Thanks to Barbara La Valleur, who directs a local block nurse program in St. Paul: . She wrote this letter to the editor in today’s Minneapolis Star Tribune about how her organization’s work is keeping people at home longer, at a much lower cost than institutional care … and outlines the opportunity we have to radically change how we fund local solutions to helping people live the way they desire …

Your July 9 editorial about reaching out to help seniors live at home and the challenges of Meals on Wheels programs is a drop in the tidal wave bucket before the inevitable Aging Tsunami crashing our way.Latest figures show that more and more seniors are living longer and most have the same goal: to remain in their homes for as long as possible. Meals on Wheels is a valuable service that supports their goal. That’s also what the Living at Home/Block Nurse Programs (LAH/BNPs) do for Minnesota seniors.According to the latest Cost and Services analysis report issued by the Elderberry Institute, the average annual cost per elder served by the 40 Minnesota LAH/BNPs reporting in 2006-07 was $530 compared to $53,154 in average annual costs to maintain a senior in a nursing home.That same report states that Minnesota’s LAH/BNPs served 11,578 seniors and kept 1,138 at home avoiding nursing home placement at a savings of $36.8 million.LAH/BNPs are nonprofits each serving a specific geographical area with a small staff and group of generous volunteers who help seniors with rides to medical appointments among many other services.Funding for LAH/BNPs has traditionally been through city, county and state (Department of Human Services) grants, foundation grants, small fundraising campaigns, donations by seniors and the community. The average budget for a rural program is $54,000 while for metro programs it’s $110,000.Like other program directors, I balanced my time this week between completing required reports, writing a grant, and spending time with our clients (checking in with Tom to make sure he’s OK, arranging for a ride to the doctor for José and dealing with Myrtle’s crisis because she forgot to take her medication and her caregiver daughter lives in another state).In the recently announced 2008-09 Department of Human Services Community Service/Services Development competitive grant bidding process, only one-third of the 114 applicants received funding.

Unless we embrace a radical change to fund these programs, the public expense to support seniors in nursing homes will dramatically increase. The LAH/BNP healthcare model is a proven, affordable and happy solution for our seniors.

BARBARA LA VALLEUR, ST. PAUL;

EXECUTIVE DIRECTOR, PAYNE-PHALEN LIVING AT HOME/