The Coronavirus and its Effect on Social Security

Published in the Woonsocket Call on March 22, 2020

As the coronavirus (COVID-19) spreads across the nation, the Social Security Administration (SSA) and other federal agencies strive to cope with meeting the huge challenges they face resulting from the unexpected pandemic outbreak, attempting to juggle worker safety while maintaining their daily operations.

On March 19, Key House Democratic and Republican Committee Chairs send a clear message to SSA as to the importance of minimizing any disruptions to its operations during the coronavirus crises. Throughout its 85-year history, Social Security recipients (seniors, families who have lost a breadwinner, and people with disabilities) have never missed getting their monthly check. Keeping this in mind, House Ways and Means Committee Chairman Richard E. Neal (D-MA) and Ranking Member Kevin Brady (R-TX), along with Social Security Subcommittee Chairman John B. Larson (D-CT), Ranking Member Tom Reed (R-NY), Worker and Family Support Subcommittee Chairman Danny K. Davis (D-IL) and Ranking Member Jackie Walorski (R-IN), sent a letter on March 19 to Social Security Administration (SSA) Commissioner Andrew Saul calling on the agency to continue their work to prioritize health and transparency in an effort to minimize disruptions as they administer vital services during the coronavirus crisis.

“We know the decision to close SSA field offices…was a difficult decision. … This move will save lives and will also protect the health of SSA frontline staff, whose public service is so critical,” the key House lawmakers wrote.

“We understand that as coronavirus spreads, you are prioritizing work that fulfills SSA’s core mission,” the letter continued. “We fully support this prioritization.”

“We are writing to urge the Social Security Administration (SSA) to vigorously safeguard the health of the public and agency employees during the coronavirus crisis, while also minimizing disruptions in services to the American people,” stated the House lawmakers. “Telework is a commonsense response to coronavirus and we urge you to maximize its use across SSA. In addition, we encourage SSA to communicate regularly and robustly with the public and with its employees about SSA’s coronavirus response. Social Security is a program that affects the lives of all Americans. As SSA’s response to coronavirus evolves, the public must be able to count on timely information about how to access benefits and services, including assistance when a problem arises.”

The members emphasized that that they stand ready to work with the agency to ensure it has the resources and authority it needs to operate effectively during the crisis while ensuring SSA remains able to send benefits on time each month.

COVID-19 Changes Way SSA Does Business

The COVID-19 pandemic has changed the way SSA does business across the nation. Effective Tuesday, March 17, SSA closed all local Social Security offices for in-person service. SSA says that this decision protects the population it services — older Americans and people with underlying medical conditions—and its employees during the crisis.

But SSA employees remain at their cubicles, the processing of benefits and claims continues. However, critical services can be accessed online. The agency directed the pubic to visit its website (https://www.ssa.gov/) or its toll-free number, 800-772-1213 for customer service. You can apply for retirement, disability, and Medicare benefits online, check the status of an application or appeal, request a replacement Social Security card (in most areas), print a benefit verification letter, and much more – from anywhere and from any of your devices.

According to SSA, there is also a wealth of information to answer most of your Social Security questions online, without having to speak with an SSA employee in person or by phone. Visit our online Frequently Asked Questions at http://www.socialsecurity.gov/ask.

However, those persons who are blind or terminally ill, or need SSI or Medicaid eligibility issues resolved related to work status can obtain in person services in local offices.

SSA also provides COVID-19 related information and customer service updates on a special website (https://www.ssa.gov/coronavirus/)
According to a March 19 blog posting by the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM), “The Ways and Means committee leaders suggest SSA allow employees to telework where possible, in accordance with federal guidelines. National Committee senior legislative representative (and former 35-year SSA employee) Webster Phillips says the agency’s teleworking capabilities have been diminished since Andrew Saul came on board as administrator – and will take time and resources to build back up.”

The NCPSSM’s blog posting noted, “SSA will discontinue several of its normal activities in order to prioritize beneficiaries’ needs. “There are workloads that they’re not going to process while this is going on, focusing exclusively on paying benefits,” says Phillips. Those include stopping all Continuing Disability Reviews (CDRs) and curtailing eligibility re-determinations for SSI recipients.”

