T he I mpa c t o f the COVI D-19 Pa nde mic o n Olde r No rth - - PowerPoint PPT Presentation
T he I mpa c t o f the COVI D-19 Pa nde mic o n Olde r No rth Ca ro linia ns a nd the Pro g ra ms T ha t Se rve T he m April 9,2020 Ma ry Be the l Bo a rd Me mb e r/ Re tire d E x. Dire c to r, NC Co a litio n o n Ag ing T ra c y
April 9,2020
Ma ry Be the l Bo a rd Me mb e r/ Re tire d E
T ra c y Co lva rd Cha ir o f the Bo a rd, NC Co a litio n o n Ag ing Vic e Pre side nt o f Go ve rnme nt Re la tio ns a nd Pub lic Po lic y, Asso c ia tio n o f Ho me a nd Ho spic e Ca re NC
Mo re tha n 1 in 5 No rth Ca ro linia ns a re 60+
E ffe c tive 2019, the sta te ha s mo re pe o ple 60 a nd o ve r tha n unde r the a g e o f 18. I n 2018, 80 c o untie s in the sta te ha d mo re pe o ple 60 a nd o ve r tha n unde r 18.
wo o r Mo re Chro nic Co nditio ns
iving Arra ng e me nts (65+)
ive Alo ne
he ir Ho me s
ive in Gro up Qua rte rs
c o no mic Sta tus (65+)
e ve l
nc o me b e twe e n 100%-199% o f the Po ve rty L e ve l
*I nfo rma tio n c urre nt a s o f April 8, 2019 11:00a m, So urc e : COVI D-19 NC Da shb o a rd
Prevalence
0-17 yrs (1%) 18-24 yrs (8%) 24-49 yrs (42%) 50-64 yrs (29%) 65+ yrs (21%)
Deaths
0-17 yrs (0%) 18-24 yrs (0%) 25-49 yrs (7%) 50-64 yrs (13%) 65+ yrs (80%)
so c ia l iso la tio n
a nd the ir sc a ling b a c k o n c o mmunity vo lunte e ring is fe lt b y the pro vide rs
e xtra mile to se e the ir ne e ds a re me t
he c o mmunity is c o ming to g e the r. Ne w pa rtne rships a re b e ing de ve lo pe d a nd e xisting c o lla b o ra tive e ffo rts a re flo urishing . Ma ny pub lic / priva te pa rtne rships a re b e ing fo rme d
she lf-sta b le me a ls o nc e a we e k. A fe w a re still pro viding ho t me a ls five da ys a we e k. F ro ze n me a ls a re mo re e xpe nsive
pro viding “g ra b to g o ” me a ls a nd de live ring me a ls to pa rtic ipa nts ho me s
“no urishing ” me a ls e ve n if re c ipie nts do no t me e t 1/ 3 RDA
a re de live ring me a ls
he re a re 94 pro g ra ms in the sta te in 50 c o untie s
c e nte rs
c lo se d in the la st de c a de . Pub lic re imb urse me nt is a b o ut ha lf
2020
pa rtic ipa nts
ne e ds
he re is a DSS in e ve ry c o unty in the sta te
de pa rtme nt is still re spo nsib le fo r ha ving se rvic e s a c c e ssib le to the pub lic
e y se rvic e s fo r a dults a re Me dic a id, F
Se rvic e s (F NS - fo o d sta mps), Sta te / Co unty Spe c ia l Assista nc e , Adult Gua rdia nship a nd Adult Pro te c tive Se rvic e s
he c e rtific a tio n pe rio d fo r F NS a nd Me dic a id ha ve b e e n e xte nde d
NS will re c e ive the ma ximum a mo unt a llo we d fo r Ma rc h 2020 a nd April 2020 fo r the ir ho use ho ld size
D-19, it is e xpe c te d tha t the re will b e a n inc re a se in APS re po rts. F unding fo r APS is a lre a dy stra ppe d
he re a re 1,184 lic e nse d in-ho me a ide pro vide rs, o ve r 200 c e rtifie d ho me he a lth pro vide rs, a nd o ve r 200 ho spic e pro vide rs in the sta te .
