AARP Gives Us a Snapshot of the Millennial Caregiver

Published in the Woonsocket Call on June 3, 2018

AARP’s latest caregiver report places the spotlight on the Millennial generation, those born between 1980 and 1996, ages 22 to 38 in 2018. “Millennials: The Emerging Generation of Family Caregivers,” using data based primarily from the 2015 Caregiving in the U.S. study, notes that one-in-four of the nearly 40 million family caregivers in America is now a Millennial.

The 11-page report, released by AARP’s Public Policy Institute on May 22, 2018, takes a look at the Millennial’s generational experiences and challenges as they support an aging parent, grandparent, friend or neighbor with basic living and medical needs.

“Caregiving responsibilities can have an impact on the futures of younger family caregivers, who are at a particular time in their lives when pivotal social and professional networks are being formed,” said Jean Accius, PhD, Vice President, AARP Public Policy Institute, in a statement with the report’s release. “We must consider the unique needs of millennial family caregivers and ensure that they are included in programs and have the support they need to care for themselves as well as their loved ones,” she says.

The Millennial Caregiver

According to the AARP report, Millennial caregivers are evenly split by gender but also the most diverse group of family caregivers to date, notes the report. More than 27 percent of the millennial caregivers are Hispanic/Latino, or 38 percent of all family caregivers among Hispanic/Latinos.

The AARP report notes that Millennials are the most diverse generation of family caregivers when compared to other generations. Eighteen percent are African-American/Black, or 34 percent of all African-American/Black family caregivers. Eight percent are Asian American/Pacific Islander, or 30 percent of all the AAPI family caregivers, says the report, noting that less than 44 percent are white, or 17 percent of all white family caregivers. Finally, twelve percent self-identify as LGBT, which makes them the largest portion of LGBT family caregivers (34 percent) than any other generation.

About half of the Millennial caregivers (44 percent) are single and never married while 33 percent are married. If this demographic trend continues a smaller family structure will make it more likely to have a caregiver when you need one.

More than half of the Millennial caregivers perform complex Activities of Daily Living (ADLs), including assisting a person to eat, bath, and to use the bathroom, along with medical nursing tasks, at a rate similar to older generations. But, nearly all Millennials help with one instrumental activity of daily living including helping a person to shop and prepare meals.

While Millennial caregivers are more likely than caregivers from other generations to be working, one in three earn less than $30,000 per year. These low-income individual’s higher out-of-pocket costs (about $ 6,800 per year) related to their caregiving role than those with higher salaries, says the AARP report.

As to education, Millennial caregivers have a high school diploma or has taken some college courses but not finished. But, one in three have a Bachelor’s Degree or higher.

According to the AARP report, 65 percent of the Millennial caregivers surveyed care for a parent or grandparent usually over age 50 and more than half are the only one in the family providing this support. However, these young caregivers are more likely to care for someone with a mental health or emotional issue — 33 percent compared to 18 percent of older caregivers. As a result, these younger caregivers will face higher emotional, physical and financial strains.

The AARP report notes that Millennials are the most likely of any generation to be a family caregiver and employed (about 73 percent). Sixty two percent of the boomers were employed and were caregivers. On top of spending an average of more than 20 hours a week (equivalent to a part-time job) in their caregiving duties, more than half of the Millennials worked full-time, over 40 hours a week. However, 26 percent spend more than 20 hours of week providing family care.

Although most Millennial caregivers seek out consumer information to assist them in their caregiving duties, usually from the internet and from a health care professional, the most frequent source of information is from other family members and friends.

While Millennial caregivers consume information at a higher rate, most (83 percent) want more information to supplement what they have. The tope areas include stress management (44 percent) and tips for coping with caregiving challenges (41 percent).

A Changing Workforce

Millennials are encountering workplace challenges because they are less understood by supervisors and managers than their older worker colleagues. More than half say their caregiving role affected their work in a significant way, says the AARP report. The most common impacts are going to work late or leaving early (39 percent) and cutting back on work hours (14 percent).

As we see the graying of America, it makes sense for employers to change their policies and benefits to become more family friendly to all caregivers, including Millennials, to allow them to balance their work with their caregiving activities.
It’s the right thing to do.

