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Name: AARP-NC
Location:
Raleigh, North Carolina
United States
Raleigh, North Carolina
United States
Work:
AARP State Office Staff
AARP State Office Staff
My Journals (15)
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These programs are presented in conjunction with the North Carolina Attorney General, The NC Department of the Secretary of State, The North Carolina Department of Insurance, The North Carolina Treasurer, Better Business Bureaus and Area Agencies on Aging.
- June 5- Hendersonville
Lake Pointe Landing, 3333 Thompson St., 8:30 a.m. - 12:00 noon
- June 12- Waynesville
81 Elmwood Way, 8:30 a.m. -12:00 p.m.
- June 12-Cherokee
Tsali Manor Senior Center, 133 Tsali Manor Street, 1:30 p.m. - 5:00 p.m.
- June 13-Murphy
First Baptist Church, 517 Hiwassee Street, 8:30 a.m. - 12:00 p.m.
- June 17- Greenville
Pitt County Senior Center, 4651 County Home Rd., 8:30 a.m. - 12:00 p.m.
- June 18- Washington
Grace Martin Harwell Senior Center, 310 W. Main St., 8:30 a.m. - 12:00 p.m.
- June 24- Monroe
Union County Agricultural Center, 3230 D Presson Road, 8:30 a.m. - 12:00 p.m.
- June 25- Marion
McDowell Senior Center, 100 Spaulding Road, 8:30 a.m. - 12:00 p.m.
- July 8- Winston-Salem
Hanes Mall Best Health 3320 Silas Creek Parkway, 12:00 p.m. - 4:00 p.m.
- July 15- Burlington
Harvest Baptist Church, 3741 S. Church St., 8:30 a.m. - 12:00 p.m.
- July 17-Oxford
Location (TBD), 8:30 am - 12:00 p.m.
- July 25-Elizabeth City
Location (TBD), 9:30 a.m. - 2:00 p.m.
- September 18- Winston-Salem
LJVM Coliseum, 2825 University Parkway, 1:00 p.m. - 4:00 p.m.
- September 24- Smithfield
The Public Library of Johnston County and Smithfield, 305 Market Street, 9:00 a.m. - 12:00 p.m.
- October 30- Lumberton
Lumber River Area Agency on Aging, 12:30 p.m. - 4:00 p.m.
Added: May 23, 2008
Views: 200 | Comments: 0 | Bookmarks: 0
Views: 200 | Comments: 0 | Bookmarks: 0
Issue: Consumers need information about how well adult care homes are providing quality care so they can make informed decisions about placement in these homes.
AARP Position: AARP supports the rules for a rating system of adult care homes as adopted by the N.C. Medical Care Commission. The rules were later adopted by the N.C. Rules Commission; however, ten letters objecting to the rules were submitted by representatives of the N.C. assisted living industry which sends the issue back to the General Assembly for consideration in the Short Session. If the General Assembly fails to pass legislation in the Short Session, the rules move forward and go into effect in 2009. AARP does not support legislative action that would change the rules.
Background: The rules adopted by the Medical Care Commission create a star rating system for adult care. The ratings are to be based on the following:
· Inspections and complaint investigations conducted by the Department of Health and Human Services to determine compliance with licensing statutes and rules.
· Type A penalties (the most serious), Type B penalties, and Citations (least serious) imposed on the facility by the Department.
· Corrections to the above cited penalties and citations.
Ratings are based on a 100 point scale and correspond to zero to four stars as shown below:
- Four stars – any facility whose score is 100 points or greater on two consecutive annual inspections.
- Three stars – for scores of 90 to 100 points.
- Two stars – for scores of 80 to 89.9 points.
- One star – for scores of 70 to 79.9 points.
- Zero stars – for scores of 69.9 or lower.
Starting with 100 points, facilities lose points for:
- 2 point loss for each citation of noncompliance with the statutes or rules.
- 10 point loss for each Type A violation.
- 3.5 point loss for each Type B violation. If the Type B violation remains uncorrected after a re-inspection, the facility loses an additional 3.5 points.
- 10 point loss if the facility’s admissions are suspended (unless they are suspended for failure to file cost reports).
- 31 point loss if the facility receives a notice of revocation against its license.
The facility gains points for:
- 1.25 point gain for corrected citations of noncompliance which are not related to Type A or uncorrected Type B violations.
