Trump Spending Priorities Would Fray Social Safety Net Programs

Published in the Woonsocket Call on March 16, 2019

Last Monday, President Donald Trump released his proposed FY 2020 budget request to Congress. Lawmakers, who rejected many of these budgetary spending requests in the president’s previous two submitted budgets proposals, consider his latest to be “dead-on-arrival.”

But, Trump’s $4.7 trillion fiscal blueprint, outlined in the 150-page “Budget for a Better America,” gives us a clear picture of his spending priorities and policies he seeks to implement through executive orders and regulator changes.

Trump’s FY 2020 spending plan proposes funding increases for combating the opioid epidemic, improving veteran’s health care, fixing the nation’s crumbling infrastructure ($200 billion increase), even giving the Pentagon a 5 percent increase in spending exceeding what the military asked for. White House senior advisor Ivanka Trump successfully pushed for the FY 2020 budget to include $750 million to establish a paid parental leave program and a $1 billion one-time fund to provide childcare to under served populations.

Trump’s budget proposal makes a commitment of $291 million to eliminate the spread of HIV within a decade, it slashes the National Institutes of Health’s funding by 12 percent, and the budget for the Centers of Disease Control and Prevention by about 10 percent.

Trump does not back away from his controversial stance of building a wall, putting in an additional $8.6 trillion for the construction of a U.S. Mexico border barrier. Congress had earlier opposed his demand for $5.7 billion for the construction project.

Trump Budget Proposal Puts Senior’s Earned Benefits at Risk

In 2016, Presidential candidate Trump had pledged not to cut Medicare, Medicaid or Social Security, but he does in his submitted FY 2020 budget proposal.

Trump calls for a 5 percent cut in non-defense federal agencies, including a whopping $ 1.5 trillion in Medicaid over 10 years. The budget plan instead allocates $1.2 trillion to create “market-based health care grants,” (a.k.a block grants) for states that would start in 2021. This gives states the power to set their own rules for this program.

Medicaid expansion under the Affordable Care Act (ACA) would be eliminated by Trump’s FY 2020 budget proposal by ending ACA’s protections for people with pre-existing conditions and causing millions of people to join the ranks of the uninsured. About 15 million more Americans have joined Medicaid since the ACA expansion was enacted.

Trump’s budget proposal also cuts Medicare by $845 billion over the next decade by cutting payments to hospitals and physicians, rooting out fraud and abuse, and by lowering prescription drug costs.

Meanwhile, the Social Security Disability Insurance program takes a huge budgetary cut of $25 billion and the Social Security Administration’s (SSA) operating budget is slashed by 1 percent, at a time when the agency is working hard to ratchet up its customer service provide to SSA beneficiaries.

Trump’s budget proposal would cut $220 billion from the Supplemental Nutrition Assistance Program (SNAP), popularly referred to as the food stamp program. The program currently serves 39 million people. Under this budget, beneficiaries would be required to be employed for 20 hours a week to be eligible for assistance and replacing the EBT-debit card used to purchase groceries with the delivery of a “Harvest Box” filled with non-perishable foods like cereal and pasta, canned goods and surplus dairy products.

Housing and Urban Development’s 202 housing program for seniors and people with disabilities takes a $36 million hit, says long-time aging advocate Bill Benson, principal of Washington, D.C.-based Health Benefits ABC, in the March 15th issue of Aging Policy and Public Health News.

According to Benson, several Older Americans Act programs including the Family Caregiver Support program would be cut in Trump’s budget proposal. The Long-Term Care Ombudsman Program would be cut by $1 million. Elder Justice Programs would also be cut under the President’s budget including a $2 million cut to the Elder Justice Initiative at Administration for Community Living.

” Cruelest of all [budgetary cuts] is the proposed out-right elimination of the Social Services Block Grant (SSBG) which is the only source of sustained federal funding to states for Adult Protective Services (APS),” says Benson. Some 37 states use SSBGs to support their APS programs. SSBG is also used by states for a number of other services benefiting older adults including home-delivered meals and case management.

Shortchanging Seniors

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM) warns that Trump’s budget proposal shortchanges seniors. “In combination with 2017’s tax cuts for the wealthy and the administration’s failure to allow Medicare to negotiate with Big Pharma, the Trump budget shows that his administration is not plugged into the realities of being elderly in America,” he says.

