Report: Hiring Older Workers Makes Good Business Sense

Published in Woonsocket Call on May 3, 2015

Here’s a sound strategy for America’s CEOs to follow to improve their corporation’s bottom line. AARP’s recently released study suggests, just hire or retain older workers.

An AARP study, released on April 27, discredits widespread myths and misconceptions about age 50+ employees, showing that they have skills and abilities that can make them key to operating a successful business. The report, “A Business Case for Workers Age 50+: A Look at the Value of Experience 2015,” says that the argument for employing older employees has grown even stronger during the last decade, reinforcing a 2005 AARP study that found that these experienced workers are highly motivated, productive and even cost-effective.

Researchers claim that this study documents for the “first time why attracting and retaining experienced age 50+ workers is critical for businesses seeking an advantage in the labor market.”

Older Workers Sound Investment

“Leading employers across all industries value the expertise and experience of workers 50+ and know that recruiting, retaining and engaging them will improve their business results,” said AARP CEO Jo Ann Jenkins in her statement on the releasing the 92 page report.

Just as today’s 50+ population is disrupting aging and eroding negative stereotypes, today’s 50+ workforce is adding value by exhibiting traits that are highly sought after in today’s economy,” Jenkins added.

Adds Roselyn Feinsod, senior partner at Aon Hewitt, a multinational company providing human resources, retirement and health solutions, that prepared this report, “Workers age 50+ are highly valuable within many organizations – particularly in those industries that require highly skilled workers or workers with unique skill sets, such as health care or energy.”

Researchers say that the AARP report comes at a time when experienced workers are playing an increasing role in America’s workplace. In 2002, workers age 50+ made up only 24.6 percent of the workforce. By 2012, they were 32.3 percent. By 2022, they are projected to represent 35.4 percent of the nation’s total workforce.

The AARP new study addresses a widespread misconception that older workers cost “significantly more” than younger workers. In fact, adding more talented older employees to your workforce can result in only minimal labor cost increases, says the researchers, noting that 90 percent of large employers now base pay in part on job performance, rather than exclusively on length of employment.

In addition, in terms of retirement costs, only 22 percent of large companies now offer a defined benefit pension plan, down significantly from the 68 percent in 2004.
Looking at the 50+ segment of the workforce from a performance standpoint, AARP and Aon Hewitt say that older workers remain the most engaged age group. The study reports that 65 percent of workers age 55+ are considered “engaged”, based on survey data, while younger employee engagement averages 58 to 60 percent.

Although the generational differences in engagement might not seem large, “it takes only a five percent increase in engagement to achieve three percent incremental revenue growth,” the report finds. This can translate into a large company with $5 billion in revenue achieving a $150 million revenue increase as a result of even a five percent engagement improvement, the study says.

The report concludes “An engaged older workforce can influence and enhance organizational productivity and generate improved business outcomes.” Other advantages of older workers include their job experience, professionalism, strong work ethic, lower turnover, and knowledge.
AARP commissioned the study to assess the advantages of both retaining and attracting older workers. The analysis relies primarily on data from Aon Hewitt databases, an extensive literature review and interviews with 18 large employers to obtain anecdotal information on how they approach older workers.

Contributing to Rhode Island’s Economy

“We have noted in the past the relevance of Rhode Island’s so-called Longevity Economy,” said AARP Rhode Island State Director Kathleen Connell. “Despite being just 36% of Rhode Island’s population in 2013 (expected to grow to 38% by 2040), the total economic contribution of the state’s 50-plus population accounted for 46% of Rhode Island’s GDP ($24 billion). Now we see another reason to embrace the older population.

Connell notes that “This new report reinforces the value of older Rhode Islanders as they continue to be a key asset in the workforce. It is especially good to have reliable data that exposes the false concept that older workers cost significantly more than younger workers. The truth is, that older workers increase labor costs minimally while contributing experience and stability to businesses across the spectrum.

“Many employers in Rhode Island understand this. AARP Rhode Island gets frequent calls from business actively seeking older workers. They know the value and the wisdom they bring to the workplace,” says Connell.

According to Charles Fogarty, Director of the Division of Elderly Affairs (DEA), the recently released AARP study helps his agency spread this message, “older workers are expected to play a key role in sparking Rhode Island’s comeback.”

“We support policies and programs to help this crucial segment remain active in the labor force by connecting older workers to services and training,” says Fogarty, noting that AARP’s study confirms, “our seniors are a valuable asset in our workforce given their wealth of knowledge, ability to mentor younger colleagues, and commitment to hard work.”

Deputy Director Lisa D’Agostino, of the state’s Department of Labor and Training agrees with DEA’s Fogarty. “Age 50+ workers are a talented segment of our workforce that is often overlooked and untapped when businesses seek workforce solutions. Given today’s demand for a skilled workforce the solution is simple – mature workers can bring the talent, leadership and work ethic employers need,” she says, noting that labor force participation for this group is on the rise and unemployment rates are lower than that of the prime working age population and have been for the last ten years.

