- The Washington Times - Saturday, March 29, 2003

DES MOINES, Iowa (AP) In their fight to balance the state budget, lawmakers are tapping an assisted-living trust that keeps people like 77-year-old Ruth Ritter out of the nursing homes they dread.

The 3-year-old trust pays for the meal deliveries, visiting nurses and transportation that make it possible for many seniors to live independently in their own homes.

But with tax revenue down and legislatures nationwide struggling to meet state needs, Iowa lawmakers have turned to the $392 million Senior Living Trust.

They took $48.5 million for 2002 Medicaid expenses and $36 million for 2003. Gov. Tom Vilsack, a Democrat, has recommended taking $65.6 million more by the end of fiscal 2004.

"At the present rate, you can be the least optimistic and say it's going to be out [of money] in 2005, or be maybe the most optimistic and say it's going to be out in 2007," said Joel Olah, executive director of the Aging Resources of Central Iowa.

Even the government estimates the fund could be more than $100,000 in the red by 2009.

For Miss Ritter and others like her, it's more than disappointing.

"If it wasn't for this money, I couldn't stay in my home," she said. She has diabetes and degenerative arthritis in her knees, and the trust pays for an aide to come to her Des Moines home as often as twice daily to help her bathe and do housework.

"Nursing homes are garbage disposals for old people," she said. "I don't think [the elderly] get the grade of care they need."

The trust was started with $95.6 million from the federal Health Care Financing Administration in 2001. Tom Lenz, a regional official with the agency, now called the Centers for Medicare and Medicaid Services, said there were no provisions on how the state should use it.

Mark Haverland, director of the Iowa Department of Elder Affairs, said the trust was intended to reduce the state's reliance on nursing homes and Medicaid by providing community services.

The strategy, he said, had two goals: One was to give money to nursing homes to convert unused beds to assisted-living space; the other was pay for in-home assisted-living services such as meal delivery and health care.

About $6 million to $8 million is currently spent each year on those types of services, he said.

If left intact, the trust could have drawn as much as $10 million to $15 million each year in interest, he said.

"When you stop and think how much is being saved by keeping someone out of an institution and in their own home, which is much-less-expensive than Medicaid … it is a tremendous savings," said Nicola Gould, executive director of the Advocacy Network for Aging Iowans.

According to Elder Affairs, 19 percent of Iowa's population is 60 years and older, and that percentage is expected to grow as baby boomers reach retirement age.

"What they're doing now is undermining that in the long run because those funds are supposed to be there many years from now," Mr. Olah said.

State Auditor David Vaudt has cautioned lawmakers to come up with a clear repayment plan for the trust and other similar funds they have used.

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