As the number of older Missourians increases, demand for programs serving older adults and people living with disabilities has grown dramatically. However, the availability of and funding for these services has not kept pace.
This report provides an overview of state programs serving older adults and people living with disabilities in Missouri, with a specific focus on the adequacy of state funding to support these programs.
Our findings suggest that Missouri does not adequately fund services for older adults and people living with disabilities, particularly critical wrap-around services targeted toward community dwelling Missourians that are designed to prevent and delay the need for much more costly institutional care.
We find that:
- Recent cuts to home-based care threaten to roll back the progress and cost savings that have been realized due to Missouri’s shift away from institutional care, pushing older Missourians into more costly and restrictive care settings.
- Funding for programs designed to support independent community living and enhance quality of life for older adults and people living with disabilities is both low and stagnant. These programs account for less than 1% of the state budget and have grown little over time despite increasing need for and rising cost of providing services.
- Community-based supports and services have been hit especially hard by cuts related to budget shortfalls in the last decade. These programs were cut by over 40% between FY2017 & FY2018 and have yet to recover to prior levels.
- Programs enacted through statute, such as the “Circuit Breaker” tax credit and the senior levies, do not automatically adjust to keep pace with demand, leading to an erosion in the value of benefits over time and fewer Missourians able to access needed services.
Interactive Budget Tracker
The interactive tool below illustrates how Missouri funds programs serving older adults and people with disabilities over time.
Investments in each program are shown in three ways to allow advocates to better understand how the value of appropriations have changed over time given both the rising cost of services and a dramatic increase in the number of older Missourians:
Total funding appropriated by year: the first measure shows the actual appropriation for each program from FY2007-2022.
Total funding by year adjusted for inflation: the second measure shows the appropriation adjusted to today’s dollars to provide a more accurate picture of how the value of the appropriation has changed over time given the rising cost of providing services.
Investment per Missourian over age 60: the final measure shows the per capita investment in each older Missourian adjusted for inflation in order to provide a more accurate picture of how the value of the appropriation has changed given a dramatic increase in the number of eligible Missourians as well as the rising cost of providing services.
*Prior to FY2016 a large portion of MO Rx was funded through earmarked state funds as opposed to general revenue. Changes implemented by the Affordable Care Act necessitated a change in funding structure; thus the lack of general revenue funding prior to these years does not represent a lack of state support for MO Rx. Rather, prior to cuts imposed in FY2018 the level of overall state support (earmarked & general revenue) for MO Rx was consistent with the funding levels seen in FY2016 & FY2017 at which point the fund switch was fully implemented.
This report was prepared by Missouri Budget Project in partnership with the Missouri Association of Area Agencies on Aging (MA4) and Missouri Council on Aging, and was supported by Missouri Foundation for Health.