LTC Must Be Placed on Candidates’ Radar Screen

Published in the Woonsocket Call on May 29, 2016

Presidential candidates might just think twice about their political campaign positions on long-term care. With the graying of nation’s voters, Congress will be pushed to put long-term care on its policy agenda. When the dust settles after the Democratic and GOP conventions, the winning candidates must address long-term care issues in their debates before the November election.

In 2013, America’s age 65 or older population made up only 14 percent of the total population, but by 2040, this demographic group will nearly double to comprise about 22 percent. According to the U.S. Department of Health and Human Services the majority of these individuals will require some form of long-term care services (specifically, help with activities of daily living—such as cooking, bathing, or remembering to take medicine—that can be provided in a home or institutional setting.)

Misconceptions About Medicare and Social Security

Survey results in a 17 page report, “Long-Term Care in America: Expectations and Preferences for Care and Caregiving, released by Associated Press (AP)-NORC Center for Public Affairs Research, notes that most older Americans expect Medicare and Social Security to pay for long-term care services while these federal programs generally do not. The survey findings also indicate that respondents, age 40 and over, strongly supported public policies that help a person save for long-term care services and for those that defray the cost of care giving, including state paid family leave programs.

“This survey provides much-needed data on how people perceive the issue of long-term care in the United States,” says Trevor Tompson, director of The AP-NORC Center, in a statement released on May 16, 2016 with the survey findings… “The need for long-term care services and support to assist seniors with activities of daily living is increasing exponentially. Financing high-quality services so that the costs are manageable for families and governments will remain a big challenge for decision-makers,” he added.

“Older Americans of today and tomorrow have a 50 percent chance of living with substantial and often expensive daily needs,” adds Dr. Bruce A. Chernof, President and CEO of The SCAN Foundation. “Medicare and Social Security were not built to cover long-term care, leaving American families unprotected, and as the survey shows, unaware of this fact,” he says.

The AP-NORC survey found that while older Americans’ confidence in being financially prepared to pay for long-term care services remains low overall, there has been a slight increase in public confidence over the past four years, consistent with other measures of consumer confidence post-recession, according to the Consumer Confidence Index. In 2013, 27 percent reported feeling very or extremely confident in their ability to pay for long-term care, increasing to 29 percent in 2014, 32 percent in 2015, and 36 percent in 2016.

The polling finds reveal that a widespread misconception as to what Medicare covers for long-term care services. Older respondents, with an annual household incomes less than $50,000, are more likely to expect to rely on government programs such as Social Security, Medicare, and Medicaid, while those with higher incomes expect to rely more on personal savings to pay for their needed long-term care services. Still, 3 in 10 of these wealthier older Americans report that they will rely on Medicare to support their care as they age. This reflects common misperceptions among older Americans about the long-term care services that Medicare covers, notes the AP-NORC survey.

Thumbs Up to Aging in Place

Seventy seven percent of the survey respondents would prefer to “age in place” and receive care in their own home, w with far fewer preferring to receive care in a senior community (11 percent), a friend or family member’s home (4 percent), or a nursing home (4 percent). Among those respondents who prefer to receive care at home, there are gender differences in preferences for who provides that care: men would prefer to receive care from a spouse (51 percent vs. 33 percent), and women would prefer to receive care from their children (14 percent vs. 35 percent).

There is widespread support for policies to help caregivers face the costs of providing long-term care, with 72 percent supporting state programs to provide paid family leave, 83 percent supporting tax breaks for caregivers, and 73 percent supporting a Social Security earnings credit for caregivers taking time out from the workforce to provide care.

According to the AP-NORC survey, forty-three percent of the survey respondents have either been caregivers in the past or currently providing long-term care to a family member or close friend. Among those with experience as caregivers, 4 in 10 report having to miss work to provide care.

The researchers found that prior experience with long-term care is associated with greater support for several public policies to help people finance long-term care and to help alleviate costs for caregivers. These individuals expressed higher levels of concern about aging and are more likely to anticipate that it is at least somewhat likely that a loved one will need care in the next five years, compared to those without direct care giving experience.

