Cincinnati Enquirer For seniors, levy a lifeline Tough times mean fewer services 10:13 PM, Aug. 4, 2012 Purchase Image Gary Skibinski, care manager with the Council on Aging of Southwestern Ohio, talks with Elizabeth Matchem, 101, who lives alone. She receives medical transportation, homemaker services and lifeline services through the Council on Aging. The agency for the second time in five years faces cutting services. Though its rate would stay the same, the senior services levy will generate fewer dollars than it has in the past. / Photos by Cara Owsley/The Enquirer Written by Sharon Coolidge Colleen and Mike Ellis raised three daughters in Norwood. He worked at General Electric; she worked at Kroger. They dreamed of a retirement spent traveling. But complications from surgery two years ago left Mike Ellis, 70, with kidney and brain damage. Instead of traveling, Colleen Ellis, 68, has spent the time since that surgery nursing her husband, who now uses a wheelchair. She can t leave him alone.
Elderly Services Program comparison Though they get pensions, Mike Ellis care is so expensive that without help from the Hamilton County senior services levy he would have had to go to a nursing home. The levy pays for seven delivered meals a week and for a caregiver to come three times a week to bathe Mike. The same aide comes twice a week at night so Colleen can get a few hours of unbroken sleep. We enjoy our freedom, Colleen Ellis said. Here, we can sit on the porch, we can watch TV, there s companionship. The senior services levy will be on the ballot this fall; it s virtually guaranteed to pass, as it has each time since it was first on the ballot in 1992. Five years ago it passed with 70 percent of the vote. The key decision about the levy one that will affect the people who use it and the Hamilton County taxpayers who pay for it will actually be made this week. Commissioners must decide by Wednesday on the funding level. For the first time in the levy s history, commissioners are pondering cutting it. The owner of a $100,000 home currently pays $29.32 to support the levy, which brings in about $19.6 million a year. Property values across the county have decreased, meaning that same rate will now bring in about $19.1 million a year. Commissioners plan to leave the rate unchanged, reducing funding to the lower level. They could raise the millage to keep total funding the same. The agency that administers the levy, the Council on Aging of Southwestern Ohio, has agreed to the cut. President and chief executive Suzanne Burke said living on less is possible, but at a cost: Fewer seniors will get services. Services will be targeted to the most frail, she said. We recognize families and individuals are struggling, Burke said. So we felt like the best position was to try and live within the parameters set and make the changes as needed.
Commissioners also are considering funding for the Mental Health Levy, which will also be put to voters this fall. Hamilton County Board of Commissioners President Greg Hartmann, a Republican, said that no amount of money would be enough to match the need. We have to balance the important services and the missions the senior services levy and the mental health levy against increasing tax burden when people are earning less and their homes are worth less, he said. Commissioner Todd Portune, the board s lone Democrat, said last week that commissioners must make sure the levies are set at an amount that citizens will approve. We d all like to put on a levy that is helpful as can be, but that is not the answer, Portune said. We have to consider whether it s on at a rate that will pass. Republican Commissioner Chris Monzel said citizens need do ask, Why do I have all these levies? and question who s getting what. A citizens committee appointed by commissioners to examine the agency s operations says the agency can cut more than it has. It suggested the Council on Aging of Southern Ohio raise eligibility to age 67 from 60 now require proof of citizenship and limit advertising. The expected cuts come as the number of seniors is about to balloon. Nearly one-fourth of Hamilton County residents will be age 60 or older by 2020, up from nearly one-fifth in 2010, according to Miami University s Scripps Gerontology Center. Ohio has 12 senior agencies. Southwestern Ohio s serves Butler, Clermont, Clinton, Hamilton and Warren counties. The local Council on Aging operates a call center and oversees federal, state and local long-term care programs that help seniors and adults with disabilities remain in their homes. The typical client: an 82-year-old disabled woman, living alone on a modest income. In 2011, the Hamilton County Elderly Services Program served 7,259 seniors. The average monthly cost per person is $349.
Hamilton County contracted with 58 providers in 2011 to provide home care, emergency response lifeline systems and home-delivered meals among other things. Commissioners paid former Cincinnati City Manager Jerry Newfarmer s consulting firm Management Partners $63,500 to study how well the agency was spending tax dollars. The conclusion: The Council on Aging is a well-run organization that has sought to maximize the value of the levy for the citizens of Hamilton County. Some clients never heard from; others call every day Gary Skibinski has been a care manager for the local Council on Aging for 14 years. At 65, he s older than some of his clients. He came to the job after years first as a Franciscan friar and then as a disaster-relief worker for the American Red Cross. He has 148 clients right now. I had more, he said, but some went to Heaven and some went to nursing homes. He sees clients on a need basis. Some need more attention than others. He visited Elizabeth Matchem, 101, in the East Side home where she has lived for half of her life. She can still do that because she has help from Hamilton County s senior services levy. It provides home-care assistance, a combination of homemaking help and personal care; a call-for-help alert system and medical transportation. It also gave Matchem a walker and an easy-to-get-out-of chair. Matchem tells Skibinski: I don t want to live in a nursing home. Skibinski: You don t have to. He chides her for venturing down to the basement to do laundry. She laughs and says she s particular about clothes. As he says goodbye, Matchem tells him that she appreciates his stopping by. She follows him outside onto the porch, where she ll wait for the mailman in the warm afternoon breeze.
