It’s Time to Pass RAISE Family Caregivers Act

Published in the Pawtucket Times on September 18, 2017

Editor’s Note: Four months after S. 1028, titled the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act, was introduced in the Senate, an updated House companion bill (H.R. 3759) gets dropped into the chamber’s legislative hopper. On September 13, Reps. Gregg Harper (R-MS) and Kathy Castor (D-FL) along with original cosponsors Reps Michelle Lujan Grisham (D-NM) and Elise Stefanik (R-NY) introduced the legislation that calls for the development of a strategy to support family caregivers. It was referred to House Committee on Education and the Workforce. At press time, Rep. David Cicilline (D-RI) will shortly become a cosponsor of H.R. 3759.

On May 3, Sens. Susan Collins (R-ME), the Chairman of Senate Aging Committee, and Tammy Baldwin (D-WI) reintroduced the RAISE Family Caregivers Act, with Sens. Lisa Murkowski (R-AK) Michael Bennet (D-CO) signing on as cosponsors. At press time, there are now 12 cosponsors. Sen. Collins and Baldwin and Reps. Harper and Castor first introduced the family caregiver legislation in July 2015, and it passed the Senate unanimously in December 2015.

Eight days later the Senate Health, Education, Labor and Pensions Committee unanimously passed this legislation by a voice vote later that month and the bipartisan legislation will now be considered by the full Senate.

The Nuts and Bolts

The House bill introduced this week is updated from the Senate version introduced in early May. That Senate version is almost identical to the Senate-passed version from 2015.

The RAISE Family Caregivers Act directs the Secretary of Health and Human Services to develop and update a national strategy to support family caregivers. The legislation would also create a Family Caregiving Advisory Council comprised of relevant Federal agencies and non-federal members, also including family caregivers, older adults with long-term care needs, individuals with disabilities, employers, health and social service providers, advocacy organizations engaged in family caregiving, state and local officials, and others with expertise in family caregiving.

The newly established Advisory Council would be charged with making recommendations to the Secretary. The strategy would be updated to reflect new
developments. The Advisory Council’s initial report would include an initial inventory and assessment of federally funded caregiver efforts that would be incorporated into the initial strategy. The strategy would then identify recommended actions that government, providers, communities, and others could take to support family caregivers.

The activities under the bill would be funded from existing funding appropriated for the Department of Health and Human Services. No new funding is
authorized and it would sunset in five years.

This bipartisan caregiver legislation has been endorsed by over 60 aging and disability organizations, including the AARP, the Alzheimer’s Association, the w Michael J. Fox Foundation and the Arc.

Shouldering Caregiver Burdens

“Every day, more than 40 million ordinary Americans take on the challenge of caring for parents, spouses, children and adults with disabilities, and other loved ones so they can live independently at home and in their communities,” says AARP Chief Advocacy & Engagement Officer Nancy A. LeaMond. “The RAISE Family Caregivers Act is a commonsense, bipartisan step to recognize and support our nation’s family caregivers. AARP appreciates the leadership of Representatives Harper and Castor, and we urge Congress to pass this important piece of legislation,” she notes.

According to LeaMond, the nation’s family caregivers assist loved ones with eating, bathing, dressing, transportation, medical tasks, managing finances, and more. Many do this while working full time and raising families. The unpaid care family caregivers provide—37 billion hours valued at about $470 billion annually—helps delay or prevent more costly care and unnecessary hospitalizations, saving taxpayer dollars.

“Caregiving is, in one way or another, now an inevitable part of everyone’s future,” said AARP Rhode Island State Director Kathleen Connell. “It has been said that if you ask people about caregiving they fall into one of three or more categories: They know a caregiver, they are a caregiver or they will require a caregiver. AARP works hard at the state and federal level to direct resources and support to family caregivers. In Rhode Island, we have fought successfully for temporary caregiver insurance (TCI), the CARE Act, accessory dwelling unit legislation and a new fund to help offset the cost of ‘livable’ home improvements that benefit caregiving and make aging in place easier.”

