No one from DISH has ever said the annual sub is the reason for the fee. Even the executive offices basically said "because you're a long time, valued customer I'll remove the fee" last year when giving the credit. If going monthly would get rid of it I can probably talk her into that. I think she pays annually more for the convenience of it that any perceived savings. Maybe autopay is the way to go if she doesn't want to write a check every month.
DirecTV is sounding good for her though. I doubt DISH will ever get her locals (Springfield MA DMA) as I've never heard them mentioned. Dtv just added them in HD. All American Direct is up to $12.99 a month IIRC, so just the savings on networks would help. I'm sure she won't be thrilled to have to learn new channel numbers, but that's probably the only downsde.