LCAO Calls for Fourth Stimulus Bill to Protect the Health and Well-Being of Seniors

Published in the Wooonsocket Call on April 19, 2020

As part of the Economic Impact Payment provision in the recently enacted $ 2.2 trillion stimulus bill, at press time about 80 million Americans have already received their $ 1,200 stimulus check ($2,400 for joint filers) through direct deposit. But for those 70 million Americans waiting for this payment by paper check, this Congressional handout may not be delivered to their mail box by early May, predict a Democratic Senator.

While the U.S. Treasury Department denies that embossing President Donald Trump’s signature on the “memo” section of the check will delay the delivery of paper checks, Senate Finance Committee Ranking Member Ron Wyden, (D-Ore.) disagrees.

A Break in Protocol

In an April 15 statement, Wyden stated: “Donald Trump is further delaying cash payments to millions of Americans struggling to pay the rent and put food on the table to feed his ego. Only this president would try to make a pandemic and economic catastrophe all about him.”

According to an article published in the Washington Post on April 14, “It will be the first time a president’s name appears on an IRS disbursement, whether a routine refund or one of the handful of checks the government has issued to taxpayers in recent decades either to stimulate a down economy or share the dividends of a strong one.”

The Washington Post article, penned by Reporter Lisa Rein, reported that Trump had initially approached Treasury Secretary Steven Mnuchin, who oversees the Internal Revenue Service, to be allowed to sign the checks. “But the president is not an authorized signer for legal disbursements by the U.S. Treasury. It is standard practice for a civil servant to sign checks issued by the Treasury Department to ensure that government payments are nonpartisan,” says the article.

Political insiders say that we can expect to see a fourth stimulus package hammered out between the Democratic-controlled House, the GOP-led Senate and Trump, to pump billions to jumpstart the nation’s sputtering economy. A second round of cash payments may well be part of this economic stimulus package, they say.

“We could very well do a second round,” said President Donald Trump at a White House news conference held over a week ago. “It is absolutely under serious consideration,” he said.

Last week’s commentary publicized Max Richtman, president and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, call to Congress to protect seniors in a fourth stimulus package (go to https://herbweiss.blog/2020/04/12/congress-must-protect-seniors-in-phase-four-stimulus-package/).

The continuing political battle over crafting the fourth stimulus bill has been put on hold for now with Democratic and WRepublican congressional leaders extending recess. After conferring with public health experts, the House and Senate will not come back into session until, Monday, May 4th.

Calling on Congress to Protect Seniors During the COVID-19 Pandemic

In an April 8 letter, the Washington, DC-based Leadership Council on Aging Organizations (LCAO), representing 69 national nonprofit organizations, urged Congressional lawmakers to ensure that a fourth stimulus package will protect the health and wellbeing of seniors and their families. LCAO’s 19-page communication provides over 50 recommendations (in the areas of housing services, income security and health and community resources) that are key to helping and providing the needed support to assist seniors cope with the raging COVID-19 pandemic.

Specially, LCAO calls on Congress to put funding for affordable housing in a fourth stimulus bill, by funding $ 1.4 billion for federally assisted housing supports to make up for vacancies along with decreased rents from HUD-and USDA-assisted older adult residents, and for emergency housing assistance. Investing $1 billion for new Section 202 Homes would result in short-and long-term jobs as well as 3,800 affordable homes becoming available with service coordinators, says LCAO. Congress was also requested to allocate $450 million in emergency assistance for HUD-assisted senior housing communities, too.

LCAO opposes any attempts to weaken the nation’s Social Security and Medicare programs. The aging group strongly resists any efforts to include a provision in the stimulus bill that would eliminate the payroll contributions to these programs and pushes for the expansion of Social Security and Supplemental (SSI) benefits to enhance the income security of America’s retirees.

Over 10 million workers and retirees have earned benefits under multiemployer pension plans, says LCAO, urging Congress in their letter to allocate sufficient funds to protect the “hard-earned benefits” of these retirees.

With a growing number of the nation’s seniors relying on the support of caregivers, LCAO calls for support of older adult caregivers and children through the expansion of the refundable tax credit for “other dependents.”

Within the next five years, 25 percent of the workforce will be age 55 and over, says LCAO, noting that it becomes crucial to provide adequate funding to the Senior Community Service Employee Program for workforce training.

It’s important to protect seniors from confusing and unfair billing hospitals and payment scams. This can be accomplished by establishing standards for billing that will help seniors manage the aftermath of health care costs due to the pandemic.

Each year, Medicare loses $60 billion to fraud and abuse. LCAO also requests $20 million for the Senior Medicare Patrol to educate Medicare beneficiaries on combating fraud and abuse scams.

