Residents of Alaska's Pioneer Homes could see a 5 percent rate increase if the state Health and Social Services commissioner approves proposed regulations.
The program's director says the increase is necessary to bring the rates closer to the actual cost of care. The program's budget for its six homes is about $37 million, and residents pay about $12 million per year. State subsidies account for the rest of the operating budget, according to Director John Vowell.
Others, such as the daughter-in-law of a Sitka Pioneer Home resident, fear the increase represents a continuing slippage of senior benefits after the end of state longevity bonuses last year.
"How long are they going to subsidize them? They're cutting right and left," said Dani Fenn, of Juneau.
The homes provide state-run care for Alaska residents 65 or older. The program cares for 436 residents in its Juneau, Sitka, Ketchikan, Anchorage, Fairbanks and Palmer locations. Of those, 259 residents receive payment assistance from the state. Several residents without resources don't pay anything, Vowell said.
The proposed regulations would condense the homes' five levels of care to three levels of care. The first two levels won't change much, except for a 5-percent rate increase, Vowell said. The current levels III, IV and V would be combined into the new level III.
"We're finding that the people in those three highest levels of care have the same need requirements, so we feel that it is much better to combine those," Vowell said.
Residents who pay $2,135 for level I care receive housing, meals, emergency assistance and recreation. The new proposal would raise the level I rate to $2,240. Level II care includes assisted living, though not during the night, and currently costs $3,865 per month. The new rate would be $4,060.
The proposed level III care, for residents who need the most staff assistance, would cost $5,880 per month. The current average for level V care is $5,270, but the proposed rate would actually be a rate decrease for those who need the highest level of care.
Even with the rate increases, Vowell said the state still would be paying most of the homes' costs. Currently a level I resident pays 46 percent of the state's cost for his or her care.
Residents' cost of staying at the homes has gone up significantly in the last eight years. In 1996, the state began a seven-year incremental rate increase that ultimately raised rates as much as 234 percent for level V care by 2003. Last year there was no increase.
Fenn, whose 91-year-old mother-in-law lives at the Sitka home, said the state has not provided enough notice for the proposed regulations. The state held a public comment teleconference last week, and Fenn said her husband was the only relative present at the Sitka home for the meeting.
State Longevity Programs Manager Virginia Smiley said letters about the proposal and the public meeting were sent to residents, legal guardians and newspapers in cities where homes are located.
"I believe the total mail count was something like 3,100 notifications. I think we got the message out there," Smiley said.
Marie Darlin, coordinator for the AARP Capital City Task Force, said the senior citizens' group has not taken a position on the cost increase.
Fenn said she worries about the stability of the payment assistance program.
Vowell said there are no plans to get rid of payment assistance.
He said participants in the public hearing were worried about the rate increases, but that they spoke positively about the quality of care the homes provide.
"The question always has been if residents are receiving the care, shouldn't they be paying to the maximum of their ability for that care?" Vowell said. "It comes down to who is really responsible for paying the cost of care if an individual has the ability to do so."
The comment period on the regulation proposal ends April 9. Comments may be directed to Virginia Smiley at firstname.lastname@example.org or by fax at 465-4108. Comments also may be mailed to PO Box 110690; Juneau, AK 99811-0690.