Keynote: Fine Calls for Community Health Stations Across Rhode Island

Published in the Woonsocket Call on May 20, 2018

Last week, the Rhode Island Minority Elder Task Force (RIMETF) held a Health and Wellness Fair at the Cape Verdean Progressive Center in East Providence to put a spot light on minority health care needs.

Dr. Michael Fine, a primary care physician who formerly was the state’s Health Director, and now serves as Senior Population Health and Clinical Officer at the Blackstone Valley Community Health Care, Inc., gave the keynote address, calling for an overhaul of America’s ailing health care delivery system.

Although RIMETF’s primary mission is to raise money and seek grants to provide limited emergency assistance to low-income seniors in crisis situations, the organization also promotes the advancement of inclusive programs for minority elders, says Susan Sweet, the nonprofit’s founder, a former state official who advocated for, developed and operated programs and services provided to the state’s vulnerable populations, including elders. She continued that work after retirement from the state. “During the last two decades, RIMETF provided more than $53,000 in grants,” she said.

According to Sweet, RIMETF’s $200 grants help low income seniors to pay utility costs, rent, food, medications, clothing, furniture, personal healthcare items and other necessities of life. She says that 80 grants are given out annually, about half going to minority applicants.

But, the decision to host a Health and Wellness Fair on May 11, 2018, was tied to minorities having a lack of access to health care services and to have Dr. Fine outline a better way of providing care to Rhode Island’s minorities, adds Sweet. “To this day the state’s diverse minorities continue to remain in the dark about health care programs and services that they can access and that lack of information has a detrimental impact on their health and well-being,” says Sweet.

Health Disparities in Rhode Island

During his thirty-minute keynote, Dr. Fine, a primary care physician who formerly was the state’s Health Director, and now serves as Senior Population Health
and Clinical Officer at the Blackstone Valley Community Health Care, Inc., provided the details as to how lack of access to health care adversely impacts the health and life expectancy of Rhode Island’s minorities.

According to Dr. Fine, infant mortality in the African American population is about three times as high than in the white population. Diabetes is about two times more common in the African-American population than it is in the white population. He also noted that life expectancy in the United States is 4.5 years less among the African American population than it is among the white population.

Zeroing in on Cape Verdeans, Dr. Fine noted that the Rhode Island Department of Health does not track the health of this minority group separately from other groups. The state’s primary care practices and community health centers don’t have a good way to decide who counts as a Cape Verdean for health tracking purposes, he said. But about half of the Cape Verdean community in Rhode Island live in Pawtucket and Central Falls, so that health information collected using the electronic medical record by Blackstone Valley Community Health Center (BVCHC), Inc, provides the first ever look at the health status of Cape Verdeans in Rhode Island.

It’s difficult to know if that data is complete, because it doesn’t allow us to count all Cape Verdeans at the BVCHC, but only those people who speak Cape Verdean Creole or those who identify themselves as having been born in Cape Verde. “Because we have no complete way to identify the health status of the Cape Verdean population, we have no certain way to identify specials needs and opportunities to provide better health care to this minority group,” says Dr. Fine. In addition, because Cape Verdean Creole is not a written language, “we have no way to certify Cape Verdean medical translators” which means some of the health care needs of Cape Verdeans go unaddressed, he adds.

But, there are better ways to improve the health care of Rhode Island’s Cape Verdeans, says Dr. Fine. “We must make sure that all Cape Verdeans are enrolled in a primary care practice or community health center,” he says, noting that electronic medical systems can provide better measures of the health of this population.

Dr. Fine called for Cape Verdeans to be appointed to boards of health care organizations to represent them in decision of allocation of resources, to demand better translation services, and to improve delivery of health care to Rhode Island’s Cape Verdeans.

As to Rhode Islanders, Dr. Fine noted that 25 to 45 percent don’t get primary care and prevention. As a result, there are 1,200 unnecessary deaths a year from heart disease and stroke. There are 200 unnecessary deaths a year from colon cancer and 65-70 unnecessary cases of HIV. Up to 200,000 Rhode Islanders remain smokers, he says.

Dr. Fine continued to detail the negative impact on the health of Rhode Islanders if they did not visit a primary care physician. More than 1,500 babies are born to teenagers, more than a third to minorities. Not to mention that there are 330 to 400 avoidable deaths from influenza every year due lack of immunization (500,000 Rhode Islanders are currently not immunized every year). And there are 330 deaths a year from prescriptions and other drug overdoses, he says.

It’s Time for a Change

Dr. Fine warns that major changes must be made to the nation’s health care delivery system to reduce spiraling health care costs and to provide better access. This solution can be modeled after his Central Falls Neighborhood Health Station (CFNHS), he says. It’s a multi and interdisciplinary approach, bringing a wide variety of health care professionals together, from physician, nurses, physician assistants, mental health workers, nutritionists, substance abuse workers and midwifes, to rehabilitation professionals, CFNHS’s must also provide urgent care and primary care services, be open on weekends and have “sick today access appointments.” Says Dr. Fine.

