March 5th, 2009

Department of Aging Senate Appropriations Hearing

March 4, 2009

John Michael Hall, Acting Secretary of Aging 

Lottery funds allotted to senior citizens:

Senate (question): Can you assure that the lottery revenue will continue to support senior citizens?

Hall (reply): The legislation that Governor Rendell is bringing does not disturb the status quo and agenda with the priority being senior citizens.

Senate (question): With the opening of casinos and online gambling and gaming becoming more prevalent, what impact will this have on the programs that depend on lottery revenue? In Pittsburgh and Lehigh Valley, where there are casinos, they have already experienced a drop in revenue.

Hall (response): Overall, statewide it has had little effect.

Senate: This is something that we should take into consideration now, before we are looking at an empty well. We should start looking now at the possibility of other water sources.

Personal Care and Assisted Living:

Concerns of the Senate:

1.        The new assisted living program will not offer as much as seniors deserve and will fall short as personal care has.

2.       The quality of the physical living spaces within the new assisted living facilities, “heard the spaces are the size of a prison cell and many are not even handicap accessible.”

Hall (response):

1.        We are setting a new model for care. The statute that this body passed mandated that standards and guidelines must remain above those set in personal care.

2.      We are trying to balance concerns about the share cost of developing these apartments and if Medicaid can even afford these rates and locating resources to fund them. It is our goal that these apartments are as close to living at home as possible with personal bathrooms, locks on doors and in allowed cases, kitchens.

Long-term Care Insurance:

Hall: Citizens should start planning and making arrangements now. Long-term care insurance is a great solution for seniors, but it has had problems with market penetration so we would like to be able to provide more confidence and stability so seniors can feel security with that investment.  

Stimulus Money for Technology:

Hall: We will be utilizing roughly $4 million for technology. Technology in the coming years will have to be able to “talk” to our older technology and some of the money will be spent to ensure “translation” between the new and old. We are still working to decide where the majority of those funds will be allocated. Home based care technology is becoming a necessity in home care and we will be looking into that.

Home Care-givers:

Senate (question): This shift for home and community based care is going to require other systems in place to support those programs. The new staff employed to care for the increasing number of senior need proper training; we want to ensure they are qualified.

Hall (response): This country struggles with a shortage of nurses and direct care workers and this hinders the amount of confidence people put in a program expected to care for their loved ones. We are looking into new standards and training for those care givers so that seniors can be properly cared for. This is a high priority for us.

The Department of Aging and Long-term Living:

Much of the hearing was spent discussing the possibility of merging Department of Public Welfare and the Department of Aging to create the Department of Aging and Long-term Living. The following is in addition to what was discussed at the February 23rd House Hearing with the Department of Aging on this proposal.

Hall: With regard to the merger, the Administration on Aging (AOA) and the Center for Medicaid Services (CMS) both welcome the direction we are headed.

Senate (question): For departments that have always had single advocacy, what will this mean now for the dual advocacy and how are you going to facilitate this smooth transition?

Hall (response): The Act 70, older Americans Act advocates the interest of older Americans that we’ve worked to uphold. That act has been added to the legislation for this merger with very little change. The needs and services for Adults with Disabilities and Seniors are becoming increasingly similar.

Senate (question): Between the two of these departments, there are four different bureaus and two agencies, this is going to take work. In reality, how is this actually going to help “real” people.

Hall (response): Because the needs and uses of these departments are becoming so similar, we will be able to offer a less confusing, more coherent service with one location to go to for all answers.

We also hope that this will strengthen the infrastructure for home and community based care.

Providers, home health services and all of those working within this industry are frustrated with the lack of accountability and trying to decipher which and whose rules to follow.

 States who have successfully accomplished this have gone the furthest experienced the most progress within their care services.