“In the upcoming special session of the General Assembly, another key caregiving bill will be before lawmakers,” Connell added. “Earned Paid Sick Leave will be especially helpful to working family caregivers whose employers do not offer paid time off. Temporary caregiver insurance requires several days advanced notice. That can be helpful, for example, if a family member has a scheduled test or medical procedure. Earned paid sick leave would allow employees to used paid sick time when they are called away to attend to immediate emergencies.”

“The RAISE Family Caregivers Act is intended to provide a policy framework for improving caregiver support from national level down to states, cities and towns. In short, where the caregiver rubber meets the road,” Connell said.

Caregiver Legislative Proposal a Bipartisan Issue

According to AARP’s Public Policy Institute, there are 40 million family caregivers in the United States who provided an estimated $470 billion in uncompensated long-term care in 2013. In the Ocean State at any time during the year, an estimated 134,000 Rhode Island family caregivers step up to provide 124 million hours of care for an aging parent or loved one, most often helping them to live independently in their own homes.

With many caregivers putting their own health at risk, experiencing experience high-levels of stress and have a greater incidence of chronic conditions like heart disease, cancer, and depression, these individuals need the support and assistance that the enactment of the RAISE Family Caregivers Act could help bring about. Both sides of the aisle must put their political differences aside and push for passage. Both Republicans and Democrats shoulder caregiving duties.

Quickly passing the RAISE Family Caregivers Act in the Senate and House and sending it to the desk of President Donald Trump for his signature is the right thing to do.

Report: Cognitive-Simulating Activities Good for Your Brain’s Health

Published in Woonsocket Call on August 6, 2017

Don’t expect playing “brain games” to have the long-term brain health benefits oftentimes reported in newspapers. According to a statement released last month by the Global Council on Brain Health (GCBH), the scientific evidence supporting the benefits of “brain games” is at best “weak to non-existent.” But, the researchers say you can engage in many stimulating activities to help sharpen your brain as you age.

GCBH’s latest statement on “Cognitive Stimulating Activities” follows earlier reports issued by this independent organization created by AARP, advocating on behalf of its 38 million members with the support of Age UK, one the United Kingdom largest charities advocating for seniors. Previous areas included: “The Brain Body Connection;” The Brain Sleep Connection;” and “The Brain and Social Connectedness.”

The 25-page GCBH report, released on July 25, says that while many find “brain games” to be fun and engaging activities, oftentimes the claims made by companies touting the game’s cognitive benefits are exaggerated. The researchers noted that there are many ways to support and maintain your memory, reasoning skills, and ability to focus, such as engaging in formal or informal educational activities, learning a new language, engaging in work or leisure activities that are mentally challenging, and connecting socially with others.

Keeping Mentally Sharp

The report debunks “brain health” myths, too. Contrary to the many stories told about the brain as we age, the GCBH finds that a person can learn new things, no matter their age. Getting dementia is not an inevitable consequence of growing older. Older persons can learn a second language. And, people should not expect to forget things as they age.

“The GCBH recommends people incorporate cognitively stimulating activities into their lifestyles to help maintain their brain health as they age,” said Marilyn Albert, Ph.D., GCBH Chair, and Professor of Neurology and Director of the Division of Cognitive Neuroscience at Johns Hopkins University in Baltimore, Maryland. “The sooner you start the better, because what you do now may make you less susceptible to disease-related brain changes later in life.”

“We know that the desire to stay mentally sharp is the number one concern for older adults,” said Sarah Lock, AARP Senior Vice President for Policy, and GCBH Executive Director. “Seeking out brain-stimulating activities is a powerful way for a person to positively influence their brain health as they age.”