Richtman says that Trump’s budget plan also proposes to eliminate federal grants that help pay for programs under the Older Americans Act, such as Meals on Wheels and home heating assistance for the elderly poor.”

According to Richtman, the 116th Congress gives seniors hope with introduced legislation that would boost Social Security benefits and expand Medicare coverage to include dental, hearing and vision services, changes that an overwhelming majority of Americans support. He calls on Congress to “quickly reject this callous budget proposal — and take decisive action to enhance the well-being of older Americans.

Robert Greenstein, president of the Center on Budget and Policy Priorities, sees Trump’s newly released budget proposal as very troubling, too. “It sharply cuts funding in the part of the budget that invests in future economic growth through education and training, scientific research, infrastructure, and the like,” he says.

“It reverses progress in making affordable health care available to people who don’t have employer coverage or can’t afford private coverage. It cuts basic assistance substantially for families, children, and elderly and disabled people who are in need and struggle to get by. And, it doubles down on policies that take away health care, food, and housing when adults aren’t able to meet a work requirement,” says Greenstein.
“Despite bemoaning deficits, it calls for making the costly 2017 tax cuts — which largely benefit those who already have high incomes and wealth — permanent,” he adds.

Richtman believes that Trump’s 2020 spending proposal serves as a warning of what the administration would do if it were not for the firewall known as the Democratic-led House of Representatives. “These draconian ideas – though rejected by voters in the 2018 mid-terms – remain in the conservative political bloodstream, requiring continued advocacy on the part of seniors and their champions in Congress,” he says.

The release of Trump’s FY 2020 budget program begins the Democratic party’s efforts to retake the White House and Senate in the 2020 presidential election, just over 598 days away. By making major cuts in Social Security and Medicare and turning Medicaid into a state block grant program, Trump is giving Democratic challengers in the 2020 presidential election fodder to create politically-charged themes for ads to turn senior voters against him for seeking cuts in these popular domestic programs.

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

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.

Financial Exploitation of Elderly Must Be Addressed

Published in Pawtucket Times, February 7, 2015

 Professor Philip Marshall, Coordinator of the Historic Preservation Program at Roger Williams University in Bristol, entered Room 562 in the Dirkson Senate Building not to testify on historic preservation policy, as he often did, but to share a family tragedy.  Marshall’s testimony detailed how his grandmother, New York philanthropist Brooke Astor, was financially exploited in her later years by his father.

Brooke Astor, a philanthropist, socialite and writer, was presented the Presidential Medal of Freedom by President Bill Clinton in 1998, for her generous giving of millions of dollars to social and cultural cause.  Marshall, one of four witnesses who came before the U.S. Senate Special Committee on Aging this past Wednesday, would say, that his 105 year old grandmother, who died on August 13, 2007, was considered to be “New York’s First Lady,” and a “humanist aristocrat with a generous heart.”

Marshall, a resident of South Dartmouth, Massachusetts, told the panel his mother would never have wanted to be known as “one of America’s most famous cases of elder abuse.”

“Nor did she, while in the throes of dementia, choose to be victimized to be deprived, manipulated and robbed – all as a calculated ‘scheme to defraud,’ as later characterized by the Manhattan District Attorney,” said Dr. Marshall.

Astor’s financial exploitation “may be her greatest, most lasting legacy,” says  Marshall.

In his testimony, Marshall told the attending Senators that after a three-month battle for guardianship to protect his grandmother’s assets, a settlement was reached five days before the court date.  A criminal investigation launched by the Manhattan District Attorney after a potential forgery was referred to his Elder Abuse Unit, would later lead to the indictment in 2007 of his father and a lawyer, says Marshall.

Two years later, after a six-month criminal trial the jury would find Marshall’s father guilty on 13 of 14 counts against him.  All, but one, were held up on appeal.

“While my grandmother’s stolen assets were reclaimed, many elders never reclaim their money – or their lives,” observes Marshall.  “Here, for financial transactions, enhanced detection, mandatory reporting, and greater reporting of suspicious activity will help,” he says.

A Growing Epidemic

 In her opening statement, Senator Susan M. Collins, (R-Maine) who chaired, the Senate Aging Panel’s hearing, “Broken Trust: Combating Financial Exploitation Targeting Vulnerable Seniors,” warns that a growing epidemic of financial exploitation is happening – one that she estimates to cost seniors an estimated $2.9 billion in 2010, according to the Government Accounting Office.