Fine has documented early successes in the CFNHS’s delivery of health care. Adolescent pregnancy was been reduced by 24 percent in 2016 and emergency medical service runs were reduced by 5 percent in just 12 months.

Dr. Fine envisions a Neighborhood Health Station in every community of 10,000 persons. When up and running, “we’ll increase life expectancy, reduce infant mortality and revitalize the local economy,” he says, by reducing health care costs.

Concluding the Health and Wellness Fair, Director Charles J. Fogarty, of the Rhode Island Division of Elderly Affairs, who will be retiring next month, was recognized by RIMETF for his 40 years of public service and his support for the work of the Minority Elder Task Force.

For more details regarding the work of the RI Minority Elder Task Force or to make a donation, write RIMETF, 5 Leahy Street, Rumford, RI 02916 or call Lori Brennan Almeida, Chairperson, at 401-497-1287.

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A Storm Cloud Looms Over Older Americans Month

Published in Woonsocket Call on May 13, 2018

Two years after President John F. Kennedy had formally designated May as “Senior Citizens Month” at a meeting of the National Council of Senior Citizens in 1963, President Lyndon B. Johnson signed the Older Americans Act into law, formally declaring May as Older Americans Month. When Kennedy first proclaimed May as Older American’s Month, there were just 17 million Americans who had reached age 65. According to the recently released 2017 Profile of Older Americans, one in seven Americans are 65 or older, and just two years from now, this this demographic group’s numbers will skyrocket to 56 million people.

Nothing but Empty Words

Since Kennedy’s inaugural proclamation, all presidents have proclaimed the month of May as Older American’s Month. Not surprisingly President Donald J. Trump recently proclaimed May as Older Americans Month, too, calling upon “all Americans to honor our elders, acknowledge their contributions, care for those in need, and reaffirm our country’s commitment to older Americans this month and throughout the year.”

Trump even touted his Administration’s priorities on fighting on the behalf of the nation’s older Americans. “The Department of Justice, for example, is focused on protecting seniors from fraud and abuse. My Administration is also committed to protecting the Social Security system so that seniors who have contributed to the system can receive benefits from it. We are also dedicated to improving healthcare, including by increasing the quality of care our veterans receive through the Department of Veterans Affairs and by lowering prescription drug prices for millions of Americans.”

But do Trump’s words in his April 30th resolution to proclaim May as Older Americans Month, match his past political actions. Not so.

Just almost three months ago the President released his 2019 budget and this fiscal blueprint did not show a commitment to aging programs and services.

Draconian Cuts in 2019 Trump Budget

Although Trump’s 2019 budget proposal was “Dead on Arrival” on Capitol Hill, as reported in my February 18, 2018 Commentary, his budgetary wish list of cuts would have been devastating to many programs and services for older Americans, as detailed by a policy analysis performed by the Washington, DC.-based National Committee to Preserve Social Security and Medicare (NCPSSM).

Trump’s budget included $1.4 trillion in Medicaid cuts, $490 billion in Medicare cuts, and repeal of the Affordable Care Act. Breaking his campaign promise not to touch Social Security, Trump called for steep cuts up to $64 billion from the Social Security Disability Insurance program.

Trump’s budget proposal also called for over $500 billion in cuts to Medicare, many of these savings coming from cuts to Medicare providers and suppliers. This was another campaign promise broken.

Trump’s budget cuts would have drastically impacted Medicare’s spending on prescription benefits and beneficiary costs, too. It would save $210 million over 10 years by eliminating the cost-sharing on generic drugs for low-income beneficiaries.

Not surprisingly, Medicaid was not immune to Trump’s 2019 budget cuts. He called for changing the structure of the program into either a per capita cap or Medicaid block grant, with a goal of giving states more flexibility of managing their programs. Through 2028, the president’s budget would cut $1.4 trillion from the Medicaid program through repealing the Affordable Care Act, and restructuring the program.

Trump’s budget proposal also calls for the elimination of the Older Americans Act Title V Senior Community Service Employment Program (SCSEP). The program, funded at $400 million in FY 2017. provides job training to nearly 70,000 low-income older adults each year.

Community Services Block Grants ($715 million), the Community Development Block
Grant ($3 billion) and the Social Services Block Grant ($1.7 billion) programs were also targeted to be eliminated. Some Meals on Wheels programs rely on funding from these federal programs, in addition to OAA funding, to deliver nutritious meals to at-risk seniors.

Trump also called for the elimination of funding to the Low-Income Home Energy Assistance Program, cutting assistance for heating and fuel costs to low income seniors. It would have also eliminated funding for The Senior Corps programs including the Retired and Senior Volunteer Program, Foster Grandparents and Senior Companions. These programs enable seniors to remain active and engaged in their communities, serving neighbors of all ages, with the benefit of enhancing their health and wellbeing.

Finally, research into cancer, Alzheimer’s Parkinson’s and other diseases affecting older persons would be negatively impacted with $ 46 million in funding cuts to National Institute on Aging at the National Institutes of Health.

