Tag Archives for Administration for Community Living

HHS Shake-Up Sends Shockwaves Through Aging Network

Published on April 31, 2025

Taking a page from President Donald J. Trump’s to “Make America Great Again,” last week the U.S. Department of Health and Human Services (HHS) announced a major restructuring of the federal agency to “Make America Healthy Again.” The dramatic restructuring in accordance with Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”

The U.S. Department of Health and Human Services (HHS), under management of HHS Secretary Robert F. Kennedy, Jr., last week announced a major restructuring and renaming of the federal agency under the initiative “Make America Healthy Again.” This dramatic reorganization follows Trump’s Executive Order, Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” said HHS Secretary Robert F. Kennedy, Jr. in a statement announcing the massive overhaul. “This Department will do more—much more—at a lower cost to taxpayers.”

“Over time, bureaucracies like HHS become wasteful and inefficient, even when most of their staff are dedicated and competent civil servants,” Kennedy added. “This overhaul will be a win-win for taxpayers and those HHS serves. That’s the entire American public, because our goal is to Make America Healthy Again.”

During the Biden administration, HHS’s budget increased by 38%, and its staffing grew by 17%, prompting the new HHS chief to place the federal agency on the budgetary chopping block.

According to HHS, this restructuring will not impact critical services while saving taxpayers $1.8 billion per year through a reduction of approximately 10,000 full-time employees. When combined with other cost-cutting initiatives, including early retirement, and the Fork in the Road program, the total downsizing will reduce HHS’s workforce from 82,000 to 62,000 employees.

HHS also plans to streamline departmental functions. Currently, the agency’s 28 divisions contain redundant units. Under the restructuring plan announced on March 27, 2025, these units will be consolidated into 15 new divisions, including a newly created Administration for a Healthy America (AHA). Additionally, core organizational functions—such as Human Resources, Information Technology, Procurement, External Affairs, and Policy—will be centralized. The number of regional offices will be cut from 10 to five.

As part of the restructuring, several agencies will see workforce reductions. The U.S. Food and Drug Administration (FDA) will cut approximately 3,500 full-time employees, focusing on streamlining operations and centralizing administrative functions, though HHS asserts these reductions will not affect drug, medical device, or food reviewers, nor inspectors.

Similarly, the U.S. Centers for Disease Control and Prevention (CDC) will downsize by approximately 2,400 employees, refocusing its efforts on epidemic and outbreak response. The National Institutes of Health (NIH) will eliminate 1,200 positions by centralizing procurement, human resources, and communications across its 27 institutes and centers. Meanwhile, the Centers for Medicare and Medicaid Services (CMS) will cut around 300 positions, targeting minor duplication within the agency. HHS insists these changes will not impact Medicare or Medicaid services, but improve them.

Restructuring HHS to Focus on Chronic Illness Prevention

HHS’s overhaul aligns with the agency’s new priority of ending America’s chronic illness epidemic by focusing resources on ensuring safe, wholesome food, clean water, and the elimination of environmental toxins.

The Administration for a Healthy America (AHA) will consolidate five agencies—the Office of the Assistant Secretary for Health, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Toxic Substances and Disease Registry, and the National Institute for Occupational Safety and Health—into a single entity. This unification aims to enhance health resource coordination for low-income Americans, emphasizing primary care, maternal and child health, mental health, environmental health, HIV/AIDS, and workforce development.

Additionally, the Administration for Strategic Preparedness and Response, responsible for national disaster and public health emergency response, will be transferred to the CDC to strengthen its core mission of protecting Americans from health threats.

To combat waste, fraud, and abuse, HHS will create a new Assistant Secretary for Enforcement, overseeing the Departmental Appeals Board, the Office of Medicare Hearings and Appeals, and the Office for Civil Rights.

Furthermore, HHS will merge the Assistant Secretary for Planning and Evaluation with the Agency for Healthcare Research and Quality to form the Office of Strategy, enhancing research to inform policy decisions.
Critical programs under the Administration for Community Living (ACL), which supports older adults and people with disabilities, will be integrated into other HHS agencies, including the Administration for Children and Families, the Office of the Assistant Secretary for Planning and Evaluation, and the Centers for Medicare and Medicaid Services (CMS). HHS assures that these changes will not impact Medicare or Medicaid services.