To read the full report, visit: https://www.aarp.org/ppi/info-2018/millennial-family-caregiving.html.

Visit http://www.aarp.org/caregiving for more resources and information on family caregiving, including AARP’s Prepare to Care Guides.

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Trump Signs Legislation to Undo Nation’s Banking Rules

Published in the Woonsocket Call on May 27, 2017

On May 22, 2018, The Senior Safe Act, a bipartisan bill authored by U.S. Senators Susan Collins (R-ME) and Claire McCaskill (D-MO) to help protect older American’s from financial exploitation and fraud, passed the House of Representatives by a vote of 258-159 as part of a bipartisan banking reform package after previously passing the Senate in March by a vote of 67-31. President Donald J. Trump’s signed the bill into law rolling back regulatory oversight of the nation’s financial industry.

The Senior Safety Act is part of S. 2155, the “Economic Growth, Regulatory Relief and Consumer Protection Act,” a bill that modified the provisions of the Dodd-Frank Act, which was passed by Congress in 2010 to oversee the financial industry after the financial crash and recession of 2008-09.

Protecting Older Investors from Financial Exploitation

Through the watchdog efforts of the Senate Aging Committee, financial exploitation of seniors was identified as a top senior issue to combat. According to the Government Accountability Office, financial fraud targeting older Americans is a growing epidemic that costs seniors an estimated $2.9 billion annually. These frauds range from the “Jamaican Lottery Scam,” to the IRS impersonation scam, to the financial exploitation of seniors through guardianships. Earlier this year a hearing was held to update the public about the committee’s efforts to combat scams targeting older Americans as well as unveil its 2018.

As the Chairman and former Ranking Member of the Senate Special Committee on Aging, Senators Collins and McCaskill introduced the Senior $afe Act last year. Existing bank privacy laws can make it difficult for financial institutions to report suspected fraud to the proper authorities. The Senior $afe Act address this problem by encouraging banks, credit unions, investment advisors, broker-dealers, insurance companies and insurance agencies to report suspected senor financial fraud. It also protects these institutions from being sued for making reports so long as they have trained their employees and make reports in good faith and on a reasonable basis to the proper authorities.

“As Chairman of the Senate Aging Committee, I have been committed to fighting fraud and financial exploitation targeted at older Americans,” said Senator Collins. “The Senior $afe Act, based on Maine’s innovative program, will empower and encourage our financial service representatives to identify warning signs of common scams and help prevent seniors from becoming victims.”

Judith M. Shaw, Maine Securities Administrator and chair of the North American Securities Administrators Association’s Committee on Senior Issues and Diminished Capacity, says that this legislation incentivizes financial service institutions, including those in the securities industry, to train key employees on the identification and reporting of suspected financial exploitation of seniors. “This is a significant and important tool in the ongoing efforts to protect senior investors,” she adds.

Adds Jaye L. Martin, Executive Director of Legal Services for the Elderly, “We know from our proven success with Senior Safe in Maine that education of financial services professionals is a key component to identifying and stopping financial exploitation of seniors. There is no doubt this bill will help prevent seniors all over the country from becoming victims.”

With the passage of S. 2155, Keith Gillies, President of the National Association of Insurance and Financial Advisors (NAIFA), said, “The Senior Safe Act provides “much needed protection for older investors and will allow advisors to better protect their clients’ interests.”

“Advisors are often the first line of defense for scammers looking to take advantage of investors,” says Gillies, noting that studies have found older Americans are often a prime target.

The Pros and Cons of S. 2155

Since the Dodd-Frank legislation’s passage eight years ago, 20 percent of small banks have been put out of business, said President Trump and a ceremony where he signed S. 2155 into law. He predicted that the roll back of the costly banking reform regulations, both “crippling” and “crushing” to community banks and credit unions, would stimulate the banking industry to increase lending to businesses.

Banking regulations made it virtually impossible for new banks to be established to replace those that had closed their doors, said Trump, denying small businesses with access to capital. “By liberating small banks from excessive bureaucracy — and that’s what it was: bureaucracy — we are unleashing the economic potential of our people,” said Trump.