Oak Hill resident Hank Rosenthal, 64, confirms the importance and value of hiring older workers. But, during his two-year job search, after being laid off, he experienced job discrimination, he claims. “Having been interviewed by numerous Human Resource professionals, they just seem incapable of understanding that the years of experience someone has gained is an asset. They seem unable to appreciate that knowledge, experience, and even skills acquired over a lifetime can be transferred and used in virtually any organization or business,” he says.

Rosenthal, now gainfully employed, views his older contemporaries as being “more stable, reliable, have better work ethics and generally make great employees, in line with the observations of the AARP report. With the difficulty in finding employment he believes that companies have not figured this out yet. “What a terrible waste of human capital,” he says.

While older workers may be forced to continuing working to pay their bills, many employees will take jobs for both psychological and social fulfillment. Hiring and retaining older workers may be a simple way for American businesses to maintain their competitiveness in a world economy. The report says that this can easily be accomplished by having “flexible workplaces, options for transitioning to retirement and fostering generational diversity and inclusion.” The AARP report is a must read for any CEO or Human Resource Director.

For the full report, go to http://www.aarp.org/research/topics/economics/info-2015/business-case-older-workers.html.

Herb Weiss, LRI ’12, is a Pawtucket-based writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.

Making Genocide and Holocaust Education Mandatory

Published in Woonsocket Call on April 26, 2015

By Herb Weiss

With newspapers reporting an increase of religious and cultural intolerance and hate crimes, it is refreshing to see the Rhode Island General Assembly pass resolutions condemning the systematic and barbarous murder of Armenians and Jews.

On Friday, April 24, Armenians across the nation stopped to remember the Ottoman authorities eight-year brutal campaign taking place 100 years ago to eliminate their ethnic group from its homeland in what is now Turkey. Both chambers of the Rhode Island General Assembly passed resolutions calling this day, “Armenian Genocide Remembrance Day” and urging President Obama and Congress to officially recognize the genocide which resulted in the estimated death of 1.5 million Armenians and to make restitution for the loss of lives, confiscated properties, those who endured slavery, starvation, torture, and unlawful deportations.

Taking Responsibility for Your Actions

On April 6, it was a personal and professional triumph for Rep. Katherine S. Kazarian (D-Dist. 63, East Providence), a fourth-generation Armenian-American, to take the lead in sponsoring Rhode Island’s House resolution to commemorate the 100th Anniversary of the Armenian Genocide of 1915. In the afternoon before the vote, the East Providence lawmaker unveiled her resolution at a ceremony in the State House State Room attended by elected state officials and fellow lawmakers.

“The only thing worse than trying to eliminate an entire generation and culture is to deny that such a genocide ever took place,” said Kazarian. “For the past 100 years, the government of Turkey has continually refused to acknowledge their part in the ethnic cleansing of the Armenian people, “she said. Until the Armenian genocide that happened 100 years ago on her ethnic group is recognized by the government of Turkey, Kazarian promised to return to the State House every year to keep the issue alive.

Rhode Island Attorney General Peter Kilmartin says, “On this 100th anniversary, it is more important than ever to remember the horror and tragedy that the Armenian people went through, and it is long overdue that as a nation, we recognize the Armenian Genocide. Hopefully, through recognition, vigilance and education, this type of history will cease to repeat itself.”

“From my first days as a legislator to today as Attorney General, I have always advocated for recognition of the Armenian Genocide, and more recently filed an amicus brief in support of the Armenian fight to seek the return of stolen Armenian Genocide era assets through the United States Courts,” says Kilmartin.

“There are many parallels between the Armenian Genocide and the Holocaust carried out by Adolf Hitler, which ultimately killed six million Jews,” says the Attorney General, stressing that the Armenian Genocide served as an example for Hitler, who used the lack of consequences for the perpetrators of the Genocide as encouragement for the Nazis in planning the Holocaust.

“When giving a speech to Nazi leaders one week before the invasion of Poland, which effectively began World War II, Hitler reportedly noted, ‘who, after all, speaks today of the annihilation of the Armenians?,’ notes Kilmartin, saying that “some historians have even suggested that if more had been done to thwart the Ottomans’ massacre of Armenians, perhaps the Holocaust could have been prevented.”

Eradicating Religious and Cultural Bigotry

Marking the 70th anniversary of the liberation of Auschwitz, Buchenwald, Dachau and Bergen-Belsen concentration camps, Rep. Mia Ackerman (D-Dist. 45, Cumberland, Lincoln) submitted a resolution commemorating Holocaust Remembrance Day (Yom Ha’Shoah). The resolution was passed by the House of Representatives.