Sounding the Alarm

Following the announcement of HHS’s restructuring plans, which would broad without a lot of detail, aging advocacy groups quickly released statements to voice strong concerns.

“For decades, the federal health programs that retirees and people with disabilities depend on have been ably administered under both Democratic and Republican administrations. However, the radical cutbacks proposed by the Trump administration place the delivery of these programs in jeopardy,” warned Dan Adcock, Director of Government Relations & Policy at the National Committee to Preserve Social Security and Medicare (NCPSSM).

Adcock also noted that HHS plans to eliminate the ALC and divide its responsibilities between two offices with no prior experience in this area. “This administration has already demonstrated a reckless disregard for public interests in favor of slashing operations and staff under the guise of ‘efficiency,’” he added. “So far, all they have done is create chaos and confusion, disrupting essential programs for seniors and the disabled. We view Secretary Kennedy’s plans with alarm.”

Nancy LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer at AARP, also urged HHS to prioritize older Americans’ health needs. “HHS must ensure access to senior centers, community health centers, nutritious meals, Medicare assistance, and other vital services that countless older Americans rely on. Health is central to the lives, well-being, and financial security of AARP’s members and the more than 100 million Americans over age 50,” she emphasized.

Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, echoed these concerns. “The announcement of workforce cuts at HHS comes at a time of unprecedented growth in America’s aging population. The proposed reorganization of ACL and its integration into other agencies requires careful consideration.”

Fulmer stressed that ACL administers programs essential to older adults’ daily lives, such as meal delivery, transportation to medical appointments, and chronic disease management. Absorbing these functions with far fewer staff demands careful planning. The government’s commitment to older adults requires a cautious approach, she said.

The Center for Medicare Advocacy also expressed deep concerns, particularly regarding plans to restructure ACL and consolidate oversight of Medicare appeals. “Given what we have seen with Social Security Administration cuts and restructuring, HHS’s claim that these changes won’t impact critical services rings hollow,” said Co-Director David Lipschutz.

LeadingAge, a national association representing nonprofit aging services providers, called for HHS to ensure older adults and their caregivers are not overlooked. “Cutting staff responsible for critical agency functions raises serious concerns. How will the work our members rely on get done? How will this impact quality care for older adults?” asked President and CEO Katie Smith Sloan.

Sloan also cautioned that reducing HHS’s field offices from 10 to five could impact CMS’s ability to oversee nursing home surveys and provider compliance. “A 25% workforce reduction must be undertaken with extreme care—especially given the millions of older adults who depend on these services,” she emphasized.

For a fact sheet on the HHS restructuring, visit https://www.hhs.gov/about/news/hhs-restructuring-doge-fact-sheet.html

Alzheimer’s Disease Initiative Program Grant Now Recruiting Rhode Island Participants

Published in RINewsToday on August 15, 2022

Last January, CareLink, a nonprofit network of post-acute and community-based providers, received a grant from the Administration for Community Living, a division of the U.S. Department of Health and Human Services. After the required planning period, and identifying community resources and referral organizations, and training staff, CareLink is now able to recruit program participants. Carelink, an East Providence-based healthcare organization, received funding for a three-year grant that offers innovative therapeutic services and programs. In addition, it connects participants with resources and provides caregiver education.  

CareLink’s services and programs will support older people with ADRD who live in the community alone or with a care partner, individuals with intellectual and developmental disabilities who are at greater risk for developing dementia, and persons living in ethnically and culturally diverse communities with limited access to medical care due to economic, language, or other barriers. 

The $904,133 Alzheimer’s Disease Program Initiative (ADPI) grant enables the nonprofit to better support the 24,000 Rhode Islanders with Alzheimer’s Disease and Related Disorders (ADRD). These services are even more critical as this number is projected to double by 2040. In addition to individuals with ADRDs, the grant targets services for individuals with intellectual and developmental disorders and those living at home alone with a diagnosis of cognitive impairment. 

Grant funds will be used to deliver two nationally recognized, non-pharmacological, evidence-based treatment programs – Cognitive Stimulation Therapy (CST) and Skills2Care®. These programs are provided to individuals living with ADRD, and when appropriate to their caregivers, at no cost. Specially trained CareLink occupational therapists and speech-language pathologists who have experience working with individuals with Dementia and their caregivers provide these interventions.   

Two Nationally Recognized Therapeutic Interventions to be Offered

CST addresses memory, thinking skills, and quality of life thru 14-biweekly sessions of structured 45-minute therapy sessions, featuring different topics.  Each session includes a warm-up activity, a song, and a “reality orientation board” that details the date, time, place, and weather.  Sessions include a variety of activities including the discussion of current news, listening and singing to music, playing word games, and participating in activities such as baking. This program can be provided using both individual and group sessions meant to foster social engagement and community. Both Speech-Language Pathologists and Occupational Therapists provide this beneficial program.

Skills2Care® provides training for the individual and their caregiver on managing challenging behaviors. This program, delivered by a trained Occupational Therapist, during five ninety-minute home visits, includes techniques to reduce challenging behaviors, promote functioning, improve caregiver communication, home environment safety, and tips focused on caregiver self-care, including problem solving and teaching stress management techniques. 

“Our focus is on providing innovative treatment for individuals with dementia and their caregivers,” explains Dr. Chris Gadbois, chief executive officer of CareLink, Inc. “We’re integrating interventions and supports for patients and caregivers within the home environment, building upon the recommendations of the individual’s medical professional and resources within the community.” 

“The strong relationships CareLink has with a wide array of community partners will enable this program to reach Rhode Islanders from different backgrounds across the state. We have been overwhelmed by the enthusiastic support of the community for this effort to improve the lives of patients and their caregivers,” says Gadbois. 

“The Rhode Island Alzheimer’s Disease and Related Disorders Advisory Council congratulates CareLinkRI on securing this competitive funding for these important services,” said Council Chair Nancy Sutton, MS, RD.

“A diagnosis of Alzheimer’s or a related dementia is a devastating diagnosis for an individual, their family, and their loved ones. People need to talk to their healthcare provider about any concerns of memory loss, regardless of their age. We know that an early diagnosis allows patients and caregivers to connect with services and resources right away—before they experience a crisis.”

“Dementia care is complex and requires a full team to assist patients and their families navigate the healthcare system and community resources. This funding helps to support and expand a much-needed program where providers can refer patients and caregivers as soon as they receive a diagnosis.”

Christine Gadbois, representing CareLinkRI, is an active member of the Rhode Island Alzheimer’s Disease and Related Disorders Advisory Council, and has informed the Council on this newly funded initiative. Other Council members include the Rhode Island Department of Health, Office of Healthy Aging, Butler Hospital, and Rhode Island Hospital’s memory clinics, and the Alzheimer’s Association – Rhode Island Chapter, and they are all collaborating with CareLinkRI to ensure easy access.

“Alzheimer’s disease and related dementias take such a toll on our communities, and support services like those provided through CareLink and its partners are essential for thousands of constituents and their families,” states Senator Louis DiPalma (D-District 12). “I’m extremely grateful for this award to CareLink which will make an enormous difference in the lives of Rhode Islanders in the years to come.” 

While CareLink is the grant recipient and manager, they have partnered with numerous local agencies, including The Cove Center, Avatar, Trudeau Center, Accesspoint RI, and Meals on Wheels. CareLink is also reaching out to local medical providers, including specialty clinics such as RI Mood and Memory. “We know it is critical to engage community partners to successfully reach a diverse group of individuals who will benefit from these services across the state,” says Robyn Earley, Chief Growth Officer of CareLink. 

“We know these programs are impactful and we are working to integrate these services into the larger landscape of resources for persons with dementia and related disorders, adds Earley. 

Looking for Participants

On May 26, 2022, Earley reports that CareLink began its recruitment efforts for study participants in the community through general outreach. “We are now working on outreach to Rhode Island medical providers, senior centers, intellectual and developmental disability service organizations, senior housing, and other community agencies that serve individuals with cognitive impairments. We are targeting individuals at home through outreach/partnership with MOW, Hope Health, etc.” she says, noting that a plan is in place to outreach to Resident Services Coordinators at senior high-rises to reach the live-alone population.

