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.

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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.

Women Capable of Changing Corporate Culture with Effective Communication

Published in Woonsocket Call on March 11, 2018

Effective communication is a major factor for women executives to be successful on the job and for having healthy personal relationships, says Author Donna Mac, a well-known corporate communications trainer and keynote speaker. Ms. Mac is based in south eastern Massachusetts, with 30 years of experience in the communications industry.

The corporate communications expert notes that a recent article in Psychology Today says that whether a partner’s communication “lifts you up or brings you down” is the single largest predictor of divorce. “That one trait can also translate into work too, observes Mac. “Often, a company’s greatest talent leaves a job because of miscommunication or a lack of communication and limited trust,” she says.

“Our society is changing at an incredible pace, so we often fail to have those vital conversations or to take time to ensure that understanding has taken place. Details fall through the cracks and we spend more time picking up the pieces than if we had taken a few moments to communicate effectively in the first place,” says Mac.

Western Women Will Save The World

In 2012, Mac said, the Dali Lama was quoted as saying, “western women will save the world”. “I agree and disagree”, says Mac. “I believe His Holiness saw the importance of bringing softer, more nurturing communication skills into the workplace. It’s clear he was talking about the skills that prove to people that you’ve taken the time to think and care about them,” she says.

Mac says, “Empathetic communication skills are more important now than ever. But the workplace also needs employees who have thick skin; professionals who are able to articulate the rules, regulations and take a firm stand on issues. Those skills,” Mac says, “are the kind that will get you noticed by upper management. They come from someone not afraid to do and say the right thing at the right time, even if discomforting,” she says.

“I see it all the time. Like when a boss doesn’t provide her employees constructive feedback for fear of how that worker will feel,” says Mac, noting that when this happens it can be a great disservice to the employee and the organization because you’ve lost an opportunity for everyone to maximize the potential of the company and its people.

Speaking & Communicating Mindfully

Even with three decades of communication experience under her belt, Mac doesn’t lose sight of the fact that she’s still has more to learn. “I learn new modalities all the time. These days, I’m helping people become more mindful of how they communicate and what they can and cannot control. I’ve sharpened these skills through some recent mindfulness training. That means shutting down our noisy, overstimulated brains by sitting in silence, noticing our biases and doing breathing exercises”.

“It’s amazing”, Mac says, how communicating mindfully helps with the fear of speaking. We fear speaking at the podium and we also fear having challenging conversations. Being more mindful helps you feel more confident as you acquire the tools necessary to communicate.”

“We’ve been taught not to focus on our weaknesses,” Mac says, “but if you want to communicate more effectively, it’s vital that you know what they are. This way, if you are more reserved, you are not overpowered by colleagues or partners who are more outgoing. If your communication skills are more boisterous, you can learn the virtues of slowing down, judging less and listening better.”

“I help people understand people, so they’re able to tune in and relate better. Email and texting is not going away but I think everyone knows that our society can be healthier with more human-to-human interaction and less time on our cell phones! We will also have a more balanced society when communicators are able to be kind and to speak with certainty.”

Mac suggests that if you want to become a more effective communicator, don’t focus on changing others. “When you begin to find your voice after being more introverted, you can actually become more influential pretty quickly. If you’ve been a very communicative person and begin to ask more questions and listen, those around you will notice.”

“It takes time, energy and effort to become a more effective communicator but the benefits at work and at home are well worth it. Plus, the time for all people to acquire the confidence and ability to speak is long overdue. So, ask yourself,” Mac suggests, “are you ready and able to take on the challenge?”

With the #MeToo movement and growing number of incidents of sexual harassment being reported daily, says she spends more time looking forward than in the past. “Just about every woman has a story of being or feeling intimidated. And it’s a different world now. Thanks to the many women who have come forward, it’s a perfect time to learn how to shut down someone who is seeking to take advantage.”

Mac says, “I can’t help with the current laws of the land or regulations in various businesses. But everyone in the workplace, women and men, need to the courage and ability to tell an abuser to stop…to say statements like, “I find that comment way out of line and I am asking you to stop now” or “Help me understand what you mean by that. I’m sure you realize that I don’t stand for any type of intimidation”.

“Give them eye contact and stand in your powerful silence. It’s quite effective.”

