Tag Archives for James Firman

Trump Budget Proposal Makes Draconian Cuts to Aging Programs

Published in Woonsocket Call on March 19, 2017

Since his inauguration, GOP President Trump/s controversial and surprising Cabinet picks, some who have even called for the elimination of federal agencies that they were appointed to oversee, has sent a chilling message to the nation. That is business as usual is over inside the Washington Beltway, especially as to how federal dollars will be spent. The release of Trump’s first budget proposal, for fiscal year 2018, reveals draconian cuts throughout the federal government, this causing alarm among aging advocacy groups.

Trump Slashes Funding for Aging Programs and Services

James Firman, President and CEO, of the Washington, D.C.-based National Council on Aging (NCOA), notes Trump’s 62 page $.15 trillion budget proposal to remake the nation’s federal agencies and the programs they provide eliminates the Senior Community Service Employment Program (SCSEP), which provides job training and placement for adults 55 and over who have limited incomes and are trying to make ends meet. “Last year under SCSEP, 70,000 older adults received on-the-job training while providing nearly 36 million hours of staff support to 30,000 organizations, he says, noting that the value of this work exceeded $800 million, or nearly twice the program’s appropriations.

Trump’s budget proposal also zeros out the Low-Income Home Energy Assistance Program (LIHEAP), which provides assistance to low-income households to meet the costs of electricity, heating, and cooling, says Firman, noting that about a third of the nearly 7 million households receiving LIHEAP benefits include an older adult aged 60 or older.

Finally, Trump’s budget proposal eliminates the Corporation for National and Community Service (CNCS), which funds volunteer programs that serve distressed communities and vulnerable population, says Firman, noting that three Senior Corps programs (the Foster Grandparent Program, Senior Companion Program, and Retired Senior Volunteer Program (RSVP), will lose funding. “Together, these programs provide the nation with approximately 96 million hours of service, with a value of $2.1 billion,” he says.

“While the President’s budget blueprint does not cut Social Security Administration (SSA) funding (unlike the drastic reductions in non-defense discretionary spending), the 0.2% increase for SSA does little to solve serious customer service deficiencies for Social Security beneficiaries,” says Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare (NCPSSM). “Seven years ago, the SSA’s budget was cut by 10% (after adjusting for inflation), just as waves of Baby Boomers were beginning to retire and place a strain on the agency’s resources,” he says.

Richtman noted that while the numbers of Social Security beneficiaries were increasing, SSA was forced to implement a hiring freeze in 2016 and was not able pay its workers overtime. As a result, hold times on the SSA toll-free customer service number are now an average 15 minutes, more than 60 SSA field offices around the country have been shuttered, and the average wait time for a disability hearing has climbed up to 590 days.

Richtman points out that one million people are awaiting their scheduled disability hearing. “The disability case backlog and customer service will only get worse under the flat operating budget proposed by the President. To make up for previous cuts and restore vital services, the National Committee supports a 7% increase in the SSA’s operating budget,” he says.

NCPSSM’s Richtman warns that Trump’s “skinny budget” may keep millions of vulnerable seniors from participating in the Meals on Wheels program. As Meals on Wheels America has pointed out, Trump’s budget blueprint eliminates the U.S. Department of Human Development’s (HUD) Community Services Block Grant and Community Development Block Grant (CDBG), on which some local Meals on Wheels programs rely on to deliver nutritious meals, safety checks, and friendly visits to seniors who need these services. (The President’s budget blueprint does not mention the Older Americans Act, which provides 35 percent of Meals on Wheels funding nationally.)

Richtman calls on President Trump to ride along with a Meals on Wheels delivery van and see for himself how seniors thrive on the meals they receive and the much-needed human interaction that comes with the food. “Maybe then he would move to protect – rather than cut – this vital program for our nation’s seniors,” he says.

Budget Proposal Puts Food Delivery Program on Budgetary Chopping Block

Trump’s elimination of HUD’s CDBG program in his proposed budget proposal will drastically impact many Meals on Wheels programs across the nation, but, fortunately Meals on Wheels of RI (MOWRI) will not be hit as hard, says Heather Amaral, executive director of Meals on Wheels of RI. But, Rhode Island’s only non-profit home-delivered meal program, will be indirectly impacted by Trumps CDBG cuts, she worries, noting that other programs that support her work receive these HUD funds, specifically, community centers that house our Capital City Café sites or local drop-off sites for the Home Delivered program. The Senior Community Service Employment Program that provides staff for several of our Café sites is also slated for elimination in President Trump’s “Skinny Budget.”

Amaral also is concerned about Trump cutting the U.S. Department of Health and Human Services’ budget by 18 percent. “Our Older Americans Act Title III funding flows through this department. It is safe to assume that this significant cut will result in a reduction of our funding—funding that has remained at stagnant for over 10 years,” she says.

“It is impossible to predict any service cuts until a final federal budget is approved and any cuts to MOWRI are known. Any funding reductions will have a negative impact on her nonprofit agency’s ability to keep up with the increased demand of Rhode Island’s growing senior population,” says Amaral.

