Aging

State attorneys are asking a Ketchikan judge to dismiss a class-action lawsuit brought by three Pioneer Home residents after monthly rates more than doubled: with top tier residents liable to owe $15,000 a month for state-run assisted living.

Attorneys filed a suit in Ketchikan Superior Court on behalf of Pioneer Home residents in Juneau and Ketchikan claiming that dramatic rates increases threaten to bankrupt elderly Alaskans who live in the state-run assisted living homes.

The lawsuit asks a judge to issue an injunction against the rate increases and prevent any residents from being evicted for not paying.

One of the plaintiffs, Ketchikan resident Eileen Casey, is now nearly $100,000 in debt to the facility and administrators have threatened to kick her out of the home, according to court filings.

The state Attorney General’s office’s 12-page answer filed on Dec. 23 doesn’t dispute these facts. Rather, it asks the court to toss the lawsuit on technical grounds by calling into question the plaintiffs’ standing and other factors.

State attorneys also argue that the plaintiff facing eviction hadn’t paid her rent prior to the hike or applied for assistance. It also denies the claim that previous incremental rate increases make a large jump — of around 138 percent in some cases — unfair.

The state’s filing lays out some general avenues for a defense. It could argue that Pioneer Home residents haven’t been harmed by rate increases; it could argue that residents had other options for relief besides suing and it could argue that the plaintiffs are acting in bad faith by challenging their bills in court.

A timeline for the lawsuit remains unclear. In the meantime, the octogenarians and nonagenarians continue to live in Pioneer Homes in Ketchikan and Juneau. They are among the 497 residents in six Pioneer Homes affected by the increases.

Three Alaska Pioneer Homes residents are suing Gov. Mike Dunleavy and the state, seeking to block a sudden rate increase that would more than double the cost of staying at the homes.

Lawyers for Marion and Howard Rider of Juneau and Eileen Casey of Ketchikan, as well as the Riders’ adult son Brad Rider, filed a class-action lawsuit in Ketchikan Superior Court on Monday.

The plaintiffs argue that having their rates more than double in a single month is unreasonable and made without reasonable notice. They also say that residents are faced with decisions like divorce and bankruptcy as a result of the increases.

Alaska Department of Health and Social Services Commissioner Adam Crum and Pioneer Home Director Clinton Lasley are named as defendants along with Dunleavy and the state.

The lawsuit seeks to represent a class of plaintiffs that include any Pioneer Homes residents, as well as the residents of the Alaska Veterans and Pioneer Home in Palmer, affected by the rate increase.

Marion Rider saw her monthly rate increase on Oct. 1 from $4,692 to $11,185, while Casey’s monthly rate increased from $4,600 to $10,606, according to the lawsuit. Casey has been threatened with eviction due to $95,000 in debt she accumulated before she was approved for Medicaid, according to the lawsuit.

A spokesperson for the Department of Law said the department “has just learned of this lawsuit and will need time to review and respond to the complaint.” The spokesperson added that the department generally doesn’t comment on the merits of ongoing litigation.

This story has been updated.

Gov. Mike Dunleavy is agreeing to restore funding to the state’s Senior Benefits Payment Program.

The $21.6 million in general funds pays low-income seniors an amount ranging from $76 to $250 a month. Dunleavy said he was moved to restore funds he vetoed after seniors spoke out on the importance of the program. But the governor also signaled many deep cuts will remain when he presents his revised operating budget later this week.

Dunleavy spoke at a senior center in Chugiak on Monday as a few dozen people ate lunch.

“I just want you to know that the funding for senior benefits is going to be in this year’s budget, and you should start receiving those benefits soon,” Dunleavy said during brief remarks.

The administration aims to retroactively pay benefits that have not made it to recipients since the start of the fiscal year. The state announced on July 1 that it would stop payments to 11,320 residents in order to “contain costs and reduce dependence of individuals on state funds.”

Dunleavy said hearing feedback from seniors and their families changed his position on eliminating the payments.

“You hear more and more folks, their personal stories, about how this income helps them oftentimes stay independent, oftentimes helps them with food,” Dunleavy said. “You really get down to basics when you’re talking with folks.”

The restored funding, combined with $800,000 added to the program by legislators, works out to $21,586,000 in total. The administration is not yet certain when senior benefits payments will be dispersed.

For many at the Chugiak-Eagle River Senior Center, the governor’s visit was a surprise.

John Kehr didn’t pay much attention to the governor’s remarks. He doesn’t receive any senior benefits, and he has no plans of leaving his home for a supported living facility. Still, according to Kehr, for some residents this is a welcomed reversal in the budget battle.

“I think it’s going to help them,” Kehr said of seniors receiving benefits. “For some of them, it would have been a pretty hefty cut.”

