Tag Archives for U.S. Senator Bob Casey

Spotlight on scams and frauds targeting older Americans 

Published in RINewsToday on September 23, 2024 

Although the U.S. Senate Special Committee on Aging, initially established in 1961 as a temporary committee, later becoming a permanent Senate Committee in 1977, has no legislative authority, it studies an array of issues related to older Americans. Last week, U.S. Senator Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, held a full Committee Hearing, taking a look at an important issue impacting older Americans, the rampant increase of scams and frauds.

The hearing entitled “Fighting Fraud: How Scammers are Stealing from Older Adults,” lasting over one hour and thirty minutes, highlighted the psychological and economic impacts that frauds and scams have older adults, who are disproportionately targeted by fraudsters.

During the hearing, held on Sep. 19, Casey unveiled the Aging Committee’s 9th annual Fraud Book, “Fighting Fraud: Scams to Watch Out For.” The 93-page book, hot off the press, provides seniors with an overview of the most prevalent scams to help them identify and avoid being victimized. The Fraud Book also contains valuable resources for scam victims.

At this hearing, Casey also touched on the 2017 Republican tax law, called “Scammed Then Taxed,”which details how the law’s repeal of the theft loss deduction has imposed significant taxes on many scam victims.

The 91-page Majority Staff Report details the results of a months-long investigation examining how the removal of the casualty and theft loss tax deduction—repealed by Republicans in the 2017 tax law has devastated many American fraud victims.

This report details how some older adults—who lose the most to frauds and scams—are now facing huge tax bills on top of losing all their assets, leading them to feel as though they have been victimized twice.

According to the report, for a century, the theft loss deduction allowed taxpayers who experienced theft to receive a tax deduction to offset their losses. The repeal of this provision has meant that fraud victims are now often obligated to pay taxes on money that has been stolen.

Keeping Scammers from Stealing from Older Adults

In his opening statement, Casey stated: “At today’s hearing, we heard tragic stories from scam victims and law enforcement about how fraudsters are getting more sophisticated and aggressive with their scams and throwing the lives of older adults into chaos.” The Pennsylvania Senator stressed the importance of educating older adults about the threats they face from frauds and scams.

Casey rattled off a list of common scams, detailed in the released Fraud Book, including grandparent scams, investment scams, tech support scams, to name just a few.

With the advent of Artificial Intelligence, scammers have now gotten even more sophisticated, especially by cloning the voice, warned Casey, making their phone and online message even more convincing to the older victim.

“That may explain why recent FBI data shows that fraud losses among older adults have gone up in recent years – reaching $3.4 billion in 2023,” says Casey.

Casey also called for more resources to be provided to persons who have been victimized by scams, including those who have been forced to pay taxes on money they’ve lost due to changes in the 2017 Republican tax law.

Like Casey, in his opening statement Ranking Member Mike Braun (R- Indiana) also stressed the need to prioritize education and outreach to older adults help them to recognize red flags that warn of scams.

“Our community banks and credit unions are often the first line of defense intervening on transactions that just don’t add up,” says Braun. “In my home state of Indiana, one community bank has been able to stop over $1.2 million worth of scams this year,” he notes.

According to Braun, last year Medicare lost an estimated $60 billion due to fraud, errors, and abuse. “Every dollar lost to fraud is a dollar that can be spent on vital programs for American seniors,” he says.

The Indiana Senator noted that he has requested the U.S. Government Accountability Office (GAO) to initiate a full audit of Medicare fraud. The GAO has begun its audit in July, says Braun, noting it to be the most comprehensive audit in Medicare’s history.

And Braun expects the GAO investigation to uncover “how much fraudsters are stealing from the American taxpayer” and to revamp the current Medicare Fraud Prevention System to reduce fraud taking place. 

Witnesses testifying before Senate Aging Committee

Casey invited Susan Whittaker, an Administrative Assistant at Lehigh County Aging and Adult Services in Allentown, Pennsylvania, to testify at the hearing about her late husband’s experience as a QuickBooks scam victim.  At the time of the scam, Bill, 75, suffered from dementia along with other chronic conditions.

