2009 Legislative Priorities

1. Provide funding to sustain Project C.A.R.E. (Caregiver Alternatives to Running on Empty). Project C.A.R.E. provides information, referral, consultation and linkage to caregivers of persons afflicted with Alzheimer’s disease. By helping families keep a loved one in the home longer, less time will be required for institutional care. The resulting savings in public funds are substantial. We recommend that $1,000,000 in recurring funds be appropriated to sustain Project C.A.R.E. in the 18 counties it now serves and to expand it into other counties.
2. Increase funding for home and community based services for older adults by increasing the Home and Community Care Block Grant by $5 million. Home and community-based services include home-delivered meals, adult day care, health care, in-home aid and other services that help impaired older adults stay in their homes. These services are less costly than institutional care. The rapidly growing population of older adults is increasing the demand for these services. There are thousands of people on the waiting list for Home and Community Block Grant services.
3. Increase funding for senior centers by an additional $2,000,000 in recurring funds for a total of $3,265,316 a year. Senior centers provide programs and services that enhance the health and wellness of older adults and support their efforts to remain independent. The 163 senior centers currently in operation or under development serve 97 counties. The requested increase in recurring funds would enable these senior centers to expand their services to meet the needs of a growing population of older adults.
4. Implement practical and cost-effective steps to address concerns related to the mixing of populations, including younger adults with mental illness and frail older persons residing in long term care facilities. These steps would include specialized health training for facility personnel. Approximately 40% of persons residing in adult care homes have a diagnosis of mental illness. With the recent focus on mental health reform, deinstitutionalization, and the placement of persons with mental illness in the least restrictive environment, many problems related to the mixing of populations exist in long-term care facilities.
5. Establish a cap on the increase in the assessed value of property determined during revaluations for persons over the age of 65, eligible for a Homestead Exemption. Revise the limits of the Act to income of $35,000. The 2000 census estimates that 12.7% of NC’s elderly over 65 have an income below the poverty level. Frequent reassessments of property values have resulted in much greater tax burdens within this population.

2008 Legislative Priorities

1. Increase funding for home and community based services for older adults by increasing the Home and Community Care Block Grant by $5 million. Home and community-based services help impaired older adults stay in their homes. Key services include home-delivered meals, adult day care/day health care, in-home aide, and respite care for family caregivers. As the older population continues to grow, so does the demand for services. Those in particular need of services are the over 125,000 older adults in the state who are 85 and older and those who are disabled. More than a quarter of the persons age 65 and older living in the community have two or more physical or mental conditions that make it difficult for them to do such activities as walking, dressing, and bathing. Although there is an increased need for services, the state is losing ground in its effort to help frail older people in the community. There are over 11,000 people on the waiting list for Home and Community Care Block Grant services.
   
2. Increase funding for senior centers by $634,684 for a total of $2 million per year. There are 163 senior centers in North Carolina currently operational or under development in 97 counties in the state. These centers provide a variety of programs and services to enhance the health and wellness of older adults and to support their efforts to remain independent in their communities. The current recurring state appropriation for senior centers is limited to $1,365,316. With limited funding, many senior centers are short-staffed and unable to grow their services, activities, space and operating hours, at the time expectations for senior centers have grown (e.g., participation in Medicare Part D education and counseling).
   
3. Appropriate an additional $15,000 in Recurring Funds for the operation of the Senior Tar Heel Legislature. The Senior Tar Heel Legislature currently receives $3,000 per year to cover the expenses of the Senior Tar Heel Legislature. However, the costs of the meeting space, breaks, mailings, and a meal are approximately $6,000 per meeting or $18,000 per year. The Senior Tar Heel Legislature requests an additional $15,000 be appropriated from the General Fund to the Division of Aging and Adult Services to cover the costs of the Senior Tar Heel Legislature's three scheduled meetings per year.
   
