ATLANTA -- At the state Capitol, everyone wears a name tag or some kind of badge announcing their business. One of the most common is a round, green sticker with the number 4 on it.
It stands for Be There 4 Seniors, a nonprofit campaign that lobbies to protect state services for older state residents. Also very visible are the white stickers of AARP members working the halls.
Perhaps chiefly, they are concerned about rising prices, the specter of more sales taxes and state budget cuts bumping against the limits of fixed incomes and faltering health. And then, there’s planning for the future, trying to make sure Georgia laws and budgets can support options for living arrangements down the road.
Talk of a state sales tax on groceries has upset plenty of people, including the crew of midstate senior citizens who gathered in a basement room of the state Capitol last week for strategy and coffee before breaking into groups to go lobby their legislators.
“If they put more taxes on it,” declared Betty H. Solomon, of Montezuma, “that’s more money we don’t have.”
She was among the 40 or so Middle Georgia AARP members who came to Atlanta.
Hazel Thompson, also of Montezuma, pointed out that Social Security has not increased to match the cost of living for two years. It would be unfair, she said, to lose benefits: “We worked to earn this.”
The proposed state sales tax on groceries could raise about $600 million per year, according to The Tax Council, a blue-ribbon panel that studied Georgia’s tax structure last year and recommended the levy. And the council also advised taxing all retirement income, instead of granting a waiver for income up to $35,000. Right now, that state tax is shrinking and is scheduled to disappear in 2016. The council calculates that by 2016, that would come to about $270 million in unrealized revenue.
Finally, the council also suggested that the state should tax consumption, not income, and that the code should be simple and include as few tax breaks as possible.
Lawmakers have held hearings on the council recommendations, but they do not have to follow any of them. No floor debates have been scheduled.
The surprising price of house calls
Rosita Huckeba of Warner Robins emphasized affordable home health care. “Because nursing homes are so expensive, no one can afford them,” she said, and “people are left stuck at home without care.”
She’s looking for features that would enable people to stay at home, safe and healthy. That would include such things as Meals on Wheels deliveries, personal care help, housekeeping and relief for caregivers, said Sharon Dawson, the aging services manager at the Area Agency on Aging in Macon, the part of the Middle Georgia Regional Commission that administers those programs.
About 600 more people want to be on her Meals on Wheels routes in the 13 counties of Middle Georgia. But her state funds, which pay for part of the 900 to 1,000 meals delivered daily, are on the state chopping block.
A federal stimulus grant offset a state budget cut of about $1 million last year, but that money’s spent. Groups such as the Georgia Council on Aging, a state agency, are urging the Legislature to restore the money. By the council’s math, that’s about 138,000 meals.
Since federal government spending is rattling along a continuing resolution rather than a proper budget, it only gets more difficult to plan expenditures.
And Dawson notes that there’s higher demand for her other programs. Nearly 800 caregivers are waiting to get appointments with home aides, who will stay with homebound people while the caregiver runs errands. About 750 people have requested aides to visit their homes to help them with personal care -- dressing, hair care and the like.
Said Dawson, “Our goal is to keep people in their homes and communities where they’ve lived and worked all their lives.”
Besides that, it’s cheaper for people to live at home.
Dawson’s office also administers the separate Medicaid-funded Community Care Services program. It offers home care services to people who would be eligible for Medicaid and a nursing home. It’s a so-called Medicaid waiver program. The number of waivers the state can hand out each year depends on Medicaid funding levels.
By Dawson’s statistics, the program took care of 777 people at about $1,200 per client per month last fiscal year. Nursing home care would have cost about $2,600.
The state House will publish a fiscal 2012 budget proposal in the coming weeks that will be debated and probably finalized by April.
Aging in place or not?
But for many people, a point comes when it’s not wise to live at home. Georgia law offers two options.
Personal care homes supply room and board, and they have staff to help with dressing and grooming, but it’s not medical care. Nursing homes are much more clinical: they’re for people who need 24-hour medical supervision.
But people need a choice in between, said state Rep. Chuck Martin, R-Alpharetta.
“If folks get just a little less ambulatory, “ explained Martin, “the rules and regs now say they have to go to skilled nursing (a nursing home), but if they don’t completely need all of that care, we want them to be able to stay in that facility.”
For example, take someone who has Parkinson’s disease, he said. Some Parkinson’s patients tremble so much that they cannot measure out their own medicine. For that reason, state code now assigns that person to a nursing home. Personal care homes can’t administer medicine. Or, if someone comes to need a wheelchair, the state says a nursing home for them. Personal care homes cannot take residents who can’t evacuate themselves in case of fire. The list of these in-between cases -- needing some help but not full-time help -- is long.
Martin filed a bill in the state House that creates a middle path by defining assisted-living communities. These would have a minimum of 25 beds and could accept residents capable of “assisted self-preservation” -- say, staffers to push a wheelchair in case of emergency.
It also creates a new profession: medication aides who are trained and licensed to help people with any kind of prescription.
“And if people can stay at assisted living, it’s cheaper than a nursing home,” Martin pointed out.
Both Democrats and Republicans have signed House Bill 405. It’s had one committee hearing and a follow-up is scheduled this week.
Last year, Martin authored a similar bill that got a committee recommendation, but it never made it to a vote in either chamber.
To contact writer Maggie Lee, e-mail firstname.lastname@example.org.