Serving more seniors with less funding

Regional investments into elder care in the home mean big savings for individuals and taxpayers when keeping seniors out of expensive nursing facilities.

Regional investments into elder care in the home mean big savings for individuals and taxpayers when keeping seniors out of expensive nursing facilities.

Executive Director of the Area Agency on Aging of Northwest Michigan (AAANM) Robert C. Schlueter gave the Charlevoix County Board of Commissioners an overview of his organization’s activities on Wednesday June 26.

“We have been around for over 35 years—and I have been with the organization for 27 years—and I have to say that I have never seen so many things in flux and so many changes going on as we’re seeing right now with the Affordable Care Act and other issues,” he said. “Everything is heading in a good direction. The focus—we are primarily a home health care provider—is we work with a lot of private-public entities to help people stay at home. That is our biggest effort.”

Schlueter said there are also a lot of “wrap-around” services the AAANM provides that includes training for caregivers.

“All across the country there is a huge push for home and community-based care,” he said. “The first one, we like to say is because it’s the right thing to do. That’s where people want to be, especially when people can’t live safely at home alone, we provide stepping stones to their end of life care.”

Schlueter said the average cost of caring for someone in their home was nearly $1,800—$6,500 per month for nursing home living—the last time he ran the numbers.

“It is much cheaper to keep somebody at home when that’s possible,” he said. “Now, there comes a time when they must be moved into a more highly skilled setting, and there’s also help for the process.”

The AAANM’s biggest offering is long-term care support services.

“We also fund many of the programs that affect your residents directly such as meals on wheels programs,” he said.

Schlueter said it is difficult and costly to provide meals to the elderly in rural areas.

“Most of our meals are provided by volunteers and they drive hundreds of miles a week to deliver 15 or 20 meals (each),” he said. “It’s expensive but it’s absolutely necessary. Nutrition programs we’re promoting heavily and advocating for—the reason being is that one of the biggest reasons people run into health issues is that they’re not eating right.”

Schlueter added, “When they aren’t eating right everything falls and the health care costs rise significantly.”

Schlueter said whether it is a congregate meal or home-delivered meals, his group is trying to increase dollars to those programs. The home-delivered meals are becoming more popular as the congregate meals are seeing decreased attendance.

The AAANM is also providing technical training to ensure caregivers are highly skilled enough to provide topnotch care.

“We have developed three significant programs that we are working with people throughout our region,” Schlueter said. “They are the Better ‘Training, Better Quality’ which is actually a collaboration with Michigan State School of Medicine, ‘PATH’ which is a Personal Attention Towards Health, this is helping people pay attention to their diabetes, to any other issues that they have and giving them information on how to do that correctly; and then ‘Creating Confident Caregivers’”

The AAANM helps caregivers attend the classes by giving them a stipend while they are in class and finding respite care for their loved one while they are attending.

“We try to remove all the barriers so they can get to the training and they can learn how to deal with all the physical care, all of the mental care for themselves and the individual they’re taking care of,” Schlueter said. “It’s an investment in all of our programs, all of our funding, because the better they are out there the less apt these people are to go into an expensive acute care center.”

Nearly nine percent of the AAANM’s distributed funds—or $615,727—ends up in Charlevoix County, which makes up nearly seven percent of the population the AAANM serves. Charlevoix’s matching funds are approximately $4,364 annually.

In addition to operating the Medicare/Medicaid Assistance Program and the Care Management Program, the AAANM is also working on an effort to help streamline medical information and reduce duplicity among groups.

The AAANM covers the 10 counties of Antrim, Benzie, Charlevoix, Emmet, Grand Traverse, Kalkaska, Leelanau, Manistee, Missaukee and Wexford.

According to Schlueter, the sequestration caused by the federal government has negatively affected his budget.

“We, in April, took a $70,000 cut,” he said. “Most of that hit our core programs—which is the most disappointing part—our meal programs, our community-based care programs. And, then, starting in Oct. 1 we’ll get another $130,000 cut to our overall programs and then every year we’ll get about five-and-a-half percent cut until they get that resolved.”

Schlueter added, “We’re spending a lot of time talking about how we can replace those funds because the population we serve isn’t getting smaller. In fact, Northern Michigan has the fastest growing elderly population in the state and they are also some of the hardest to serve in terms of isolation.”

Some of the AAANM’s provided services in 2012 include the following:

  • Creating Confident Caregivers Program—served 110 clients
  • Long-Term Care Ombudsman—served 233 clients
  • Senior Employment Program—served 16 clients
  • Contracted Services
  • Adult Day Health—served 23 clients
  • Adult Day Transportation—served 22 clients
  • Congregate meals—served 5,167 clients
  • Home-delivered meals—served 2,057
  • Legal assistance—393 clients
  • Purchased Services—MI Choice Waiver
  • Adult Day Health—3,812 clients served
  • Home-delivered meals—15,430 clients served
  • Homemaking—9,707 clients served
  • Personal Care—123,068 clients served
  • Personal Emergency Response Systems—99 clients served
  • Private duty nursing—5,972 clients served
  • Respite Care—41,225 clients served
  • Transportation—101 clients served

The AAANM’s 2012 budgeted expenses included the following:

  • Community Services—$268,330
  • Care Management Services—$787,199
  • Care Management Support—$567,431
  • MI Choice Waiver Support & Services—$5,518,685
  • Home-delivered meals—$791,014
  • Congregate meals—$512,858
  • Administration/Support/Planning—$335,442
  • Other—$205,959
  • Senior Employment—$134,638
  • Program Development—$54,846
  • Shared Housing—$11,864
  • Creating Confident Caregivers—$25,929
  • Total—$9,214,195

Revenues in 2012 included:

  • MI Choice Waiver—$5,605,685
  • Local Cash—$43,000
  • Federal Support (Older Americans Act)—$2,094,924
  • State Support—$1,192,931
  • Care Management—$65,259
  • Other—$200,532
  • Shared Housing—$11,864
  • Total—$9,214,195

For more information on the Area Agency on Aging of Northwest Michigan, call (231) 947-8920 or go to