Also reported in my December 10, 2018 Commentary, Trump and the GOP-controlled Congress successfully passed the Tax Cut and Jobs Act, that was projected to add $1.5 billion to the nation’s deficit over the next decade. Under the 2010 “pay-as-you-go” law, that triggers automatic spending cuts to domestic programs when the nation’s deficit increases, the GOP’s sweeping tax plan (that Trump strongly supported) would have triggered automatic spending cuts to federal programs, including a $25 billion cut to Medicare in 2018 alone. But vigorous lobbying by AARP and NCPSSM, along with a long-list of other aging, health care and union groups, narrowly averted the draconian cuts by convincing the House and the Senate to waive them as part of a temporary spending bill to prevent a government shutdown.

Strengthening Federal Assistance to Seniors

When President Johnson signed the Older Americans Act into law on July 14, 1965, to raise the awareness of the problems facing seniors and to honor them, he formally proclaimed the month of May as Older Americans Month.

This year’s Older Americans Month is celebrated in every community across the nation as Medicare, Medicaid and Older Americans Act programs are under fierce legislative attack by President Trump and the GOP-controlled Congress.

With the 2018 mid-term elections just six months away, older voters can send a message to Capitol Hill – Strengthen Social Security, Medicare, and the Older Americans Act, expand Medicaid, and bring back health insurance to millions of Americans who lost their coverage because of the Republican tax plan that repealed key provisions of Obamacare.

With a Democratic-controlled Congress, next year’s theme for the Older Americans Month, might be “Strengthening Federal Assistance to Seniors.”

“First They Came for the Jews…”

Published in Woonsocket Call on April 29, 2018

On April 26, 2018, the Senate Judiciary Committee held a hearing on Senate Resolution No. 2696, urging law enforcement officials to recognize white nationalists and neo-Nazi groups as terrorist organizations. The Senate Resolution would enable law enforcement to pursue such groups’ activities and whereabouts with the resources and attention devoted to domestic terrorist groups. It would be tragic for the Senate panel to not pass this resolution introduced by Senators Goldin, Miller, Nesselbush, Quezada, and Crowley. Representative J. Aaron Regunberg introduced the House companion measure (H.B. 8131).

In response to last year’s racially-charged violence in Charlottesville, state legislatures across the nation have considered similar legislation. Roger Williams, founder of the Colony of Rhode Island and Providence Plantations, was a staunch advocate for religious freedom and tolerance. With that commitment, it is important for Rhode Island lawmakers to not send Senate Resolution No. 2696 to legislative purgatory but to pass it to strongly denounce the white nationalist and neo-Nazi ideologies of racial, social and religious intolerance that terrorize the state’s racial, ethnic and religious minority communities.

Anti-Semitic Incidents Increasing in Rhode Island

Last month, the Anti-Defamation League (ADL) reported that the increase in anti-Semitic incidents in the Ocean State have nearly doubled from 2016 to 2017, with the number of reports jumping from 7 to 13. Let’s put a face on these incidents. According to the Jewish Alliance of Greater Rhode Island, it was reported by media that just one day after an anti-Semitic act of vandalism in the City of Pawtucket, on May 23, 2016, Stebbins Stadium in Cranston was spray painted with graffiti, including swastika symbols as well as hate messages directed to Muslim and African American communities. Among the incidents reported in 2017 by the media: a swastika burned into a sign located on a bike path in Barrington, anti- Semitic graffiti spray painted on Warwick Vets High School and a swastika made from human waste found in RISD dorm bathroom.

But, white nationalists and neo-Nazi hate ideology is also increasing throughout the nation. The increase is reflected nationally with the ADL reporting a nearly 60 percent increase.

The jarring historical imagery of the torchlight procession of supporters of Adolf Hitler moving through the Wilhelmstrasse in Berlin on the evening of January 30, 1933 came to life to Rhode Islanders and to millions of Americans last year when hundreds of neo-Nazis, white nationalists, KKK, militia members and other right-wing groups gathered for a “Unite the Right” rally in Charlottesville, Va. Carrying tiki torches, flags with swastikas and confederate flags, they came to the City’s Emancipation Park, chanting “Jews will not replace us”, “Blood and Soil” (a Nazi rallying cry), “White Lives Matter,” along with homophobic, racists and misogynistic slurs.

It’s Time for Rhode Island to Speak Out

While both GOP and Democrat Congressional lawmakers lambasted President Donald J. Trump’s choice of words for laying the blame of violence at the Charlottesville rally at the feet of both the far-right demonstrators and counter protestors, there were some who remained silent or defended his comments, saying his words were adequate.

With the increased public visibility of the neo-Nazis, white supremacist and other hate groups, and with President Trump failing to use his position and moral authority to strongly condemn the ideology of hate groups, the Rhode Island General Assembly is now positioned to take on this responsibility.

