Montana Voices: Proposed state budget cuts would derail Alzheimer’s care plan

Dr. Patricia Coon

Last March, Gov. Steve Bullock was presented with the Montana Alzheimer’s and Dementia State Plan, which is a direct call to action to improve dementia care in communities throughout our state.

As a geriatric doctor at the Billings Clinic, I am a proud member of the Montana Alzheimer’s Disease and Related Dementias Workgroup, which is collaborating with a large coalition to address Alzheimer’s and dementia needs.

Our plan, though, is rendered useless if the funding for the exact services and programs that serve people with Alzheimer’s disease and dementia are cut to the bone.

By the year 2025, about one in four Montanans will have surpassed the age of 65, jumping from about 100,000 people now to 240,000. In fact, our senior population as a share of the state population is already fourth-highest in the nation.

As our parents and grandparents age, families struggle with the stress of caring for loved ones who are experiencing the debilitating effects of degenerative brain diseases. Currently, 20,000 people live with Alzheimer’s or a related dementia in Montana and another 49,000 family members and friends provide their care.

Alzheimer’s disease is one of the most important healthcare crises of our generation. It is prevalent, under-diagnosed, and carries significant caregiver burden. It is one of the costliest chronic diseases to society and the sixth-leading cause of death in Montana.

It is not hyperbole when I say that the cuts made to human services during the last legislative session were devastating. The proposed cuts, if enacted, set us up for total failure to properly serve the people and communities of Montana. These cuts to services and programs to support our spouses, parents and grandparents are cruel.

If the governor and Legislature cannot work together to develop long-term solutions to balance the budget, there will be unnecessary suffering to many Montana families and seniors. We urge legislators and the governor to come together for a special session in order to prevent further harm.

Without their action and leadership, the cuts could include:

♦ $20 million from Medicaid services, which provide care in homes or assisted living.

♦ Eliminating hospice care for Medicaid recipients.

♦ Eliminating health-care coverage for certain Medicaid health-care workers.

♦ Closing 16 adult protective services offices.

♦ Over $45 million in lost personal care services that help people stay in their homes — basic care, supporting services daily living.

♦ Eliminating funding to reform adult guardianship system.

♦ Eliminating prescription drug assistance for over 10,000 seniors.

♦ Reduction of $1.4 million for Medicaid incontinence supplies.

The state will ultimately pay a greater price for cuts to senior and in-home care services because Montanans will be forced into nursing homes for their long-term and end-of-life care. Nursing homes are far more expensive and many people with dementia may not do well living in large, institutional facilities.

Better and less costly options include small, specialized assisted living facilities and memory care units and enhanced services at home where people experiencing dementia can stay connected to their families and familiar environments.

Personal care services that allow people to continue to live in their homes are crucial for people’s quality of life, family support and individualized care.

On top of the financial cost of living in and receiving care in an institution, nursing homes take an emotional toll as well. Individuals do better when they are not separated from their communities, their families and everyone they know.

No one should face Alzheimer’s disease or any other dementia alone. The Montana Alzheimer’s Disease and Related Dementias Workgroup urges the Legislature to work with Gov. Bullock to hold a special session in which real, long-term solutions are on the table for a balanced approach.

Dr. Patricia Coon chairs the Montana Alzheimer’s/Dementia Work Group.