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Seniors' co-pays for day care shrinks waiting list

| Sunday, Jan. 5, 2003

A waiting list of 800 senior citizens in Washington, Greene and Fayette counties seeking state funding for adult home- and day-care services has been cleared, thanks to the state picking up part of the tab.

Under the program, implemented last January, senior citizens pay a share of the costs for adult home-care services. Seniors' contributions are based on their income, with the state Department of Aging paying the remainder.

The co-pay scale is based on individual income, starting at 125 percent of the poverty rate — or $923 a month — and extending to 300 percent of the poverty rate — or $2,215 a month — according to Kevin Longenecker, a specialist on aging services with the Department of Aging.

The program has allowed some seniors who ordinarily would have been awaiting funds from the Department of Aging to receive care much earlier by having them pick up co-pay costs. Co-pays have helped to move seniors at the lower end of the income ladder off the waiting list.

"It is a success story," said Leslie Grenfell, executive director of Southwestern Pennsylvania Human Services Agency on Aging, which matches clients to local services.

Some seniors on the waiting list had to pick up the full costs out of their own pockets, said Shelley Hower, administrator for privately owned Quality Family Care in Canonsburg. As a result, they often scaled back on the days they received care. But such circumstances have changes, she said.

More clients are receiving care for more days because they have to pay less themselves, she said.

Although a boon for patients, the program has driven up financial losses at Washington County Health Center in Arden, according to county human-services director George Krcelich. He said the center this year will lose $35,000 — almost double the $18,000 that it lost in 2001, before the cost-sharing program began.

The problem, Krcelich explained, is the state pays up to $44 per day for clients receiving adult day care, although costs to the center are $58 a day.

"Our employees are unionized, so we pay higher union wages," he said. "Other organizations can pay regular wages. We cannot make ends meet."

The average cost per day for adult day-care services in the state is $42, Longenecker said.

Brookwood Center Inc. in Venetia hasn't been impacted negatively by cost-sharing, said Executive Director Sherri Adams. But, she added, clients certainly have appreciated the benefits.

"It truly was a godsend for the consumer," she said. ""A lot of people on this waiting list passed away, waiting for services."

Brookwood Center client Marjorie Clement, 84, of Venetia, agreed on the program's benefits to seniors.

"It's less expensive now," Clement said.

Although facilities providing care to seniors must be licensed, not all can draw from state and federal money, Grenfell said.

Cost sharing did not change how clients pay for home-delivered meals, protective and legal services, transportation and senior-center services.

Sharing the cost


A sampling of the sliding co-pay scale for the state Department of Aging's consumer cost-sharing program, showing the percentage of costs that clients pay for home services, such as adult day care:

  • Monthly income of $923 to $960: 2 percent
  • Monthly income of $1,551 to $1,587: 50 percent
  • Monthly income of $2,178 to $2,115: 98.5 percent

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