The meeting of the Subcommittee on Health and Human Services of the Special Advisory Commission of Senior Citizens was held on Thursday, November 5, 2009, and Friday, November 6, 2009 at 2:30 PM, and 8:30 AM respectfully, at the Holiday Inn, Capital Plaza Hotel in Frankfort, Kentucky. Edna Hawkins, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Edna Hawkins, Chair; Frances Baccus, Joe Doebler, Bob Elliott, Carol Fausz, Helen Hansford, Betty Huff, Ray Kremer, Phillip Martin, Vivian Niece, Betty Olson, Opal Phillips, Lillian Rice, Jeane Robertson, Pat Sutton, Ernest Taylor, and Mary Trimble.
LRC Staff: Miriam Fordham, Jonathan Scott, and Cindy Smith.
The Health and Human Services Subcommittee focused on two topics during its Thursday meeting: (1) a presentation on the 2010 legislative agenda for services to seniors, provided by Deborah Anderson, Commissioner, Department for Aging and Independent Living; and, (2) a presentation on the fall prevention program for older adults, provided by Dr. Anne Harrison, Director of Professional Studies at the University of Kentucky.
Commissioner Deborah Anderson discussed the outlook for DAIL in the upcoming legislative session. The state’s current budget situation, the $1.1 billion deficit, has put the department in survival mode. There are four issues that the department is dealing with: budget cuts, a hiring freeze, a waiting list for services, and a lack of resources. Most of the legislation that the Cabinet for Health and Family Services will be focusing on is clean up legislation rather than legislation involving new initiatives. The department is looking at a number of issues and programs and exploring ways to continue to provide services. These issues include cost sharing; shifting eligible individuals from state General Fund programs to Medicaid for long-term care services; hospital discharge planning; creating an elder abuse unit with dedicated funding; increasing the number of volunteers; establishing a universal plan of care and single entry demonstration project; establishing a self directed care option in the Homecare program; a long-term care awareness project; and addressing Alzheimer’s care training and the need for Alzheimer’s care in the future with the aging baby boomers.
Dr. Anne Harrison discussed the fall prevention program for older adults that has been initiated as part of the Kentucky Safe Aging Coalition. Falls are the most common cause of injury-related death in older adults; affect 30 percent of adults over 65 each year; are the most common cause of non-fatal injuries in older adults; are the seventh leading cause of death in people over 75; and, as a result, drive up medical costs. In Kentucky, on a daily basis in 2007, falls involving people aged 65 or older resulted in 60 outpatient encounters, 16 hospitalizations, and between eight and nine hip fractures. It is estimated that almost 23,000 older adults are treated in Kentucky’s hospitals as outpatients and 6,000 are hospitalized from falls. In 2006, falls among older adults resulted in $142 million in hospital inpatient charges. Data is now available on-line for falls among older adults in each county.
Some of the risk factors for falls include reduced balance; decreased strength in the lower extremities; unstable gait; and cognitive issues. Medical conditions such as arthritis; a central nervous condition like Parkinson’s or stroke; visual impairment; dizziness; and reduced sensation also play a role. Other risk factors include taking more than four medications daily, improper assistive devices, and environmental hazards. Interventions to prevent falls include strengthening and balance programs; medication adjustment; updating eyeglasses; home assessment and modification of environmental hazards; and awareness campaigns. Dr. Harrison also stressed the need for public policy solutions and advocacy.
During the session on Friday, the subcommittee discussed and formulated the slate of legislative recommendations. The subcommittee's legislative recommendations are as follows:
(1) With the understanding that there are 20,600 seniors on waiting lists for services, urge the 2010 General Assembly to maintain current funding for the Department for Aging and Independent Living to provide services to seniors and continue to look for additional revenue sources.
(2) Urge support of the Area Agencies on Aging and Independent Living in the statewide implementation of a universal plan of care for the delivery of services.
(3) In light of the 43,195 adult abuse cases reported in 2008 and the unreported cases, urge the 2010 General Assembly to support legislation to establish an adult abuse registry.
(4) Urge support of the Department for Aging and Independent Living to emphasize cost sharing when appropriate for Title III programs to increase services to seniors and decrease waiting lists.