he se pro vide rs se rve a ppro xima te ly 100,000 pa tie nts pe r ye a r a nd e mplo y a ro und 400,000 pe rso ns
he re is a se ve re ne e d fo r PPE fo r mo st fro nt line wo rks who to uc h pa tie nts to c a re fo r the m
a nd g o thro ug h a c rimina l b a c kg ro und c he c k. Mo st she riff’ s o ffic e s ha ve shut do wn fing e rprinting to re duc e tra ffic in the ir b uilding s in mo st c o untie s so this is c a using a de la y in g e tting wo rke rs in the c o mmunity
D-19 whic h is a g re a t he lp to pa y fro nt line wo rke rs a b e tte r wa g e
mo re mo ne y a nd a slig htly sa fe r e nviro nme nt tha n he a lthc a re . So me wo rke rs a re a pplying fo r une mplo yme nt b e c a use the y a re sc a re d
he re a re 591 a dult c a re ho me s (7 b e ds a nd up) a nd 593 fa mily c a re ho me s (2-6 b e ds) in the sta te tha t pro vide ho using fo r o ve r 30,000 re side nts
the fe a r o f the virus
c o mb a t COVI D-19
COVI D-19 c a se s if ne e de d
D-19 in thre e re side ntia l c a re fa c ilitie s whic h inc lude a dult c a re ho me s a nd fa mily c a re ho me s
t is re c o mme nde d tha t a ll a ssiste d living fa c ilitie s re stric t visito rs during the pa nde mic
a c ilitie s a re re q uire d to ha ve a n a ppro ve d writte n disa ste r pla n a nd a ll ho me s must tra in sta ff o n the sta te a ppro ve d infe c tio n c o ntro l c o urse
he re a re 421 lic e nse d nursing ho me s in the sta te lo c a te d in 98 c o untie s tha t c a re fo r ne a rly 38,000 individua ls e ve ry da y. T he y e mplo y ne a rly 40,000 pe o ple sta te wide
ne e d 24/ 7 me dic a l supe rvisio n a nd c a re
se pa ra te units within a fa c ility fo r ne g a tive re side nts a nd po sitive re side nts o r tho se with unkno wn sta tus
D-19 ha s wo rse ne d the sho rta g e o f dire c t c a re wo rke rs a va ila b le to ho me s
ho spita ls, a nd nursing ho me a sso c ia tio ns to e nsure c o o rdina tio n a mo ng fa c ilitie s to de te rmine whic h fa c ilitie s ma y de dic a te the mse lve s to a c c e pting a nd c a ring fo r COVID-19 pa tie nts, with suppo rt to pro vide a dditio na l supplie s a nd PPE , if a va ila b le
&A c o ntinuo usly
fa milie s a nd individua ls c a n c a ll to o b ta in fre e a nd c o nfide ntia l info rma tio n o n he a lth a nd huma n se rvic e s re so urc e s within the ir c o mmunity, is re c e iving a hig h vo lume o f c a lls. NC 2-1-1
a nd re so urc e s a re a va ila b le in mo st la ng ua g e s
ine (1-866-578-4673) whic h is ta rg e te d to pe o ple 65+ who wa nt to ta lk with so me o ne ha s g o ne fro m o ne line to thre e line s in the la st se ve ra l we e ks. I t ha s re c e ive d o ve r 600 c a lls sinc e mid-Ma rc h
llne ss (NAMI ) NC re po rts inc re a se d c a lls o n the ir He lp L ine re la te d to a nxie ty, stre ss, a nd pe o ple wa nting suppo rt
pro visio ns, ma ny a g e nc ie s a re imple me nting c o ntinuo us
do no t ha ve e q uipme nt suc h a s c e ll pho ne s, la pto ps, ta b le ts, a nd o the r ite ms ne e de d to he lp e nsure the y a re a b le to
we re no t inc lude d in c urre nt o pe ra ting b udg e t
he re is g re a t de pe nde nc e o n the use o f the I nte rne t, no t o nly fo r using te le me dic ine a s a sub stitute fo r o ffic e visits with do c to rs a nd o the r me dic a l pro vide rs b ut fo r suc h thing s a s pro viding a so urc e o f c o mmunic a tio n fo r o lde r a dults in lo ng - te rm c a re fa c ilitie s with the ir fa mily me mb e rs who a re no w re stric te d fro m visiting the m. Unfo rtuna te ly, re lia b le I nte rne t a c c e ss is no t a g ive n in e ve ry c o unty in o ur sta te
ne w fle xib le re g ula tio ns re g a rding Me dic a re re imb urse me nt fo r te le he a lth. T his ma y c re a te a b a rrie r to se nio rs a s so me do no t ha ve a c c e ss to sma rtpho ne s, do no t kno w ho w to use the vide o c ha t c a pa b ility, o r do no t ha ve a de q ua te a nd re lia b le I nte rne t se rvic e to suppo rt vide o c o mmunic a tio ns