- 1.25 point gain for corrected citations based on a follow-up inspection for facilities that did not have any Type A or Type B violations.
- 2.5 point gain for correcting a Type A violation, and a 2.5 point gain at the next annual inspection if no further Type A violation is identified.
- 1.25 point gain if the facility corrects a previously uncorrected Type B violation.
- 5 point gain if a facility’s previous admission suspension is removed.
- 2.5 point gain if the facility participates in any quality improvement program approved by the Department.
- 2.5 point gain if the facility receives NC NOVA special licensure designation.
- 1 to 2 points for having back up electrical generator capability.
- 2 to 3 points for having automatic sprinklers in good working order.
The rating will include a breakdown of the points added and subtracted in making up the numerical rating, and posted in a location visible to the public.
Support for the Star Rating System: In addition to AARP North Carolina, other organizations supporting the rules include Friends of Residents in Long Term Care, the NC Regional Long Term Care Ombudsman Association, the NC Association on Aging, the NC Adult Foster Care Association, the NC Adult Day Services Association, AMVETS, the Mental Health Association of NC, NCPIRG, the NC Chapter of the National Association of Social Workers, and the NC Justice Center.
Opposition to a Star Rating System: The N.C. Association of Long Term Care Facilities and the N.C. Assisted Living Association have expressed opposition to the rules.
Relevant Information from AARP Poll: In March of 2007, AARP North Carolina commissioned a poll of registered voters in the State on several issues before the N.C. General Assembly, including the star rating system. 78% of those polled indicated they were in favor of a rating system for adult care homes.
Key Facts on Proposed Star Rating System:
- Adult care homes ratings are to be based on meeting minimum State licensure standards (what homes should be doing). This is determined by regular inspections of homes conducted by the State. Areas addressed in the standards include:
- admission and discharge procedures
- medication management
- physical plant
- resident care and services, including food service, resident activities programs, and safety measures
- resident rights
- sanitation grade
- special care units
- use of physical restraints and alternatives
- The rating system does not require any additional work by the adult care home nor does it place any additional regulation on the home. A home’s rating is based on their regular inspection which is already required by law.
- The rating system does not change the State’s standards for adult care homes.
- Consumers need the rating system to help them make more informed decisions about placement in a home. Consumers do not have public information readily available about the quality of adult care homes as is already available about nursing homes, home health agencies, and hospitals which is provided by the federal government. Consumers often have to made quick decisions about placement in adult care homes and without some basis for evaluating homes, they do not have a starting point for making an informed decision.
- The rating system will not put homes out of business; however, if a home is not meeting minimum State standards, its rating will reflect that. If consumers have choices about placement options, a home’s rating may be a factor in the decision of which home a consumer chooses.
- North Carolina has had a rating system in place for child care centers for many years. This has resulted in a better quality of child care throughout the entire state. It is envisioned that a rating system for adult care homes will likewise elevate the care provided by homes across the state.
- In the rating system proposed, every adult care home starts with 100 points for meeting minimum standards. Demerits are deducted for citations of noncompliance with statutes and rules, including citations of Type A and Type B violations. Merits are awarded for correcting citations and violations as well as for participating in quality improvement programs, having a generator, and having an automatic sprinkler system.
A Type A violation is defined as a condition or conditions that have resulted in death or serious physical harm to a resident or are likely to result in death or serious physical harm. Examples of Type A violations are:
· A confused resident who is not properly supervised wanders away from a home and as a result suffers serious harm or death.
· The wrong medication is given to a resident and he/she suffers strong adverse affects.
A Type B violation is an identified condition which impacts the quality of care of the residents in an adult care home. Examples of Type B violations are:
· Criminal background checks are not done on staff.
· Residents do not receive medication as ordered.
· Personal care staff are not tested for tuberculosis
· Staff do not have CPR training.
· Staff can not effectively execute procedures in response to a fire drill.
Added: April 28, 2008
Views: 319 | Comments: 0 | Bookmarks: 0
Views: 319 | Comments: 0 | Bookmarks: 0
Issue:
Reports indicate that over 40% of persons residing in adult care homes carry an active diagnosis of mental illness. The mixing of persons with mental illness and frail older adults in these facilities can create a situation that is not good for either of these groups and can impact the safety and well-being of residents.