Senator Jon Tester (D-Montana) calls the Economic Growth, Regulatory Relief, and Consumer Protection Act a jobs bill, saying “it is a much-needed solution for the folks who power our local economies.”

In an op-ed in the Greater Fort Wayne Business Weekly, Senator Joe Donnelly (D-Indiana) said, “This banking package is reasonable, balanced, and the result of thoughtful negotiation and compromise. It would take measured steps to encourage community financial institutions to boost lending and provide new protections for consumers. And it’s an example of what we can achieve when we work together to break the gridlock in Washington.”

But others strongly oppose passage of S. 2155.

Although S. 2155 has a provision to protect seniors from financial exploitation, Democratic Policy and Communications Committee Co-Chair David N. Cicilline, expressed strong concerns when the Houses passed S. 2155, he jokingly refers to as “the Bank Lobbyist Act.”

“Ten years ago, Wall Street’s recklessness brought our economy to the brink of collapse. It has taken Rhode Island years to recover. In many ways, we are still recovering.,” noted Rhode Island’s Congressman representing District 1. “The Dodd-Frank financial reform law ended the worst of the Big Banks’ excesses. It established the Consumer Financial Protection Bureau and gave working people a voice against the most powerful corporations in our country,” he said, noting that the passing of S. 2155 has reversed this progress.

It’s a massive giveaway to the wealthy and the middle class is getting screwed. This is a raw deal for working men and women. The American people deserve A Better Deal,” Cicilline said.

Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, warns that with the deregulation of banks, the GOP “are still gunning for Social Security under the guise of entitlement reform.”

Richtman predicts the passage of S. 2155 and it’s signing into law “makes another financial crisis more likely.”” He asks, “How fair is it to ask workers to be responsible and save when the government strips away protections intended to keep our savings secure?”

“Retirees’ Social Security benefits must be preserved because, at least for now, they are the only thing workers can depend on after the next financial crash,” says Richtman.

The Senior $afe Act was endorsed by organizations, including AARP, the North American Securities Administrators Association (NASAA), the Conference of State Bank Supervisors (CSBS), the Credit Union National Association (CUNA), the National Association of Federally-Insured Credit Unions (NAFCU), the National Association of Insurance Commissioners (NAIC), the National Association of Insurance and Financial Advisors (NAIFA), the Securities Industry and Financial Markets Association (SIFMA), the Insured Retirement Institute (IRI), Transamerica, and LPL Financial.

2050 and the Caregiver Dilemma

Published in the Woonsocket Call on April 22, 2018

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

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

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

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

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

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

Who Will Take Care of Aging Baby Boomers?

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

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

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

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

Real Challenges Face Congress as the Nation Ages

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

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

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

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

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

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

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

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

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

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

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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.

Aging Groups Fear that Deficit May Lead to Attacks on Entitlement Programs

Published in Woonsocket Call on January 21, 2018

In early December, the GOP-controlled Senate passed by a partisan vote of 51 to 49 its sweeping tax rewrite, sending the $1.5 trillion tax package, detailed in a 492 page bill, to the Conference Committee to iron out the differences between the Senate and House bills. The House’s Tax Cuts and Jobs Act (H.R. 1), was passed by a 227-to-205 vote on November 16, 2017. Congress ultimately passed the Conference Committee’s revised tax bill, sending it to President Trump’s desk for signature. While the new tax law has a few positive provisions for seniors, aging groups predict a frontal assault by the GOP-controlled Congress and White House in 2018 to make cuts on Medicare, Medicaid, and Social Security to balance to ballooning federal deficit.

Just days before President Trump signed into law on December 22, 2017, the Tax Cuts and Jobs Act (P.L. 115-97), considered to be the biggest tax reform overhaul in over 30 years, AARP’s Chief Executive Officer, Jo Ann C. Jenkins, sent a letter to Congress raising the Washington, DC-based aging groups concerns with the law’s significant shortcomings as well as highlighting its impact “on the nation’s ability to fund critical priorities.”

