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.
20 comments:
good change. The AAA should visit for intake. Someone who is a hoarder living in squalor, or someone whose residence is in disrepair or living without an essential can now get some services. Feels gross we weren't already back to doing normal intakes.
Another nail in lamont's political coffin. Even the most weak-minded knows that 8 years without raising taxes is not sustainable. So when the tax increase comes and it will, don't blame TZ. Just wake up and realize what a charlatan McClure was and is.
“The state believes that direct interaction with an applicant and the use of standardized tools are more reliable measures for determining what kind of long-term care is needed.”
There are two possibilities here:
Either the state:
1). Has been paying the county to perform the direct interaction, use of standardized tools AND ineffective desk reviews all along and is now cutting the funding for the unnecessary desk reviews; or
2). The direct interaction and use of standardized tools hasn’t been fully funded in the past and the state isn’t providing additional funding to do so.
There are several conclusions that can be drawn from those possibilities:
A). The state has provided additional money for more direct interaction and use of standardized tools and it’s being accounted for on a different line item. In this case, Zrinski is trying to frame the reduction in the desk review line item as an overall cut. If this is the case, she is being dishonest and also failing to make the necessary cuts to the department since they will no longer be doing the unnecessary work.
B). The state cut the funding for the unnecessary work, but also failed to provide the additional funding needed for more personal interaction. In this case Shapiro is a lying sack and is lying about taking care of seniors because he wants to be president. If this is the case, Zrinski should hold a press conference and call out Shapiro over the cut.
C. The other possibility is that the work was never needed and only created in the budget to suck down some sort of federal covid grants. In this case, both the county and state have been lying to us while they fleeced the taxpayers. In this scenario, cuts should again be made at the county level to remove the unnecessary expense that is no longer being funded by the state or federal government.
Why don’t people want to work at Gracedale? A one star facility, abuse warning and provisional license? Probably. But what’s it like to work there? That’s a good question, right? Would be great if some of those folks would comment on here. What a fall from “grace” (no pun).
Wait. If they aren't doing the job the funds aren't needed....correct??? If I don't fill up the gas tank anymore I don't need money to fill up the gas tank!!!
What it sounds like you and the county wanted that money so you could misappropriate the funds to something else. Which those funds were not to be used for that.
Misappropriation of state and federal funding might be a crime??? I'm no lawyer.
This is so sad the handling of this place that you will openly admit how this place got in trouble when you are robbing Paul to pay Peter.
And yes taxes are going up way up. To keep gracedale and the rest of the county functioning. Because Lamont dug a very big hole for this county and ran away before kicking us into it.
Or as our last county controller said. You pour it from this bucket to this other bucket..
Who was that again???
I guess I’m still confused. Where was the $260 per desk review coming from? Who was being “billed.” Was this a user fee or were insurance companies/Medicare/Medicaid paying for them. Were they funded by the COVID slush fund? If they are no longer being done, shouldn’t there be some cost savings? Shouldn’t the “in person” interviews result in some sort of revenue? If not, why were they charging for the more streamlined virtual reviews? I know these are a lot of questions, but this all reeks of the “other people’s money” mode of governments in action.
Then who is going to perform the face to face interviews and reviews to determine the level of care? That was a function of the local AAA’s in the past.
Well from what I read they are still gonna be completed. And if the feds reimburse the county for them. They will still be paid.
The billing went to the Pa Office of Long-Term Living (OLTL), a state office that probably receives its funding from the feds. I do not know whether Aging will do the in-person interviews or whether they wil be done by some managed care organization.
I have not said I wanted this money so I could misappropriate it to another purpose. What I have written is that this is a revenue loss for the county, but that the policy for the elimination of desk reviews is designed to encourage a better assessment.
Don't forget the tax decrease right before his election!!!!!
The physician provider determines level of care
Great points. There is always more to the story
Desk Reviews are to monitor AmeriHealth, PA Health Wellness and UPMC. All Waiver Providers. The ones that make millions of dollars. Desk Reviews ensure that these MCOs are doing their jobs and meeting the requirements. See it as Oversight. Also, When and individual becomes ineligible for whatever reason, Aging notifies OLTL of change and if it's appropriate or not. Maybe they should have changed the price-Cheaper billing rather than get rid of it. After April 1st, see how many more protective services cases, telephone phone calls there will be because the MCOs are not doing their jobs. The MCOs will continue to make millions on people with disabilities.
Your comment is uninformed. There are several departments at Aging. Assessment, options, caregivers protective service among them. There ARE assessments being done on a daily basis depending on the older adult's needs.
Anon 6:50 am said: “ Even the most weak-minded knows that 8 years without raising taxes is not sustainable.”
This is the most idiotic comment ever.
What about all the growth in the county over those years? All the projects and grants that were approved that county and local politicians told us would bring a gazillion dollars to the benefit of the county? All those inflated economic development dollars that were supposed to come from all those projects?
Remember those?
But now that the state has cut unnecessary funding for unneeded work, it’s being used to justify a coming county tax increase by an incompetent county executive.
Give me a break!
Zrinski voted in favor of many of those projects. Was she lying to us then about the benefits or is she lying to us now to justify a tax hike?
The reality is that when something is deemed unnecessary or inefficient, you cut that expense. Only in government is wasting your money somehow excused, and the expense continues forever.
I believe that someone once said the closest thing on earth to eternal life was a government program. It’s politicians like Zrinski that make that statement true.
Do you know what a grant truly is? Most likely not. Grant money isn’t giving to simply dump into the county’s general fund.
Grant funds may only be used to pay for the item or services you applied for in your grant application.
So it’s doesn’t matter if the county received a “gazzilion” dollar grant, those funds can only be used on what they were awarded to pay for.
And a tax increase (WHICH IS DEFINITELY NEEDED) isn’t coming due to missing out on $400,000 in monies from the commonwealth.
Do you complain just to complain? Or really that uneducated on how the county works?
Maybe Bernie can research why Shapiro’s budget is so far “over budget “. Something like 4.3 billion over budget? Geez!
Shapiro is a fraud- he's only interested in his political ambitions!
What is the Director of Human Services position on these issues?
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