In response to the violent weekend in Charlottesville, Va., the Illinois Senate adopted a similar resolution, sponsored by Sen. Don Harmon, D-Oak Park, urging law officials to recognize white nationalists and neo-Nazi groups as terrorist organizations. As a state founded on the principle of religious freedom, Rhode Island can follow.

It is an appropriate time to remember the speech given by Martin Niemoller, a German Lutheran minister who opposed the Nazis and was sent to several concentration camps. He survived the war and explained:

“First, they came for the Jews. I was silent. I was not a Jew.
Then they came for the Communists. I was silent. I was not a Communist.
Then they came for the trade unionists. I was silent. I was not a trade unionist.
Then they came for me. There was no one left to speak for me.”

For Rhode Island lawmakers, it is time for you to speak out.

2050 and the Caregiver Dilemma

Published in the Woonsocket Call on April 22, 2018

The year 2030 marks an important demographic turning point in U.S. history according to the U.S. Census Bureau’s 2017 National Population Projections, released last month. By 2030, older people are projected to outnumber children. In the next twenty years, when these aging baby boomers enter their 80s, who will provide informal caregiving to them.

Almost three years earlier, in a July 2015 report, “Valuing the Invaluable: 2015 Update Undeniable Progress, but Big Gaps Remain,” the AARP Public Policy Institute warned that fewer family members will be around to assist older people with caregiving needs.

According to AARP’s 25-page report, coauthored by Susan C. Reinhard, Lynn Friss Feinberg, Rita Choula, and Ari Houser, the ratio of potential family caregivers to the growing number of older people has already begun a steep decline. In 2010, there were 7.2 potential family caregivers for every person age 80 and older. By 2030, that ratio will fall sharply to 4 to 1, and is projected to drop further to 3 to 1 in 2050.

Family caregivers assisting relatives or close friends afflicted with chronic, disabling, or serious illness, to carry out daily activities (such as bathing or dressing, preparing meals, administering medications, driving to doctor visits, and paying bills), are key to keeping these individuals in their homes and out of costly nursing facilities. What is the impact on care of aging baby boomers when family caregivers no longer provide assistance in daily activities?

“In 2013, about 40 million family caregivers in the United States provided an estimated 37 billion hours of care to an adult with limitations in daily activities. The estimated economic value of their unpaid contributions was approximately $470 billion in 2013, up from an estimated $450 billion in 2009,” notes AARP’s caregiver report. What will be the impact on the nation’s health care system without family caregivers providing informal care?

The Census Bureau’s 2017 National Population Projections, again puts the spot light on the decreasing caregiver ratio over the next decades identified by the AARP Policy Institute, one that must be planned for and addressed by Congress, federal and state policy makers.

Who Will Take Care of Aging Baby Boomers?

With the expansion in the size of the older population, 1 in every 5 United States residents will be retirement age. Who will provide informal caregiving in our nation with a larger adult population and less children to serve as caregivers?

“The aging of baby boomers means that within just a couple decades, older people are projected to outnumber children for the first time in U.S. history,” said Jonathan Vespa, a demographer with the U.S. Census Bureau. “By 2035, there will be 78.0 million people 65 years and older compared to 76.4 million under the age of 18.”

The 2030s are projected to be a transformative decade for the U.S. population, says the 2017 statistical projections – the population is expected to grow at a slower pace, age considerably and become more racially and ethnically diverse. The nation’s median age is expected to grow from age 38 today to age 43 by 2060.

The Census Bureau also observed that that as the population ages, the ratio of older adults to working-age adults, also known as the old-age dependency ratio, is projected to rise. By 2020, there will be about three-and-a-half working-age adults for every retirement-age person. By 2060, that ratio will fall to just two-and-a-half working-age adults for every retirement-age person.

Real Challenges Face Congress as the Nation Ages

Jean Accius, Ph.D., AARP Policy Institute’s Vice President, Independent Living, Long-Term Services and Supports, says, “The recent Census report highlights the sense of urgency to develop innovative solutions that will support our growing older adult population at a time when there will likely be fewer family caregivers available to help. The challenges that face us are real, but they are not insurmountable. In fact, this is an opportunity if we begin now to lay the foundation for a better system of family support for the future. The enactment of the RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act, which would create a strategy for supporting family caregivers, is a great path forward.”

Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare, gives his take on the Census Bureau’s 2017 statistical projections, too.

“Despite how cataclysmic this may sound, the rising number of older people due to the aging of baby boomers is no surprise and has been predicted for many years. This is why the Social Security system was changed in 1983 to prepare for this eventuality. Under current law, full benefits will continue to be paid through 2034 and we are confident that Congress will make the necessary changes, such as raising the wage cap, to ensure that full benefits continue to be made well into the future,” says Richtman.

Richtman calls informal caregiving “a critical part of a care plan” that enhances an older person’s well-being. “While there currently are programs such as the Medicaid Waiver that will pay family members who provide caregiving support more can be done to incentivize caregiving so that loss of personal income and Social Security work credits are not barriers to enlisting the help of younger individuals to provide informal support services,” he says.