Across the table, Thomas Blavka agreed. The preservation of the senior benefits program is good news for people who rely on it. But he and his wife are more concerned about rates at the Alaska Pioneer Home increasing 40%-140% starting next month.

“We could make it,” Blavka said, but “it’d hurt. We’re in our 90s now, so won’t be long (before) we’ll be using some of them facilities.”

Restoring funding for senior benefits does not affect the reduced subsidies to the Pioneer Homes. Alaska Department of Health and Social Services Commissioner Adam Crum said the administration is trying to give Alaskans a realistic picture of the state’s financial expenditures.

“The whole goal with the Pioneer Home rate was to make sure that we were meeting, actually advertising what the cost of care is. It’s very expensive for us as a state to do this,” Crum said. “We want to make sure we maintain the level of care for those individuals, but we also have to have the honest conversation of how much it costs.”

At the highest level of care, that means Pioneer Home residents currently paying around $6,800 a month will see an increase to $15,000 a month.

Rates are set to increase dramatically Sept. 1 for elderly Alaskans living in Pioneer Homes. That’s as the administration of Gov. Mike Dunleavy sticks with a plan to have the state-owned assisted living facilities generate enough revenue to cover their costs.

According to notices posted by the Department of Health and Social Services, the Pioneer Homes are also changing how many levels of service there will be for elders, based on what care they require, from three different levels of service to five. Depending on the level of care, a resident could see their monthly rate more than double.

“It’s the same services that we’ve always been providing, we’re just really putting pen to paper,” said Clinton Lasley, director of the state’s Division of Pioneer Homes. “They’re being charged what it costs to provide the service.”

Some have worried that fewer people will be able to afford to live at the homes, and Lasley acknowledged he has had some difficult conversations with elders and their family members about their concerns they will have to move.

But he stresses that — as per state statute — the Pioneer Homes would not evict someone who could not pay and that the state is still subsidizing care for those who cannot fully afford it, through an assistance program according to how much they can pay.

“Those individuals that were paying the rate that we had advertised, but may be able to pay more towards their care, will be asked to do that,” Lasley said. “And then if they need payment assistance, we would use the same payment assistance qualifiers that we use for any other resident that lives in the home.”

The rate increases come after a more than $7 million reduction to the Pioneer Homes’ budget, still a smaller cut than what Dunleavy first proposed.

House Bill 96 would reverse the rate increases. It has passed the House and has not yet been taken up by the Senate.

Alan Borbridge and his sister cared for their mother at home for as long as possible. Cecilia Borbridge wanted to age at home. She came to Baranof Island as a teenager to attend Sheldon Jackson when it was still a high school. And she never left.

For the past ten-odd years, home and family care worked for the Borbridge family. But after a minor stroke earlier this year, Cecilia’s needs began to exceed Alan’s capacity.

“It was enough to where it became too much for me and my sister to manage on our own,” Borbridge said. “It was pretty obvious she needed 24/7 care.”

That meant finding a long-term care option for Cecilia, which wasn’t easy.

The fact that many elderly people struggle to secure and afford long-term care is nothing new. With Gov. Mike Dunleavy’s budget vetoes, potential cuts to senior benefits and Medicaid have many concerned. But the elder community faces another potential setback – this one tied to cuts to the Alaska Legal Services Corporation.

The fate of the vetoes is currently uncertain: House Bill 2001 restores much of the funding eliminated in Gov. Dunleavy’s line-item vetoes. That bill passed the House and Senate, but awaits the governor’s signature — or a second round of vetoes.

When Cecilia needed full-time, professional help, Alan and his sister turned to Sitka Pioneer Home in town. His mother required Tier III care at a cost of some $7,000 a month, Borbridge said. Despite being on a fixed income, Cecilia still made too much money each month to qualify for a Medicaid waiver that would defray the costs of care.

Monthly payouts from her retirement fund put her “way over income” to qualify for that waiver, Borbridge said. That’s because, depending on the specifics, Medicaid waivers or Medicaid is often the only way for low-income seniors to get support for long-term care, said Catherine Rogers, a member attorney at the Alaska Legal Services Corporation.

Alongside other legal advice for low-income people, she spends a lot of her time helping elderly people afford medical care through something called a Miller Trust, or Qualified Income Trust. That’s what Rogers helped Alan set up for Cecilia. She also helped the Borbridge family manage their assets – another necessary step to qualify. The cuts to Alaska Legal Services could mean fewer people will have access to that support.

Without insurance through a Medicaid waiver, there was no way the Borbridge family could have afforded the Pioneer Home long-term. A Miller Trust changed that. They could funnel the “extra” money that pushed Cecilia over the Medicaid limit into a special account. It’s a complicated — but essential — tool for the elderly community, Rogers says.