This month we celebrate Women’s History Month, to showcase the contribution women have made throughout society. Yes, history can be made in corporate American when women stop apologizing for speaking directly. You can do this while still being kind and respectful. It’s like blending traditionally male and female communication traits when you are able to speak using both your brain and your intuition.

Donna Mac is author of Guide to a RICHER LIFE–Know Your Worth, Find Your Voice & Speak Your Mind, and The Six Pillars of Effective Communication. She is also a keynote speaker and private coach. For more details, go to http://www.dmacvoice.com.

Efforts to Revise State Alzheimer’s Plan are in Full Swing

Published in Woonsocket Call on February 25, 2018

By Herb Weiss

Lt. Governor Dan McKee is gearing up Rhode Island’s fight against the skyrocketing incidence of Alzheimer’s disease, called by some as one of the ‘biggest epidemics in medical history.’ Last Wednesday, he announced $30,000 in grants secured by his office and the Rhode Island chapter of the Alzheimer’s Association to hire a consultant to update the state’s five-year plan on Alzheimer’s Disease and Related Disorders. Tufts Health Plan Foundation and the Rhode Island Foundation each pledged $15,000 to support the rewriting of the initial State Plan.

Updating the State’s Alzheimer’s Plan

The updated State Plan, to be created by a collaborative effort of the Rhode Island chapter of the Alzheimer’s Association, the Division of Elderly Affairs and the Office of the Lt. Governor, will provide state lawmakers with a road map for the state, municipalities and the health care system, to confront the continuing Alzheimer’s crisis. It will take a look at the current impact of Alzheimer’s disease on a growing number of Rhode Islanders and outlines what steps the state must take (legislatively and regulatory) to improve dementia-capable programs and services for people with Alzheimer’s and their family caregivers.

Lt. Governor McKee and the Executive Board of the Alzheimer’s Disease and Related Disorders, a working group of comprised of distinguished researchers, advocates, clinicians and caregivers, are now beginning their efforts to meet their deadline by the end of 2018 of having a completed state plan to submit to the Rhode Island General Assembly.

With financial support provided by the Rhode Island Foundation and Tufts Health Plan Foundation, the Alzheimer’s Association, Rhode Island Chapter, as fiscal agent, can now hire a consultant to assist in updating the initial state-five-year plan approved by the Rhode Island General Assembly in 2013. Once the updated report is completed and approved by the Rhode Island General Assembly, the Executive Board can will seek legislative and regulatory changes to carry out its recommendations to ensure that it is more than just a document—that it comes to shape the state’s public policies on Alzheimer’s.

“Rhode Island has been a national leader in Alzheimer’s research. Each day, we make great strides in expanding clinical trials and innovating treatments. Over the last few years alone, the local landscape of prevention and treatment has changed dramatically and positively. The updated State Plan will be an invaluable tool for local leaders, researchers, physicians, advocates and families as we work together to build momentum in the fight against Alzheimer’s,” said Lt. Governor McKee.

“A Living Document”

“We face an emerging crisis with the prevalence of Alzheimer’s disease projected to increase to as many as 27,000 Rhode Islanders by 2025. Alzheimer’s disease is a pivotal public health issue that Rhode Island’s policymakers cannot ignore. With the rapidly growing and changing extent of the Alzheimer’s crisis, it is essential that Rhode Island’s State Plan becomes a living document that stakeholders regularly consult and re-evaluate,” says Donna McGowan, Executive Director of the Alzheimer’s Association, Rhode Island Chapter.

“Communities have greater interest in age-friendly initiatives. There’s a growing understanding of the critical role older people play. They are an asset to community, and their voices and insights are invaluable to the public discourse on what communities need,” said Nora Moreno Cargie, vice president, corporate citizenship for Tufts Health Plan and president of its Foundation.

“A coordinated, strategic approach to Alzheimer’s will lead to better outcomes and healthier lives. Working with generous donors, we’re proud to partner with Tufts to fund this crucial work,” said Jenny Pereira, the Rhode Island Foundation’s vice president of grant programs.

Put Older Woman, Older Veterans on the Radar Screen

The updated state plan must address the growing needs of older woman and the state’s aging veterans population.

