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February 2, 2018

Advocacy & Policy

LeadingAge National Approves Public Policy Priorities for 2018

The LeadingAge national board of directors earlier this week approved their Legislative and Regulatory Advocacy Priorities for 2018. The priorities were adopted using a new process led by the Public Policy Committee and developed in consultation with state executives from each LeadingAge affiliate. The 2018 priorities are classified as either:

  • LEAD (maximum organizational effort and nationwide commitment)
    o Could include multiple partners
    o To be limited to 2 to 3 issues at any one time
  • ENGAGE (moderate organizational effort and targeted activity)
    o Examples include coalition work, participating in sign-on letters, submittal of statements for the record, comments on regulations.
  • MONITOR (active tracking)

The priorities will be used to develop a focused set of asks on issues most important to the membership that will be used on Capitol Hill visits with congressional delegates during PEAK in March.

Congress Passes RAISE Family Caregiver Act

The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act has passed Congress with bipartisan support. A broad coalition of aging and disability organizations advocated for the passage of the legislation. The Act requires the Secretary of Health and Human Services to develop, maintain, and update a strategy to recognize and support family caregivers. An advisory committee will be formed to develop the strategy with public input. The development of the initial strategy will take up to 18 months, followed by biennial updates.

Medicaid Work Requirements

North Carolina, along with ten other states, has received permission from CMS to require Medicaid recipients, with some exceptions, to either work or participate in activities such as job training and volunteering in order to qualify for benefits. The ruling from CMS affects the federal Medicaid waiver request submitted by the McCrory administration in June 2016 and amended November 20 by the Cooper administration. The state's request for the work requirement applies only if Medicaid expansion, which is opposed by the General Assembly, comes to fruition in North Carolina. Governor Cooper's administration has not asked for permission to add work requirements to the state's existing Medicaid health insurance program, which covers more than 2 million people.

Aging Subcommittee Meeting Rescheduled

The meeting of the Aging Subcommittee of the Joint Legislative Oversight Committee on Health and Human Services scheduled for January 18 was cancelled due to snow and ice. The next meeting of the Subcommittee will take place on Monday, February 12, at 1:00 p.m. in room 643 of the Legislative Office Building.

2017 Summary of Legislation Related to Aging Now Available

The Legislative Analysis Division of the North Carolina General Assembly has released its summary of legislation related to aging. This helpful seven-page document can be accessed by CLICKING HERE.

Legislative Committee Looks at Access to Healthcare in Rural Areas

The Legislative Study Committee on Access to Healthcare in Rural North Carolina recently met for the first time. The Committee was established because of a concern about an increasing shortage of doctors and health care facilities in the state. The committee did not take any formal action at the meeting but heard a series of presentations on the issue. Among information shared at the meeting was the following: North Carolina ranks 29th in the country in the number of active doctors per capita, 32 counties don't have a psychiatrist, five rural hospitals have closed since 2010, and three counties (Camden, Gates and Tyrrell) have no primary care doctors. It was noted that the rural healthcare shortage is tied to economic development issues. Materials from the meeting can be accessed here. See a story from NC Health News on the meeting here.

Transportation Needs

The House Select Committee on Strategic Transportation Planning and Long Term Funding Solutions recently met and one of the items on the agenda was transportation planning for aging populations. The Committee heard from Blair Barton-Percival, Area Agency on Aging Director at the Piedmont Triad Regional Council. He shared demographics on the senior population and discussed the importance of transportation in helping older adults to live independently and to have access to appropriate services and supports. He also discussed transportation barriers and some of the challenges of public transportation. He suggested that in order to provide adequate services, the state should increase funding for the Home and Community Care Block Grant, investigate changing trends and payment models in healthcare, focus funding on addressing social determinants of heath and save on the high expenses of nursing home care on the back end, and find opportunities within transitioning North Carolina from a traditional fee-for-service Medicaid to managed care. To see copies of the power point presentations for speakers at the meeting, click here.

DMV Urges Caution in Eliminating Nurses In Evaluating Driver's Medical Condition

In a presentation to the Joint Legislative Transportation Oversight Committee, state Division of Motor Vehicles (DMV) Commissioner Torre Jessup urged legislators to be cautious if they still want to consider eliminating DMV nurses from the process used to evaluate a driver's medical condition. The 2017 state budget included a provision requiring DMV to study the issue and determine any issues that may arise from using only the recommendation of the applicant's or licensee's examining health care provider as to the ability of the applicant or licensee to operate a motor vehicle. In presenting the findings of the study, Jessup noted that the study was "too limited to explore all the issues and ramifications of eliminating nurses," and he recommended that "a more comprehensive study should be done before making a decision" on the future of DMV nurses. The study found potential problems in relying solely on drivers' healthcare providers to determine if they can safely drive. About 31 percent of healthcare providers don't provide recommendations on whether their patients should have driving privileges. The study found that the DMV's nurse reviewers were more likely than the healthcare providers to apply condition-specific driving restrictions -- such as limiting someone from driving at night -- instead of completely revoking licenses. The study said that future studies should include input from healthcare industry groups.

