Every month, the agency where Mary Beals-Luedtka works has $100 to spend on grocery deliveries for a few of the area’s seniors. Beals-Luedtka oversees a senior services agency that covers four vast counties in northern Arizona — predominantly rural, poor and home to several Native American communities that have been devastated by COVID-19.

Caseworkers there serve about 120 seniors each, arranging meal dropoffs, Medicare counseling and rides to the doctor’s office.

Which seniors get the $100 grocery delivery? Each caseworker can pick two.

“It’s brutal,” Beals-Luedtka said. “We have to choose the neediest people, and that’s nearly impossible.”

Hers is one of dozens of federally funded agencies that are holding together a frayed safety net for the country’s elderly while teetering on the edge of a financial cliff. Financed by Congress under the Older Americans Act, these are the agencies that fund hundreds of senior centers, and together they coordinate iconic programs such as Meals on Wheels, as well as senior transportation, technological help, home care, translation services, home modification, Medicare counseling and legal aid — anything an older person may need to live at home and avoid a premature move to a nursing facility. The centers also serve many adults with disabilities and provide support to overworked home care professionals.

They are a vital resource for millions in normal times. During a pandemic that is uniquely dangerous for older people and disabled people, their services — and the ability to live at home rather than in extended care — can spell the difference between life and death.

But funding has simply not kept pace. In the two COVID-19 relief bills passed in March, Congress set aside $1.05 billion in additional funds for the Older Americans Act, which turned out to be just a fraction of the overall need.

We have to choose the neediest people, and that’s nearly impossible. Mary Beals-Luedtka, director of the Area Agency on Aging for the Northern Arizona Council of Governments

“We blew through our share,” Beals-Luedtka said. The funding allowed her agency to distribute two meals a day, seven days a week for three months. But the coronavirus pandemic had doubled the number of seniors depending on her agency, to more than 2,000. By July, they cut back meals to once a day, five days a week for just the neediest seniors. Some clients cried when they got the phone call; a waiting list grew to hundreds of people.

To help plug the gap for her agency and hundreds of other sites, a bipartisan group of lawmakers initially suggested that the latest relief package, passed in December, include an extra $750 million in Older Americans Act funding — the same level of emergency funding as was in the March economic relief package.

Senators and House members reassured advocates up until the eleventh hour that the final package contained the full $750 million. But at the last minute, when the package disappeared into leadership negotiations, advocates got word that all $750 million was on the chopping block. The final package contained just $175 million for meal delivery and virtually nothing for other services.

Advocates were aghast. “Soon these crises will be happening in every state,” said Sandy Markwood, CEO of the National Association of Area Agencies on Aging. “It’s really devastating.”

“With this last package, we’ve gone from a significant investment in meeting the needs of older adults in order to stay at home — where they are in desperate need of food and services and support — to one that is woefully inadequate for helping people live at home safely.”

Markwood is praying for more funding in a new round of COVID-19 relief under the incoming Congress, especially now that Democrats will control the Senate.

In the meantime, senior centers across the country are growing desperate.

In rural southeast Illinois, administrators of the White County Senior Citizens Center recently wondered if they could make payroll this coming Friday. The center delivers roughly 7,000 meals a month to mostly low-income seniors in two counties. It has already been dropped by its food vendor once, and at the beginning of January it was owed nearly $59,000 in reimbursements by the state of Illinois. In New York, a coalition of senior advocates recently warned the governor that a waiting list for senior services is now 11,000 people long.

‘We’re It’

The challenge is a combination of staggering need and unprecedented costs. COVID-19 has left families poorer and seniors more isolated, and made caregiving potentially deadly. Just two months into the pandemic, more than 90% of agencies on aging were serving new clients, and 70% of their existing clients needed extra services, according to a May survey by Markwood’s group.

Supplemental money from cities, states and partner charities have dried up, while seniors have grown desperate for any services that allow them to avoid deadly long-term care facilities. “Our agencies are even getting calls from people who want to take loved ones out of long-term care,” Markwood said.

Senior centers and agencies have gone deep into their pockets to transform communal dining rooms into grab-and-go and delivery operations, to buy new delivery vehicles and otherwise adapt their services for a world gripped by the coronavirus crisis. The agency in northern Arizona recently found some funding to provide groceries, medication and three months of food to recovering COVID-19 patients who are being discharged from a Navajo County hospital.

The isolation is really starting to take its toll on some of them. They need to know someone is there. A worker at the White County Senior Citizens Center in Carmi, Illinois

In Tucson, the drop in funding has forced the county’s senior agency to slash a program that delivered groceries to more than 600 families in public housing. The senior agency can afford delivery for only about 150 households, with none of the subsidies it provided over the summer. “They’ll have to be finding other ways to pay for their groceries,” said W. Mark Clark, the president and CEO of the Pima Council on Aging.

Beals-Luedtka is coming up with a tier system to decide which of her seniors is most in need of the once-a-day meal deliveries her agency can afford — weekdays only.

Senior centers in rural parts of the country are especially strained. Older adults are more likely to live in rural areas, where public services are threadbare and there are no soup kitchens or large churches.

“We’re it,” said Vicki Harrelson, who heads the White County Senior Citizens Center in Carmi, Illinois.

At its peak, the White County center was delivering roughly 7,000 meals per month — lunch and dinner Monday through Friday, and frozen meals on the weekend. The center has had to purchase new vans for meal deliveries and hire a dishwasher and several facility workers because the nonprofit that used to underwrite those positions no longer had the money.

Besides meals, the center provides what is many seniors’ only contact with the outside world.

“I call most of our seniors to check in every day,” said Pam Cobb, the center’s receptionist. “My calls have been lasting longer. The isolation is really starting to take its toll on some of them. They need to know someone is there.”

They’ll do anything to try to serve people. But when the money runs out, they can’t. Sandy Markwood, CEO of the National Association of Area Agencies on Aging

The center’s future, though, is extremely tenuous. An overhaul of the state’s beleaguered financial management system appears to have delayed reimbursements to many of the state’s senior centers.

The $59,000 that the White County center is owed in reimbursements, and how soon it arrives, may determine whether the center can survive another few weeks.

Their food vendor dropped them due to unpaid bills in mid-December, then resumed deliveries after the senior center paid the vendor $24,000 — still not the entirety of what it owes. The senior center cut evening meals starting the first Monday of the new year, and last week it was not clear the center would have the $14,000 it needs to make payroll on Jan. 15. The center ultimately made payroll by laying off two employees.

The center has run through a bequest and a modest Paycheck Protection Program loan. The budget is so meager that a local restaurant has promised to donate its tips.

Thousands of centers have some version of this compounding disaster, Markwood said.

“These are people with hearts of gold,” Markwood said. “They’ll do anything to try to serve people. But when the money runs out, they can’t.”

An earlier version of this article described the May survey by the National Association of Area Agencies on Aging as a survey of senior centers; in fact, it was a survey of regional agencies that fund many centers.

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