Maureen Maigret, Vice Chair of the Long Term Care Coordinating Council and Chair of its Aging in Community Subcommittee, suggests zero in on the special needs of older woman. “Alzheimer’s disease and related dementias is of special concern for older women as the they are more likely to suffer from the debilitating disease due to greater longevity, more likely to need long term care services and supports and are more often than men to be caregivers either unpaid or paid of persons with Alzheimer’s disease. The Aging in Community Subcommittee of the LTCCC has several pieces of legislation to strengthen support for caregivers and to enhance home and community based services,” says Maigret.

Last year, the USAgainstAlzheimer’s, (UsA2), released the issue brief, “Veterans and Alzheimer’s Meeting the Crisis Head on,” with data indicating that many older veterans will face a unique risk factor for Alzheimer’s as a direct result of their military career.

“Forty nine percent of those aging veterans age 65 ((WW2, Korea, Vietnam and even younger veterans, from the Iraq and Afghanistan conflicts in the coming decades), are at greater risk for Alzheimer’s compared to 15 percent of nonveterans over age 65,” say the authors of the issue brief.

UsA2’s issue brief pulled together research findings released by the U.S. Department of Veteran’s Affairs (VA). On study estimates that more than 750,000 older veterans have Alzheimer’s disease and other dementias, another noting that the number of enrollee with Alzheimer’s grew 166 percent from roughly 145,000 in 2004 to 385,000 in 2014.

The minority communities are at even greater risk for Alzheimer’s and minority veterans are predicted to increase from 23.2 percent of the total veteran population in 2017 to 32.8 percent in 2037, says a cited VA study.

The issue brief also cited one study findings that indicated that older veterans who have suffered a traumatic brain injury (TBI) are 60 percent are more likely to develop dementia, Twenty-two percent of all combat wounds in Afghanistan and Iraq were brain injuries, nearly double the rate seen during Vietnam – increasing these younger veterans’ lifetime Alzheimer’s risk.

The Rhode Island Foundation and the Tufts Health Plan Foundation grant funding was key to the Lt. Governor McKee being able to update its state’s plan to battle Alzheimer’s disease. It provides state policy makers with a roadmap o effectively utilize state resources and dollars to provide care for those afflicted with debilitating cognitive disorder. It is money well spent.

The Alzheimer’s Association will shortly issue a Request for Proposal (RFP) seeking a research consultant to assist in revising and updating e the State Plan. For details about the RFP of the State’s Alzheimer’s Plan, email Michelle La France at mlafrance@alz.org.

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

Trump’s Budget Proposal Comes ‘Dead on Arrival’ to Aging Groups

Published in Woonsocket Call on February 18, 2018

Last Monday, President Donald Trump released his 2019 budget proposal, “An American Budget,” providing guidance to Congress on how to spend hundreds of billions of dollars in new federal spending plan authorized by the Bipartisan Budget Act recently passed into law. Trump’s federal spending wish list clearly shows that many programs and services for older Americans will take a huge hit if any of these proposals are picked up by the Republican-controlled Congress.

The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) expresses concern that Trump’s budget proposal contains many of the same harmful proposals that the Administration and Republican-controlled Congress has pushed before, including $1.4 trillion in Medicaid cuts, $490 billion in Medicare cuts, and repeal of the Affordable Care Act.

Social Security on the Chopping Block

According to the NCPSSM’s analysis released this month, the President’s budget blue print calls for deep cuts to Social Security Disability Insurance, breaking his campaign promise not to touch Social Security.

Trump proposes to slash up to $64 billion from Social Security Disability Insurance (SSDI) benefits through eight demonstrations “ostensibly” geared toward helping disability beneficiaries to stay at work or return to work, says NCPSSM, noting that these Social Security Administration’s (SSA) demonstration projects, established in 1980, had only “a modest effect on beneficiaries’ workforce participation.”

NCPSSM’s analysis warns that the President’s proposed budget also calls for other benefit cuts for disabled seniors, including limiting the retroactivity of applications for disability benefits from 12 months to six months. It would also deny unemployment compensation payments to SSDI beneficiaries who work but get laid off. Social Security Income recipients that live together, even with families, would see their benefits reduced, too.