Finally, “SSA also has discontinued in-person disability hearings to protect the health of claimants and employees. Instead, those hearings will take place via telephone or video conference, where possible,” adds the blog posting.

The Bottom Line…

On March 19, SSA Commissioner Andrew Saul, issued a statement to assure the 65 million Social Security recipients that SSA payments will continued to be processed. He stated, “The first thing you should know is that we continue to pay benefits.”  But Saul warned, “Be aware that scammers may try to trick you into thinking the pandemic is stopping your Social Security payments but that is not true. Don’t be fooled.”

The United States Postal Service has so far experienced only minor operational impacts in the United States as a result of the COVID-19 pandemic. So, with Saul’s assurances and the postal service still delivering mail, you can expect to get your benefits.
Stay healthy.

AARP Tele-Town Hall Informs Seniors What They Need to Know About COVID-19

Published in the Woonsocket Call on March 15, 2020

Twenty-four-hour programming on cable television, television networks, talk radio and newspapers report the spread of coronavirus (COVID-19) across the nation. According to the Centers for Disease Control and Prevention (CDC), just days ago there were about 700 confirmed and presumed U.S. cases from 38 jurisdictions, that’s 36 states and New York and D.C. There are more than 100,000 cases worldwide. CDC officials expect this count to go up. counts to go up.

At the AARP’s Coronavirus Information Tele-Town Hall event, held Tuesday, March 10, federal health experts gathered to the symptoms of COVID-19, how to protect yourself, and what it means for older adults and family caregivers. The event was moderated by AARP’s Vice President of Content Strategy and; Communications Bill Walsh and featured Admiral Brett P. Giroir, M.D., , Assistant Secretary for Health at the U.S. Department of Health and Human Services; Nancy Messonnier, M.D., and internist and Director of CDC’s National Center for Immunization and Respiratory Diseases; and Seema Verma, Administrator at the Centers for Medicare and; Medicaid Services.

The invited experts warned seniors to take heed. People age 60 and over are at high risk of catching COVID-19, it’s severity especially for those with underlying medical conditions.

Getting the Best Source of Medical Information

According to AARP’s Walsh, the Washington, DC-based nonprofit convened the tele-town hall about coronavirus in an effort to protect the public. “While we see an important role for AARP to play in providing consumer information and advocacy related to the virus, the public should be aware the best source of medical information is the Centers for Disease Control and Prevention,” he said.

At this briefing Messonnier noted that reports out of China that looked at more than 70,000 COVID-19 patients and found that about 80 percent who had the virus had a mild case and recovered. About 15 percent to 20 percent developed a serious illness.

The COVID-19 virus affects adults, especially seniors, says Messonnier. noting that people over age 60 are at a higher risk of becoming seriously ill from this virus, especially if they have underlying health conditions such as diabetes, heart disease.

Although younger people with underlying health problems are also at risk, the top official at CDC stressed that older people with health problems are the most vulnerable. She noted that her parents are in their 80s, and even though they don’t live in community reported to have the virus, she advised them to stay close to home.

CDC’s Messonnier suggested that seniors stock up on over-the-counter medications to treat fever, cough and other symptoms, as well as tissues, common medical supplies, and routine medications for blood pressure and diabetes.

Although there is no vaccine to prevent coronavirus and there are no specific medicines to treat it., there are many things you can do to prevent the illness, says Messonnier. She urged seniors to avoid contact with people who are sick. Keeping the COVID-19 virus at bay can be as simple as simply washing your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place, she said, urging seniors to wash your hands after touching surfaces in public places. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol [if you can find it].

Messonnier warns seniors to avoid touching high-touch surfaces in public places – like elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something. It’s difficult for many but just avoid touching your face, nose, and eyes, she says.

Messonnier also suggested that seniors to clean and disinfect their homes to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phone). Also, avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.

Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships, warns Messonnier.

Messonnier also called on people over age 6o to follow “social distancing strategies,” such as teleworking and avoiding crowds, especially in poorly ventilated spaces. This might mean that if your grandchild has a fever and runny nose, it may not be the right time to visit, she says.

“If COVID-19 begins spreading in your community, keep in touch family and friends by phone or email to let them know how you are doing,” recommends Messonnier. Consider ways of getting foods brought to your house through family, social, or commercial networks. Have at least three days of household items and groceries on hand so that you will be prepared to stay at home for an extended period of time, she adds.

And if you rely on a caregiver for routine help, make arrangements for backup care in case your primary caregiver becomes sick, suggests Messonnier.

Seema Verma, who oversees the Centers for Medicare & Medicaid Services, reported that major health insurers are now responding to the pandemic coronavirus outbreak by pledging to relax prescription refill limits on “maintenance medication” for Medicare Advantage and Part D beneficiaries.

Hot Off the Press…

“No matter what type of [Medicare] program you are in, you can get a coronavirus test with no cost sharing, Verma announced noting that she has gotten a commitment from insurance companies to also cover coronavirus tests with no cost-sharing.

Medicare now pays for telehealth services. “You can Skype with them. You can send them pictures, and all of those are covered services, so your doctor can bill for those particular services, says Verma.

If you have difficulty stocking up on your prescriptions at the pharmacy, consider refilling your medications with a mail-order service, recommends DHHS’s Giroir. Ask your physician to switch your prescription from a 30-day supply to a 90-day supply to “keep you out of the doctor’s office or a crowded grocery store or pharmacy,” he adds.

“This is not the time to panic. Stay informed, take it seriously because it can be a serious disease, stay up to date. We are committed to doing whatever we can to communicate,” says Giroir, noting that CDC’s website is a great source of information, but you want to know what is going on in your local community because that is where you get the most direct information about the risk.

For details, about COVID-19, go to https://www.cdc.gov/coronavirus/2019-nCoV/index.html. Also, go to https://health.ri.gov/diseases/ncov2019/.
Here’s a transcript of the event: https://www.aarp.org/health/conditions-treatments/info-2020/tele-town-hall-coronavirus.html.

Taking a Look at Physical Activity and Cardiac Health

Published in Woonsocket Call on March 8, 2020

Spring time is coming. Get out your walking shoes…

Physical exercise (that doesn’t have to be strenuous to be effective) can lead to longer, healthier lives, according to two preliminary research study findings presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic P Scientific Sessions 2020. The EPI Scientific Sessions, held March 3-6 in Phoenix, is considered to be the premier global exchange of the latest advances in population-based cardiovascular science for researchers and clinicians.

“Finding a way to physically move more in an activity that suits your capabilities and is pleasurable is extremely important for all people, and especially for older people who may have risk factors for cardiovascular diseases. Physical activities such as brisk walking can help manage high blood pressure and high cholesterol, improve glucose control among many benefits,” said Barry A. Franklin, Ph.D., past chair of both the American Heart Association’s Council on Physical Activity and Metabolism and the National Advocacy Committee, director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Michigan, and professor of internal medicine at Oakland University William Beaumont School of Medicine in Rochester, Michigan.

In one session, Dr. Andrea Z. LaCroix, Ph.D., of the University of California San Diego (UCSD), presented her study’s findings that showed the importance of walking, stressing that every step counts in reducing cardiovascular disease deaths among older women.

USCD’s study was supported by The National Heart, Lung, and Blood Institute of the National Institutes of Health.

According to the UCSD study’s findings, women who walked 2,100 to 4,500 steps daily reduced their risk of dying from cardiovascular diseases (including heart attacks, heart failure, and stroke) by up to 38 percent, compared to women who walked less than 2,100 daily steps. The women who walked more than 4,500 steps per day reduced their risk by 48 percent, in this study of over 6,000 women with an average age of 79.

LaCroix says that the UCSD study’s findings also indicated that the cardio-protective effect of more steps taken per day was present even after the researchers took into consideration heart disease risk factors, including obesity, elevated cholesterol, blood pressure, triglycerides and/or blood sugar levels, and was not dependent on how fast the women walked.

