“There’s a New Sheriff in Town” at SSA

Published in RINewsToday on June 20, 2020

On June President Joe Biden has asked two political holdovers from the President Trump’s administration, Social Security Commissioner Andrew Saul and his deputy, David Black, who had previously served as the agency’s top lawyer, to resign. Saul ultimately was fired after refusing to resign Friday, July 9, while Black resigned upon the president’s request that day. 

Biden named as acting commissioner, Kilolo Kijakazi, whom he earlier had appointed to a lower-level Social Security Administration (SSA) position, deputy commissioner for retirement and disability policy. 

The White House affirmed its authority to “remove the SSA Commissioner at will” by citing a Supreme Court ruling and a legal opinion from the Justice Department. Previously, under statute, the president could only remove the SSA commissioner for “neglect of duty” or “malfeasance in office.”

Saul’s term as Social Security Administrator ended in 2025 and according to The Washington Post, he states he plans to dispute the White House firing and continue to work remotely at his New York City home.

“I consider myself the term-protected commissioner of Social Security,” Saul told The Washington Post, calling the attempt to unseat him a “Friday Night Massacre.”

Minority Members of Senate Aging Committee Oppose Firing

Ranking Member Tim Scott (R-South Carolina), Senators Susan Collins (R-Maine), Richard Burr (R-North Carolina), Marco Rubio (R-Fla..), Mike Braun (R-Ind..), Rick Scott (R-Fla..), and Mike Lee (R-Utah) sent a letter July 14 to President Biden urging him to reinstate and honor the Senate confirmed, six-year term of Saul as SSA Commissioner. 

Members of the Senate Special Committee on Aging find the politically motivated action especially worrisome as it will have drastic effects on SSA services that help millions of older Americans with basic expenses like housing, food and medicine. 

The letter explains “Commissioner Saul was confirmed by the Senate in an overwhelmingly bipartisan vote in 2019… led the agency through one of the most trying periods in its history during the COVID-19 pandemic… was confirmed by the Senate to serve a full six-year term that expires in 2025 and he should have remained in his position unless removed for cause, as written in federal law.

The committee requested the Biden administration explain what authority an acting commissioner—not confirmed by the Senate—would possess to carry out the statutorily obligated duties of the SSA commissioner. 

 On the Other Side of the Aisle…

“From the beginning of their tenure at the Social Security Administration Andrew Saul and David Black were anti-beneficiary and anti-employee. The Biden Administration made the right move to fire both Saul and Black after they refused to resign, says chairperson John B. Larson (D-CT), of the House Ways and Means Social Security Committee, who had called for Saul and Black’s removal in March 2021. “As [Supreme Court] Justice Alito recently stated, the president needs someone running the agency who will follow their policy agenda,” he says.

According to Larson, since June 17, 2019, Saul’s control over SSA policies have “disproportionately harmed vulnerable Americans like low-income seniors and persons with disabilities, immigrants and people of color.

During Saul’s tenure, Larson noted that the SSA implemented a new rule that denied disability benefits for older, severely disabled workers who are unable to communicate in English, resulting in approximately 100,000 people being denied more than $5 billion in benefits from 2020 to 2029. However, there has been considerable discussion of the misinterpretation of the intent of this change.

SSA also finalized a new regulation that dramatically reduced due process protections for Social Security appeals hearings, by allowing the SSA to use agency attorneys instead of independent judges for the hearings, says Larson.

Larson also expressed concern about SSA proposing to change the disability review process to cut off benefits for some eligible people and proposing to make it significantly harder for older, severely disabled workers to be found eligible for disability benefits. 

According to Larson, Saul also advanced the Trump Administration’s anti-immigrant policies by resuming “no-match letters” to employers with even minor discrepancies between their wage reports and their employees’ Social Security records. These letters effectively serve to harass immigrants and their employers, often leading to U.S. citizens and work-authorized immigrants being fired, he said.

Finally, Larson charged that Saul embraced the Trump Administration’s anti-federal employee policies, including forcing harsh union contracts that strip employees of rights and ending telework for thousands of employees just months before the COVID-19 pandemic started – a particularly ill-fated decision given the critical role telework has played in SSA’s ability to continue serving the public during the pandemic. 

Thumbs Up from Aging Advocacy Groups 

“The Social Security Commissioner should reflect the values and priorities of President Biden, which include improving benefits, extending solvency, improving customer services, reopening field offices, and treating SSA employees and their unions fairly. That was not the case with former Commissioner Saul, and we look forward to President Biden nominating someone who meets that standard,” says Max Richtman, President and CEO, National Committee to Preserve Social Security and Medicare.

