Miss. Inner-City, Rural Care Rising for Black Elders Despite Struggles

Miss. Inner-City, Rural Care Rising for Black Elders Despite Struggles

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Photo: A care home resident in rural Mississippi enjoys the Andy Griffin Show. (Alice Tisdale/Jackson Advocate)

Second of two articles. Read Part 1 here.

JACKSON, Miss.—Mississippi, along with the rest of the nation, is aging rapidly as the huge baby boomer generation, 78-million strong, surpass age 65. As they confront both their own health issues and those of their elderly parents, the demand is growing for better eldercare options, especial for rural and inner-city seniors.

Besides inner-city nursing homes, discussed in part one of this series, personal care homes (PCHs) are intended to provide seniors a home-like setting for residents who don’t quite meet the criteria for nursing home placement, but may not have the funds for assisted living.

PHCs, called board-and-care homes in other states, also tend to be the choice for Mississippi residents suffering from dementia, such as Alzheimer’s disease, and emotional disorders that hinder their abilities to live independently.

Care Home Struggles to Survive

One such residence is Jackson’s First PCH. The home, located in West Jackson, is only two blocks from the learning oasis of Jackson State University and even closer, in the opposite direction, to Lynch Street C.M.E. Church, Christ the King Catholic Church and Mt. Nebo Baptist Church.

Yet, the 12-bed facility, founded as in 1953 as Jackson’s first personal care home in 1953, is struggling to survive.

Precipitating the crisis, alleged the home’s board chair, Jimmie Robinson, was a former employee’s misappropriation of some $200,000.

The embezzlement case is now in the hands of the state attorney general. Because Jackson’s First is the only one of the 16 PCHs in Hinds County receiving county funds. Local officials and community groups are awaiting the case’s outcome to determine how best to meet the needs of the elders and mentally challenged residents.

To complicate matters, the Jackson’s First PCH board is in a bout with the Internal Revenue Service.
While this situation is unique to Jackson’s First PCH, local and state authorities as far away as California are confronting how to prevent closures of the limited eldercare facilities serving lower-income seniors and people with disabilities.

“We’re hurting. It takes about $8,000 a month to operate the facility. I just spent $700 of my own money to get the air conditioning fixed,” he said. “We need finances bad,” Robinson stated.

Facility director, Victoria White stated, “We’re running out of food, and we need soap and other supplies for the residents.”

Staff, Community Support Are Key

“I took my tax refund check and bought things we needed. All we have to work with is the residents’ Social Security checks. We lost our funding from the Hinds County Board of Supervisors,” White said. “The residents are like family to me. It’s not just a job. We need help.”

One resident, Mr. Willie, a former truck driver from Pickens, Miss., says he can’t remember living anywhere else besides Jackson’s First. And Miss Mary is proud of her long residency, as well. “On July 31, it’ll be 13 years,” she said. Of course, cake and ice cream will be in order.

White said she recently she worked four days straight because funds were not available to pay the five staff members she supervises to work their normal full-time shifts.

With cutbacks in company transportation, White said she’s also making sure residents get to their doctor appointments and church services.

One group willing to step up to help raise funds for Jackson’s First is the Salt and Pepper Men’s Club of Jackson, an area seniors group, which will hold its annual Labor Day fundraising cookout for the home. Members are helping out in the meantime.

Also, White noted, students at Mississippi College come periodically to play games with the residents. A few of the 12 residents attend adult day health care, where vulnerable seniors get supervised health care, meals and socialization with other seniors.

One resident, Miss Lisa has been at Jackson’s First off and on for several years. She has high praise for her care provider. “Victoria is wonderful. She uses her own money to make sure we have what we need. She’s so nice,” she said.

Miss Lisa helps out in her own way by sweeping the walkway. “Yep, I like to sweep.”

Rural Areas Medically Underserved

Outside of urban areas, 53 percent of Mississippi’s population is rural and 51 of the state’s 82 counties are considered medically underserved.

Rural residents typically have higher poverty rates, tend to have higher levels of chronic diseases, have fewer doctors, hospitals and nursing care services.

Although rural communities face an increasing need for eldercare services, they generally have less access to such options. Studies have shown a higher use of nursing home services among often isolated rural elder, as well as lower rates of home health and other community-based, in-home service use.

Too often rural elders are limited to only so many days of post-hospital care services financed by Medicare. The federal program covers only some rehabilitation coverage, home health care and skilled nursing facility (SNF) care. For instance, at SNFs, Medicare will only pay if a patient had been hospitalized for at least three days within 30 days before going to the home,

The rules are so complicated and outdated that leading experts are calling for change. The Affordable Care Act (ACA) is funding pilot projects to test different method to broaden the care.

Currently, for example, if you have a stroke Medicare will only cover the treatment needed to stabilize your condition medically. But it won’t pay for care you may need to manage safely at home, say if the stroke left you partially paralyzed or blocked your ability to communicate what you want and need without long-term rehab.

The state-run Medicaid program offers more care options, but people have to have very low incomes to qualify.

Emerging Federal, State Efforts

Although federal policy still lacks coordination and support for rural capacity building, a combination of federal, state and local community involvement will ensure the development of expanded elder care options in rural communities.

Meeting the challenge to provide strategies for building and sustaining rural
community-based long-term care systems in Mississippi are a growing number of agencies, organizations and programs.

Key agencies are Mississippi’s Office of Rural Health at the Mississippi State Department of Health, funded though the federal Office of Rural Health Policy; the Mississippi Rural Health Corps, a joint endeavor of the state's 15 community and junior colleges and Mississippi State University Extension Service, supported through the United States Department of Agriculture; and the Mississippi Rural Health Association (MRHA), a nonprofit grassroots network.

Last year, the Mississippi State University Extension Service launched HealthConnect to assist rural communities to improve local health care.

The HealthConnect website notes that in rural America, doctors are leaving and hospitals are closing. Working with partners like the Mississippi Hospital Association, HealthConnect aims to help communities develop tools, such as community grants, to address critical health care issues necessary to improve the quality of life for their residents.

In addition, the National Advisory Committee on Rural Health and Human Services (NACRHHS) chaired by former Mississippi governor Ronnie Musgrove, is a 21-member panel of nationally recognized rural health experts is charged with providing recommendations on rural issue to the U.S. Secretary of the Department of Health and Human Services.

This article is adapted from a series Alice Thomas-Tisdale wrote for Mississippi’s Jackson Advocate, where she is publisher. She developed the series supported by a MetLife Foundation Journalists in Aging Fellowship organized by The Gerontological Society of America and New America Media.