“Our programs directly address issues that are critical to Rhode Island’s vulnerable homebound seniors,” she says, noting that last year, MOWRI delivered 345,262 meals to over 2,560 homebound residents.

Last Thursday, White House budget director Mick Mulvaney defended the Trump budget proposal cuts to the widely popular Meals on Wheels program. He told reporters that the program “sounds great” but is “not showing any results.”

Amaral counters by saying that research is providing the tremendous benefits of participating in the meals and wheels program — for seniors, homebound, family members, municipalities and the Rhode Island

The Brown University “More than a Meal” Report (published 2015), a randomized, controlled study of Meals on Wheels Programs across the country, reported that those who received daily-delivered meals experienced the greatest improvements in health and quality of life indicators,” says Amaral. The most vulnerable of our recipients, those who live alone, were more likely to report decreases in worry about being able to remain in home and improvements in feelings of isolation and loneliness, she noted.

Meanwhile, a U.S. Administration on Aging (AoA) Study, published in September 2105, found that those receiving daily-delivered meals are more likely to report improvements in mental and physical health, reductions in feelings of isolation and anxiety about being able to remain at home, and lower rates of hospitalization and falls, adds Amaral.

“In that same report, AoA statistics show that a home delivered meal program can deliver a year’s worth of meals to a senior for the same cost as one day in the hospital, or one week in a nursing home, notes Amaral.

Speaking at the Hubert Humphrey Building dedication in Washington, D.C. on November 1, 1977, former U.S. Vice President (1965-69) Hubert Humphrey stated “the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.” A quick read of the Trump’s budget proposal revealing huge cuts for domestic programs, it’s clear to many that his Administration has failed it’s test.

If you want to learn more about MOWRI, sign up for meals, volunteer or donate, please visit http://www.rimeals.org or call 401-351-6700.

Better Understanding of Strokes Can Help Seniors Protect Their Health

Published in Pawtucket Times on May 19, 2003

Even if Americans know about the negative impact of their lifestyle choices, that knowledge may not be enough to change their behaviors, especially those behaviors that lead to strokes.

According to a new survey released by the National Council on Aging (NCOA), Americans understand that those who have had a stroke are at a greater risk for a future one, ye stroke survivors are not taking all the possible steps to protect their health.

Strokes can result from a sudden interruption of blood flow to any part of the brain, which can ultimately injure or kill brain tissue.

Strokes can lead to severe impairments, including debilitation from paralysis, short-term memory loss and even speech and vision problems. About one-third of all strokes are recurrent, even though there are lifestyle changes and medications available today that can help to reduce that risk.

In this telephone survey, which was funded by a grant from Sanofi=Synthelabo and Bristol-Myers Squibb, 66 percent of the survey respondents said they knew someone who had suffered a stroke, but many of those who survived were not exercising regularly (32 percent), refraining from smoking (19 percent) or watching their diet (18 percent). These simple lifestyle changes are known to help prevent future strokes.

“Those who have already had a stroke can make changes to their everyday routines  to lower their risk for a second stroke or heart attack,” Mark Alberts, M.D., professor of neurology, at Northwestern University Medial School in Chicago, stated in a NCOA release.

“It is particularly important that stroke survivors and their families or caregivers work closely with their physicians to develop an individualized treatment plan, which will often include medication,”  says Alberts.

Along with the basic lifestyle changes, taking appropriate medications can also reduce the risk of recurrent strokes.

For instance, the researchers say many patients may benefit from antiplatelet therapy that prevents blood platelets from sticking together and clotting, helping to reduce stroke risks.

According to the NCOA study, after surviving a stroke, men have a 42 percent chance of having another within five years, and women a 24 percent chance during that same time period.

The general public seems to be confused regarding what stroke risks factors and symptoms are, the researchers found.

The NCOA survey findings indicate that many Americans incorrectly identified excessive stress (87 percent), overexertion while exercising (56 percent), dehydration (38 percent), asthma attacks (24 percent) and wearing constrictive clothing (16 percent) as risks factors for stroke.

Additionally, survey respondents also mistakenly selected shortness of breath (53 percent) and heart palpitations (50 percent) as stroke symptoms. Nearly two-thirds of those surveyed failed to recognize that age increases stroke risk, especially for those over age 65.

Although seniors are at the greatest risk of having a stroke, they seem to show little concern, researchers noted. While two-thirds of all strokes occur among those ages 65 and older, only 12 percent of those surveyed in that age group noted they are more concerned about suffering a stroke, given other choices like Alzheimer’s disease and diabetes.

A whopping 70 percent of the olde respondents told researchers they never talked to their doctors about stroke risk.

”For older Americans, strokes pose a significant health risk so it is alarming to us that so few seniors have discussed their personal risk for stroke with their doctors,” said James P. Firman. NCOA’s president and CEO. “Better education is clearly needed to help all Americans understand their risks of stroke to protect their health.”

