Friday, December 16, 2011

A Look Back at 50 Years of the Special Committee on Aging

On Wednesday, the United States Senate Special Committee on Aging held a forum entitled "Aging in America: Future Challenges, Promise and Potential.” The event featured many speakers, including aging experts and key Special Committee staff, and commemorated the Committee's 50th anniversary.

The Special Committee is responsible for bringing attention to key issues relating to older adults. Although it has no legislative authority, the Special Committee on Aging studies issues, conducts oversight and investigates fraud and waste.

Kathy Greenlee, the Assistant Secretary for the Administration on Aging, spoke about the milestone legislation and judicial action that affects the aging community since the inception of the Special Committee in 1961, including:
  • Creation of Medicare and Medicaid (1965)
  • Federal Nursing Home Reform Act (1987)
  • Americans with Disabilities Act (1990)
  • The Olmstead Decision (1999)
  • Affordable Care Act (2010)
Assistant Secretary Greenlee also emphasized the importance of preventative care across the lifespan, and that it is possible to deliver better care for those who need it at lower costs by using a home and community-based approach.

There has been a significant difference in the lives of older adults over the last half century, and the next 50 years is sure to be transformative as well.

Kelly Stellrecht
Outreach and Field Coordinator
Elder Economic Security Initiative

Thursday, September 15, 2011

Pass the American Jobs Act and Put Women Back to Work

How do we resolve the current economic impasse? We put Americans to work, men and women. That will require a Herculean effort on the part of our leaders to catalyze job creation. As millions of Americans continue to look for meaningful employment, the President has put forward The American Jobs Act, a blueprint for getting Americans back to work, and we look to Congress to act quickly on this legislation.

Women are facing increasing unemployment rates and older women are facing higher rates of long-term unemployment. Wider Opportunities for Women (WOW) finds the “Pathways Back to Work Initiative” particularly encouraging because it includes employment and job training opportunities that create needed entry points for women of all ages, especially for those who are low-income workers.

Job training programs have proven to be successful in fighting unemployment. In the past year, programs like those proposed have helped put more than 4 million Americans back to work. These investments can continue to assist unemployed Americans, particularly women, get back to work with good jobs that pay higher wages and provide economic security for their families. Targeting funds toward enhancing opportunities for women and other under-represented groups by training women in non-traditional fields like construction and encouraging entrepreneurship among the long-term unemployed will ensure that we build an economy that lifts everybody, not just a few.

Take Gloria Morrison, for example. After juggling part-time jobs since high school as a security officer, sales manager, pizza deliverer and martial arts instructor, her part-time work dried up, and she sank into a depression because she was unable to find work. WOW’s Building Futures job training program for un- and underemployed residents in Washington, DC helped Gloria build new skills in marketable, middle-income work. Now she’s part of an apprenticeship program that is not only a job, but the first step on a career ladder that will provide her both job and economic security.

The President’s plan gives hope that we can move forward with investments in our economy that will be both innovative and effective, and we call on Congress to move now to pass this plan.

Donna Addkison
Wider Opportunities for Women

Wednesday, August 24, 2011

Super Committee, Don’t Leave Behind Older Women and Their Families

Times are tough for hardworking Americans of all ages. That’s why it’s imperative that Congress look for a balanced approach (including revenues) to deficit reduction, while protecting low- and middle-income elders who rely on programs like Social Security, Medicaid, Meals on Wheels, the Senior Community Service Employment Program and more.

As hard-working people see the availability of pensions dwindle, many find themselves wholly reliant on Social Security in their retirement years. Social Security is the only source of income for 1 out of 5 elders, and women are more than 60% more likely to live in poverty in their senior years than men are. Due to pay equity issues, the occupational segregation of women in low-wage jobs, and cycling in and out of the workforce due to take care of children and family members, women often find themselves with a Social Security payment that falls short of economic security.

The Elder Economic Security Standard Index (Elder Index) provides a clear picture of the plight faced by women living on average Social Security income. The Elder Index measures the income that older adults require to maintain their independence in the community and meet their daily costs of living. The average annual Social Security income for all women provides a single elder homeowner without a mortgage just under 70% of the income required to achieve economic security. If she rents her home, her average annual Social Security income will provide only 55% of the income required to achieve economic security.

Without employer-based retirement savings income, such as a pension, and/or housing and health care subsidies, the average annual Social Security income alone, although a critical economic security foundation, leaves women struggling to choose among necessities such as heating oil, prescription drugs and food. To close the income gap many elders must draw on state and federal supports including Medicare, Supplemental Security Income (SSI), the Supplemental Nutrition Assistance Program (SNAP), the Low-Income Home Energy Assistance Program (LIHEAP) and the Medicare Part D (prescription drug) Low Income Subsidy (LIS). As Congress looks for ways to reduce the deficit, it is important that they protect the programs that low- and middle-income Americans rely on to make ends meet in their later years.

