With less money and more demand, programs for seniors suffer
This post first appeared in the St. Louis Beacon: August 13, 2008 - They call them "meal holidays" or "dark days."
As costs have risen faster than funding, some social service agencies are facing tough decisions about providing meals for the senior citizens who rely on them. Others are looking for ways to keep afloat as demands for help multiply faster than the dollars coming into their coffers.
Because of funding cuts in April and July, some agencies in St. Louis city may stop some meals and services, such as housekeeping. A waiting list has been established for seniors needing meals. Four other counties in the St. Louis area have been slowly cutting back and have been unable to expand their services to meet the growing demand.
All states receive most of their funding for senior programs, such as Meals on Wheels, through the federal Older Americans Act. In Missouri, that amounts to $21.6 million. That total is then filtered down to 10 area agencies on aging, using a formula that includes factors such as income and the number of people over 60.
The area agencies are often referred to as "triple A's." St. Louis city has its own area agency, SLAAA. St. Louis, Jefferson, St. Charles and Franklin counties make up the Mid-East Area Agency on Aging, MEAAA.
Carondalet Senior center works to avoid 'dark days'
The Carondelet Senior Center on Michigan Avenue has a list of days each month circled and highlighted. These are days when meals at the center, home-delivered meals and the transportation to get the food aren't paid for. The center serves more than 100 meals a day to the elderly.
In 2007, Carondelet's budget was $37,313. This year, it dropped to $23,433. Despite a funding shortfall of more than $10,000, the center has been working to keep the food coming.
"We will serve our people," Sister Mary Ann Nestel, head of the Carondelet Community Betterment Federation Inc., said. The organization runs the Carondelet Senior Center.
Nestel and the seniors at the center have been writing letters to state leaders, trying to raise awareness of the shortfalls. Nestel even wrote to Gov. Matt Blunt.
Still, although they have tried, most agencies don't have the staffing or funds to push their cause politically when the Legislature is in session, David Sykora, the head of SLAAA, said.
"One of the things that has traditionally been the problem is not the [representatives] from the cities," said Katrie Spink of the Carondelet Senior Center. "They understand the problem. It's the out-state reps. They view this as welfare, and they won't support this. But they'll vote for crop subsidies every time -- and that's not welfare? The farmers are having a hard time, but we don't have Meals on Wheels. We're not talking about luxury items here. It's just food to live."
Ann Bannes, who heads St. Andrews Resources for Seniors, said that she knows of 52 seniors who have lost services because of the shortfall. The agency managed to find help for some, but not everyone. Seventeen have yet to get the services they need, Bannes said.
"They're just sitting there," she said.
Unfortunately, Bannes said, the problems are only going to worsen. "We have a problem now. If we can't meet the problem now, what are going to do in 12 years?" Bannes said. "I just don't see a lot of sensitivity to this issue on the part of our leaders."
For the seniors gathered in their center on Michigan and for those who open their doors for meals each day, the "dark days" have yet to come. In July, the Sisters of St. Joseph of Carondelet donated the food needed. August and September are also provided for. The staff at the center are determined that there will not be a "meal holiday" if they can help it.
"We all get old," Spink said. "I mean, between (old) age and death there isn't much. We're like the last stopgap for them and when we get hindered, who can they turn to for help?"
In the city, SLAAA uses the money to run its own programs, and it also contracts certain services out. MEAAA runs most of its own senior centers. The city's agency, which gets about 7 percent of Missouri's funding, has $500,000 less to distribute so it has been forced to dip into carry-over funds to pay for seniors' programs, said David Sykora, the executive director of SLAAA.
For 2008, SLAA's budget from federal and state money combined for 2008 was $3.82 million; for fiscal 2009, which began in July, the budget is $3.72 million. Sykora said that the money could be made up for with Medicaid billing later in the year, but that doesn't help now.
Sykora added that the remaining $400,000 of the shortfall came from a lack of carryover funds he had in previous years.
The number of people in need, though, "isn't going to go down," Sykora said. "Nobody is wasting money. These are not luxuries. The amount of money allocated for senior programs -- community-based programs -- is atrocious. Our budget this year is bare bones."
To cope with the lack of funds, SLAAA established a waiting list for services like meals. Since it was set up, the list has had 146 people on it. Eighty-nine people were on the list as of Monday. While Sykora hopes to have those cases served by the end of this week, the problem isn't solved, he said.
"In the next seven weeks, I will probably get 107 more," Sykora said. "And I won't be able to serve them."
Randy Rodgers, deputy director of the state's Division of Senior and Disability Services, says carry-over funds typically act as a sort of savings account for area agencies on aging. But once that money is spent, there's no more money to be had.
"We never want to see an agency in a position where it has to discontinue services to an individual or to scale back services to a group of people," Rodgers said. "Sometimes we have money left and sometimes we don't."
With more than a million seniors in Missouri, Rodgers said the pressure on agencies to provide services is growing faster than the money to pay for it. Rodgers' agency and the "triple A network" already serve between 125,000 and 150,000 statewide.
Sykora has been encouraging all his agencies to get the word out about the funding problems and to contact their elected officials.
Even when an area agency has money to continue providing meals, it must constantly watch costs. John Gamache, director of planning for St. Louis County's area agency, serves over 1 million meals a year.
"If the price of milk goes up 1 cent, it costs us an extra $10,000," Gamache said.
Although MEAAA gets the largest chunk of the funding pie -- at about 22.3 percent -- its increases from the state haven't kept pace with costs.
"It's basically flat-lined," Gamache said.
MEAAA once offered rides to its senior centers in four counties five days a week. Now, it's four days, one day less. To cut costs, it has consolidated kitchens and delivers more meals. However, Gamache said that the agency has been unable to expand services like housekeeping and care-giver support programs, programs that will be in greater demand as the million-plus seniors in Missouri grow in number and need more care.
"There's a whole lot greater need out there than we can provide for," said Gamache.
Amelia Flood is a freelance writer in St. Louis.