By: Gema G. Hernández

The Bush administration is executing its plan to reduce services and programs for elders and frail individuals without any public outcry from the Media and from the same elders and frail adults the plan will negatively impact. It is time for us to wake up and to begin to investigate the changes that are taking place. It is to question changes in program eligibility criteria and in Medicaid funding formulas. The changes that are becoming effective July 1, are taking away the peace of mind the Older Americans Act and Medicaid have provided for years.

All the pieces of the protection elders used to have are going to eventually be eradicated from our memories. This includes the programs of the Great Society and the many positive outcomes of several White house Conferences on Aging. Let us take for example some of the wake up calls we have received lately. Wake up call one: Florida SB 1226 signed into law by Governor Bush on July 1, 2004.

To make the drastic changes of Florida SB 1226 more acceptable to the elders, agencies and caregivers, the Governor has written a letter accompanying the signing of the bill. The letter expresses reservations about the impact this bill would have on elders and on the service providers. While the Governor feels uneasy about signing this bill, I did not see a boogey man behind him forcing him to sign the bill, nor did I see the Governor’s staff using their tremendous political capital to delay the passage of this bill by recommending one of their famous commissions to study the impact such drastic changes would have on elders and individuals with disabilities before it was signed into law.

Why, we may ask, does the Governor of Florida have reservations now? Could this be a political spin in case later on in his political career this merging of the Frail Elder Medicaid Waiver program with the Nursing Home Diversion program is mentioned as part of an anti poor elder campaign with detrimental effects on the future of Long Term Care? I think the spin doctors are years ahead of the general public. My congratulations to them for thinking ahead and shame on us for letting this wake up call pass with no fight.

It is surprising that agencies are accepting the “merger” of two completely distinct programs with such peacefulness and complaisance. This innocent merger will change eligibility criteria, will cut funding and will open the door for the complete reform of the Medicaid program to start as soon as the votes for the presidential election are counted. I used the word “reform”, but in reality I should have used the complete elimination of the Medicaid program to happen right after the elections. If we put together the signing into law of Florida SB 1226, add the transfer of “all” Medicaid waivers to the complete control of the Agency for Health Care Administration and add the plan to outsource CARES to be done in phases to start later on this year, the results are clear, a much weaker aging network and a much weaker Florida Department of Elder Affairs. CARES, by the way, is the unit that assesses and determines Nursing Home placement and eligibility for Medicaid.

The series of events previously mentioned in just 12 months makes us wonder what role, if any, the Florida Department of Elder Affairs will be playing in Long Term Care. Is this a way of bypassing the Florida Constitution which mandates the creation of the Department of Elder Affairs? The administration has avoided a constitutional referendum and by default has left a Department in name only, but with no serious functions to perform. By the way, this is what Representative Carole Green of Ft Myers wanted in 2001 and Carole Green is headed to Washington so watch out for her in the nation capital.

This phenomenal strategy designed to dismantle and render useless the power of elders and the agencies that provide services to elders would slowly eliminate the direct access organizations such as Area Agencies on Aging and Community Care Programs have with elders. Instead, the power would be given to HMOs that will control not only the Medicaid budget but also the services elders and frail individuals would receive.

Wake up call number 2 is coming from the Area Agency on Aging and their urge to change their names. The latest is the Area Agency on Aging in West Palm Beach that wants to change its name with the blessings and support of everyone. This change of name would allow the Area Agency on Aging in the Treasure Coast to become a “resource center for adults”. This means individuals with disabilities regardless of age will be part of the core client base defeating the purpose of the Older Americans Act and of the first White House Conference on Aging. The change of names and target clientele comes with funding from the federal government who wants to facilitate the merging of multiple client populations without a fight from elders. The new client population for the “centers” will include elders, disabled adults, mental health cases and drug and alcohol dependent individuals. How are elders feeling about these changes? Who is asking and informing elders about these changes? Could the change of name also represent the anti senior feeling and the avoidance of acknowledgement elders exist and some elders may need services. The euphemism of calling an area agency on aging “resource” “alliance” “solutions” is a way to place elders in a closet not to be seen or heard instead it is time to focus on the beautiful people.

A technical question should be raised at this time. The Older Americans Act does not mention senior resource alliance, alliance on aging, or senior first as the names of the agencies that should be part of the Administration of Aging network of agencies. Could the name change and the change in function for the Area Agency on Aging prevent them from receiving funding exclusively and without competition from the Administration on Aging? Someone should look this up before all the names are changed overnight, allowing society to avoid responsibility for elders.

Wake up call number 3 comes from the North Florida Area Agency on Aging having a public meeting to decide if they should provide direct services to the elders and the caregivers in their geographical area. What services are they thinking of providing, Transportation, Meals or Case Management? Why do they have now the urge to provide direct services to clients? Why do they have the urge to ask for income and the ability to pay? Could this be because the ultimate plan is to eliminate Area Agencies on Aging and give those contracts to HMOs under the new and improved Medicaid Modernization Plan?

The alarm is ringing we must wake up now.