AOA Reauthorization Bill Goes to President Obama for Signing

Published in Woonsocket Call on April 10, 2016

The Older American’s Act (OAA) current authorization expired in fiscal year 2011 because lawmakers were unable to reach an agreement on its reauthorization. On a bipartisan basis, Congress has finally passed the long-stalled legislation reauthorizing the OAA when the Senate passed the House-amended bill on April 7. Three weeks earlier the House had passed an amended version of S. 192, the Older Americans Act Reauthorization Act of 2016, by a unanimous voice vote. This legislative proposal amended the bill passed by the Senate on July 16, 2015. Now the passed legislation goes to President Obama, once signed it becomes law.

The very bi-partisan Senate reauthorization bill was sponsored by Chairman Lamar Alexander (TN) and Ranking Member Patty Murray (D-WA), of the Senate Committee on Health, Education, Labor and Pensions, and had 27 co-sponsors from each party.

OAA Authorization Has Lots of Positives

OAA’s latest reauthorization offers new support for modernizing multipurpose senior center, highlights the importance of addressing senior’s economic needs, permanently requires health promotion and disease prevention initiatives to be evidence-based, and promotes chronic disease self-management and fall prevention.

The law also includes: stronger elder justice and legal services provisions; needed clarity for caregiver support and Aging and Disability Resource Centers; new opportunities for intergenerational shared sites, and promotes efficient and effective use of transportation services.

Legislative inertia and a general undercurrent of opposition to any government programs by some members of Congress slowed consideration of the bill , says Dan Adcock, Director of Government Relations and Policy for the National Committee to Preserve Social Security and Medicare (NCPSSM). “You need champions to break through the ‘legislative inertia’ and OAA just did not have enough,” he says.

Senators Lamar Alexander (R-TN), Patty Murray (D-WA) and Bernie Sanders (I-VT) along with Reps. John Kline (R-MN) and Bobby Scott (D-VA) worked hard to finally get the Senate and House to pass this year’s OAA reauthorization, Adcock noted, stressing that there was no opposition to the bill when it passed the House and Senate on voice votes

While the passed OAA reauthorization bill has many positives, its chief weakness is that it does not raise the funding authorization level enough, says Adcock. “Unfortunately, the Older Americans Act has suffered under flat funding and sequestration cuts for several years and will need significant increases in appropriations to meet the critical demands of a senior population that will nearly double by 2030, warns Adcock, noting that that an increase of 12 percent a years is needed for the next several years to raising funding to an acceptable level.

“AARP urges President Obama to quickly sign this bill,” said AARP CEO Jo Ann Jenkins. “We are appreciative of the bipartisan work to get this bill passed. Reauthorizing the OAA will help the millions of vulnerable older Americans who depend on the programs and services that the OAA helps to fund.

“Reauthorizing the OAA is as important as ever to modernizing and improving the aging services network in our country. It’s passage reflects the heroic efforts of many advocates working together to educate Congress about how programs funded by the OAA support older Americans,” observed Steven R. Counsell, MD, AGSF, American Geriatrics Society President.

Adds Senator Sheldon Whitehouse (D-RI), who serves on the Senate Select Committee on Aging, “I am glad we were able to reauthorize and improve the Older Americans Act. This legislation authorizes more funding for meals and social services seniors depend on. It includes new protections against elder abuse, which I’ve been fighting to pass. And it gives residents of long-term care facilities-who often can’t communicate their wishes-a stronger advocate to speak on their behalf.”

Ratchet Up AOA Funding

For more than 50 years the Administration on Aging with its National Aging Network (State Units on Aging and Area Agencies on Aging) has provided federal funding, based on the percentage of the locality’s population 60 and older, for nutrition and supportive home and community-based services, disease prevention/health promotion services, elder rights programs, the National Family Caregiver Support Program and Native American Program.

Aging advocates will tell you that Congressional funding has not kept with the rising inflation or the increased demands of an aging society. Deep Congressional budget cuts, push by the GOP, have significantly reduced OAA’s ability to provide services to those on increased waiting lists. Being “penny-wise and pound foolish” should not be the way Congress looks at future OAA reauthorizations. NCPSSM’s Adcock will tell you that programming geared to helping seniors to age in place at home in their communities can save billions by reducing costly nursing facility and hospital stays.

Hopefully, the President is expected to sign it in a week or two. Hopefully he signs this it quickly on Monday .