GCBH pulled 13 independent health care professionals and experts together, who work in the area of brain health-related to cognitive functioning, to examine “Cognitively Stimulating Activities.” This group crafted the report’s consensus statement and recommendations after a close examination of well-designed randomized scientific studies published in peer review journals and studies replicated by other scientists.

Taking Control of Your Brain Health

The report concluded that people have control and influence over their brain changes throughout their lifespan. People can maintain their memory, cognitive thinking, attention and reasoning skills as they age by doing brain-stimulating activities. There is sufficient evidence that brain-stimulating activities are beneficial to staying mentally sharp over your lifespan

The researchers found through their literature review that training on a specific cognitive ability such as memory may improve that specific ability, but scientific evidence suggests you need to continue to apply that training to maintain or improve the ability over time.

The researchers also found that there is insufficient evidence that getting better at “brain games” will improve a person’s overall functioning in everyday life. Maintaining or improving your brain health is tied to the activity being “novel, highly engaging, mentally changing and enjoyable.”

The GCBH report suggested that just by learning a new skill, practicing tai-chi, learning photography, even investigating their family history, you can stimulate their brain and challenge the way they think, improving “brain health.” Also, social engagement and having a purpose in life, like “volunteering as a companion and mentoring others in your community,” can be mentally stimulating and improve your “brain health.”

But, the researchers say don’t forget physical activity, such as “dancing and tennis.” because the mental engagement and physical exercise can mentally benefit you, too.

The GCBH, founded in 2015, is an independent international group of scientists, health professionals, scholars and policy experts working on brain health issues. Convened by AARP with support from Age UK, the goal of the GCBH is to review the current scientific evidence and provide recommendations for people so that they can maintain and improve their brain health.

The full GCBH recommendations can be found here: http://www.globalcouncilonbrainhealth.org.

Yes, routinely challenging your brain can lead to improved “brain health. As the old adage says, “Use it or lose it.”

Three GOP Senators Derail ‘Skinny’ Repeal Maneuvers

Published in the Woonsocket Call on July 30, 2017

After seven years of vowing to repeal and replace President Obama’s Affordable Care Act, nicknamed Obamacare, Congressional GOP efforts went down in flames on Friday when Sens. John McCain, of Arizona, Susan Collins of Maine, and Lisa Murkowski, of Alaska, voted nay in supporting the Senate Republican’s “skinny” repeal bill.

Sen. McCain, giving his no vote with a thumb down gesture, left Republican Senators gasping and Democratic Senators clapping. The 80-year old Arizona Senator, recently diagnosed with an aggressive brain cancer, had flown back to vote. The Senator’s vote was considered the decisive vote to derail the GOP’s long-time efforts to repeal and replace Obamacare.

Senate Republicans Begin Efforts to Repeal Obamacare

On July 25, GOP leadership began its efforts to begin debate on the Senate health care bill to repeal AHA. On that Tuesday afternoon, the Senate passed a “motion to proceed” vote by 51-50, the deciding vote being cast by Vice President Mike Pence. The votes outcome allowed the upper chamber to begin debate on the Senate Republican’s Obamacare repeal-and-replace proposal. Sens. Collins and Murkowski had opposed this motion, but McCain, returning to Washington, D.C. after being diagnosed with brain cancer, voted yes to proceed with the debate.

Senators began a 20- hour period of debate, considering various amendments to the House version of the health care bill. By a vote of 43 to 57, the Senate rejected one version that included Sen. Ted Cruz’s (R-TX) controversial amendment that would have allowed those with pre-existing conditions to be separated into plans with much higher premiums. The Senate also rejected, by a vote of 45 to 55, another version that would have repealed the ACA with no replacement but with a two-year delay, giving GOP senators more time to create their replacement.

Late Thursday evening, GOP Senate leadership finally unveil its expected “skinny” repeal bill, formally called the Health Care Freedom Act, that would repeal ACA’s individual and employer mandates, temporarily repeal the medical device tax, and give states more flexibility to allow insurance that doesn’t comply with Obamacare regulations.