“The citizens of Rhode Island have a rich tradition of fighting those who would trample individual liberty and human dignity,” said Representative Ackerman. “We must never allow anyone to forget the time when a handful of evil people tried to turn the earth into a graveyard by systematically exterminating an entire race of people.”

The resolution, which was passed by both the House and Senate, also applauded the courageous efforts of those who took part in the Warsaw Ghetto Uprising of 1943, stating “the brave actions in April and May of 1943 stand as testimony to a rare and indomitable human spirit and extraordinary courage exhibited in the darkest hours of man’s inhumanity.”

According to the Conference on Jewish Material Claims Against Germany, by 2020 there will be only 67,000 Holocaust survivors left, 57 percent who will be at least 85 years old. How can the story of the horrific holocaust be told to the younger generation when the eye witnesses are dying off?

Andy Hollinger, Director of Communications for the Washington, D.C.-based U.S. Holocaust Memorial Museum, makes an obvious comment. “No one who did not live through the Holocaust can experience its horrors, he says, noting that “Holocaust survivors are our best teachers.”

Today, about 80 Holocaust survivors are still telling their stories and working to educate new generations about this history at the U.S. Holocaust Memorial Museum.

“When they are no longer here we will rely on the collections — artifacts, documents, photographs, films, and other materials to tell this story,” says Hollinger, noting that the Museum is “racing to collect the evidence of the Holocaust.”

“We’re working in 50 countries on six continents to ensure this proof [witness testimonies, artifacts, and documents] is secured, preserved and made available through exhibitions and, increasingly, digitally, adds Hollinger.

Marty Cooper, Community Relations Director, Jewish Alliance of Greater Rhode, believes it is “vitally important that the next generations learn about the holocaust and other genocides and atrocities that have taken place and continue to take place.” He calls for genocide education to be mandatory and part of the middle and high school curriculum.

One of the great lessons we can learn from the Holocaust and Armenian genocide is that hatred cannot go unchallenged. It must be immediately confronted wherever it emerges, by governments, religious leaders, nonprofit and business organizations, more important by each and every one of us. We must avow that these horrendous atrocities will never happen again to future generations.

Herb Weiss, LRI ’12 is a Pawtucket writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.

“Doc Fix” Law Brings Permanent Changes to Medicare Physician Payments

Published in Woonsocket Call on April 19, 2015

Congress put aside its fierce partisan bickering and came together to pass H.R. 2 – the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This week President Obama took the opportunity to sign the legislation package into law.

The Congressional fix repeals and replaces the flawed Medicare physician reimbursement system known as the sustainable growth rate or Sustainable Growth Rate (SGR). For the past 13 years, physicians have faced the possibility of an arbitrary cut in their Medicare payments unless Congressional lawmakers passed a so-called “Doc.fix” Medicare bill. Since 2003, Congress has passed 17 short-term bills to block these cuts in Medicare doctors’ fees that were called for under the existing law.

On April 14, the U.S. Senate passed the MACRA by a whopping 92 to 8 (the House passing its version of the bill in late March by a large margin, 392-37). Two days later, at an outdoor signing ceremony in the Rose Garden, President Obama signed the legislation into law, with the House bill brokers, Speaker John Boehner (R-Ohio) and House Minority Leader Nancy Pelosi (D-Calif.) in attendance. .

A Permanent Fix Prevents Payment Cuts

Just hours before a cut in reimbursement that would take place this week, a rare bipartisan Congressional effort prevented a 21 percent cut in Medicare payments to occur. It’s a permanent fix. And the new law extends the Children’s Health Insurance Program, which has provided coverage to millions of American children.

At the signing, Obama called the passage “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs,” noting that it would also strengthen the nation’s health care delivery system for the long run.

Obama stated this new law “creates incentives to encourage physicians to participate in new, innovative payment models that could further reduce the growth in Medicare spending while preserving access to care.”

According to the Center for Medicare Advocacy (CMA), a national nonprofit, nonpartisan law group that provides education, advocacy and legal assistance to older people and people with disabilities, the estimated cost of the new law is roughly $214 billion over 10 years. CMA says roughly half (approximately $35 of the total $70 billion over 10 years) will come from Medicare beneficiaries through changes that will increase their out-of-pocket costs for health care.(through means testing of higher-income Medicare beneficiaries, increased Part B premiums, and added deductibles to Medigap plans purchased in the future.”

CMA adds that the nation’s pharmaceutical and insurance industries were not required to pay for any of this law, although doing so would have paid for a major portion of the SGR replacement.

On the Back of Medicare Beneficiaries

Aging advocacy groups, including the Center for Medicare Advocacy and AARP, failed in their attempts to improve the Senate bill Medicare beneficiaries, including a repeal of the annual therapy caps, raising eligibility standards for low-income programs and permanently extending outreach and education funding for critical programs aimed at low-income beneficiaries. The Senate bill passed without amendments.