Maggie Flowers
Field Manager
Elder Economic Security Initiative

Wednesday, July 27, 2011

The Initiative Hits the Road to South Dakota!

Kelly Stellrecht and I recently returned from the Sioux Falls area where I met many dedicated advocates working to help elders achieve economic security across the state.

Experience Works, who is our lead partner in the state, hosted a meeting for their partners to discuss the Initiative and how it will increase their capacity to advocate for seniors. Representatives from Experience Works across the state were there along with staff members from Senators Johnson and Thune’s offices, Volunteers of America, USDA, AARP, Rosebud Indian Reservation and Adult Services and Aging.

Shirley Stuart, State Director of Experience Works welcomes the group.

Learning about the South Dakota Initiative.
The event provided a great opportunity to introduce the framework and tools behind the Initiative, including the Elder Economic Security Standard™ Index (Elder Index), and began preliminary discussions on policy priorities to promote elder economic security in South Dakota. Also at the meeting, the Gerontology Institute at the University of Massachusetts Boston presented draft Elder Index data to the group showing what it really costs to retire in three counties in the state. When the Elder Index is officially released this fall, data for all 66 counties will be available.

Their work is important as more than one in four seniors in South Dakota relies on Social Security as their only source of income, amounting to an average income of $10,941/year for women and $14,826/year for men. Additionally, 11% of elders are living below the federal poverty level of $10,890 a year for an individual. The Argus Leader recently highlighted the needs of seniors in South Dakota and the efforts underway through the Initiative.

The South Dakota Initiative is brimming with ideas of how to educate the public and push for public policies that help seniors achieve economic security. Ideas centered on creating a clearinghouse for available services and organizing transportation for seniors in rural communities. Over the next few months, they will develop a robust policy agenda to accompany the Elder Index for South Dakota.

Find out more about the South Dakota Initiative and get involved if you live in the state!

Thursday, July 7, 2011

Elder Initiative Launches in Colorado

Today the Elder Economic Security Initiative™ officially launched in Colorado!

Our state partner, the Colorado Center on Law and Policy, hosted an event focusing on long-term care and family economic security, cosponsored by the African American Caregivers Association. Speakers discussed the Elder Index, which includes data on what it costs for elders to make ends meet in each county. This marks the 14th state to launch the Elder Economic Security Initiative.

Check out the media coverage of the release so far:
The Colorado reports are now available online:

Friday, June 17, 2011

Medicaid Provides Much More Than Aid to Families

While commonly thought of as a program for low-income families with children, the majority of Medicaid dollars are actually spent on health care for adults age 65 and older and people of all ages with disabilities. In fact, 21% of Medicare beneficiaries, or 9 million people, are also eligible for Medicaid. 

According to Tricia Neuman, Vice President and Director of the Medicare Policy Project at the Kaiser Family Foundation, who spoke at a briefing on the subject last week, many Medicare beneficiaries are struggling to get by in retirement. As we know from the Elder Index, the annual costs for basic expenses are $20,326 for a single elder renting an apartment in the US. In comparison, one half of all Medicare beneficiaries live on less than $22,000, for African-American beneficiaries the average is $14,198 and Latino beneficiaries it is $13,527.

To make matters worse, half of all Medicare beneficiaries have less than $53,000 in combined savings. When taking into account that nursing home costs average $75,000 annually, you can imagine how quickly people can spend down to Medicaid reliance. 

With so much discussion around capping Medicare and Medicaid spending, it is important to educate yourself for the fight ahead. Join us to learn more about Medicaid by signing up for WOW’s webinar: Budget Battles: Threats to Medicaid on Thursday, June 30 at 3:00pm Eastern.

Maggie Flowers
Field Manager
Elder Economic Security Initiative

Friday, June 3, 2011

The CLASS Act and Older Americans

We are excited to have a guest post by Kate Josephson of Advance CLASS, Inc. as a follow up to our week-long blogging event.

The Boomer generation is creeping up in age and Medicare and Medicaid services are under fire. Everyone has heard what is happening on Capitol Hill these days – Congressman Ryan’s (R-WI) Budget Plan would turn Medicaid into block grants, causing long-term services to change in this country for anyone who depends on those supports to live in their community. Medicare coverage could also start to deteriorate. Just this past week, it was predicted by Trustees of the Social Security and Medicare trust that Medicare and Social Security are due to run out sooner than expected. What will our nation’s citizens do if the Treasury bonds used to fund these programs run out?

