Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
Area agency on aging: means any agency that has been designated by the commission to plan for and provide services to the elderly and disabled within a defined geographic area. See Tennessee Code 71-2-103
Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
Oversight: Committee review of the activities of a Federal agency or program.
Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105
(1) Meet as necessary to transact business; provided, that meetings shall be held at least quarterly;(2) Promulgate bylaws to provide for the election of officers, establishment of committees, meetings, and other matters relating to commission functions;(3) Elect a chair, a vice chair, and three (3) representatives, one (1) from each of the three (3) grand divisions, who shall comprise the executive committee to function between quarterly meetings;(4) Allocate funds for projects and programs for older persons and disabled adults, subject to the limits of the appropriation by the general assembly and funds available or received from the federal government for such projects and programs. The commission is authorized to accept funds from the federal government and private sources and to administer such funds to achieve its purposes pursuant to § 71-2-104(a);(5) Serve as an advocate within government and in the community for older persons and disabled adults in Tennessee;(6) Designate planning and service areas and area agencies on aging in accordance with the Older Americans Act (42 U.S.C. § 3001 et seq.), and federal regulations promulgated under the Older Americans Act. The commission shall review the boundaries of the planning and service areas from time to time and shall change them as necessary to comply with the Older Americans Act or to reflect changes in governmental boundaries or major changes in population distribution;(7) Adopt the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, for the purpose of administrative hearings and rulemaking as required under this part;(8) Receive the cooperation of other state departments and agencies in carrying out the policies and objectives of this part;(9) Enter into such contracts and make such grants within the limits of appropriated funds, as are necessary or appropriate under this part, and in a manner consistent with state or federal law;(10) Make available to older persons information concerning the nutritional benefits of eating garden produce to promote participation by older persons in community gardens, as defined in § 43-24-102; and(11) Provide to the general assembly, no later than January 15 of each year, an updated report and analysis of the waiting list for the state options program.(b) In addition to the powers, responsibilities or duties granted to the commission elsewhere in this part, the commission may:
(1) Promulgate, amend, revise, and rescind such rules as are necessary and appropriate to carry out the purposes of this part in accordance with the Uniform Administrative Procedures Act, including rules necessary for the proper management and oversight of the home and community based options program;(2) Notwithstanding § 71-5-1419(c), promulgate rules and regulations allocating resources between urban and rural areas to program components that provide services to elderly and disabled individuals in need of assistance who do not qualify for long-term care services under the Medical Assistance Act of 1968, compiled in chapter 5, part 1 of this title;(3) Create subcommittees to undertake such special studies as it shall authorize and include in such subcommittees persons qualified in any field of activity relating to aging or disability, or both;(4) Advise the governor and the heads of state departments and agencies regarding policies, programs, services, allocation of funds, and the needs of older persons and disabled adults in Tennessee and make recommendations for legislative action to the governor and to the general assembly;(5) Hold hearings, conduct research and other appropriate activities to determine the needs of older persons and disabled adults in the state, including particularly, but not limited to, their needs for health and social services, and to determine the existing services and facilities, private and public, available to meet those needs;(6) Develop and conduct, alone or in coordination with other agencies, research and demonstration projects and programs that provide training, education, and services to advance the interests of older persons and disabled adults;(7) Stimulate more effective use of existing resources and services for older persons and disabled adults and develop programs, opportunities and services that are not otherwise provided for older persons and disabled adults, with the aim of developing a comprehensive and coordinated system for the delivery of health and social services; and(8) Conduct, develop, and implement, alone or in coordination with other agencies, research, pilot projects, and programs designed to promote and encourage healthy aging.(c)(1) In addition to the powers, responsibilities, and duties granted to the commission, the commission shall operate an outreach and counseling program through the state health insurance assistance program (SHIP) to provide state residents with information, education, and counseling relative to:
