Funding formula for county services is complicated

There is an often lot of confusion about how the Office for Aging Services are funded and who is eligible to receive services. So, this month I thought I would explain a little history of our programs and services and how it is supposed to help all people over the age of 60 and caregivers of any age.

In 1965, President Lyndon Johnson signed several pieces of legislation creating Medicare, Medicaid and the Older Americans Act. All of these programs are funded by our taxes. Medicare is an insurance that covers acute medical care generally for people over 65. Part A which covers hospital care is fully funded by your taxes, part B is covered by a combination of taxes, premiums and co-pays. Often people do not realize they are paying for Medicare part B as is deducted directly from your monthly social security check. Medicare may cover a limited number of days in a nursing home for rehab or homecare following a hospital stay, but generally does not help people who have long term care needs for ongoing help.

Medicaid was developed as insurance for the poor and this is also funded by our taxes. The difference is Medicaid is available to anyone of any age under a certain income limit. Some differences about Medicaid are that it can pay for acute medical care, it can supplement Medicare (if you have it) and it can pay for long term care for people with chronic health problems who need ongoing help. Since nursing homes are very expensive, most people who enter a nursing home permanently end up on Medicaid within a few months when they have exhausted their own funds. Nursing Homes are not the only option, Medicaid can also pay for care at home for people who have chronic health conditions and qualify for Medicaid.

When congress developed these programs in 1965, they realized there was a gap. Who was going to help older people who were not poor enough to get Medicaid? Who was going to help older people who needed long term help after their Medicare was done paying? And who will be the voice for older people to develop the programs and services they need to help them live their best life as an older person? The Older American Act was part of the solution.

The Older Americans Act established Area Agencies on Aging (AAAs) also known as Offices for Aging (OFA) in New York. Every state has AAAs but some are regional rather than county by county like in NY. These offices are meant to assist older adults when other programs do not. They are not an insurance and do a lot more than provide in-home care for frail elders. Like Medicare and Medicaid they are partially funded by our taxes and also funded by contributions from the people who use the services. Unfortunately, Aging programs are not an entitlement, meaning that it is not guaranteed to everyone over 60. Every year congress sets a funding level for our programs and the local offices have to do the best we can to help as many people as possible. Less than 2 million of our annual budget comes from Federal government. The state and local government pitch in another 3.5 million.

As we have discussed in other articles there are a wide range of Aging programs. There is a home care program similar to what is provided under Medicaid and Veteran’s administration to help the frail elderly who do not qualify for Medicaid or VA care. This program could help anyone over 60 who has a true need determined by an assessment. Unlike Medicaid or Veterans programs, the help is not free. People pay on a sliding scale according to their income, so it is available to anyone who meets the qualifications regardless of income. For those who are very low income they are asked to donate what they can. Most of the 650 people who receive OFAS home care services, pay between 5% and 30% of the cost and OFAs funding pays the rest. (70%-95%), which is a pretty good deal. Any money contributed by clients goes back into the program and helps us to expand services to more people.

While some OFAs programs that are funded primarily by State dollars require cost sharing, many others are available for a donation or “free-will” contribution. Some of these include health insurance counseling, meal programs, health and wellness programs, caregiver support services, legal services and transportation. People who receive services like these will get a quarterly contribution request. These programs are funded by federal funding which requires OFAS to ask for you to contribute but you are not required to give anything. Everyone should examine their own circumstance before donating. These programs are generally available to anyone over the age of 60 because they are not part of Medicaid or Medicare funded services. And of course, OFAS is charged with being an advocate for all older adults so if you are having a problem with Medicare or Medicaid, we will help you free of charge to make sure you get the programs and services you are entitled to.

Regardless of what program you receive from the Office for Aging Services, we always tell you before the services starts whether there will be a cost or not. Services can be canceled at any time without penalty and there is never a contract to sign or a lien on your assets. And of course, you can always get FREE advice about the program and services available to older adults and caregivers in Chautauqua County when you call our NY Connects Helpline at 716-753-4582. Hopefully this helps everyone better understand the role of Office for Aging Services in helping older adults. If you have any questions or comments about what we do to help the citizens of Chautauqua County, please contact us at 716-753-4471 or the number above.

Mary Ann Spanos is director for Chautauqua County Office of the Aging.


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