Issue Position: Seniors

Issue Position

The goal of government policies and programs should be to support the ability of people to take care of themselves for as long as they can. Where government assistance is needed, it is important to have a range of options to avoid the need for more costly services later. State tax and retirement policy decisions should honor existing financial commitments.

My favorite definition of seniors is "65 and better!" That's the goal for most, but it's not always the reality.

Going door to door over the years, I've had an 83-year-old call down to me from her perch on a second story window sill where she was washing windows. I've also talked to a bone-tired 76-year-old man whose been nursing his wife for the last 5 years. I represent the dynamic, stimulating continuing care community of Greenspring Village. I also represent distressed people with loved ones in under-staffed nursing homes.

I'm determined that where government must step-in, it will be with the flexibility and adequate funding that fosters human dignity. I am equally determined that our tax policies allow seniors to manage their resources in order to maintain their financial independence.

NURSING HOMES

Virginia is one of the few states with no minimum staffing standards for nursing homes. The seriousness of this issue is underscored by the fact that Christopher Reeve -- even with all the care he received -- died from bedsore complications. With the high number of frail elderly in nursing homes on Medicaid and the acuity required to be placed in a nursing home under Virginia's minimally-financed Medicaid program, it is especially critical that we join the 37 other states who have minimum staffing requirements.

Virginia's lack of standards is directly related to the fact that reimbursement rates for Medicaid patients in nursing homes run $500 below actual monthly costs on average. Nursing homes who do have adequate staffing do so by charging private pay patients significantly more. I see this as a hidden tax to make-up for what Virginia's low Medicaid rates don't cover. It would cost the state $24.5 million (matched by another $24.5 million in federal Medicaid funds) to require that patients in every nursing home throughout Virginia have at least 3.5 hours of direct care services per 24 hours. 2005 marks my 5th year fighting for this issue and I will not give up.

In 2008, my bill HB 1051 provided that the cap on medical malpractice suits applies only to healthcare services provided in nursing homes and not to injury or death caused by business decisions such as staffing, security, maintenance, or food preparation.

In 2007, I carried a bill to establish a Nursing Facility Quality Improvement Program that will provide on-site training and quality improvement assistance at nursing homes that are not in compliance with state regulations that is funded from fines paid for violations. Another one of my bills (HB 2636) helped establish a pilot program to provide geriatric mental health services to people over age 65 with serious mental illness and to provide psychiatric consultation and training to the staff of long-term care facilities.

ASSISTED LIVING

Many elderly and others who cannot take care of themselves but are not seriously ill enough to require medical care in a nursing home are in Assisted Living Facilities. Many of these facilities are comparable to what nursing homes were 15 years ago, as Virginia's Medicaid standards have made it tougher to qualify for nursing home care.

In 2005, I was pleased to work with a number of key legislators and responsible assisted living operators to create much-needed protection for over 30,000 people who are in assisted living throughout Virginia. Our legislation creates

*oversight for dispensing medications,
*better mental health screening,
*licensure of operators so that the bad apples can't just close one home and open another, and
*emergency help for residents in unsafe homes.

Fines were substantially increased from just $500 to up to $10,000 (the maximum fine currently possible for veterinarians), but we also provided that fines could be used to remedy conditions. We also increased the number of inspectors and their training. Finally, we modestly increased state funding for needy residents by $50 per month, but the total is still far below actual costs.

TAXES

To support home health care providers, every session since 2006, I have introduced bills to give a tax credit for unreimbursed Home Health Care expenses and to provide a tax deduction for nursing assistants and home health aides who provide Medicare-authorized home health or long-term care services to individuals in their homes.

See Real Estate Tax Relief under Community Concerns

I opposed total repeal of the estate tax. We cannot afford it. I do support partial repeal and, in 2004, I introduced a bill (HB5004) to removed the tax on estates under $10 million and on all estates where the majority of the assets are in a closely held business or a working farm. This would cost Virginia about $50 million annually. Total repeal is costing 3 times that amount. I firmly believe that funding minimum staffing standards for nursing homes is far more important to seniors than repealing the estate tax on mega-millionaires.

VETERANS

I was successful in 2005 in getting two Services Officers located in Northern Virginia; one conveniently located near the Shirley Industrial Park off Edsal Road. See Veterans under Human Services for further details. In 2000, I was embarrassed when I learned that Virginia would be one of the last states to contribute to the campaign to build the National World War II Memorial. My resolution HJ210 (2000) had the full support of the General Assembly to get the administration to release Virginia's contribution.

ESTATES

I am preparing legislation for the 2010 Session to prevent many small estates from the cost and hassle of probate.

In 1998, my bill (HB334) waived the need for an inventory or payment of settlement fees when an estate is under $10,000. And in 1997, I moved the age-old prohibition against naming someone who is not a resident of Virginia to be named as the sole executor of an estate. (HB347)

END OF LIFE DECISIONS

One commentator observed, "Most people have a lot more confidence in their loved ones than they do in some legislator." Here are some good web sites to help you take control of your life:

www.aarp.com takes you to "Care and Family" where you need to click on "End of Life."
www.caringinfo.org is the National Hospice site, which has Virginia's advance directive form.
www.abanet.org/aging has a "Consumer Tool Kit for Health Care Decisionmaking" put together by the American Bar Association.
www.uslivingwillregistry.com is a national registry for living wills.

In addition, my bill (HB861 - 1998) allows a person to designate someone other than a family member to make end-of-life decisions on his or her behalf. Prior to this, hospitals and others would only deal with next of kin.

HEALTH INSURANCE COVERAGE

In 2001, I got a bill passed (HB2704) to require insurance and HMO coverage when pharmacists provide services, such as diabetes training, which otherwise would be performed in a doctor's office.

In 2000, my bill (HB923) passed to require a pro-rata refund of premiums when long-term care insurance policies are cancelled or adjusted.

SAFETY

HB1848 (1999) corrected a potentially serious problem when the 1998 Session, in trying to stop scofflaws from abusing handicapped parking privileges, passed a law requiring date-of-birth, sex, and name (!) to be displayed on the mirror placard. My bill allows people to cover up the name so that disabled persons don't become targets for con artists or burglars.

Domestic violence bills I got passed in 1998 and 1997 (HB583 and HB2071) both expanded the response of law enforcement to domestic violence to include elder abuse.

QUALITY OF LIFE

Under the Senior Citizens Higher Education Act, seniors have been able to enroll tuition-free in college courses on a space available basis if their federal tax income was less than $10,000. Due to the way a federal retiree's income is taxed, this has never been equitable and the cap hadn't been raised since 1989. My bill in 1999 (HB2274) changed the taxable income used from the federal to the state. Because of the Age Tax Credit, this effectively increases the income cap to $22,000 and treats federal retirees more equitably.

In 2000, I was please to sponsor the legislation (HB195) that gives a sales tax exemption for the Lifetime Learning Institute of Northern Virginia.

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