Calling on Congress to Increase Alzheimer’s Funding

Published in Woonsocket Call on February 21, 2016

Three weeks before President Obama released his Fiscal Year 2017 Budget on February 9,  Senators Susan Collins (R-ME), who chairs the U.S. Select Committee on Aging, and Amy Klobuchar (D-MN) along with seven of their colleagues, called on the Democratic President to increase funding for Alzheimer’s research as part of his last proposed budget request. Senator Sheldon Whitehouse (D-RI), who sits on the Senate Aging Panel, was among the cosigners.

In the bipartisan January 28 correspondence,  the cosigners said, “If nothing is done to change the trajectory of Alzheimer’s, the number of Americans afflicted with the disease is expected to more than triple between 2015 and 2050,” the Senators wrote.  Already our nation’s costliest disease, Alzheimer’s is projected to cost our country more than $1 trillion by 2050… Surely, we can do more for Alzheimer’s given the tremendous human and economic price of this devastating disease.”

Furthermore, cosigners warned that “$2 billion per year in federal funding is needed to meet the goal of preventing or effectively treating Alzheimer’s by 2025.” 

 Aging Groups Express Disappointment

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), says that the Consolidated Appropriations Act, 2016, (P.L.114-113) provided $936 million in FY 2016 (a $350 million or 59.7% increase over FY 2015) for Alzheimer’s disease research at the National Institute on Aging (NIA), the nation’s leading funder of Alzheimer’s disease research.

Richtman expressed disappointment that Obama’s budget proposal did not recommend funding about the FY 2016 level for Alzheimer’s disease and dementia research, it was essentially flat funded.

“Scientists have estimated that spending at least $2 billion a year on research is necessary to accomplish the national Alzheimer’s plan goal of preventing or effectively treating Alzheimer’s disease by 2025,” says Richtman.

According to NCPSSM’s 2016 Legislative Report, “the number of people suffering from Alzheimer’s disease or a related dementia is expected to skyrocket over the next few decades because many people are living longer and the incidence of Alzheimer’s disease increases with age.”

Richtman says “making a significant investment in funding towards finding a cure and appropriate treatments for persons with Alzheimer’s disease and dementias is key to reducing the massive financial drain this disease will impose on the future of the Medicare program, along with the devastating emotional and financial toll exacted on the millions of Alzheimer’s victims and their family members and caregivers.”

The Alzheimer’s Foundation of America (AFA) also expressed disappointment in the proposed $337 million cut in research funding at NIA, contained in Obama’s 2017 Fiscal year budget proposal. “The Administration has been a champion in the fight against Alzheimer’s disease; however, we are disappointed that, in his final budget, the President is retreating,” said CEO and President Charles J. Fuschillo, Jr., of the Alzheimer’s Foundation of America (AFA). “We were hoping President Obama would take the dramatic step necessary to confront the dementia crisis in this country head-on. We will continue to work with Congressional appropriators to ensure we are on the path to a cure,” says Fuschillo, Jr.

Like NCPSSM, Cicilline, Reed, Whitehouse, and many members of congress, the New York-based AFA urged the Administration to build on the historic 60 percent increase in Alzheimer’s research funding that was included in this year’s budget that provided an additional $1 billion in research funding in the upcoming federal budget.  If done, total federal spending would reach almost $ 2 billion, an amount that Alzheimer’s experts say is necessary to finding a cure or meaningful treatment by 2025 (detailed in the National Plan to Address Alzheimer’s Disease.

According to AFA, currently Alzheimer’s disease is the sixth leading cause of death in the United States, with studies indicating it could actually be as high as the third-leading caused.  But this devastating disorder is the only disease in the top 10 for which there is neither a cure nor impactful treatment.  Furthermore, “even with the Fiscal Year 2016 funding increase, funding for Alzheimer’s lags far behind HIV/AIDS, cancer and heart disease.

On the Home Front

Congressman David N. Cicilline, who successfully led the effort in the House to increase funding for Alzheimer’s research by more than 50% last year, sees a need for increased funding a necessity in the Fiscal Year 2017. “Alzheimer’s disease afflicts 22,000 Rhode Islanders and their families each year,” the Democratic congressman representing Congressional District 1.

With Congress poised to begin hammering out next year’s federal budget, Cicilline plans to continue his efforts in the House to fight for an increase federal funding for a treatment and a cure of the devastating disorder.  He urges for Alzheimer’s disease research remain a major funding priority for policymakers at every level of government.

