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SC Aging audit finds thousands of seniors on waiting lists, chronically low morale

Munn

Connie Munn leads the state's Department on Aging. File/Adam Benson/Staff 

COLUMBIA — An audit of the agency tasked with helping South Carolina's seniors live independently found a host of problems, including no statewide plan for reducing waiting lists, not correctly distributing money and insufficient oversight of groups actually providing the services.

The report by the Legislative Audit Council, released Monday, also found chronically poor morale in an agency that's been in near-constant transition for two decades. Before the state Senate confirmed director Connie Munn in January, none of the 10 directors who had come and gone since 2003 — staying as little as six months — had any background in aging programs.

Almost three-fourths of employees responding to a survey in January complained of back-biting and malicious gossip, fewer than half believed what their managers told them, half said there's gender discrimination and about half said promotions aren't based on merit.   

"This shows what she was walking into," audit director Earle Powell said of Munn, whose experience in senior issues includes leading a regional aging office.

It's the first legislative audit of the state Department of Aging, which became a stand-alone, Cabinet agency last year. It was previously under the lieutenant governor's office, occupied by six different politicians in the last decade. Poor morale and allegations of discrimination were largely why the Senate refused to confirm Munn's predecessor, Stephen Morris, a friend of Gov. Henry McMaster's who was originally hired in 2015 when McMaster was lieutenant governor.  

"You had so much turnover. How can you get any direction?" Powell said, adding the timing was right for a thorough review. 

The audit can serve as a "good guidebook" for Munn, he said, crediting her for already implementing many of the recommendations.   

While Munn thanked the audit council, which is the Legislature's auditing arm, for pointing out deficiencies she says are being corrected, she still took issue with the finding that her agency had no plan to reduce waiting lists. She said that's the responsibility of the regional providers. 

As of January, more than 5,000 seniors were on waiting lists for services, mostly for home-delivered meals and in-home personal care, with totals varying widely between the state's 10 regions for aging programs. Other services with waiting lists were homemakers who help with housekeeping and cooking, transportation, minor home repair, yard work and group dining at senior centers, according to the audit.  

The agency does not track the number of people on waiting lists or how long they've been waiting, the audit said. 

"Without timely and accurate waiting list data, (the agency) cannot fully understand the extent of unmet needs throughout the state and will be unable to determine the effectiveness of its efforts to reduce waiting lists," reads the audit. 

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Sen. Katrina Shealy, who requested the audit, said the agency needs to come up with a plan of some sort in a state where the population of residents 60 and older has increased 40 percent in the last decade.

Despite the hike in the older population, the number of seniors receiving Aging services increased just 1.3 percent between 2008 and 2018, the latest year a breakdown was available. For some services, including homemakers and group meals, the number receiving help actually declined, according to the audit.  

About 36 percent of the agency's $52 million budget comes from state taxes, while the bulk comes from the federal government. 

"Ask the Legislature for more money. That's a plan," said Shealy, R-Lexington, adding that requires knowing how much is needed and having the data to back it up. "Get in line and ask for the money. The Legislature's not going to offer it to you if you don't ask for it."

Munn accused auditors of not understanding the issue's complications and the agency's role in essentially funneling money to regional providers. 

"In various cases, it is not funding alone that will eliminate waiting lists, but the availability of resources, staff, and transportation issues that can preclude services being provided," Munn wrote in her official response. The harsh reality is, as seen during the COVID-19 pandemic, waiting lists can never fully be eliminated due to the growing number of seniors in need of services."

Still, she wrote, the agency will develop better tracking protocols. 

Another problem is that the agency is not using the most recent Census data when distributing money to the 10 regions. The difference in what regions would receive using updated numbers is small by percentage, at less than 1 percent, but could still mean some regions should be receiving more than $100,000 additional for services.  

And for preventative health services, the agency isn't using a different formula that gives priority to rural areas that lack access to medical care, as required by the federal Older Americans Act. It's only a technical violation, as the federal government has approved how South Carolina distributes that money.

But it still means the agency isn't ensuring that the seniors who most need the services are getting them, auditors said.

Nearly half of the LAC's recommendations deal with the need to monitor the local governments and businesses providing the services around the state, to make sure they're following the rules, spending money appropriately and not offering shoddy services. For the bulk of the programs, there was no documentation of any monitoring, the report said. 

Munn said she started an initiative for uniform monitoring in January. Those efforts have been delayed by COVID-19 but should be in place within the next six months, she said. 

Follow Seanna Adcox on Twitter at @seannaadcox_pc.

Assistant Columbia bureau chief

Adcox returned to The Post and Courier in October 2017 after 12 years covering the Statehouse for The Associated Press. She previously covered education for The P&C. She has also worked for The AP in Albany, N.Y., and for The Herald in Rock Hill.

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