In Greater Lansing, the Tri-County Office on Aging's state-funded in-home services program provides about 120 residents with aides who help them get dressed, make meals or go to the doctor's office.
But another 300 are on an ever-growing waiting list.
"Right now, there are people who have been waiting a year," said Marion Owen, the agency's executive director. "What we are losing is our safety net for older adults."
Many older citizens, and the groups representing them, fear things will get worse as Michigan faces a projected budget deficit of about $1.6 billion in the year that begins Oct. 1.
This time, the hard choices land on the desk of Rick Snyder, the new Republican governor. Snyder hasn't indicated what cuts he might propose, but he has opposed raising taxes.
This year's challenge is especially daunting because it comes on top of nearly a decade of budget cuts.
"We just can't afford the services that are now being delivered in the state with the tax base we have," said Gary Olson, former director of the Michigan State Senate Fiscal Agency, a nonpartisan agency that analyzes budget issues for the state Senate.
"Everything is going to have to be on the table," he said.
Like everyone, older citizens have dealt with the consequences of budget cuts: roads with potholes, reduced police services and state office closings. But they've also faced reductions in programs unique to them, such as Meals on Wheels, in-home services and senior centers.
The state cut Meals on Wheels by more than $600,000 between 2005 and 2009 and reduced the number of people served by about 2,000 to just under 50,000. Support for home services declined by roughly $400,000, and the number of people served fell by about 4,000 to just over 21,000.
With the end of feeral stimulus dollars, waiting lists for services are likely to grow, said Sharon Gire, director of the Michigan Office of Services to the Aging.
Snyder will present his budget in February. He advocates "value- for-money budgeting" — funding programs based on their success, not on previous spending levels.
Mary Ablan, executive director of the Area Agencies on Aging Association of Michigan, said she is encouraged that Snyder has emphasized prevention services. She noted that in the state of Washington, which Snyder cites as a budgeting model, citizens made helping older people stay in their homes one of their priorities.
"We have a good story to tell. We have data that show that older people can be maintained in their homes for a much smaller cost than if they were to move to a nursing home or live in assisted living," she said.
Some Medicaid services — such as dental and podiatry services, which were eliminated twice in the past decade — are potentially on the chopping block again.
A number of groups, including AARP Michigan, advocate a mix of revenue increases and spending cuts to limit reductions in services. One option is lowering the 6 percent sales tax rate but expanding it to services.
Tax breaks for older residents likely will come under scrutiny. Those include an additional personal tax income tax exemption of $2,300, large income tax exemptions for pensions, and special treatment on the homestead property tax credit.
AARP members support a balanced approach to protecting services and keeping taxes at a reasonable level, said Eric Schneidewind, AARP Michigan president.
"Our position is that all groups are going to have to sacrifice," Schneidewind said. "We are prepared to be part of that, but not bear it alone."
Chris Andrews is a freelance writer living in Okemos, Mich.