Tennessee: Tennessee State Senate, District 27

Candidates

Bobby Carter, Republican
Don McLeary, Democrat

Issues: Nursing Home Quality | Home and Community Based Services | Tax Reform |

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Question

What specific steps would you take to ensure that nursing homes provide quality care?

AARP Response

Nearly 40,000 Tennesseans are receiving care in 360 nursing homes across the state. A great majority of nursing home residents are Medicaid recipients, with the state providing nearly $900 million annually for their care. AARP Tennessee supports reform legislation which improves the quality of care provided to nursing home residents. Legislation should include reforms in the Medicaid reimbursement system to provide incentives to deliver high quality care; increasing minimum nurse staffing requirements; strengthening the ombudsman program; barring providers with criminal records or whose facilities have been cited repeatedly for deficiencies in major quality-of-care requirements; improving the facility inspection program; employing a full range of sanctions for quality-of-care deficiencies, including civil money penalties, a ban on all new admissions, monitors, directed plans of correction, denial of Medicaid payment for new admissions and appointment of temporary managers and receivers, and imposing remedies swiftly, with harsher sanctions for recurring, serious or widespread deficiencies.

Issue	Yes	No	Unclear
Supports increased staffing requirements
Supports improved facility inspections and stronger sanctions
Supports reforms in the Medicaid payment system

Candidate Response: Bobby Carter

It is important to increase staffing requirements for these important facilities. I would support improved facility requirements coupled with stronger sanctions. The Medicaid/TennCare program needs to be reformed.

Candidate Response: Don McLeary

I would support any reform that would provide the quality that our seniors deserve as it relates to nursing home operations. If more staffing is needed then let’s provide it. If more inspections are needed to make sure our seniors are being treated with dignity and proper care, then let’s provide it. The same would apply for the Medicaid payment system. If it needs to be reformed, then let’s examine the alternatives.

Question

What specific steps would you take to ensure that consumers in need of long term care have access to a full range of services outside of nursing homes?

AARP Response

Tennesseans needing long-term care should have the choice to stay at home rather than a nursing home as the only option. Home-and-community-based services are needed by persons of all ages with physical or mental impairments. These services include personal care, nursing and home health care, adult day care, case management, social services, habitation and rehabilitation and assistive technologies. Home-and-community-based services may be needed on a regular or respite basis over a period of several months, years, or a lifetime. People prefer to receive long term care services in their own home or in a community setting. AARP Tennessee supports increased funding for home-and- community-based services under a Medicaid waiver program and for services to persons who do not meet Medicaid eligibility requirements. We also support expanding available services to ensure a full continuum of long-term care services, that enhance choice, independence, dignity and individual well-being.

Issue	Yes	No	Unclear
Supports expansion of services and funding
Supports redirecting resources from nursing homes or specific funding source

Candidate Response: Bobby Carter

I would support expanding services and greater funding. I would certainly support redirecting resources to follow the patient rather than the system.

Candidate Response: Don McLeary

This is a big issue with me in that I believe more funding should be provided to home health care to allow our seniors to stay in their homes and receive care. I have proposed in a recent debate that the State establish a formulary in order to save between 200 to 300 million dollars in prescription drug costs. With this savings we would have the option to redirect money towards the home health care needs of our seniors. The comptroller of The State of Tennessee gave me these cost saving projections.

Question

What would you propose to ensure that our state’s revenue system provides stable and adequate funding for needed government services such as education and health care?

AARP Response

AARP Tennessee believes that our state is facing a severe and deepening revenue crisis. The current tax system does not provide adequate funds to pay for basic, essential services, and relies heavily on the sales tax. The current system is regressive, with lower and middle-income families paying far more as a percentage of their incomes than higher income families. AARP supports tax reform legislation that provides adequate and stable revenue for basic services; keeps up with our state’s growing economy; and addresses the inequities now realized by many lower and middle-income families. We support tax reform that eliminates the sales tax on food, clothing and non-prescription drugs, lowers the overall sales tax rate, repeals the Hall tax on dividend and interest income, and replaces these with a broad-based, graduated-rate income tax. Such a plan would lower the tax burden on the vast majority of Tennessee families and retirees.

Issue	Yes	No	Unclear
Supports lower sales taxes and replacement with broad-based income tax
Supports specific plan to meet demands for needed services

Candidate Response: Bobby Carter

I could not support an income tax in Tennessee as it is unconstitutional.

Candidate Response: Don McLeary

My position is not for a state income tax. I support setting priorities and healthcare and education are my top two. We should fully fund our top priorities. With better management of our resources and new solutions such as establishing a State formulary that could save as mush as 300 million dollars. State government can live within its means just like the hard working Tennessee families do every day, and we can still take care of our children and senior citizens.