AARP’s Position:
AARP asks that the General Assembly move forward in implementing practical and cost effective steps to address concerns related to the mixing of populations in adult care homes.
Background Information:
In recent years as there has been more focus on mental health reform, deinstitutionalization and the placement of individuals with mental illness in the least restrictive environment, the number of persons whose chief diagnosis is mental illness being placed in adult care homes has significantly increased. In many cases, the adult care home has become the site of placement because there is no other option for housing the person with mental health problems. Recent reports indicate that in 115 adult care homes in the State, more than half of the residents have documented mental illness.
Unfortunately, the mixing of persons with mental illness, many of whom are younger adults, with frail older adults has resulted in many problems. There are reported cases of older residents being assaulted, and in a few instances killed, by younger residents with mental health problems. Patient advocates report that frail older adults are often intimidated by living in the same facility with persons with mental health problems, particularly if they are agitated.
Many adult care homes are not equipped to care for persons with mental health problems whose needs may be quite different that those who are older. Often, staff at homes have no special training in working with persons with mental illness.
There have been a number of attempts during the last seven years to address the problems which have resulted from the mixing of persons with mental illness and older adults in adult care homes. Laws have been passed and studies done to find solutions, however, not enough has been done to follow-through or provide funding to solve the problems. In 2006, responding to consumer and advocates demands for action, a Subcommittee composed of members of the NC Study Commission on Aging and the NC Joint Legislative Oversight Committee on Mental
Health, Developmental Disabilities, and Substance Abuse Services (MH/DD/SAS) was formed to address the issue of mentally ill residents in adult care facilities. The Subcommittee made recommendations to the Study Commission on Aging and the Joint Legislative Oversight Committee on MH/DD/SAS which resulted in several pieces of legislation being introduced in the 2007 legislative session.
Senate Bill 164 which passed in 2007 (1) directs the NC Department of Health and Human Services to study rules and regulations regarding housing individuals with mental illness in the same facility vicinity as individuals without mental illness and (2) directs the Department to recommend staff training requirements for direct care workers in adult care homes to provide appropriate care to residents with mental illness. In addition, a special provision was included in the budget bill last session which directed the Department to develop a Transitional Residential Treatment Program service definition to provide 24-hour residential treatment and rehabilitation for adults who have a pattern of difficult behaviors related to mental illness, which exceeds the capabilities of traditional residential settings. Funding was also appropriated ($7.5 million for 2007-08) for additional independent and supportive-living apartments for people with disabilities and for operational cost subsidies ($3.5 million for 2007-08 and $4.5 million for 2008-09) for independent and supportive-living apartments for individuals with disabilities.
The legislative action last year is a good beginning for ensuring that there are appropriate placement options for individuals with mental illness; however, the time for concrete action in now particularly in light of developments pertaining to mental health reform. Follow-up is needed relative to legislation passed last year and new efforts are needed to continue to address the challenge of the mixing of populations.
Relevant Information from AARP Poll:
In March of 2007, AARP North Carolina commissioned a poll of registered voters in the State on several issues before the N.C. General Assembly, including the mixing of young people with mental illness with frail older adults in adult care homes. 71% of those polled indicated they were in favor of additional taxpayer funding so that older adults and mentally ill persons can be housed separately.
Support for Appropriate Placement of Individuals with Mental Illness:
In addition to AARP, Friends of Residents in Long Term Care and the NC Regional Long Term Care Ombudsmen Association support legislative efforts to address concerns related to the mixing of populations in adult care homes.
Added: April 28, 2008
Views: 291 | Comments: 0 | Bookmarks: 0
Views: 291 | Comments: 0 | Bookmarks: 0
Issue: Adult protective services and guardianship laws in North Carolina have not been updated in many years and do not address the realities of the current society in which we live. Both laws need to be amended to better protect at-risk older and disabled citizens in our State.
AARP Position: AARP supports the 2007 recommendation of the Study Commission on Aging to appropriate funds to enact a pilot program to assess proposed changes to the adult protective services statues. The proposed changes include the implementation of an Adult Protective Services (APS) Clearinghouse Model for the State.
AARP also supports the recommendations of the House Study Committee on State Guardianship Laws and the bills introduced in the 2007 legislative session pertaining to these recommendations.
