Tag Archives for Medicaid

2020 Census Data Impacts Federal Funding Allocated to Aging Programs and Services

Published in the Woonsocket Call on January 19, 2020

By April 1, every home across the nation will receive an invitation from the U.S. Census Bureau, a nonpartisan government agency, to participate in the 2020 Census. Once this invitation arrives, it’s important for you to immediately answer the short questionnaire by either going on-line, phone, or by mail. When you respond to the census, you’ll tell the Census Bureau where you live as of April 1, 2020.

The U.S. Constitution: Article 1, Section 2, mandates that the country conduct a count of its population once every 10 years. The 2020 Census will mark the 24th time that the country has counted its population since 1790

The population statistics generated by the upcoming 2020 Census will be used to distribute over $700 billion annually in federal funds back to tribal, state and local governments. The collected census data also determines the number of seats each state has in the U.S. House of Representatives, provides insight to governments, business and community planning groups for planning purposes, and finally defines congressional and state legislative districts, school districts and voting precincts

2020 Census Statistics and the Graying of America

According to a blog story published on Dec. 10, 2019, by American Counts (AC) Staff, the upcoming 2020 Census will provide the federal government with the latest count of the baby boom generation, now estimated at about 73 million. The boomer generation born after World War II, from 1946 to 1964, will turn 74 next year. When the 2010 census was taken, the oldest had not even turned 65.

Baby Boomers are also projected to outnumber children under age 18 for the first time in U.S. history by 2034, according to Census Bureau projections. With an increasing need for caregiver and health services and less family caregiver support, the boomers will be forced to depend on federally-funded support services, their allocation depending on policy decisions based on census data.

“Data from the 2020 Census will show the impact of the baby boomers on America’s population age structure,” said Wan He, who has for over 21 years overseen the Aging Research Programs for the Population Division of the U.S. Census Bureau.

AC’s blog article, part of a Census Bureau series detailing the important community benefits that come from responding to the 2020 Census questionnaire, stresses that exact count of American’s age 65 and over is important for tribal, local, state and federal lawmakers to determine how they will spend billions of dollars annually in federal funds on critical aging programs and services for the next 10 years.

While everyone uses roads, hospitals and emergency services some state and federal programs specifically target older Americans – the 2020 Census statistics will be used to distribute funding to senior centers, adult day care facilities, nutrition programs including meals on wheels, and the Supplemental Nutrition Assistance Program, job-training programs, elder abuse programs, Medicare Part B health insurance and Medicaid, the health insurance program for low-income people including those age 65 and older.

“The census is really important to us in the aging community,” said John Haaga, of the National Institute on Aging in Washington, D.C. in the AC’s blog article. “It’s our only way to figure out how things are different across the country, what areas are aging faster, where elderly disabled people live, or where older people are concentrated, like Appalachia or West Virginia, because young people are leaving for the cities,” says Haag, noting that “Older people are remaining behind there.”

Haaga noted, “Other states, such as Florida, have large older populations because people are moving there to retire.”

“You can start to look at specifics like how many older people are living alone who are more than 10 miles from an adult day care centers,” says Haaga. “You can answer questions of access and how to improve it,” he adds, noting that census statistics helps lawmakers or business people decide where to open health clinics or senior citizen centers, among other services.

Calls for Action: Fill Out that Census Questionnaire

AARP has three main goals, according to State Director Kathleen Connell. “First,” she said, “to ensure a fair and accurate census count by educating our​ members and older adults about the census outreach efforts. Second, to provide tips and resources to encourage safe participation while protecting themselves from bad actors and census related fraud during this time. And third, to help people age 50 and over gain employment as census enumerators.”

“AARP has long been involved in informing people about the census, including the fact that the headcount is labor intensive – to the tune of 400,000 temporary staff. In the past, retired adults have made up a good portion of those who work in the decennial count of Americans, often as enumerators who go door-to-door in neighborhoods. In many communities, the Bureau will be looking for bilingual applicants.”

To be sure, Connell adds, the loss of a Congressional seat would have an impact on Medicare funding and other services that support Rhode Island’s age 50 and over population. “If a subset of people doesn’t participate in the census, the area in which they live will be represented as having fewer residents than it actually does; the costs to states and communities could be large, consequential and long-lasting. A census that is as complete and accurate as it can be – and doesn’t undercount the number of residents in a given area – is a vital resource for everyone,” she said.

Connell sits on the RI Complete Count committee and the AARP State Office is using its email list and social media in a series of reminders and encouragement to participate in the census. AARP also is reaching out to members who might consider becoming census workers.

Adds Jennifer Baier, AARP Senior Advisor, Census lead: “Many federally funded programs rely on census data to distribute billions of dollars to states and localities across the country. According to the George Washington Institute of Public Policy, Rhode Island receives about $3.8 billion per year based on Census data. That includes funds for schools, roads and hospitals and also programs that aid older Americans, such as Medical Assistance Program (Medicaid) Medicare Part B, Special Programs for the Aging, Meals on Wheels, Heart Disease Prevention Programs and more.”

“The 2020 Census is just nine questions long, and takes about 10 minutes to fill out – those ten minutes impact millions of dollars of federal funding in every state and communities across the country,” says Baier.

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.