The Community Living Assistance Supports and Services Act (CLASS Act) was introduced in Congress by the late Senator Kennedy in 2005. It later became part of the Affordable Care Act passed by Congress in March 2010. The idea of the CLASS Act is to help working Americans plan ahead to pay towards the cost of the home care or community assistance they may need if they develop a functional impairment. Anyone who is at least 18 years old and working can pay into the program for just five years to receive a lifetime benefit. The all-cash benefit of at least $50 per day can be triggered once an individual is unable to perform two or more activities of daily living (ADLs) or the cognitive equivalent.

Studies have found that as Americans age they prefer to stay in their homes if at all possible. Studies have also found that it is cheaper for older adults to remain in their homes than it is for them to move into nursing homes. The CLASS Act would allow an elderly person to remain in their home by being able to pay for a few hours of personal care attendant; or the person could save the cash benefit to pay for household changes or even supplement their nursing home care. Either way, home-based personal care would allow the affected individual would be able to remain a connected member of their community for as long as possible.

Throughout the past year, the CLASS Act has come under the scrutiny of Congress. It was blasted by Representative Phil Gingrey and was termed as a “Ponzi Scheme” by Senator Kent Conrad. In March, Representatives Gingrey and Boustany introduced legislation repeal the CLASS Act – however, they offered no plan to replace it. Even though many government officials are worried about the sustainability of CLASS, the Secretary of the U.S. Department of Health and Human Services has vowed, consistent with the mandate of the law, that she would not introduce an unsustainable product to the American people. The Obama Administration has continued to heed the call for people with disabilities and older Americans to be able to receive care without becoming poor enough to be eligible for Medicaid.

In the Spring of 2011, the Administration set up the Office of CLASS under the umbrella of the Administration on Aging (AoA). Kathy Greenlee, the Assistant Secretary for Aging is leading the office. Now that the office is up and running, older Americans and citizens with disabilities can be sure that their needs will be addressed for future generations. As the CLASS Act moves forward, there will be countless benefits for those people who choose to enroll. Many Americans have a difficult time planning for the future; many don’t like to think about it, and many are unaware of how to properly plan. The CLASS Act will give individuals the opportunity and guidance to be able to plan for their futures without taxpayer assistance. The choice to live your life as you choose is a fundamental cornerstone of this nation – it is time we made that choice available to all our citizens.

Tuesday, May 31, 2011

Honoring Women's Service on the Front Line

Yesterday we celebrated Memorial Day -- a day of remembrance for those who have died in military service. When we think about military service, we may often conjure up the image of a “military man” who is part of a “Band of Brothers”. In our images of war women have traditionally been regulated to nurses in field hospitals, government workers, or ‘taking care of the home front’ in our collective memory. While these were essential roles women perform save lives and provide critical services and jobs at home and abroad, women have also made significant contributions in combat historically and in our current wars.

Women have a long history of serving in many combat jobs in the US military. Some highlights include---during the Revolutionary War while women served as nurses, cooks, and laundresses, they were also spies and combat soldiers in disguise. In 1775, Sarah Shattuck, Prudence Wright and other women of Groton, MA, put on their husbands' clothing, and armed themselves to defend the Nashua River Bridge.
In the Civil War both the Union and Confederate armies prohibited women from enlisting.   However women did enlist and, often did so, by disguising themselves as men. While we don’t have an official count of the number of women who served in combat during the Civil War, estimates suggest close to 400 women did.
During World War I regular Army and Navy military nurses served overseas, yet they often did so without being given an official rank. During World War II, the need for workers both in the military and on the home front, led to the dismantling of gendered assumptions of work and occupations, and women played pivotal and non-traditional roles. With the help of women workers, total industrial production doubled between 1939 and 1945; over 300,000 aircraft, 12,000 ships, 86,000 tanks, and 64,000 landing craft and millions of artillery pieces and small weapons were produced in American manufacturing. Women also served as spies, strategic analysts and code breakers. In the combat zones of WW II women served and died for the war effort.  And 90 women were held as prisoners during the war.

Women’s participation in military service continues to grow. More than 260,000 women have served in Operations Iraqi Freedom, Enduring Freedom and New Dawn, and more than 25,000 are serving in the Iraq and Afghanistan today. Not only do they serve, they have lost their lives in this service. As of last month 137 women have died in both wars; with 60 women dying in combat. And, of course, women serve on active duty outside of Iraq and Afghanistan. Currently 14.5 percent of the active duty military members are women; close to 20 percent of the reserve military, and 15 percent of the National Guard.  

So women are pivotal to our military service, and they are on the front line; despite official military policy that bans women from units that are in direct combat missions. Recently, Rep. Loretta Sanchez (D-CA) introduced an amendment “Women’s Fair and Equal Right to Military Service Act” to the 2012 defense authorization bill, to officially recognize women on the front line. This amendment would repeal the policy that prevents women from serving on the front lines. This amendment is quite important, as this existing policy serves as a barrier to women’s advancement in the military, impacts women’s access to benefits, and, simply, does not represent the reality of women in the military.

The military is one of the most powerful areas of gender segregation in our labor market. As we remember those who have bravely served in combat, let us commit to ensure that our military policies and programs that impact women reflect the full realities of the service they perform. In doing so, we will be taking one important step toward providing real recognition and equity for our servicewomen.

Mary Gatta, Ph. D.
Senior Scholar
Wider Opportunities for Women

Friday, May 27, 2011

Day 5: Transportation

In honor of Older Americans’ Month, Wider Opportunities for Women (WOW) is hosting a week-long blogging event to acknowledge how federal income supports build economic security for elders. Select experts from national organizations will author blog posts on the policies that allow elders to close the income gap. WOW will facilitate an online dialogue allowing advocates, service providers, elders, family caregivers and others to learn about the federal programs that build elder economic security and, more importantly, to take action. Each day will focus on a particular aspect of an elder’s budget.

Make your voice heard by taking part in WOW’s blogging event:

• Read and comment on blog posts featured on the National Elder Economic Security Initiative blog.
• Share the blog posts via Facebook, Twitter and e-mail
Sign and send WOW’s statement of principles for elder economic security.

Let Congress know that you support federal funding to support elders ability to age in place with dignity. We need your voice to protect all things that build economic security for elders.

FRIDAY: On Transportation, featuring...
 THURSDAY: On Food Security, featuring...
WEDNESDAY: On Health Care and Long-Term Care, featuring…
TUESDAY: On Housing, featuring…
MONDAY: On Income Security, featuring...

Sorry, but You're Grounded

Authored by Susan Rees, Director of National Policy, Wider Opportunities for Women

“The conversation” – you know, the one where you try to convince your aging Mom or Dad to give up their car keys -- is occurring with greater frequency across the country. Middle class and suburban elders are increasingly facing the “stranded home alone” situation that has confronted younger people who don’t own cars and residents of distressed urban and rural communities who have always lacked access to decent, affordable transit systems or specialized transportation services. The baby boomers, faced with telling their parents they’re “grounded,” also dread the knowledge that it won’t be long before they are the ones whose independence and mobility will be challenged.

No wonder that 80% of Americans believe the country would benefit from an expanded, improved public transportation system, according to a 2011 poll commissioned by the Rockefeller Foundation.
Safe streets and sidewalks and accessible, affordable transit options are critical with the aging of our population. By 2025, 60 million people, one in five Americans, will be 65 or older. Livable communities should be available to anyone, whether they live in cities, suburbs or rural areas.  Everyone needs safe streets and sidewalks and affordable housing close to transit. These are the things that will enable seniors to get out, get their groceries, receive medical care, maintain their physical activity and, in short, age in place in their communities.

The Elder Economic Security Standard™ Index shows that transportation is the second or third largest expense in an elder’s budget after housing and, for some, out-of-pocket health care costs. Yet various pending budget proposals, including a balanced budget amendment or universal spending cap, would cut federal transportation subsidies by 30% or even more. Already, 80% of the nation’s transit systems have eliminated routes, cut service hours, increased fares, or a combination of all three, according to the American Public Transportation Association.

There is another way. Curbing our national debt can be achieved over a longer timeframe than proposed and with the help of equitable revenue increases.  Meanwhile, President Obama’s transportation initiative could be adopted to create jobs and generate new revenues while providing the kind of transportation services our elders depend upon.

Thursday, May 26, 2011

Day 4: Food Security

In honor of Older Americans’ Month, Wider Opportunities for Women (WOW) is hosting a week-long blogging event to acknowledge how federal income supports build economic security for elders. Select experts from national organizations will author blog posts on the policies that allow elders to close the income gap. WOW will facilitate an online dialogue allowing advocates, service providers, elders, family caregivers and others to learn about the federal programs that build elder economic security and, more importantly, to take action. Each day will focus on a particular aspect of an elder’s budget.

Make your voice heard by taking part in WOW’s blogging event:

• Read and comment on blog posts featured on the National Elder Economic Security Initiative blog.
• Share the blog posts via Facebook, Twitter and e-mail
Sign and send WOW’s statement of principles for elder economic security.

Let Congress know that you support federal funding to support elders ability to age in place with dignity. We need your voice to protect all things that build economic security for elders.

THURSDAY: On Food Security, featuring...
WEDNESDAY: On Health Care and Long-Term Care, featuring…
TUESDAY: On Housing, featuring…
MONDAY: On Income Security, featuring...

    It is More than Just a Meal

    Authored by Paul Downey, President/CEO, Senior Community Centers of San Diego and President, National Association of Nutrition and Aging Services Programs

    Even the most skeptical contrarian would have trouble disputing the link between proper nutrition and overall health, particularly for seniors. So why is this truism important in the cacophony that passes for debate on how to cut federal spending and reduce the debt?

    The answer is in the next linkage. Better health allows seniors to remain independent longer. This delays or eliminates the need for higher levels of care like skilled nursing facilities. Besides being much happier, seniors living independently have greater economic security because they do not have the burden of spending $5,000 a month or more for institutionalized care. For seniors without personal resources, independence means that the tremendous financial burden for institutionalization is not transferred to their families or taxpayers.

    The aging network in the United States serves more than 200 million congregate and home delivered meals (HDM) via the Older Americans Act.  The impact of these meals is healthier seniors who are able to remain independent in their own homes at considerable cost savings to themselves and the community. Providing senior meals is cheap insurance when compared to the exorbitantly expensive alternatives.

    That is why the budget proposed by Congressman Paul Ryan (R-WI) to cut domestic spending for the Older Americans Act to fiscal year 2008 levels represents a false economy. Draconian cuts to senior meals will mean significantly more unhealthy seniors who are no longer able to live independently. The question for Congressman Ryan and his cohorts is, do you want to make an investment in the health and wellbeing of older adults or pay through the nose later via Medicare and Medicaid?  

    I hope when that question is ultimately answered, our elected leaders will conclude that the return on investment of health promotion rather than illness represents the best choice from a human and fiscal perspective. 


    Is America Failing our Seniors?

    Authored by Enid Borden, President and CEO, Meals On Wheels Association of America

    In 2008, the Meals On Wheels Association of America released the results of a groundbreaking research report entitled "The Causes, Consequences and Future of Senior Hunger in America" that our Foundation had commissioned. The findings of the co-principal investigators, Dr. James Ziliak of the University of Kentucky and Dr. Craig Gundersen then of the University of Iowa, were shocking and unacceptable. In 2001, the research showed, five million seniors in the United States, or one in nine, were facing the threat of hunger. The next year, we asked the same researchers to examine several more years of data and update the report. By 2007, the number of seniors facing the threat of hunger was six million. Any reader who can do the math knows that is a 20 percent increase in just six years. But without context, the average reader might not be able to grasp the magnitude of the number. Let me give some context. There are 33 states in this country that each have total state populations of less than 6 million.

    Is America failing our nation's seniors? And if we are moving in clearly the wrong direction where senior hunger is concerned today, what of the future?

    The baby boomers (and I am one of them) are now entering the ranks of older persons, and it is safe to assume that we will be a demanding lot, constantly in search of more and different kinds of services. We will not likely want to live in assisted living or the even less desirous nursing home environment as have generations before us. Rather, we will want to live independently in community settings. Yet that raises a critical question: Can community-based organizations and the concomitant services needed keep up with the demand? Or will America, having failed to turn the tide on senior hunger with the current generation continue down the path of failure with the next-- and much larger-- generation of our nation's seniors?

    It is easy to focus on the short-term view of the past, the last couple of decades that have seen a faltering economy that went from great highs to unparalleled, sustained lows and a burgeoning population of older adults, and to lay the blame here. But we have seen depression in the place of deep recession in the more distant past. And we have seen population surges like that of the last century, not driven by birth rates, but by immigrants who came to these shores seeking a better life. Many of those older persons, like my own grandparents, came into this vast, wonderful land of ours, this great melting pot, seeking the American dream. Even with its own troubles, America did not fail them.

    But it is different for millions of older Americans today. At least 6 million in 2007; and while we do not have more current research to account for the impact of the economy of the past several years on seniors, one researcher has suggested that the real number of those facing hunger's real, ominous and daily threat might be 30 percent higher.

    All the while, when the national debate, turns to seniors and senior issues, the discussion seems confined primarily to Social Security and Medicare - "their programs," those entitlements to which individuals who have paid into the system look for help to sustain them in their elder years. They regard their payments to the trust funds as investments, and they expect to reap some advantages from those investments. Fair enough. But because these programs are entitlements -- which means both that they guarantee some benefit and that they are costly to the budget to maintain (particularly as there are fewer and fewer young people paying into the system than in years past) -- they have become the rallying cry for those who say "look at what we do for seniors. What more do they want?"

    Well, sometimes it's not about what they want, but what they need. Feeding the hungry is not a response to an optional want. It's a moral obligation and food is certainly something to which every man, woman and child is entitled. Plainly put, it's not good enough any longer for Meals On Wheels to be viewed as a feel-good, do-good social service program. Surely local Meals On Wheels programs are that, and they are integral parts of the fabric of every community. That is why the data show us that 99 percent of the American public views these programs positively. But that's not enough. Our elected officials love these programs, and we are grateful for that. At least once a year they are pleased to do a photo-op delivering a meal. But is once a year enough?

    When budget issues arise in Congress and the two parties are duking it out on the floor of the Congress, Meals On Wheels generally comes up. But is it good enough to use the story of cutting off meals to seniors and then fail to make adequate funds available to meet the need, so that in the end, after the partisan sparring is over, Meals On Wheels programs in fact have to reduce the number of meals or the number of seniors they serve?

    So, I ask the question again. Is America failing our nation's seniors? And, what do we do about it? We, at Meals On Wheels programs throughout the United States, continue to deliver the best services and meals that we can. We are asked to perform two separate tasks. First, to simply feed those seniors who would otherwise go hungry. Second -- and this sets Meals On Wheels and our services apart -- to ensure that those being fed receive food that is nutritious; that meets government guidelines for nutritional composition; that is maintained at proper temperatures, even if they are being transported forty or more miles along with other meal deliveries being made to other seniors waiting for their food; that is medically, ethnically, and religiously appropriate; and that tastes good, too.

    Is America failing our nation's seniors? The statistics would say the answer is yes. But are we failing our nation's seniors? No. We are Meals On Wheels, and Meals On Wheels programs are not failing our nation's seniors. Our programs are a lifeline and an anchor for the hundreds of thousands of seniors who need a helping hand. Yes, we can and we will end senior hunger and provide nutritious meals at the same time. We have the courage of our convictions and we will stand up against those who would seek to shut us out and shut us down. There simply is no other option.

    Stand with us. In this the richest nation on Earth no one should go hungry. We must not fail our nation's seniors. Stand with us in this fight.

    Wednesday, May 25, 2011

    Day 3: Health Care and Long-Term Care

    In honor of Older Americans’ Month, Wider Opportunities for Women (WOW) is hosting a week-long blogging event to acknowledge how federal income supports build economic security for elders. Select experts from national organizations will author blog posts on the policies that allow elders to close the income gap. WOW will facilitate an online dialogue allowing advocates, service providers, elders, family caregivers and others to learn about the federal programs that build elder economic security and, more importantly, to take action. Each day will focus on a particular aspect of an elder’s budget.

    Make your voice heard by taking part in WOW’s blogging event:

    • Read and comment on blog posts featured on the National Elder Economic Security Initiative blog.
    • Share the blog posts via Facebook, Twitter and e-mail
    Sign and send WOW’s statement of principles for elder economic security.

    Let Congress know that you support federal funding to support elders ability to age in place with dignity. We need your voice to protect all things that build economic security for elders.

    WEDNESDAY: On Health Care and Long-Term Care, featuring…

    Health Care Security in Retirement: It's More than Medicare

    Authored by Laura Howard, The Association of BellTel Retirees

    A main issue facing retirees in America is the security of their health care.  And we're not talking about Medicare.  There are approximately 14.3 million retirees who earned health care benefits in retirement during their working years.  However, employer-sponsored retiree health care benefits are disappearing in the United States. 

    According to the Kaiser Family Foundation's Employer Health Benefits 2010 Annual Survey, employer-provided health coverage for retirees has decreased significantly in the past two decades and continues to decline.  In 1988, 66 percent of companies with 200+ workers who offered health benefits to employees were offering similar benefits to retirees.  By 2008, only 31 percent of large firms offered coverage to retirees, and in 2010 the number dropped once again to 28 percent. 

    Many retirees worked 20, 30 or more years for their employer, remained loyal to their companies and, in return, companies committed to providing health care coverage in retirement.  These benefits were considered deferred compensation and employees were asked to take lower pay, less vacation time, or other concessions for the assurance that their retirement health care would be secure.  Companies also benefited from the lower rates of pay through lower payroll taxes and lower pension obligations.  Over a career, these concessions add up to large investment by retirees in their own future health care and financial security which many employers have chosen to ignore.

    For many retirees, this uncertainty comes at a time when costs continue to rise but pensions have not been increased, Social Security COLAs have stopped, and 401ks have diminished due to the economy. 

    Unfortunately, when policy makers and even the general public think about seniors' health care, they only focus on Medicare.  While it is a large and important component, seniors know that their health care is more than just Medicare, and many have the out-of-pocket expenses to prove it.  Retirees are continually being asked to do more with less and asking them to pay for the health care benefits they earned during their working years is unfair and irresponsible. 

    The issue of health care security is inextricably linked to one's financial security in retirement.  Seniors have many factors to consider when deciding whether or not to retire; the security of their health care benefits is a major consideration.  Preserving these earned benefits is critical to maintaining the independence and financial security of retirees while reducing the burden on Medicare and Medicaid.

    The Association of BellTel Retirees believes that Congress must adopt policies and pass legislation that hold corporations accountable to their employees and retirees and does not allow them to breach a trust that was earned through years of hard work. 

    Medicare: An American Success Story

     Authored by Vicki Gottlich, Senior Policy Attorney, Center for Medicare Advocacy

    Medicare is an American success story. When the program was enacted in 1965, half of all older people were uninsured. Now virtually all older people have health insurance through Medicare. Medicare also helped reduce the percentage of older people living at or below the poverty rate, from 25% in 1965 to 16% in 2008.

    And Medicare provides protection for more than just older people and people with disabilities who are eligible for the program. Family members have peace of mind knowing their older relatives or relatives with disabilities have health insurance to pay for needed medical care – and from knowing that they won’t have to choose between paying for a parent or disabled relative’s health needs and a child’s college education.

    Like all domestic programs, Medicare is under attack as costing the federal government too much money. In fact, the budget recently passed by the House of Representatives pretends to save money by turning Medicare into a voucher program. Instead of receiving a defined and guaranteed set of health benefits, people eligible for Medicare would get a fixed dollar amount to go buy whatever health insurance they could afford with the voucher in the private market. 

    Ironically, Congress created Medicare because these same private insurance companies did not want to sell insurance to older people and people with disabilities, whose age and chronic conditions made them more costly to insure. There is no guarantee that in a voucher program private insurance companies would sell health insurance policies to Medicare beneficiaries, or that the vouchers would cover the cost of the insurance policies, or that the policies would cover the full range of benefits currently provided under Medicare. And the Congressional Budget Office has already stated that, under the voucher program, Medicare beneficiaries would pay twice as much for their health care as they do under Medicare today.

    Ironically, too, private insurance companies have not done a good job in reducing the costs of Medicare. In the 1990’s, and again in 2003, Congress expanded the role that private insurance companies play in Medicare on the theory that they would save money for the program. Instead, the private HMOs and other Medicare Advantage plans ended up costing Medicare on average 13% more than Medicare would have paid if the same person had remained in the traditional Medicare program. These overpayments increased the cost of Medicare Part B premiums and depleted the Medicare trust fund more quickly. To protect Medicare, health care reform legislation enacted last year changed the way private health plans are paid to reduce overpayments and to reward quality.

    Medicare is also threatened by proposals to impose global spending caps on all domestic programs. Such caps would require an across-the-board cut for all domestic spending by a set percentage amount. The cuts to Medicare would be so steep that the only way to continue the program would be to change eligibility and benefits – and perhaps to turn Medicare into a voucher program as House Republicans have already voted to do.

    To all those who want to cut Medicare because of the current fiscal difficulties, I say, “Medicare already gave at the office.”  Health care reform legislation enacted in 2010 included changes to the program designed to reduce Medicare expenditures by promoting more effective delivery systems that will improve quality and reduce costs; by eliminating fraud, waste, and abuse; and by revising how health care providers are paid.  These reforms should be allowed to take effect before policymakers look to take more out of Medicare.

    And, while the cost of Medicare to the federal government raises concerns for some, advocates for older people and people with disabilities worry about the cost of Medicare to the beneficiaries it serves. Medicare beneficiaries pay, on average, twice as much out-of-pocket for their health care than others, and the share of their income that they pay in out-of-pocket costs continues to rise.  In an ideal world, we would be advocating to reduce the burdens of Medicare by adding catastrophic coverage in the form of a cap on out-of-pocket expenses. But, unfortunately, we don’t live in an ideal world where all policy makers understand the benefit of a universal health insurance program for older people and people with disabilities. Just the opposite - some policy makers want to increase costs to beneficiaries by turning Medicare into a voucher program or by asking beneficiaries to pay more in premiums or for Medicare-covered services.

    In sum, Medicare is an American success story. For 45 years it has offered health coverage to vulnerable populations and helped to reduce poverty. It would be fiscally irresponsible to destroy Medicare in the guise of deficit reduction, and to move this country back to the mid-Twentieth Century, when older people and people with disabilities could not obtain health insurance. 