Putting Medicare on the Chopping Block

In December 19 correspondence, Jenkins noted that AARP opposed the tax bill because of its negative impact on older adults. She expressed concern that there would be increased calls for greater spending cuts in Medicare, Medicaid and other domestic programs serving older Americans, with the tax legislation increasing the nation’s deficit by $1.5 trillion over the next ten years (with an unknown amount beyond 2027).

“Indeed, the non-partisan Congressional Budget Office (CBO) has confirmed that unless Congress takes action, the reconciliation legislation will result in automatic federal funding cuts of $136 billion in fiscal year 2018, $25 billion of which must come from Medicare,” said Jenkins. With the tax legislation’s repeal of Obamacare’s individual mandate, health care premiums would increase by 10 percent (with 64-year olds paying an average increase of $1,490) and there would be 13 million fewer Americans with health coverage, says Jenkins, citing a CBO’s analysis of the tax legislation.

However, AARP did appreciate that the Tax Cuts and Jobs Act retained the medical expense , deduction and restored the 7.5 percent income threshold for all tax filers for two years, said Jenkins, noting that “almost three-quarters of tax filers who claimed the medical expense deduction are age 50 or older and live with a chronic condition or illness, and seventy percent of filers who claimed this deduction have income below $75,000.”

Finally, Jenkins also said that the Tax Cuts and Jobs Act retained the additional standard deduction for those age 65 and older, as well as rejected proposals to make significant changes to the tax treatment of retirement contributions, which would have negatively affected the ability many tax filers to save for their retirement.

Targeting Social Security, Medicare, and Medicaid

Like Jenkins, the Washington, DC-based National Committee to Preserve Social Security and Medicare also sees Medicare, Medicaid and Social Security becoming more vulnerable to benefit cuts due to the huge $1.5 trillion increase in the public debt resulting from the enactment of the GOP’s tax law.

According to the NCPSSM’s Government Relations and Policy staff in a January 2018 policy brief, key supporters of the Tax Cuts and Jobs Act made it very clear that Medicare, Medicare and Social Security, would be targeted to balance the federal budget immediately after its approval. “For example, Senator Marco Rubio (R-FL) said that the tax bill is just the first step before “…instituting structural changes to Social Security and Medicare…” benefits to reduce the federal deficit. Similarly, House Speaker Paul Ryan (R-WI) said that “we’re going to have to get back next year [2018] at entitlement reform, which is how you tackle the debt and the deficit.” In other words, the majority leadership will seek cuts to Medicare, Medicaid and Social Security benefits as the next step to pay for the deficits this tax bill will create,’ NCPSSM’s policy brief.

In 2018, NCPSSM anticipates that the GOP-controlled Congress will seriously look at privatizing Medicare, raising the Medicare eligibility age, increasing beneficiary out-of-pocket costs, expand means testing of Medicare premiums, and block granting Medicaid, as a way to reducing the huge federal debt.

NCPSSM says that under the GOP’s Medicare privatization plan, when people become eligible for Medicare benefits they would not enroll in the current traditional Medicare program, which provides guaranteed benefits, but would receive a voucher to purchase private health insurance or traditional Medicare through a Medicare Exchange. The voucher’s amount would be determined annually when private health insurance plans and traditional Medicare participate in a competitive bidding process.

Medicare costs could also be cut by gradually increasing the eligibility age of Medicare to correspond with Social Security’s retirement age which is increasing from 65 to 67. Although this GOP strategy would initially save money, it would increase “system-wide health spending for everyone else,” warns NCPSSM.

NCPSSM says that “savings from redesigning the Medicare benefit [to reduce the federal deficit] by combining the Part A and Part B deductibles and making changes to supplemental insurance (Medigap) policies, would likely increase costs for people with Medigap policies.”

In 2018, the GOP Congress also might even consider expanding means-testing of Medicare premiums to reduce the federal deficit, says NCPSSM. “Expand income-related premiums under Medicare Parts B and D until 25 percent of beneficiaries are subject to these premiums [would reduce costs]. A Kaiser Family Foundation study found that this proposal would affect individuals with incomes equivalent to $45,600 for an individual and $91,300 for a couple in 2013,” says NCPSSM’s policy brief.

Medicaid provides funding for health care to low-income seniors, people with disabilities, children and some families. “We anticipate [GOP] proposals will be made that would end the current joint federal/state financing partnership and replace it with per capita caps (or a block grant, at state option) giving states less money than they would receive under current law,” says NCPSSM’s policy brief, noting that repealing the Medicaid expansion under Obama’s Affordable Care Act would prevent low-income adults from accessing health care services.

Concerns Over Fast-Track Reforming Social Security

Finally, NCPSSM’s policy brief warns that GOP lawmakers might push for a “fast-track” procedure that would lead to cutting social security benefits. This proposal would require the President to submit a plan to be considered in Congress under “expedited procedures” to reform Social Security if the Social Security Trustees determine the Trust Funds do not meet a 75-year actuarial balance. NCPSSM views this proposal “as a way that to circumvent public scrutiny of proposals to reduce Social Security programs.”

NCCPSSM also anticipates a GOP proposal to eliminate concurrent receipt of unemployment insurance and Social Security Disability Insurance (SSDI) for beneficiaries who work, get laid off and as a result qualifies for Unemployment Insurance.

Last month, the GOP-controlled Congress and White House enacted the largest tax reform bill. AARP, NCPSSM and other aging advocacy groups warn that Social Security, Medicare and Medicaid will be targeted by the GOP lawmakers to balance the tax reform law’s $1.5 billion costs. Older voters must now become politically active in protecting and strengthening these programs for both current beneficiaries and future generations” With the looming 2018 mid-term elections, may be Congress might just listen.

Congress Passes RAISE Family Care Givers Act

Published in the Woonsocket Call on January 14, 2018

With the dust finally settling after the heated partisan battles over the dismantling President Obama’s landmark Obamacare and later reforming the nation’s tax code, Congressional Democrats and Republicans put political and philosophical differences aside to overwhelming pass by voice vote the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act of 2017.

The RAISE Family Caregivers Act of 2017, introduced in the U.S. Senate by Senators Susan Collins (R-ME) and Tammy Baldwin (D-WI), was passed on January 8, 2017. Two months earlier a House companion measure (H.R. 3759), introduced by Reps. Gregg Harper (R-MS) and Kathy Castor (D-FL), was passed. At press time, the legislation now heads to the President’s desk to be signed into law.

The caregiver legislation would direct the U.S. Secretary of Health and Human Services to develop and sustain a strategy to recognize and support family caregivers across the nation. This bipartisan legislation has been endorsed by more than 60 aging and disability organizations, including AARP, the Alzheimer’s Association, the National Committee to Preserve Social Security and Medicare, the Elizabeth Dole Foundation, the Michael J. Fox Foundation, and the Arc.

Universal Praise for Congressional Passage

Congress clearly understands that caregiving is not a partisan issue but a life experience for millions of Americans.Yes, everyone at some time in their life may take on the role of caregiver for parents, spouses, children and adults with disabilities, or personally know caregivers.

According to AARP’s Public Policy Institute, there are 40 million family caregivers in the United States who provided an estimated $470 billion in uncompensated long-term care in 2013. In the Ocean State at any time during the year, an estimated 134,000 Rhode Island family caregiver step up to provide 124 million hours of care for an aging parent or loved one, most often helping them to live independently in their own homes.

“Family caregivers play an essential role in our communities by dedicating time and attention and making countless personal and financial sacrifices to care for their loved ones,” said Sen. Collins upon the Senate bills passage. “I am delighted that our bipartisan legislation to develop a coordinated strategic plan to leverage our resources, promote best practices, and expand services and training available to caregivers will now become law,” adds the Maine Senator, who chairs the Senate Special Committee on Aging.

Senator Sheldon Whitehouse sees the value of the RAISE Family Caregivers and its impact to Rhode Island caregivers. “The passage of the bipartisan RAISE Family Caregivers Act is an important first step toward easing the burden on the caregivers who mean the world to the family members they care for.” says the Rhode Island Senator who serves on the Senate Special Committee on Aging.