Professional Development

Apply Today for the LeadingAge NC Leadership Academy 2018-19

You won't want to miss applying for the next class of LeadingAge North Carolina's Leadership Academy. The program is open to anyone who works for a member community. Each community may nominate only one person.  So make sure someone from your community is nominated for this year-long program designed to develop statewide aging services leaders. Learn more and apply now.

Save the Date!

2018 LeadingAge North Carolina Spring Conference and Trade Show

The Omni Grove Park Inn
May 14-17, 2018
Asheville, NC

Co-workers want to receive email notifications about registration and other announcements? Be sure to tell them to visit our website and register in the top right corner of the page as community member staff, or business member staff if your company is a business member.

Trade Show Registration Open

Business members please note that registration for the 2018 Trade Show is open. Booths are going quickly so be sure to reserve yours today and renew your business membership to connect with nonprofit retirement communities across the state.

Mid Managers Series is Back - Save the Date!

Create a Highly Engaged Effective Team
Facilitated by Rick Schlentz of EXTRA!Ordinary, Inc.

Part 1: April 1
Arbor Acres in Winston-Salem

     Part 2: August 15
     WhiteStone in Greensboro

$200 for series and $125 per session
Non-member: $300 for series and $175 per session
4.0 NHA CEUs per session

More details here. Registration will open soon.

2018 Event and Education Calendar Now Available

Please click here to view and print LeadingAge North Carolina's 2018 Event and Education Calendar for yourself and your staff. Be sure to mark your calendar for several programs. Be on the lookout for registration announcements by email, social media, and our website. We look forward to seeing you!


Register Now for Infection Control Program Offered in March

S.P.I.C.E. offers this three-day program every spring and fall. It is designed to provide participants with current and practical information for the recognition and management of common infection prevention issues in non-acute care facilities, with an emphasis on long term care. Basic statistics for surveillance and antibiotic stewardship are new additions to the course.

Infection Control in Long Term Care Facilities
March 26-28, 2018
William and Ida Friday Center, Chapel Hill, NC

Click Here to Register
Please see the new registration policy
Get a Course Quote by clicking here

Strategic Thinking

New Public Health Report on Family Caregiving in an Aging America
January 18, 2018, PRWeb

The National Alliance for Caregiving has released an advocacy report, From Insight to Advocacy: Addressing Family Caregiving as a National Public Health Issue. The report is offered as one response to an emerging trend: eldercare is projected to be the fastest-growing employment sector within health care. With as many as 44 million people estimated to provide care to an older adult or person with a disability, current research has noted that unpaid family caregiving impacts not just individuals, but family units, communities, states, and the nation.

The report identifies actions that can be taken by state and local coalitions, health systems, and policymakers to understand and address the impact of family caregiving on the public's health.

Long Overdue Alzheimer's Planner Helps Anyone Figure Out Next Steps
January 28, 2018, Tacoma News Tribune

Advanced directives generally aren’t given much attention until a medical crisis descends on an individual or family. A University of Washington doctor decided to change things up. Barak Gaster, a primary-care physician at the UW School of Medicine, came up with a five-page summary of options for those who want to get ahead of an Alzheimer’s or other dementia diagnosis.

His Health Directive for Dementia, available for download free online, has gained wide attention, particularly after it was featured by The New York Times.

"That's My Inheritance": When Hospice Patients Die, Their Opioid Pills Remain
January 25, 2018, The Virginian-Pilot

Under federal law when a patient dies and pills are left over, the pills belong to the patient’s family. Hospice workers tell the family how to safely destroy them. But according to this article abuse of opioids in hospice care – mostly by family and friends who have access to them – is an often overlooked facet of the national opioid crisis.

Steve Jobs Knew How to Write an Email. Here's How He Did It
Justin Bariso, Inc.

Conversational and real doesn't have to mean sloppy. Clear thinking leads to clearer writing, and vice versa. A detailed look at an old email from Steve Jobs teaches some important lessons.

News and Notes

New Prescribing Rules for Opioids

As part of North Carolina's battle against opioid abuse, new rules for how doctors prescribe painkillers took effect on January 1. An epidemic of overdoses prompted lawmakers in 2017 to pass the Strengthen Opioid Misuse Prevention (STOP) Act, which set new limits on the quantity of the drugs that can be prescribed during a patient's first visit. Doctors can now prescribe only five days' worth of opioids for acute pain, such as after a car crash or a muscle injury or broken bone. After that, they can refill the prescription at their discretion. For pain that follows a surgical procedure, doctors will now be limited to a one-week prescription for opioids. After that, they can prescribe refills as needed, but that first prescription will be restricted. The new limits do not affect prescriptions of opioids for chronic pain patients, including those with long-term back injuries or people in nursing homes or hospice care. Advocates of the STOP Act say this is to reduce the chances that patients will become addicted to the medications and to reduce the number of pills being sent home with people who may not actually need them or take them. Learn more here.