Adds Richtman, the Medicare and Medicaid benefits which reimburse for the home-based services and skilled nursing care “will be unduly strained ”as the diagnosed cases of Alzheimer’s disease skyrockets with the growing boomer population. He calls on Congress to “immediately provide adequate research funding to the National Institutes of Health to accelerate finding a cure in order to save these programs and lower the burdens on family caregivers and the healthcare system. “

Finally, AARP Rhode Island State Director Kathleen Connell, says “Our aging population represents challenges on many, many fronts, including healthcare, housing, Social Security, Medicare and, of course, caregiving. It would be nice to think everything would take care of itself if there were more younger people than older people. But that misses the point entirely. The needs of older Americans are a challenge to all Americans, if for no other reason than most of us end up with multiple late in life needs. And too many reach that point without savings to cover those needs.”

“It’s worth noting, by the way, that many of the solutions will come from people 50 and older — many of whom will work longer in their lives to improve the lives of older Americans. We need to stop looking through the lens of ‘old people’ being the problem and instead encourage and empower older Americans to take greater control over their lives as they help others,” says Connell.

“Congress needs to focus on common sense solutions to assure families that Social Security and Medicare are protected. The healthcare industry needs to face the medical challenges. And at the state and local level, we must focus on home and community-based health services,” adds Connell.

For details about the Census Bureau’s 2017 statistical projections, co to http://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html.

For more information about AARP’s July 2015 caregiver report, go to http://www.aarp.org/content/dam/aarp/ppi/2015/valuing-the-invaluable-2015-update-new.pdf.

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House Fails to Pass GOP’s Balanced Budget Amendment

Published in Woonsocket Call on April 15, 2018

Following the recent passage of the $ 1.3 trillion omnibus government spending bill and the massive GOP tax cut bill that added more than a $1 trillion to the nation’s despite economic growth, and with midterm elections looming, the House GOP leadership quickly acted to tackle the spiraling nation’s deficit by bringing H.J. Res. 2, a balanced budget amendment (BBA), to the floor for a vote. Simply put, the amendment requires that total annual outlays not exceed total annual receipts. It also requires a true majority of each chamber to pass tax increases and a three-fifths majority to raise the debt limit.

House Judiciary Chairman Bob Goodlatte (R-Va.), introduced H.J. Res. 2, which he notes is nearly identical to text in legislation that passed the House in 1995, but failed in the Senate by one vote. This would be the Virginia Congressman’s last chance to push for passage of a BBA because he is not seeking re-election at the end of this term.

Last October. House Speake Paul Ryan (R-WI) agreed to vote on Goodlatte’s BBA, in exchange for conservative votes from the Republican Study Committee, chaired by Mark Walker (R-NC), on a procedural budget measure needed for Republicans to move forward on tax reform.

BBA Gets Thumbs Down by House Lawmakers

As expect, the House GOP’s BBA was defeated by a vote of 233 to 184, falling far short (by 57 lawmakers) of the two-thirds vote required for passage of an amendment under the Constitution. Six Republicans voted against it while only seven Democrats voted for it. But, the GOP’s BBA had little chance of becoming law because the required support of two-thirds in the Senate and Democratic Senators unified in their opposition, and finally the requirement that 38 states ratify the constitutional amendment.

“Our extraordinary fiscal crisis demands an extraordinary solution. We must rise above partisanship and join together to send a balanced budget amendment to the states for ratification.

I urge all my colleagues to join me in supporting this amendment and in freeing our children and grandchildren from the burden of a crippling debt they had no hand in creating, so they can be free to chart their own futures for themselves and for their own posterity,” Goodlatte said during the House floor on Thursday evening.

During the four-hour debate, House Republican Conference Chair Cathy McMorris Rodgers (R-WA), asked Congress to balance its budget like typical families do. She said,“Families across the country sit down at their kitchen tables every month and make tough decisions to balance their budget so that they can make ends meet. Just like American families, the federal government should spend within its means. A Balanced Budget Amendment, which requires a two-third majority in both chambers of Congress to pass, is a needed and important mechanism to restore fiscal discipline. “

On the House Floor, Democratic Leader Nancy Pelosi called the BBA “a brazen assault on seniors, children and working families – the American people we were elected to protect.”

“Make no mistake, this GOP con job has nothing to do with fiscal responsibility. It is not balanced in terms of money because of their GOP Tax Scam that’s placed us in a bad spot fiscally and it’s not balanced in terms of values,” says Pelosi, noting that GOP fiscal responsibility comes down to “ransacking Medicare, Medicaid and Social Security and breaking our nation’s sacred promise of dignity and security for seniors and families.”

Before the House vote on the BBA, Darrell M. West, vice president and director of Governance Studies at the Washington, D.C.-based the Brookings Institution, stated “I would be surprised if the bill made it through Congress.” He added, “It’s hypocritical for Republicans to support a balanced budget amendment after they cut taxes by $1.5 trillion and added significantly to the federal deficit. Voters will see through that and understand the vote is about scoring political points and not making good public policy.”