c ha lle ng e d with the pa nde mic . T wo pro g ra ms tha t c o me to mind a re a dult da y c a re / a dult da y he a lth c a re a nd a dult pro te c tive se rvic e s. I n a dditio n, the ma in funding so urc e fo r a lo t o f the c o mmunity-b a se d se rvic e s no te d (Ho me a nd Co mmunity Ca re Blo c k Gra nt) ha d la rg e wa iting lists fo r se rvic e s prio r to the o nse t o f COVI D-19 (11,114 o n wa it list in Ja nua ry)
pro fits whic h re ly o n c ha rita b le g iving a nd fund ra ising to fund sig nific a nt pe rc e nta g e s o f the ir b udg e ts. Ag e nc ie s a re a lre a dy se e ing a re duc tio n in g iving a nd ma ny o f the m ha ve ha d to c a nc e l fund ra ising e ve nt fo r the fo re se e a b le future . Also , ma ny no n-pro fits de pe nd
he re a re mo re tha n 1,200 pe o ple o ve r the a g e o f 65 in priso ns in the sta te . E lde rly priso ne rs a re mo re like ly to ha ve multiple o r se rio us he a lth c o nditio ns like he a rt dise a se o r dia b e te s tha t c o uld le a d to hig he r risk
D-19. Unde r No rth Ca ro lina la w, so me pe o ple who a re te rmina lly ill, pe rma ne ntly a nd to ta lly disa b le d o r a g e 65 o r o lde r c a n b e re le a se d a nd re turne d ho me thro ug h me dic a l re le a se . Also , the Se c re ta ry o f the De pa rtme nt o f Pub lic I nstruc tio n ha s a utho rity to “e xte nd the limits o f c o nfine me nt” fo r pe o ple who a re pe rma ne ntly a nd to ta lly disa b le d o r te rmina lly ill so the y c a n re c e ive me dic a l c a re
xpe dite the proc e ss for e nsuring additional fe de ral funding c oming into the state ge ts to the loc al le ve l quic kly and that the re is fle xibility with ac c ountability in how the funding c an be use d to me e t ne e ds in the c ommunity
ake ste ps to e nsure that pe ople c an ge t the se rvic e s the y ne e d whe n the y ne e d the m. Se e k fe de ral approval for waive rs and othe r administrative “fixe s” to e xpe dite se rvic e de live ry
Spe c ific c ritic a l ne e ds a re : 1) Pro vide a dult c a re ho me s with funding fo r the te mpo ra ry Sta te / Co unty Spe c ia l Assista nc e (SA) pa yme nt whic h ha s no t b e e n a va ila b le fo r a lmo st a ye a r, 2) Se e k a ppro va l fro m the fe de ra l Ce nte rs fo r Me dic a re a nd Me dic a id Se rvic e s (CMS) to pro vide mo re fle xib le a c c e ss to the $30 millio n in Civil Mo ne y Pe na ltie s (CMP) funds fo r skille d nursing fa c ilitie s to supple me nt pro g ra ms de sig ne d to impro ve the q ua lity o f life o f nursing fa c ility re side nts during this e me rg e nc y pe rio d, 3) I nc re a se the da ily re imb urse me nt ra te fo r a dult da y se rvic e s, 4) Pro vide a dditio na l funding to c o unty de pa rtme nts o f so c ia l se rvic e s fo r a dult pro te c tive se rvic e s, a nd 5) Co mpe nsa te g ro up c a re fa c ilitie s a nd lo c a l a g ing a g e nc ie s fo r the inc re a se d c o sts the y a re inc urring due to the COVI D-19 pa nde mic
take to e xpand the workforc e ac ross the c ontinuum from dire c t c are worke rs to me dic al pe rsonne l. Po lic ie s pe rta ining to he a lth c a re a c c e ss,
sic k le a ve b e ne fits, c hild c a re a ssista nc e , a nd o the r wo rk pla c e pro visio ns ne e d to b e e xa mine d. I n a dditio n, po te ntia l o ptio ns fo r inc re a sing the supply o f wo rke rs suc h a s a llo wing me dic a l a nd nursing stude nts to g ra dua te e a rly, a ddre ssing pro visio ns re la tive to lo c um te ne ns pro vide rs, fa st tra c king re c ipro c ity o f lic e nsure fo r pro vide rs fro m
use o f vo lunte e rs a nd no n-c linic ia ns a s fe a sib le ne e d to b e e xplo re d.