Susan told Senators that her husband had received an email receipt on Tuesday, that appeared to be from QuickBooks. It claimed that a software upgrade fee of $499 had been charged to the business account that Bill used to manage his son’s company.  He knew that he hadn’t purchased this upgrade.  Calling the company and requesting a refund, he was told to pay $500 upfront, thru a created Venmo account, install an application on his computer and provide personal financial information.  Once done, Bill would get his money back.

On Friday, by the time Susan had learned about the financial transaction, $28,000 had been withdrawn from their accounts. Although the bank ultimately recovered $8,000 the following week, $20,000 was gone — money that her husband was planning to use to buy medications.  And he lost his job, too.

“This scam was devastating and had a devastating effect on Bill—both financially (losing $20,000) and emotionally,” stated Susan, forcing her husband to begin rationing his medications.

“We just couldn’t afford them [medications] anymore… He also lost his sense of self-worth. I was really sad to see this very intelligent and past business owner, become so afraid to read emails and use a phone. It was a huge setback for him, and I think contributed to his worsening health conditions…he stopped living,” said Susan.  

Kathy Stokes, Director of AARP’s Fraud Prevention Program, told Senators that there has been a “meteoric” growth in fraud crimes. When considering fraud that goes unreported, Stokes noted that the Federal Trade Commission estimated the cost of fraud at $137 billion in 2022.  But most fraud experts say that this is far higher than the $ 8.9 billion in losses reported that year, she added.

Beyond educating seniors about fraud prevention thru the sharing of information online at aarp.org/fraudwatchnetwork, AARP covers the issue in AARP the Magazine, AARP Bulletin, biweekly emails or text ‘watchdog alert newsletter,” and on its podcast “A Perfect Story,” notes Stokes.

“Beyond education, AARP is unique in its focus on supporting victims of fraud and their families,” says Stokes, noting that its Fraud Watch Network Helpline receives 500 calls a day.

“Addressing fraud requires more than piecemeal solutions; it demands a whole-of-society approach,” warns Stokes. “But together, educators, policymakers, law enforcement and industry can turn the tide against vicious crime gangs who hold the power right now. Together we can disrupt their business model, protect millions of consumers, and keep billions of dollars in saving and retirement accounts and in our economy,” she says.

“Currently, we are all failing the very people who need us the most: older adults- m any of whom can’t afford to lose anything, let everything. We are failing in our most basic duties to protect those in their golden years who are living off their nest eggs they worked for their entire lives and who are beyond the ability to rejoin the workforce to make the money back,” charged Scott Pirrello, who oversees the San Diego District Attorney’s Office’s Elder Abuse Prosecution. 

“Too many very well intended programs are not implemented in a way to truly impact the tsunami of fraud that we are facing each day,” he said.

Pirrello told the Senators about the success of the Elder Justice Task Force (EJTF), created by his office, working with the San Diego FBI, to combat elder fraud. Oversea scammers depended on organized networks of money launders operating in the United States, he said, noting that EJTF worked to disrupt these networks.

Like the other witness, Pirrello called for investing in education, as well as adequately fund task forces like the EJTF, to fight against scammers.

One of the biggest crimes affecting Medicare beneficiaries and persons with disabilities is Medicare fraud, waste and abuse, says Nancy Gilmer Moore, who works for the Indiana Association of Area Agencies on Aging managing its Senior Medicare Program. “Health care experts estimate improper Medicare payments are approximately $ 60 billion a year,” she says.

Gilmer Moore admitted to the Senate Aging Panel that she was personally the target of the “Intermittent Urinary Catheter fraud scheme.  Medicare paid the fraudsters $1,500 a month (for supplies never ordered) before she noticed it on her statement. Moore ultimately reported the suspicious claims to Centers for Medicare and Medicaid Services and requested a new Medicare number since her number was compromised.

“Be on the lookout for duplicate billing, services or products not rendered or received and services not ordered by their physicians,” urged Gilmer Moore, noting that beneficiaries and caregivers should never give their Medicare number or financial information over the telephone to an unknown called.  Medicare does not make. unsolicited phone calls.

For information on fraud prevention, go to aarp.org/fraudwatchnetwork.

To download a copy of the 2024 Fraud Book, go to https://www.aging.senate.gov/imo/media/doc/2024_fraud_book_english.pdf.

