Contact
Mary Edwards for a
list of delegates
by county

Additional
Information

North Carolina Division of Aging and Adult Services

Priority 1: Maintain Home and Community Care Block Grant services for impaired older adults at the current level.

Need for Legislative Action: In-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, particularly the 85+ population which is more likely to need these services, so does the demand for services. There are currently over 11,000 older adults on waiting lists for key services such as in-home aide and home delivered meals. State funding for home and community based services has not increased since 1998-99. As a result of the zero-growth in state support for these services, there has been a decline in the number of persons served and the number of services provided in the last two years. The state is loosing ground in its effort to serve frail older adults in the community.

Priority 2: Strengthen dental care services for residents in long term care facilities.

Need for Legislative Action: Dental care for persons in long term care facilities is documented as difficult or nearly impossible to obtain, particularly for residents who rely on government assistance. In a study conducted by the North Carolina Regional Long Term Care Ombudsmen from March 1999 to June 2000 of 618 nursing homes and adult care homes in the state, 51% of the facilities reported extreme or great difficulty in obtaining basic dental care for their residents on Medicaid or State/County Special Assistance. Barriers to providing dental care to long term care residents include lack of providers with expertise in serving the special care needs of long term care residents, limited reimbursement/no financial incentive to serve this population, and problems in transporting special need residents to private dental offices. The lack of dental care causes needless suffering, lower quality of life, and shortened life span for long term care residents. In order to address this problem, mobile non-profit dental units have been established in three communities in the state. They have been highly successful in addressing the dental needs of residents in long term care facilities. Funding is requested to support six mobile care units in the state to serve the needs of these residents.

Priority 3: Take steps to ensure that the Medicaid Community Alternatives Program for Disabled Adults (CAP/DA) remains a viable service for older and disabled adults in our state.

Need for Legislative Action: CAP/DA is one of four programs under Medicaid which provides home and community care as a cost-effective alternative to institutionalization. The program provides a package of services to allow disabled adults age 18 and older who qualify for nursing home care to remain in their private residences. In SFY 2001-02, CAP/DA served 11,667 people at less cost than nursing home care, but this was a year of uncertainty for the program. Because of the budget shortfall in the Medicaid program, a freeze was placed on CAP/DA October 1, 2001. Effective August 1, 2002, this freeze was partially lifted and local CAP/DA lead agencies were allowed to fill vacancies in the program as long as their caseload sizes were maintained at the July 31, 2002 level. Following lengthy debate during the last legislative session, the General Assembly appropriated an additional $61 million for CAP/DA. The additional funds made it possible for the Division of Medical Assistance to allow counties to increase their caseload for a statewide average of 9,600 per month (630 fewer than in October of 2001). CAP/DA will again be an item for discussion in the 2003 legislative session. The Studies Bill of 2002 directs the N.C. Institute of Medicine to study CAP/DA and to report its findings and recommendations to the 2003 General Assembly. The General Assembly is urged to maintain support for CAP/DA. This program is critical to the state’s efforts to allow disabled adults choices in their care options and to adhere to the requirements of the U.S. Supreme Court’s Olmstead decision.

Priority 4: Support the development and operation of senior centers.

Need for Legislative Action: There are 158 senior centers in North Carolina currently operational or under development in 95 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. For 2002-03, the state appropriation for senior centers was cut by $381,000. Currently, there is only $984,000 remaining in state funding to support senior centers. Due to the reduced funding, many senior centers have had to reduce the variety of activities and services they offer, reduce operating hours or days, close satellite locations due to loss of personnel, reduce outreach to older adults in remote areas, and delay needed maintenance and repairs to facilities and equipment.

Priority 5: Take steps to ensure that national criminal background checks for employees of long term care facilities are completed.

Need for Legislative Action: State legislation was first passed in 1996 pertaining to criminal background checks of applicants for employment in long term care facilities. In meeting the requirements for background checks, a problem has been identified in obtaining national criminal background check information. Current federal law does not permit the FBI to release background check data directly to long term care facilities. For this reason, legislation was passed this last legislative session that stipulates that national criminal background checks of adult care homes and nursing home employees shall not take place before January 1, 2004. The Studies Bill of 2002 authorizes the Legislative Research Commission to study how federal law affects the distribution of national criminal history record check information and the problems federal restrictions pose for implementing state required record checks. Action needs to be taken to ensure that any problems in obtaining national criminal background checks are addressed and steps are taken so that this data is received by appropriate entities in our state.