House Lawmakers Bombarded with Opposition Letters

Days before the House vote the National Committee to Preserve Social Security and Medicare (NCPSSM), AARP expressed opposition to the passage of the BBA by sending a letter to the Hill, urging House lawmakers to reject the GOP’s constitutional amendment. Hundreds of aging, health care, educational, unions, and business groups were cited in the April 12, 2018 issue of the The Congressional Record as opposing the amendment.

Max Richtman, NCPSSM’s President and CEO, wrote House lawmakers warning that a BBA would unravel the nation’s social safety net by making gigantic entitlement cuts by blocking benefit payments from the Social Security and Medicare Part A trust funds because “all federal expenditures, including these earned benefits, would have to be covered by revenue collected in the same year. “

A BBA would also force Congress to make huge spending cuts to Medicare Parts B, C and D, Medicaid, and many other social safety net programs for seniors, to rein in the nation’s deficit and pushing lawmakers to make “massive new tax cuts.,” says Richtman.

“While the balanced budget amendment did not dictate any particular approach to deficit reduction, by altering established Congressional voting procedures it would have increased the likelihood that the fiscal policies adopted in coming decades would favor the well-off at the expense of middle- and low-income Americans. The amendment would have required a two-thirds vote of the full membership of the House and Senate to raise taxes. Spending cuts, by contrast, would continue to require only a majority of those present and voting and could be passed on a voice vote,” observed Richtman.

Finally, Richtman noted that the risk of a federal government default would increase because a BBA requires a three-fifths vote of both the House and the Senate to raise the national debt limit, rather than the current simple majority.

AARP Executive Vice President Nancy LeaMond also expressed opposition to the BBA in a letter to House lawmakers charging that the amendment would impact the solvency of Social Security and Medicare, “subjecting both programs to potentially deep cuts without regard to the impact on the health and financial security of individuals.” Programs that provide meals or heating assistance to low income seniors would also see available resources diminish, she predicted, she said.

The lack of a dependable Social Security and Medicare benefit [if a BBA was passed] would be devastating for millions of Americans. Social Security is currently the principal source of income for half of older American households receiving benefits, and roughly one in five households depend on Social Security benefits for nearly all (90 percent or more) of their income. Over 50 million Americans depend on Medicare, half of whom have incomes of less than $24,150. Even small fluctuations in premiums and cost sharing would have a significant impact on the personal finances of older and disabled Americans,” said LeaMond.

Midterm Elections Just Six Months Away

The nonpartisan Congressional Budget Office (CBO) predicted early this week that the annual government’s deficit is projected to be $ 1 trillion next year. And the nation’s $21 trillion debt would skyrocket to 33 trillion by 20028. With the midterm elections just six months away, combined with the CBO’s recently released economic analysis, the Republican party’s image as being the fiscally responsible political party is now shattered.

Even controlling both chambers of Congress and with President Donald Trump in the White House, GOP lawmakers must now look for political issues that may resonate with their constituents. Further attempts to dismantle Socials Security and Medicare may not be the way to go.

Senate Aging Panel Releases its 2018 Fraud Book

Published in Woonsocket Call on April 1, 2018

In early March, the U.S. Senate Special Committee on Aging again put the spotlight on common fraud schemes directed at America’s seniors at a panel hearing, “Stopping Senior Scams.” At the Senate panel hearing, held in Dirksen Senate Office Building 562, the Committee officially released its 2018 Fraud Book detailing the Top 10 scams reported to its Fraud Hotline last year. In 2017, the Committee’s Fraud Hotline received more than 1,400 complaints of frauds targeting seniors around the country, clearly revealing the extent of this epidemic.

Last year, the most prevalent scam reported to the Committee’s Hotline, detailed in the Senate Aging Committee’s 56-page 2018 Fraud Book, was the IRS Impersonation Scam in which con artists call, pretending to be IRS representatives, to collect payment of taxes and threaten arrest if payment is not immediately made by phone (During tax filing season, seniors and others should be on high alert for scam artists claiming to be the IRS).

The March 7th hearing was the third hearing this Congress—and the 12th in the past three years—that the Senate Aging Committee has held examining scams affecting older Americans. These hearings c=examined notoriously widespread scams including the IRS imposter scams, lottery and sweepstakes scams, computer tech support scams, grandparent scams, elder financial exploitation, and identity theft.

“This Committee’s dedication to fighting fraud against older Americans is raising awareness and it is making a real difference,” said Chairman Susan Collins (R-ME), of the Senate Aging Committee, in her opening remarks. “Just two weeks ago, the Department of Justice announced it has charged more than 250 people with stealing more than half billion dollars from more than a million Americans. This is the largest ever law enforcement action to protect our nation’s seniors from fraud,” noted Collins.

Seniors Lose Billions in Exploitation Schemes and Scams

Collins called the “stakes extremely high” in fighting against the skyrocketing incidence of senior fraud, noting that according to the Government Accountability Office, older American’s lose a staggering $2.9 billion a year to an ever-growing array of financial exploitation schemes and scams.