Adds Alex Lawson, Executive Director of Social Security Works: “Today is a great day for every current and future Social Security beneficiary. Andrew Saul and David Black were appointed by former President Donald Trump to undermine Social Security. They’ve done their very best to carry out that despicable mission. That includes waging a war on people with disabilities, demoralizing the agency’s workforce, and delaying President Biden’s stimulus checks.”  

Introducing New SSA Commissioner, Kilolo Kijakazi…

Kilolo Kijakazi has a Ph.D. in public policy from George Washington University, an MSW from Howard University, and a BA from SUNY Binghamton University. Kijakazi’s Urban Institute bio notes that she served as an Institute Fellow at the Urban Institute, where she “worked with staff across the organization to develop collaborative partnerships with those most affected by economic and social issues, to expand and strengthen Urban’s agenda of rigorous research, to effectively communicate findings to diverse audiences and to recruit and retain a diverse research staff at all levels” while conducting research on economic security, structural racism, and the racial wealth gap. 

Kijakazi was previously employed as a program officer at the Ford Foundation, a senior policy analyst at the Center on Budget and Policy Priorities, a program analyst at the Food Nutrition Service of the Department of Agriculture, and an analyst at the National Urban League.

According to Wikipedia, before entering the Biden administration, Kijakazi was a board member of the Winthrop Rockefeller Foundation, the National Academy of Social Insurance and its Study Panel on Economic Security, the Policy Academies and Liberation in a Generation, as well as a member of the DC Equitable Recovery Advisory Group, adviser to Closing the Women’s Wealth Gap, co-chair of the National Advisory Council on Eliminating the Black-White Wealth Gap at the Center for American Progress, and member of the Commission on Retirement Security and Personal Savings at the Bipartisan Policy Center. 

“Kilolo has an amazing ability to find and build connections among individuals and institutions that should be working together on critical public policy issues and policy discussions are much better for that inclusionary approach,” says Margaret Simms, an Institute Fellow in the Center on Labor, Human Services, and Population at the Urban Institute.

Senate Aging Committee Tackles COVID-19’s Devastating Impact on Seniors

Published in the Woonsocket Call on May 24, 2020

In the midst of bipartisan bickering on Capitol Hill as to what should be included in the fifth coronavirus (COVID-19) stimulus package, the Senate Aging Committee holds Congress’s first hearing in Senate Russell Office Building 301 on the disproportionate toll the COVID pandemic is having on the nation’s seniors, particularly those who reside in nursing homes.

Adults ages 65 years and older represent two out of every five hospitalizations and eight out of every 10 deaths from the virus. The 1.5 million nursing home residents and seniors residing in group care settings (including assisted living facilities) are especially at risk. Nationwide, residents and workers in nursing homes and other long-term care settings represent more than one-third of all COVID-19 deaths. According to reports, to date more than 34,000 nursing home residents have died from COVID-19.

COVID-19’s Deadly Toll on Seniors

The Senate hearing, “Caring for Seniors Amid the COVID-19 Crisis,” held on Thursday, March 21, 2020, explored what can be done to better protect this vulnerable population. Over two hours, Senators heard testimony from a panel of experts who are supporting older adults in hospitals, nursing homes, home health settings, and the community. (Due to the limited access to the Capitol Complex, the public is only able to view the morning hearing live on the committee’s website at https://www.aging.senate.gov/hearings/caring-for-seniors-amid-the-covid-19-crisis.

“COVID-19 has brought tremendous hardship and tragedy, placing a heavy burden on the frontline workers, straining our healthcare and distribution systems, and imposing a deadly toll on our seniors in particular,” said Senator Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Those in nursing homes and congregate care centers are especially at risk. Nationwide, nursing home residents represent one-third of all coronavirus deaths. In Maine, the toll on nursing home residents is even higher,” adds Collins.

“Our nation is facing the greatest public health crisis it has seen in a century. This terrible virus is causing death and destruction at lightning speed, especially among older Americans who are most vulnerable for complications from COVID-19,” added Ranking Member Bob Casey (D-Pennsylvania). “We have added unprecedented amounts of funding to purchase personal protective equipment, testing and ensure seniors in the community have access to home and community-based services that keep them out of congregate settings, but this is not nearly enough. We cannot stop working we cannot stop legislating, we cannot stop appropriating dollars to help our seniors,” says Casey.

“This unprecedented time calls for equally unprecedented action. The Administration has to do more and Congress has to do more to help our seniors and their families at every turn,” said Casey. During the hearing, the Senator highlighted his bill (S.3768), the Nursing Home COVID-19 Protection and Prevention Act, introduced with Senator Sheldon Whitehouse (D-Rhode Island, which would help mitigate the pandemic’s disproportionate impact on nursing homes by helping states purchase personal protective equipment (PPE) and testing and fund premium pay, overtime and other essential benefits for nursing home workers.

