Older Americans to Benefit from Bipartisan Budget Act

Published in the Woonsocket Call on February 11, 2018

While many were sleeping, funding to operate the federal government expired midnight Thursday, though it was restored about eight and a half hours later with action from Congress to end the brief government shutdown, when President Donald Trump signing the 652-page Bipartisan Budget Act of 2018 early Friday morning.

The $400 billion budget agreement funds the federal government through March 23 to give lawmakers time to pull together the details needed to craft full appropriations bills that become the official federal budget.

Lawmakers had expected the massive budget bill to pass before the midnight deadline to avoid a government shutdown but Sen. Rand Paul (R-Ky.), delayed the Senate vote past midnight to protest the additional billions of dollars being added to the federal budget deficit by the legislation.

Ultimately the House approved the bill by 240 votes to 186, almost four hours after the Senate had passed the budget bill by 71 to 28 three hours earlier. The GOP-controlled House needed the help of 73 Democratic lawmakers to pass the budget bill because 67 House Republicans voted against the legislation.

The Nuts and Bolts

The two-year budget deal eliminates strict budget caps that were set in 2011 to reduce the federal deficit and allows Congress to increase military and domestic spending by $300 billion, along with adding another $90 billion for emergency disaster aid for Texas, Florida and Puerto Rico and throws in billions more for infrastructure, the opioid epidemic and health programs. It also suspends the debt limit for one year – until after the upcoming midterm elections.

Specifically, the newly enacted Bipartisan Budget Act of 2018, would allocate $165 billion to the Pentagon and defense spending while $131 billion would be directed to domestic programs. In addition, $20 billion would be spent on infrastructure programs such as surface transportation, rural water and wastewater systems, $ 7 billion in community health centers to provide care to low-income people, $6 billion to fight the opioid crisis, and $4 billion directed to veteran’s health care.

The budget agreement also repeals the controversial Obamacare’s Independent Payment Advisory Board (IPAB), which was designed to limit Medicare costs. It also gives a ten-year extension to the Children’s Health Insurance Program (CHIP), which is four years longer than the previous spending bill passed last month. Finally, the legislation did not address the dilemma of 700,000 “Dreamer immigrants who are in the United States illegally after being brought here as children and who” are enrolled in the Deferred Action for Childhood Arrivals program, set to expire on March 5, nor did it provide funding for President Trump’s proposed southern border wall.

“A Pretty Good Deal for Seniors”

Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, sees the Bipartisan Budget Bill of 2018 “a pretty good deal for seniors.”

“Seniors will feel these changes in their pocketbooks and even in the way they feel physically,” says Richtman, in a released statement. “We have been fighting for these measures for quite some time and are happy to see Congress take action on a bipartisan basis.”

According to Richtman, the Bipartisan Budget Act of 2018 closes Medicare Part D “donut hole” in 2019. The prescription drug coverage gap embedded in the original law, which the Affordable Care Act has been gradually closing, will be altogether eliminated one year early. This will save seniors thousands of dollars in out-of-pocket prescription drug costs., he says.

Richtman says that the enacted Budget agreement also repeals Medicare therapy caps. The bill scraps arbitrary caps on physical, speech, language and occupational therapies that have cost senior’s money – or delayed care at crucial times. Beneficiaries will now find it easier – and more affordable – to get the therapies they need without undue interruption, he notes.

The Bipartisan Budget Act of 2018 also lifts non-defense domestic spending caps, allowing Congress to appropriate more adequate funding for the Social Security Administration’s (SSA) operating budget, says Richtman, noting that the federal agency has suffered from draconian budget cuts since 2011 which have impinged on customer service, even as 10,000 Baby Boomers retire every day. He notes that “this badly-needed (but yet unspecified) higher level of funding should allow SSA to improve customer service for the program’s 67 million beneficiaries.”

But, on the negative side, says Richtman, the new law increases Medicare premiums for some individuals by further expanding Medicare means-testing. “Congress continues to expand Medicare means-testing, and they will not stop until middle-class seniors are burdened with higher Medicare premiums,” he warns.

