AOA Reauthorization in the Senate’s Hand

Published in Woonsocket Call on November 10, 2019

Last month, after a 40-minute debate, the House moved to pass H.R. 4334, The Dignity in Aging Act of 2019, a bipartisan reauthorization of the Older Americans Act (OAA) that provides funding for a wide range of popular local and state programs. These programs make sure seniors have access to food thru Meals on Wheels, transportation, part-time job opportunities to support financial security and to combat social isolation and other basic services they need to live independently and with dignity.

Introduced on Sept. 16 by Rep. Suzanne Bonamici (D-OR), who chairs the House Education and Labor Committee’s Subcommittee on Civil Rights and Human Services which has jurisdiction of AOA, and 25 cosponsors (eleven Democrats and fourteen Republicans, the House Committee on Education and Labor reported out a marked-up 68 page bill on Oct. 28, and a motion to suspend the rules and pass the bill as amended was agreed to by a voice vote on the House floor that day. The bipartisan bill would reauthorize $12.5 billion through 2024 for AOA programs assisting seniors.

Although the Houses passes a bill to reauthorize the OAA, the Act expired at the end of the fiscal year on Sept. 30. With bipartisan support it is expected that the reauthorization will move through both chambers as quickly as possible. Until then, OAA programs will continue to operate, and funding will flow either through enactment of continuing resolutions (CRs) or final FY appropriations legislation.

The Nuts and Bolts

Specifically, the House passed AOA reauthorization bill establishes a National Research, Demonstration, and Evaluation Center for the Aging Network in the Office of the Assistant Secretary of HHS. It would create an initiative to coordinate federal resources to promote the independence and safety of adults living at home as they age. The legislation would also provide tailored support to family caregivers who play a vital role in helping again Americans maintain their independence. It also puts a stronger focus on addressing social isolation among seniors by empowering local organizations to test local solutions.

On the day of the floor vote, over 70 aging and health care groups including AARP, Meals on Wheels, the Medicare Rights Center, and National Association of Area Agencies on Aging, wrote to House Speaker Nancy Pelosi and Ranking Member Bobby Scott, urging the House to swiftly advance H.R. 4334 to reauthorize the AOA because the current reauthorization of the Act expired September 30, 2019.

The OAA, initially passed in 1965 with Medicare, Medicaid, along with landmark civil rights laws, as part of President Lyndon B. Johnson’s Great Society initiative. OAA currently serves roughly 11 million older Americans, including 3 million older Americans who regularly rely on this federal program to meet their basic needs. The law provides funding to each state based on its share of the nation’s older adults.

The population of Americans age 60 and over has grown more than 60 percent since 2001, but OAA funding has only grown by roughly 20 percent. In 2010, OAA funding was $42.95 per senior in today’s dollars. Today it is $27.25 per senior. According to the Government Accountability Accounting Office, as a result, 83 percent of low-income older Americans who experience food insecurity do not receive any meal services through OAA. The same report found that two-thirds of older Americans who struggle with daily activities received limited or no homebased care services.

Most important, The Dignity in Aging Act includes an inflation-adjusted 7 percent increase in funding for OAA programs in the first year, followed by a 6 percent increase in each of the four years that follow. This results in more than a 35 percent total increase in program funding over the five-year reauthorization period, boosting OAA funding above its historical high watermark in FY2010.

Calls for AOA Reauthorization

“Aging Americans have supported our communities throughout their lives – now it is our turn to care for them,” said Bonamici. “I’m proud that the House passed my bipartisan Dignity in Aging Act, which will provide seniors and their caregivers with desperately needed resources and expanded services,” says the lawmaker who was first elected to Congress in 2012.

“I have heard and read too many stories about seniors rationing medication or saving portions of their meals so that they can stretch their resources just a bit further into the week,” Bonamici said on the House floor. “… This bill provides a rare bipartisan opportunity to help millions of older Americans across the country spend less of their limited income on costly care and, just as importantly, to empower every individual to age with dignity.”

I look forward to working with my colleagues in the Senate so this legislation can swiftly be signed into law,” says Bonamici, who also played a key role in the last reauthorization of OAA in 2016.

After passage of H.R. 4334, Rep. David N. Cicilline (D-RI) said, “After a lifetime of working hard and playing by the rules, Rhode Island seniors should never have to worry about making ends meet. I was proud to support the bipartisan Dignity in Aging Act to help ensure all seniors can retire with dignity and economic security. The Senate should take this bill up without delay.”

