Robert Howard

Supervisor Robert Howard (left) spoke out about increased cuts to Milestone Area Agency on Aging.

MUSCATINE — Muscatine County Board of Supervisors discussed weathering cuts to Area Agencies on Aging at their Monday meeting.

This past week, a majority of Iowa Senate Republicans released their proposal for budget cuts that will need to go into effect before June. Their proposal would cut $52 million from the state's $7.2 billion budget. That is up $22 million from Gov. Kim Reynolds' proposal to tackle mid-year budget shortfalls. The affected organizations range from the state universities to the judiciary. 

"The state has tried really hard to get a handle on the budgetary process and all the types of organizations that fund in the health arena"  said Robert Howard, supervisor of District 1. "The whole idea there is for the state to make a more efficient and effective distribution of funds and use of funds for these kinds of organizations.

"And although the state meant well, not everything you try is necessarily going to be effective and work well in all areas," Howard said. "Not only has it been a challenge, but when they were faced with having to reduce the cost by cutting budgets without knowing the effect that they’re having — it’s not just affected Milestones — it's affected every single region that has been established. I just don’t think they knew what the outcomes would be."

Milestone Area Agency on Aging is Muscatine's regional provider.

Howard said that tax cuts in the past were probably needed to some extent, but the continued cutting will have real impacts.

"We had some fat and we cut some fat,” Howard said. “That part was good. But you have to live in the real world. The elderly have nowhere else to turn. And we have to offer them the services. There is just no other place to look."

Becky Passman, CEO of Milestone, said the governor's original cut, which saw a recommendation of 1.8 percent or $30,000 from their agency, would have been difficult enough.

"However, when the Senate came back with this $52 million proposition, that inflated what we were looking at to about $90,000 that we’d have to absorb over the next five months," Passman said. 

Passman said that an easy way to explain the cuts is how that would impact one of the agency's services — delivering meals to seniors. 

Cutting that $90,000 is equivalent, Passman said, to cutting 10,248 meals. 

"This may be the only hot meal they get," Passmann said. "Many live in isolated areas. They may have no family nearby. This is a way for them to get a hot nutritious meal as well as companionship, to get checked on and make sure they are doing all right."

Passman said she was struck by a comment by state Sen. Charles Schneider. According to the Associated Press, he said the goal was to the make the cuts "in a way that's fiscally responsible and that reflects the priorities that we as Iowans all hold most dear."

"We would hope that these priorities would include caring for our most vulnerable populations, seniors and those with disabilities," Passmann said. 

Making mid-year cuts even more difficult, on Nov. 30, Amerihealth, one of the three national companies managing Iowa's Medicaid program, pulled out of the state. They used agencies like Milestones to handle case management. Milestone lost 35 percent of its 2017 revenue. 

"We had to lay off all of our case management workers," Passman said. "Since case management was such a large program, we still provide the service, but we only have a handful of people that we are serving, not the 800 that we had previously."

Passman said she had no problem with working with the state of Iowa to find more efficient ways to get services for lower costs. She said her organization is working to continue serving those senior and disabled populations they were charged with.

"We have already gotten very lean," Passman said. "We are working very efficiently to continue to sustain losses just makes it harder to serve the people who need us most."

Passman said that she hopes the public and their representation in state government appreciates the cost savings of services that work to keep seniors healthy and in their own homes.

"Support for senior services and family caregiver support pays off in so many ways beyond just being the right thing to do," Passman said. "It’s also the fiscally smart thing to do."

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