Tag Archives for osteoporosis

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.

Seniors Held Their Ground During Legislative Session

Published in Pawtucket Times on July 16, 2001

As the dust settles with the aftermath of the 2001 General Assembly session, senior advocates and providers held their ground with the state legislature allocating small funding increases in some existing programs, but no major expansions or new programs were implemented.

More than 2,500 bills were introduced during the 2001 General Assembly session, with lawmakers considering a small handful of proposals that specifically targeted senior programs and services.

Pawtucket Rep. Antonio J. Pires, who heads the House Finance Committee, gives his take to The Times on the session as it related to older Rhode Islanders.

During this year’s legislative session senior advocates called on the General Assembly to consider increased funding for Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE).

Recognizing the high cost of prescription drugs and its adverse impact on the elderly, lawmakers ratcheted up the $10.3 million RIPAE program by $ 2 million. With the passage of the state’s Fiscal Year 2002 budget, the size of a large phone book, lawmakers appropriated a 20 percent increase to support the RIPAE program, stated Pires.

The General Assembly expanded the drug formulary lists of drugs to include prescription drugs to treat osteoporosis,” Rep. Pires noted. Additionally, he added that the state’s budget now provides 100 percent of covered drug costs incurred once the program’s poorest clients spend more than $ 1,500 in coo-payments in a year.

While senior advocates had pushed for more drugs to be covered by RIPAE drug formulary, Pires stated, “We can’t afford to pay for an o pen formulary program yet because of budgetary limitations.” In next year’s legislative session, when more state monies are available, coverage for gastrointestinal drugs will seriously be considered, he added.

“It’s a trade-off,” Pires said, in explaining why lawmakers choose not to add drugs to the RIPAE formulary list but rather to increase the eligibility income limits to allow an estimated 3,l50 seniors and disabled persons to participate in the state’s Medical Assistance Program. This program pays for nursing home care for low-income eligible seniors. The enacted state budget included $ 1.8 million from all sources of funds, including $ 857,485 in general revenues to increase the eligibility income for those who are 65 years old or disabled. Now individual income limits increased from $ 576 to $  686 per month, he said, noting that income limits for couples also increased from $ 889 to $ 921 per month.

According to Pires, the Fiscal 2002 State budget also includes $ 85,000 to continue funding the state’s elder guardianship program enacted last year. “The program brings volunteer guardians to assist frail elderly who are cognitively impaired and without families or friends in decision making,” he said. This year’s funding would allow a full-tie coordinator to be hired who will recruit and train the volunteer guardians. Ultimately, the funding would also allow the program to be phased in statewide over a three-year period, he said.

“We also continue to fund the state’s Elder Information Network Program,” Pires added, noting that the FY 2002 budget includes $ 425,000, a $ 12,300 increase over last year’s budget. Funding for this program provides grants to 15 community-based agencies to employe specialists to link information and services across the state.

This session Rhode Island lawmakers also moved to soften the blow of federal cutbacks to RIPTA by providing an additional $ 2.5 million to the state’s transportation agency. “RIPTA found itself in need of cutting routes to balance it’s budget,” Pires stated, noting that the General Assembly responded to the federal cuts by appropriating one-half cent of the state’s gasoline tax to help the agency keep its exiting bus routes.

“RIPTA may have to make some adjustments to their bus routs but not to the extent that they had fared,” Pires said. Ensuring that buses continue to run throughout the state are important because this mode of transportation provides older riders their mobility and independence, he said.

Finally, on the heel of calls by the nursing home industry and senior advocates, Pires noted that the General Assembly allocated $ 4.5 million with a $ 4.5 million federal match, to provide higher salaries for certified nursing assistants to keep them in their profession.

While nursing home providers did not get the $ 14.1 million, they requested, the 2002 state budget called for a funded study to develop a new plan on how nursing homes would be funded, Pires said. “We anticipate that the modern payment principles that will be developed will ensure continued quality of care for the elders in facilities,” he added.

But the funding allocated by the General Assembly to alleviate the direct care staff shortage and a study to develop a new payment methodology still leaves many nursing home providers and senior advocates seriously concerned about the direction of quality care with the inadequate paid to a shrinking work force.

Based on an independent study, providers found that last year health care worker turnover approached 92 percent in Rhode Island facilities due to low wages in relation to the work performed, stated Hugh Hall, chair of the  Direct Care Staffing Coalition and administrator of Cherry Hill Manor.

Hall noted that certified nursing assistants must complete 125 hours of training followed by a state licensing exam, both written and practical, to perform this type of work. These workers have found they can make as much or more working in local retail establishments than in nursing facilities, he says.

While nursing home providers appreciate the funding that the legislature has approved, it doesn’t go far enough, says Hugh, to address the inadequate wages that the state is funding for direct care workers. “The state continues to cut the same size of the pie for an ever-increasing aging population,” he noted.

In response to those seeking better funded programs this year, Pires stated, “We had limited resources to expend so there wasn’t a lot of new programming this year but quality of life and independence remains my top priority as chairman of the House Finance Committee.” The eight-term Democrat noted that this year’s focus was to ensure that the existing level of senior services would not be cut but maintained with some incremental expansion.