“We are particularly pleased that this legislation permanently repeals Medicare’s therapy caps, something that AARP has long supported. Millions of vulnerable patients who need occupational, physical, and speech-language therapy will now be protected from an arbitrary limit on how much Medicare will pay for needed therapy,” said Nancy LeaMond, AARP’s Executive Vice President and Chief Advocacy & Engagement Officer, in a released statement..

“AARP is also pleased that Congress expedited the closing of the Medicare prescription drug coverage gap known as the ‘donut hole,’ which will now close in 2019, one year earlier than currently scheduled. Medicare beneficiaries will soon get permanent relief from higher out-of-pocket costs for prescription drugs. We also applaud the provision that adds biosimilar drugs to the Medicare Part D Coverage Gap Discount Program. This change will lower out-of-pocket costs and encourage the development and use of these drugs,” adds LeaMond.

Pets Can Bring You Health, Happiness

Published in the Woonsocket Call on February 4, 2018

My newly adopted three-month old chocolate lab, Molly, keeps me on my toes. Literally. My daily walks around the block and playing ball in the back yard equal over eight thousand steps calculated by my Fitbit App. Being a pet owner I can certainly vouch for research findings published over the years that indicate that older adults who also are pet owners benefit from the regular exercise and bonds they form with their companion animal.

The Positives of Owning a Pet

According to Dr. William Truesdale, owner of Seekonk, Massachusetts Central Avenue Veterinary Hospital, “having a companion animal can greatly improve your life. Of course you should always choose the right pet based upon your lifestyle and activity levels,” says the veterinarian who has practiced for over 43 years.

“Studies have demonstrated that having a pet in the home can actually lower a child’s likelihood of developing related allergies or asthma. Children exposed early on to animals tend to develop stronger immune systems overall (as published in the Journal of Allergies and Clinical Immunology),” says Truesdale.

“The Centers for Disease Control and Prevention (CDC) have conducted heart related studies on people who have pets. The finding showed that pet owners exhibit decreased blood pressure, cholesterol and triglyceride levels. All of which can ultimately minimize their risk for having a heart attack,” adds Dr. Truesdale, noting that people affected by depression, loneliness or PTSD may find that a companion animal may greatly improve their overall mood.

“As a dog owner myself and knowing so many people who find companionship and just plain fun as a pet owner, I can attest to the many benefits,” said AARP RI State Director Kathleen Connell. “While not for everyone, there is an abundance of evidence supporting this. I have heard so many stories about pets in senior living centers and even service pets that provide furry contact for patients in nursing homes and hospitals I know they can do so much to brighten a day. And when you are on Facebook, you almost expect to see friends’ proud dog and cat pictures.

“When it comes to dogs, they need walking. Anything that gets older people up and out of the house is a good thing, even if it requires carrying a supply of clean-up bags. Bending and stretching is exercise, you know. In addition, there inevitably is increased social interaction as people meet and make new pet-owner on the sidewalks and at dog parks. It’s all good.”

Pet-Friendly Policies Abound in Health Care Settings

Dr. Karl Steinberg, a San Diego-based hospice and nursing home medical director and Chief Medical Officer for Mariner Health Central, has seen the positive impact of pets in patient care settings. For over twenty years the long-term care geriatrician has taken his own dogs with him to nursing homes, assisted living facilities and on house calls to hospice patients almost every day. ”It generates a lot of happiness,” says Steinberg.

Steinberg sees first-hand on a daily basis the joy they bring to the residents, even those with severe dementia. “It slows down the day a little bit, because when you walk past a room and someone shouts, ‘Oh! A dog!’, you can’t just walk on down the hall. You stop and share the unconditional love, and it’s so worth it.,” says the geriatrician and hospice physician

For years, Administrator Hugh Hall has brought Bella, a Labrador Retriever, to visit residents of the West Warwick-based West View Nursing and Rehabilitation. Bella is considered “an important member” of the Rehabilitation staff of the 120 bed skilled nursing facility,” says Hall, noting the 8-year old canine is utilized by therapists to assist and motivate patients in their recovery.

“Residents love the ability to ability to interact and hold or cuddle with Bella and visiting pets,” observes Hall, noting that his dog is the “official greeter” at the facility’s main entrance. “The residents get to pet her and reminisce about their pets of the past and this memory is warm and happy,” he says.