Expenditure and Service Data for Persons 60 and Over

The NC Division of Aging and Adult Services has posted information on the reported public expenditures by funding source and major service categories for persons in the state 60 and over for State Fiscal Year 16-17. Data is provided for Divisions within the Department of Health and Human Services and the Department of Transportation. Service categories listed are adult care homes, economic support, physicians and other health care, home health and in-home care, institutional care, and social supportive services. According to the report, expenditures for these agencies totaled $4,266,067,537. In addition, the Division has posted expenditure and service information for each county in the state.

State's Population Growth, Part 1

North Carolina remained the 9th most populous state in 2017, keeping pace with No. 8 Georgia and putting more distance between it and No. 10 Michigan, according to the latest estimates from the U.S. Census Bureau which were released the end of December. As of July 1, an estimated 10,273,419 people lived in North Carolina, nearly 117,000 more than the previous year. The growth rate of 1.1% made North Carolina the 12th fastest growing state, just behind South Carolina and ahead of Montana. North Carolina added another 116,730 people in the last year -- close to the entire population of Wilmington. North Carolina's growth puts it on track to pick up at least one more congressional seat after the 2020 census, at the expense of states such as Ohio, Rhode Island and Illinois, which have grown little or seen no growth since 2010. The state has 13 seats in the U.S. House and just missed being apportioned a 14th after the 2010 census. To read more about the census bureau report, click here.

State's Population Growth, Part 2

North Carolina was a slightly less popular place to move to during 2017, but remains in the top 10, according to the recently released annual United Van Lines' report. The state ranked eighth for the second consecutive year, compared with fifth in 2015 and third in 2014 and 2013. There were 5,192 inbound household shipments, down from 5,447 in 2016. The 2017 inbound totals were the fifth highest in the nation. By comparison, there were 4,021 outbound shipments, compared with 3,923 in 2016.

Tell National about Your Efforts on Payment and Service Delivery Reform

Member communities should have received a survey late last week from LeadingAge national with a link to a brief member survey seeking information on your community’s level of activity related to alternative payment models, such as accountable care organizations and bundled payment; initiatives to improve the coordination and integration of the services for older adults or other innovations you may be pursuing.

Completing the survey will take no more than 20 minutes and much less for those not currently engaged in payment or service delivery reform activities. Responses will be compiled into an inventory of members’ activities. The inventory will help national:

  • Better understand the depth and breadth of activity around the country;
  • Demonstrate to CMS and Congress that post-acute and long-term services and support providers are capable of leading these and other models that involve taking on financial risk as well as the responsibility for integrating services for older adults; and
  • Share the results of the survey and more-detailed case studies on some of the innovative activities with members to inspire additional innovation and highlight promising practices.

If you have any questions or did not receive the email with the survey please contact Nicole Fallon.

Order Your Copy of the 2017 AL Salary & Benefits Report

We are pleased to announce that the 2017-2018 Assisted Living Salary & Benefits Report has just been released. This year marks the 20th year of publishing the Report. The discounted price for LeadingAge members is $275.

In addition, LeadingAge national's Behavioral Health Study is now underway. If applicable to your community, questionnaires are available by clicking here. The study deadline is March 12th with publication in April.

Apply Now for LeadingAge National Leadership Educator Program

Be a part of the LeadingAge Leadership Educator Program—an opportunity to join a small group of selected individuals who will learn the art of designing and delivering leadership programs from seasoned educators and Leadership Academy facilitators Dr. Judy Brown and Wendy Green. Applications are due February 5th.

Learners will tap into their natural skills and capacities to become expert facilitators skilled in leadership and education design, methodology and implementation.

Applicable in any setting where you want to create productive dialogue that inspires leadership growth, these unique facilitation skills can be leveraged in settings ranging from retreats and staff meetings to trainings, stand-ups, and even one-on-one mentoring. Learn more and apply now.


Mark Hensley began work January 16 as Associate State Director of AARP North Carolina for the Triad area. Prior to assuming this position, he was Dementia Services Coordinator at the NC Division of Aging and Adult Services.

Thank you for using Value First. Our goal is to continue helping LeadingAge members save money in all aspects of their operations. Value First is a full-service GPO (group purchasing organization) owned by LeadingAge national and twenty-five state associations, including LeadingAge North Carolina.

In addition to our Construction Services Program and free cost analysis in the food, medical, janitorial, and office supplies categories, we are also available to help you and your staff save money on equipment and services that you might not normally think of in connection with a GPO.

Do not hesitate to contact Vanessa Ceasar at 404-421-3956 if you need assistance with anything listed below—or other big-ticket items that are not on the list.

• Cabinetry
• Carpet
• Cellular employee discounts
• Coin-operated laundry equipment
• Commercial cleaning equipment
• Elevator maintenance
• Exercise equipment
• Furniture
• Hard surface & resilient flooring
• HVAC equipment
• Kitchen equipment
• Linens
• Medical waste removal
• Nurse call systems
• Passenger vans
• Patient transfer equipment
• Physical rehabilitation services
• Roof repair


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