To watch the Senate Aging Panel’s hearing on fighting fraud, go to https://www.aging.senate.gov/hearings/fighting-fraud-how-scammers-are-stealing-from-older-adults.

To see the Majority Staff Report, “Scammed Then Taxed,” go to

https://www.casey.senate.gov/news/releases/scammed-then-taxed-casey-unveils-new-report-showing-how-republican-tax-law-further-devastated-scam-victims

Hoarding and seniors: “The Consequences of Clutter” Report 

Published in RINewsToday on July 22, 2024

With the number of seniors afflicted with a hoarding disorder expected to skyrocket to over 14 million, on July 2 U.S. Sen, Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, unveiled a report putting the spotlight on its impact on older hoarders and their communities.  For seniors those consequences include health and safety risks, social isolation, eviction, and homelessness. For communities, those consequences include public health concerns, increased risk of fire, and dangers to emergency responders.

According to the report, citing the Administration for Community Living’s 2020 Profile of Older Americans, the number of seniors in the U.S. is expected to increase from about 54 million in 2019 to over 94 million in 2060. “Because hoarding disorder disproportionately impacts older adults, experts worry that aging could fuel a rise in hoarding in the coming decades,” notes the report, quoting NPR Morning Edition’s Rose Conlon. 

According to the Majority Staff of the Senate Aging Committee who wrote the report (with a whopping 270 citations), it was developed for information purposes only and does not represent the findings or recommendations formally adopted by the Committee.

Hoarding is a chronic and progressive condition

The report notes that this chronic and progressive condition impacts roughly two percent of the general population, while it affects about six percent of those over the age of 70.

“Hoarding disorder is a heartbreaking condition that is posing challenges to older adults, their families, and their communities across the country,” said Chairman Casey (D-PA) in a July 2 statement announcing his report. “The federal government has an obligation to ensure that Americans can age with dignity and this report makes clear that obligation must include doing more to address hoarding disorder,” he says.

According to Casey, the new report, “The Consequences of Clutter: How Hoarding Disorder Affects America’s Older Adults, First Responders, and Their Communities,” demonstrates the scope and severity of the challenges of this complex mental health condition and offers a path forward for how we can help people, communities, and local governments contend with this condition. 

Local communities throughout the United States are already working to address cases of hoarding disorder, including through the formation of hoarding task forces to coordinate response efforts, says

Casey’s report, noting that the local resources  available often do not correspond with the level of challenge communities are facing. 

Casey’s report issued a series of nine recommendations for how the federal government can increase support to communities that are contending with hoarding disorder, including expanding access to treatment for the condition, providing local officials with more extensive guidance and training to support afflicted individuals, and expanding the scope of tracking and research about how hoarding disorder is affecting individuals and communities nationwide.

The report compiles 55 requests for information, responses, and stakeholder statements submitted by non-profits, social services organizations as well as state and local governments to gather information to better understand the impact of hoarding in local communities. 

“Overall, the report does a good job of outlining the importance of the topic and identifies the federal and state agencies that should be involved in assessment and intervention,” says Randy O. Frost, professor emeritus of psychology at Smith College and a leading researcher on hoarding and related topics.

“Hoarding Disorder is a relatively [recognized] new disorder, having just entered the DSM in 2013. Consequently, there are not identified agencies who can claim ownership of the problem and the potential solutions.” This report legitimizes this problem for attention from these agencies, says Frost, noting that this report also highlights the fact that the prevalence of hoarding is extremely high among the elderly.

“Severe cases are sometimes life threatening for the individual and those living nearby or those called in to provide help,” adds Frost.

An Expert’s take…

According to Frost, the report covers the important issues related to hoarding, including education of the general public as well as family, friends, and people suffering with the problem. It highlights the need to train professionals in best practices for intervention. An important assumption underlying the report is that this is a problem which touches many different social service disciplines, from first responders to assisted living facilities, adult protective services, animal control, mental health, public health, child health, elder services, etc. “When a local case is identified, in current practice, it is not unusual for 4 or 5 of these agencies to be involved, often not knowing what each other are doing. Integration among these agency professionals is crucial for dealing with hoarding efficiently,” he says.