LCAO’s letter also asked Congress for adequate funding of mass testing for COVID-19, data collection and accelerate Medicare enrollment to provide seniors and people with disabilities with access to needed medical treatment, two populations with the highest risk for being afflicted by the devastating virus. Congress must also ensure access and affordability to prescription drugs, says the Washington, DC-based aging advocacy group.

LCAO urged Congress to give states sufficient Medicaid funding to keep hundreds of thousands of Medicaid recipients from losing health coverage, which would increase the risk of these individuals spreading the COVID-19 virus.

The need to social distancing may force day care centers to close. LCAO says that a fourth stimulus bill package might add language within the Medicare and Medicaid Home and Community Based Service funding to authorize states to apply retainer payments to adult day care centers for the purpose of providing services to seniors outside the physical center.

LCAO also made a recommendation to prevent the unnecessary transfers of seniors to hospitals and nursing homes and support those recovering from COVID-19 by increasing beneficiary access to home health care by eliminating Medicare’s requirement that they be home bound to quality for this benefit.

LCAO’s letter supported the expanded access to hospice care by allowing physician assistants to certify need and to create a federal fund to identify and set up alternative care sites to nursing homes that meet the same minimum federal standards of care.

LCAO pushed for an additional $50 million to fund the Medicare State Health Insurance Program, a program providing unbiased, free and personalized information to assist seniors to chooses Medicare products, to help seniors understand their specific health care coverage needs under this COVID emergency.

The fourth stimulus bill, says LCAO, must also include funding to ensure providers in health care facilities and at community-based programs, be given personal protective equipment. These providers should be provided free child care and sick leaved during this crisis, too.

Considered “a frontline resource in the battling the pandemic,” LCAO calls for the adequate funding to Geriatric Workforce Enhancement Program, administered by the Health Resources Administration.

LCAO, noting the importance of federal programs that assist seniors to stay at home (including the Older Americans Act that directly serve seniors and caregivers, and the Supplemental Nutrition Assistance Program, the largest federal nutrition program), asks Congress to increase funding, benefits and streamline the application process to these programs to address healthcare and food needs during this pandemic.

With the COVID-19 virus spreading throughout the nation’s nursing homes and assisted living facilities, LCAO calls for more funding to the nation’s long-term care ombudsman program for remote online training and education of nursing facility staff and volunteers, and to the National Ombudsman Resource Center for training materials.

With elder abuse and neglect cases in the community reaching 63,000 in 2018 and an expected surge in incidences due to the pandemic, LCAO calls for funding of $ 120 million for the nation’s state and local Adult Protective Services programs in the next stimulus bill. Also, allocating $4.1 billion for the Social Service Block Grant Program can provide critical services to vulnerable seniors through adult protective services, adult day care and in-home support services, congregate and home delivered meals, case management programs.

Finally, in a fourth economic response package, LCAO calls on lawmakers to include $15 million for the Retired Senior Volunteer Program and $10 million for the Senior Companion program to provide volunteer opportunities for seniors in their communities during the pandemic crisis. Congress might also consider “easing or suspending the current age requirements for participation,” to allow younger seniors to participate.

Remember Your Older Constituents

With the Trump Administration and GOP lawmakers pushing to put billions of dollars into the fourth stimulus bill to support the nation’s large corporations and small businesses, during the COVID-19 pandemic, it is important for Congress to not forget the needs of the nation’s seniors. If you run into your Congressman or Senator, make sure you urge them to seriously consider the needs of their older constituents.

To get a copy of LCAO’s letter to Congress, go to https://www.lcao.org/files/2020/04/LCAO-April-2020-Letter-for-COVID-19-Package-4-FINAL.docx.pdf .

Reflecting on a Loved One’s Life Time of Achievements

Published in the Woonsocket Call on December 29, 2019

A few weeks ago, my sister Nancy called to give me the bad news that my brother-in-law, Justin Aurbach, was diagnosed with an aggressive and deadly cancer known as glioblastoma, or more commonly referred to as GBM. This 77 year old Dallas-based endodontist who I knew as relatively healthy, a believer in vitamins and physically active most of his adult life, was now house-bound receiving 24 hour a day care by home health caregivers, along with his daughters Stephanie and Allison, and his partner Ruth who were now all part of a revolving schedule of care.

I booked a quick trip to Dallas to sit with him and show my support and concern. It had been a few years since I had been there and I wondered what the conversation might entail, knowing that our 53-year old relationship could cover a lot of ground. Justin and my sister were always collectors of art, and I soon found myself sitting at a kitchen table, surrounded by colorfully carved images of watermelons, where he and I reminisced as the time flew by.

Justin reminded me that we first met in 1967 when he came to pick-up my older sister Mickie, taking her to dine at Campisi’s Restaurant, a local pizza hangout. Even though it took place over five decades ago, he clearly remembered first meeting my mother as she greeted him from the couch, sitting with her thick soled shoes propped up on the ottoman, smoking a cigarette and wearing her trademark leopard print blouse. He recalls her holding Tony, the family’s three-legged Toy Poodle.