“Despite popular beliefs, there is little evidence that people need to aim for 10,000 steps daily to get cardiovascular benefits from walking. Our study showed that getting just over 4,500 steps per day is strongly associated with reduced risk of dying from cardiovascular disease in older women,” said LaCroix, the lead study author who serves as distinguished professor and chief of epidemiology at the UCSD. Co-authors of the study are John Bellettiere, Ph.D., mph; Chongzhi Di, Ph.D.; Michael J. Lamonte, Ph.D., M.P.H.

“Taking more steps per day, even just a few more, is achievable, and step counts are an easy-to-understand way to measure how much we are moving. There are many inexpensive wearable devices to choose from. Our research shows that older women reduce their risk of heart disease by moving more in their daily life, including light activity and taking more steps. Being up and about, instead of sitting, is good for your heart,” said LaCroix.

LaCroix’s study included more than 6,000 women enrolled in the Women’s Health Initiative with an average age of 79 who wore an accelerometer on their waist to measure their physical activity for seven days in a row; these participants were followed for up to seven years for heart disease death.

This study was prospective, and half of the participants were African-American or Hispanic, stated LaCroix, noting that the use of an accelerometer to measure movement is a strength of the study. However, the study did not include men or people younger than 60, she said, calling for future research to examine step counts and other measures of daily activity across the adult age range among both men and women.

In another session, Joowon Lee, Ph.D., a researcher at Boston University (BU) in Boston, noted that higher levels of light physical activity are associated with lower risk of death from any cause.

According to the findings of BU’s study, older adults were 67 percent less likely to die of any cause if they were moderately or vigorously physically active for at least 150 minutes per week, (a goal recommended by the American Heart Association) compared to people who exercised less.

However, the researchers observed that, among the participants with an average age of 69, physical activity doesn’t have to be strenuous to be effective. Each 30-minute interval of light-intensity physical activities – such as doing household chores or casual walking – was associated with a 20 percent lower risk of dying from any cause, they said, noting that on the other hand, every additional 30-minutes of being sedentary was related to a 32 percent higher risk of dying from any cause.

“Promoting light-intensity physical activity and reducing sedentary time may be a more practical alternative among older adults,” said Joowon.

The BU research study, supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, evaluated physical activity levels of 1,262 participants from the ongoing Framingham Offspring Study. These participants were an average age of 69 (54 percent women), and they were instructed to wear a device that objectively measured physical activity for at least 10 hours a day, for at least four days a week between 2011 and 2014.

The researchers say that the strengths of this study include its large sample size and the use of a wearable device to objectively measure physical activity. However, the participants of the Framingham Offspring Study are white, so it is unclear if these findings would be consistent for other racial groups, they note.

Co-authors of the study are Nicole L. Spartano, Ph.D.; Ramachandran S. Vasan, M.D. and Vanessa Xanthakis Ph.D.

Report Outlines Strategy for Combating Senior’s Social Isolation and Loneliness

Published in the Woonsocket Call on March 1, 2020

Nearly one in four older adults residing in the community are socially isolated. Seniors who are experiencing social isolation or loneliness may face a higher risk of mortality, heart disease and depression, says a newly released report from the National Academies of Sciences, Engineering and Medicine (NASEM), a Washington, D.C.-based nonprofit, nongovernmental organization.

For seniors who are homebound, have no family, friends or do not belong to community or faith groups, a medical appointment or home health visit may be one of the few social interactions they have, notes the NASEM report released on Feb. 27, 2020. “Despite the profound health consequences — and the associated costs — the health care system remains an underused partner in preventing, identifying, and intervening for social isolation and loneliness among adults over age 50,” says the report.

“I’m pleased the AARP Foundation sponsored study by NASEM confirms the connection between social isolation or loneliness and death, heart disease and depression for older adults. It also finds that the health care system and community-based organizations have a critical role to play in intervening,” says AARP Foundation President Lisa Marsh Ryerson.

“We also know social isolation, like other social determinants of health, must be addressed to increase economic opportunity and well-being for low-income older adults,” says Ryerson.