Financial exploitation is a growing problem in Rhode Island, too, notes Senator Sheldon Whitehouse (D-RI), a member of the Senate Aging Panel. “Sadly, this number likely underestimates the cost to victims because older adults often do not report abuse, particularly when it involves a family member.”

Senator Whitehouse noted that this week’s Special Committee on Aging hearing examined the challenges to identifying and prosecuting fraud schemes and highlighted strategies to prevent the financial exploitation of seniors. “There are steps we can take to address this problem, and I strongly support the Older Americans Act, which recently advanced out of the HELP Committee and addresses financial exploitation and other forms of elder abuse,” he added.

“Over the past several years the Rhode Island State Police has experienced a steady increase in the number of complaints of elderly exploitation and larceny from individuals over sixty-five-years, says Colonel Steven O’Donnell, who oversees the Rhode Island State Police.  During the past six years his Agency has investigated 40 complaints amounting to a total loss to victims of over $1,000,000.00.

According to O’Donnell, in 2010, State Police investigated four complaints related to elderly exploitation and/or larceny.  Four years later, 14 complaints were investigated. “These increases may be attributed to the increased computer literacy of willing perpetrators and the increased accessibility to bank accounts online, which provides perpetrators the opportunity to conduct their criminal activity behind closed doors,” he says.

Combating Financial Exploitation

To ratchet up the protection of older Rhode Islanders against financial exploitation, Rhode Island Attorney General Peter Kilmartin and the Rhode Island General Assembly passed a bill last year that extends the statute of limitations for elder exploitation from three years to ten years. Kilmartin says the new law, sponsored by retired Representative Elaine A. Coderre (D-District 60, Pawtucket) and Senator Paul V. Jabour (D- District 5, Providence), gives law enforcement officials the necessary time to build a proper case for charging and subsequent prosecution, bringing it in line with other financial crimes.

“The law about financial exploitation is on the books—let’s enforce it,” says, Kathleen Heren, State Long Term Care Ombudsman, at the Warwick-based Alliance for Better Long Term Care. “What a sad world we are in where a senior or a disabled person loses everything they have scrimped and saved for to a greedy individual who, in the majority of cases, is a family member,” she adds.  Over the years she has also seen financial exploitation involving clergy, lawyers, bank tellers, brokers, and “people who you would never suspect would steal from a frail elder.”

“Many people who hear “elder abuse and neglect” [or financial exploitation] think about older people living in nursing homes or about elderly relatives who live all alone and never have visitors. But elder abuse and financial exploitation are not just problems of older people we never see. It is right in our midst, and as Attorney General, I am committed to doing all I can to protect all of the citizens of our state,” says Kilmartin.

“Many elders rely on others for assistance, but oftentimes think they can easily trust these helpers to handle their financial affairs, only to be robbed of their hard earned money,” says Kilmartin, noting that in some cases the perpetrator leaves the victim penniless.

Kilmartin notes that financial exploitation of elders is one of the most challenging crimes to investigate, charge and prosecute.  By the time law enforcement becomes aware of the abuse and investigates the matter, the statute of limitations has often expired.  “The statute of limitations needs to be more reasonable so these complicated cases can be prosecuted appropriately,” states Rhode Island’s Attorney General. “Seniors, especially those who must rely on others for care, were unnecessarily made more vulnerable by the previous short statute of limitations,” he says.

According to Kilmartin, The Office of Attorney General has a specialized unit of prosecutors and investigators that handle elder abuse cases.  Several years ago, the Elder Abuse Unit was created because of the large percentage of Rhode Islanders who were age 60 and over. The special needs of the older victims and the fact that elder abuse, neglect and exploitation crosses all racial, socio-economic, gender and geographic lines made the need for a special unit apparent.  Coupled with this fact that this age group is the State’s fastest growing demographic, crimes against older persons often times go unreported, presenting high temptation and low risk for prosecution.

In Rhode Island, there is a mandatory duty of all citizens to report a suspicion of elder abuse and/or elder financial exploitation. To report elder physical abuse and/or elder financial abuse, contact your local police, Rhode Island State Police or the Rhode Island Division of Elderly Affairs at (401) 462-3000 or dea.ri.gov.

Herb Weiss, LRI ’12 is a Pawtucket writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com or at 401 742-4372.