I applaud the Herald-Leader for recognizing the seriousness of senior care in Kentucky.
Big kudos also to the leadership and staff of the Cabinet for Health and Family Services and the Area Agencies on Aging and Independent Living for streamlining their processes, as described in the April 7 editorial.
Truly, this is an enormous step for Kentucky.
Based on the foundation of Kynect, Kentucky is the first state to use a singular computer portal system to provide oversight for all services a person may be eligible to receive from all state and federal programs. Seniors will also now have a single point of entry, one application process for all of the related services through the Aging and Disability Resource Center in each of Kentucky's 15 area development districts.
By streamlining the Medicaid, state-funded and Older Americans Act resources that are funneled through different state agencies, this flexible, new approach will make care so much more efficient and effective.
In addition to the portal, Kentucky will implement a renewed Home and Community Based Services Program for persons who are aging or disabled. The program will allow service providers to perform more than one task at a time. The same provider who gives a bath can also administer medication, clean the house and take a client to the doctor. And for the first time, individual program assessments will be completed independently of the agencies providing the services.
But keep in mind that these merged programs apply to Medicaid-funded services only. Very generally, a single senior can own a home and a car, but can't have more than $7,000 in other assets and $2,000 annual income to be eligible. Many services funded by the public do not have this cap and are not funded adequately. The Area Agency on Aging and Independent Living agency has been cut 27 percent since 2009.
How can a person who owns a house and a car possibly maintain either of these, in addition to their other living expenses (except Medicaid services), if they earn $2,000 or less a year and have minimal assets?
It's not a realistic scenario for remaining independent. Most of our seniors have too many assets to access these services, but not enough to fully provide for their own aging care.
In effect, middle-income people are not able to access subsidized services.
Only if a person has abundant assets, or very few, will they likely be able to access care they can afford.
Already, I know of many stories of otherwise responsible, independent seniors having to totally expend their assets, lose their homes and make themselves fully dependent on the state, just so they can access the most basic care and medication.
In 2010, there were 829,193 persons aged 60 and older in the commonwealth, or 19 percent of the total population.
This proportion is projected to increase to over 25 percent by 2030. This represents a larger, looming issue for Kentucky — a system that will create middle class poverty, forcing an aging and large boomer middle class to cash in its independence, increasing the demand on Medicaid even more.
While the cabinet and the area agencies just hung the moon with the new portal, program and person-centered approach, Kentucky now faces a larger dilemma that we must address together and more broadly as a state, applying the same creativity, leadership and cooperation embodied in this present example.