While many gave thumbs up to the new law, Max Richtman, President and CEO of the Washington, DC –based National Committee to Preserve Medicare and Medicaid, sees big problems with MACRA. “The Senate ‘Doc Fix’ vote has traded one bad policy for another, shifting the costs of Congress’ failed Medicare payment formula for physicians to seniors who can least afford to foot that bill. Contrary to claims by supporters, on both sides of the aisle, this ‘doc fix’ will hit millions of seniors who aren’t ‘wealthy’ by any stretch of the imagination. Seniors at all income levels who are already paying steep premiums for Medigap plans to help control their health care costs will now be hit with even higher costs. Forty-six percent of all Medigap policy holders have incomes of $30,000 or less.”

Richtman added, “Medicare beneficiaries will also be forced to contribute nearly $60 billion in premiums over the next decade thanks to passage of this so-called ‘fix.’

It’s no surprise that conservatives applaud this legislation as ‘the first real entitlement reform in two decades’ because it fulfills their political goal of shifting costs to seniors, cutting benefits and expanding means-testing to push Medicare further and further away from being the earned benefit seniors have long valued and depended on.”.

“Trading a bad deal for doctors for a bad deal for seniors is not a legislative victory and it is a surprising move from so many in Congress who have previously vowed to protect Medicare from harmful benefit cuts and seniors from cost-shifting,” says Richtman. .

AARP CEO Jo Ann Jenkins also expressed strong disappointment in the Senate not passing an amendment that would have removed Medicare’s arbitrary cap on physical therapy, speech language pathology, and occupational services. “Many Medicare patients, particularly stroke victims and people with Parkinson’s and Multiple Sclerosis would have benefited,” says Jenkins. With a majority of the Senate agreeing with this amendment, Jenkins says that AARP will continue to lobby to remove the arbitrary coverage cap.

But, Jenkins sees the positives. “Passage of MACRA moves Medicare in the right direction toward better quality health care and greater transparency for patients. These changes will benefit Medicare beneficiaries, as well as physicians and other providers, hospitals, and the overall health care system,” she says.
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Through the enactment of MACRA Congress put aside its political differences that made a permanent fix to a flawed law. If you can do it once, let’s see our lawmaker do this again, to provide improved programs and services to our nation’s older population.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Rethinking Rhode Island’s LTC Delivery System

Published in the Woonsocket Call on April 12, 2015

AARP Rhode Island releases a state-specific analysis, of the 2014 edition of “Raising Expectations: A State Scorecard on Long-Term Services and Supports (LTSS) for Older Adults, People with Physical Disabilities, and Family Caregivers” that just might give state officials cause for concern, a low rating on its long-term care delivery system, when compared to other states.

The 2011 Scorecard was the first multidimensional assessment of state performance of LTSS. Like this earlier version, the release of the 109 page 2014 report, referred to as the LTSS Scorecard, and its state-specific analysis (prepared by policy consultant Maureen Maigret), measuring how well the nation and each of the states is doing in providing long-term care services, does not bode well for the nation’s littlest state. It finds the Ocean State ranks 38th nationally on 26 performance indicators, with it achieving the lowest rank of all New England States.

“Our analysis provides a closer look at where Rhode Island is keeping pace and where we fall short,” said AARP State Director Kathleen Connell. “The report indicates that, as the state with the highest percentage of persons 85 and older, we face exceptional challenges. It is our hope that the General Assembly and state policymakers find the analysis to be a valuable tool,” she says.

Failing Grades

The 2014 LTTS Scorecard indicates that Rhode Island:

• Ranks 4th highest among states in nursing home residents per 1,000 persons age 65 and over

• Has a high percent of low-care nursing home residents and spends a far higher percent of its LTSS dollars than the national average on nursing home care as opposed to home and community-based services.

• Has some of the highest long-term care cost burdens in the country making private pay long-term services unaffordable for the vast majority of older households.
But, on a positive note, the state-specific analysis noted that Rhode Island’s best progress was made in the Legal and System Supports dimension largely due to the 2013 passage of the Temporary Caregiver Insurance program and Caregiver Assessment requirements for Medicaid Home and Community Based Services (HCBS).

In addition, to revisiting the 19 recommendations made following the release of AARP’s 2011 Scorecard, the more recent 2014 analysis recommends five new major policy initiates to improve the littlest state’s LTSS. Among the recommendations: funding of an Aging and Disability Resource Center; the developing an online benefits screening tool to allow access to income-assistance benefits and conducting outreach programs to increase participation; reviewing the Rhode Island’s Nurse Practice Act to allow nurse delegation of certain health maintenance and nursing tasks to direct care workers; requiring hospitals to provide education and instruction to family caregivers regarding nursing care needs when a patient is being discharged; and exploring emerging medical technologies to better serve home and community based clients.