4. Provide Dental Care for Older Adults with Special Needs and in Rural Areas. The Senior Tar Heel Legislature recommends that $1.35 million be allocated to the Office of Rural Health and Community Care to recruit dentists for underserved areas in North Carolina including dentists that would focus on providing care in long-term care facilities. The Division of Public Health and the Office of Rural Health and Community Care would use the model of existing mobile dental clinics to provide access to care for residents residing in long-term care facilities, as well as seniors and the disabled living at home.
5. Provide funding to sustain Project C.A.R.E. (Caregiver Alternatives to Running on Empty). The Senior Tar Heel Legislature recommends that $500,000 in recurring funds be appropriated from the General Fund to the Division of Aging and Adult Services to sustain Project C.A.R.E., which currently serves 14 counties, and to expand it into other counties.
   

2007 Legislative Priorities

1. Increase funding for home and community based services for older adults by increasing the Home and Community Care Block Grant by $5 million. Home and community-based services help impaired older adults stay in their homes. Key services include home-delivered meals, adult day care/day health care, in-home aide, and respite care for family caregivers. As the older population continues to grow, so does the demand for services. Those in particular need of services are the over 125,000 older adults in the state who are 85 and older and those who are disabled. More than a quarter of the persons age 65 and older living in the community have two or more physical or mental conditions that make it difficult for them to do such activities as walking, dressing, and bathing. Although there is an increased need for services, the state is losing ground in its effort to help frail older people in the community. There are over 10,700 people on the waiting list for Home and Community Care Block Grant services as of October 12, 2006.
2. Increase funding for senior centers by $634,684 for a total of $2 million per year. There are 163 senior centers in North Carolina currently operational or under development in 97 counties in the state. These centers provide a variety of programs and services to enhance the health and wellness of older adults and to support their efforts to remain independent in their communities. The current recurring state appropriation for senior centers is limited to $1,365,316. With limited funding, many senior centers are short-staffed and unable to grow their services, activities, space and operating hours, at the time expectations for senior centers have grown (e.g., participation in Medicare Part D education and counseling).
3. Shift the cost of Medicaid from counties to the State. Counties are currently contributing $450 million, annually, to pay for Medicaid benefits with much of this going to pay for frail and elderly North Carolina citizens. This has created a significant economic burden on counties. The Senior Tar Heel Legislature recommends that the State of North Carolina assume the entire cost of Medicaid, thereby relieving the counties of that burden. In addition, the State's assumption of Medicaid responsibility should not alter the current tax allocation to the counties while maintaining current state levels of services.
4. Provide Prescription Drug Assistance for low-income persons age 65 and over. Although older adults are now eligible to be a part of Medicare Part D Prescription Drug Plans, there are significant gaps in services that leave North Carolina older adults again choosing between medicine and food. Even with the Extra Help program and the new NCRx program, many older people still need help with lack of coverage during the "doughnut hole." The Senior Tar Heel Legislature recommends that North Carolina reinstitute a program to serve as a "wrap around" for the Medicare Part D program. These funds should be used for 1). Persons 65 and over who are not eligible for the full federal "Extra Help" subsidy; 2). Persons whose income is not more than 175% of the federal poverty level; and 3). Persons who need assistance during the "doughnut hole" coverage period of Medicare Part D.
   
5. Provide Dental Care for Older Adults with Special Needs and in Rural Areas. The Senior Tar Heel Legislature recommends that $1.35 million be allocated to the Office of Rural Health and Community Care to recruit dentists for underserved areas in North Carolina including dentists that would focus on providing care in long-term care facilities. The Division of Public Health and the Office of Rural Health and Community Care would use the model of existing mobile dental clinics to provide access to care for residents residing in long-term care facilities, as well as seniors and the disabled living at home. Additional funding should also be appropriated to the existing loan program that the Office of Rural Health and Community Care operates. The loan program assists with loan payments of dentists willing to serve persons over age 65 who are not eligible for full Medicaid benefits, Medicaid eligible persons, persons whose income is not more than 150% of the federal poverty level and seniors needing mobile dental services. However, the loan program is not funded.