The Trump Administration also proposes $12.393 billion for SSA’s FY 2019 appropriation for administrative funding, says NCPSSM, warning that this $89 million funding cut will result in longer waits for decisions on initial disability claims and time to speak to a representative from SSA’s 800 number. “With 10,000 baby boomers reaching age 65 every day, SSA needs substantial yearly increases just to keep pace with increased workloads, says NCPSSM.

President Trump’s budget plan only funds production and mailing of only 15 million Social Security statements. “This proposal is part of SSA’s overall plan to limit sending statements only to individuals who are 60 or older rather than sending them to all workers every five years,” says the aging advocacy group, urging the Administration “to send these important financial planning documents to all workers, as is required in section 1143 of the Social Security Act.”

Medicare Takes a Blow

President Trump’s draconian budget calls for over $500 billion in cuts to Medicare, many of these savings coming from cuts to Medicare providers and suppliers. This is another campaign promise broken.

NCCPSSM warns that President Trump’s 2019 budget proposal also includes policy changes to the prescription drug benefit that would impact Medicare’s spending and beneficiary costs. It would create an out-of-pocket maximum for Part D. Medicare t beneficiaries with very high drug costs would no longer have cost sharing responsibility once they hit the catastrophic threshold. This would add $7.4 billion in costs over 10 years.

Trump’s budget proposal would also change the way the threshold for moving out of the coverage gap or “donut hole”” is calculated that would make it more costly to seniors to move through it. “Taken together with an out-of-pocket cap, it will mean savings for some seniors with very high drug costs, but costs will climb for a larger number of seniors. This saves $47.0 billion over 10 years,” reports NCPSSM.

Finally, Trump’s 2019 budget proposal saves $210 million over 10 years by eliminating the cost-sharing on generic drugs for low-income beneficiaries.

Hurting Medicaid Recipients

In FY 2015, federal and state governments spent about $158 billion or 30 percent of Medicaid spending on long-term services and supports (LTSS). The federal and state partnership pays for about half of all LTSS for older adults and people with disabilities.

The President’s 2019 budget proposal slashes the program’s funding by 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, restructuring the program.

NCPSSM expresses concern that if states lose money under per capita caps or block grants, state law makers would have to make up the funding themselves if federal funds do not keep up with their Medicaid population’s needs. This can happen by either by cutting benefits and/or limiting eligibility, requiring family members to pick up more nursing home costs, or scaling back nursing home regulations that ensure quality, service and safety protections.

And That’s Not All

NCPSSM’s analysis says that 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 $ 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 are 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’s 2019 Budget proposal would also eliminate funding for the Low-Income Home Energy Assistance Program (LIHEAP) This program received $3.39 billion in FY 2017. “Of the 6.8 million households that receive assistance with heating and cooling costs through LIHEAP each year, 2.26 million or one-third are age 60 or older,” says NCPSSM.

Trump’s budget plan also eliminates funding for Senior Corps programs including the Retired and Senior Volunteer Program, Foster Grandparents and Senior Companions. Current Senior Corps funding at the FY 2017 level is $202.1 million. “These programs enable seniors to remain active and engaged in their communities, serving neighbors across the lifespan, and benefitting their own health in the process. In 2016, 245,000 Senior Corps volunteers provided 74.6 million hours of service,” says NCPSSM. .

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

Aging advocacy groups view Trump’s second budget “flawed,” jam-packed with “damaging policies” for Congress to enact with an aging population. It’s “Dead on Arrival.” If Trump and GOP lawmakers choose not to listen to their older constituents, the results of the upcoming mid-term elections might just get their attention.

Older Americans to Benefit from Bipartisan Budget Act

Published in the Woonsocket Call on February 11, 2018

While many were sleeping, funding to operate the federal government expired midnight Thursday, though it was restored about eight and a half hours later with action from Congress to end the brief government shutdown, when President Donald Trump signing the 652-page Bipartisan Budget Act of 2018 early Friday morning.

The $400 billion budget agreement funds the federal government through March 23 to give lawmakers time to pull together the details needed to craft full appropriations bills that become the official federal budget.

Lawmakers had expected the massive budget bill to pass before the midnight deadline to avoid a government shutdown but Sen. Rand Paul (R-Ky.), delayed the Senate vote past midnight to protest the additional billions of dollars being added to the federal budget deficit by the legislation.