suc h as short- te rm financ ial assistanc e and c ounse ling on options and budge ting.
aging se rvic e provide rs to e xpand the ir se rvic e s to re ac h out to olde r adults in the ir c ommunitie s
nsur e that staff wor king with olde r adults in the home (e x. fr
age nc ie s and c ounty de par tme nts of soc ial se r vic e s) and in all c ar e se ttings (inc luding home c ar e , hospic e , assiste d living, and nur sing home ) have ade quate pe r sonal pr
) and that issue s with te sting for COVID- 19 ar e addr e sse d to the e xte nt possible . I
n a dditio n to g lo ve s, fa c e ma sks, a nd g o wns, the re is a lso a ne e d fo r a de q ua te supplie s o f dia pe rs, wipe s, a nd ha nd sa nitize r. Sta ff who wo rk with o lde r a dults, pa rtic ula rly tho se with c o mpro mise d immune syste ms, sho uld a lso b e a prio rity fo r COVI D-19 te sting
al Ce nte r s for Me dic ar e and Me dic aid se r vic e s to allow audio- only c ommunic ation for te le he alth unde r the Me dic ar e pr
am
e ss me asur e s to c ombat fr auds and sc ams tar ge ting the e lde r ly.
nsur e ac c e ss to r e liable br
y c ommunity in our state , and pr
r e imbur se me nt for te c hnology r e quir e d to sustain ope r ations
Assoc ia tion’s E lde r a nd Spe c ia l Ne e ds L a w Se c tion, the NC Assoc ia tion of County Dir e c tor s of Soc ia l Se r vic e s, a nd
r e le va nt e ntitie s to e va lua te the ne e d for c ha ng ing Nor th Ca r
e quir e me nts pe r ta ining to e sta te pla nning a nd powe r
a ttor ne y doc ume nts
de r to fa c ilitate voting by olde r a dults in upc oming e le c tions, the Ge ne r a l Asse mbly a nd the Sta te Boa r d of E le c tions should e xa mine a bse nte e voting pr
e xpa nding the use of Multipar tisan Assista nc e T e a ms (MAT s). T
he se te a ms a re c urre ntly ma inta ine d b y e ve ry Co unty Bo a rd o f E le c tio ns to he lp tho se in fa c ilitie s suc h a s nursing ho me s, ho spita ls, a nd a ssiste d living fa c ilitie s re q ue st a nd sub mit a b se nte e b a llo ts. T he ro le o f MAT s c o uld b e e xpa nde d to a ssist a nyo ne o utside o f the se fa c ilitie s who ne e ds a ssista nc e
g iving c re dit or de duc tion tha t would be a va ila ble to a ll North Ca rolinia ns to e nc oura g e the m to support the work
c ontinue to fund support for non- profits in the DHHS budg e t
xa mine the me dic a l re le a se a nd me dic a l furloug h provisions a s the y a pply to olde r prisone rs to de te rmine if the y a re be ing use d to the c urre nt e xte nd ne e de d to sa ve a s ma ny live s a s possible , c onse rve prison he a lthc a re re sourc e s, a nd prote c t the public he a lth