Ranking Member, Bob Casey (D-PA), called for more aggressive action to be taken “to ensure that not one more senior loses another penny to a con artist.” The Pennsylvania Senator called for working more closely with businesses to create “another line of defense to help prevent assets from ever leaving the hands of unsuspecting victims.”

Witnesses Stephen and Rita Shiman from Saco, ME, came to share and educate others as to how they fell victim to a grandparent scam. During his testimony, Shiman acknowledged the special bond between grandparents and their grandchildren. “The scammers knew this well and took full advantage of it with my wife and myself. They knew that when a grandchild is in trouble, grandparents go all out to help,” he said.

With over 20 years working as a lead volunteer with Pennsylvania, chairing the nonprofits Consumer Issue Task Force, Witness Mary Bach explained how her 15-member task force team from across the commonwealth keep residents of all ages educated about current scams sweeping the state. She stated, “[w]e know that education is power, and when someone hears the specifics of a scam they are much less likely to be victimized. If you can spot a scam, you can stop a scam!”

Witness Doug Shadel, State Director of AARP Washington State. testified about the current state of fraud targeting seniors and outlined that impostor scams are still the most prevalent.” In the new age of technology, it is easier than ever for scammers to be someone they are not,” he said, noting that “combining this ability with a tactic to incite fear or excitement upon their victim, paints a very convincing picture, one that has enabled scammers to easily take many seniors of their hard-earned savings.”

Finally, Witness Adrienne Omansky of Los Angeles, CA, described how she formed the Stop Senior Scams Acting Program in 2009 after learning from students in her commercial acting class about fraud they had experienced. Over the past few years, this volunteer group has grown significantly and now performs in about 30 venues each year, ranging from small veteran’s halls to a large convention center. As part of her testimony, Omansky played a few clips of the Public Service Announcements her group has recorded and shared several of the lessons the members of her acting program have learned through their own performances, including that seniors are often more comfortable learning about scams from their peers.

AARP Fights Against Senior Fraud

AARP recognized early on that older Americans are extremely vulnerable to fraud and identity theft,” says AARP Rhode Island State Director Kathleen Connell. “It’s a multi-billion-dollar problem and getting worse. That’s why our organization has made a significant investment in public outreach as well as a free alert system available to our members as well as the general public.

“One aspect of prevention that has been our focus is explaining to people how con artists operate. We hired Frank Abagnale, the real-life former con man depicted in the movie Catch Me If You Can, as a national spokesman. His job is to help people spot a con. He goes way beyond “if it’s too good to be true.” Abagnale explains the psychological triggers that con artists employ to snag even the seemingly brightest and most cautious victims. This is laid out in our free publication The Con Artists Playbook. It is a hand out at events and presentations we’ve been conducting across the state the past three years.

“The AARP Fraud Watch Network is a free service,” Connell continued. “Sign up and you will receive email alerts on the latest scams. One of our Fraud Watch presenters is fond of saying that when you hear about a scam on the TV news it is natural to say, ’I’d never fall for that. ’Maybe, he tells audiences, it’s only because you were just warned. That’s the thing. It’s the new scam that you haven’t heard about that is especially dangerous. In addition to the alerts, you can report scans so the word spreads as new cons make the rounds. There’s also a national fraud hotline (877-908-3360) with specialists who take on any questions. And an online map allows you identify scams reported in your area. We urge everyone to check out the Web site (www. fraudwatchnetwork.org) to learn more.”

For a copy of the 2018 Senate Aging Committee Fraud Book, go to http://www.aging.senate.gov/imo/media/doc/Fraud%20Book%202018%20FINAL.pdf.

New Report Says Alzheimer’s Disease Is Now Major Public Health Issue

Published in the Woonsocket Call on March 25, 2018

For the second consecutive year, total payments to care for individuals with Alzheimer’s or other dementias will surpass $277 billion, which includes an increase of nearly $20 billion from last year, according to data reported in the Alzheimer’s Association 2018 Alzheimer’s Disease Facts and Figures report recently released last Tuesday.

According to the Alzheimer’s Association, the annual report, first released in 2007, is a compilation of state and national specific statistics and information detailing the impact of Alzheimer’s disease and related dementias on individuals, families, state and federal government and the nation’s health care system.

“This year’s report illuminates the growing cost and impact of Alzheimer’s on the nation’s health care system, and also points to the growing financial, physical and emotional toll on families facing this disease,” said Keith Fargo, Ph.D., director of scientific programs and outreach for the Alzheimer’s Association, in a statement. “Soaring prevalence, rising mortality rates and lack of an effective treatment all lead to enormous costs to society. Alzheimer’s is a burden that’s only going to get worse. We must continue to attack Alzheimer’s through a multidimensional approach that advances research while also improving support for people with the disease and their caregivers,” he said.