According to Cicilline, “In FY18, Rhode Island received $7,013,999 through the Older Americans Act. These funds are used to provide Meals and Nutrition Services, Supportive Services and Preventive Health, and the National Family Caregiver Support Program. This reauthorization will mean that older Rhode Islanders will continue to receive these services,” says the Rhode Island Congressman who serves as co-chair of the House Democratic Policy and Communications Committee

The Washington, D.C.-based AARP also applauded the passage of H.R. 4334. In a statement, AARP Senior vice president Bill Sweeney said, “The Dignity in Aging Act addresses AARP’s family caregiving priorities, including further strengthening support for family caregivers, extending the RAISE Family Caregivers Act, and providing increased funding levels for OAA programs. OAA programs provide services like home-delivered meals, transportation, medical appointments, protection from elder abuse, and job training.”

Sweeney says, “an estimated 40 million family caregivers provide a staggering $470 billion annually in unpaid care to their loved ones—ranging from bathing and dressing to paying bills and transportation and assisting with complex medical/nursing tasks. By supporting family caregivers, we can help people live independently in their own homes, helping to delay or prevent more costly nursing home care and unnecessary hospitalizations.”
Sweeney urges Congress to reauthorize OAA by the end of the year to help ensure the sustainability of OAA programs.”

A Final Note

Now the action of reauthorizing AOA moves to the Senate where a bill has not been formally introduced. But Senators Susan Collins (R-ME) and Bob Casey (D-PA) the chairman and ranking member of the Senate Special Committee on Aging are working on a reauthorization bill, says Richard Luchette, Communications Director for Rep. David N. Cicilline. With Senate Majority Leader Mitch McConnell (R-Kentucky) systematically blocking Senate voting on House passed legislation, Luchette urges the McConnell to take up the House bill so that seniors will be provided the services they rely on.

Seniors Can Expect Small Increase in Their 2020 Social Security COLA

Published in the Woonsocket Call on Oct. 27, 2019

The Social Security Administration (SSA) announces Oct. 10 that Social Security and Supplemental Security Income (SSI) benefits for nearly 69 million Americans will increase 1.6 percent in 2020 (Some recipients receive both Social Security and SSI benefits).

Social Security and SSI recipients will be notified about their new benefit amount by mail in early December. This COLA notice can also be viewed online through their my Social Security account. People may create or access their my Social Security account online at http://www.socialsecurity.gov/myaccount.

According to SSA, the 1.6 percent COLA increase will begin with benefits payable to more than 63 million Social Security beneficiaries in January 2020. Increased payments to more than 8 million SSI beneficiaries will begin December 31, 2019. The Social Security Act ties the annual COLA to the increase in the Consumer Price Index as calculated by the Department of Labor’s Bureau of Labor Statistics.

The maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase from $132,900 to $137,700, says SSA.

The earnings limit for workers who are younger than “full” retirement age (age 66 for people born in 1943 through 1954) will increase to $18,240. SSA will deduct $1 from benefits for each $2 earned over $18,240.

The earnings limit for people turning age 66 in 2020 will increase to $48,600. SSA will deduct $1 from benefits for each $3 earned over $48,600 until the month the worker turns age 66.)

There is no limit on earnings for workers who are “full” retirement age or older for the entire year.

COLA Not Keeping Up with Rising Cost of Living

Over the years, Social Security’s COLA has not provided financial protection against rising costs, charge aging advocacy groups.

Social Security checks in 2019 are as much as 18 percent lower due to the impact of extremely low COLAs over the past 10 years, says an analysis recently released by the Arlington, Virginia-based The Senior Citizens League (TSCL). TSCL’s Social Security policy analyst, Mary Johnson authored this analysis.

Johnson’s analysis noted that from 2000 to 2010, COLAs routinely averaged 3 percent
annually. People who have been receiving Social Security checks since 2019, have only seen a COLA higher than 2,8 percent one time (in 2012), she said, noting that Social Security benefits have lost 33 percent of buying power since 2000.

Johnson’s findings reported that in 2010, 2011, and 2016 there was no COLA payable at all and, in 2017, the COLA was just 0.03 percent. However, in 2018, the COLA was 2 percent, but rising Part B premiums consumed the entire increase for roughly half of all beneficiaries.

