Budget cuts mean 50,000 fewer senior meals, empty offices at Department on Aging

Walk into the Iowa Department on Aging’s office and you’ll see a darkened area where a receptionist once sat.

Nearby are empty offices and bare desktops.

The department has 17 employees, 40 percent fewer than if it was fully staffed. The agency has 11 vacant positions and they are going to remain vacant.

“We are never going to be able to fill them,” department Director Linda Miller said, shaking her head.

Miller said she hasn’t asked Gov. Kim Reynolds for additional funding partly because Reynolds and her staff are already aware of the effect that the budget cuts are having.

“In my opinion, those people are not stupid over there and they know what’s going on here,” she said. “But we’re making it work.”

'We are unavailable to take your call'

Down the hall is another state agency dedicated to assisting Iowa seniors: The Iowa Long-Term Care Ombudsman’s Office, which investigates complaints against nursing homes and assisted-living centers.

Iowans who call the office to report abuse or neglect are often routed to an automated messaging system:

"We are unavailable to take your call at this time. Please leave your name, phone number and a brief message and we will return your call within three business days … Thank you for calling and have a great day.”

The empty desks and the phone messages are indicative of a larger problem: Fewer resources translates to fewer services for Iowans in need.

The proposed budget cuts at the Department on Aging, for example, are expected to result in 50,000 fewer meals delivered to vulnerable seniors.

Cuts at the ombudsman’s office have eliminated virtually all on-site visits to the 600-plus nursing homes and assisted living centers the office is required by law to monitor.

'Status quo budgeting'

This is what “status quo budgeting” looks like in state government.

While the phrase suggests state agencies are maintaining current levels of staffing and services, the reality is much different, particularly when zero-growth budget proposals are followed by layers of mid-year spending cuts.

For the next fiscal year, which begins in July, Reynolds asked state agencies to submit status quo budgets that will hold the line on spending.

But she also has proposed a $30 million cut to the current fiscal year budget, which, if approved, is expected to trigger a similar-sized cut to next year’s budget.

If the Iowa Senate’s more aggressive $55 million spending cut is imposed, “then we are talking around 50,000 fewer home-delivered meals and long waiting lists for people needing services,” said Joe Sample, executive director of the Iowa Association of Area Agencies on Aging.

Iowa’s six regional Area Agencies on Aging, which connect Iowa seniors with community services, receive state and federal funding that flows through the Department on Aging. When the department’s budget is cut, the Agencies on Aging share the pain, Miller said.

“The AAAs are now in a position to implement waiting lists, which we've tried to avoid for years,” Sample said. “There’s no other place to cut.”

Even if the governor’s more modest budget cuts are imposed, there likely would be 20,000 fewer meals provided to older Iowans.

Slashed services for poor seniors

In addition, about 200 low-income seniors would see cuts in assistance for what’s called "material aid" — medical equipment, medication support, eyeglasses, emergency lifelines and home-utilities assistance.

Nine years ago, the Department on Aging had 40 full-time employees — more than double its current staffing. Its total budget this year is $28.5 million, which is $2 million less than what it was in 2007.

Miller, a Republican who served 10 years in the Iowa House of Representatives before taking over the Department on Aging in December 2016, said the spending cuts hurt, but she won't ask for additional funding.

“I don’t feel like that’s probably productive on my part,” she said. “It doesn’t make sense for me. It’s just not a good strategy right now.”

As for the ombudsman’s office, its budget this year is $1.16 million, nearly 13 percent less than last year.

Iowa's poor ranking for nursing-home visits

Even before those cuts, Iowa — which has one of the oldest populations in the nation — ranked last among states in nursing home visits by the long-term care ombudsman.

According to a study by the Institute of Medicine, each state should have at least one long-term care ombudsman for every 2,000 nursing home residents. To meet that standard, Iowa would need to hire at least 18 additional ombudsmen.

In 2013, Iowa legislators approved a bill that would have increased the number of ombudsmen from eight to 10, but then-Gov. Terry Branstad vetoed it.

Why volunteers can't help

Pederson says she also wants to revive a statewide network of unpaid, volunteer ombudsmen — Iowans who visit care facilities and report any concerns — as a less costly way to improve oversight in nursing homes.

The volunteer ombudsman program, mandated by Iowa law, is currently all but dead. Funding for the program was eliminated by lawmakers in 2009, restored in 2012, then cut again.

Currently, there are 63 volunteer ombudsmen in Iowa, a 25 percent decrease from 2016. At least 90 percent of Iowa’s licensed care facilities have no volunteer ombudsmen.

In fact, Pederson’s office is refusing applications from prospective volunteers because she no longer has a staff coordinator to review applications, help with background checks and arrange for training.

The money that was used to pay for that position was eliminated in last year’s budget cuts.