State plans more cuts for Elder Care

By Cynthia
 Hochswender

cynthiah@lakevillejournal.com

SHARON, Conn. — The intersection of greater needs and fewer dollars was examined at a legislative breakfast Thursday, Nov. 12, at Sharon Health Care Center.

Administrator John Horstman had organized the meeting, and invited state Rep. Roberta Willis (D-64) and state Sen. Clark Chapin (R-30), to give the center’s residents and staff a chance to express concerns and wishes for, among other things, funding.

A frank and open discussion

Horstman is a relatively new arrival at Sharon Health Care; he has been there since February as administrator, but had been the administrator at Geer in North Canaan for 16 years before that. 

The three residents and four staff members who attended the breakfast complimented Horstman on making changes for the better at the retirement and rehabilitation facility. In particular, commented resident John del Duco, he has been good at sharing information and making sure that “he comes out and talks to us all about what’s happening in meetings. He’s a leader. He’s a keeper.”

The residents were part of the meeting this time, which was spurred in part by concerns that Connecticut Medicaid is going to cut the personal care expenditure it gives to residents.

It had been $75 per person per month but has already been cut to $60 per person per month. There are concerns that the allowance will be cut even further.

“They need that money if they want to get a haircut or buy new clothes,” Horstman said. “And with the holidays coming up, everyone wants to be able to buy a gift for family members.”

“I put off buying clothes for as long as I can,” said resident Eve Purdy. She listed all the items in her closet, which amounted to about three pairs of slacks and a few shirts. “I’m at the point where I can’t put it off any longer; it’s an I-must-buy situation now.”

Everyone at the table lamented the pending closing of the Sharon Hospital Auxiliary’s Bargain Barn resale shop (which subsequently did not close).

The auxiliary had dissolved when no volunteers would step up to run the organization, which provides scholarships and support for nursing programs and nursing students in addition to other charitable work. 

The Bargain Barn sells well-made clothing at very low prices, a boon for the health care center residents.

“My phone lit up with people calling when the Bargain Barn closed,” Willis said. “It’s an institution, a longtime fixture in the community. People depend on it, and it also supports a lot of causes.”

(WHDD Robin Hood Radio of Sharon announced that day that it will take over operating the Bargain Barn.)

Replacing essentials

There were also concerns about finding funds for what Amy Whitcomb (a center resident who is a facilitator for the other residents ) called durable medical equipment.

“Glasses, for example,” she said. “If you have cataract surgery or if your prescription changes, there’s no money for new glasses. You can only replace them once every three years.”

Motorized wheelchairs are a similar problem. If one breaks, they can only be replaced with a manual version.

Willis noted that the Legislature had cut the $60 personal expenditure allowance already but then restored the funds. 

The state budget is always shifting. Chapin warned that the deficit is so bad that the Legislature is likely to call an emergency session next month for  spending adjustments. Horstman was pleased that the state had decided to give nursing homes $26 million for employees. There had been some debate about how that money would be distributed but the matter seemed to be resolved (facilities are supposed to get funds based on the number of beds). Chapin warned that those funds might end up being cut from the budget, since they haven’t been disbursed yet.

Low salaries are a problem for Sharon Health Care and all area health care facilities. Lisa Balducci, the director of nursing,  said that in particular there is a shortage of Certified Nursing Assistants (CNAs). 

“We can’t find CNAs,” she said. “We are really struggling and we’re not alone.”

Sawyer Thornton, head of the dementia program, noted that the need for aids is going to increase as more and more patients need dementia care. 

Although the CNA shortage seems to be a statewide problem, the lack of affordable housing here certainly doesn’t help. 

Willis reported on a forum held Monday night at Sharon Hospital on that topic. There is a consensus that more “entry point” rentals are needed.

“It isn’t just for low-wage workers,” Willis commented. “It’s also for people who are moving here for a new job and want to decide if this is the right fit for them before they commit to purchasing property.”

Traveling is hard

Long drives are a problem for staff members (Horstman said he drives from Prospect every day; Therapeutic Recreation Director Jacqui Sweet drives 35 miles each way). But the challenges of getting residents to medical appointments has increased exponentially. 

Many residents need to be in special wheelchair transports, which are expensive to purchase and maintain and require a trained driver. Specialty care is often as far away as Poughkeepsie. Anything other than very basic dental care requires a trip to Torrington to find a provider who accepts Medicare or Medicaid. 

“Doctors used to come here to see the patients,” Horstman said, “but now they get such a small fee from Medicare that they lose money coming to see our residents.”

There’s just no money

The legislators were sympathetic but the inescapable fact is that they’re charged with reducing the state budget, which has a deficit of about $350 million. 

Willis noted that the state wants to increase funding to help people stay in their homes as they age. For that reason, money is not necessarily given to facilities; it’s supposed to “follow the person.”

As everyone around the table acknowledged that more money is needed but is unlikely to be found anytime soon, Horstman paused and said, “Well, at least can you …”

“Just leave you alone?” Willis said with a laugh.

Horstman laughed too but acknowledged that if the state could at least stop adding on new unfunded mandates it would be very helpful. 

He then predicted that the future of elder care is probably going to be marked by a return to the traditional three-generation family, with more parents living with their children and grandchildren in their last years. Facilities will be primarily used for  short-term rehab stays and for dementia care.

“That way the grandparents offer some financial assistance through their Social Security checks and the children are the younger generations can help grandma and grandpa.”