A year later, Mickie and Justin would recruit my twin brother, Jim and me to be ushers at their wedding in 1968. Through the ebb and flow of their life together, from raising children, grandchildren and building a successful dental practice, he reflected on their 41 year marriage, noting ‘how it flew by’ before Mickie passed in 2008.

Justin reminded me of the sage advice he gave me before I entered my freshman year at the University of Oklahoma. “Drink in moderation and put studies before chugging pitchers of beer,” he said. It is funny the things you tend to remember, I thought.

As our conversation became more focused on his health, Justin thought that the symptoms of the tumor might first have appeared over five years ago, when he became dizzy while taking a bike ride. Last August, the symptoms returned while riding again, and a Cat Scan would ultimately reveal his tumor.

Turning 60

In 2003, I had the opportunity to interview Justin about turning age 60 for my weekly senior commentary in the Pawtucket Times. He shared the following thoughts about being at the peak of his career professionally, while only five years shy of reaching retirement age.

In my commentary, Justin said, “It’s great [moving into your 60s], however, far too much [cultural] negativity has been directed at this chronological age.”

At that time, my brother-in-law was in relatively good physical shape. While he would acknowledge that he could not run a four-minute mile, he joked that he never could anyway. As he approached his sixth decade, he admitted that he played a little golf like many of his friends, walked and jogged, and even took time to lift weights.

Dr. Justin E. Aurbach, DDS, had accomplished much in his career by the age of 60. As the first endodontist in the Dallas-Fort Worth area, he was the first in the region to perform endodontic microsurgery, when at that time there were only 78 endodontists in the nation performing such surgery. He is past president of the DFW Endodontic Society, The Southwest Society of Endodontics, and the Dallas County Dental Society. He served as general chairman of the Southwest Dental Conference.

Justin believed strongly that he would still be ‘at the top of his professional game, improving with age’, as he proudly boasted. During my interview with him, he said, “not only am I technically better, but my years of life experience have made me wiser in respect to knowing what can and cannot be done in my life.”

The endodontist attributed much of his success to his wife, children and the many supportive family and friends that were part of his large extended family.

By age 60, his philosophy of looking at the “glass half-full rather than half empty” allowed him to cope with life’s difficulties. This life stage was also a time of excitement and learning for him, while he glided into the years he referred to as “best time of your life.”

Getting to the Big “70”

Ten years later, we would speak again about his approaching the age 70 milestone. He reflected on how so much time had passed, which he noted flew by in “the blink of an eye.” During my 2013 interview with him published in my weekly commentary in this paper, he told me that he would “certainly keep forging ahead at a break-neck pace,” promising that new goals would replace those that were accomplished.

He recalled having attended dozens of funerals, said final goodbyes to his wife, father, father-in-law, mother-in-law, along with many close friends and colleagues. Justin noted that “reading the Dallas Morning News obituary page and constantly attending funerals made him aware of the need to accomplish his set goals with the limited time he had left -” but life goes on,” Justin told me. A year after his wife’s death in 2008, the aging widower again found love and began to date Ruth.

Looking ahead into his 70’s, Justin had no plans to retire. Though financially secure, he aspired to maintain a very full practice until his eighty-fifth birthday. He found added fulfillment teaching endodontic residents at Texas AM Baylor School of Dentistry, a job that he hoped would continue into his 70s, while also staying active in the medical group.

Justin has been an avid bike rider for over 30 years, and despite being 70, he would continue to sneak in a ride when possible, even with his busy schedule. He enjoyed the City of Dallas’s fine restaurants, loved to cook for family and friends, and looked forward to a good play or chamber music performance from time to time. His mantra may well be “Live your life to the fullest, don’t put off tomorrow what you can do today.”

Looking Ahead

Justin says, since the diagnosis of his terminal illness, his house has been flooded with family, friends, referring doctors and even former dental students. “I have made a lot of friends and accept that I have impacted people in a very positive way,” he said, as he cites as an upside of his illness.

As we concluded our talk, he says, “Don’t wait to do things. You never know what the future has in store for you,” adding that he learned this lesson from Ruth.
“Simple things in life are your best bet to living a good life,” Justin tells me, stressing that it doesn’t cost a lot of money to enjoy your life.”

Justin acknowledges that he may live another two to six months with the GBM tumor, but remains optimistic, for there are those who have lived for another 14 years. In his remaining time, he hopes to maintain a “quality of life” that allows him to continue to attend musicals and plays, or perhaps even take short trips.

