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.
   

2006 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. State funding for home and community based services is almost 2% less now than it was in FY2000-01. During the last four years, there has been a decline in the number of persons served and the number of services provided through the Home and Community Care Block Grant. Numerous counties in the state are reporting over 200 seniors on waiting list for key home and community base services.
2. Re-enact the long-term care insurance tax credit as recommended by the N.C. Study Commission on Aging. The General Assembly passed legislation in 1998 to allow individuals who purchase a long-term care insurance policy to claim a state income tax credit. The purpose of the credit was to encourage more people to purchase long-term care insurance policies which assist with the cost of in-home and nursing home care. This results in a public benefit of having an increased number of people paying privately for long-term care services. The credit was 15% of the premium paid, not to exceed $350 for each qualified long-term care insurance contract. It was effective for the tax year which began on January 1, 1999. The legislation had a sunset provision and the credit expired at the end of the 2003 tax year. Legislation is needed to re-enact the tax credit which is referenced in G.S. 105-151.28 and G.S. 105-160.3(b)(7).
3. Increase funding for senior centers by $3 million. There are 160 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 $1,415,316. Many senior centers have had to reduce the variety of activities and services they offer, reduce operating hours or days, close satellite locations, reduce outreach to older adults in remote areas, and delay needed maintenance and repairs to facilities and equipment because of funding constraints.
   
4. Take steps to better support grandparents and other family members raising minor kinfolk (children). Statistics from the 2000 Census show that in North Carolina over 135,000 children under the age of 18 live in grandparent-headed households. Another 39,000 live in homes headed by relatives other than grandparents. The growing number of grandparents or other family members raising minor children is a social phenomenon not limited to any particular ethnic group, geographic location, or economic circumstances. Substance abuse, illness, death, divorce, abandonment, child abuse or neglect, job loss, incarceration and other circumstances contribute to reasons children are being raised by relatives other than their parents, either permanently or temporarily. Several current State Statutes need to be modified to better provide adequate legal authority for "kinship caregivers" to parent these children including the following:
   
   G.S. 115C-366(a3) - pertains to assignment of students
   
   G.S. 115C-113 - pertains to diagnosis and evaluation and an individualized education plan,
   
   G.S. 90-21.1 - pertains to when a physician may treat a child without consent of parent, guardian or person in loco parentis.
   
   Legislation is also needed to expand subsidies for child care (before and after school) to include kinship caregivers and to enact a "de facto custodian" law to allow a court to declare a relative or non-relative caregiver as a child's de facto custodian.

2005 Legislative Priorities

1. Strengthen efforts to protect the quality of our state's air, water, and soil and appropriate $10 million in grant funds for communities to address environmental contamination.
2. Increase funding for home and community based services for older adults by $5 million.
3. Enact legislation for a permanent long-term care insurance tax credit.
4. Increase funding for senior centers by $3 million.
5. Modify North Carolina General Statutes to better support grandparents and other family members raising minor kinfolk (children).