“There is a lot more that could be said about this problem, and a lot more detail could have been included regarding specific recommendations,” he said, stressing that this was not the purpose of the report. “The report was to outline the problem and point different agencies in appropriate directions moving forward. It does so and is a welcome effort from a federal agency,” he says.

Spotlight on Rhode Island

“Hoarding is a serious problem that has apparently not been adequately addressed in Rhode Island as well as in the nation as a whole,” charges long-time advocate for vulnerable and marginalized populations Susan Sweet, former associate director of the Department of Elderly Affairs, and founder of the Rhode Island Minority Elder Task Force (RIMETF).  “While it is present in all age groups, adults over 60 years have the highest level of hoarding behavior and the most risk because of diminished physical and often cognitive abilities,” she says.

“This report outlines the difficult life circumstances that elders with the problem of hoarding face.  The Rhode Island network of aging programs and advocates for older adults do not have the resources to create and implement effective remedies,” warns Sweet. “I hope that shining a light on the issue will encourage policy, funding, and attention to what is a mental health issue and a complication in physical illnesses that create obstacles in attempts to help elders afflicted with the disorder,” she says.

According to Sweet, the Ocean State is one of the few areas and the only state that has organized a Hoarding Taskforce to point the way towards effective client management, education and training of eldercare healthcare, mental health programs and social work entities.  The health and well-being of individuals and communities is greatly impacted by the fire hazards, evictions, safety issues, and other self-neglect problems that occur with hoarding behavior.

“Awareness of the prevalence of hoarding and the danger to our communities and citizens should quicken the pace of funding and support to combat this growing threat,” says Sweet.

Like Sweet, Robin Covington, a member of Rhode Island’s Hoarding Task Force, sees the value of the released Senate Aging Committee’s report on hoarding and its recommendations. “As an adult protective services caseworker I saw firsthand the implications of hoarding,” said Covington, who serves as Coalition Director of Saint Elizabeth Haven for Elder Justice. “Hoarding creates health, fire hazard and safety risks, social isolation, eviction and homelessness,” she said. 

“Often times, people who hoard don’t think they have a problem because of their attachment to their possessions, which makes it difficult to deal with”, says Covington.  Because of its behavioral aspects a person with this behavior needs clinical assistance, she notes, not just decluttering of personal items. 

Covington believes that there is a lack of programs and clinical support in place in Rhode Island to address the increasing problem of hoarding. However, the state’s Hoarding Taskforce is working on helping support case managers and providers by developing a workforce initiative to support individuals with clutter or hoarding tendencies. 

Increase funding for Case Manager interventions

But more funding must be given to Community Action Programs who subcontract with OHA to oversee Adult Protective Services. “It’s pricey to cover the costs of visits, intervention and coordination of a clean-up company,” Covington says. 

A lot of times when it is someone over 60, a report to Adult Protective Services is provided and a CAP agency case manager goes out and visits the older adult to put eyes on them and to help with an intervention like the coordination of a clean-up company, but that can be expensive, notes Covington. 

As a Licensed Clinical Social Worker for over 23 years and RIMETF’s president  Lori Brennan-Almeida has seen the negative impact of hoarding up close.  For over 20 years, she has seen RIMETF provide emergency assistance to seniors age 55 and over to pay for services to clean their apartments to avoid eviction.

“Clinical intervention is necessary to stop seniors from hoarding”, says Almeida, stressing the importance of home-based therapy. “Grief counseling may be needed because a person often forms an attachment to compensate for a personal loss,” adds Brennan-Almeida.  

“Without counseling, hoarding may well continue after the debris is gone from their apartment and the senior will just collect more items”, says Brennan-Almeida.  

Keeping tabs on hoarding

“This is our first ever hoarding report,” says Misha Linnehan, Deputy Press Secretary for Sen. Casey.  When asked if there would be a follow-up report next year, she stated: “There are currently no plans for another but it is always a possibility.” 

Kudos to Chairman Casey and the Majority Staff for putting resources, time and effort into crafting this report.  For those people in the trenches, future reports should be written and formal Senate Aging Committee hearings held to keep tabs on this growing problem and to determine if the recommendations from this first report are being implemented. 

Don’t drop the ball on this one.