CBO’s analysis of the “skinny” repeal bill, estimated that 15 million more people would be uninsured next year than under Obamacare, with 16 million more in 2026, and that premiums would increase 20 percent next year, compared to current law.

Earlier that day, Sen. McCain and Republican Senators Lindsey Graham of South Carolina and Ron Johnson of Wisconsin, held a news conference threatening to oppose the “skinny” repeal bill if the House Speaker did not offer sound guarantees that the House would enter negotiations after the Senate passed it. They feared that the House would end up passing “the skinny bill” rather than a more comprehensive bill hammered out in conference committee.

Ryan’s carefully crafted statement to the concerned Senators that the House would be willing to go to a conference committee did not include a specific guarantee that the House would not vote on the Senate’s proposal. Both Graham and Johnson went on to vote for the legislation. But, after his surprising vote it seems that McCain still had his concerns.

Before the Senate vote, President Trump even tweeted his displeasure of Murkowski’s opposition, her no vote against debating Obamacare repeal, says the Alaska Dispatch News. The state’s daily newspaper reported that Interior Secretary Ryan Zinke called the state’s Senators, Murkowski and Dan Sullivan, to inform them that Murkowski’s vote would “put Alaska’s future with the administration in jeopardy.”

After Zinke’s call, “Murkowski, who chairs the Senate and Natural Resources Committee, sent a message back to the Interior Secretary and Trump. Overseeing the agencies confirmation process, a committee hearing on nominations to the Interior and Energy departments, was “postponed indefinitely” with no reason given, stated the Alaska Dispatch News.

Finally, early Friday, by a vote of 49-51, Senate Republicans failed to repeal Obamacare with three Republican senators — McCain, Collins and Murkowski – joining 48 Democrats to vote against the “skinny” repeal bill. Sen. McCain’s reputation as a political maverick was evident when he voted against GOP Senate leadership. But, this vote will be considered his political legacy.

A Sigh of Relief

Reacting to the defeat of the Senate’s ‘skinny’ repeal bill, AARP Executive Vice President Nancy LeaMond, in a statement, called the vote “a victory for Americans age 50-plus.”

“The ‘skinny’ bill the Senate defeated would have dramatically increased health care costs, caused millions to lose their health coverage, and destabilized the insurance market,” says LeaMond.” She also thanked Senators Collins, McCain, and Murkowski, Senate Democrats and Independents who “called, emailed, rallied and wrote to object to this seriously flawed bill.”

Max Richtman, President and CEO of the National Committee to Preserve Social Security, in a statement stated, “Senators Susan Collins, Lisa Murkowski and John McCain were under extreme pressure from the White House and their colleagues to vote with the party instead of voting for the American people. It’s important to applaud them for stopping this train wreck of a healthcare bill. We have to wonder, however, why other Senators were willing to put their constituents at risk by cutting off their healthcare coverage.”

“We urge the majority party to put raw politics aside and work with Democrats to improve the Affordable Care Act in a way that benefits millions of American families in both blue states and red states. Let’s move forward, not back,” said Richtman.

A Bipartisan Approach

President Trump and Congress must finally listen to listen to their constituents to create policies to bring health care coverage to those in need. It is time to put politics aside and work in a bipartisan manner to hammer out a viable solution to provide affordable health care insurance to millions of Americans without coverage. McCain, Collins, and Murkowski, did just that when they resisted their party’s pressure to vote their own personal conscience not party line. They believed that the bill they voted against would do more harm than good.

Obamacare can be reworked to become more cost effective and to provide more health insurance to those in need of coverage. A recently released USA Today/Suffolk University poll at the end of June says that “just 12 percent of Americans support the Senate Republican health care plan. But, “a 53 percent majority say Congress should either leave the law known as Obamacare alone or work to fix its problems while keeping its framework intact.”

The majority of America says keep Obamacare, but make it better. Hopefully, lawmakers will listen.