Addressing A Confusing Issue
I hope everyone is enjoying the beautiful summer days in Chautauqua County. I am always amazed at how much there is to do, so I hope you are taking some time to enjoy the bounty. This month I want to address an issue that confuses many people about Office for the Aging programs and services.
People often ask me, “Why aren’t Office for the Aging services free?” Others wonder, “Why does OFA request voluntary donations for transportation, insurance counseling, meals and other services?” They think since it’s “voluntary” that means “I don’t have to give so that equals free.” Strictly speaking, that is true. Voluntary means that you can give what you want for the service and you will not be denied if you are unable to give, but unfortunately that does not mean free. Let’s examine why OFA asks for donations or requires “cost-sharing” for some of their programs while other government agencies do not.
All government programs – whether it is welfare, veterans, Medicaid, Medicare, Social Security, road repair and snowplowing – are supported by funds that come from our taxes. Property and sales taxes are the main way the local government gets its funding to pay for programs. The federal and state governments are also funded by income taxes in addition to fees like those deducted from our paychecks (for Social Security and Medicare) while we work. Some of the money comes back to the local government in the form of grants, that the local government is required to put up a percentage of the cost (ranging usually from 10-35 percent) depending on the program in order to get the funds. Already this is sounding very complicated but to simplify things … all government programs are supported by our taxes in some way, whether it is income tax, property tax, sales tax or other government fees.
When social programs like Medicare, Medicaid, welfare, food stamps and Office for the Aging services were established by federal laws, our elected officials decided whether to make the program a mandate or discretionary funding. Programs that are placed in mandated funding mean everyone who needs it will get it and local governments are required to use their tax dollars to provide these services because they are necessary for people to live. Other programs like Office for the Aging, road repairs and veteran services are discretionary, meaning that they do not have to be provided by the local governments. If they are provided, usually the local government has to put up a larger percentage of the funds, usually 25-50 percent, rather than 10 percent of the mandated programs. When the state and local government puts together a budget, the only decisions our elected officials can really make is how much do we put toward all the “discretionary” programs?
Now this still does not answer the question, why does OFA ask for donations or require cost-sharing? Well, it really goes back to when the Older Americans Act was established in 1965. Back then the government wanted to help older adults after they retired who may be struggling but was not sure how many would need assistance. They put OFA funding under discretionary so they could decide each year how much to spend on the program and they required local governments to ask for donations hoping that the people who used the service would help to pay for it. There are similar programs in the Medicaid system, so people of truly low income get this service without donating.
OFA programs are only given when people do not qualify for a mandated program like Medicaid. Later, the state established other services under Office for the Aging to help people “age in place” who again could not get similar assistance under Medicaid. Using the logic that these people may have the ability to pay for some of the cost since they were not poor enough to qualify for Medicaid, the state required people who use these programs to pay a percentage depending on their income. In theory this sounds like a great system but when all these program including Medicare, Social Security, OFA and others were established, few people lived beyond their 65th birthday.
As the over-65 population explodes, combined with increased costs for health care, food and fuels and increased unemployment, less money is available to put toward discretionary programs. Mandated programs are using more of the tax dollars collected from all sources leaving less for discretionary programs unless of course the local, state or federal government wants to raise taxes . Who is going to vote for that? Certainly not seniors on a fixed income. The government is trying to change this dynamic and that is why Medicare (through the Affordable Care Act) and Medicaid through Medicaid Redesign are being overhauled. This process is not easy and the legislation passed has not been perfect but it is necessary to change programs that were established over 40 years ago since our needs as a people and country have changed.
What this means for OFA is that we are getting less money from taxes than ever before so donations and cost-sharing have become extremely important to ensuring senior programs and services are available for everyone who needs them. OFA has done other things to help our funding situation. We established an endowment fund at the Chautauqua Region Community Foundation. The Mac McCoy/OFA fund gives people who use our services but unable to donate in their lifetime the ability to give back to the program after they pass. Friends and family can make memorial donations to this fund which will only be used for senior services.
OFA has established private pay services like the Chautauqua County medical monitoring. This program uses the buying power of the county to give people who want to purchase this service through OFA a discount. Our monitoring service, similar to Lifeline and Life Alert, is less expensive than others because of our volume purchase. Proceeds from the sales go to help fund this service for people who cannot afford the cost. Even with these measures there was still a long wait for OFA home services, so this year the County Legislature decided to put extra money from our taxes, $250,000, into OFA’s budget to help more people stay in their homes. It’s a tough decision with so little discretionary funds and many programs in the community wanting assistance from the government. I am certainly glad I do not have to be the one to say “yes” to some and “no” to others or raise taxes to say “yes” to everyone.
I hope that this helps everyone to understand our programs a little bit better and you will give more thought to contributing what you can when donations are requested. For more information on programs and services available in our community to help seniors and people with disabilities call our NY Connects Helpline at 753-4582, 363-4582 or 661-7582. Remember we are here to help you.