Senior issues newsletter [Vol. 32, No. 2 (Jan. 21, 2011)]

Senior Issues Newsletter

The Georgia General Assembly convenes for 40 days beginning each January. Day 3 of the session is January 24th.
Be There 4 Seniors Rally Thursday, January 27th, 11:00 am Join us on HthoeuWseaasnhdinSgetonnatSetCreaeltenstdeaprs of the Capitol
The Budget Process
Governor Deal's FY2011 Amended Budget and FY2012 Budget proposals were briefly reviewed in the Jan 14th senior issues newsletter. These reports can be found in their entirety by selecting "Governor's Budget Report FY 2011" and "Governor's Budget Report FY 2012" at http://opb.georgia.gov. This week the House and Senate Appropriations Committees heard from Gov. Deal, the state's chief economist, and state department heads. Proposed reductions in state funding and the impact of the end of ARRA (stimulus) funding were highlighted, and committee member had the opportunity to ask questions.
During the Department of Human Services budget hearing, Representative Jimmy Pruett questioned why the ARRA funding which was provided when state funds for Elderly Nutrition were cut was not replaced in the FY 2012 budget as were other ARRA funds which are now ending. He noted the nearly 5,000 people needing and waiting for this service and the fact that this $1,045,000 funding item would provide at least 138,000 meals. Senator Horacena Tate received no definitive answer when she questioned whether the substitution of Social Services Block Grant funds for state funding in the FY 2012 aging Transportation budget would be new and increased SSBG dollars or would be taken from other aging services (see article below for more detail).
During the Department of Community Health budget hearing, a question was posed concerning the effect on the budget if federal health care reform were repealed. Commissioner Cook answered that he felt that budgeted technology improvements to the Medicaid eligibility system are critical regardless of any changes in health care policy.
Of special concern to aging advocates in the DCH budget for FY 2012 is the elimination of Medicaid dental care, vision care and podiatry for adults. Georgia already covers only emergency dental services for most adults; if eliminated, there will be no care for abscesses or other dental problems which cause older adults to lose their teeth and ability to maintain good nutrition. Medicaid vision care for adults is quite limited now as routine tests and eyeglasses are not covered, but diagnosis and treatment of eye diseases is. Older adults are at grave risk of losing their eyesight if problems such as glaucoma go undetected and untreated. Podiatry care is especially important for people with diabetes and those with poor circulation from cardiac illness who are at risk of infection and possible amputation. In each case, money saved now by eliminating these services will result in significantly higher emergency room, hospitalization, and long term care expenditures. House Appropriations Subcommittees will now start work on the FY 2011 budget. The Health Subcommittee's hearing on Department of Community Health January 24th at 2:00.
Social Services Block Grant Hearings
Hearings for five Block Grants were held January 20th as well, with Senators Jack Hill and Renee Unterman and Representatives Terry England and Penny Houston presiding. Only aging advocates offered testimony. Ann Williams, Legislative Chair for the Georgia Council on Aging, asked for continued utilization and an increase of Social Services Block Grant (SSBG) funds for aging programs to meet the needs of the growing population. SSBG is designed to meet the goals of preventing or remedying neglect, abuse, or exploitation of children and adults, preventing or reducing inappropriate institutional care and achieving or maintain economic self support and economic self sufficiency. Vicki Johnson, also a member of the Georgia Council on Aging, asked that the proposed substitution of SSBG funds for state funds in the FY 2012 transportation budget under DHS Administration consist of additional SSBG funding. Reallocation within the aging budget without increased funding would only reduce critical programs like Ombudsman, Adult Protective Services, Meals, or Adult Day Care.

The Senior Issues Newsletter is a publication of the he Georgia Council on Aging, the Senior Citizens Advocacy Project and the Georgia Gerontology Society. Volume 32, No. 2, January 21, 2011

