AARP North Carolina is focused on five key priorities for the 2010 short session of the North Carolina General Assembly:
Increase Funding for Project C.A.R.E. to Support Caregivers of Persons with Dementia
One in four adult North Carolinians provide regular care for someone age 60 or older. Almost half are caring for someone with dementia.
AARP supports strengthening programs and services for family caregivers of persons with dementia. We ask the General Assembly to appropriate recurring funding for Project C.A.R.E. (Caregiver Alternatives to Running on Empty), which provides support, education, training and consumer-directed respite care to caregivers of persons with Alzheimer’s disease and other dementias.
The program is operational in 22 counties, primarily in western and eastern North Carolina. In FY 2008-09, over 680 families were served by Project C.A.R.E. 92% of the families served reported that participation in the program allowed them to provide care of their family member at home longer.
Recurring state funding is needed to meet the required federal match requirements for this grant. Currently federal funds cannot be used to fund traditional respite care services. Therefore, state funds are also critical to ensuring the availability of these services for Project C.A.R.E. families.
Expand Dental Care Services
Obtaining dental care services is a major problem for many older and disabled residents of our state who have special care needs. This population includes residents of nursing homes, adult care homes, and group homes for developmentally disabled adults, plus community dwelling residents who suffer from conditions such as head injuries, dementia, strokes, multiple sclerosis, and muscular dystrophy.
AARP supports recommendations made by the Special Care Dentistry Advisory Group to the N.C. Study Commission on Aging and to the N.C. Public Health Study Commission to improve the availability of dental care services to special care populations.
Traditional dental practice does not work for many people with special care needs including frail older and disabled persons. Transportation issues to and from facilities and lack of wheelchair 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.
Preserve Medicaid Eligibility and Services for Older and Disabled Adults
AARP supports preserving Medicaid eligibility and services for older and disabled adults in our state.
In the spring of 2010, the Secretary of the N.C. Department of Health and Human Services announced that Medicaid was expected to have a shortfall of $250 million in FY 2009-10. This deficit is expected to continue into the 2010-11 fiscal year. On April 13, 2010, in a presentation to the Health and Human Services Subcommittee of the Joint Appropriations Committee, the Department of Health and Human Services made recommendations for cuts in optional Medicaid services to meet budget targets set by the Governor. Among the cuts in optional Medicaid Services proposed were the following:
- Eliminate personal care services for adults ($55 million)
- Eliminate funding for dental care services for adults ($27.6 million).
- Eliminate optical supplies (visual aids, glasses, and contact lenses) for adults ($1.1 million).
- Eliminate optical services, including routine eye exams, for adults ($1.8 million).
- Eliminate podiatry services for adults, except for services related to diabetes complications and certain vascular diseases ($535,436).
Medicaid is a powerful economic stimulus tool for North Carolina. If Medicaid was cut, it would hurt the economy of our state. For every dollar North Carolina cuts in Medicaid, the state loses $1.82 in federal matching funds. For every dollar North Carolina avoids cutting, $2.82 is put into the state’s economy. Jobs are provided and tax revenue is generated for both state and local governments.
Support Increased Funding for Home and Community Based Services
Home and community-based services funded by the Home and Community Care Block Grant help older adults stay in their homes. Most counties have large numbers of people on the waiting list for services, many of them frail and over the age of 85. As the older population in our state continues to grow, the demand for these services also increases.
Eighteen different home and community-based services can be funded by the Home and Community Care Block Grant. Key services funded include in-home aide, home-delivered meals, adult day care/day health care, transportation assistance and respite care for family caregivers. Counties determine which of the 18 services they will fund.
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. .
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 and in-home aid services. The Division of Aging and Adult Services estimates that it would take $28.5 million to address the current waiting list for services in the state.
Support State Long-Term Care Insurance Partnership Program
Innovative and creative public and private efforts to address the funding of long-term care are needed. AARP North Carolina supports the development of a Long-Term Care Partnership Program which would save state Medicaid dollars and also encourage the purchase of private long-term care insurance.
In 2006, the N.C. General Assembly passed legislation which authorized the N.C. Department of Health and Human Services to develop a North Carolina Long-Term Care Partnership Program. The purpose of the program is to reduce future Medicaid costs for long-term care by delaying or eliminating dependence on Medicaid.
In 2007 and 2008, the N.C. Division of Medical Assistance (Medicaid) convened a workgroup to develop recommendations for the partnership program. This workgroup developed draft recommendations. In 2009, with no efforts underway to implement a Partnership Program, the N.C. Department of Insurance initiated a workgroup to examine how the state should move forward. These recommendations will be put forth in the 2010 legislative short session and are supported by the N.C. Department of Health and Human Services.
Preliminary data indicates that there is modest savings to the state Medicaid programs due to the partnership programs. In addition to the cost savings that may result, AARP believes that non-traditional programs such as the Long-Term Care Insurance Partnership Program need to be tried if for no other reason than to get more people to begin to think about planning for their long-term care and to consider the purchase of long-term care insurance policies.