“Family caregivers play a key role in supporting their loved ones in Rhode Island and throughout the nation. adds Democratic Policy and Communications Committee Co-Chair David N. Cicilline. “The RAISE Family Caregivers Act ensures that family caregivers have the support and the resources they need to do their jobs safely and effectively. As a co-sponsor of H.R. 3759, I made sure my colleagues understood that this bill needed to become law as soon as possible, and I am glad that it passed both Chambers without objection. Now I urge President Trump to sign it and allow this important law to take effect”

“Thanks to the efforts of bipartisan Senate and House champions—Senators Collins and Baldwin and Representatives Harper and Castor—the RAISE Family Caregivers Act will help address the challenges family caregivers face,” said AARP Chief Advocacy & Engagement Officer Nancy A. LeaMond, in a statement. “Family caregivers are the backbone of our care system in America. We need to make it easier for them to coordinate care for their loved ones, get information and resources, and take a break so they can rest and recharge,” she says.

According to LeaMond, family caregivers take on a range of tasks including managing medications, helping with bathing and dressing, preparing and feeding meals, arranging transportation, and handling financial and legal matters. She estimates that the unpaid care that family caregivers provide helps delay or prevent costly nursing home care, which is often paid for by Medicaid.

What’s in the RAISE Family Caregiver Act?

The RAISE Family Caregivers Act directs the Secretary of Health and Human Services to develop and update a national strategy to support family caregivers. The legislation would also create a Family Caregiving Advisory Council comprised of relevant Federal agencies and non-federal members, also including family caregivers, older adults with long-term care needs, individuals with disabilities, employers, health and social service providers, advocacy organizations engaged in family caregiving, state and local officials, and others with expertise in family caregiving.

The newly established Advisory Council (meetings open to the public) would be charged with making recommendations to the Secretary. The strategy would be updated to reflect new developments. The Advisory Council’s initial report would include an initial inventory and assessment of federally funded caregiver efforts that would be incorporated into the initial strategy. The strategy would then identify recommended actions that government, providers, communities, and others could take to support family caregivers.

The development of the initial strategy would take up to 18 months, followed by updates of the strategy biennially. The bill would improve the collection and sharing of information, including information related to evidence-based or promising practices and innovative models regarding family caregiving; better coordinate, assess, maximize the effectiveness, and avoid unnecessary duplication of existing federal government activities to recognize and support family caregivers. The strategy and work around it could help support and inform state and local efforts to support family caregivers, promoting greater adoption of person- and family-centered care in all health and Long-Term Service and Support (LTSS) settings, with the person and the family caregiver (as appropriate) at the center of care teams

In addition to requiring the development of a strategy to support the nation’s family caregivers, the bill also establishes an advisory body that will bring together stakeholders from the private and public sectors to make recommendations that communities, providers, government, and others are taking and may take to help make the big responsibilities of caregiving a little bit easier.

The activities under the bill would be funded from existing funding appropriated for the Department of Health and Human Services. No new funding is authorized and it would sunset in five years.

Calls for More Caregiver Assistance

“In Rhode Island, we’re working hard at staying ahead on legislation supporting caregivers,” said AARP Rhode Island State Director Kathleen Connell. “We passed temporary caregiver insurance, which covers thousands of working caregivers with salary protection much like TDI (Temporary Disability Insurance). Earned-paid sick leave fills in a gap that caregiver TDI may not cover in emergency situations. The AARP-back CARE Act now requires hospitals, upon admitting patients, identify a designated caregiver, inform that person on discharge and provide training for at-home medical tasks. We have passed legislation making it easier for caregivers to modify their homes. And just this month, the state opened applications for a grant program we fought for in the current budget that provides up to $5,000 in hard cash for caregivers who make qualifying home improvements.” (Download a grant application at http://www.aarp.org/ricaregiving)

“We cannot stop here,” added Connell. “And the RAISE Act keeps the need for ongoing strategic planning and smart policymaking on the front burner. The numbers demand escalating action that will improve conditions not just for people who need care, but their family caregivers as well. But it is very important to emphasize that all taxpayers benefit when someone with chronic illness or aging disabilities can stay in their homes, rather than move into Medicaid-supported nursing homes. We all win when we support caregivers.”

