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Agency for "elders' has foes, friends

Even before E. Bentley Lipscomb grabbed a brush and started painting his own office, critics attacked his new state Department of Elder Affairs as another bureaucracy that would funnel money into salaries instead of services.

A year later, Lipscomb, the 55-year-old department secretary, earns praise from some of those same critics for raising the profile of elder issues in Florida.

But it doesn't appear the rough ride is over yet for Lipscomb, who marked the department's first anniversary Oct. 1. The longtime aging services official and former top aide to Gov. Lawton Chiles still is dogged by a handful of influential state legislators with questions about his department's effectiveness and cost.

The criticism started early, has slowed some, but hasn't stopped.

First, there was the $2-million the department invested in computers. Lipscomb defended the purchase, saying the money _ unused program money _ would have been lost if he hadn't spent it. He also said the computers would increase efficiency.

Then there was a state Senate committee report that said the new department was spending almost $1-million more on salaries for the same programs that existed before the department was created. Lipscomb says the committee's numbers were wrong.

"I haven't seen anything happen except Bentley Lipscomb has a good job," said retiring state Sen. Jack Gordon, D-Miami Beach, a frequent critic. "I've felt, and I still do, that Elderly Affairs didn't need to become its own department."

Lipscomb is annoyed by such comments. "I think we've done an excellent job," he said. "This agency did not cost the people of Florida an additional bit of money."

Lipscomb points to a list of achievements: helping more people get home care, bringing in more volunteers, advocating elder issues with federal and state officials, and increasing efficiency in the programs he oversees.

"But, yes, we didn't do enough," he said. "People are still going into long-term care who didn't need to. We didn't get enough done on Alzheimer's. We opened shop right as the Legislature was starting, so we didn't get all we wanted through."

Lipscomb says the department's second year will provide a better test of how well he and the Chiles administration represent older Floridians, and whether the department will quiet skeptics who Lipscomb says "still are working to see it fail."

How it started

Florida voters approved the creation of a Department of Elderly Affairs in November 1988. But nothing happened for two years, until then-U.S. Sen. Lawton Chiles seized upon the idea during his campaign for governor.

Chiles hit tirelessly at the issue. He said Florida, with 3-million people older than age 60, should be a leader in helping "elders."

Chiles found much popular support for his plan to transfer programs from the megasized Department of Health and Rehabilitative Services into a department specifically for elder affairs. Florida's older residents said they often felt disconnected from the state's huge bureaucracy.

But some legislators were reluctant to set up a new bureaucracy.

"Most of the real advocates for the elderly in the Senate were opposed to a separate department," said state Sen. Curt Kiser, R-Palm Harbor. "We continue to oppose a separate department. But I've been hesitant to be critical. It does take time for a new department to take hold."

What the department does

The Department of Elder Affairs handles four areas:

Programs under the federal Older Americans Act, which provides about $56-million for meals, transportation and adult day care.

Community Care for the Elderly; the state's $53-million program tries to keep frail older people out of more costly nursing homes by providing home care such as help with chores, personal care and meals.

Alzheimer's Disease Initiative, a $4-million program that provides training for families or others taking care of Alzheimer's victims at home. The program provides trained caregivers who come into the home for a short period of time to give family members a break. It also helps finance model day-care centers, referral services and research.

Low-Income Home Energy Assistance, a $2-million program that helps pay power bills for poor older people.

The department manages a large volunteer program. During the last year, more than 24,000 people volunteered to deliver meals, answer phones or provide transportation, for example.

Now that the state has a department, a new theme is emerging: It needs to be stronger.

"There are still some programs for the elderly in HRS," Kiser said. "More and more people are coming to the conclusion they need to be in one place."

The parts remaining in HRS include the billion-dollar Medicaid programs that pay for nursing home care; the Medicaid Aged and Disabled program, which covers the cost of prescription drugs; the Optional State Supplement program that provides money to keep elders in foster homes or adult congregate living facilities; and a program that gives money to caregivers to help old people stay in their homes.

Lipscomb said he thinks it is important to consolidate to provide one central place for most issues affecting elders. He especially wants to take responsibility for establishing a clear policy on long-term care.

Lipscomb is the voice

Lipscomb's ability to connect with Florida's older residents is likely his best asset.

For those familiar with Lipscomb, a mid-September day provides a vintage scene: The secretary, who is scheduled to speak at the Silver-Haired Legislature, walks into the grand hall outside the state Senate and House chambers in Tallahassee, and his hand is instantly seized. The people surround him like an old friend.

He walks a few steps and huddles with another group. During his speech, Lipscomb is praised for his department and stopped several times by applause.

"This department gave us a voice," said Michael Diglio of Hudson, a leader in the Silver-Haired Legislature, a model government of elders.

Those words are echoed throughout the four-day conference.

"Having the department gives us a good chance to get in on discussions and make ourselves heard," said former Hernando County Judge Monroe Treiman, 73, of Brooksville.

Lipscomb has spoken throughout the state. His department's monthly newspaper, the Elder Update, goes to almost 100,000 people, mostly older Florida residents who get it free. The paper, with department news and features on elder political, economic and consumer issues, costs about $10,000 a month to print and distribute, with the money coming from federal funds and private donations.

Lipscomb is tireless in maintaining media contacts, keeping his name and his issues in the news.

"Older people need to be united, to speak in one voice," Lipscomb likes to say. "And we are here to help."

Lipscomb said he and his 60 employees have met 80 percent of the goals during the department's first six months. Among other achievements, they received approval to raise the amount of money _ from $422 a month to $1,266 _ a person can make and still qualify for Medicaid home services. This should result in more people qualifying for the assistance this fiscal year. About 8,000 people receive such services now.

But the department's own performance report in July shows several promises that couldn't be completed.

"We need to do something about the high cost of long-term care," Lipscomb said. "We must find ways to help people stay in their homes, to help families care for folks in their communities instead of in an institution."

Lipscomb wants to make Elder Affairs the lead state agency for solving the problems associated with caring for older people. He wants more money for home care and changes in how Medicaid money is spent.

"When the Legislature meets in January," Lipscomb said, "we'll be ready."

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