How One County Plans to Provide Elderly Services Amid Federal Cuts

ALMOST every day the bus that takes Olivia Coggins to the cramped senior center in East Point, Ga., slowly drives by a construction site still littered with debris.

It doesn't look like much now. But Ms. Coggins and the other seniors on the bus ogle the new Fulton County senior center with the rapt anticipation of teenagers checking out a new shopping mall.

The $2.3 million H.J.C. Bowden Center - due to open next month - is one of five multipurpose senior centers Fulton County, Ga., is building. It is, say county officials, the biggest county-funded construction program for seniors in the nation.

The goal is to serve area seniors better by clustering services in one spot. At each center, retirees will be able to pay utility bills, visit doctors or dentists, eat meals, use a therapeutic pool, check out a library book, and participate in a host of recreational and educational activities.

Fulton County's initiative puts it at the vanguard of innovative local government efforts to improve services to the elderly at a time when Washington is expected to reduce federal aid to this segment of society and distribute funds through block grants to the states.

County government's, which are responsible for providing many of the services to senior citizens, are expected to have less money to meet citizens' needs under the block-grant formula.

"Counties are very concerned," says Sandra Markwood, a program director of volunteerism at the National Association of Counties in Washington.

In an effort to balance the budget by 2002, a Republican-led Congress is aiming to trim the fat off government. It is proposing to trim three programs that would affect seniors: Medicare, Medicaid, and the Older Americans Act. Medicaid, an entitlement that currently pays for about 75 percent of the nursing-home costs for the elderly, would get cut by $182 billion under the Republican plan. Medicare, which also provides health care to the poor, would take a $270 billion hit. A House committee has voted to cut the Older Americans Act by $100 million, a move that could eliminate elder-abuse dollars, preventive health-care money, and nutrition programs such as Meals on Wheels that help homebound seniors.

"In response, counties will have to become more innovative in administering services to seniors," says Barbara Prescott, resource and training coordinator for the Sedgwick County, Kan., area agency on aging.

"The trend for counties is to have more community-based services available and more linking of information, services, and people," she says.

That's what Fulton County is attempting to do with its new senior multipurpose centers. "We're working with community-based agencies - the American Association of Retired Persons, our health department, different entities that will provide programs," says Valerie Wilson, director of the Fulton County Office of Aging. "There's no way county government can [administer services] alone."

The National Association of Counties (NACo), which met for its annual meeting in Atlanta recently, recognizes that seniors are one of the fastest growing populations and that senior services will be impacted if Washington votes for spending cuts. Thus, it has made aging its focus for the coming year.

"When we're talking about Medicare and Medicaid cuts, I understand we may have to reduce some of those dollars, but that doesn't mean we have to necessarily reduce services," says Douglas Bovin, NACo president.

He emphasizes bringing the generations together. "We have started back in my county in Michigan grandparent appreciation night, which sounds kind of superficial, but ... there has to be more contact with people who are dependent."

Still, despite efforts at the county level to create partnerships in the community to meet senior needs, many working directly with the elderly voice concern about how far impending cuts may go. Fulton County's new senior centers, while able to provide more services for many elderly, won't help those who are disabled or in nursing homes and depend on Medicaid, for instance.

If expected Medicaid cuts go through, "a lot of people will be displaced," says Ms. Wilson. "They won't have the means to stay in nursing homes. The system is not set up to take care of them, and that's the big dilemma counties must face."