RI Hoarding Task Force

Janet Spinelli and Kelly McHugh are co-chairs of the RI Hoarding Task Force which is convened through the RI Elder Mental Health and Addiction Coalition co-chaired by Chris Gadbois and Janet Spinelli. 

The RI Hoarding Task Force has two committees including the HD Task Force Toolkit Development Committee lead by Christopher Liu, an undergraduate at Brown University and the HD Task Force Website and Outreach Committee.  

Anyone interested in joining the Task Force can email RIEMHAC@gmail.com  More information and resources can be found at RIHoardingtf.ri.gov which is supported through the EOHHS Money Follows the Person Program.

For download a copy of the Senate Aging Committee’s hoarding report, go to chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.aging.senate.gov/imo/media/doc/the_consequences_of_clutter.pdf

Nursing home workforce crisis deepens with minimum staffing standards

Published in RINewsToday on February 13, 2023

“The long-term care industry is enduring the worst workforce crisis in its history, in Rhode Island, and across the country. Although providers are committed to recruiting and retaining staff to provide quality care for residents, despite our best efforts, many nursing homes have fallen short of the staffing ratio set by the RI Department of Health,” notes James Nyberg, Executive Director of the East Providence-based Leading Age Rhode Island (LARI), representing nonprofit providers of aging services.

“We are extremely  concerned about the impending fines that will be imposed on nursing homes here in Rhode Island as a result of our state’s existing nursing home minimum staffing ratio statute,” said Nyberg. Because of staffing ratio mandates, “the industry would have faced fines of over $11 million, in just one sample quarter (April – June 2022), since over 70% of nursing homes are not in compliance,” he said.  

“While April-June was a sample, the fines go into effect for July-September and we will receive a similar notice in just a few weeks, with only 10 days to pay the fine,” says Nyberg, stressing that these fines will only increase going forward if nursing homes are unable to meet the minimum staffing ratio.

Nyberg calls on the Rhode Island General Assembly to rescue Rhode Island’s nursing homes and provide relief from these penalties by delaying them and exploring an alternative approach to support the efforts of nursing homes to meet the ratio.  He warns that the current fine-based approach is excessive and counterproductive and will lead to reduced access to care and threaten the survival of the state’s nursing homes.

Nyberg points out that the current workforce shortages are already preventing nursing homes from filling open positions, limiting new admissions, and forcing organization closures (five nursing homes have already closed since the COVID pandemic began).  These challenges are also resulting in backlogs at hospitals, which are unable to discharge patients due to reduced capacity in nursing homes.  

“We are working with numerous stakeholders on various initiatives to develop a pipeline of workers, but the simple fact is that it will take time.  In addition, as you know, the industry has faced years of underfunding from Medicaid, which pays for the majority of nursing home care.  This has made recruiting and retaining workers more difficult than ever,” says Nyberg. 

John Gage, President of the Rhode Island Health Care Association (RIHCA) agrees with Nyberg’s assessment of the nursing home workforce.  “Nursing homes across the nation are facing an historic labor shortage as the direct result of chronic Medicaid underfunding and the devastating impact of the Covid-19 pandemic on the workforce, he says, noting that the state’s nursing home workforce is down 20% since the start of the pandemic, with 2,000 workers lost from Jan. 2020 to June 2022.  Nationwide, the nursing home workforce is down 210,000 workers.

According to Gage, Rhode Island’s staffing mandate, while well-intentioned, will siphon tens of millions of dollars from resident care. In the first year of full implementation of the state’s minimum staffing mandate, RIHCA estimates that facilities will be fined upwards of $60 million. “These fines will imperil care, not bolster it,” he warns.  

Without legislative action, Rhode Island nursing homes will be fined an estimated $11 million on or about February 28, 2023, because of their inability to attract workers to meet the mandate from July 1, 2022, through September 30, 2022, Gage charges. “There are simply not enough available workers to fill the open staff positions, and resources are scarce.  Nursing homes will be devastated by these fines.  Facilities will reduce admissions, backing up hospital referrals and clogging hospital beds.  More nursing facilities will close – five have already closed since the beginning of the pandemic,” he predicts.  

Gage asks, “Who will care for Rhode Island’s frailest elders?” To recreate a minimum staffing mandate in nursing homes on the federal level would be a huge mistake, especially given the historic workforce crisis here in Rhode Island and nationwide,” he says.  

