Category Archives for Congress

Presidential Commission Kicks off Social Security Reform Debate

Published in Pawtucket Times on December 17, 2001

Amid the nation mobilizing for a global fight against terrorism, a sliding economy with a rising unemployment rate, the President’s Commission to Strengthen Social Security last week released its bipartisan plan to fix the ailing Social Security program.

With elections looming next year, Congress will be forced to turn it attention to politically sticky domestic issue, how to modernize and restore the fiscal soundness of the Social Security program.

Finishing up its seven months of work, the 16-member Presidential Commission, divided evenly among Democrats and Republican, voted unanimously to sent its 165-page final report in draft form to the Bush White House. Two days after the panel released its report, House Republicans threw two bills into the legislative hopper, mirroring several of the recommended approaches.  The Social Security debate has begun.

While the Commission estimates that it will cost at least $2 trillion to revamp Social Security, it does not identify where the funds will come from.

Specifically, three approaches were suggested by the federal panel as a way of bringing reforms to the Social Security program. All involved the creation of voluntary personal accounts with a premise that workers investing in these accounts would ultimately receive higher retirement benefits by their investing in the social market.  Meanwhile, two plans seek provide better retirement benefits by their investing in the stock market.  Meanwhile, two plans seek to provide better benefits to low-income workers. All plans would seek to restore the fiscal stability of Social Security.

Senior advocacy groups are now weighting in on this highly visible and controversial policy issue that will likely become a key election issue next year. “None of the three draft plans put forward by the Commission today achieves the goal set out by the President, closing the gap in the program’s solvency over the next 75 years. None of the plans explain how it will achieve solvency. These plans do not change the fact that private accounts expose future beneficiaries to unnecessary risk and widely varying outcomes in retirement security,” charges Max Richtman, executive director of the National Committee to Preserve Social Security and Medicare.

Furthermore, with the push to privatization through individual accounts, the Commission does not address the issue of the impact to the existing Social Security program if moderate and higher-wage earners pull their money out of the  system, states Richtman, stressing that the Commission does not see to have considered the potential impact of such an adverse selection on the stability of the program.

“With privatization, the devel is always in the details, and the Commission has failed to provide adequate details,” Richtman adds. ”They have not provided the nuts and boots of how the plans would work and how they would affect real people.”

According to AARP CEO William Novelli, a number of questions remain unanswered by the Commission report, specifically, “the long-term financing of benefit guarantees, particularly if current budget projects and market rates of return prove to be overly optimistic.”

When the Social Security debate begins, Novelli calls for other reform proposals to be considered, such a diversifying the Social Security Trust Funds’ investments by including federally-backed debt instruments, along with raising the wage base for payroll taxes and adding newly hired state and municipal employees to the program.

U.S. Rep. T. Matsu (D-CA), Ranking Member of the Social Security Subcommittee of the House Ways and Means Committee agrees with the concerns of senior advocates. Restoring solvency of the Social Security program by workers investing part of their payroll tax in the stock market is a flawed approach and not the best strategy to  restore the fiscal integrity of the Social Security program, he says.

Privatization of Social Security would either require benefit cuts or a large infusion of federal dollars, warns U.S. Rep. Patrick Kennedy (D-RI), who serves on the House Appropriations Committee and sits as a member of the House Aging Caucus.

The Rhode Island Democrat who gives the Commission report a thumbs-down, states, “There is no question that we need to encourage American’s to save more for retirement, but while we do this, we should not throw the ‘baby out with the bath water’ by raising the retirement age, diverting the Social Security Trust Fund into privatization schemes or cutting benefits to seniors.” The four-term Congressman, whose legislative district has a large elderly constituency plans to make Social Security reform a key for his campaign in the upcoming elections next year.

Jeff Neal, a spokesperson for U.S. Sen. Lincoln Chafee (R-RI), tells All About Seniors that the senator does not necessary support or oppose some amount of privatization. “No amazingly specific proposal has come forward, been debated or has been thoroughly analyzed yet, Neal says. “Until that happens, it is impossible to determine if it is a good idea or not.”

Neal adds that Sen. Chafee believes that all the Democratic concerns need to be debated and resolved before Congress goes forward with any plan. “Democratic talking points look at the Commission work as a very simplistic level. Social Security is possible, besides the Medicare program, the most complex federal program, and a great deal of debate and input from both sides will be needed to tackle the solvency issue,” he says.

“Rhode Islanders need to step up and take credit for being leaders in the best social reform, notably Medicare,” urges AARP Executive Director Kathleen S. Connell. The late Democratic Congressman John Fogery and Aime J. Forand were the moving forces to create the is key federal program to protect the health and well-being of America’s seniors. “It is up to the current Rhode Island delegation to pick up the torch and lead the efforts to enact meaningful legislation to preserve and protect the Social Security program.”

