Thursday, July 24, 2014
   
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Sequester hits home—at meal time

Little by little, the mandatory federal budget cuts Congress authorized—formally called the sequester—are beginning to pinch across most all government programs. One program that will clearly feel the impact affects home-delivered meals for the country’s oldest and most vulnerable people.

These are the invisible hungry that don’t have a loud voice in Washington. They are too frail or too proud to stand on the streets and beg, but they depend on money from Congress as well as state and local governments to fund meals that are delivered to their doors usually once a day five days a week. In some parts of the country they are on waiting lists—sometimes for as long as a year—for a meal because local programs are short on funds to provide them, and the number of people needing food continues to rise.

According to the Meals-on-Wheels Association, a group representing senior nutrition programs across the country, about five million seniors over age 65—11% of the senior population—faced the threat of hunger in 2005. Today almost 15% do.

“Between 2001 and 2010 we have seen a 78% growth in the number of seniors facing hunger,” says Enid Borden, founder and president of the National Foundation to End Senior Hunger.

The Center for Effective Government, a Washington-based watchdog group, estimates that the sequester will result in a $10 million cut in home delivered meals authorized under the Older Americans Act. How those cuts trickle down to local programs and affect seniors varies from state to state. In the end a specific program decision to cut services depends on what other funding sources are available and what other obligations the program must meet.

In Nebraska the federal Area Agencies on Aging had been bracing for sequester cuts, but Rod Horsley, executive director of the South Central Nebraska Area Agency on Aging in Kearney, told me that left-over funds from previous years will prevent the sequester cuts at least for this year.

Some parts of the country will see reduced services very soon. In New Haven, Conn., for example, Kathy Pontin who directs the meal program, say she must cut her budget by 5 to 6% to comply with the sequester. That means 5,500 fewer meals served next year. She knows her waiting list will begin growing again, but she says you can’t call someone and say “Guess what! You’re not going to get a meal any more.’”

In Nebraska the federal Area Agencies on Aging had been bracing for sequester cuts. But the problem won’t become serious right away. Rod Horsley, executive director of the South Central Nebraska Area Agency on Aging in Kearney, told me that left-over funds from previous years will prevent the sequester cuts at least for this year.

Nebraska is hardly out of the proverbial woods, though. Horsley explained Nebraska programs might face funding shortfalls next year. Rural Nebraska counties have lost population according to the 2010 Census, and the federal funding allocation for the meal programs is based on the number of people age 60 and older. As that population goes down, so do funds, which means other sources like local and state governments or community fund raising must fill in the gaps. “It’s not a beautiful picture by any means,” Horsely said.

Some programs offer a private pay option that allows families to buy meals when no government-funded slots are available. Program directors say fewer and fewer people are able to pay privately as families find it hard to come up with the money to pay for meals for their loved ones.

It’s not uncommon for a person to begin paying privately, but stop when funds run low. When they stop the meals, they usually don’t say they can’t pay for them. Most elders don’t like to admit they have no money for food.

Home-delivered meals financed under the Older Americans Act are free to anyone over age 60 and who demonstrates a need for the program (often determined by assessment forms and point scores). But recipients often make voluntary contributions toward the meals. Those, too, are going down.

The Center for Effective Government argues that cutting funds for food, which is so basic to the health of the elderly, may be pennywise and pound-foolish. Cutting funds for meals-on-wheels will end up costing the government some $479 million over the next seven months in nursing home costs paid by Medicaid. Malnutrition is a major reason for costly hospital and nursing home admissions and readmissions.

“We’re cutting the very basic needs of human beings at a time when we’re trying to cut health care costs,” says Christie Hinrichs, president of Tabitha Health Care Services, a meal provider in Lincoln.

It isn’t just some bloated bureaucracy that gets hurt by the sequester. Those affected may well include real people in your own communities and your own families.

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