Advocacy in Action .... Make Your Voice Heard!
Here are specific actions you can take to further our advocacy of our state's elders.....
1. Come to the Capitol. Join other aging advocates who will come in person to support funding and services for older adults:
(Be There for Seniors Rally) January 27th, 11:00 am, Washington Street Side of the Capitol
(Senior Week at the Capitol) February 22nd -24th, 9:00 am-2:00 pm, South Rotunda of the Capitol
2. Continue to speak to your legislators through calls, visits, letters, and e-mail. Please encourage them to support the following funding in the FY2011 Amended and FY2012 Budgets:
Restore $1,376,718 for non-Medicaid and HCBS respite services almost 135,000 hours of respite care to support older adults and their caregivers Restore $225,000 for Alzheimer's disease services 20,500 hours of day care services Continue using the Nursing Home Civil Monetary Penalty (CMP) funds to support $611,520 for Adult Protective Services and $1,000,000 for the Long Term Care Ombudsman programs (use of CMP funds reduces the state's funds that must be spent on such programs)
3. Learn about legislation that impacts seniors. This newsletter will inform you each week. You can follow legislation on the newly re-designed website of the General Assembly: www.legis.ga.gov. You can watch the General Assembly and certain Committee Hearings in action at http://www.gpb.org/lawmakers. Watch GPTV's "Lawmakers" each evening at 7:00 pm to see the events of the day at the Capitol.
4. Take encouragement and inspiration from recent advocacy results! Advocates and professionals came together and successfully impacted the rule making of the Department of Community Health on Personal Care Homes to ensure that better consumer choices for long-term care will be available.
Annual Budget Conference Held
Over 200 human service advocates, health advocates, legislators, and budget analysts met on Friday, January 21st, at the annual Georgia Budget and Policy Institute conference to hear about and discuss the budgets before the General Assembly and Congress in 2011. The impact of various funding reductions is becoming clearer as the budgets are reviewed more closely, and participants had an opportunity to discuss the budget and the impact of Tax Reform efforts with Representative Larry O'Neal, Majority Leader, and Representative Stacey Abrams, Minority Caucus Leader, who are both experts in tax law. A number of other legislators attended and had conversations with advocates throughout the day.
The Augusta Chronicle reported on Saturday that Allan Essig, executive director of GBPI said, "During the budget hearings, every agency said, `we'll take our hits now, but remember us next year or whenever the money comes back into the budget.' But the new normal is this level of revenue for the state." He also indicated that, while the legislature just began hearings on the details of the budget, it's unlikely to remove most cuts because legislative leaders oppose raising taxes, especially while the unemployment rate tops 10 percent. See "Gov. Deal budget plan worries social service advocates" http://chronicle.augusta.com/latestnews/2011-01-21/ga-social-services-advocates-concerned-about-budget-cuts.
GBPI has released a thoughtful report analyzing the DHS budget prepared by Clare S. Richie, M.P.A., Senior Policy Analyst. In reviewing the Division of Aging Services budget, she noted that "State funds are at the minimum required level to receive federal funds under the Older Americans Act. Georgia fell to this minimum level after former Governor Perdue requested an additional 4 percent cut in state funds in August, 2010... Any new cuts in the amended FY 2011budget or the FY 2012 budget to state or local funds beyond the cuts mentioned, could risk noncompliance with the Older Americans Act. The consequence could be an estimated $6 dollar loss in federal funds for every $1 of unmet state and local required funds."
The Division of Aging Services has taken a 15 % drop in state funding compared to its pre-recession level. That includes cuts of 19 % from the pre-recession level to Elder Abuse Investigations & Prevention and 28 % to the Council on Aging. Ms. Richie noted that these cuts come at a time when "the Georgia Council on Aging reports that Georgia seniors are in increasing need of services:
23 percent have incomes between 50 and 100 percent of the federal poverty line; 22 percent live alone; Ranked 6th in the nation for food insecurity between 2001 and 2007 at 8.6 percent; and, Waiting lists have grown to 4,399 for home delivered and 312 for congregate meals."
For more information, you can download and read reviews by GBPI at their website www.gbpi.org : "Georgia's Budget Primer 2011," "Human Services is `Down to the Bone,' and "Governor's Proposed Health
Budgets: Have We Hit the Bottom?"