Finally, one-third of the survey respondents reported having done no planning at all for their own long-term care needs. This 2016 finding is similar to the 31 percent who said the same in 2015 and remains lower than the 47 percent and 44 percent who said they had done no planning in 2014 and 2013, respectively.
One Size Does Not Fit All

Meghan Connelly, Chief Program Development at Rhode Island’s Division of Elderly Affairs, provides some thoughts about the findings of the AP-NORC survey. “Long-term care options are not “one-size-fits-all”. In Rhode Island, there are a number of choices one can make, ranging from living independently and receiving care at home to nursing home care. This report highlights that consumers want options when it comes to making these decisions for themselves, or assisting loved ones with long term care choices,” she says…

Connelly adds, the AP-NORC survey “supports the findings of past research: that the overwhelming majority of people want to receive long term care services at home,” noting that in the Ocean State there are many home- and community-based care options. She says that”home care may be available through a physician’s office; at the time of discharge from a hospital or nursing home; or through referrals to state-subsidized programs administered by agencies under the Executive Office of Health and Human Services.”

“The AP-NORC survey also underscores the need to adopt progressive financial policies that support family caregivers who provide the greatest percentage of needed long term care to their elderly or disabled loved ones at home,” warns Connelly.

Greg Crist, Senior Vice President of Public Affairs at the Washington, D.C.-based American Health Care Association (AHCA), notes, “This data generally tracks what our own research has shown: Americans don’t think of this topic every day, and honestly, this is a topic they’d rather avoid. No one likes the thought of aging, and with that aging, the increasing likelihood they will help in their later years. No one welcomes a loss of independence. But here’s the good news – the sector is adapting and innovating.”

Crist asserts nursing homes are meeting the challenge of caring for aging baby boomers. “We’re meeting the growing demands of Boomers, particularly as clinical needs grow, but also in offering amenities such as custom dietary menus, social media communities, and personal rehab care plans that speed recovery times. Whether in Rhode Island or elsewhere, this is an evolving health practice, recognizing that change is needed to meet the new preferences of older Americans,” notes Crist.

Listen to the Older Voters

The AP-NORC survey findings mirror other “long-term care perception” studies released by AHCA and AARP. Democratic presidential candidates Hillary Clinton, Bernie Sanders, and GOP standard bearer Donald Trump must not forget the needs of America’s exponentially growing older population. These older voters do not want to fall through the nation’s public policy safety net when they require the most assistance, paying for costly long-term care services. As the survey report notes, older Americans strongly support Family Leave programs and also call for government administered Long Term Care Insurance programs.

For a copy of the report go to http://www.longtermcarepoll.org/Pages/Polls/long-term-care-in-america-expectations-and-preferences-for-care-and-caregiving.aspx..

GAO Report Reveals Social Security Benefits Gap between Rich, Poor

Published in Woonsocket Call on May 1, 2016

We intuitively know that there is a growing income gap between America’s rich and poor. We heard it for months during the presidential democratic debates. But a newly released GAO report documents this charge, the disparities and their impact on Social Security Benefits.

Growing disparities in life expectancy between America’s rich and poor is eroding the progressive nature of Social Security. A new Government Accountability Office (GAO) report, “Shorter Life Expectancy Reduces Projected Lifetime Benefits for Lower Income,” requested by Senator Bernie Sanders, shows that low-income American men (making about $20,000 a year) will lose 11 percent to 14 percent of their lifetime Social Security benefits while high-income men (making $80,000 annually) will see a 16 percent to 18 percent benefit boost due to this growing gap.

Life Expectancy Impacts SSA Benefits

The GAO study, released on April 4, 2016, found that raising the Social Security retirement age would result in even fewer benefits for lower-income groups. Lower-income men are living between 4 and 13 fewer years than higher-income men, and lower-income women are living between 2 and 14 fewer years than higher-income women.

“Poverty should not be a death sentence,” said Sanders, who serves as ranking member on the Primary Health and Retirement Security Subcommittee. “When over half of older workers have no retirement savings, we need to expand, not cut, Social Security so that every American can retire with the benefits they’ve earned and the dignity they deserve,” he says.

According to 64 page GAO report, the wealthiest Americans are not only living longer and collecting more in Social Security benefits, they are also contributing less of their income toward Social Security. Almost all of the income gains over the past three decades have gone to those earning above the $118,500 earnings cap and have therefore been exempt from Social Security taxes, costing the Social Security Trust Fund over $1.1 trillion, says the report.

“Today, the wealthiest Americans contribute less to Social Security than at any other time in recent history. We must reject calls to raise the retirement age and instead strengthen Social Security by ensuring millionaires and billionaires pay their fair share,” Sanders said.