(A) Medicare;(B) TennCare;(C) Medicare supplement insurance;(D) Enrollment in the medicare prescription drug plan (Part D), and the accompanying low-income subsidy;(E) Finding help with the cost of prescription drugs during coverage gaps and access to drugs not covered under Part D;(F) Medicare advantage options;(G) Long-term care planning and insurance;(H) Claims and billing problem resolution, information, and referral on public benefit programs;(I) Employer and retiree health insurance options for those with medicare and veterans benefits; and(J) Other military health insurance for those with medicare.(2) Minimally, such outreach shall include:
(A) A program to assist medicare-eligible persons in processing the necessary documents in order to participate in the programs in subdivision (c)(1);(B) A toll-free number staffed during business hours to provide information regarding the programs in subdivision (c)(1);(C) A website or referral to website links that provide information regarding the programs in subdivision (c)(1); and(D) Presentations to senior groups regarding the availability of the programs in subdivision (c)(1).(3) The commission shall implement the outreach program within the commission’s available resources.(4) The commission may delegate any or all such responsibilities to a private or public contractor.(5) The commission is authorized to make application for grants to fund programs set forth in subdivision (c)(1).(6) The commission may adopt rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this subsection (c).(d) Nothing in this part or the Long-Term Care Community Choices Act of 2008, compiled in chapter 5, part 14 of this title, shall authorize the commission to exercise any control or authority over any aspect of the administration of programs for home and community-based long-term care services that were operating on the basis of federal waivers in effect on June 19, 2001.(e)(1) As used in this subsection (e):
(A) “Agency” means an area agency on aging and disability and has the same meaning as “area agency on aging” as defined in § 71-2-103;(B) “Alzheimer’s disease or related dementia” means the diseases and conditions characterized by a decline in memory, language, problem-solving, and other thinking skills that affect an individual’s ability to perform everyday activities;(C) “Informal caregiver” means a spouse, adult child, relative, or friend who provides unpaid care services to an individual, in the individual’s home, who suffers from Alzheimer’s disease or related dementia;(D) “Program” means the Alzheimer’s and dementia care respite program created by this subsection (e); and(E) “Respite care”:
(i) Means temporary, substitute support or living arrangements to provide a brief period of relief or rest for informal caregivers. As used in this subdivision (e)(1)(E)(i), “substitute support” includes, but is not limited to, the following homemaker services:
(a) In-home respite or companionship;(b) Adult day care;(c) Assistance with personal care, bathing, medication monitoring, and chores;(d) Caregiver training for unpaid, informal caregivers;(e) Four (4) hours of overnight respite in a facility; and(f) Any other goods or services necessary to maintain the person with Alzheimer’s or related dementia at home; and(ii) Includes in-home care by appropriately trained individuals, or care in an adult day care, assisted living, or nursing home setting, on an intermittent, occasional, or emergency basis.(2)(A) There is created the Alzheimer’s and dementia respite care pilot program to provide home- and community-based services through grants provided to each of the nine (9) area agencies on aging and disability in this state.(B) The program may be operated using an agency’s existing respite care infrastructure.(C) An agency shall report the costs of the agency’s respite care infrastructure to the commission each year of the pilot program.(D) The program must:
(i) Be based on grants provided to each of the nine (9) area agencies on aging and disability in this state for respite care services for the sole benefit of individuals who are experiencing symptoms of Alzheimer’s disease or related dementia or who have received a clinical diagnosis of Alzheimer’s disease or related dementia;(ii) Be operated from July 1, 2022, to December 31, 2025;(iii) Actively serve up to a total of two hundred twenty-five (225) enrollees, at one time, in each fiscal year of the program’s operation;(iv) Reimburse utilizing the commission on aging and disability’s yearly approved homemaker service unit cost rate;(v) Give priority for enrollment to those individuals on the wait list for the current state-funded OPTIONS program as of May 25, 2022;(vi) Exclude an individual with Alzheimer’s disease or related dementia who is eligible for long-term care services under the Medical Assistance Act of 1968, compiled in chapter 5, part 1 of this title; and(vii) Provide preference to individuals at or below two hundred fifty percent (250%) of the federal poverty level.(3) Each agency shall submit a written report no later than January 15, 2023, and by January 15 each year thereafter until the close of the pilot program period, to the chairs of the health and welfare committee of the senate and the health committee of the house of representatives on the status of the program. The report must include, at a minimum, the following:
(A) The total funds spent on the program;(B) The amount of administrative costs to operate the program;(C) The number of individuals and informal caregivers served by the program;(D) The income ranges of the individuals and informal caregivers served by the program; and(E) The efficacy of the program.(4) This subsection (e) does not create an entitlement to services through the program, and the services provided and the number of individuals served by the program are subject to appropriations by the general assembly.
