The Iowa Senate will be considering its funding de-appropriation for the current fiscal year budget today (SF2117). The bill now calls for a reduction of $220,024. This is a reduction in the current year’s funding, which ends June 30, 2018. If funding cuts get through the Senate, House, and the Governor, then this will be the second time within the past 12 months that funding has been reduced for Iowa’s aging network of Area Agencies on Aging. Further, the entire de-appropriation will need to be completed within the next four months. These funding reductions, along with the loss of care coordination/case management services provided under Medicaid is like dying from a thousand cuts.
Iowa’s Area Agencies on Aging (AAAs) have endured significant financial challenges since 2010. In 2010, Iowa’s General Assembly mandated a reduction in the number of Iowa’s planning and service areas from thirteen to six with no additional funding to do so. That same year, millions of dollars were provided for other reorganization activities of other State systems. In 2015, Iowa’s Medicaid managed care system effectively removed Iowa’s AAAs from care coordination/case management services for older Iowans by giving this responsibility to managed care organizations. At this point, Iowa’s AAAs have all but been completely removed from providing this service under their contracts with the remaining managed care organizations. Finally, during last year’s legislative session, the FY ’17 budget was cut through de-appropriations. The FY ’18 budget’s starting point was the FY ’17 de-appropriation. Now, that same reduced FY ’18 budget is at risk of further reduction through the proposed de-appropriations being considered in SF 2117.
The result of previous cuts and loss of providing Medicaid services has resulted in significant staff reductions for the AAAs and cuts to services wherever the AAAs could cut. Services, such as nutrition/meal programs, elder abuse prevention, and in-home services that help older Iowans remain independent in their home for as long as possible, to name a few, will need to be further reduced or reviewed for reduction that will likely result in waiting lists for people in need of essential supports and services.
While there was much appreciated additional funding provided for Iowa’s aging and disability resource center (LifeLong Links) in 2015, it was not considered full funding for the program and has been at-risk for reduction on a continual basis since appropriated. This is, however, evidence that strong advocacy and education of Iowa’s elected officials can be effective. Indeed, SF 2117 has been amended from a much higher proposed reduction from its previous version. Some legislators have responded to emails about the concern held by Iowa’s aging network and the people it serves but continuing to educate elected officials of the harm these cuts will cause is essential.