Senator Jack Reed, serving as a member of the Labor-HHS Appropriations Subcommittee, says, “Last year, we successfully included a $350 million boost in new spending for Alzheimer’s research, a 60% increase over the previous year.  Looking ahead to the coming fiscal year, we still have our work cut out for us in this challenging budgetary climate, but I am pushing to secure additional resources to help prevent, treat, and cure Alzheimer’s, as well as for education and outreach.”

“More and more Americans are being impacted by Alzheimer’s disease and we need a serious national commitment to finding cures and treatments.  That means making strategic investments now that will help save lives and future dollars in the long-term,” notes the Senator.

A Call for Action

Experts tell us an impending Alzheimer’s disease epidemic is now upon us. Federal and state officials are scrambling to gear up for battle, developing national and state plans detailing goals to prevent or treat the devastating disease by 2025.

According to the Rhode Island Chapter of the Alzheimer’s Association, an estimated five million Americans over age 65 are afflicted with Alzheimer’s disease in 2013.  The prevalence may well triple, to over 16 million, if research does not identify ways to prevent or treat the cognitive disorder, says the Rhode Island nonprofit.  By 2050, it’s noted that the estimated total cost of care nation-wide for persons with Alzheimer’s disease is expected to reach more than $1 trillion dollars (in today’s dollars), up from $172 billion in 2010.

Congress must not act “penny wise and pound foolish” when it ultimately comes to determining the amount of federal dollars that will be poured into Alzheimer’s research in next year’s fiscal budget.  Less dollars or level funding will only increase state and federal government’s cost of care for Alzheimer’s care in every municipality in the nation.  A total of 469 seats in the Congress (34 Senate seats and all 435 House seats) are up for grabs in the upcoming presidential election in November.  Lawmakers must remember that every voter may be personally touched, either caring for a family member with the cognitive disorder or knowing someone who is a caregiver or patient.  That ultimately becomes a very powerful message to Capitol Hill that it is important to increase the funding to NIA to find the cure.

 

 

Obama’s Budget DOA, Thanks to GOP Gridlock

Published in the Woonsocket Call on February 14, 2016

With a GOP-controlled Congress President Obama’s final budget arrives “dead on arrival” on Capitol Hill.  The 182-page 2017 Fiscal Year budget, submitted on February 9, detailing $4.1 trillion in federal spending, which starts October 1, seems to be not worth the paper it’s written on.

Obama, a “lame duck” president in his last term, will not get his day in court.  Since the 1970s, a long-standing political tradition has brought the Office of Management and Budget Director and other senior administration officials, to present the president’s entire budget to Congress.  However, the Chairs of the House and Senate budget committees snubbed the Democratic President by issuing a joint statement saying, there will be no hearings before their panels this year. Sadly, political gridlock, fostered GOP Senate and House leadership, still seems to be alive and well on Capitol Hill.

Crafting the budget proposal now is in the hands of a very conservative Congress. But there a positives in Obama’s budget proposal, provisions that hopefully be placed in an enacted budget.

Obama’s budget proposal makes critical investments to fund domestic and national security priorities while adhering to the bipartisan budget agreement signed into law last fall.  It lifts sequestration in future years.  The budget proposal also attempts to drive down the federal deficit through smart savings from health care, immigration, and tax the wealthy and banks.

The Budget also seeks to tackle a multitude of domestic issues including confronting climate change, finding new clinical treatments for attacking cancer, advancing biomedical research, fighting infectious diseases, protecting the nation’s water supply and fostering clean energy initiatives, ratcheting up military readiness, revitalizing the American manufacturing sector, and funding job training and education initiatives.

Obama’s Final Budget and Seniors

But Obama’s 2017 Fiscal Year Budget has a number of budget provisions that directly impact older Americans, too.

According to  President and CEO Max Richtman, of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, like last year’s Obama recently released budget proposal proposes no changes in the way Social Security benefits are determined which is “good news for seniors.”

Richtman says that his aging organization worked tirelessly to make sure the FY 2017 budget did not include any Social Security proposals that would negatively impact benefits for current or future beneficiaries.  He notes, “The new budget proposes a substantial increase in the Social Security Administration’s (SSA) budget — $13.067 billion for SSA’s FY 2017 appropriation for administrative funding.  This is a $905 million, or 7.44 percent, increase over the FY 2016 enacted level.”