Ultimately the House approved the bill by 240 votes to 186, almost four hours after the Senate had passed the budget bill by 71 to 28 three hours earlier. The GOP-controlled House needed the help of 73 Democratic lawmakers to pass the budget bill because 67 House Republicans voted against the legislation.

The Nuts and Bolts

The two-year budget deal eliminates strict budget caps that were set in 2011 to reduce the federal deficit and allows Congress to increase military and domestic spending by $300 billion, along with adding another $90 billion for emergency disaster aid for Texas, Florida and Puerto Rico and throws in billions more for infrastructure, the opioid epidemic and health programs. It also suspends the debt limit for one year – until after the upcoming midterm elections.

Specifically, the newly enacted Bipartisan Budget Act of 2018, would allocate $165 billion to the Pentagon and defense spending while $131 billion would be directed to domestic programs. In addition, $20 billion would be spent on infrastructure programs such as surface transportation, rural water and wastewater systems, $ 7 billion in community health centers to provide care to low-income people, $6 billion to fight the opioid crisis, and $4 billion directed to veteran’s health care.

The budget agreement also repeals the controversial Obamacare’s Independent Payment Advisory Board (IPAB), which was designed to limit Medicare costs. It also gives a ten-year extension to the Children’s Health Insurance Program (CHIP), which is four years longer than the previous spending bill passed last month. Finally, the legislation did not address the dilemma of 700,000 “Dreamer immigrants who are in the United States illegally after being brought here as children and who” are enrolled in the Deferred Action for Childhood Arrivals program, set to expire on March 5, nor did it provide funding for President Trump’s proposed southern border wall.

“A Pretty Good Deal for Seniors”

Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, sees the Bipartisan Budget Bill of 2018 “a pretty good deal for seniors.”

“Seniors will feel these changes in their pocketbooks and even in the way they feel physically,” says Richtman, in a released statement. “We have been fighting for these measures for quite some time and are happy to see Congress take action on a bipartisan basis.”

According to Richtman, the Bipartisan Budget Act of 2018 closes Medicare Part D “donut hole” in 2019. The prescription drug coverage gap embedded in the original law, which the Affordable Care Act has been gradually closing, will be altogether eliminated one year early. This will save seniors thousands of dollars in out-of-pocket prescription drug costs., he says.

Richtman says that the enacted Budget agreement also repeals Medicare therapy caps. The bill scraps arbitrary caps on physical, speech, language and occupational therapies that have cost senior’s money – or delayed care at crucial times. Beneficiaries will now find it easier – and more affordable – to get the therapies they need without undue interruption, he notes.

The Bipartisan Budget Act of 2018 also lifts non-defense domestic spending caps, allowing Congress to appropriate more adequate funding for the Social Security Administration’s (SSA) operating budget, says Richtman, noting that the federal agency has suffered from draconian budget cuts since 2011 which have impinged on customer service, even as 10,000 Baby Boomers retire every day. He notes that “this badly-needed (but yet unspecified) higher level of funding should allow SSA to improve customer service for the program’s 67 million beneficiaries.”

But, on the negative side, says Richtman, the new law increases Medicare premiums for some individuals by further expanding Medicare means-testing. “Congress continues to expand Medicare means-testing, and they will not stop until middle-class seniors are burdened with higher Medicare premiums,” he warns.

“We are particularly pleased that this legislation permanently repeals Medicare’s therapy caps, something that AARP has long supported. Millions of vulnerable patients who need occupational, physical, and speech-language therapy will now be protected from an arbitrary limit on how much Medicare will pay for needed therapy,” said Nancy LeaMond, AARP’s Executive Vice President and Chief Advocacy & Engagement Officer, in a released statement..

“AARP is also pleased that Congress expedited the closing of the Medicare prescription drug coverage gap known as the ‘donut hole,’ which will now close in 2019, one year earlier than currently scheduled. Medicare beneficiaries will soon get permanent relief from higher out-of-pocket costs for prescription drugs. We also applaud the provision that adds biosimilar drugs to the Medicare Part D Coverage Gap Discount Program. This change will lower out-of-pocket costs and encourage the development and use of these drugs,” adds LeaMond.