Author Archives for Herb Weiss

Courtesy of AARP: Long-Term Care Data at Your Finger Tips

Published in the Woonsocket Call on September 2, 2018

Across the States 2018: Profiles of Long-Term Services and Supports, by Ari Houser, Wendy Fox-Grage, Kathleen Ujvari, of AARP’s Public Policy Institute, was released days ago. The jampacked 84-page AARP reference report gives state and federal policy makers comparable state-level and national data culled from a large number of research studies and data sources, some of the data gleaned from original sources.

AARP considers the 10th edition of Across the States, published for the past 24 years, “the flagship publication” to assist policy makers make informed decisions as they create programs, and policies for long-term services and supports (LTSS). State-specific data “is easily found, “at your fingertips,” claims AARP.

Across the States, released August 27, 2018, includes a myriad of aging topics include: age demographics and projections; living arrangements, income, and poverty; disability rates; costs of care; private long-term care insurance; Medicaid long-term services and supports; family caregivers; home- and community-based services (HCBS); and nursing facilities. Each state profile is a four-page, user-friendly, print-ready document that provides each state’s data and rankings.

Looking at Trends

AARP Public Policy Institute researchers have identified four trends in reviewing state data. Of most importance to Congress and state legislatures, Across the States gives a warning that America’s population is aging. The nation’s age 85 and over population, those most in need of aging programs and services, is projected to triple between 2015 and 2050, a whopping 208 percent increase.

But, by comparison, the population younger than age 65 is expected to increase by only 12 percent. The under age 65 population, currently, 85 percent of the total population, is projected to be 78 percent in 2050. Bad news for propping up the Social Security system with the worker-to – beneficiary ratio declining.

Across the States researchers say that the demographic shift of an increasing older population will have an impact on family caregiving. “The caregiver support ratio compares the number of people ages 45–64 (peak caregiver age) to the number ages 80+ (peak care need),” notes the report. Today, there are about 7 people ages 45–64 for every person age 80. By 2050, that ratio will drop to 3 to 1.

America’s older population is also becoming more diverse, reflecting overall trends in the general population. Across the States researchers note that the Hispanic population age 65 and over is projected to quadruple between 2015 and 2050.

Finally, Across the States report notes that State Medicaid LTSS systems are becoming more balanced due to the increase of state dollars going to fund home and community-based services (specifically to care for older people and adults with disabilities). But, this trend varies in level of balance, say the researchers, noting that: “The percentage of LTSS spending for older people and adults with disabilities going to HCBS ranged from 13 percent to 73 percent in 2016. While 40 states became more balanced, 11 states became less balanced for older adults and people with physical disabilities in 2016 compared with 2011.”

Taking a Closer Look

Across the States notes that the age 85 and over population is projected to significantly outpace all other age groups when the aging baby boomers begin turning age 85 in 2031. In 2015, people ages 85 and older made up 2 percent of the US population. By 2050, they are projected to represent 5 percent. By contrast, in the Ocean State the age 85 and over population was 2.7 percent of the state’s population. By 2050, look for the oldest-old population to inch up to 5.4 percent.

Throughout the nation the cost for private pay nursing facility care is well out of reach of most middle-income families. Across the States notes that in 2017 the annual median cost for nursing facilities is $97,455 for a private room and $87,600 for a shared room. But, in Rhode Island the annual cost is higher, with a private room costing $ 104,025 and $ 101,835 for a shared room. The researchers say that for the cost of residing in a nursing facility for one year, a person could pay for three years of home care or five years of adult day services.

Because of the high costs, most people go through their life savings paying for costly care and ultimately have to rely on the state’s Medicaid program. Nationally, the percent of Medicaid as primary payer in 2016 was 62 percent (61 percent in Rhode Island).

According to Across the States, family caregivers provided $470 billion worth of unpaid care in 2013, more than six times the Medicaid spending on home and community-based services. In Rhode Island, 134,000 provided 124 million hours of care annually with an economic value $ 1.78 billion. But, AARP’s report warns federal and state policy makers about the stark demographics in America’s future that will for the nation’s “Oldest Old” to scramble to find a caregiver, due to a shortage. Will state’s have the financial resources to fund programs and services to make up for this demographic reality.