Finally, Obama’s newly released budget helps SSA to improve customer service for those applying for SSA and/or disability benefits by hiring additional front-line employees for its teleservice centers and local offices as well as additional staff to reduce the backlog of disability applications that have accumulated in SSA’s hearing offices, he says.

NCPSSM also applauded the President’s budget proposal for allowing Medicare to negotiate for lower prescription drug prices.

Richtman observed it has taken Congress a long time to acknowledge that the high cost of prescription drugs has hit older American’s hard in their wallets.  “Medicare spends billions providing Part D drug coverage each year while beneficiaries including seniors, the disabled and their families also face rising out-of-pocket costs and higher premiums, he says, noting that “All the while, drug makers continue to reap the profits of their price gouging.”

In his budget proposal Obama has again proposed lifting the ban preventing Medicare from negotiating prices with the drug companies, notes Richtman, warning that “Big Pharma has lobbied hard to keep the ban in place but seniors expect, this time, Congress will do the right thing and finally allow Medicare to negotiate for fair prices.”

Richtman says there are other budget provisions that benefit the nation’s seniors.  Specifically, the closing the Part D donut hole two years earlier, additional funding for in-home services, and reforms for overpayments going to private insurers in Medicare Advantage.

Meanwhile, the President’s budget was not all good news, adds Richtman, noting that “Once again, the budget proposes shifting even more healthcare costs to seniors by extending Medicare means-testing to the middle class and increasing out-of-pocket costs such as the home health care copayment and the Part B deductible.”

The President’s new funding request also targets vulnerable older Americans, by increasing funding from the 2016 Fiscal year Budget.  The President has increased last year’s budget by more than $10 million in discretionary resources for supportive services, also increasing the Congregate and Home-Delivered Nutrition Programs (like Meals on Wheels) by $14 million.  The Aging and Disability Resource Centers is also given a $2 million increase.

Other programs benefit from Obama’s budget proposal, too.  Elder Justice Initiative and Lifespan Respite Care Programs each would receive $2 increases from last year.  The Commodity Supplemental Food Program would get $14 million more.   The budget proposal also puts $10 million in for a new initiative to improve senior access to the Supplement Nutrition Assistance Program.  Section 202 Housing for the Elderly also gives a bump from last year in the tune of $72 million.

But the budget request slashes funding for programs that serve low-income seniors, specifically the Low-Income Home Energy Assistance Programs and the Community Development Block Grant takes huge fiscal hits.

Views from the Side Line 

             Obama’s budget proposal preserves programs for seniors, funding Social Security and Medicare, says Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution, “Not many Republicans are taking this budget very seriously as they plan to write their own budget. The GOP alternative likely is going to include changes to programs affecting senior citizens, he warns.

Rhode Island’s Congressional delegation weighs in on the looming heated partisan budget debate where law makers will be toeing the part line.

Congressman David Cicilline, notes that he is disappointed that the House Budget Committee will not ‎holding hearings on President Obama’s budget proposal. “We should be discussing ways to strengthen Social Security, preserve Medicare, and ensure retirement security for every American. Unfortunately, it’s clear that House Republicans don’t want to have this discussion,” he says.

U.S. Senator Sheldon Whitehouse weighed in on the brewing pre-election budget battle.  “I’m pleased to see that the President’s budget protects Social Security and Medicare from the cuts sought by many Republicans.  As the President has proposed, we should reduce the deficit by closing wasteful tax loopholes, not by compromising the programs essential to our seniors, and not after saving Rhode Island seniors $14.4 million in prescription costs thanks to the Affordable Care Act.”

Finally, U.S. Senator Jack Reed notes that the President’s budget proposal reflects a number of his ongoing efforts to support Rhode Island seniors.  “This budget blueprint proposes significant investments in the health and well-being of aging Americans, and I will work hard to champion these proposals as we work through the appropriations process this year, he says.

“I am particularly glad the President heeded my call to propose meaningful steps towards lowering the cost of prescription drugs, which is critical for middle class families,” adds the Senator.

Now the work begins as Congress starts to craft it’s 2017 Fiscal Year Budget.  Democratic Congressional lawmakers can glean and fight for provisions in Obama’s eighth and final budget that positively benefit older Americans. With Senator Reed, sitting on the Senate Appropriations Committee, the Rhode Island’s Senior Senator and the state’s Congressional Delegation will play a major role in shaping the nation’s future aging programs and services.