“Otherwise they cannot afford the healthcare that they need,” Rogers said.

But it isn’t a trust like any other: After a person passes, the state can tap the Miller Trust to reimburse itself for whatever it paid out for that person’s care through Medicaid. Rogers advised Alan to set up a Miller Trust for his mother. And it worked. She got into the Pioneer Home, where she lived for three months before passing.

“The way I look at it, it was a help-help for us and the state,” Borbridge said. “Everybody’s happy, everybody gets their money.”

A Miller Trust isn’t something that just anyone can walk into a bank to set up. It requires careful legal advice. Alan didn’t even know a Miller Trust was an option before he talked to Alaska Legal Services.

That legal advice might get harder to come by in Southeast Alaska, depending on whether or not Gov. Dunleavy signs House Bill 2001. His vetoes from earlier this summer eliminated state funding for Alaska Legal Services. The House voted to restore that funding, but until the bill is signed into law, the future of legal aid remains in limbo.

Alaska Legal Services faces a loss of about $759,000, or about 15% of its budget. It might not sound catastrophic, but that money helps Alaska Legal Services operate in rural communities like Sitka, said Nikole Nelson, executive director of the organization.

Without the legal aid the organization provides, more people might struggle to afford or access help with things like setting up trusts.

“People can lose their house, protections, or ability to access healthcare,” Nelson said.

Nelson says Alaska Legal Services expects to serve 1,393 fewer people statewide without state funding. Three offices are expected to close — she doesn’t know yet which ones.

This elimination of funding is unprecedented. In the Alaska Legal Services Corporation’s 52-year life, it has always received a state appropriation.

“Since we’ve opened our doors,” Nelson said. “So this would be the first time.”

Rogers, the attorney in Sitka, says the threat of fewer services thanks to budget cuts leaves people like Borbridge at risk.

“These are people that are already on [the] cusp of not being able to afford things,” Rogers said. “Without someone doing this kind of work you leave vulnerable people unprotected.”

For the Borbridge family, the Miller Trust was make or break. Cecilia had savings, Alan says, but far from enough to consider a stay in the Pioneers Home without Medicaid and the Miller Trust. And there’s no way Alan could have figured it all out on his own.

“Minimum $150 or $200 an hour for an attorney, that’s really out of the question for a lot of people,” he said. “You don’t wake up in the morning and say ‘you know, I need to spend a few thousand on attorneys.’”

Alan lives on a fixed income. So without legal advice to help navigate the aging process, he — and many of the people in his community — are wondering where they’ll turn next.

For months, city officials in Juneau and other communities across the state have warned that proposed cuts to the state budget would push the financial burden onto local taxpayers.

As the Alaska Legislature continues to grapple with the state’s budget, Juneau will be dealing with the direct and indirect impacts of Gov. Mike Dunleavy’s budget vetoes.

During a meeting last week, Juneau Assembly member Rob Edwardson echoed a point that was a common refrain during city budget meetings throughout the spring.

“This isn’t a cost cut, this is a cost shift,” Edwardson said. “These things, our citizens are going to end up paying for, where it was the state rightfully paying for it to begin with.”

According to a city memo, immediate impacts for this fiscal year are estimated to be $5.2 million. The majority of that comes from the loss of $3.7 million in school bond debt reimbursement.

The Juneau Assembly will determine how to make up the difference at upcoming meetings. They may use savings to cover debt payments for now and increase property taxes later.

Bartlett Regional Hospital also expects to raise service fees in order to make up for a $1.5 million loss in Medicaid funding.

Those are things it’s easy to put an immediate price tag on.

As Assembly member Michelle Bonnet Hale pointed out, it’s harder to know how residents will feel the impact on an individual level.

“I’m very concerned by immediate impacts on people’s lives, like people losing their senior benefits with no warning,” Hale said.

Patrick Kearney is one of more than 300 seniors in Juneau who qualify for the state’s Senior Benefits Program. He had heard cuts were coming, but he thought he might be exempt — until his check didn’t arrive earlier this week.

While he didn’t rely on the income, he said he did budget for it.

“I had, like, $175 extra to spend. So now I’m going to have to be even more cautious,” Kearney said.

He said he mainly used the money for groceries and extra things, like occasional trips to the movies.

Now he’s waiting to see what happens.

“Part of me wants to (say), ‘OK, do I get ready to move out of Alaska?’ But where do I go?” Kearney said.

Other impacts that are hard to quantify just yet include the University of Alaska, which lost $134 million in state funding. That could endanger programs and research at the University of Alaska Southeast campus. 

Homeless and housing service providers and early childhood education also saw significant cuts, raising questions about how those programs will be affected locally.

On Monday, the Juneau Assembly will consider a resolution calling on the Alaska Legislature to restore vetoed funding to the state operating budget.