Senior services – including expanding support for Meals on Wheels, contracting to provide free dental care for veterans (many of whom are seniors), and addressing funding and staffing issues at the Grand Traverse Pavilions – dominated discussion at the Grand Traverse County commission meeting this week.

Commissioners Wednesday approved funding support for two key programs that will benefit local seniors. The first is Meals on Wheels, a program that delivers meals to homebound seniors over the age of 60 on a weekly basis. Hot meals are also available for congregate dining through the Grand Traverse Senior Center Network. The program not only ensures seniors have access to nutritious meals but provides a vital social connection and regular safety checks for clients, representatives said. In Grand Traverse County, 77,716 meals were delivered to seniors in 2022.

Meals on Wheels is administered locally through the Northwest Michigan Community Action Agency (NMCAA) and funded by a variety of sources, including the Area Agency on Aging (which represents almost a third of the program budget), the USDA, donations, fundraising, and grants. Grand Traverse County has historically contributed $20,000 annually from its senior millage funds. But for the past several years, “the NMCAA has experienced funding deficits within the Meals on Wheels program, along with the growing costs of doing business,” according to Grand Traverse County Commission on Aging Director Lana Payne. “Increasing food and fuel costs have especially impacted the Meals on Wheels program. Over the past three years there was also special COVID funding for the meal programs, which is now longer available.”

That led to a request to increase Grand Traverse County’s contribution up to $125,000 for 2024 and 2025. The bulk of that funding – 94 percent, or $117,500 – will go toward home-delivered meals, while the other six percent ($7,500) will go to congregate meals. County commissioners unanimously approved the funding boost, with Commissioner Ashlea Walter saying she had participated in a Meals on Wheels ride-along and got to experience firsthand the impact the program had on clients. She said in retrospect, Grand Traverse County likely should have “put more money” into Meals on Wheels sooner to better support the program’s budget.

Commissioners Wednesday also approved a one-year contract for the Grand Traverse County Department of Veterans Affairs to pay United Way $6,000 per month through its Veterans Fund to help cover free dental services for veterans, many of whom are seniors. United Way’s United We Smile program offers numerous services – including X-rays, fillings, cleanings, extractions, dentures, partial dentures, crowns, bridges, sealants, and more – with no out-of-pocket costs for veterans. Approximately 82 veterans are in the pipeline to receive assistance.

The agreement says VA staff will be on-site weekly to work with veteran clients participating in the United We Smile program. United Way CEO Seth Johnson said the clinic provides enough services to get every client up to “stable oral health,” regardless of how many visits that takes. There is no cap to how many clients can be served, he said; the VA’s $6,000 monthly contribution likely won’t cover the full program expenses but will help offset costs.

Finally, commissioners heard a presentation Wednesday on plans to address funding issues at the Grand Traverse Pavilions. Grand Traverse County has been covering bills for the nursing facility while it waits for key payments to come in – including Medicaid reimbursement and a potential Employee Retention Credit through the IRS – with the Pavilions now in debt to the county for approximately $4.5 million.

CPA Rob Long of Plante Moran – which is helping the Pavilions create a financial recovery plan – noted that sustainability is a significant problem for nursing homes industry-wide, many of which are struggling due to declining client populations, staffing challenges, and regulatory constraints. He said the “economics have broken down” for facilities like the Pavilions. Declining occupancy numbers are particularly noticeable in Grand Traverse County: While the industry as a whole hovers around a 78 percent occupancy rate, the Pavilions is at 59 percent. The facility’s 2023-24 budget anticipates having 145 nursing facility patients and 57 clients in its assisted living cottages. The three other nursing facilities in Grand Traverse County have occupancy rates of 69, 71, and 77 percent, Long said.

Using a combination of factors – including receiving its anticipated outstanding payments, raising room rates, and cutting 15 full-time employees, none of whom are direct-care workers – Long said the Pavilions is anticipated to pay back the county by the end of 2024. County Administrator Nate Alger said an official agreement between the entities could extend that repayment period to March 2025. Long said the repayment plan doesn’t depend on receiving the IRS credit – which may or may not materialize – and doesn’t rely on increasing the number of Pavilions clients, since census is difficult to predict. However, the budget does include dollars for marketing and communications, with Long saying that increasing occupancy should still be a key goal for the Pavilions and would assist its sustainability.

In the long term, however, county and Pavilions officials may need to look at options to “right size the facility,” Long said. “There’s a likelihood that 240 beds is more than your community is going to need going forward.” He said officials could look at streamlining operations or facility space, and/or finding an administrative structure that better fits the size of its client base. An ad hoc committee of commissioners – comprised of Chair Rob Hentschel and Commissioners TJ Andrews and Darryl Nelson – has been formed to evaluate options for the Pavilions.