On February 28th, several of Centralina’s regional Ombudsmen attended the Friends of Residents in Long-Term Care (FOR) 2023 Legislative Day in Raleigh. The purpose of the event was to meet with legislative representatives to advocate for and support issues currently affecting aging communities across our state. Partner organizations such as the NC Coalition on Aging and AARP-NC were also in attendance advocating for similar issues. Members of the North Carolina Ombudsman Association went into the full-day event with several talking points to share and openly discuss with legislators. Here is an expanded look at some of the issues our Ombudsmen championed that day.
1. Increase the Personal Needs Allowance to $70 per month for Medicaid nursing home residents.
Since 1986, North Carolina has opted for the federal minimum personal needs allowance for nursing home residents to be only $30. Nursing home residents use these funds to buy clothing, snack foods, activity expenses or other personal items. Many essential items are not included with Medicaid, such as a beauty shop appointment. That appointment alone would be at least $30 or more, and many times families have to pick up the cost of this and other essentials like clothing or food. To help residents afford these items, FOR and the Ombudsmen requested the allowance be increased to at least $70.
2. Provide funding for 11 regional long-term care Ombudsmen (LTC) to meet recommended national staffing standards.
North Carolina has more than 90,000 LTC beds and 35 approved full-time equivalent ombudsmen staff positions. The National Academy of Sciences Institute of Medicine recommends that there should be one Ombudsman for every 2,000 beds. To meet this recommendation, 11 additional Ombudsmen would need to be hired for a total of 46. These additional positions accrue an expense of $1.5 million in necessary recurring funds to meet best practice staffing standards and the increased demands of LTC Ombudsman roles. Ombudsmen not only advocated for additional staff, but they also requested that distribution of approved funds be given to the region’s most in need of additional ombudsmen, based on the number of beds per region.
3. Support the long-term care direct care workforce by encouraging paying a livable wage.
Certified nurse assistants (CNAs) provide around-the-clock, one-on-one care to nursing home residents, making them experts on what the individuals they care for need to stay happy and healthy. Duties of CNAs include implementing bathing, toileting, grooming, feeding and all other personal care functions for the resident. Despite the extensive work they do, most CNAs are only paid between $8-$15 an hour. Personal care assistants, often working at adult care homes (ACHs) who don’t hire CNAs, are usually not making any more than the minimum wage. Quality of care is directly related to the adequacy, competence and stability of the direct care workforce, and Ombudsmen advocated for higher pay rates for those who do this back-breaking work day in and day out.
4. Continue to advocate for increased awareness of:
- The need for ACH facilities to accept a portion of their beds for State/County Special Assistance (SA) recipients
- Consumers who do not qualify for SA and do not have private pay dollars to be placed in an ACH
Now that Medicaid expansion has been signed by Governor Roy Cooper, providers need to start preparing for the impact. Ombudsmen explained the qualifications for SA to legislators and how it is differentiated from Medicaid. The current gross income limits are $1,355 for ACH and $1,737 for ACH memory care. The lack of affordable housing forces many older and disabled adults into nursing homes sooner than needed, which in turn costs the state more money. Ombudsmen explained to the legislators what the realistic costs are of private-pay residents ($3,500-$12,000 per month) and emphasized the large disparity between qualifying for SA and the cost of private pay.
Overall, the day was seen as successful with lots of productive meetings and a plethora of information shared, most of which legislators were open to thoroughly discussing. Our Ombudsmen encourage members of our region to continue to advocate for older and disabled adults, including the priorities discussed with legislators. Use this link to find your state representatives and how you can contact them to further advance these and similar aging-related issues you’re passionate about.