Department of Community Health Board Meeting, January 13, 2011
The Department of Community Health holds its board meetings every 2nd Thursday of each month at 10:30 a.m. on the 5th Floor at 2 Peachtree. However, despite the snow and ice that disabled much of Atlanta, the Department of Community Health (DCH) held its regularly scheduled Board meeting on January 13. Newly appointed Commissioner David Cook described the commitment of the Department to improve the health of our citizens, to provide access to services, and to promote high quality health care. Commissioner Cook reported that satisfying these objectives would continue to be challenging for at least three reasons. First, the loss of approximately $700 million in Federal stimulus funds beginning in 2011 will dramatically affect the state's budgets, particularly for FY2012. Second, health policy will have to shift to comply with federal health care reform (The Affordable Care Act), creating questions about how to fund such changes. Finally, there has been a movement for some time to establish a Department of Public Health rather than continuing Public Health as a division of DCH, a decision which Commissioner Cook hopes is made soon.
The Board was given an update on the status of recent proposed rules on Personal Care Homes that were released for public comment by DCH on November 29, 2010. Because of the weather, and the sheer volume of public comments, the Department recommended to the Board that the rules be tabled for the time being until more stakeholders could be involved. Approximately 900 letters of public comment were received by the Department! Over 200 people attended the Public Hearing on the proposed Personal Care Home rules held on December 29, 2010, and speakers ranged from seniors living in personal care homes and owners of senior communities to advocates and family members. Commissioner Cook also indicated that he would meet regularly with the Commissioners of the Department of Human Services and the Department of Behavioral Health and Developmental Disabilities to better communicate and coordinate the efforts of all the departments.
Department of Human Services Board Meeting, January 19, 2011
The Department of Human Services holds its board meetings every 3rd Wednesday of each month at 10:30 a.m. on the 29th Floor at 2 Peachtree. The Board of the Department of Human Services (DHS) met briefly on January 19th, the first meeting of new DHS Commissioner Clyde Reese, but was unable to conduct any official business as there was not a quorum present. Commissioner Reese was appointed by Governor Deal after serving as interim Commissioner of DCH, where he also served for many years as General Counsel. Commissioner Reese discussed the budget challenges faced by DHS. While FY2011 was likely to benefit from a slight improvement in the state's economy, FY2012 will be difficult financially. Programs have been reduced to only services that are required the "nice-to-haves" are all gone. The Department is being reorganized effective immediately, and Commissioner Reese introduced to the Board his new Deputy Commissioners (see chart below).

New Legislation of Interest
Since 2011 is the first year of a two-year cycle, no legislation has carried forward from the last legislative session. Any bills from last session must be reintroduced.
H.B. 47. Sponsors: Ramsey (72nd), Meadows (5th), Maxwell (17th), Sheldon (105th), Peake (137th), Lindsey (54th): would authorize out-of-state individual accident and sickness insurance policies, that is, health insurance contracts that have been approved under other states' laws, to be sold in Georgia. Medicare Advantage policies and Medicare Supplement policies would potentially be impacted.
Tax Reform in Georgia Will Impact Older Adults
The Special Council on Tax Reform and Fairness released its recommendations for reform of Georgia's tax system on January 7th. The Council was established by legislation in 2010 to study the state's current revenue structure, make recommendations that would lead to the betterment of Georgia, change the state's philosophy of taxation from income tax to consumption-type taxes, increase the stability of tax revenue for more predictability in the budget, and enhance perception of fairness. Although it was anticipated that legislation would quickly follow the release of the report, the leadership of both the Senate and the House have indicated a desire to study the report in more detail, and there does not appear to be universal support for all recommendations. While the report itself is lengthy, you can download and read an expert analysis of the report "Almost There....Tax Recommendations Improve Finances, but Shift Taxes" by the Georgia Budget and Policy Institute at their website (www.gbpi.org). Certainly, the Georgia Council on Aging continues to express concern that taxes on services and groceries will disproportionately affect many older adults and others who are at the lower end of the income scale in our society.
News on Health Care Reform
This past week, U.S. House Republicans followed through on their pledge to repeal the Affordable Care Act (ACA), passing the bill (H.R. 2) by a vote of 245 to 189, with voting along strict party lines. The House also adopted a resolution, 253-175, instructing four committees to draft new health care legislation in the form of a series of small bills. The resolution directs the panels to focus on 13 areas: lowering health care premiums, overhaul of the medical liability system, prohibiting federal funding for abortions, providing access to health coverage for people with pre-existing conditions, increasing the number of insured Americans, and protecting the doctor-patient relationship, among others. In the U.S. Senate, Majority Leader Harry Reid (D-NV) has vowed to block any bill to repeal the Affordable Care Act. However, the Senate is considering various efforts to revise or refine portions of the Affordable Care Act.
Georgia's new Attorney General Sam Olens announced this past week that his office will join in representing the Governor in the lawsuit against health care reform. The previous AG did not bring his office into the effort, and Governor Perdue utilized private, pro bono counsel.
Information about specific legislation: Georgia Council on Aging (404)657-5343. Bills and information about the General Assembly: www.legis.ga.gov/en-US/default.aspx. Copies of bills: House Clerk's office (404)6565015.