Guest blogger: Pamela Piering, Director, Aging and Disability Services, Seattle Human Services Department

The House and Senate proposed budgets are consistent in their areas of cuts to aging services.  For the most part, these changes have been anticipated by aging advocates, although vigorous lobbying for seniors in recent weeks is encouraging a more balanced approach to look at both revenues and cuts.   Here is a quick overview of the similarities and differences of the two budgets with respect to older adults:

• Medicaid Home Care:  the current average cut of 10% in hours across all in-home clients will remain in place for the next biennium.  This means that older adults and adults with disabilities who use personal care services to remain living independently at home will receive significantly fewer hours of care.
• Senior Citizens Services Act:  the proposed $1.16 million cut for the next biennium translates into approximately $156,000/year reduction for King County.  The Act funds a wide variety of social services that support the health and well-being of older adults so that they can live independently in the community. The Seattle-King County Advisory Council on Aging will make recommendations on how to take this cut, and it will likely fall on Client Services funds and some lower priority smaller services.  The countywide priority areas of Information and Assistance, Transportation and Case Management will likely be preserved.  
• Medicaid Case Management rate:  the current rate cut of 3% will remain in place for the next biennium.  This means higher caseloads for the social workers and nurses who coordinate care for elders and adults with disabilities..
• Worker Training:  both budgets provide funding for the expanded basic training for non-family member Independent Providers and Agency Providers only.  It delays the enhanced basic training for all other long term care workers until the next biennium.  

Other cuts include a 25% cut to the state subsidy of health benefits for Agency Home Care workers.  Under additional cuts, clients with developmental disabilities will likely have to choose between adult day health and employment services.  In the Medicaid medical program, funding for hearing aids and eyeglasses are eliminated and there is a limit on occupational, physical and speech therapy visits per year.  Both budgets eliminate most dental care for adults except those in nursing homes or home and community based waiver programs.  Also, both budgets eliminate the Medicare Part D co-pay subsidy for those who are eligible for both Medicaid and Medicare.

 There are a few differences in the budgets as well:

•  There is an add to Family Caregiver Support through the diversion of some nursing home funds.  The House funds this at $3.45 million for the biennium, while the Senate has a higher amount of $6.6 million for the biennium.  This is good news and may offer better training and support to family members who provide so much of the daily care (unpaid) for their relatives.
• The Senate budget requires a new $1 co-pay for Medicaid transportation trips.
• The Senate has a $340,000 cut to the Kinship Navigator program, which assists relatives who are raising younger kin, such as grandchildren, in obtaining needed services.

While these cuts erode a portion of the basic foundation of social/health services for older adults in Washington state, service providers, advocates and planners will all be working together to prioritize services to address those in greatest need.