Background Information: Adult Protective Services
Legislation passed in 2005 directed the NC Department of Health and Human Services’ APS Task Force to collaborate with stakeholders and others interested in improving APS. The APS Clearinghouse Model is the product of that collaborative effort. This Model is aimed at enhancing the capacity of county departments of social services to serve vulnerable and older adults who are abused, neglected or exploited or are at significant risk of abuse, neglect or exploitation. Under the current state APS law, which was enacted in 1973, county departments of social services can only intervene if a person is deemed to be disabled and they have actually been abused, neglected or exploited.
The goals of the Clearinghouse Model are to: increase North Carolina’s ability to reach out to citizens to offer voluntary services; enable the State to respond to high risk situations before harm occurs and provide the opportunity to assist older adults who are victimized, but not incapacitated; allow APS to intervene before the adult’s health deteriorates to life-threatening levels; and allow APS to provide information and services to a greater number of adults.
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The first step in the implementation of the APS Clearinghouse Model requires a pilot of the Model. The Study Commission on Aging recommended legislation in 2007 (HB 198 and SB 108) to appropriate funds ($1,492,000 for 2007-08 and $1,930,000 for 2008-09) for this pilot program to assess proposed changes to the APS statutes and to require a report on the evaluation of these changes. No action was taken on these bills in the 2007 legislative session.
Background Information: Guardianship
Guardianship is a legal relationship in which someone (a guardian) is authorized by the clerk of superior court to be the substitute decision maker for an incompetent adult. In response to concerns about the current guardianship laws in the State, the 2006 NC House of Representatives authorized the House Study Committee on State Guardianship Laws. This Committee, which was composed of representatives from all groups involved with the guardianship process in North Carolina, identified the need to reform and modernize State guardianship laws. After an extensive study, the Committee made nine recommendations in its report to the 2007 legislature, including redefining the definition of “incompetent adult”; further detailing the powers, duties, and liabilities of guardians; and funding for public guardianship programs. Bills were introduced relative to these recommendations; however, no action was taken on these bills. Bills introduced were:
§ House Bill 250 would establish the Joint Legislative Study Commission on state guardianship laws.
§ House Bill 794 would raise the ceiling on the total amount of personal property a guardian is allowed to sell without a court order.
§ House Bill 795 would appropriate approximately $5 million for guardianship services provided by local human service agencies.
§ House Bill 796 would authorize the Division of Motor Vehicles to consider recommendations from the clerk or court in determining whether to revoke the drivers license of a person adjudicated incompetent under the guardianship laws.
§ House Bill 797 would make changes in the eligibility, training, and education of guardians.
§ House Bill 798 would amend the procedures for determining incompetency under the laws relating to guardianship.
§ House Bill 799 would redefine the powers, duties, rights, and liabilities of guardians of the person of minors and incompetent persons.
§ House Bill 811 would revise the state's guardianship statutes with respect to jurisdiction, venue, procedure, appeals, and portability.
§ House Bill 813 would redefine the role of court‑appointed attorneys in incompetency and guardianship proceedings.
Added: April 28, 2008
Views: 301 | Comments: 0 | Bookmarks: 0
Views: 301 | Comments: 0 | Bookmarks: 0
Issue:
Many senior centers in the state struggle financially as they attempt to offer programs and services for older adults.
AARP’s Position:
In the 2007 legislative session, the General Assembly appropriated $200,000 in non-recurring funding for Senior Center General Purpose Funding. AARP supports making this funding recurring as well as asks that significant additional funding be appropriated to support senior centers.
Background Information:
A senior center is a community facility where older adults come together for services and activities that reflect their skills and interests and respond to their diverse needs. Centers are a resource for the entire community – in many cases serving as a community focal point. In addition to providing services and information on aging, they are a resource to family and friends who care for older persons. For older persons who are at risk of losing their self-sufficiency, senior centers may be the entry point to an array of services that will help them maintain their independence.
Examples of services provided at senior centers include information and referral, health and wellness programs, employment assistance and training, health insurance counseling, prescription drug counseling, in-home assistance, home delivered meals, legal assistance, educational sessions, intergenerational programs, group meals, recreational trips, and volunteer opportunities.