Some clients you never hear from. Others will call everyday, Skibinski said. Care manager brings company and a smile Melanie Wiechel pulled up to Mary Veser s neatly kept ranch on a quiet Colerain Township cul-de-sac, laptop in hand, smile in place. As Veser s care manager for services from the Council on Aging, Wiechel visits the 91- year-old a few times a year. Veser is one the 120 clients for whom Wiechel is responsible now. Though Wiechel said, I try not to count. She was checking whether Veser still needs more help than she s getting. A health aide, provided by levy dollars, answered the door. It s good to have the company, said Veser as she slowly maneuvered her walker into the dining room. Her son and grandson often check in on her, family that many council clients don t have. She came on the program in January 1997 after her husband s death. Veser can t raise her arms much above waist level because of painful, crippling arthritis. She has brief tremors, too. Still, she cooks for herself and hosts a weekly pinochle game. The levy pays for house cleaning, bathing services and medical transportation. Veser answered Wiechel s questions. No, she hasn t fallen in the last six months Yes, she can see OK, thought her eyesight isn t what it was. Yes, she probably needs a hearing aid, but she doesn t want one. Do you need any other services? Wiechel asked. No, I would be ashamed to ask, Veser said. Don t be, Wiechel said. They hug goodbye.
Have your say Contact the commissioners: Greg Hartmann: (513) 946-4405 or greg.hartmann@hamilton-co.org Chris Monzel: (513) 946-4409 or chris.monzel@hamilton-co.org Todd Portune: (513) 946-4401 or todd.portune@hamilton-co.org Proposals from the Tax Levy Review Committee and the Council on Aging s response on: Advertising Review committee: The agency should cut its ad spending. They aren t advocating concealing services but said there is a fine line between making eligible seniors aware of available services and creating demand for such services among the more general population.
Agency response: We have an obligation to make sure people know what is available. Advertising is a very small amount of total outreach. Between Jan. 1 and June 30, the agency spent $12,674 on advertising. That s a little over one tenth of one percent of the levy revenue from that period. Requiring proof of citizenship Review committee: The agency should require it. This is not meant to discriminate against any group, but rather to help keep programs actuarially sound. Agency response: Clients must live in Hamilton County. U.S. Administration on Aging rules state these services cannot be denied to a person based solely on citizenship status. So if you do test and services are denied, the agency would lose approximately $1.2 million a year in federal Older Americans Act revenue. That money helps reduce the burden on county taxpayers. If we were to require proof of citizenship, we don t think we would find more than a million in savings by denying services to illegal immigrants. Raising the minimum eligibility age for levy-funded services Review committee: If further restrictions are put in place, upping the age limit should be looked at first. If suggested benefits start at age 67, the age at which full Social Security retirement benefits are given. Right now the Hamilton County levy helps 316 clients ages 60 to 67 or 6 percent of the total enrollment. Agency response: This is not a retirement program. It is for seniors who are disabled or impaired. There are younger people with more serious issues, like early dementia, chronic disease and the aftermath of strokes. Those people could end up in a nursing home at a far greater cost. Hamilton Butler Clermont Warren Franklin Annual levy revenue $20,713,926 $10,974,162 $5,721,193 $6,110,248 $25,810,605 Total operating revenue for levy $22,920,759 $11,885,883 $7,620,214 $6,585,694 $27,226,990 Total operating expenses for levy $22,920,759 $11,885,883 $7,046,147 $6,585,694 $26,757,826 Administrative cost for levy Not $1,297,401 $828,640 $714,557 $391,070 separate Intake & assessment cost for levy Care manager cost for levy $226,391 $238,899 Not separate $90,416 $3,485,527 $1,893,879 $930,683 $1,071,999 Not separate Number of levy supported clients 5,477 3,027 5,000 1,766 7,134 Number of care manager for levy 41 24 15 14 67 Number of service providers for levy 49 50 1 36 90 Number of programs offered 14 16 9 9 County population, 2010 census 802,374 368,130 187,363 212,693 1,163,414 Average total operating cost per client Average program cost per client served $4,185 $3,927.00 $1,409.00 $3,729.00 $3,751.00 $3,270.00 $2,948.00 NA $2,849.00
Administrative cost per client served Intake and assessment cost per client served Care manager cost per client served Clients per care manager Source: Managing Partners, consultants In depth: Compare programs Hamilton Butler Clermont Warren $237.00 $274.00 $143.00 $221.00 $41.00 $79.00 NA $51.00 $636.00 $626.00 $186.00 $607.00 133 126 333 126 Franklin 106 See how Hamilton County s elderly services program compares with those in other counties. Read last week s story about the mental health levy at Cincinnati.com/elections. Sharon Coolidge I m your Hamilton County watchdog. I tell you what your elected officials are doing and keep track of how they spend your tax dollars. Follow me on Twitter @Moxiegirl10. Find me on Facebook or e-mail me at scoolidge@enquirer.com