“The investment in these therapeutic tools has a significant impact on the quality of life and independence of those with dementia,” she says. These interventions enable individuals with cognitive impairments such as ADRD to live longer and more successfully in the community. 

Ultimately, CareLink intends to provide services to over 300 people by the end of grant, three years from now.  

“We have already learned so much from the first month of service and I anticipate continued growth and learning throughout,” says Earley.

For details about this study or for referrals, please contact CareLink at ADPLdementia@carelink.org.  Or call 401 490-7610, Ext. 116.  

To learn more about CareLink, go to www.carelinkri.org/

Herb Weiss, LRI’12, a Pawtucket writer covering aging, health care and medical issues. To purchase his books, Taking Charge: Collected Stories on Aging Boldly, and a sequel, go to herbweiss.com.

AARP Town Hall Gives Its Best to Educate Seniors on COVID-19

Published in the Woonsocket Call on April 5, 2020

With more than 278 Americans now infected with the Coronavirus virus (COVID-19) and at least 7,159 people dying from the deadly virus, according to an April 3 blog article the New York Times, “about 311 million people in at least 41 states, three counties, eight cities, the District of Columbia and Puerto Rico are being urged to stay home.” The Washington, DC-based AARP continues to intensify its efforts to educate seniors about COVID-19 by hosting weekly Coronavirus Information Tele-Town Hall events.

At AARP’s second Coronavirus Information Tele-Town Hall event, held Thursday, March 19, during the 90 minute live event, federal health experts gathered to answer questions about the latest changes to address the health impacts of COVID-19, family caregiving needs, and to give tips on how seniors can stay safe from scams and frauds. AARP’s Vice President Bill Walsh served a host and the panel of experts featured Dr. Jay Butler, M.D., the deputy director for infectious diseases at the Centers for Disease Control and Prevention, (CDC), Lance Robertson, the assistant secretary for aging and administrator of the Administration for Community Living (ACL) and Daniel Kaufman, the deputy director for the Federal Trade Commission’s Bureau of Consumer Protection. AARP’s Jean Setzfand. AARP’s senior vice president served as moderator.

CDC’s Butler called for the public to stay informed and take the coronavirus virus seriously. “As we’ve learned more about COVID-19, it’s very clear that most people who become infected do recover and do very well. But unfortunately, some get very sick. And some even die. And the risk of more severe illness is greatest for those who are older and for persons with underlying health conditions, especially chronic heart, lung or kidney disease, and those with diabetes,” he says.

Juggling Costs and Benefits While Promoting Social Distancing

According to Butler, grocery stores are juggling costs and benefits with promoting social distancing by designating special hours for seniors to shop if they don’t have someone who can make “that run to the grocery store or have delivery services available.”

“We’re at the end of flu season so if you develop symptoms (cough, muscle aches, headache, and temperature) it doesn’t mean that you have COVID-19, says Butler. For those concern, it is important to talk with your health care provider who will determine whether or not you should be evaluated and whether or not a test may be necessary, he adds, noting that COVID-19 testing is now covered by Medicare Part B when it’s ordered by a health care provider.

“Of course, if you suddenly become very ill—and that would be things like shortness of breath, chest pain, difficulty in getting your breath at all or noticing that your face or your lips are turning blue—that’s when you call 911, and get in as quickly as possible,” says Butler.

Butler notes that the primary transmission of the COVID-19 virus (as well as the six other coronaviruses that were previously known to cause disease in humans), is respiratory droplets.

By coughing or sneezing you produce droplets that contain the virus that can spread as far as five or six feet away from you, he says stressing that this is why social-distancing can protect you from catching the virus.

Many express concerns that COVID-19 can be picked up by handling letters and packages. But, says that the likelihood of transmission of is extremely low. So, consider sending a package a loved one in an assisted living facility or nursing home because it can be meaningful, says Butler.

For those over age 75 to age 80, Butler recommends that these individuals practice social distancing by connecting with their children or grandchildren by phone video chat to being exposed to COVID-19.

Butler gave simple tips for residents of senior living complexes to protect themselves from COVID-19. When you come back into your apartment after taking out trash to the chute or dumpster, “wash your hands,” he says. “And that means about 20 seconds with soap and water.

