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North Carolina Social Services Consortium
2001 Long Session
Legislative Agenda
Services to Elderly and Disabled Adults
From 1990-1997, there was a 145% increase in long-term care expenditures, which totaled nearly $1.2 billion in 1996/7. The costs of in-home and community care are substantially less than the costs of institutional care (approximately 20% lower for those individuals who are eligible for either institutional or home care through Medicaid). Home care is the fastest growing portion of the health care market (NCHC Reform Commission). The primary funding source for most services to elderly and disabled adults is the federal Social Services Block Grant (SSBG), which has faced numerous devastating cuts over the past decade.
Family Economic Security
All families want to thrive. We believe that families are responsible for nurturing, protecting and providing for their children and frail elderly to the greatest extent possible. However, when their efforts fall short, it is in society’s best interest to intervene with supportive assistance to assure that the family can thrive. For families to thrive, they must be able to access sufficient income and government supports and services to achieve economic security. The Work First caseload decline has ended and child day care waiting lists are increasing. While caseload decline is positive, the true measure of success is the health and wellbeing of children and their families. We don’t know much about whether families who leave Work First are earning a living wage or are more desperate than ever. More appropriate, family-centered outcome goals should be targeted, such as increased family prosperity and intergenerational self-sufficiency. Child support is critical to the economic security of many families. A unified child support system in DHHS-DSS makes sense for the families of this state. Working together, state and local partners can devise an orderly and efficient transition to a consolidated system, moving Clerk of Court cases to local CSE agencies. Without adequate planning, the potential for a public relations disaster exists. Families deserve better.
Services to Children and Their Families
There is a crisis in social worker turnover in North Carolina’s child welfare system, which jeopardizes the future success of our efforts to assure the safety and well-being of children who have been abused and neglected and prevents us from providing permanence for those children as quickly as possible. Currently, NC relies heavily on federal and county funding in the child welfare system. Further, adoption is often the most appropriate permanent plan for children in the foster care system. The adoption system in North Carolina needs to be strengthened to support families who adopt.
Health Care Access
Seniors make up 12% of the population, but pay for 1/3 of all prescription drugs. Medicare does not pay for the cost of prescription drugs for our elderly. At least 1/3 of seniors do not have insurance coverage for prescription drugs. Many do without essential medications resulting in deterioration of their health and the need for more expensive health care. Further, waiting lists are being created for North Carolina’s Health Choice for Children program, despite the availability of millions of federal dollars. As families make the transition from welfare to work, we must continue to ensure that they continue to receive health benefits because losing health care coverage is the #1 reason that families cycle back onto Work First.
Technology
Technology is critical for effectively and efficiently serving families and individuals in need in a non-duplicating manner and without adding staff. Unfortunately, technology has not been well funded in our system. As a result, our clients suffer with outdated, cumbersome eligibility determination systems and with social workers who are overburdened by paperwork at the expense of direct client contact. The process of applying for public assistance is complicated, time consuming, and often repetitious from program to program. There are different but similar processes for each public assistance program. Families have to repeat the same information over and over to different workers. This process is time-consuming for low-income working families who need to be at work and it is not cost-effective for tax payers.
1. Support funding for technology in social services to improve citizen access, seamless service delivery and accountability for outcome results to policy makers and the public, particularly ONE shared application and eligibility determination process for all publicly funded assistance programs.