NOTE: “The Rhode Island Chapter of the Alzheimer’s Association has a commitment to assisting caregivers navigate the various challenges of caring for someone living with Alzheimer’s and other related dementias,” says Donna McGowan, Executive Director of the Alzheimer’s Association, RI Chapter. Call 1-800-272-3900 for details about caregiver and provider services (including confidential support, information, and referrals to local resources via access to a 24/7 Helpline, care consultation, caregiver support groups, education programs for families, and online information (www.alz.org/ri ).

Covering All the Aging Bases in 2017

Published in Pawtucket times on January 1, 2017

As an age beat columnist, it has been a very eventful year in covering aging, health care and medical issues that impact older Rhode Islanders. During 2017, over 42 “fresh” commentaries along with previous printed ones appeared in the Pawtucket Times and Woonsocket Call. Readers were kept abreast on a dazzling array of political issues, including a GOP President and Republican-controlled Congress attempting to whittle popular domestic entitlement programs like Social and Medicare programs, attempts to derail Obamacare, and the passage of the largest tax code changes in the past 30 years.

Throughout 2017, a few of my weekly commentaries drew attention to individuals who worked tirelessly on behalf of older Rhode Islanders. It is important to recognize volunteers who assist Rhode Island’s aging network provide programs and services to the state’s growing older population. One commentary noted Phil Zarlengo tireless efforts, and his receiving AARP’s most distinguished volunteer award. Another commentary gave kudos to the Rhode Island Minority Task Force’s 10 “Everyday Heroes.”

Meanwhile, other commentaries penned that year touched on a wide range of aging issues, from a Senate calling to better protect seniors during disasters, improving your cognitive health, enhancing communication at home, taking a look at how innovative companies help caregiver employees, to taking a look how a person made “lemonade out of life’s lemons” who shared her insight others.

Below are five article, providing you with the breadth and depth of this year’s commentaries. Over 300 commentaries including the below ones can be viewed on my blog, herbweiss.wordpress.com.

1. “Spumoni’s: “Where Everybody Knows Your Name”: Study Says Being Socially Active May Improve Cognitive Functioning,” published I the Feb. 26, 2017 issue of the Woonsocket Call, and one day later in the Pawtucket Times.

Mark and Nancy Shorrock, of Attleboro, Massachusetts, now in their seventies and married for 52 years, began dining at Spumonis twice a week with their children in the 1980s, and remember being drawn to the Italian-style restaurant because of its reputation of serving “good food.” Over the years, as the Shorrock’s three children became more independent and “doing things on their own,” the couple began increasing their trips daily to the Pawtucket resident for dinner since it was so close by. Of course, their network of friends increased, too.

What the Shorrocks know innately, a 24-page report, “The Brain and Social Connectedness: GCBH Recommendations on Social Engagement and Brain Health, “released by the Global Council on Brain Health in February 14, 2017, tells us that larger social networks may positively impact your health, wellbeing, even your cognitive functioning. This report is available at http://www.GlobalCouncilOnBrainHealth.org.

“It’s not uncommon for our social networks to shrink in size as we get older,” said Marilyn Albert, Ph.D., GCBH Chair, Professor of Neurology and Director of the Division of Cognitive Neuroscience at Johns Hopkins University in Baltimore, Maryland. “This report provides many helpful suggestions about the things we can do to improve the quality of our relationships with family and friends, which may be beneficial in maintaining our mental abilities.”

The Brain and Social Connectedness report addresses the social benefits of having pets, the role that age-friendly communities play in fostering social ties, and how close relationships promote both physical health and psychological well-being. The report also covers how social media like Facebook and Skype helps older adults maintain their social connections.

2. “Carvelli: Making Lemonade Out of Life’s Lemons,” published in the April 9, 2017 issue of the Woonsocket Call, and one day later in the Pawtucket Times.
Author and life coach Linda Carvelli believes that everything in life has a purpose and that resilience will get you through any obstacle in your path. She succinctly illustrates this philosophy in her 340 page memoir, “Perfectly Negative: How I Learned to Embrace Life’s Lemons Lessons.” The self-published book details how she faced personal and family tragedy (divorce, becoming unemployed, and caring for her mother and sister with breast cancer who ultimately died, and herself being diagnosed with breast cancer.)