For a copy of Across the States report and Rhode Island specifics, go to: http://www.aarp.org/content/dam/aarp/ppi/2018/08/across-the-states-profiles-of-long-term-services-and-supports-full-report.pdf.

Senate Spending Bill Increases Research Dollars to Combat Alzheimer’s disease

Published in the Woonsocket Call on August 26, 2018

Last Wednesday evening, the US Senate overcame political gridlock by passing a 2019 fiscal “Minibus” spending bill that allocates funding for the Department of Defense; and Labor, Health and Human Services, Education, and Related Agencies (accounting for 65 percent of all discretionary spending). Within the Health and Human Services appropriation, the National Institutes of Health’s budget increased by $2 billion to $39.1 billion, a 5.4 percent increase over the agency’s current funding level.

The Labor, Health & Human Services, Education and Related Agencies Appropriations bill passed on Augusts 23 by a broad bipartisan vote of 85 to 7, the spending bill combining the Senate Appropriations Committee-passed FY 2019 Labor-HHS spending bill (S. 3158) with the text of the Senate committee-passed Defense spending bill (S. 3159). The Senate-passed appropriations bill, with both Rhode Island Senators supporting, adds an additional $425 million for Alzheimer’s research at the National Institutes of Health (NIH) for a total of $2.3 billion. The increases in Alzheimer’s funding surpasses the $2 billion research goal of the National Plan to Address Alzheimer’s Disease. If signed into law, this would mark the fourth consecutive year of historic action by the U.S. Congress to address the growing Alzheimer’s epidemic through funding research.

As to other NIH health initiatives, the 2019 fiscal spending bill also allocated $429.4 million for the BRAIN initiative to map the human brain, (a $29 million increase), and $376 million for the All of Us precision medicine study, this was $86 million more than in FY 2018.

The Senate Labor, Health and Services, and Education appropriations subcommittee first recommended the Alzheimer’s funding increases in June, with the full Senate appropriations committee later giving its support.

Bipartisan Support for Combating Alzheimer’s Disease

Ahead of the Senate floor vote, U.S. Senator Roy Blunt (Mo.), chairman of the Appropriations Subcommittee on Labor-HHS, called for increased federal dollars to invest in research to find a prevention and cure for Alzheimer’s disease. “Treating those with Alzheimer’s costs taxpayers $21 million every hour and, without a treatment or cure, will top $1.1 trillion by 2050 – about twice as much as the annual defense budget,” the Senator calculated.

Blunt warned his Senate colleagues that the nation must get serious with confronting the Alzheimer’s epidemic and finding a cure through research. The Senator stated: “Every hour, Alzheimer’s disease costs taxpayers at least $21 million. Every single hour. Someone in the United States is developing Alzheimer’s every 65 seconds,” noting that $277 billion in tax dollars are spent a year on Alzheimer’s and dementia-related care. It’s hard to talk about this without giving numbers, but numbers are not the most riveting thing, particularly when you talk about millions, or billions, or even trillions.

“What does that really mean? That really means that we’re spending basically an amount equal to half of the defense budget on Alzheimer’s and dementia-related care. Just the overwhelming impact of that, if we don’t do something differently than we’re doing right now, just because of the projected long life and demographics of the country, in 2050, which is 32 years from now, we’ll be spending, in today’s dollars, $1.1 trillion on Alzheimer’s and dementia care. $ 1.1 trillion… That’s twice the defense budget of last year, twice the defense budget. …,” says Blunt

“If we could just delay onset of Alzheimer’s, if we could figure out how to come up with something that would slow down the onset of that disease. If we could delay onset by an average of five years, we’d cut that $1.1 trillion by 42 percent, almost in half. If we could have the average person that gets Alzheimer’s, get it five years later than they are getting Alzheimer’s today, almost half, 42 percent of that $1.1 trillion would go away,” said Blunt.

Greater Investment in Alzheimer’s Funding Still Needed

With the Senate appropriations bill pumping more federal dollars into Alzheimer’s research, UsAgainstAlzheimer’s Chairman George Vradenburg issued a statement
saying: “We believe that Alzheimer’s is the second inconvenient truth of the 21st century. Alzheimer’s is the century’s most fearsome — and inevitable — health and social economic threat to the baby boom and future generations, including, in particular, to women and communities of color. Even with this strong commitment from the Senate, greater investment is still needed if we are to deliver meaningful progress in care and treatment to the six million Americans, 50 million globally, living with this disease and their more than 16 million caregivers. In addition to supporting research, we must elevate brain health as an important part of the path to a cure through regular primary care physician assessments of cognitive health — and early and accurate diagnosis of the cause of any cognitive impairment. The Concentrating on High-value Alzheimer’s Needs to Get to an End (CHANGE) Act, comprehensive legislation aimed at overcoming barriers to a faster cure for Alzheimer’s disease, does just that and we urge Congress to pass the CHANGE Act immediately.”