It seems like a long time but it’s the same amount of time it usually takes getting through the alphabet or to sing Happy Birthday twice,” adds Butler. Or just use a hand sanitizer with at least 60 percent alcohol as an alternative to hand washing.

ACL Administrator Robertson provided tips to unpaid caregivers who cannot visit their loved ones in nursing homes due to the necessary visiting restrictions. He says, get the facility’s up-to-date contact information along with details as to ways as how to make virtual visits, video chats and regular phone calls. He says, don’t forget to send cards and notes, not only to your loved one, but to other residents even to staff to say thank you.

Communicating with Your Loved Ones

Enhance your verbal communication by asking the facility staff to schedule the time for your call. “If your mom is most alert in the morning, pick a morning time, think about what music they might like and play that in the background or sing along or sing directly to your loved one,” recommends Robertson.

Robertson notes, “If you find the conversation struggling a bit, maybe play a game of trivia, reminisce, work on a crossword puzzle together, sing songs, read poetry or other materials.

Watch a TV show at the same time and just discuss. Again, throw in some creativity and you can help prevent both boredom and isolation.”

For those more technically savvy, face-to-face interaction through FaceTime, Messenger, Facebook, Zoom, can enhance your contact, says, Robertson.

Adds Robertson, make sure you ask the facility staff to keep the scheduled time of the care conference, holding it over the phone. “We know they’re busy, but it’s imperative that you remain linked as a caregiver,” he says.

For those caregivers seeking resources to take care of their loved one at home, call ACL’s Eldercare Locator, recommends Robertson. It’s toll-free 1-800-677-1116.

During this COVID-19 emergency FTC’s Daniel Kaufman warned that you will see “unscrupulous marketers” trying to take advantage of senior’s fears by selling them bogus treatments. In early March, he told the listeners that the FTC and the U.S. Food and Drug Administration (FDA) sent out warning letters to seven companies that were claiming products (such as cheese, essential oils and colloidal silver) could treat or prevent the coronavirus. He quipped, these companies are not making these claims anymore and urged seniors to report any scams they come across by going to ftc.gov/complaint.

Kaufman says that seniors can also go to ftc.gov/coronavirus or just go to ftc.gov to see a very prominent link for coronavirus scams. If you want to receive consumer alerts directly from the FTC, you can go to ftc.gov/subscribe.

Skyrocketing of COVID-19 Related Scams

According to Kaufman, FTC is seeing an increase in scams, from phishing emails, charity and stock scams, to robocalls selling cleaning supplies and masks.

“We are seeing a lot of bogus emails that are going out to consumers, that use headers about coronavirus to get people to open them. You know, these are fake emails that are purporting to come from legitimate and important organizations like the World Health Organization or the CDC,” says Kaufman. “Don’t click on links when you get those emails. Don’t open those emails. They will download viruses or be harmful to software onto your computer, or they will try to get your private information or credit card information,” he adds.

Watch out for charity scams, too, warns Kaufman. “You know, this is a difficult time and we all want to help. But we want to make sure we’re helping charities and not scammers who are pretending to be charities, he says, suggesting that you do your homework to protect your pocketbooks.

With COVID-19 spreading across the nation you are now seeing more robocalls touting products and services to protect you from being exposed to virus. “Just hang up. Keep in mind that anyone who’s robocalling you, if they’re trying to sell you a product, they’re already doing something that’s unlawful,” he says.

Kaufman also recommends that seniors use a credit card when purchasing products, whether it’s cleaning supplies or masks, on websites. “It’s pretty easy to set up a website that’s purporting to provide, to sell these kinds of products. And they’re taking consumers’ payment information but not delivering, he notes.

Finally, Kaufman urges seniors to watch out for watch out for fraudsters who are touting that a certain company’s stock that is certainly going to explode because they have products that can treat coronavirus. Don’t fall for this stock scam and buy this stock.

For the latest coronavirus news and advice, go to http://www.AARP.org/coronavirus.

To see transcript, go to http://www.aarp.org/health/conditions-treatments/info-2020/tele-town-hall-coronavirus-03-19.html.