The current analysis finds that only four recommendations out of the 2011 recommendations have been implemented, most notably those to promote coordination of primary, acute and long-term care and to strengthen family caregiver supports.

Meanwhile, only six recommendations were partially implemented, including the expansion of the home and community co-pay program and authority (but not implementation) under the 1115 Medicaid waiver renewal to provide expedited eligibility for Medicaid HCBS and for a limited increase in the monthly maintenance allowance for persons on Medicaid HCBS who transition out of nursing homes. Finally, nine recommendations, although still relevant, have not been implemented.

Response and Comments

Responding to the release of AARP’s 2014 Scorecard and state-wide analysis, Governor Gina Raimondo says, “we need to ensure that we have a strong system of nursing home care for those who truly need those services, but we must invest our Medicaid dollars more wisely to support better outcomes. We cannot continue to have the fourth highest costs for nursing home care (as a percent of median income of older households) and also rank near the bottom of all states in investments in home and community-based care.”

According to Raimondo, the state’s Working Group to Reinvent Medicaid is looking closely at AARP’s Scorecard and state-specific analysis and Rhode Island’s spending on nursing home and long-term care. Health & Human Services Secretary Elizabeth Roberts has directed her staff to look directly at the proposals recommended by AARP Rhode Island.

“I expect the Working Group will include specific proposals stemming from these findings in their April budget recommendations and their long-term strategic report they will complete in July,” says the Governor.

AARP Rhode Island Executive Director Connell, representing over 130,000 Rhode Island members, was not at all surprised by the findings of the recently released 2014 Scorecard. “Based on benchmarks set in the 2011 Scorecard, it was apparent that there was much work to do,” she says, recognizing that there are “limited quick fixes.”

“Some steps in the right direction will not lead to an immediate shift in the data. This is a big ship we’re trying to steer on a better course. We were encouraged, however, by ‘improving’ grades for lower home-care costs and the percentage of adults with disabilities ‘usually or always’ getting needed support rising from 64 percent to 73 percent,” adds Connell.

Connell says that the Rhode Island General Assembly is considering legislation to improve the delivery of care, which might just improve the state’s future AARP ‘report’ cards.” “In this session, there is an opportunity to improve long-term supports and services with passage of several bills, including one that would provide population-based funding for senior centers,” she says, stressing that it’s a “responsible investment that will help cities and towns provide better services.”

Connell adds, “The proposed CARE Act gives caregivers better instruction and guidance when patients are discharged and returned to their homes. This can be a cost saver because it can reduce the number of patients returned for treatment or care.”

The larger mission for state leaders is the so-called ‘re-balancing’ of costs from nursing care to home to community-based care. That’s where real savings can occur and home is where most people would prefer to be anyway.”

Finally, Virginia Burke, Executive Director of the Rhode Island Health Care Association, a nursing facility advocacy groups, supports the implementation of the policy initiatives recommended by AARP’s state-specific analysis. But, “The primary driver of our state’s nursing facility use is the extremely advanced age of our elders,” Burke says, noting that the need for nursing facility care is more than triple for those aged 85 and older than for seniors just a decade younger. Due to the state’s demographics you probably won’t see a change of use even if you put more funding into community based home services, she adds.

Governor Gina Raimondo and the General Assembly leadership will most certainly find it challenging to show more improvement by the time the next Scorecard ranks the states. Older Rhode Islanders deserve to have access to a seamless system, taking care of your specific needs. Creative thinking, cutting waste and beefing up programs to keeping people in their homes as long as can happen might just be the first steps to be taken. But, the state must not turn its back on nursing facility care, especially for those who need that level of service.

Herb Weiss, LRI ’12 is a Pawtucket writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.

How to Keep Social Security off the GOP Chopping Block

Published in Woonsocket Call on April 4, 2015

One of the first political skirmishes to protect the nation’s Social Security program, 589 days before next year’s Presidential election, took place on March 24th in the U.S. Senate during budget debate. Leading the charge, Rhode Island Senator Sheldon Whitehouse called up Senator Wyden (D-OR)’s budget amendment, requesting a Senate point of order against legislation to cut benefits, raise the retirement age, or privatize Social Security.

During the debate, “Social Security benefits are a solemn promise that our seniors have earned over a lifetime of work,” said Whitehouse, a founding member of the Senate’s Defend Social Security Caucus. “Sadly, Republicans have made it their mission for decades to dismantle that promise, attempting to turn it over to Wall Street and cut benefits through misguided ideas like the so-called ‘chained-CPI’,” he charges, noting that the Democratic sponsored amendment protects Social Security from right-wing attacks and ensure that retirees can count on their earned retirement benefits.

