Services to elderly would shrink under proposed budget

Growing older in Nevada may be getting more difficult as the state's strained finances affect programs designed to keep seniors out of nursing homes and keep property tax payments low, members of a legislative money subcommittee were told Wednesday.

In spite of waiting lists and a growing senior population, the Division of Aging and Disability Services is holding steady the number of spaces available in some home- and community-based programs that serve people on the brink of entering a nursing home, and reducing space in another.

The programs, funded by Medicaid, state general funds and tobacco settlement money provide services such as adult day care, paid companions and Lifeline 911 devices if seniors are eligible for nursing homes but want to live independently.

While those services cost less than institutionalizing a person, they are considered optional and are not legally mandated, as institutional care is.

Applying for nursing home waivers to get in-home care instead is also a cumbersome process, division officials said.

Senate Majority Leader Steven Horsford, D-North Las Vegas, took objection to policies that do not prioritize in-home care.

"We continue to make decisions to cut this and continue to maintain institutional care," Horsford said. "Where do you want your loved one? In a nursing home, or in a place where they will get a better quality of care?"

Other proposed cuts have prompted reams of letters from senior citizens across the state - so many that state employees have not been able to keep up.

A plan to eliminate the Senior Citizens' Property Tax Assistance program, which provides property tax rebates of up to $500 each for nearly 18,000 seniors each year, shifts much of the $5.6 million annual program budget to elder protective services.

Carol Sala, administrator of the Division of Aging and Disability Services, said the protective services were a priority because the department is understaffed.

The rebate program has drawn some scrutiny because it allows seniors who live in apartments or nursing homes to receive a rebate.

The intention behind that policy is helping seniors who have property tax costs passed along to them by their landlords, Sala said.

Other changes in the division include expanding the state's Elder Protective Services program by 15 employees, and charging counties for the services instead of using money from the general fund.

The program deploys social workers to investigate an increasing number of abuse and exploitation claims.

"Some of the things we're walking into are appalling," Sala said.

When the program starting absorbing the work of Clark County last year, the department reached 77 cases per social worker, more than three times the nationally recommended ratio of 25:1. While the ratio has gone down, the department wants to restructure to bring the ratio to 40:1 in the upcoming biennium.

Investigating cases takes time as social workers must build trust with the person who is allegedly being abused, Sala said, and current staffing levels prevent that.