The Chicago-based Alzheimer’s Association and the Alzheimer’s Impact Movement (AIM) also applauded the Senate’s 2019 spending bill that puts more money into Alzheimer’s research. “Every 65 seconds someone in the U.S. develops the disease,” said Harry Johns, Alzheimer’s Association and Alzheimer’s Impact Movement (AIM) President and CEO. “But, thanks to increased NIH funding American scientists are now advancing basic disease knowledge, ways to reduce risk, new biomarkers for early diagnosis and drug targeting, and developing the needed treatments to move to clinical testing,” he says.

The Senate appropriations bill now goes to conference negotiations with the House and must be signed into law by President Donald Trump. The 2019 Fiscal Year begins October. 1.

Midterm Elections Can Impact Social Security’s Long-Term Survival

Published in the Woonsocket Call on August 19, 2018

After just weeks celebrating the 53rd Anniversary of Medicare to score political points, Democrats, aging groups and Social Security Advocates put 83 candles on a cake to celebrate President Franklin D. Roosevelt’s signing of Social Security Act into law on August 14, 1935. The new Act created a social insurance program designed to pay retired workers age 65 or older a continuing income after retirement.

With the midterm elections looming, less than three months away, the Democrats are gearing up their efforts to recapture the House and Senate. Polls tell us that Social Security is being positioned as a key issue to energize voters, especially in competitive races, to control both legislative chambers.

According to the Washington, DC-based AARP, recent polling suggests Social Security and Medicare will be key issues for 50-plus voters. Recent
AARP/Politico polls found a significant majority of age 50 and over Arizona voters report Social Security (78 percent), health care (76 percent) and Medicare (75 percent) are “very important” issues to them as they head to the polls in November. Also, significant majorities of older Florida voters age 50 and older say Social Security (82 percent) and health care (78 percent) will be very important to their vote for Congress this fall. In this swing state, nearly three-quarters of Florida voters cite the future of Medicare as an important election issue.

Social Security Checks Prime States and National Economic Engine

AARP, the National Committee to Preserve Social Security and Medicare (NCPSSM) and Social Security advocates say it’s a great time to remind political candidates for House and Senate races of the popularity of Social Security and Medicare and both programs impact on the nation’s fiscal health. The Washington, DC-based NCPSSM calls Social Security and Medicare an economic generator, annually paying out more than $ 800 billion in benefits to over 57 million beneficiaries who put this money back into their local, state and federal coffers.
In the Ocean State, there are 222,851 Social Security beneficiaries, including 152,898 Retired Workers, 37,133 Disabled Workers, 11,680 Widow(er)s, 5,810 Spouses and 15,330 Children Social Security benefits that pump $3 Billion each year to state’s economy, says NCPSSM, its figures taken from the nonprofits state-by-state analysis of how much revenue Social Security contributes to the economy of every Congressional District in each state.

“Social Security has a very big footprint in Congressional districts across the country, which is a tremendous benefit not only for beneficiaries, but for entire communities,” says Max Richtman, NCPSSM’s president, and CEO. “Yet, in the face of clear evidence of Social Security’s effectiveness, conservatives want to cut and privatize the program. Candidates in this year’s mid-term elections must ask themselves whether their communities can afford to lose billions of dollars in economic stimulus – not to mention the baseline financial security that these earned benefits provide retirees and their families. The answer for anyone who seeks to represent the people should be a resounding ‘No,’” he says.

Yet, throughout the years, GOP lawmakers sought to ensure the solvency for the Social Security program by cutting benefits, raising the retirement age and
to privatize the program. Democrats call for the raising or eliminating the payroll cap on taxable wages, now $ 118,500 a year, to bring more revenues into Social Security from the nation’s wealthy. They say Social Security must be considered an earned benefit rather than an entitlement because working Americans pay into the system each paycheck, and receive benefits when they retire or become disabled.