Robert Marshall, Ph.D., who serves as assistant director of health at the state Department of Health, gave All About Seniors his thoughts about the NCOA research study.

He said strokes are the number-three killer in Rhode Island – in 2000, 964 Rhode Islanders age 50 and over died of stroke.

“We call these preventable deaths’ because we know that by reducing risk, such as smoking, obesity, lack of exercise, uncontrolled high blood pressure, many  people can avoid death and disability from stroke, adds Marshall.

“It is unfortunate, but not surprising, that so many strokes are recurrent,” said Marshall. “Human nature being what it is, many people find it difficult to change the behaviors that got them into trouble in the first place- things like smoking and lack of exercise,” he notes.

“We all need to do a better job supporting stroke survivors and helping them use the experience as a springboard to a longer healthier and happier life,” Marshall added.

Older Rhode Islanders can easily take charge of reducing their chances of having a stroke or a recurrent stroke.  Positive lifestyle changes (e.g., more exercise, a better diet, giving up cigarettes, and taking prescribed medications are key lifestyle changes to protecting your health.

Report Examines Myths, realities of Consumer -Directed Services

Published in Pawtucket Times on March 17, 2003

Eighty-nine-year-old Lillian Brannon raves about the Arkansas-based “Independent Choices (A Cash and Counseling Demonstration Program) that allowed her to stay independent and at home with the assistance of four aides.

The program “has really changed my life so much,” she says. “It has really helped me to live more independently than I have ever have …I would not trade it for anything.”

Tammy Svihla, who suffers from MS gives a thumbs-up to the New Jersey-based “Personal Preferences” programs that has allowed her to more creatively used Medicaid funds. Svihla notes she was able to purchase a “Lazy-boy” lift chair, usually not covered by Medicaid. It was logical for Svihla to purchase the lift chair because it was difficult for her to get up from her couch because of soft cushions.

These two  testimonials, among three others, set the tone for a newly released report that examines the myths and realities that now surrounds the philosophy of consumer-directed services.

The orientation allows consumers to make choices about the services they receive, assess their own needs, and determine how ad by whom these needs should be met, and then  monitor the quality of services they have received.

“The Myths and Realities of Consumer-Directed Services for Older Persons,” authored by Marie R. Squillace, PhD., federal project officer, National Family Caregiver Support Program with the U.S. Department of Health and Human Services, and President and CEO James Firman, Ed.D., of the National Council on Aging, attempts to build upon current knowledge obtained from research and demonstration projects to make   consumer direction “an integral part of the options available for all older persons who may need long-term care.”

Throughout the 24-page report the authors use personal experiences, case studies, and research to dispel 12 myths about the philosophy of consumer-directed services.

Let’s take a look at three of the myths.:

Squillace and Firman urge the reader to not believe the myth that consumer-directed services are not appropriate for seniors with disabilities or for those with cognitive impairments.

Here’s the reality: studies of programs like California’s In-Home Supportive Services (IHSS), show that many elderly can express daily preferences for care and can benefit from that control. For more than 30 years, low-income persons over age 65 who are enrolled in the IHSS program have  hired, fired, trained, scheduled and supervised individual providers.

Moreover, the Family Caregiver Alliance in San Francisco adds research indicates that persons with early to moderate cognitive impairment still can express daily preferences for their care, sharing their values and preferences.  For those with significant cognitive disabilities, a University of Maryland Center on Aging report suggests family caregivers, a circle of friends, or close associates who know the consumer well can interpret the person’s non-verbal expressions.

Another myth of the Squillace and Firman report is that “self-directing consumers will “misuse funds” or “be exploited.”

Not true, say the authors, citing “Cash and Counseling Programs” that will allow consumers to use their alliances to purchase needed services so they can stay in their own homes with the assistance of a fiscal intermediary organization (FIO).

In reality, the authors note most prefer to have their funds held by the FIO, which conducts bookkeeping and accounting services to help them manage their individual helpers and pay taxes for their workers. The management can minimize concerns about misuse of funds and financial exploitation of vulnerable individuals while diminishing the administrative responsibilities placed on self-directed consumers, the report says.

Finally, some spread the myth that consumer direction is just an experiment, noting more, nothing less. But Squillace and Firman say this philosophy has progress “far beyond the experimental phase.

A growing number of consumer advocates, program administrators and policy makers are now embracing this philosophy.”

The authors recite a 2001 survey that identified 139 consumer-directed service programs that were operating across most of the nation, except Tennessee and the District of Columbia. “The estimated total number of people being served by these programs reached about half a million.

Squillace and Firman state: “Consumer direction is not a sliver bullet or a panacea for the nation’s long-term care challenge, but it is an important part of the solution.”

I believe that.

If they haven’t, hopefully the directors of the Department of Elderly Affairs and Human Services will develop programs that encompass the philosophy consumer directed services.  Enhanced quality of life can be a result of aging baby boomers and seniors controlling the choice over the purchase of their long-term care services. Ultimately, it is all about empowerment.

For more information about consumer-directed care, visit www.consumerdirection.org.

\