Republican Senator Enzi from Wyoming raised a point of order, calling Wyden’s amendment non germane to the budget resolution being debated. With the Democrats rallying 51 Senators to vote yea, 60 votes were required to wave Enzi’s point of order.

Although his attempts to protect Social Security in the Senate budget failed, Richard Davidson, Whitehouse’s Rhode Island Press Secretary, tells this columnist that the Senator plans to continue his efforts to keep Social Security off the GOP budget chopping block and from being privatized by supporting legislation like the Keeping Our Social Security Promises Act, legislation that would raise the income cap on the payroll tax to ensure the program’s solvency.

Davidson also states that the Social Security trust funds are projected to be fully solvent though 2033, and there’s no immediate funding crisis. But, in the longer run, Whitehouse believes the program must be bolstered by applying the payroll tax, which currently only applies to income up to $118,500, to higher levels of income, he says.

Protecting SSDI

One month before the Senate Budget debate, the GOP-controlled Senate Budget Committee put a spotlight at a hearing on the impending insolvency of the nation’s Social Security Disability Trust Fund (SSDI). The federal government has predicted that SSDI fund reserves will run low by the end of 2016, at which point millions of disabled beneficiaries could see up to a twenty percent cut in benefits.

At the Senate hearing, entitled “The coming crisis: Social Security Disability Trust Fund Insolvency,” Democrats called for an easy quick fix to the problem, specifically the shifting of a small percentage of the Social Security payroll tax from the retirement trust fund to the disability trust fund. No big deal, they say, because these transfers have occurred 11 times in the past with bipartisan support without political bickering. But, from this hearing it seemed clear that GOP Senators, who control the Senate, now see things differently and are threatening to block the infusion of funds to SSDI.

Approximately 10.2 million Americans received SSDI benefits in 2013, including roughly 42,000 Rhode Islanders. In order to qualify, beneficiaries are required to have worked in a job covered by Social Security, and must have been unable to work for a year or more due to a disability.

A February 9 posting on the Plum Line blog, penned by Greg Sargent for the Washington Post web site, takes a look a look at this SSDI entitlement debate.
In his opinion blog, Sargent says that GOP lawmakers claim that a “restricting a fund transfer is all about forcing a necessary discussion on how to improve Social Security’s long term finances, rather than merely “kicking the can down the road.” On the other hand, the Washington Post blogger believes Democrats see the Republicans as “exaggerating the sense of crisis to realize one of two political goals. Either they want to force immediate, and unnecessary, cuts – or they want to hold the disability fund hostage, in order to have another run at cuts to the broader program [Social Security].”

Gathering the Troops

At a March 23rd panel discussion hosted by the Providence-based Headquarters of Community Action Partnership , Whitehouse and Congressman Jim Langevin with Rhode Island Senator Donna Nesselbush, a disability attorney, along with SSDI recipients, disability groups, and the Social Security Administration, came to discuss the solvency of SSDI and its impact on the Ocean State. The lawmakers called for shifting Social Security payroll taxes to financially shore up the ailing SSDI program. Both lawmakers also supported a long-term solution, fully funding the federal retirement and disability programs by lifting the cap on the amount of income that is subject to the payroll taxes that fund the program.

“Right now, a millionaire hedge-fund manager pays the same amount of taxes into the Social Security system as someone who makes $118,500,” said Whitehouse. He called for “wealthiest Americans to pay a fair share into the program, so that it’s not funded disproportionately on the backs of middle-class workers.”

Congressman Langevin stressed “SSDI is not only a critical safety-net for disabled workers, their children and spouses, it is also a promise we make to everyone who pays into the Social Security trust fund that they won’t be impoverished if they are left with a debilitating condition or disability.”
Although Whitehouse’s efforts to protect the nation’s Social Security and Disability programs were derailed in the Senate Budget debate because of a GOP procedural call, it’s only the first of many political skirmishes to come. The upcoming 2016 Presidential elections will firmly put this entitlement issue on the nation’s radar screen, hopefully to address once and for all.

But, here’s my message to Whitehouse: Even if you lose a skirmish, or battle, you can always win the war. Keep pushing.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Putting the Brakes on Testosterone Prescriptions

Published in Pawtucket Times on March 30, 2015

Sophisticated mass marketing pitching testosterone to combat age-related complaints combined with lax medical guidelines for testosterone prescribing can be hazardous to your physical health, even leading to strokes and death, warns an editorial in this month’s Journal of the American Geriatrics Society.
The March 2015 editorial coauthored by Dr. Thomas Perls, MD, MPH, Geriatrics Section, Department of Medicine, Boston Medical Center in Boston, and Dr. David Handelsman, MBBS, Ph.D., ANZAC Research Institute, in New South Wales, Australia, expressed concern over commercial-driven sales of testosterone, effectively increasing from “$324 million in 2002 to a whopping $2 billion in 2012, and the number of testosterone doses prescribed climbing from “100 million in 2007 to half a billion in 2012.”