Key Congressional Races to Watch

And there are a lot of Congressional races to watch during the upcoming mid-term elections. According to fivethirtyeight.com, a website that focuses on
opinion poll analysis and politics, “… 39 Republicans and 18 Democrats are not running for re-election. That includes 13 Republicans and 10 Democrats who are leaving to seek another office, such as governor. Excluding them, 26 Republicans and eight Democrats are walking away from their political careers at the end of the 115th Congress. That’s the most “pure” retirements by Republicans — and the fewest by Democrats — since the 2008 election.”

NCPSSM is closely monitoring both House and Senate races, calling for voters to support candidates who commit to strengthening and expanding Social Security. “These Social Security champions can be found across the country, in both red and blue states,” says the Social Security advocacy group.
Here are just a few campaigns to watch.

NCPSSM says one of these Social Security campaigns is Kathleen Williams, a water conservation expert, who is running for the House seat in Montana currently occupied by Republican Greg Gianforte. The Republican Congressman, elected in 2017, voted for the sweeping GOP tax plan, the Tax Cuts, and Jobs Act, increasing the national debt by $ 1.9 trillion between 2018 and 2028, according to the Congressional Budget Office. The skyrocketing deficit puts Social Security, Medicare and Medicaid on the GOP radar screen for cuts to the nation’s debt and deficits. Gianforte’s opponent pledges to “make sure that our seniors can retire with dignity by protecting Medicare and Social Security no matter what.”

Another, in Arizona, three-term Democratic Congresswoman Kyrsten Sinema, formerly serving in both chambers of the State Legislature, is running for retiring Republican Senator Jeff Flake’s seat, a race that could determine which political party takes control of the Senate. “Sinema says, “We can’t allow… Washington to threaten the Medicare and Social Security benefits Arizonans have earned through a lifetime of hard work.” Her likely opponent, Republican Congresswoman Martha McSally, like Congressman Gianforte, voted for the GOP tax plan and Sinema has accused her of wanting to privatize Social Security while her Congressional voting record does not reflect this charge.

Finally, in Illinois’ 12th Congressional district, where challenger Brendan Kell, serving as the state’s attorney for St. Clair County and earned a commission as an officer in the U.S. Navy opposes incumbent Mike Bost. The Republican voted for the GOP’s failed Balanced Budget Amendment – Democrats and NCPSSM considering this a backdoor strategy to slash Social Security. The Democratic challenger Kelly that “instead of cutting Social Security, Medicare and Medicaid, as those in Congress currently want to do… we have to fight against that and expand the access and coverage overall.”

You Can Make a Difference

With the outcome of the midterm elections, especially in battleground state, AARP’s voter engagement multifaceted campaign “Be The Difference. Vote” is mobilizing older voters to get them to vote in primaries and in the November general election. The “get out the vote” initiative will put issues of particular importance to aging baby boomers and seniors front and center— issues like Medicare, Social Security, financial security, prescription drug costs, and family caregiving.

AARP is tracking key races, sponsoring debates, and hosting candidate forums and tele-townhall events. Election information is provided through a full-scale digital effort, including aarp.org/vote, the AARP Now app, social media outreach, graphics, and news alerts. AARP is also using direct mail, phone banks and transportation assistance to help people get to the polls.

Social Security celebrates its 83 Anniversary this month. Older voters can send a message to Capitol Hill by casting votes for candidates to strengthen and expand the program instead of voting for those who call to privatize Social to replace the federal government-administered system.

A Final Note…

Congressman David Cicilline (D-RI) will release a new report from the U.S. House Democrats’ Seniors Task Force during an event at Rumford Towers in East Providence this Monday. The report outlines the history of Washington Republican efforts to attack Social Security and Medicare.

Cicilline, who serves in the House Democratic Leadership, also plans to outline the policies that Democrats will advance if they take control of the House this November. Democrats have outlined a series of proposals to lower the costs of prescription drugs and health care premiums.

“Republicans are on the side of powerful special interests. Democrats are for the people,” Cicilline told me. “When Democrats take the majority, we’re going to pass legislation giving Medicare the ability to negotiate the cost of prescription drugs. We’re going to make Social Security and Medicare a priority by requiring the wealthy to pay into the system as much as everyone else and improving cost-of-living adjustments.”