When Governor Josh Shapiro signed the 2025-6 state budget in November, his office announced that it was investing $10 million more in services for older adults. So when NorCo Executive Tara Zrinski announced last week that the county's Area Agency on Aging is actually facing a $400,000 budget cut, I was a bit confused. After making inquiries with Zrinski and others, I can tell you what is happening and why.
What is Being Cut? The Area Agency on Aging (AAA) currently conducts something known as a "desk review" to determine if someone is eligible for long-term care services, be it a nursing home or in-These are performed under something known as the Aging Well contract. This review is done without meeting the applicant in person. Instead, medical records and other paperwork are reviewed and an assessment is made.
AAA conducted 1,440 desk reviews in 2025 at $259.35 a pop, which resulted in $373,464 in revenue in 2025.
This program is being eliminated. After April 1, AAA can no longer perform or bill for them. So that revenue stream after March. It's not quite $400,000 but is substantial.
Why Are Desk Reviews Being Cut? This is the decision of Pennsylvania's Office of Long-Term Living, which oversees long-term care services, which can be a nursing home or in-home care.
The state believes that direct interaction with an applicant and the use of standardized tools are more reliable measures for determining what king of long-term care is needed.
Desk reviews were expanded as a result of COVID and backlogs in eligibility determinations. Now that the pandemic is over, administrative shortcuts are being removed.
The goal is to make eligibility determinations based on direct clinical assessments, which align more closely with federal Medicaid.
Elimination of a funding stream for the AAA and county is an unintended consequence of this change, but it will improve the health and safety of applicants.
Unfortunately, the permanent loss of a revenue stream that probably would come close to $400,000 in 2026 and will be nonexistent in 2027, is yet another blow to county finances. Just a few weeks ago, the county contributed $7 million to Gracedale so it could balance its books in 2025. Its reliance on agency nursing is increasing because it must in order to meet the state minimum standards for nursing care, and that will cost the county more money. It's safe to say we are looking at a tax hike next year.
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