Mike, a 12 -year old Labrador often makes the “rounds” with Geriatrician David A. Smith, MAD, CMD, at facilities in Central Texas. His pet’s impact on residents is very positive and improves the quality of his rapport with residents enabling him to get “better history and better compliance from them” he says.

“In a meta-analysis of non-pharmacologic therapies for behavioral problems in Nursing Home Residents with dementia, pet therapy was one of only a small number of interventions that showed statistical benefit,” says Smith, who is a past president of AMA: The Society for Post-Acute and Long-Term Care Medicine.

Smith warns that there is a downside in owning a pet. Frail adults may trip over a pet. Elders may age out of the ability to care for a pet, placing an additional burden on a caregiver who must care for the pet. Plans need to be in place for the placement of a pet in case of a move to an assisted living facility or if an owner passes away.

Life-Like Pets Can Also Bring Benefits to Older Adults

But, for those who find taking care of a living pet taxing because of deceased mobility or memory loss, Hasbro, Inc., has created a new realistic pet, an animatronic cat with soft fur, soothing purrs, and pleasant meows and a barking dog, especially designed to bring companionship to older adults.

In 2015, the Joy For All Companion Pets brand, featuring the animatronic cat, was Hasbro’s first foray into products designed specifically for older adults. In addition to captivating older adults, Joy For All Companion Pets can help enhance the interaction between caregivers and their loved ones by incorporating lighthearted fun, joy, and laughter into time spent together.

In 2016, Hasbro’s the JOY FOR ALL Companion Pet brand included a lifelike pup that sounds, and feels like a real dog; when the pup’s “owner” speaks, it looks toward him/her and reacts with realistic puppy sounds. That year the Pawtucket-based toy company collaborated with Meals on Wheels America to fight senior isolation and loneliness, which affects one in four seniors across the country. Hasbro donated $100,000 to Meals on Wheels America and provided JOY FOR ALL Companion Pets to local Meals on Wheels programs across the country in order to provide comfort and companionship to the nation’s most vulnerable citizens.

“Aging loved ones and their caregivers have been thrilled with the Companion Pet Cats, and we are inspired by their positive feedback and personal stories,” said Ted Fischer, vice president of business development at Hasbro in a statement announcing the new life-like product. “The Cat delivers a unique way for all generations to connect deeply through interaction and play, but dog lovers continually asked when we planned to add a dog to the line. We are truly excited for the new JOY FOR ALL product – the Companion Pet Pup – to bring even more lighthearted fun and laughter to seniors and their families.”

“We heard from seniors across the country that companionship was important to their happiness. Many live alone, miss having a pet, or are no longer able to care for a pet,” said Fischer. “While it’s not a replacement for a pet, the Joy For All Companion Pet Cat is a life-like alternative that can provide the joy and companionship of owning a real pet, without the often cumbersome responsibilities,” he says.

The Joy For All Companion products are available for purchase on JoyForAll.com.

Fogarty Retiring as Elderly Affairs Director

Published in Woonsocket Call on January 28, 2018

Just days ago, Director of Rhode Island’s Division of Elderly Affairs (RIDEA), Charles J. Fogarty, announced his retirement to take place at the end of June, after 4 decades of public service. There have been nine directors since the establishment of DEA, including Fogarty.

Fogarty’s plans to retire at the end of the current legislative session. When this occurs, Governor Gina Raimondo will make an appointment to the RIDEA director position. The position requires advice and consent of the RI Senate.

Fogarty began his career in public service in 1978 as a junior policy advisor for Governor J. Joseph Garrahy. He served as lieutenant governor, from 1999 to 2007, having the distinction of being the last lieutenant governor to preside over the State Senate. From 2011 to 2015, Fogarty served as the director of the Department of Labor and Training, ending up his career as the Director of RIDEA.

During his years of public service, Fogarty, 62, has been focused on long term care and home- and community-based services and supports for older Rhode Islanders. He played a key role in steering and expanding the work of the Long-Term Care Coordinating Council during his tenure as Lieutenant Governor for two terms. Under his leadership at the Department of Labor and Training, he reformed the unemployment insurance process. During his stewardship as Director at Elderly Affairs (since January 2015), he has led a division providing services and advocacy for over 166,500 older adults living in Rhode Island.

