Whether you live on the East Coast or West Coast, if you use personal assistance your state’s department of aging will pick your pocket more cleanly than a 400-pound-man clears his plate at a cheap buffet. Unless you’re fortunate enough to already be destitute.
Well, when I say “from East to West,” I really mean the relatively small sample of California and Pennsylvania. It seems these two states have something in common: If you’re under 60 and need personal assistance, chances are your state’s personal assistance program might nibble at your wallet but you’ll be left with enough to at least pay your bills. But once you turn 60, you’re shunted over to your state’s aging program and WOO BOY are you GONNA PAY THEN!
Here’s what Maggie Dee in California reports about this:
… when you turn 60 and move into "senior services", yes, one retains services previously received BUT then income comes into play. Example, a good friend turned 60 six months ago. He was on the work exemption for a tiny plant watering job within his apartment complex. THE DAY he turned 60 he was slapped with a "Share of Cost" that was **astounding**. To retain his In-Home Supportive Services his SOC was $810 A MONTH! His pensions (real estate and R.N. work over the years) threw him into a tail spin penalty. He had to give up his home care program (150 hours a month) and moved to the state of Washington with a lot of Latter Day Saints help to survive "as a senior". Seems to me that something is wrong with this pix! It seems like the right hand does not know what the left hand is doing! How can this be bridged? Not only should services remain but with a no-penalty for transferring to senior services. ...
$810 a month … that’s a steep penalty for a guy who’s only “crime” was being gainfully employed. And it’s no better in my home state, Pennsylvania, where Marlene Chait, Ed.D., reports:
My 60th birthday was the last day that I had PAS services from a provider for the PA Attendant Care Program. When I was receiving services under the PA Attendant Care my medical and disability expenses were so high I was told that “I did not have a co-pay for two years.” However, when Philadelphia Corporation for Aging came on the scene they told me my co-pay will be over $1000 a month and they follow the medical model and I would have to have my services before 5 p.m. with many less hours. Refusing, and many communications later, I was put on the waiting list for the Options program. When my name came up, PCA came out a second time and told me my co pay will be over $500. a month with services from a home health agency. I was given the choice to pick a home health agency, which also operates on the medical model. However, I was so desperate I overlooked that the independent living model of consumer choice was not an option and that I did not have a choice. Moreover, it does not matter whether it is a $1,000 a month or $500. a month I do not have that kind of money. PCA knows that I have depleted my savings.
Some might think this is a job for the Community Choice Act and Money Follows the Person. But these initiatives are, rightly so, directed at Medicaid reform and aren’t – yet – designed to reform the aging service delivery for people who aren't poor.
In the past, our movement has had the luxury of being young. Back in the '70s, we were founded by young college students and civil rights activists who were very comfortable pushing for disability programs that were markedly different than aging programs. It made perfect sense at the time. But those who were young in the '70s are now all being shuffled over to aging where, after their bank accounts are emptied and their pensions are depleted, they find the services aren’t half what they are for the under-60 crowd.
Now is the time to do to the aging system what was done for disability programs: Make them affordable, consumer-driven, consumer-responsive programs that do more than give you a bath a week and charge you 100 bucks for the “privilege” of needing your washcloth soaped.
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