Social Security funds could be up for grabs

Published in Pawtucket Times on September 10, 2001

Don’t expect quick government action to provide prescription drug benefits to seniors or immediate meaningful Social Security or Medicare reforms soon.  With the backdrop of a $1.35 trillion Bush White House tax cut, a shrinking budget surplus combined with an ailing economy and dwindling consumer confidence, Congress may be forced to take from “Peter to pay Paul.”

But let me give you the political translation…According to a recent released Congression Budget Office (CBO) August 2001 report, the federal government will need to use $9 billion of the tax receipts used to buy bonds invested in the Social Security trust fund in the fiscal year that ends September 30 to made ends meet, increasing the likelihood that heated bipartisan bickering and congressional gridlock will occur when lawmakers being their efforts to pass next year’s 13 spending bills.

Don’t look for things to get better soon, says the nonpartisan CBO, because by 2003 it’s estimated that $18 billion in Social Security reserves will be needed to keep the government in operation.  By 2005, CBO notes that if current tax and spending policies are followed, and the economy performs as the agency estimates, on budget surpluses will emerge.

Senior groups have expressed concern about the federal government having the dip into the cash generated from Social Security payroll taxes, calling it a tragedy that will block passage of any meaningful prescription drug benefit proposals or Medicare and Social Security reforms.  “The loss of tax revenue due to the present’s tax cuts and the slowing economy will lead to new federal debt and $600 billion in additional interest payments over the next ten years,”  predicted Max Richtman, executive director of the Washington D.C. based National Committee to preserve Social Security and Medicare.

“It’s enough to pat for a generous prescription drug benefit under Medicare,” Richtman says.

“Now it looks like the federal government will have to pay bondholders instead of providing seniors with the help they need on prescription drugs, Richtman added, noting that it’s a case of misplaced priorities.

“The $600 billion (in additional interest payments) could fund a prescription drug program with co-payments and deductible at a level that is more affordable for all seniors,”  Richtman says.  Meanwhile, any funds not used could help pay for repair of glasses, refitting dentures and new batteries for hearing aids, all costs not covered by Medicare. 

Adds Ed Zesk, president of Aging 2000, a nonprofit consumer organization focused on improving health care for seniors, “Its is unfortunate that the Bush administration got caught up in tax cut rhetoric to the point where they are focused into a corner and gave a tax cut without accessing its impact on the future of Medicare and Social Security.  While Americans certainly appreciate a few bucks back from Uncle Sam it is a shame that a nation we are potentially mortgaging our future health care and Social Security for a short term tax rebate.

“Clearly the tax cut has made it virtually impossible to develop any kind of meaningful prescription drug proposal for Medicare,”  Zesk told All About Seniors.  “This is just one example of the long-term benefit being sacrificed for the short-term gains,” he says.

Kathleen S. Connell, executive director of AARP Rhode Island, states that  AARP also opposes a federal government raid on the Social Security funds to finance other government programs.  However, the nation’s largest senior advocacy group was pleased that earlier this year both Congress and President Bush had agreed to protect Social Security by using surplus funds in the program for only debt reduction.  “To use the surplus funds other than for debt reduction would undermine that consensus and signal a trend that we believe would not be good economic policy,” Connell said.

According to AARP research, the overall balances for the program funds would not be affected and full benefits could be paid up until 2038, Connell said.  “The key thing that needs to be understood as long as the surplus is used for debt reduction, it would reduce the obligation of future generations and free up money to help the economy.”

With Congress going back into session, lawmakers must now begin the task of passing 13 appropriation bills for the fiscal year beginning October 1.  With the CBO report raising the issue of spending the Social Security receipts, it is now time for Congress to quit finger-pointing and charging each other of raiding the  Social Security and Medicare program.

With the graying of America, Congress must be aside its political differences and work toward long-range bipartisan solutions to ensure the solvency of the Social Security and Medicare programs.  No longer should seniors accept quick political fixes from either political party.

Congressional report spotlights nursing home abuse

Published in The Times dated August 6, 2001

Congressional investigators have recently released a scathing report charging that within the last two years more than 30 percent of the nation’s nursing homes – about 5,285 facilities – were cited by state inspectors for at least one abuse violation that had the potential to cause harm.

These facilities were cited for almost 9,000 violations during the two-year congressional study, the report said.

Citing information gleaned from a sampling of state inspection reports or formal complaints, the 15-page report released last week at a hearing called by Henry Waxman (D-Calif), Minority Chairman of the House Committee of Government Reform, found that in more than 1,600 nursing facilities, approximately one out of every 10, the abuse violations were serious enough to cause significant harm to residents or to place them in immediate jeopardy of death or serious injury.