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), says that the GAO report is especially important when you consider the push in Congress to raise Social Security’s retirement age to reduce benefits. “Forcing average Americans to delay retirement until 70, as suggested by some in Washington, would mean even smaller benefits for lower-income groups,” he says.

Richtman notes that NCPSSM has long opposed increasing the Social Security retirement age, stating that it is “nothing but a cruel cut in benefits” The GAO report shows exactly how cruel it would be, he says.

Instead of cutting Social Security, Richtman calls on Congress to boost benefits so that retirement income program can continue to fulfill its promise providing an adequate base of income for America’s seniors.

Lawmakers Push to Protect Social Security

Sanders, a presidential Democratic candidate, has introduced legislation that would ensure that Social Security would be able to pay every benefit owed to every eligible American for the next 58 years. His plan would increase benefits by more than $1,300 a year for seniors with less than $16,000 in annual income. This includes boosting yearly cost-of-living adjustments by making the consumer price index better reflect seniors’ rising costs for health care and prescription medicine.

To shore up the retirement program’s trust fund, the Senator would lift the cap on taxable income so everyone who makes more than $250,000 a year would pay the same percentage of their income into Social Security as middle-class working families.

“This report reinforces the importance of strengthening Social Security and preserving the guarantee of Medicare, especially for working and middle class Rhode Islanders,” said Congressman Cicilline (D-RI), who is a co-sponsor of the Protecting and Preserving Social Security Act. “After a lifetime of hard work, Rhode Islanders should be able to retire with economic security and peace of mind, he says, pledging to continue his efforts to support “commonsense” legislation that strengthen Social Security benefits.

The GAO study is a warning that proposals to raise the retirement age “would fall hardest on those who can least afford it,” says Senator Sheldon Whitehouse (D-RI). As a founding member of the Defending Social Security Caucus, Whitehouse plans to explore ways to strengthen the Social Security, “the bedrock of American retirement security.”

GAO made no recommendations in this report. However, in comments the Social Security Administration (SSA) agreed with GAO’s finding that it is important to understand how the life expectancy in different income groups may affect retirement income. The federal agency sees financial literacy as a key factor in preparing for a “secured retirement.”

According to a SSA official, “Social Security offers one of the best tools for the public to plan for their retirement and educate themselves about their benefits – a my Social Security account which is a secure, personalized online account that can be created at http://www.socialsecurity.gov/myaccount. With a my Social Security account, people can check their Social Security Statement to learn about future Social Security benefits, verify annual earnings, and plan for their financial future. More than 23 million people have already created secure, convenient accounts,” he says.

In recent years Congress has looked for ways to keep the Social Security program afloat by adjusting Social Security tax contributions, increasing retirement age, and reducing benefit amounts. Now with the release of the new report findings, the message is clear. Congress must not tinker with Social Security until it understands the unanticipated impact on those receiving the benefit checks, especially on the lower-income retirees.

For more information, contact Charles Jeszeck at (202) 512-7215 or jeszeckc@gao.gov.

Survival Story: Former Business Owner Overcomes Devastating Setbacks

Published in Senior Digest, April 2016

If you are in pursuit of the American Dream, you probably weren’t given a roadmap that would guarantee a successful journey. Ask the average man or woman on the street today what immediate thoughts come to mind about owning your own business, and you’ll probably hear ‘being your own boss’, and ‘working your own hours’ that top the list of perceptions. But when opening your own business becomes the alternative to unemployment in your later years, as Donald, Russell, Jr. found out, it may not be what you expected or even planned. Like millions of middle-aged workers in the early 1990s, a severe economic downturn forced this Central Falls resident to make choices that ultimately would financially hit his pocketbook as he approached retirement.

Donald Russell had worked his way up from stock boy to manager at F.W. Woolworth Co., one of the areas original five-and-dime stores. During his 33 year career with this large big-box retail company, what was at the time the fourth largest retailer in the world operating over 5,000 stores, he eventually managed seven of the retail company’s stores, one located in Providence (at Westminster and Dorrance Streets), and the others in Massachusetts, Vermont and New York.

But everything changed in the late 1990’s, and this 117 year old company struggled to compete with the growing big discount stores. F.W. Woolworth filed for bankruptcy protection, and Russell, facing unemployment, had to quickly make major career decisions. He knew that, “at age 52, big box competitors don’t want you,” or if he was offered a position, the salary would be much lower than what he was used to. “I could not take less because I had to pay for my daughter’s college education,” he added.

