[ti:Older Americans in Government Program Struggle to Buy the Basics]
[al:As It Is]
[ar:VOA]
[dt:2023-03-28]
[by:www.voase.cn]
[00:00.00]Living simply is at the heart of Alex Morisey's Quaker religion.
[00:09.33]The 82-year-old graduated from a good college and spent years working in nonprofit organizations. 
[00:20.72]He helped farmworkers, people living in public housing, and the mentally ill.
[00:28.04]He was also an aid worker in Central and South America.
[00:33.97]Now he lives in a nursing home in Philadelphia, Pennsylvania.
[00:40.33] But halfway through the month, he has almost no money.
[00:46.57]Morisey is one of many Americans living in nursing homes who face a difficult situation. 
[00:54.92]To stay in the nursing home, they must hand over all their income and only receive a small payment, as low as $30 a month, to buy the things they would like. 
[01:11.32]The payment is called the personal needs allowance, also called a PNA.
[01:20.27]Nearly two-thirds of Americans living in nursing homes have their care paid for by Medicaid. 
[01:29.99]Medicaid is a health insurance program that is administered by the states. 
[01:36.64]It is paid for equally by state governments and the federal government. 
[01:44.03]In exchange for the coverage, all retirement and other income people on Medicaid would receive is used to pay their nursing home costs.
[01:58.91]That means the only other money residents receive from the government is the PNA.
[02:07.41]The allowance is meant to pay for anything the nursing home does not provide.
[02:14.71]This can include telephones, clothes or a birthday present for a grandchild.
[02:23.35]In some states, the PNA can be only $30 a month and it cannot be higher than $200.
[02:34.57]"It's really one of the most humiliating things for them," said Sam Brooks, a lawyer for The National Consumer Voice for Quality Long-Term Care.
[02:48.83]"It can really be a point of shame," he added.
[02:53.91]Medicaid is meant to pay health care costs for poor adults and children or those with other special needs. 
[03:06.33]Medicaid was created in 1965 along with Medicare, the federal government health insurance program for retired Americans.
[03:19.41]In 1972, the U.S. Congress established the personal needs allowance, and set the lowest amount at $25.
[03:33.23]Had the PNA been linked to inflation, it would be about $180 today.
[03:42.16]Congress raised the minimum only once, to $30, in 1987.
[03:50.37]The small allowance is difficult for nursing home residents who do not receive support from family or friends.
[04:00.71]Marla Carter visits her mother-in-law at a nursing home in Owensboro, Kentucky. 
[04:09.18]She sees how poor some residents are. 
[04:13.83]With a $40 allowance, they are dressed in clothing that is the wrong size.
[04:21.53]Some have no socks or shoes. Basic supplies run low.
[04:27.39]"That's what was so surprising to us," Carter said, "the poverty."
[04:34.32]She was so upset that she and her husband started a nonprofit, Faithful Friends Kentucky, to give out needed supplies to nursing home residents in the area,
[04:50.80]"You bring a soda or a toothbrush and they'll get so excited," she said. "It's so sad to me."
[04:59.39]Several states have increased allowances. But most remain low.
[05:05.67]The American Council on Aging, a non-profit group, says 28 states have allowances of $50 or less.
[05:17.70]Five states give residents $100 or more each month, including Alaska, which offers $200 monthly.
[05:30.44]Four states - Alabama, Illinois, North Carolina and South Carolina - remain at $30.
[05:42.09]Morisey, of Pennsylvania, entered a nursing home after a fall and, once here, learned his income would no longer be his.
[05:54.42]Pennsylvania's allowance is $45, and after a monthly $20 haircut and $5 tip, it is difficult to decide what he should buy with the remaining $20.
[06:11.12]"It's the little things," he said.
[06:14.54]"You don't think about these things until you no longer have them."
[06:19.88]His small savings are nearly gone now. Without help from his church, he could not pay for a phone.
[06:29.96]I'm Andrew Smith. And I'm Caty Weaver