Final Thoughts

As you reach your 60s and into your 70s, research tells us that exercise, eating a healthy diet, developing a strong social network of family and friends, and continuing to learn and seek out new knowledge all become important in enhancing the quality of your life and increasing your longevity in your later years. However, in our twilight years life can become of full of tough challenges and we may face difficult times.

Ultimately, like Justin, reflecting on personal and professional accomplishments can give you the inner resources necessary to meet the challenges in the final stages of your life.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Uncompensated Cost of Caregivers is a Whopping $470 Billion

Published in the Woonsocket Call on November 17, 2019

Approximately 41 million unpaid family caregivers provided an estimated 34 billion hours of care in 2017 — worth a whopping $470 billion — to their parents, spouses, partners, and friends, according to the latest report in AARP’s Valuing the Invaluable series. The 2019 estimated value of family caregiving is based on 41 million caregivers providing an average of 16 hours of care per week, at an average value of $13.81 per hour. Previous AARP Public Policy reports were released in 2006, 2008, 2011 and 2015.

“It’s encouraging to see greater recognition of the emotional, physical and financial struggles that caregivers face,” said Susan Reinhard, senior vice president, AARP Public Policy Institute, in an April 14th statement announcing the release of the 32-page report. “But the demands on family caregivers are not just a family issue and we must continue to push for meaningful support and solutions,” says Reinhard.

Every caregiver, as well as their families, know the value of their efforts,” said AARP Rhode Island State Director Kathleen Connell. “In Rhode Island, the estimated total value of 114 million hours of work by the state’s 136,000 caregivers is $1.8 billion. The aggregate is astounding, making a clear case for supporting this vital commitment made by family and loved ones.”

“These numbers inspire our members who spend many hours at the State House as AARP Rhode Island advocacy volunteers,” Connell added. “They have helped pass key legislation — the CARE Act, paid caregiver leaves and many other key bills — that have given caregivers resources and opportunities to make their task less daunting. Caregivers are truly invaluable,” she says.

Putting a Spotlight on the Nation’s Caregivers

AARP’s report notes that the estimated $470 billion equates to about $1,450 for every person in the United States (325 million people in 2017). Its economic impact is more than all out-of-pocket spending on US health care in 2017 ($366 billion). Uncompensated care provided by caregivers is also three times as much as total Medicaid spending on long-term services (LTSS) and supports ($154 billion in 2016) and even the total spending from all sources of paid LTSS, including post-acute care ($366 billion in 2016).

The AARP researchers say that the estimate of $470 billion in economic value of uncompensated care is consistent with nearly two decades of prior research studies, all of which found (like the current study) that the value of unpaid family care vastly exceeds the value of paid home care.

The AARP report, Valuing the Invaluable: 2019 Update Charting a Path Forward, also explores the growing scope and complexity of caregiving, including an aging population, more family caregivers in the paid workforce, and the increasing amount of medical and nursing tasks entering the home.

According to the AARP report, family care givers, who provide day-to-day supports and services and manage complex care tasks, are becoming more diverse. While most family caregivers are women, about 40 percent are men who are providing more assistance than just driving to doctor’s appointments and grocery stores or paying bills. Like all caregivers, they are assisting a parent, spouse or friend with bathing and dressing, pain management, managing medication, changing dressings, helping with incontinence and even preparing special diets.

While a majority of baby boomers are providing caregiving services, a growing number of younger adults are now shouldering this responsibility, too. Nearly 1 in 4 (24 percent) are millennials (born between 1980 and 1996). Despite their low salaries, the young adults are spending more of their salary on caregiving expenses than other generations. The researchers estimated that this spending in 2016 was about 27 percent of their income.

About 60 percent of family caregivers are juggling a job and providing care, too. This will continue as aging baby boomers choose to remain in the labor force to bring additional income into their household. Workplace benefits for caregivers becomes become even more important as they face economic and financial strain in their later years.

For those employees who choose to leave their job to become a full-time caregiver, they risk both short-and long-term financial difficulties, say the researchers.

Finally, the researcher’s recommendations to better support family caregivers included developing a robust and comprehensive national strategy with the needs of an increasingly diverse caregiver population included; providing financial relief and expanding workplace policies; developing caregiver training programs; and expanding state and federal funding for respite programs.

More Work Needs to Be Done

The AARP report warns that the rising demand for caregivers with the graying of the nation’s population, shrinking families will drastically reduce the supply. In 2010, there were 7.1 potential family caregivers for every person age 80 and over. By 2030, there may be only 4.1 potential caregivers for every person age 80 and over, they say.

Although significant federal and state policy are already in place to assist the nation’s caregivers, more work needs to be done, say the researchers. They call on Congress and state lawmakers to keep pace with the changing demographic, social trends and needs of the family caregiver.

Resources and information on family caregiving, including AARP’s Prepare to Care
Guides, are available at http://www.aarp.org/caregiving.