Adds Fargo, “Discoveries in science mean fewer people are dying at an early age from heart disease, cancer and other diseases,” said Fargo. “Similar scientific breakthroughs are needed for Alzheimer’s disease, and will only be achieved by making it a national health care priority and increasing funding for research that can one day lead to early detection, better treatments and ultimately a cure.”

2018 Alzheimer’s Facts and Figures

New findings from the 88-page report on March 20, 2017 reveal the growing burden on 16.3 million caregivers providing 18.4 billion hours of care valued at over $ 232 billion to 5.7 million people with the devastating mental disorder. By 2050, the report projects that the number of persons with Alzheimer’s and other dementias will rise to nearly 14 million, with the total cost of care skyrocketing to more than $1.1 trillion.

Between 2000 and 2015 deaths from health disease nationwide decreased by 11 percent but deaths from Alzheimer’s disease have increased by 123 percent, says the new data in the report, noting that one out of three seniors dies with Alzheimer’s or another dementia. It even kills more than breast cancer and prostate cancer combined. In Rhode Island in 2015, the number of deaths from Alzheimer’s disease was 453, making the devastating brain disorder the 5th leading cause of death in the state.

In 2017, 53,000 Rhode Island caregivers provided an estimated 61 million hours of unpaid physical and emotional care and financial support – a contribution to the nation valued at $768 million dollars. The difficulties associated with providing this level of care are estimated to have resulted in $45 million in additional healthcare costs for Alzheimer’s and other dementia caregivers in 2017.

State Updates Battle Plan Against Alzheimer’s Disease

“The Alzheimer’s Association’s most recent report about Alzheimer’s Disease in Rhode Island illustrates the need to take swift action in updating our State Plan to ensure Rhode Island is prepared to provide the necessary resources to families, caregivers and patients who are struggling with the disease,” says Lt. Governor McKee,

McKee adds that the updated State Plan will be a blueprint for how Rhode Island will continue to address the growing Alzheimer’s crisis. “It will create the infrastructure necessary to build programs and services for the growing number of Rhode Islanders with the disease. The updated Plan will also outline steps the state must take to improve services for people with Alzheimer’s and their families. After the update is complete, my Alzheimer’s Executive Board will seek legislative and regulatory changes to carry out the recommendations of the Plan and ensure that it is more than just a document,” he says.

“One of the many types of caregivers benefiting from AARP’s caregiving advocacy in Rhode Island are family members who care for those with Alzheimer’s,” said AARP Rhode Island State Director Kathleen Connell. “They are among the army of 10 million wives, husbands, sons and daughters nationwide. The majority are women and according to researchers, especially when it comes to dementia and Alzheimer’s care. Approximately 40 percent of those caregivers say they have no other options or choices, and a third say they provide care 24/7.

“The latest report indicates what we already know,” Connell added. “This will continue to be rising challenge in Rhode Island as our population ages. The disease will place more stress on our Medicaid-funded nursing home capacity, which should make this a concern for taxpayers. There is a strong case for increasing research funding so that someday we may reverse the tide.

“Our Web site, http://www.aarp.org, provides abundant resources for these dedicated caregivers. AARP in states across the nation, including Rhode Island, have worked to pass legislation that provides paid respite for caregivers who have jobs as well as caregiving obligations. We have supported the Alzheimer’s Association here in Rhode Island for many years and, last year, a small team of AARP volunteers participated in the Alzheimer’s Walk. Joined by others, they are gearing up for this year’s walk.”

Increased Research Funding Needed Now

Donna McGowan, Alzheimer’s Association, RI Chapter Executive Director, says that the 2018 Alzheimer’s Disease Facts and Figures report should send a very clear message that Alzheimer’s disease is an issue that policy makers cannot ignore. “This is an urgent public health crisis that must be addressed. Early detection and diagnosis of the disease leads to better planning, avoiding preventable hospitalizations, and over all a better quality of life for the patient and the caregiver,” says McGowan.

McGowan warns that the health care system is not ready to handle the increased cost and number of individuals expected to develop Alzheimer’s disease in the coming years. “With a vigorous National Plan in place to address the Alzheimer’s crisis, and annual budget guidance for Congress, it is essential that the federal government continue its commitment to the fight against Alzheimer’s by increasing funding for Alzheimer’s research,” adds McGowan.

Rhode Island Congressman David Cicilline sees the need for increased funding for direct services for those afflicted with Alzheimer’s disease. He voted for H.R.1625, the omnibus spending bill that increases funding for the National Institute of Health’s Alzheimer’s research by $414 million. And two years ago, Cicilline worked to pass H.R.1559, “The HOPE for Alzheimer’s Act,” which President Obama signed into law to expand Medicare coverage for Alzheimer’s treatment.

If Cicilline succeeds to get the Republican-controlled Congress to have a vote on H.Res.160, his bill to reestablish the House Select Committee on Aging, it will allow House lawmakers to hear expert testimony and make new policy recommendations to improve the delivery of care to those afflicted with Alzheimer’s and to assist caregivers, too.

For details, go to http://www.alz.org/facts.