Pitting Patients Against Patients

The editorial authors see the “40 fold” increase of testosterone sales as the result of “disease mongering,” the practice of widening the diagnostic boundaries of an illness and aggressively promoting the disease and its treatment in order to expand the markets for the drug. Glitzy medical terms, like “low T” and “andropause,” showcased in direct-to-consumer product advertising pit aging baby boomers against their physicians, who demand the prescriptions, say the authors.

“Clearly, previous attempts to warn doctors and the public of this disease mongering that is potentially medically harmful and costly have not been effective, says co-author Dr. Perls.

The epidemic of testosterone prescribing over the last decade has been primarily the proposing of testosterone as a tonic for sexual dysfunction and/or reduced energy in middle-aged men, neither of which are genuine testosterone deficiency states,” observes Dr. Handelsman.

According to the National Institutes on Aging (NIA), the nation’s media has increasingly reported about “male menopause,” a condition supposedly caused by diminishing testosterone levels in aging men. “There is very little scientific evidence that this condition, also called andropause or viropause, exists. The likelihood that an aging man will experience a major shutdown of testosterone production similar to a woman’s menopause is very remote.”

The authors agree with the NIA’s assessment, but go further. They point out in their editorial that for many men, testosterone does not decline with age among men retaining excellent general health, and if it does, the decline is often due to common underlying problems such as obesity and poor fitness. Those who hawk testosterone have developed advertising that focus on common complaints among older men such as decreased energy, feeling sad, sleep problems, decreased physical performance or increased fat.

But, many times a testosterone level won’t even be obtained and the patient is told that, simply based on these common symptoms alone or with minor reductions in serum testosterone, they have “late onset hypogonadism” or that their erectile dysfunction may be improved with testosterone treatment, say the authors. But the authors also point out the true hypogonadism is the cause in fewer than 10% of men with erectile dysfunction.

FDA Enters Debate

The U.S. Food and Drug Administration’s (FDA) recent dual commission findings concluded that testosterone treatment (marketed as ‘low T’) is not indicated for age-associated decline. The benefits of this “deceptive practice” remain unproven with the risks far outweighing the perceived benefits,” says the agency. Pharmaceutical companies are now required to include warning information about the possibility of an increased risk of heart attacks and stroke on all testosterone product labels.

Health Canada, Canada’s FDA, recently echoed the FDA’s committee findings that age-related hypogonadism has not been proven to be a disease-justifying treatment with testosterone. Both agencies warn of an increased risk of blood clots in the legs and lungs and the possibility of increased risk for heart attack associated with testosterone use.

In a statement, James McDonald, the chief administration officer for the Board of Medical Licensure and Discipline, says: “There is a concern in healthcare regarding direct-to-consumer prescribing of medication. At times, the prescription is not evidence-based, and can lead to misuse. There is concern with Testosterone, a schedule 3 controlled substance,that can be used as a performance-enhancing drug. The Rhode Island Board of Medical Licensure (BMLD) investigates complaints regarding all types of misuse of prescription medications as well as complaints regarding over-prescribing.”

Drs. Handelsman and Perls also warn about another drug commonly hawked for anti-aging, growth hormone. The FDA requires that doctors perform a test to demonstrate that the body does not produce enough growth hormone. “Those who market and sell HGH for these common symptoms nearly never perform the test because if they did a properly performed test, it would almost never be positive because the diseases that cause growth hormone deficiency in adults, such as pituitary gland tumors, are very rare,” said Perls. Growth hormone is well known for its side effects, including joint swelling and pain and diabetes. Ironically, opposite of anti-aging claims, growth hormone accelerates aging, increases cancer risk and shortens life span in animal studies.

In the editorial, Perls and Handelsman call upon professional medical societies and governmental agencies to take definitive steps to stop disease mongering of growth hormone and testosterone for conjured-up deficiencies.
“These steps include the banning of ‘educational’ and product advertising of testosterone for these contrived indications,” said Perls. “Furthermore, the FDA and Health Canada should require a physician’s demonstration of a disease process proven to benefit from testosterone administration in order to fill a lawful prescription for testosterone.”

Tightening Up Prescription Guidelines

The issue of prescribing testosterone is firmly on the medical profession’s radar screen with the FDA’s recent committee’s findings and Perls and Handelsman’s pointed editorial calling for the medical profession to seriously tighten up the lax consensus guidelines in order to stop the medically inappropriate prescribing of testosterone.
Rather than pushing testosterone, wouldn’t it be a “mitzvah – a good deed- if the nation’s pharmaceutical companies ran public service commercials stressing the importance of losing weight, exercising and eating nutritious meals as a way to effectively combat age-related problems, like low libido. But, this won’t happen because it is not a revenue generator or good for the company’s bottom line.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Study Shows Meal Deliveries Positively Benefit Seniors

Published in Woonsocket Call on March 22, 2015

In 2013, Dr. Kali Thomas, an assistant professor at Brown University’s Center for Gerontology and Healthcare Research, published a study that found home delivered meals can keep persons age 60 and older at home, allowing them to age in place.  The study’s data also indicated that some states would experience cost savings if they expanded meals on wheels because that could delay a Medicaid recipient’s entry into costly nursing home care.