Taking a Look at Universal Testing of Nursing Home Residents

Collins directed her first question at the hearing to Dr. Tamara Konetzka, a professor of health services research at the University of Chicago, who has conducted research on the disproportionate impact of COVID-19 on nursing home residents and staff. She asked Dr. Konetzka to explain how universal testing can protect residents and eventually allow family members to safely visit their loved ones.

“Dr. Konetzka, I want to have you expand a little bit more on what we can do,” said Collins. “I believe that you recommended universal testing for every nursing home resident and staff, which I think is a good idea and have been recommending. How often, however, would you have to do that, and would that allow family members who have been tested to finally be able to visit their loved ones?”

“[I]t is very important to test all residents, and not wait until residents are…symptomatic, because by then it’s too late,” replied Dr. Konetzka. “[W]hat I’ve heard from geriatricians is generally weekly [testing] would be good or at least biweekly, so that residents can then be separated and the transmission can be stopped.”

Collins also emphasized that testing was needed at every long-term care facility, since even the highest rated nursing homes have been susceptible to outbreaks.

At the hearing, Senator Collins called for the release of additional health care provider funding that was made available through the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act.

“[T]he ratings by CMS, the number of stars, has not proven to be a reliable indicator of which nursing homes are safest in this environment. And indeed, one of the worst outbreaks in Maine was at a nursing home that had five stars,” remarked Collins. “[W]hen we hear the statistics, which are so devastating…my heart just goes out not only to these patients, but to their families and to the staff of nursing homes and other assisted living facilities, congregate care settings. They’re all praying that COVID-19 does not find its way into their facility,”she said.

As the chief infectious disease specialist for New York University, Dr. Mark J. Mulligan oversees the treatment of COVID-19 patients at the University’s health system hospitals. At the hearing, he explained that seniors are at increased risk due to aging-related decline of the immune system as well as chronic conditions such as cancer, heart disease, lung disease, and diabetes, and that older adults who reside in nursing homes are the most vulnerable.

Medical Countermeasures to Combat COVID-19

Dr. Mulligan provided an overview of the medical countermeasures under development—diagnostics, monoclonal antibodies, and potential treatments such as remdesivir.

“For physicians, scientists, and leaders, the virus has continued to humble us. There’s so much we don’t know yet about diagnosis, prevention, and treatment,” said Dr. Mulligan. “The nurses and doctors I have worked with are incredibly dedicated and caring, but they have not had the medical countermeasures needed to effectively help many vulnerable seniors who have died of this disease,” he adds.

Finally, the final panelist, Dr. Steven Landers, the President and CEO of Visiting Nurse Association Health Group who oversees a team of 3,000 caregivers that cares for 9,000 people daily, provided a home health perspective on the public health crisis. According to Landers, maintaining this a supply of Personal Protective Equipment (PPE) is both challenging and expensive. “We are using over 17,000 surgical masks and over 3,500 N95 masks each week and we are also using thousands of isolation gowns, gloves, goggles and face shields. We have had to pay 7-10 times the usual prices and reach out to vendors all over the world, vendors who we couldn’t fully vet and verify, sometimes just hoping that shipments would arrive,” he say, calling on Congress to find ways prioritize home health and hospice agencies getting needed PPE.

“I have never seen the system so strained, but I also have never felt prouder of the skilled, compassionate, and courageous people I work with,” he said.

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

Senators Collins, Casey, Pushing for Reauthorization of Older Americans Act

Published in Woonsocket Call on May 19, 2019

With the Older Americans Act (OAA) scheduled to expire on September 30, 2019, the U.S. Special Senate Committee on Aging puts the spotlight on the importance of this critical law to older American’s, calling for its reauthorization.

Enacted in 1965, the OAA helps more than 11 million seniors age in their communities by funding programs that support grandparents raising grandchildren, reduce social isolation, provide congregate or home-delivered meals and offer respite care among other services.
OAA was last reauthorized in 2016 for a period of three years.

Bipartisan Push in Senate to Reauthorize OAA

While the Senate Aging Committee does not have legislative jurisdiction over OAA, the panel traditionally has put attention on the OAA by holding hearings or special events at the start of any reauthorization process. And the Chair and Ranking Member of the Senate Aging Committee – Senators Susan Collins (R-Maine) and Robert Casey (D-Pa.)—have taken an especially keen interest in this year’s OAA reauthorization process. The Senators are leading a bipartisan coalition of Senators pushing for reauthorization, which includes Senate HELP Committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wa) as well as Senators Mike Enlzi (R-Wyo.) and Bernie Sanders (I-Vt.).