Calls for Strengthening the COLA

According to the National Committee to Preserve Social Security and Medicare (NCPSSM), the upcoming COLA change will give a whopping $24 per month increase for the average beneficiary. With Medicare Part B premiums expected to rise around $8 next year, the net cost-of-living adjustment for most seniors will be only $16 per month. The new COLA brings the average monthly retirement benefit up to $1,503 — it’s just a $288 yearly raise for seniors living on fixed incomes.

NCPSSM notes that roughly half of America’s seniors rely on Social Security for at least 50 percent of their income, and 1 in 4 depending on the program for at least 90 percent of their income, the 2020 COLA increase does not go very far in helping these recipients pay their bills. A $16 per month probably won’t cover typical expenses, such as the cost of a single prescription copay, a month’s medical supplies, or transportation to a doctor’s appointment, adds the Washington, DC- advocacy group whose goal is to protect Social Security and Medicare.

“It’s ironic that as billionaires and big corporations continue to profit from the $1.5 trillion in Trump/GOP tax cuts, America’s seniors are to get by with a meager $24 monthly raise,” says Max Richtman in a statement after SSA announced the 2020 COLA increase. NCPSSM’s President and CEO. “The negligible 2020 COLA illustrates why seniors need a more accurate formula for calculating the impact of inflation on their Social Security benefits. For years, we have urged the government to adopt the CPI-E (Consumer Price Index for the Elderly), which reflects the spending priorities of seniors, including health care, as opposed to the current formula based on younger urban wage earners’ expenses,” says Richtman.

If the CPI-E were adopted, beneficiaries would see a 6 percent overall increase in benefits over 20 years compared to the current formula used, which yielded a zero cost-of-living adjustment three times during the past decade — and a mere 0.3 percent in 2017, says Richtman, noting that health care costs have increased about 6 percent in 2019 alone.

“The prices of the most commonly prescribed drugs for seniors on Medicare rose ten times the rate of inflation from 2013-2018. The cost of senior living facilities is growing at 3 percent annually – which adds up quickly over time,” adds Richtman.

Adds Webster Phillips, NCPSSM’s Senior Legislative Representative, “COLAs are out of sync with seniors’ actual expenses. Retirees have been living on very tight cost-of-living adjustments for a number of years now, which forces them to make hard decisions about their monthly budgets.”

In a statement, AARP chief executive officer Jo Ann Jenkins said, “Social Security’s annual COLA amount typically does not keep pace with all the increases in living expenses that most seniors face, including the costs of housing, food, transportation and, especially, health care and prescription drugs. AARP’s recent Rx Price Watch report found that retail drug prices increased by twice the rate of inflation during 2017, and have exceeded the inflation rate for at least 12 consecutive years,” she says.

“AARP will continue our advocacy for bipartisan solutions to help ensure the long-term solvency of the Social Security program, as well as adequate benefits for recipients. We will also continue to fight for lower health care and prescription drug costs, which are eating up a growing share of Social Security benefits,” adds Jenkins.

TSCL’s Mary Johnson says that her group calls on Congress to require a minimum COLA of no less than 3 percent every year, even in years when inflation falls below that amount. “Strengthening the COLA,” she says, “would help slow the drain of retirement savings and help keep older Americans out of poverty.”

For information about Social Security benefits and claiming strategies, those approaching retirement age may visit AARP’s Social Security Resource Center, at https://www.aarp.org/retirement/social-security/.

Report on Falls, Injuries Released

PUblished in Woonsocket Call on October 20, 2019

Last Wednesday morning in Dirksen Senate Office Building 562, the U.S. Special Committee on Aging held a hearing to put a spotlight on the economic consequences on falls and to explore ways to prevent and reduce falls and related injuries. At the one hour and 55-minute hearing, titled “Falls Prevention: National, State, and Local Level Solutions to Better Support Seniors,” its annual report, Falls Prevention: Solutions to Better Support Seniors, was released.

According to the Senate Aging Committee, falls are the leading cause of both fatal and nonfatal injuries among older adults that incur $50 billion annually in total medical costs. That number is expected to double to $100 billion by 2030, and the majority of these costs are borne by Medicare and Medicaid.

“Falls are the leading cause of fatal and non-fatal injuries for older Americans, often leading to a downward spiral with serious consequences. In addition to the physical and emotional trauma of falls, the financial toll is staggering,” said Sen. Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Now is the time, and now is our opportunity, to take action to prevent falls. Our bipartisan report includes key recommendations to take steps to reduce the risk of falls,” the Maine Senator noted in an Oct. 16 statement.