The “More Than a Meal” pilot research study, conducted by Thomas, was released on March 2, 2015 the Alexandria, Virginia-based Meals on Wheels America, the oldest and largest national group representing over 5,000 community-based senior nutrition programs. The gerontologist found benefits far beyond basic nutrition identified by her earlier 2013 study — health and psychological benefits, too, particularly for those seniors who live alone.

Details of Groundbreaking Research Study

Thomas, contracted by Meals on Wheels America with funding provided by AARP Foundation, designed and executed the 15-week pilot study, involving over 600 older participants, in eight sites around the country, including the Ocean State.  Study participants either received personally delivered fresh meals daily, or weekly bulk deliveries of frozen meals, or just simply remained on a waiting list.

The Brown University researcher found those living alone who received meals showed statistically significant reductions in feelings of isolation, an effect that was greater if they received meals daily rather than weekly.  They also felt significantly less lonely, were less worried about staying in their homes, and said they felt safer. Those also receiving meals experienced fewer falls and hospitalizations.

Thomas said that based on her personal experience as a driver for Meals on Wheels of Rhode Island and as the family member of a meals recipient (her 98-year old grandmother), she was not at all surprised to see the positive benefits she observed anecdotally emerge as significant in a rigorous research study.

Elle Hollander, President and CEO on Wheels America, notes that her members have “faced tough choices forced by limited funding, rising costs, unprecedented demand and need, and increasingly for-profit competition.”  Hollander says, “We now have the research-backed evidence that confirms what we’ve all know for decades anecdotally through personal experience: that Meals on Wheels does in fact deliver so much more than just a meal.”

AARP State Director Kathleen Connell agrees.  “It really has been no secret that home-delivered meals are a critical for the older population, as well as the disabled. With  Kali Thomas’s earlier Brown data released in 2012 in our award-winning senior hunger documentary Hungry in the West End, the newest research reinforces what Thomas said in film: the nutritional benefits and relief from food preparation allows people to live in their homes longer and to stay healthier. And so, there are long term healthcare benefits as well as savings to the state if the investment in home-delivered meals delays someone’s transition from independence or home-based care into a Medicaid-supported nursing facility.”

A Call for More State Funding

Heather Amaral, Executive Director of Meals on Wheels of Rhode Island agrees with the benefits of visiting volunteers to the recipients, but stressing that the volunteer benefits, too, from the bond that develops. “There are many studies that show volunteering is good for your health and spirit, she says.

Amaral expresses pride that Rhode Island was selected as one of eight pilot sites in the study.  “This study proves what we’ve observed through the years—Meals on Wheels deliveries keeps people out of nursing homes and in their own homes longer,” she says.

According to Amaral, in 2014 Meals on Wheels of Rhode Island’s Home Delivered Meals program provided 316,524 meals to 2,298 individuals.  Over the years she has seen federal funding remain stagnant, while state funding has declined.  Last year’s budget allocated $200,000 to Meals on Wheels, down from $530,000 that was allocated by the General Assembly in 2006.   But, Governor Raimondo’s submitted budget does reinstate $ 330,000 more in funding, if approved by the Rhode Island General Assembly, she says.

Clearly, Governor Gina Raimondo recognizes the importance of Meals on Wheels as she begins to reshape Rhode Island’s long-term care continuum.  The Governor states, “Programs like Meals on Wheels are important investments. These programs are one of the strategies in our toolbox to keep people healthy and in their own homes. Particularly as we work to reinvent Medicaid to support better health outcomes and provide better value to taxpayers, we will continue to support programs like Meals on Wheels that help our most vulnerable seniors stay in their homes and in the community.”

The Rhode Island General Assembly must not be penny-wise and pound foolish.  Support the Governor’s budget to ratchet up funding for Meals on Wheels.  It is a sound policy move to put the breaks to spiraling Medicaid costs, by making the system more efficient and rooting out fraud and waste.   We must balance the State’s limited budget funds to keep older Rhode Islanders at home as long as possible.  But, if nursing home care is need, the Rhode Island General Assembly must allocate the necessary Medicaid funding to provide efficiently delivered quality of care.

Herb Weiss, LRI ’12 is a Pawtucket-based writer who covers aging, health care and medical issues.  He can be reached at hweissri@aol.com.