Demand and supply keep pace for county senior programs
By Scott Nicholson
nicholson@wataugademocrat.com

The annual Watauga County Project on Aging report shows that while the county’s elderly population continues to grow, services are generally keeping pace with the demand.

Project on Aging director Angie Boitnotte presented the report to the county commissioners Monday. It’s required each fiscal year as part of the N.C. Division of Facilicity Services certification.

With about 7,000 Watauga residents older than 60, based on Census projections, demand for a variety of programs climbs by about 3 percent a year, Boitnotte said.

Boitnotte reported that though there were usually a few slots on the waiting list to receive in-home aides, the county has been generous in supporting programs for the elderly. The POA has an annual budget of $1.36 million, with about half that money coming from county tax revenues. Medicaid provides $309,000 and federal and state block grants provide another $262,000.

Boitnotte said POA has a Medicaid reimbursement rate of 999.6 percent, which she said was due to the diligence of the staff in pursuing claims. However, some clients didn’t receive services or lost in-home aide services because they weren’t eligible for Medicaid, and the county’s Medicaid income and claims declined overall.

The number of hours of in-home aide services dropped by nearly a fourth, down to 32,000 hours, and the POA delivered 24 fewer hours of in-home aide services to frail seniors. This was due to other agencies administering those services, Boitnotte said.

The shortage was also due to a limit on staff hours, and the waiting list for in-home aide services was an average of four people.

She said the wait varied between one to three months, depending on staffing levels, with 179 people being served at any given time.

“We’re certainly proud of the number of clients we’re able to serve across the county,” Boitnotte said. “The county has been very generous in funding programs. You can’t look at one report and see any trends, because things are always changing as the Baby Boomers age up.”

The number of people served through the Community Alternatives Program dropped, but Boitnoitte said that was because clients could choose between eight different agencies to provide the service. She felt those clients had been served by other programs and that there was no significant gap or people who were lacking in-home aide services. The CAP program is designed to allow people to stay at home instead of nursing or long-term care facilities by providing trained care providers for a certain number of hours each week.

Boitnotte’s one concern was that some clients needed more services and hours than they were receiving, saying 67 current clients were eligible for more services. “Some are getting service every other week when they could use it weekly, and some are getting two hours when they need four,” she said, adding that increased funding would be the only remedy.

Boitnotte predicted more demand in the future due to changing demographics that bring more retirees to the area.

Life expectancy could also continue to increase, and though in-home programs will keep more people out of long-term care facilities, Boitnotte said “Resources must continue to grow at a rate equal to or exceeding the population growth rate.”

Even those who are eligible for services don’t always get them.

For in-home aide programs, the most common reason for non-use of the service was the potential client declined to participate.

“We accept referrals from anybody, and when we call, sometimes they say, ‘No, thanks, we’re not interested in services,’” Boitnotte told the commissioners.

Seventy-two percent of those receiving in-home services are female and 57 percent are classified as “economically needy.” Nearly all are at risk of being placed in a facility without the aide programs.

The POA’s staff levels have remained relatively stable over the last seven or eight years, with 24 in-home aides. Generally, slots on the waiting list for aides are filled when current clients die or are placed in a facility, though others discontinue the service, move, or recover to the point that aide services are no longer needed.

The county served nearly 47,000 meals last year from its kitchens at the Western Watauga Community Center and the Lois E. Harrill Senior Center. About two-thirds of those are delivered through the Meals on Wheels program while the rest are served as congregate meals at the facilities. Boitnotte said more than 9,000 people used the western community center last year and said it may need to be expanded because of lack of meeting rooms.

The POA served another 585 clients through health screenings and medication management programs. The county is conducting a survey to see if other types of services are in demand.