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County Axes Senior Care

Santa Barbara County Will Outsource to Keep the Frail and Poor Out of Nursing Homes


With notably little fanfare, the County of Santa Barbara quietly pulled the plug on a modest but successful program that for the past 23 years has helped allow frail senior citizens on limited incomes to stay out of nursing facilities and remain in their own homes. In response to the oncoming budget crisis, county Public Health administrators gave notice to the state’s Department of Aging on April 15 that they were canceling a longstanding contract that would have funneled $850,000 in state funds into the county’s Public Health coffers this year. Public Health officials explained that in recent years, the state has increasingly failed to fully fund the effort, known as the Multipurpose Senior Service Program (MSSP). To keep the program afloat, county administrators would have had to pony up $107,000 from the county’s General Fund. But with most county department heads panicked over what promises to be an excruciating budget process this summer, that sum was deemed excessive. The county is currently contracted to provide services for up to 200 frail and poor seniors-though only 183 are currently enrolled. These services are scheduled to expire on October 31.

Some Public Health employees have commented that $107,000 seems a small price to pay to keep 183 people out of nursing home care. The cost of placing someone in a nursing home, they noted, is far more expensive than keeping them out. But the state, not the county, pays the full cost of such care. With the Public Health Department looking to make $1.5 million in cuts this year-out of a total budget of $85 million-Assistant Director Michele Mickiewicz said the time had come to find the frail elderly program a more secure home with some other organization.

Mickiewicz said Public Health and the state Department of Aging are currently in discussion with four countywide, private nonprofit agencies that now serve the elderly to assume the function now served by MSSP. “No one is going to lose service because of this,” Mickiewicz vowed. “We expect a smooth transition. We have six months to do this right, and we’re in touch with the state on a daily basis.” But some county employees now working with MSSP are not so sanguine. They fear that the intense reporting requirements imposed by the state might prove too much for Santa Barbara’s nonprofits, and that finding a new agency to provide the same work that county employees now perform could be far more challenging than Mickiewicz indicates. If that challenge is not met, they warn, poor seniors will fall through the cracks.

The decision to cut the program was made well before the county supervisors traditionally meet in early summer to discuss all budget matters. Mickiewicz explained the department acted when it did to meet the state’s requirement of six months’ prior notice for cancellation.

Currently, the 11 employees involved with the MSSP program make sure the frail and elderly get to and from doctors’ offices, ensure that home-care providers get the respite they need, and provide the degree of case management that relatives otherwise would. When the program started in 1985, the state paid the full freight and the county paid nothing. But when the state experiences budget woes, the Department of Aging has sought to shift some of that financial burden to the participating counties. And this year, the state budget crunch promises to pack a painful punch. Given that county governments-like Santa Barbara’s-rely heavily upon the state for funding, county administrators have reason for concern. Initially, Santa Barbara County department heads were instructed to trim five percent from their budgets. That was when the state budget deficit was estimated at $14 billion. But now, the state is projecting a deficit of $20 billion, so it remains uncertain the extent to which Santa Barbara officials will find themselves forced to cut even more.

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