Each year after dialogue among its members, the Coalition develops legislative priorities. The issues identified below are the Coalitions priorities for 2021; however, they do not represent the entirety of the issues which the Coalition supports and on which it takes a position. The Coalition typically has a Legislative Advocacy Day in the spring to meet with state legislators to share our priority issues.
2021 Legislative Agenda
Starting in 2019, the number of older adults (age 60+) began to outnumber children (age 0-17) in North Carolina. By the year 2030, every baby boomer (those born between 1946-1964) will be at least 65 years old. While this changing demographic shift has been known for decades, the state is ill equipped to handle the growing needs of an aging population. This dramatic shift in the state’s population comes at a time when we are also facing an unprecedented pandemic which has exacerbated existing problems and presented new challenges for our state’s seniors.
The priority issues for the NC Coalition on Aging for 2021-2022 are presented in two parts. Part 1 includes those items that Coalition members have identified as being critical for action now because the need is so great and negative consequences of immediate tremendous magnitude result from not addressing. Part 2 is a listing of top recommendations for action needed to further protect our most vulnerable older adults as well as for addressing the growing continuing and future needs of older North Carolinians. Needless to say, as long as our state is experiencing the impact of COVID-19 we must ensure that robust measures and programs are in place to protect the health and safety of older and vulnerable adults.
Critical Priority Recommendations
- Remove voting barriers for residents in group care settings by modifying current legislation which prohibits staff from assisting residents with voting. Many residents in long term care facilities were not able to exercise their constitutional right to vote during the pandemic due to their inability to receive voting assistance.
- Stabilize the direct care workforce crisis by supporting efforts to recruit and retain essential frontline workers. We ask that the temporary rate increases for Medicaid and State/County Special Assistance (SA) put in place during COVID-19 be made permanent to move the direct care workforce toward a living wage and that additional initiatives to improve benefits and supports for workers be adopted.
- Restore $50 million for state transportation funding for Rural Operating Assistance Program (ROAP) and State Maintenance Assistance Program (SMAP) which was removed from the NC Department of Transportation budget last year. This action has severely strained many public transportation systems and their ability to serve those who lack transportation to essential services.
- Remove the reimbursement rate cap for adult day services providers. The rate has not been increased since 2006 and many centers in the state are at risk of closing due to the deficit funding.
- Increase access to health care by eliminating the health insurance coverage gap. There are over 500,000 North Carolinians in the health insurance coverage gap. Expanding access to health insurance is critical for seniors not yet eligible for Medicare and the direct care workforce providing essential supports.
Recommendations to Protect the Most Vulnerable Older Adults and to Address the Continuing Needs of a Growing Aging Population
- Undertake a comprehensive study to address the challenges and opportunities of North Carolina’s increasing older adult population. The state needs a road map of how to address the implications of an aging baby boomer population. The study should support personal responsibility, recognize the important role of family caregivers, and address health disparities among racial and ethnic minorities, and the LGBTQ community.
- Increase support for home and community-based services (including Home and Community Care Block Grant (HCCBG), Community Alternatives Program for Disabled Adults (CAP/DA) and Program for All-Inclusive for the Elderly (PACE) which all have waiting lists for services.
- Invest state dollars in adult protective services (APS), mandated core services provided by county departments of social services to our state’s most vulnerable adults. In SFY 2019-2020 there were 30,779 adult protective services reports. During the same year, a total of $31.4 million was expended on the service. North Carolina counties funded 81.5% of the costs and the remaining 18.5% was from federal Social Services Block Grant (SSBG). No state funds were invested into adult protective services.
- Increase DHHS Competitive Non-Profit Grant Funding which have proven to be a lifeline in providing services and supports to seniors and adults with disabilities during COVID-19.
- Address food insecurity for seniors by supporting existing food assistance programs as well as other innovative programs initiated during COVID-19.
- Increase the Personal Needs Allowance (PNA) for residents living in assisted living and nursing homes. This allowance which residents use to purchase everything from shoes to toiletries and cell phone costs, is woefully inadequate and has not increased in decades. The PNA for nursing home residents remains unchanged at $30 a month since 1987. For residents in assisted living, the PNA is $46 a month and was last increased in 2003.
- Align the State/County Special Assistance (SA) income eligibility for residents in adult care homes with Social Security and Supplemental Security Income (SSI) cost of living adjustments to prevent residents from losing public benefits when their Social Security and SSI are increased.