The NC Division of Aging and Adult Services, which oversees senior centers in the state, reports that there are 164 senior centers (7 of these centers are under development) in 98 counties in the state. Gates and Hoke Counties do not currently have centers. The primary sources of funding for senior centers are (1) local governments, (2) the Home and Community Care Block Grant (state, federal and local funding which supports community-based services), and (3) the State’s
Senior Center General Purpose and Outreach Funds. According to the Division, federal and State funding is not sufficient to develop and sustain senior centers. Many centers also look for public and private support locally to help support their operations.
The State supports senior centers through small appropriations for Senior Center Outreach and General Purpose funds. The Senior Center General Purpose fund was initiated in 1997 and is used for any purpose that supports operations or development including equipment purchases/ repairs, building maintenance, supplies, administrative costs, activities, and construction. The State appropriation for 2007-08 fiscal year is $1,465,316 (including the $200,000 in non-recurring funding) for Senior Center General Purpose and $100,000 for Senior Center Outreach. An additional 25% local cash or in-kind match is required for State funds.
The amount of General Purpose funding which a center receives in 2007-08 from the State ranges from $5,467 to $16,404 depending on whether or not the center has met certain certification requirements. Regardless of the amount received, the funding is not adequate to support centers at the level needed. Due to funding restrictions, many 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.
Support for Senior Center Funding:
Increased funding and support for senior centers was the most frequently mentioned item during public hearings conducted by the NC Study Commission on Aging in October of 2006 in Burlington and Charlotte and was also frequently mentioned as a priority issue at the public hearing conducted by the Study Commission on Aging on March 6, 2008, in Wilson.
In addition to AARP, numerous other aging provider and advocacy organizations are asking for increased State funding for senior centers. These include the NC Coalition on Aging, the NC Senior Tar Heel Legislature, the Governor’s Advisory Council on Aging, the NC Association on Aging, and the NC Association of Area Agencies on Aging.
Added: April 28, 2008
Views: 296 | Comments: 0 | Bookmarks: 0
Views: 296 | Comments: 0 | Bookmarks: 0
Issue:
Obtaining dental care services is a major problem for many older and disabled adults. This population includes residents of nursing homes, adult care homes, and group homes for developmentally disabled adults, plus community dwelling residents with head injuries, dementia, strokes, multiple sclerosis, and muscular dystrophy.
AARP’s Position
AARP supports efforts to expand dental care services for older and disabled adults, including persons with special care needs, by developing a statewide comprehensive care program to serve special care populations, by providing initial funding for new mobile dental care programs, and by increasing the Medicaid reimbursement rates to dental care providers.
Background Information:
The traditional dental practice “does not work” for many frail older and disabled persons. Transportation issues to and from facilities and lack of wheel-chair accessible operatory space and other needed accommodations keep many mobility impaired patients out of the dental chair. In addition, most dentists in the State have not been trained to manage behaviors common to intellectually disabled citizens or those with no muscle control. Because of the lack of available care options, many older and disabled citizens in North Carolina go without dental care, resulting in oral infections which often lead to expensive medical care for illnesses such as aspiration pneumonia, uncontrolled diabetes, wound healing, stroke and heart disease. The 2005 North Carolina Oral Health Summit on Access to Dental Care called for the development of statewide comprehensive care programs designed to serve North Carolina’s special care and difficult-to-serve populations.
Currently there are two non-profit organizations (Carolinas Health Care/Carolinas Mobile Dentistry in Charlotte and Access Dental Care in Greensboro) in the State
that provide mobile dental care services to nursing home residents, group home
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residents, and community dwelling individuals with special needs. These programs have used foundation start-up monies and revenue from private and Medicaid fees, and facility retainers for sustaining funding. Both programs have indicated they need additional financial support in order to continue to stay viable.
Based on a recommendation of the NC Study Commission on Aging, the General Assembly appropriated $200,000 in non-recurring funding for FY 07-08 for a mobile dental care provider to deliver services to the frail and elderly persons with disabilities in unserved areas. Access Dental Care was awarded a contract to provide services in Durham, Orange, and Chatham Counties with this funding. Numerous other communities in the State have requested this service; however, there are no additional funds at this time to expand to other areas.