Report on Falls, Injuries Released

PUblished in Woonsocket Call on October 20, 2019

Last Wednesday morning in Dirksen Senate Office Building 562, the U.S. Special Committee on Aging held a hearing to put a spotlight on the economic consequences on falls and to explore ways to prevent and reduce falls and related injuries. At the one hour and 55-minute hearing, titled “Falls Prevention: National, State, and Local Level Solutions to Better Support Seniors,” its annual report, Falls Prevention: Solutions to Better Support Seniors, was released.

According to the Senate Aging Committee, falls are the leading cause of both fatal and nonfatal injuries among older adults that incur $50 billion annually in total medical costs. That number is expected to double to $100 billion by 2030, and the majority of these costs are borne by Medicare and Medicaid.

“Falls are the leading cause of fatal and non-fatal injuries for older Americans, often leading to a downward spiral with serious consequences. In addition to the physical and emotional trauma of falls, the financial toll is staggering,” said Sen. Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Now is the time, and now is our opportunity, to take action to prevent falls. Our bipartisan report includes key recommendations to take steps to reduce the risk of falls,” the Maine Senator noted in an Oct. 16 statement.

Pushing for Positive Change in Releasing Fall Report

“We must dispel our loved ones of the stigma associated with falling so that they can get the help they need to age in place – where they want to be – in their homes and communities,” said Sen. Robert P. Casey, Jr. (D-Pa.). “I am hopeful that our work over the past year will propel the research community to do more, get more dollars invested into supporting home modifications and encourage more older adults to be active,” said the Special Committee’s Ranking Member.

At the hearing, the Committee unveiled a comprehensive report that provides evidence-based recommendations on ways to reduce the risk of falling. The Committee received input from multiple federal agencies, including the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and the Food and Drug Administration. In addition, approximately 200 respondents representing falls prevention advocates, hospitals, community organizations, home health agencies, and others shared their expertise on this issue.

The 34-page Aging Committee’s report made recommendations as how to raise awareness about falls-related risks, prevention and recovery at the national, state and local levels. It suggested ways of improving screening and referrals for those at risk of falling so that individuals receive the preventive care necessary to avoid a fall or recover after one. It noted ways of targeting modifiable risk factors, including increasing the availability of resources for home safety evaluations and modifications, so that older adults can remain in their homes and communities. Finally, it called for reducing polypharmacy so that health care providers and patients are aware of any potential side effects that could contribute to a fall.

Increasing Medicare Funding for Bone Density Testing

In an opening statement, Collins noted that falls are often times attributed to uneven sidewalks or icy stairs, medications, medical reasons or muscle strength. But one key cause of falling is osteoporosis, which can be especially dangerous for people who are completely unaware that they suffer from low bone density, she says.

According to Collins, although Medicare covers bone density testing, reimbursement rates have been slashed by 70 percent since 2006, resulting in 2.3 million fewer women being tested. “As a result, it is estimated that more than 40,000 additional hip fractures occur each year, which results in nearly 10,000 additional deaths,” she said, noting legislation, Increasing Access to Osteoporosis Testing Beneficiaries Act that she has introduced with Sen. Ben Cardin,” to reverse these harmful reimbursement cuts.

Casey stated, “I am particularly interested in sharing this report with the relevant agencies and learning how the recommendations will be implemented. Not just put in a report. Implemented,” adds Casey.

Peggy Haynes, MPA, Senior Director, of Portland-based Healthy Aging, MaineHealth that offers A Matter of Balance, an evidence-based falls prevention program, came to the Senate hearing to share details about its impact. “The health care community has a critical role to play in fall prevention – beginning with screening for falls, assessing fall risk factors, reviewing medications and referring to both medical and community-based fall prevention interventions. Our health system is focused on preventing falls in every care setting,” says Haynes.

“The need for a range of community-based options led MaineHealth to be a founding member of the Evidence Based Leadership Collaborative, promoting the increased delivery of multiple evidence-based programs that improve the health and well-being of diverse populations,” adds Haynes.

Haynes noted that older participants attend eight two-hour sessions to help them reduce their fear of falling, assisting them to set realistic goals for increasing their activity and changing their home environment to reduce fall risk factors. A Matter of Balance is offered in 46 states reaching nearly 100,000 seniors.

Virginia Demby, an 84-year-old visually-impaired retired nurse who is an advocate for Community and Older Adults, in Chester, Pennsylvania, came to the Senate hearing to support the importance of fall prevention programs. Despite living with low vision, Demby remains physically active by participating in exercises classes for older adults at the Center for the Blind and Visually Impaired in Chester. She is an advocate for older adults and now helps the local senior center wellness manager recruit more seniors to take falls prevention classes and find new places to offer the classes.

Kathleen A. Cameron, MPH, Senior Director, Center for Healthy Aging, of the Arlington, Virginia-based National Council on Aging, discussed the work of the National Falls Prevention Resource Center, which helps to support evidence-based falls prevention programs across the nation and highlighted policy solutions to reduce falls risk.

Finally, Elizabeth Thompson, chief executive officer, Arlington, Virginia-based National Osteoporosis Foundation, testified that bone loss and osteoporosis are fundamental underlying contributors to the worst consequences of falls among older Americans: broken and fractured bones. Osteoporotic fractures are responsible for more hospitalizations than heart attacks, strokes and breast cancer combined, she noted.

For details of the Senate Aging Committee report, go to http://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf.