Block Grant; that’s the portion that will be subject to the sequestration cuts.
Winstead said that in 2007, the program served about 363,000 lunches, serving about 1,450 people per day, five days per week, all year. This year, the program will serve 308,000 lunches, which comes to about 1,230 people.
“The problem is compounded because our funding and our fundraising has not kept pace with the need of growing demand,” Winstead said. “In Wake County, our population is growing, the senior population is growing, requests for services are growing and public funding has been stagnant and even reduced.
“It’s not catastrophic, but it compounds the problems we’ve had over the past five years,” he said.
There are dozens of local Meals-On-Wheels programs through the state, along with programs that serve meals in congregate settings such as senior centers and senior day-care facilities.
Each county will make cuts a little differently, said Joan Pellettier, director of the Area Agency on Aging for the Triangle J Council of Governments, the regional planning organization that covers Durham, Chatham, Johnston, Lee, Moore, Orange and Wake counties.
“The sequestration cuts will affect things like transportation, senior center operations and in-home services such as personal care services, where trained individuals go into homes to offer assistance,” Pellettier said.
She said many of these services are cost-effective at keeping seniors at home.
“It’s a lot cheaper than sending someone to a nursing home or an adult care home, where state and federal dollars end up picking up much of the higher cost of residential care,” she said. “Day care might be six or eight hours a day. These kinds of services end up keeping people out of hospitals too.”
“We had girded our loins for something in the neighborhood of 5 percent,” Pelletier said; but depending on the programs, that cut could be a lot higher (see table).
|Sequestration Cuts to Grants Funded By the Older Americans Act|
|Program||FY 2013 Estimate||% Change from FY 2012|
|Home & Community-Based Supportive Services||$9,313,359.00||-11.91%|
|Congregate Nutrition Services||$11,649,351.00||-8.19%|
|Home-Delivered Nutrition Services||$6,123,241.00||-4.34%|
|Source: US DHHS, Administration on Aging|
“Each county has their own committee on aging,” said Lee Covington, who runs Aging, Disability and Transit Services of Rockingham County. “That’s ultimately the group that makes decisions about budgets.
“If Rockingham County loses $20,000, or $100,000, I can’t tell you yet that the money will come off of Meals-On-Wheels. There will be a process so that something comes off of all the services.”
“How do you choose?”
Pellettier said Wake County’s Meals-On-Wheels program serves primarily low-income people over the age of 75.
“Generally, the folks served from the Home and Community Care Block Grant are low-income and older, towards the higher end of the age spectrum,” she said.
Winstead explains there’s also an assessment of a potential recipient’s financial and physical resources.
“If a meal is requested, they do need to go through an assessment. They need to have limited mobility; by and large they don’t drive, they can’t get out without considerable assistance.”
That describes Veasey. She came home from the military and went to school on the G.I. Bill, getting degrees in education. Then she stayed on at her alma mater, St. Augustine’s College in Raleigh, as a teacher and administrator.
“It’s a private institution and they had a little retirement,” Veasey said. “What happens to me is I’m just above the poverty line. I don’t know what I’d do if I had not been in the service and got some VA benefits along with my Social Security.”
She takes a paratransit bus to get to her appointments at the Veterans Affairs hospital in Durham. Someone from church drives her on Sundays from door to door. There are repairs needed on the house and there are problems paying the mortgage. But Veasey doesn’t have the savings to enter a senior residence unless she can also get onto Medicaid.
“This lady served abroad in World War II, came home, did all the right things, went to school on the GI Bill,” Winstead said. “She just needs some help to live at home.
He wouldn’t say if Millie Veasey’s services would be cut; but he did say that some people’s would, and that the cuts would be painful.
“How do you pick which 50 we cut?” asked Winstead. “Facetiously, I’ve thought about sending that list to our congressional delegation and asking them to pick the 50.
“Every one of those decisions has real impact.”