Russell credits “courses he took at Boston College” for teaching him valuable lessons on how to open a small business, and with knowledge in hand, he was ready to take that leap of faith and open his own business. . Russell decided to cash out his $80,000 pension (less penalties) and combined with a loan from U.S. Small Business Administration, he would have enough capital to open a small retail business.

Getting into the Pet Business

Russell spent time researching a market niche, searching for one that would not put him in direct competition with the chain store. He discovered that the pet business was not really sought after by “big box retailers” and at that time “there were only 30,000 pet stores throughout the country. Today the number has decreased to 6,000.” Now . Russell found his niche, and in 1997 opened his business “Dr. Doolittle’s Pets & More”, a small pet store in an East Providence shopping plaza. Though situated between two large Petco stores – one in Rumford, RI and the other in North Attleboro, MA., Russell did not view the large chain stores as competition, for he knew his prices were better. In 1997 when Russell opened his store, small business accounted for about 85 percent of the nation’s economy, he states, noting that today this percentage has dropped to 70 percent.

Business was strong when Dr. Doolittle’s first opened and for over 13 years, Russell employed seven full and part time employees. However, by 2004 “the economy began to take a dive” and juggling the monthly rent, utilities and employee salaries became difficult when his cash flow slowed. Russell began to loose money.
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By 2006 his revenue had dropped 30 percent from the previous year, and neighboring big stores located in the plaza, like Ocean State Job Lot, began to close. In an effort to trim expenses, Russell was able to renegotiate his rent to a lower amount, however “losing the Stop & Shop Supermarket in the next plaza, which was a main draw to the area, “was ultimately the straw that broke the camel’s back”.

Taking from Peter to Pay Paul

Like thousands of small business owners in the Ocean State, Russell had to juggle each month to meet his expenses, which included his RI sales tax. Choosing to pay his monthly sales tax or paying his employees salary was not an easy choice to make, but he could not pay both. “I chose to pay my employees” first, with the plan to make up my [delinquent] sales tax later” he stated, noting however, that the “economy put the brakes to that”. “I could not even borrow a dime even with an excellent credit rating of 750,” added Russell. The poor economy had forced banks to cut off credit to small businesses – period.

In 2009, the Rhode Island Department of Taxation came knocking on his door, and the now 65-year-old pet store owner was forced to close his business because he was in arrears on his payment of sales taxes. While his business was his sole-source of income, the forced closing of the business put him in a ‘catch 22’ situation – blocking any attempt to rescue his business and pay off the remaining sales tax owed, which had now grown to thousands of dollars. Rather than padlock the door, the State did allow him access to the store to feed and maintain the animals until other arrangements were made.

Two weeks after his closing, Russell hammered out an agreeable payment plan with the State of RI for back taxes, but the economy never recovered, and by September, 2010 the doors closed for the final time. In a valiant effort, Russell paid off $18,500 of the $20,000 owed before he closed, but two years later to his surprise, he was blocked from registering his car because of the remaining taxes (and penalties) still owed. A dispute as to the amount of sales taxes (plus penalties and interest) paid ultimately ended with the state’s tax agency backing off and allowing him to register his vehicle.

Russell’s forced closing and ultimately his bankruptcy caught the eye of both statewide and national media. Two radio talk shows and television coverage brought the news of his closure to the public. Even the nation’s most popular Web site, “The Drudge Report,” posted articles. Amazingly, he says that over 100 pages of blog posting were also generated, too.

Making Ends Meet

Today, Russell, 72, is collecting Social Security supplemented by a part-time job delivering pizzas. He notes that beneficiaries will not receive cost of living this year. Like millions of Social Security beneficiaries, Russell feels the impact of inflation. “There is no extra money to buy groceries after paying my rent and utilities,” he says. Local food pantries provide additional food and the Pawtucket-based Blackstone Valley Community Action Program pays for some of his heating bills.

Reflecting on the lay off in his fifties that led to the opening of his small business and ultimately its closing as he reached his mid-sixties because of an ailing economy, Russell admits he did not have a strategy for getting through the tough times in his later years.

“I just coped,” says Russell. The former business owner has a strong opinion on opening a small business in Rhode Island. “Never,” he says. .