Pushing for Positive Change in Releasing Fall Report

“We must dispel our loved ones of the stigma associated with falling so that they can get the help they need to age in place – where they want to be – in their homes and communities,” said Sen. Robert P. Casey, Jr. (D-Pa.). “I am hopeful that our work over the past year will propel the research community to do more, get more dollars invested into supporting home modifications and encourage more older adults to be active,” said the Special Committee’s Ranking Member.

At the hearing, the Committee unveiled a comprehensive report that provides evidence-based recommendations on ways to reduce the risk of falling. The Committee received input from multiple federal agencies, including the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and the Food and Drug Administration. In addition, approximately 200 respondents representing falls prevention advocates, hospitals, community organizations, home health agencies, and others shared their expertise on this issue.

The 34-page Aging Committee’s report made recommendations as how to raise awareness about falls-related risks, prevention and recovery at the national, state and local levels. It suggested ways of improving screening and referrals for those at risk of falling so that individuals receive the preventive care necessary to avoid a fall or recover after one. It noted ways of targeting modifiable risk factors, including increasing the availability of resources for home safety evaluations and modifications, so that older adults can remain in their homes and communities. Finally, it called for reducing polypharmacy so that health care providers and patients are aware of any potential side effects that could contribute to a fall.

Increasing Medicare Funding for Bone Density Testing

In an opening statement, Collins noted that falls are often times attributed to uneven sidewalks or icy stairs, medications, medical reasons or muscle strength. But one key cause of falling is osteoporosis, which can be especially dangerous for people who are completely unaware that they suffer from low bone density, she says.

According to Collins, although Medicare covers bone density testing, reimbursement rates have been slashed by 70 percent since 2006, resulting in 2.3 million fewer women being tested. “As a result, it is estimated that more than 40,000 additional hip fractures occur each year, which results in nearly 10,000 additional deaths,” she said, noting legislation, Increasing Access to Osteoporosis Testing Beneficiaries Act that she has introduced with Sen. Ben Cardin,” to reverse these harmful reimbursement cuts.

Casey stated, “I am particularly interested in sharing this report with the relevant agencies and learning how the recommendations will be implemented. Not just put in a report. Implemented,” adds Casey.

Peggy Haynes, MPA, Senior Director, of Portland-based Healthy Aging, MaineHealth that offers A Matter of Balance, an evidence-based falls prevention program, came to the Senate hearing to share details about its impact. “The health care community has a critical role to play in fall prevention – beginning with screening for falls, assessing fall risk factors, reviewing medications and referring to both medical and community-based fall prevention interventions. Our health system is focused on preventing falls in every care setting,” says Haynes.

“The need for a range of community-based options led MaineHealth to be a founding member of the Evidence Based Leadership Collaborative, promoting the increased delivery of multiple evidence-based programs that improve the health and well-being of diverse populations,” adds Haynes.

Haynes noted that older participants attend eight two-hour sessions to help them reduce their fear of falling, assisting them to set realistic goals for increasing their activity and changing their home environment to reduce fall risk factors. A Matter of Balance is offered in 46 states reaching nearly 100,000 seniors.

Virginia Demby, an 84-year-old visually-impaired retired nurse who is an advocate for Community and Older Adults, in Chester, Pennsylvania, came to the Senate hearing to support the importance of fall prevention programs. Despite living with low vision, Demby remains physically active by participating in exercises classes for older adults at the Center for the Blind and Visually Impaired in Chester. She is an advocate for older adults and now helps the local senior center wellness manager recruit more seniors to take falls prevention classes and find new places to offer the classes.

Kathleen A. Cameron, MPH, Senior Director, Center for Healthy Aging, of the Arlington, Virginia-based National Council on Aging, discussed the work of the National Falls Prevention Resource Center, which helps to support evidence-based falls prevention programs across the nation and highlighted policy solutions to reduce falls risk.

Finally, Elizabeth Thompson, chief executive officer, Arlington, Virginia-based National Osteoporosis Foundation, testified that bone loss and osteoporosis are fundamental underlying contributors to the worst consequences of falls among older Americans: broken and fractured bones. Osteoporotic fractures are responsible for more hospitalizations than heart attacks, strokes and breast cancer combined, she noted.

For details of the Senate Aging Committee report, go to http://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf.