Budget cuts may hit rural seniors harderby Dan Gunderson, Minnesota Public Radio
In just a couple of decades, nearly 30 percent of the population in some Minnesota counties will be people over 65. County human service programs work to keep seniors in their homes longer but as the state works to cut the cost of these services, local officials worry about how to reach out to a rural, sometimes isolated population.
Fergus Falls, Minn. — Muriel Peterson is just shy of her 90th birthday, but you'd never know it as she settles into a comfortable chair in a sunny corner of her apartment.
She lives in Pioneer Pointe, an apartment complex for seniors in Fergus Falls. Her husband lives nearby in an Alzheimer's unit.
She wants to stay as independent as possible.
"I go to an exercise class. They set up my medications for me'" Peterson said. "There are a lot of other things they would do, but so far I don't think I need them."
Her children, who live in Wisconsin, South Carolina and Massachusetts, help keep track of her insurance related paperwork. Muriel Peterson said the falling stock market and talk of government budget cuts has caused anxiety for many of her fellow residents who wonder if they'll be able to afford the services they need.
"A lot of people are really worried. Personally, we find now that we have a lot more expenses, so what used to look like a lot isn't a lot," said Peterson. "But we're doing OK."
Muriel Peterson is a member of the fastest- growing segment of the Otter Tail County population. By next year it's estimated two of every 10 county residents will be over the age of 65. By 2030 the rate will be nearly three in 10.
The population 65 and over will double from 10,000 in 2000, to an estimated 21,000 in 2030.
Lyle Hoxtell spends his days making sure Otter Tail County seniors get the services they need -- and he's a busy guy.
"I have about 10,000 contacts in a year," said Hoxtell. "Phone calls, and face-to-face visits."
Hoxtell, who's the Aging Services coordinator for Otter Tail County Public Health, is a walking encyclopedia of the arcane regulations that often cause seniors to throw up their hands in frustration.
He doesn't just answer questions over the phone, he makes house calls to do things like fill out paperwork for an increasingly complex insurance system.
Hoxtell tells of cases where seniors had no one to help wade through the dozens of offers for prescription drug plans or supplemental health plans.
They send in the wrong form and suddenly they have no coverage, or the wrong coverage. Then it might take a month, and help from several people, to straighten out the mess.
"You think that doesn't cost us money in our health care system too? And you start looking at cuts, that's where we should be cutting costs, rather than the people who provide the service," said Hoxtell.
If human service programs are regionalized, or streamlined to save money, Hoxtell worries technology might replace some of the personal contact he considers essential.
Hoxtell might go to help a senior fill out a Medicare form, but while he's there, he may notice red flags in their behavior.
"That's where the face to face can be tremendously important," explained Hoxtell. "If they were going to make coffee and all of a sudden they say, 'Wait, I have to do something,' and they go to check the instructions they've hung in the bathroom -- you're not going to see that in a phone call."
If that person can't remember how to make coffee, they might also be forgetting to take important medications. Hoxtell has seen that lead to unnecessary hospital visits.
Minnesota has a wide variety of services for seniors, according to Area Agency on Aging Director Mark Tysver. They're funded with a combination of federal, state and local tax dollars.
Tysver says the greatest challenge is getting those services to people who need them.
"There are many types of services available, but sometimes people aren't aware there are that type of services available. It's a complicated system," said Tysver. "Over the last few years, services have changed so much to keep seniors in their homes and communities as long as possible."
Meeting the needs of seniors in a rural county often requires a personal contact, according to Tysver. For example, he pointed out, there are many Web sites full of information about prescription drug programs but seniors still call his Fergus Falls office because they don't have Internet access.
Rural residents are often isolated, some rural areas have fewer services available and rural service providers are sometimes paid less than their urban counterparts.
That's raising concern in places like Otter Tail County that budget cuts will hit seniors here harder than in the metro area.
- Morning Edition, 03/05/2009, 6:50 a.m.