Agenda - 12-04-2006-7a - Laserfiche WebLink

Browse Search

I. Access to Health Care Chapter I: Access to Health Care ~ Aging Since Medicaid is the state's largest expense after public education, legislators are always looking for ways to cut non-entitlement programs and keep eligibility levels low for benefits for the elderly. Ironically, the new Part D Medicare prescription drug program and increases in Social Security payments have resulted in the loss of Medicaid for some impoverished elderly North Carolinians. Few doctors, moreover, will accept new Medicare patients. As a result, despite the federal Medicare and Medicaid programs, many elderly and disabled residents lack access to the health care they need. A report in 2006 to the legislative Study Commission on Aging confirmed what was already well known: that there is an "institutional bias" in funding for long term care. That is, elderly and disabled people prefer to remain at home, but funding is lacking for home care although available for care in adult care homes and nursing homes. The Community Alternatives Program for Disabled Adults (CAP/DA), which provides funds for home care, is limited in the number of persons that can be accepted, as is the Special Assistance In-Home Project, which provides some funding for persons eligible for care in adult care homes. The Home and Community Care Block Grant, which is used to provide various services such as Meals on Wheels, personal care, and transportation, without regard to income (those who can pay are expected to assist with the cost of their care), has a waiting list of approximately 10,000 persons. Increases in appropriations for this fund are never adequate to make substantial reductions in the waiting list which continues to grow along with the elderly population in the state. Adult Day and Adult Day Health Centers, which offer care and stimulating activities during the day for elderly and disabled persons, constantly struggle with inadequate payments and difficult costs for transportation. Yet they offer working families a means of keeping elderly or disabled relatives at home. A continuing problem is the turnover in care givers. Low pay, lack of benefits, very hard working conditions, and lack of respect are some of the difficulties experienced by aides in stressful jobs in long term care facilities. They may work at more than one job. This situation translates directly into lower quality care for residents. A new kind of voluntary licensure for facilities named NOVA (new Organizational Vision Award) will require those facilities who choose it to provide a supportive workplace, balanced workloads, training, and career development for aides. Legislation to provide "pass-through" money that would go directly for wages or benefits of caregivers has failed to gain support from legislators. The substantial prescription drug benefit offered by the state's Health and Wellness Fund called Senior Care ($1200 a year during the last two years for elderly persons with incomes under 200 percent of Federal Poverty Level) ended with the beginning of the less-generous Part D Medicare insurance system in 2006.Other states with substantial benefits made some provision for continuation of a state assistance program; only North Carolina did not. A continuing subsidy for some low-income persons and funding for medication management for at-risk persons with multiple prescriptions are possibilities to be explored. The elderly population in North Carolina is growing rapidly. Of the more than one million citizens over 65, 60.3 percent are women, and of those over 85, 66 percent are women. Aging issues therefore,, are women's issues. And many of these women live in poverty. Their choices in long term care are limited. Families, whatever their incomes, should be able to care for elderly relatives in their own homes if possible. When . institutional care is the only option, the facility should be staffed by well-trained caregivers and provide excellent care. 2006-2007 Women's Draft Agenda