Addressing Social Isolation and Loneliness

The 266-page NASEM report, “Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System,” undertaken by the Committee on the Health and Medical Dimensions of Social Isolation and loneliness in Older Adults, outlines five goals that the nation’s health care system should adopt to address the health impacts of social isolation and loneliness. It also offers 16 recommendations for strengthening health workforce education and training, leveraging digital health and health technology, improving community partnerships, and funding research in understudied areas.

Although social isolation is defined as an objective lack of social relationships, loneliness is a subjective perception, say the NASEM report’s authors. They note that not all older adults are isolated or lonely, but they are more likely to face predisposing factors such as living alone and the loss of loved ones. The issue may be compounded for LGBT, minority and immigrant older adults, who may already face barriers to care, stigma and discrimination, the report says.

Social isolation and loneliness may also directly result from chronic illness, hearing or vision loss, or having mobility issues. In these instances, health care providers might be able to help prevent or reduce social isolation and loneliness by directly addressing the underlying health-related causes.

“Loneliness and social isolation aren’t just social issues — they can also affect a person’s physical and mental health, and the fabric of communities,” said Dan Blazer, J.P. Gibbons professor of Psychiatry Emeritus and professor of community and family medicine at Duke University, and chair of the committee that wrote the report in a statement announcing the its release. “Addressing social isolation and loneliness is often the entry point for meeting seniors’ other social needs — like food, housing and transportation,” he says.

Providing a Road Map…

The 16 recommendations in this report provides a strategy as to how the health care system can identify seniors at risk of social isolation and loneliness, intervene and engage other community partners.

As to improving Clinical Care Delivery, the report calls for conducting assessments to identify at-risk individuals. Using validated tools, health care providers should perform periodic assessments, particularly after life events that may increase one’s risk (such as a geographic move or the loss of a spouse).
The NASEM report also recommends that social isolation be included in electronic health records (EHRs). If a patient is at risk for or already experiencing social isolation, providers should include assessment data in clear locations in the EHR or medical records.

It’s important to connect patients with social care or community programs, too. The NASEM report notes that several state Medicaid programs and private insurers already has programs that target the social determinants of health. These programs can be more intentionally designed to address social isolation and loneliness of the older recipients. Health care organizations could also partner with ride-sharing programs to enable older adults to travel to medical appointments and community events, the report recommends.

The NASEM report also suggests that as more evidence becomes available, roles that health care providers are already performing — such as discharge planning, case management and transitional care planning — can be modified to directly address social isolation and loneliness in older adults. The report also details other interventions that the health care system might consider may include mindfulness training, cognitive behavioral therapy, and referring patients to peer support groups focused on volunteerism, fitness, or common experiences such as bereavement or widowhood.

Strengthening health professional education and training can be another strategy to combating the negative impacts of social isolation and loneliness. The NASEM report calls for schools of health professions and training programs for direct care workers (home health aides, nurse aides and personal care aides) to incorporate social isolation and loneliness in their curricula. Health professionals need to learn core content in areas such as the health impacts of social isolation and loneliness, assessment strategies, and referral options and processes, say the report’s authors.

The NASEM report warns that there are ethical Implications for using Health Technology to reduce social isolation and loneliness. Technologies that are designed to help seniors — including smart home sensors, robots and handheld devices — might intensify loneliness and increase social isolation if they are not easy to use or attempt to substitute for human contact. Moreover, the report found that 67 percent of the current assisitive technologies in dementia care were designed without considering their ethical implications. Developers of technology should properly assess and test new innovations, taking into account privacy, autonomy and the rural-urban digital divide.

The NASEM report says that more research is need because of evidence gaps and calls for more funding of studies to determine the effectiveness of interventions in clinical settings; to develop measures to identify at-risk individuals; and identify trends among younger adults as they age (such as use of technology and economic trends) that may inform how the health care system should target social isolation and loneliness in the future. More research is also needed to identify approaches and interventions that best meet the needs of LGBT and ethnic minority populations.

The National Academies are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.

For a copy of the NASEM report, go to http://www.nap.edu/catalog/25663/social-isolation-and-loneliness-in-older-adults-opportunities-for-the .