As a Glocester resident he was elected to the Glocester Town Council in 1984 and in 1990 was elected as a state senator, where he served for eight years. While a state senator, he served as both majority whip and Senate President Pro Tempore.

Fogarty Reflects on RIDEA Tenure

“Throughout my career, I have felt drawn to serve the people of Rhode Island. I look back fondly and feel fortunate to be a part of the forward progress Rhode Island is experiencing–particularly working with Governor Raimondo to empower seniors and help them to remain independent and living in the community,” said Fogarty.

According to Fogarty, under his helm, RIDEA has continued to process of supporting community-and home-based services for seniors and caregivers, but more needs to be done in order to really rebalance Rhode Island’ long-term care system. Aging in the community- in our own homes- is what many Rhode Islanders want for ourselves and our loved ones, he says.

“We’ve restored funding for Meals on Wheels, provided additional funding for respite services, and this year are proposing to double the amount the state invests in senior centers. Senior centers are primary gateways in the community that connect older adults and caregivers to services that can have profound impacts upon their ability to remain healthy and independent,” notes Fogarty.

Fogarty says, “If the general assembly follows Governor Raimondo’s lead and doubles the funding for senior centers, Rhode Island will be taking a huge step in the right direction of providing the appropriate support to these essential senior services.”

“We need to prepare for the shift in demographics that is occurring, and accept that the old model of providing long term care services isn’t working for the large number of Boomers who are marching towards retirement and old-age. RIDEA and other key partners are engaging in the Age-Friendly Rhode Island initiative, and we all need to work together to provide more choices and options for Rhode Islanders as they age, empowering them, and helping them to remain independent and healthy,” adds Fogarty.

Tributes to Fogarty

“Charlie has dedicated his entire professional life to Rhode Island and we thank him for his decades of service to our state,” said Governor Gina M. Raimondo, in a statement, recognizing the key role he played as DEA Director in expanding Meals on Wheels and in repealing the tax that seniors pay on their Social Security.

“As sitting Lt. Governor, I appreciate Charlie being a resource to me on issues important to our state’s seniors. Under his leadership, the Division of Elderly Affairs has been a hands-on partner in executing the initiatives of the Long Term Care Coordinating Council and the Alzheimer’s Executive Board,, says Lt. Governor Dan McKee.

“We are especially grateful for Charlie’s support in launching our Age Friendly RI Report in 2016. In a few weeks, we will be announcing an exciting development in Rhode Island’s Alzheimer’s State Plan that would not be possible without Charlie’s participation. I have enjoyed working with Charlie and I wish him all the best as he begins this exciting new chapter,” adds McKee.

Maureen Maigret, Vice Chair Long Term Care Coordinating Council, sees Fogarty’s experience as oversight as Lt. Governor of the state’s Long-Term Coordinating Council, gave him the insight ad understanding of long term care issues and the needs of older Rhode Islanders.

Maigret says that professionals in the aging network will remember Fogarty for his strong support for and educating the community about need to expand services that help older persons to stay at home and live independently for as long as possible and to pay attention to caregiver support needs.

Adds AARP Rhode Island State Director Kathleen Connell, “I have known Charlie for many years and know him to be a worthy heir of his uncle, the late-great RI Congressman, who was a leading champion of legislation and policy benefiting older Americans.”

“At Elderly Affairs, he utilized many skills and resourcefulness acquired through his time as a legislator, Lt. Governor and Labor & Training director — not to mention his personal interest in the health and wellbeing of all Rhode Islanders. His leadership has been an enormous asset at the Division of Elderly Affairs,” says Connell.

After his retirement from four decades of state service, he will continue to serve on the faculty at Johnson & Wales University, as Adjunct Professor of Leadership Studies. He also plans to volunteer with Meals on Wheels, having seen the significant impact the home-delivery meal program has on combatting senior isolation. He will also continue to be involved at his church.

On a personal level, Fogarty plans to “learn to cook,” by enrolling in cooking classes, travel and perhaps learn to speak Spanish.