In Collin’s opening statement, she pledged to “get across the finish line, on time, a robust and bipartisan Older Americans Act that will strengthen support for its bread and butter programs, while providing more flexibility for states to meet local needs.”

At the Senate Aging hearing, Collins says she plans to focus on five priority areas in the reauthorization of OOA, specifically family caregivers, nutrition, social isolation, transportation and elder justice. “By enriching the lives of seniors, the Older Americans Act improves the lives of all Americans,” says the Maine Senator, kicking off the two hour and 26-minute hearing, aptly titled, “The Older Americans Act: Protecting and Supporting Seniors as they Age.”

“The Older Americans Act is a shining example of a federal policy that works. Every $1 invested into the Older Americans Act generates $3 to help seniors stay at home through low cost, community-based services,” says Collins.

“The Older Americans Act reminds us who we are as a country. It represents our commitment to the generations who made us who we are today. And, it lifts up the seniors who need our help the most, added Casey in his opening statement.

Before the May 18 hearing, Casey noted that he had reached out to 34 Area Agencies on Aging, representing 60 percent of the counties in his home state, for their feedback about OAA’s effectiveness in delivering services to older Pennsylvanians. He asked these two questions: “How is the OAA currently working?” and “How should this important law be strengthened?”

“In every city and every town, the aging network said that there is no match for the high-quality services that senior centers and Area Agencies on Aging provide to older Pennsylvanians. The OAA programs support Pennsylvanians and their caregivers by providing meals, respite and protection from fraud and abuse. And importantly, the OAA also helps seniors age in the location of their choice, which of course is most often their homes and communities.”

Senate Panel Witnesses Give Thumbs-up to OAA

Larry Gross, the chief executive officer of the Southern Maine Agency on Aging shared with the attending Senators his more than four decades of experience serving seniors in both urban and rural areas. He explained how OAA bolsters nutrition programs, supports family caregivers, reduces social isolation and addresses elder justice. He highlighted a partnership with Maine Medical Center showing that home-delivered meals reduce hospital readmissions, and discussed innovations that he has led to improve senior nutrition and build community.

Faith Lewis, a great-grandparent from Simpson, Pennsylvania, shared her personal experience raising her 5-year-old great-granddaughter and the importance of OAA program support that assist grand families like hers. She receives support through the National Family Caregiver Support Program and regularly attends a support group for grandparents raising grandchildren that is hosted by her local Area Agency on Aging.

Lance Robertson, the Administrator & Assistant Secretary for Aging at the administration for Community Living, gave an overview of OAA, including its history, sustainability, and variability across states and communities. He shared background and data on how OAA has helped millions of seniors to age in their local communities. He also discussed his agency’s mission to connect people to resources, protect rights and prevent abuse, expand employment opportunities, support family caregivers and strengthen aging networks.

Finally, Richard Prudom, the Secretary of Florida’s Department of Elder Affairs, Mr. Prudom talked about his work with his state’s 11 Area Agencies on Aging. He offered a state perspective on interfacing both with the administration for Community Living as well as with the Area Agencies on Aging to develop programs that meet the needs of communities. He focused on priorities in supporting family caregivers, advancing senior nutrition, combating elder abuse and addressing disaster preparedness.

AARP Talks About Impact of OAA Programs

Wendy Fox-Grage, Senior Strategic Policy adviser at the Washington, DC-based AARP, in a Feb 19 blog posting, says that despite “woeful inadequacy of current funding, OAA enables 11 million older Americans to live independently. Recent evaluations confirm the positive impact on the Act’s nutrition and family caregiver program, she says.

As to evaluating the impact of OAA’s nutrition programs, Grage says that forty-two percent of congregate meal participants and 61 percent of home delivered meal participants would skip meals or eat less in the absence of these programs. Congregate meal participants are also less likely to be admitted to nursing homes, and congregate meal participants who live alone are less likely to be admitted to hospital than nonparticipant, she says.

As to caregiving, Grage noted that family caregivers received four hours or more of respite care per week reported a decline in burden over time and those who received at least one education/training, counseling, or support group session experienced an increase in self-reported confidence over time.

AARP joins Senators Collins and Casey’s call on Congress to reauthorize the Older Americans Act before the end of September. OAA’s 11 million beneficiaries, 700,000 caregivers, and providers in the nation’s aging network — consisting of the federal Administration on Aging, State Units on Aging, local Area Agencies on Aging, and local service providers – also wait for Congress to make its move and reauthorize the Act.