An additional reason for dental care access problems is that public funding through the Medicaid program which covers the health care costs of many older and disabled persons with special needs is not adequate to cover the cost of providing dental care services to this population. Medicaid dental reimbursement rates are low in general, but added to that is the fact that persons with special needs often require added time and effort which is not reimbursable. Numerous reports, including the 2008 Public Health Task Force Report recommend increasing Medicaid reimbursement to dental care providers to increase access to care. The Task Force recommends that Medicaid reimbursement rates for dental services be increased to 80% of the National Dental Advisory Service reimbursement level.
Support for Dental Care Services:
In addition to AARP North Carolina, efforts to expand dental care services for special care populations are supported by the N.C. Dental Society Committee on Aging, the N.C. Council for Developmental Disabilities, the Senior Tar Heel Legislature, the Governor’s Advisory Council on Aging, Friends of Residents in Long Term Care, and the NC Regional Long Term Care Ombudsman Association
Added: April 28, 2008
Views: 316 | Comments: 0 | Bookmarks: 0
Views: 316 | Comments: 0 | Bookmarks: 0
Issue: The cost of housing in North Carolina has risen faster than wages, putting affordable housing out of reach for thousands of our state’s families. Over two million North Carolinians live in homes they cannot afford. Over 300,000 NC households pay more than half their income for housing. The greatest unmet need for housing is for households earning $25,000 or less. For older citizens in North Carolina, they often have difficulty paying for needed repairs to keep their home habitable. Housing Trust Funds provide funding that is often matched with other governmental entities, non-profit organizations, and for-profit developers.
AARP North Carolina is particularly concerned that older citizens be able to live in a setting that is the most appropriate and desirable setting.
1. The Trust Fund helps make urgent repairs that allow older citizens to remain in their existing home.
2. The Fund also helps build apartments where rents are lower than the market rate and lower than rents on apartments build with tax credits alone. The owner has less debt due to the lower interest rate. The owner of the development is responsible for paying back the loan.
3. Supportive housing developments (e.g., group homes for the developmentally disabled or a domestic violence shelter) can be built where the owner then charges very low rents because they are repaying the principal loan only.
4. First time homebuyers benefit when Habitat for Humanity and the agency jointly participant in the first mortgage. Habitat services the loan and pays the agency its share.
A $50 million appropriation would help over 6,000 families each year, generate over 3,000 jobs annually, increase State and local tax revenues by over $30 million each year, and leverage over $200 million in total investments in affordable housing each year.
AARP Position: AARP supports additional recurring funding of $50 million for the NC Housing Trust Fund. While AARP supports all the programs funded by the Trust Fund, special interest is in the repair and renovation of existing homes for older adults and disabled adults so they may remain in their homes.
Current Law: The Housing Trust Fund was created in 1987 and is administered by the NC Housing Finance Agency. It provides “bricks and mortar” financing for affordable housing. None of the Fund is used for administrative costs.
2007 Action: The General Assembly appropriated $5 million in recurring money to raise the Housing Trust Fund budget to $8 million. The budget also included $7.5 million in one-time money for independent and supportive living apartments for people with disabilities.
Added: April 28, 2008
Views: 276 | Comments: 0 | Bookmarks: 0
Views: 276 | Comments: 0 | Bookmarks: 0
Issue:
One in four adult North Carolinians provide regular care for someone age 60 or older. Almost half are caring for someone with dementia. As a State, we need to provide better support to families caring for older and disabled adults.
AARP’s Position:
AARP supports strengthening programs and services for family caregivers. We ask for the support of the General Assembly in two specific areas for the 2008 legislative short session:
- Appropriate funding for Project C.A.R.E. (Caregiver Alternatives to Running on Empty), a program administered by the N.C. Division of Aging and Adult Services which provides consumer-directed respite care and support to caregivers of persons with Alzheimer’s.
- Pass legislation which will allow employees in the State a minimum number of paid sick days each year.
Background Information:
Family caregiving impacts almost every North Carolinian or will impact them in the future.
The Rosalyn Carter Institute for Caregiving notes that there are only four kinds of people in the world – those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers.
According to the 2005 report from the N.C. Division of Aging and Adult Services entitled “Family Caregivers in North Carolina: What Do We Know? What Are We Doing to Help”,
1.7 million adult North Carolinians are caring for an older person. This can range from assisting with basic daily activities to providing round-the-clock health care. Family caregivers are the backbone of our State’s long-term care system. Families provide at least 80% of all long-term care. According to the U.S. Department of Health and Human Services older adults receive more and more family care as disability increases. 86% of older adults at greatest risk of nursing home placement live with others and receive an average of 60 hours of unpaid care per week, supplemented by a little over 14 hours of assistance from paid helpers.