Carvelli a Warren resident, dedicated over twenty years of her professional career to computer technology and project management before writing her first full-length memoir, published in 2016, that reveals how she ultimately came to terms with her life’s mission. That is helping people overcome and learn from the challenges in their daily lives. As a board certified life coach, she brings lessons from her book to people to help them regain control of their lives, discover new perspectives, create more options, and move forward with confidence and courage.

3. “Assistance to Employee Caregivers Good for Everyone’s Bottom Line,” published on June 11 issue of the Woonsocket Call, and one day later in the Pawtucket Times.

In 2017, AARP and the Respect a Caregiver’s Time Coalition (ReACT) released a report detailing innovative practices and policies of 14 organizations (including Fannie Mae, CBS Corporation, Allianz Life, and Emory University) to support their employees with caregiver responsibilities. With the graying of America, supporting caregiver employees should be considered “a potentially new weapon” to attract or retain talented employees, say the researchers, by flexible work arrangements and paid leave policies. And there will be a need for this support.

“Family caregivers juggle their loved one’s needs with their own personal and professional goals every day. AARP hopes this report will encourage more employers understand caregiving and support their employees’ success,” said Nancy LeaMond, executive vice president and chief advocacy and engagement officer in a statement. AARP sponsored the 49-page report.

`According to researchers, interviews with business and human resources executives from the profiled organizations in the report indicated that time and flexibility are what matter most to employees when it comes to balancing work and caregiving. Close to half of the employers interviewed provide paid time off for caregiving as well as emergency backup care and flexible work arrangements.

All offer employee caregivers a combination of information resources, referral services and advice by phone. Most provide resources online, typically through an employee assistance (EAP) or an intranet portal. More than half offer phone consultations or 24/7 expert hotlines. Several interviewees stressed the value of providing on-site, independent eldercare consultants, noting that employees appreciate both the convenience and the respect for their privacy.

4. “Save the Roses and Try These Tips: Six Ways to Improving Communication at Home,” published in the February 5, 2017 issue of the Woonsocket Call, and one day later in the Pawtucket Times

Effective Communication at home with your husband, wife, or partner is key to maintaining a meaningful, healthy, environment and thriving family. Author Donna Mac, a well-known corporate trainer, based in South Eastern, Massachusetts, with 25 years of experience in the broadcasting industry, translates effective corporate communication details tips in her book, “Six Pillars of Effective Communication” which can bring healthy energy into an ailing relationship and bring you closer together with your loved one.

According to Author Donna Mac, president of Rehoboth, MA-based DMacVoice Communications, sexual infidelity, commonly linked to divorce, is not the leading cause for couples separating. 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.

Mac’s six pillars call for a person to: know and own who they are; understand the audience you are speaking to; master the topic of your conversation; anticipate the questions and reactions to your conversation; “speak to serve” by making sure the conversation is not about you; and be detach from the outcome of your discussion.

5. “Senate Aging Panel Calls for Improved Emergency Preparation and Response,” published in the October 8, 2017 of the Woonsocket Call, and one day later in the Pawtucket Times

In the wake of Hurricanes Irma and Harvey, after the death of at least nine nursing facility residents due to heat-related illness due to sweltering heat at a Hollywood, Florida-based facility that had lost power to run its air conditioner, the Senate Special Committee on Aging put the spotlight on the challenges facing seniors during natural disasters at a hearing on Sept. 20, 2017.

The expert panel detailed a variety of recommendations at this Senate panel hearing. One suggestion included creating registries to quickly locate were residents who are electricity-dependent live, for swift evacuations. Another called for fully funding the Federal Emergency Management Agency (FEMA) and investing in weather surveillance tools for better decision making.

Other recommendations included: requiring nursing and assisted living facilities have emergency evacuation plans; having support generators in the event of a power failure; gathering more research on what types of patients will benefit from evacuation or sheltering in; only allowing construction of facilities in places that minimize flooding risk; and litigation protection for facilities that abide by regulations and provide care during disaster scenarios.

If you like my weekly coverage of issues of interest to the aging network and older Rhode Islanders, a book compiling 79 of these commentaries is now available for purchase. To order “Taking Charge: Collected Stories on Aging Boldly,” go to http://www.herbweiss.com.