Are you a health care worker? We’d love to hear from you. Email editor at northcarolinahealthnews.org

By Thomas Goldsmith

Dolores Gardner of Greenville looks forward to receiving farmers-market-fresh vegetables along with meals delivered to the home she shares with her husband Austin. 

Those are coming from Pitt County Meals on Wheels in July as one of the services financed through Home and Community Care Block Grants, funds that are expected to get a hike this year in state and federal budgets.

“I do like the greens, collards, cabbage and rutabaga and salad,” said Gardner, 79, a retired public schools employee who welcomes a Meals on Wheels volunteer any day her out-and-around schedule allows it. “All of that kind of helps the body.”

Austin Gardner, 80, a former East Carolina University housekeeper, has been in poor health and needs help with daily activity, so Dolores welcomes the delivered food. 

“I have a lot of stuff to take care of — he can’t do it himself,” she said on the phone. “I say we are doing the best we can.”

Emerging from COVID-19

North Carolina’s fast-growing aging population went through a devastating and deadly 2020 because of the pandemic, with more than 10,100 of the state’s residents over the age of 65 succumbing to COVID-19. 

This year older people are getting love from both sides of the NC General Assembly aisle during work on a new biennial budget. Some of the initiatives slated for hikes — notably a boost for Adult Protective Services in funding and personnel — have been a long time coming and are addressing compelling needs. 

“There’s a lot of areas where we have some real concerns about the waiting list on a number of programs,” said state Sen. Jim Burgin (R-Angier), a co-chair of the Senate Appropriations Committee on Health and Human Services

“We’re going to try to take a big hit at that. I think people are going to like some of the things that we’re working on and some of the areas where I want to take care of children, elderly and those who are disabled.”

According to Cooper’s office and Burgin, other priorities include improving staffing levels in long-term care and $7 million more in the governor’s proposal for the state-federal Home and Community Care Block Grants. That funding powers much sought-after help such as transportation and home-delivered meals, with county officials making down-home decisions about where the money goes. 

‘The same sheet of music’

Despite fierce, partisan budget battles in recent years, Burgin is at least sending signs that all parties should be working together this time.

“I’ve always found that things work best when everybody’s working on the same sheet of music,” he said. “If we can work with the counties and help fund what they want to do, and at the same time accomplish the governor’s and the legislative priorities, I think that’s a win for everybody.” 

Rich Zeck is executive director of the Pitt County Council on Aging, which oversees the farmers market program. He offered a 30,000-foot view of the importance of staying on top of services to older North Carolinians. 

“There’s a lot of focus for the young people for children and they’re the future, but it’s the present who pays the taxes, who buys the goods and services, who keeps the economy going,” Zeck said. 

“When you have a homebound senior who’s not getting fresh fruits or fresh vegetables, it breaks down their immune system,” he said. “They’re weaker, they have more opportunities for sickness.”

That sickness causes misery for seniors and their family members and increases costs to Medicare, the federal program that pays for senior health care as well as Medicaid, the state and federally funded program that contributes to the care of low-income seniors. 

“A lot of this is preventable if they just had decent food,” Zeck said.

Innovations in fighting hunger

Cooper specified $255,000 for the N.C. Senior Farmers’ Market Nutrition Program, the project that will bring meals prepared with local produce to the Gardners. Another smaller-scale but innovative program would spend $420,000 during the two-year budget to make sure of delivery of two weeks of healthy meals to 1,000 adults at high risk after discharge from a hospital.

In a larger bid toward making sure that older people get enough to eat, Cooper called for spending $3.1 million on providing two meals weekly or $20 worth of groceries for 3,000 people. 

“I thought these were really exciting because it wasn’t just the regular home delivered meals and congregate meals,” said Heather Burkhardt, executive director of the North Carolina Coalition on Aging. “We’re on the way to do some new things with food insecurity.”

A spokeswoman for the state Department of Health and Human Services said Cooper and his administration are focusing on protecting the state’s vulnerable population from “abuse, neglect, maltreatment and exploitation,” requirements of Adult Protective Services under state law.

“Increasing funding for Adult Protective Services and required essential services will serve to strengthen the safety and well-being of this population,” DHHS spokeswoman Chris Mackey said in an emailed response to questions.

100 positions sought for APS

The administration also wants to set up an essential services fund for Adult Protective Services that would address situations where protecting a senior from danger might require spending money on a hotel room, support for a caregiver, transportation or adult day care or adult health services. Both APS and Child Protective Services (CPS) offices across the state are required to take care of vulnerable people, but have been critically understaffed, something Cooper wants to address, Mackey said.

“APS and CPS workers provide services to adults and children who are, or who are suspected of being, abused, neglected, or exploited,” she said. “Funding will be provided to fill more than 100 full-time county positions and be allocated equitably statewide based on a formula considering existing staffing levels and needs.”

Certainly state resources by the tens of millions will continue to be directed at the ongoing pandemic. COVID -19 resulted in the deaths of more than 5,000 people in the state’s long-term care homes alone, although the pace of cases and deaths slowed dramatically following a strong focus on administering vaccines to the older population.

Where the votes are

These ongoing discussions show that politicians are looking beyond the immediate crisis into governance and political battles to come. After all, in 2025, just a few years hence, one in five Tar Heels will be 60 or older and their votes as a group will count more and more.

Demographer Rebecca TIppett has analyzed trends by party by age and other indicators.

“Older adults, especially those ages 55-74, comprise a larger share of Republican voters than the overall electorate: 40% of all voters are ages 55+ compared to 47% of registered Republican voters,” Tippett wrote on the Carolina Demography website.

So it’s likely that both parties will be keeping older North Carolinians’ needs and preferences at or near top of mind for decades to come, as well as in this year’s budget process.

Republish our articles for free, online or in print, under a Creative Commons license.

Thomas Goldsmith

Thomas Goldsmith worked in daily newspapers for 33 years before joining North Carolina Health News. Goldsmith is a native Tar Heel who attended the UNC-Chapel Hill, and worked at newspapers in Tennessee...