Over 40% of North Carolina caregivers take care of someone with a memory disorder such as Alzheimer’s disease. Their “caregiving career” is often of long duration – it lasts an average of 8 years, but it may be as long as 20 years.
Although family caregiving can have many rewards, it can take a toll on the care providers. Studies show that caregivers report chronic health problems at nearly twice the rate of non-caregivers and over half of caregivers report they don’t have enough time for their family. Nationally and in North Carolina, over half of caregivers work while providing care which can present significant challenges to the worker.
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Project C.A.R.E. began as a demonstration grant program in North Carolina in 2001 in a few counties. The goal of the program is to increase quality, access, choice and use of respite and support services to low-income rural and minority families caring for a person with dementia. The program is now operational in 14 counties, primarily in western North Carolina, and the Division of Aging and Adult Services would like to expand it across the State. Through the program, families are matched with appropriate and preferred local respite and community services tailored to their unique situation and needs. Caregivers can spend up to $2,000 a year toward respite services which provide temporary relief from caregiving. In FY 06-07, over 450 families were served by Project C.A.R.E. Approximately 92% of the families served reported that participation in the program allowed them to provide care of their family member at home longer.
Federal funding for Project C.A.R.E. ends June 30, 2008. If funding is not replaced, the program will terminate. An appropriation of $500,000 would sustain the program in the current counties being served as well as establish new programs in eastern North Carolina and the upper Piedmont of the State.
Paid Sick Days: The 2005 Division of Aging and Adult Services Family Caregiving Report notes that nine of ten North Carolina caregivers report having to make work-related adjustments due to their care responsibilities. Paid sick leave is critical for a caregiver – not only because they suffer from more health problems than non-caregivers and may need to be absent from work due to their health problems, but because they may need to be away from their job to provide care for their family member or to take him/her to medical appointments. According to the U.S. Bureau of Labor Statistics, 42% of North Carolina’s workforce (1.6 million people) lack paid sick leave. 1.5 million without paid sick leave are in the private sector. In November of 2007, AARP North Carolina conducted a poll of 800 employees in the State. Of particular note relative to the issue of caregiving, 19% rated their employer as fair or poor in accommodating their caregiving responsibilities. 79% of those polled stated that they thought an employer should be required to provide a minimum number of paid sick days to full-time employees.
Legislation was introduced in the 2007 legislative session (HB 1711 introduced by Reps. Adams, Ross, Coleman, and Weiss) which would allow employees to earn a minimum number of paid sick days each year to tend to short-term health needs of employees and their family members. No action was taken on this bill.
Support for Expanding Programs and Supports for Family Caregivers:
In addition to AARP, numerous groups support funding for Project C.A.R.E. including the Senior Tar Heel Legislature, the N.C. Association on Aging, the N.C. Adult Day Services Association, the Alzheimer’s Association – Eastern N.C. Chapter, and the Alzheimer’s Association – Western North Carolina Chapter.
A coalition of groups (including AARP) lead by the N.C. Justice Center support paid sick days legislation including ACORN North Carolina, Action for North Carolina Children, AFL-CIO North Carolina, Common Sense Foundation, Covenant for North Carolina’s Children, El Pueblo, NAACP - North Carolina, NARAL NC, N.C. Child Care Coalition, N.C. Fair Share, NC NOW, and N.C. Women United.
Added: April 28, 2008
Views: 282 | Comments: 0 | Bookmarks: 0
Views: 282 | Comments: 0 | Bookmarks: 0
Issue:
Home and community-based services help older adults stay in their homes. At this time there are over 11,500 older adults, many of them frail and over the age of 85, on the waiting list for services. As the older population in our State continues to grow, the demand for these services also increases.
AARP’s Position:
AARP supports increased funding for the Home and Community Care Block Grant which funds home and community-based services for people 60 years of age and older.
Background Information:
More than a quarter of older North Carolinians living in the community have two or more physical or mental conditions that make it difficult for them to do activities such as walking, dressing, and bathing. Many of these older adults are in need of home and community-based services. Persons in particular need of home and community-based services are the over 130,000 older adults in the state who are 85 and older and those who are disabled.
