Home care cuts infuriate mother of son with disabilities

Payments to Morrill and Sharon Pickett for the home care of their son, Kevin Pickett, have been cut about a third by the state of Missouri.
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Payments to Morrill and Sharon Pickett for the home care of their son, Kevin Pickett, have been cut about a third by the state of Missouri.

Government & Politics

Remember Missouri’s vow to restore aid for 8,000 with disabilities? Hasn’t happened

By Jason Hancock


October 19, 2017 07:00 AM


More than a month ago, lawmakers pledged to come up with a plan to reverse budget cuts that could strip state aid for in-home care from more than 8,000 disabled Missourians.

Yet they seem no closer to a solution.

Republicans have floated the idea of changing a property tax credit for low-income seniors who rent their homes and using any savings to restore funding for in-home care. But Democrats and some GOP senators say it’s a nonstarter because it would simply shift the burden from one vulnerable population to another.

Democrats have rolled out a list of options, ranging from a repeal of a 2015 corporate tax cut to tapping reserves built into this year’s budget. But each is considered a long-shot in the Republican-dominated General Assembly.

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As the weeks go by, the likelihood of a solution emerging before lawmakers return to Jefferson City in January for the 2018 legislative session is getting less and less.

“There are still ongoing negotiations,” said state Rep. Justin Alferman, a Gasconade County Republican and vice chairman of the House Budget Committee. “But the further down the line we get, the closer we get to session, the less likely we’ll call a special session to address this.”

State Sen. Ryan Silvey, a Kansas City Republican and vice chairman of the Senate Appropriations Committee, agreed.

“At this point we’re probably in a holding pattern until January,” he said.

In laying out his budget proposal earlier this year, Gov. Eric Greitens called for an even deeper cut that would have caused 20,000 elderly and disabled Missourians to lose state assistance.

Lawmakers rolled that cut back to only 8,000, and eventually approved a one-time funding fix aimed at avoiding cuts to the in-home care program altogether.

But Greitens vetoed the bill, and proponents fell far short of the votes needed for an override.

Without the $35 million funding fix, the $27 billion state budget changes eligibility requirements for Missourians to qualify for in-home and nursing care services through Medicaid.

Essentially, people are now required to display more severe disabilities to get state-funded care, a change that could eventually affect more than 8,000 Missourians.

No longer able to live in their homes, many disabled Missourians who lose state aid will rack up costly hospital visits and eventually land in a nursing home, costing the state more in the long run, said state Rep. Crystal Quade, a Springfield Democrat.

“Say you’ve got a senior citizen living in their home, and they get someone to help them in their home for 10 hours a week,” she said. “They utilize that person to help them shower, take their medicine, fix meals and all these other things. If they get cut to just two hours a week, they’re choosing between their hygiene and having someone help them sort their medicine.”

If they choose to get help getting out of the shower to avoid falling, Quade said, they could “accidentally get their medicines crossed up and end up in the emergency room. That’s going to cost the state much more money.”

Alferman said the only way to find $35 million immediately in the budget to restore aid to those disabled Missourians is through the property tax credit for low-income seniors. It’s one of the rare tax credits that comes in the form of a payment to an individual.

“You can scrap other tax credits, but you won’t see any cost benefits for a long while, sometimes years,” he said. “You could raise taxes, but that will mean waiting on those taxes to be collected.”

The property tax credit in question, known as the “circuit breaker,” helps Missouri seniors and people with disabilities with fixed incomes to stay in their homes by offsetting costs related to property taxes.

For renters to qualify for the credit, income must be $27,500 or less if single, and $29,500 or less if married. For homeowners, income must be $30,000 or less if single and $34,000 or less if married.

The maximum credit is $750 for renters and $1,100 for owners. In 2016, the average credit was $535.

Legislative leaders hoped to eliminate the renter’s portion of the tax credit this year but ran into fierce Democratic opposition in the Senate. Now they’re proposing things like reducing the income limit, lowering the maximum credit for homeowners and raising the age of eligibility for the tax credit from 65 to 70.

“This tax credit is a property tax credit,” Alferman said. “We’re giving this credit to people who don’t pay property taxes. They’re renting their home. So that doesn’t make sense to me.”

Jay Hardenbrook, advocacy director for Missouri AARP, said the circuit breaker was designed to ensure a senior citizen living on a fixed income isn’t forced out of their home because of rising property taxes.

Rent goes up, he said, when the property taxes go up, “so it makes sense you would include renters in that as well.”

“A person is more able to get the most appropriate care when they are in their own home,” Hardenbrook said. “It costs the state less and people have better health outcome. The alternative is often a nursing home.”

Hardenbrook noted that in addition to the in-home care cuts, more than 60,000 elderly Missourians were cut off from a program earlier this year that had helped them pay for prescription drugs.

Those earning between 85 percent and 185 percent of the federal poverty level, or up to about $22,000 a year for an individual, had previously qualified for a program called MORx that covered 50 percent of out-of-pocket prescription costs.

Lawmakers voted to alter the program in May, saving $15 million by making those Missourians ineligible for state aid.

The legislature should be looking for ways to increase state revenues instead of being forced to constantly cut services for the most vulnerable, Quade said.

“We cannot fix our budget crisis we’re in with cuts alone,” she said. “But folks have to be willing to have a serious conversation and not worry about elections. I’m not sure if I’m hopeful or not.”

Alferman said making cuts to the circuit breaker to avoid cuts to in-home care should be a no-brainer.

“If it’s between a check at the end of the year to offset property taxes or money for life-saving Medicaid services,” he said, “I’d rather go with the live-saving Medicaid services. At the end of the day, it’s simple mathematics. We can’t spend money we don’t have.”

Jason Hancock: 573-634-3565, @J_Hancock