Abused residents were punched, choked or kicked by staff members or other residents, the report said, stating that the attacks frequently caused serious injuries such as fractured bones and lacerations.  In other instances, residents were being groped or sexually molested.

Although the report, “Abuse of Residents is a Major Problem in U.S. Nursing Homes,” prepared by Minority Staff of the Committee’s Special Investigation Division, found that the percentage of nursing facilities with abuse violations is increasing, it noted that the reasons for this increase are unclear.

In his opening remarks, Waxman stated that it had been unwise for Congress to repeal the Boren Amendment in 1997, a federal law which mandated that states provide nursing facilities with adequate funding to operate.  Because of this, he said, Medicaid funding for nursing facility care has not kept pace with the rising costs of providing care.

Waxman’s legislative prescription for attacking the growing abuse in the nation’s nursing facilities is to introduce a legislative proposal that would reestablish the abolished Boren Amendment, mandating minimum nurse staffing requirements, imposing tougher regulatory sanctions on poorly performing facilities, and instituting criminal background checks for nursing facility employees, or increasing internet disclosures on nursing facility care.

What’s playing out in Rhode Island?

According to Wayne Farrington, Chief of Facilities Regulation at the state’s Department of Health, the reporting of Rhode Island abuse complaints has risen by 10 percent.  The statewide increase in reports of abuse, neglect and mistreatment probably mirrors the tragic national problem, he tells All About Seniors, but is smaller because the Rhode Island 1987 statute has made it a misdemeanor for health care professionals or public safety officials not to report suspected abuse, neglect, mistreatment.  The size of the national increase is partially due to abuse reporting being a new requirement in some states.  Farrington added. 

Farrington states that the biggest factor that increases the number of reported calls of abuse, neglect and mistreatment is the severe statewide staffing shortage in Rhode Island’s nursing facilities.

“Overworked staff may become short tempered and this can result in abuse.  Not enough staff in the facility may also result in resident’s needs not being met,” he added.

Administrator Hugh Hall, of Cherry Hill Manor, also feels that the state’s critical staffing crisis contributes to the possibility of increased abuse and that crisis also affects the quality of care provided in the state’s 104 nursing facilities.

“Today’s nursing facility employees are underpaid, overworked creating an environment in which even the best employee may falter,” Hall said.

The administrator urges the General Assembly to increase Medicaid payments to more adequately cover the nursing facility’s actual cost of care, allowing for greater increases in direct care provider salaries.

“While last year’s average cost of care in a Rhode Island facility was $140 per day the state’s Medicaid program only reimbursed facilities $116 for the care provided, creating a serious shortage of funds in many facilities, Hall added.

“There are not enough certified nursing assistants in the system to deliver the care,” Hall said noting that opportunities must be created and a fair wage paid to attract people into this profession.

Meanwhile, Hall believes that the overwhelming majority of nursing facilities in Rhode Island provide quality care.  These facilities do criminal background checks and provide staff training.  They educate their staff about the facility’s expectation on quality patient care, he said.

Hall says facilities that have on going problems with abuse should be prosecuted to “the fullest extent of the law.”

Although Roberta Hawkins, the state’s Long-Term Care Ombudsman and Executive Director of the Alliance for Better Long-Term Care sides with Farrington and Hall about the critical need to directly confront the adverse impact of the staffing shortage in facilities, “it’s not to excuse to provide bad care,” she says.  “If facilities can’t care for residents then they should not admit them.”

A mandated continuing education program for both professional nurses and certified nursing assistants can be an effective strategy for reducing the incidence of abuse while enabling the better trained worker to care for more medically complex residents.

Additionally, Hawkins and long-term care providers are pushing for more state and federal Medicaid dollars to be allocated to provide a living wage for direct care workers.

Although lawmakers this year gave a small increase, “it’s not what was needed but it’s a start,” she acknowledges.

A divided Congress and a conservative Bush White House may well keep Waxman’s legislative proposal that addresses the problem of rising abuse in the nation’s more than 17,000 nursing facilities from every being enabled.

So, change must begin in the Ocean State.

When the Rhode Island General Assembly comes back into session next year, it becomes critical that the serious direct care staffing shortage in Rhode Island’s nursing facilities become a top legislative priority.

As the Republican and Democratic Gubernatorial candidates gear up their political campaigns and dream of becoming the state’s top elected policy official, they might well consider taking up the just cause of improving the care provided in the state’s nursing facilities.

Lawmakers can gubernatorial candidates can ill afford to ignore this key policy issue, one that puts the state’s 10,000 frail nursing facility residents in continued jeopardy of abuse, neglect or mistreatment.

On a political note, hundred of thousands of families and friends of these residents, who are voters, are watching.