Continuing care under budget cuts

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By Lois Bell

Sheridan Senior Center


SHERIDAN — As director of the Senior Center’s Help at Home program, Janet Korpela is familiar with the rollercoaster funding world for nonprofit agencies.

Her constant challenge is to provide in-home services in an environment of increasing demand with decreasing resources. So, when Korpela received news that almost $175,000 was lost through a combination of state funding cuts and program changes, her team huddled to come up with ways to respond.

Their goal? to ride out the current financial bad weather and keep services at the same levels. 

“There’s a mentality out there that our services are free,” Korpela said. “But that’s not a sustainable model. No one would last long giving their service away.”

The licensed home health care Help at Home program is offered through the Sheridan Senior Center, a nonprofit organization. But a payment stream is necessary for the program’s sustainability. Payment for services to older residents for personal care, light housekeeping and light meal preparation services come from private payments, long-term care insurance, Medicaid, a contract with the Department of Veterans Affairs and through a Wyoming Home Services grant. Occasional donations specifically directed to the program help. One donation currently provides some subsidy for in-home services for a number of older residents in the Tongue River Valley who need assistance.

Korpela said that 90-95 people in their current clientele of 200 rely on WyHS subsidies from the Wyoming Department of Health to help pay for services. But when the WDH passed budget cuts from the state Legislature through, the cuts impacted most those who need the financial help.

“Two thousand, seven hundred dollars per year would provide two hours of care once a week for 52 weeks,” Korpela said, “versus $8,000 or more a month in a care facility. We are really a cost-effective way to receive care.”

Despite proven cost effectiveness of community based in-home care, Korpela and her team have to work with the current state of funding. They developed a three-point approach to keep their current staff and long-term clientele.

“We first looked at our current (WyHS) clientele and what services they were getting,” Korpela said. “We looked at alternatives for them to get their needs met.”

Solutions included shifting clients to getting groceries delivered instead of staff shopping with them and engaging them in the Senior Center’s home delivered meals program in lieu of meal preparation.

The second response addressed the need for human contact.

“Despite all the socialization studies, instead of sitting down to a cup of tea (with a client), our aides visit while they work,” said Korpela.

Some years ago, Korpela had endorsed visiting with clients as part of their care plan.

“This is really critical especially for those who don’t have family members,” Korpela said about visitation being an essential component of care. “This is how we help people not be scammed and provides an opportunity to notice changes in health and behavior that lead to referrals to other needed services.”

The third response was to keep a few spots open to provide short-term care to people who need services only temporarily such as those recovering from surgery.

“In that way, we can provide care for more people for a shorter period of time, enabling us to respond to short-term needs. The model of in-home service is different than a group model such as Day Break,” said Korpela. “We need to dedicate one staff person per client. It’s the nature of the business.”

These three strategies provided a limited number of openings for clients who rely on WyHS assistance. As a result, no client under the WyHS program has been cut and the Help at Home team was able to add services for people under the WyHS grant funding under certain circumstances.

But the funding cuts have increased a waiting list from five to 60-plus individuals who need subsidized care on a sliding fee scale. The list makes Korpela cringe.

Korpela is upfront with people who approach for services that there is a waiting list. She will steer families to resources that help them meet their need in the interim.

“And we don’t take first-come, first-served,” Korpela said of the waiting list. “We triage the list and respond to those with the greatest need first.”

By |January 20th, 2017|

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