Gage’s comments echo concerns expressed by another group of US Senators in Jan. 20 correspondence (https://www.tester.senate.gov/wp-content/uploads/1-20-23-Nursing-Home-Staffing-Mandate-Letter-FINAL.pdf) sent to CMS by Senators John Bourasso, Jon Tester, and eleven other US Senators.  They caution the agency that a one-size fits all mandate would undermine access to care for patients, and they encouraged CMS to work with Congress on tailored solutions that address the workforce challenges facing nursing facilities.

At the federal level

Just days ago, U.S. Senators Bob Casey (D-PA), Chairman of the Senate Committee on Aging, and Ron Wyden (D-OR), Chairman of the Senate Finance Committee, called on the Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to encourage the federal agency to establish minimum staffing standards in nursing homes to ensure high-quality care for nursing home residents. In Feb. 10 correspondence, Casey and Wyden, along with Senators Sherrod Brown (D-OH), Kirsten Gillibrand (D-NY), Richard Blumenthal (D-CT), Cory Booker (D-NJ), and Elizabeth Warren (D-MA) urged CMS to advance the agency’s ongoing study to determine adequate staffing requirements in nursing homes.

“We appreciate the work that CMS has undertaken to promote safety and quality in nursing homes and applaud the Biden-Harris Administration’s commitment to protecting our nation’s seniors,” said the senators in Feb. 10 correspondence, urging CMS to “bring this work to completion.” 

“In our view, that means continuing the agency’s ongoing study to determine the level of staffing that is necessary to ensure safe and high-quality care for nursing home residents, developing an evidence-based and actionable proposal for mandatory minimum staffing levels, and a robust and transparent process—including direct stakeholder engagement— that will allow for further discussion and fine-tuning of requirements before the proposal is finalized,” wrote the senators.

The senators noted that studies have shown a correlation between inadequate staffing levels and lower quality of care. More recent studies have demonstrated that higher nurse staffing ratios mitigated the effect of COVID-19 outbreaks in nursing homes and resulted in fewer deaths. A recent Department of Health and Human Services Office of Inspector General report examining the high level of COVID-19 infections in nursing homes also pointed to the need for the establishment of minimum staffing requirements.  

In the correspondence, the senators cite the Social Security Act, which requires skilled nursing facilities to “provide 24-hour licensed nursing service which is sufficient to meet nursing needs of its residents,” including the services of a registered nurse at least 8 consecutive hours per day, 7 days a week. The letter commends CMS for working to update this vague standard that has led to substantial variation in staffing levels and quality of patient care across facilities.

“Achieving the shared goal of ensuring quality care in nursing homes nationwide is a complex undertaking, says LeadingAge’s Ruth Katz, senior vice president, policy. LeadingAge is an association of nonprofit providers of aging services, including nursing homes.

“As our Get Real on Ratios proposal highlights, a number of conditions must be met in advance of any mandate implementation,” suggests Katz. “The senators correspondence to CMS is a promising development; it covers many of the same points as our Get Real on Ratios proposal – a recognition of the critical need for adequate reimbursement; that one size does not fit all, and that workforce shortages will need to be addressed with additional support. Without addressing these, staffing mandates are impossible. We look forward to continuing our discussions with Congressional leaders on this critical issue so that older adults and families can access much-needed care and services,” she says.

“The Senior Agenda Coalition of RI fully supports the need to develop national staffing standards to ensure quality care is provided to nursing home residents across our nation. It is important to note that Rhode Island has been a leader in this area. For many years our state has required 24/7 RN coverage in nursing homes and in 2021 the legislature passed the Nursing Home Staffing and Quality Care Act that includes staffing standards,” says Maureen Maigret, Policy Advisor to Senior Agenda Coalition of RI. “Now we must work to address workforce shortage issues and ensure that adequate government resources are provided especially through Medicaid payments so the standards can be met, and our critical direct care workers receive competitive living wages in order to keep them working in long term care,” she adds.

As the House Leadership hammers out the FY 2024 budget, it is crucial that adequate Medicaid funding is allocated to allow nursing homes to attract the necessary staff to meet the state’s minimum nursing standards that it codified into law. We must address this policy problem now rather than just kick the can down the road.