In 1992, the N.C. General Assembly established the Home and Community Care Block Grant which focuses on (1) supporting frail older adults at home, (2) improving the physical and mental health of our State’s 60+ population, (3) assisting older adults and their families with access to services and information, (4) providing family caregiver relief, and (5) helping older adults remain active.
The Block Grant combines federal Older American Act funding, some funding from the Social Services Block Grant, and state appropriations. There is also a consumer contribution component to the Block Grant. Today, the Block Grant totals over $56.7 million and is the primary funding source for non-Medicaid funded home and community-based services for older adults. State appropriations account for 53% of the funding for the Block Grant. A funding formula is used to determine the allocation for each county. Counties are required to provide a 10% local match.
Eighteen different home and community-based services can be funded by the Home and Community Care Block Grant, which is administered by the N.C. Division of Aging and Adult Services. Key services which are funded include home-delivered meals, adult day care/day health care, in-home aide, transportation assistance and respite care for family caregivers. Counties determine which of the 18 services they will fund.
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According to data provided by the Division of Aging and Adult Services, in State Fiscal Year 2006-2007, 46% of persons receiving Block Grant services lived alone, 67% were unable to manage on their own, 68% were age 75 or older, and 50% reported low-income.
Although there is an increased need for home and community-based services, the State is losing ground in its effort to help frail older people in the community through the Block Grant. Not only do more people need services, the cost of service delivery continues to increase. The General Assembly appropriated an additional $4 million for the Block Grant in 2006 which was the first increase in funding since 1998-99, and appropriated an additional $536,000 in recurring funding in 2007. Due to ongoing demands for services, the waiting list for Block Grant services is more today than it was prior to these increases.
Many counties in the state report over 200 seniors on waiting lists for key services. Services with the largest waiting list are those which serve the most frail including home delivered meals, personal care services, and home management services. The N.C. Division of Aging and Adult Services estimates that providing services to the over 11,500 older adults on the waiting list would cost $17.7 million.
Support for Home and Community Care Block Grant:
Support for expanding the Block Grant has consistently been one of the top requests of aging advocates in the State for the last decade. Numerous state level groups and associations including the Governor’s Advisory Council on Aging, the Senior Tar Heel Legislature, the N.C. Association of Area Agencies on Aging, the N.C. Association on Aging and the N.C. Coalition on Aging support increased funding for the Block Grant.
Relevant Information from AARP Poll:
In March of 2007, AARP North Carolina commissioned a poll of registered voters in the State on several issues before the N.C. General Assembly, including recommended increased funding for the Home and Community Care Block Grant. 75% of those polled indicated they were in favor of additional state taxpayer funding for this program.
Added: April 28, 2008
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AARP North Carolina Legislative Priorities
2008 Short Legislative Session
· Increase funding for the Home and Community Care Block Grant which provides support for home and community-based services such as home delivered meals, in-home aide services and transportation assistance to help people 60 and over stay in their homes. There are over 13,000 older adults on the waiting list for these services.
· Expand programs and support for family caregivers. Appropriate funding for Project C.A.R.E. (Caregiver Alternatives to Running on Empty) which provides respite support to caregivers of persons with dementia and pass legislation to ensure employees are allowed at least seven paid sick days a year.
· Increase funding for the Housing Trust Fund which finances the construction and rehabilitation of affordable housing.
· Increase funding to expand dental care services, including mobile dental care programs, for older and disabled adults. There is a particular need to expand services to special need populations such as nursing home and adult care home residents and persons with dementia.
· Increase funding for senior centers. There are 163 senior centers in the state. The state appropriation for centers is less than $1.6 million. Additional state funding is needed to expand and strengthen programs and services offered at centers.
· Strengthen state elder abuse and guardianship laws. These laws, which have not been changed in many years, need to be amended to better protect our state’s most vulnerable citizens.
· Address issues related to the appropriate placement of individuals with mental illness. The placement of individuals with mental health needs in facilities with frail older adults because there are no other placement options available presents challenges and has resulted in instances where older residents have been put at risk or actually harmed. Steps need to be taken to ensure there are appropriate care options for persons with mental health needs.
(See individual issue briefings for more details.)
Added: April 28, 2008
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