    Long-Term Services and Supports and the Affordable Care Act

    Authored by Morgan Gable, HCBS & Health Legislative Representative, LeadingAge

    As you may have heard, there are various proposals that were passed under the Affordable Care Act (ACA) that are under attack (either through repeal or de-funding efforts) that would strengthen our nation’s long-term services and supports system.  Members of Congress should continue with funding and implementation efforts for these much-needed changes.  Many of these initiatives won’t take effect for a while, or are in their early stages, but some are already on the move!

    One of the most promising provisions relating to home and community-based services that is underway is the “State Demonstrations to Integrate Care for Dual Eligible Individuals.”  The Center on Medicare and Medicaid Services (CMS) announced that 15 states will receive $1 million to better integrate care for individuals who rely on both Medicare and Medicaid.

    Another exciting initiative is the Community First Choice option that is slated to begin in October 2011.  This is an important opportunity for states because it includes a 6% increase in the Federal Medical Assistance Percentage (FMAP) for providing community-based attendant services and supports for eligible Medicaid recipients.

    Another opportunity that is currently available is the Community-Based Care Transitions program. CMS is currently taking applications for this program that will assist hospitals with high readmission rates by encouraging them to partner with community-based organizations in order to better transition from the hospital back into the community.

    All of these programs, created by the passage of the ACA, provide tremendous opportunities for states to better improve the quality of care for individuals on Medicare and Medicaid, and to save money by streamlining the provision of higher quality services to older adults across the country.

    More to Medicaid than Meets the Eye

    Authored by January Angeles, Senior Policy Analyst, Center on Budget & Policy Priorities

    About 6 million of Medicaid’s beneficiaries are seniors.  Almost all of them are also eligible for Medicare, but Medicaid is critical to filling the gaps in Medicare coverage that these seniors could not afford to pay for on their own.

    Medicaid pays for certain health and long-term care services that Medicare either does not cover or covers to a more limited extent.  For example, the overwhelming majority of Medicare beneficiaries who live in nursing homes rely on Medicaid for their nursing home coverage.  Medicaid also provides more comprehensive coverage than Medicare for home health care, mental health services, durable medical equipment, and other health care items and services.

    Medicaid also pays the Medicare premiums and other out-of-pocket costs for seniors with low incomes, who would have a hard time affording these expenses on their own.  Medicare Part B premiums alone cost $1,157 per year, and beneficiaries have a co-payment of 20 percent for many outpatient services.  In 2011, Medicare deductibles are $162 for physician services and $1,132 for hospitalizations. 

    As policymakers look for ways to reduce the federal budget deficit, Medicaid is increasingly on the chopping block.  For example, the House-passed budget plan would convert Medicaid into a block grant and cuts its funding severely.  If this sort of proposal became law, low-income seniors would lose access to important supplemental benefits that Medicaid provides and go without needed health care and long-term services and supports.

    Here’s why.  Currently, the federal government pays a fixed percentage of a state’s Medicaid costs; under a block grant, it would pay only a fixed dollar amount each year and states would be responsible for all costs above that amount.  Moreover, to reduce federal spending, the House budget would provide states with much less Medicaid funding than they would receive under the current system — 35 percent less by 2022 and a staggering 49 percent less by 2030, according to the Congressional Budget Office.

    To make up for these deep reductions, states would have to greatly increase their own Medicaid spending or, as is more likely, sharply scale back eligibility, cap enrollment, and/or cut benefits.  This would make it much harder for millions of low-income seniors — among the most vulnerable Medicaid beneficiaries — to get the care they need.

    Rather than radically restructure Medicaid in ways that would simply shift costs on to states and vulnerable people, Congress should focus on ways to make the program more sustainable over the long term, such as by helping states provide more cost-efficient care without sacrificing quality.  Last year’s health reform law, the Affordable Care Act (ACA), includes several measures to slow health costs by restructuring the way we deliver care. 

    For example, the ACA establishes a center within the Centers for Medicare and Medicaid Services dedicated to improving the quality and continuity of care for seniors and people with disabilities who receive both Medicaid and Medicare — a high-needs group that accounts for 15 percent of Medicaid’s beneficiaries but 39 percent of its spending.  The ACA also sets up a number of demonstration projects that would change the way we pay providers to encourage them to deliver better, more coordinated care.

    We need to give these measures a chance to succeed.  Initiatives like these, not radical block-granting experiments, will enable us to better control health care costs and ensure that Medicaid is always there for our most vulnerable seniors. 

    Tuesday, May 24, 2011

    Day 2: Housing

    In honor of Older Americans’ Month, Wider Opportunities for Women (WOW) is hosting a week-long blogging event to acknowledge how federal income supports build economic security for elders. Select experts from national organizations will author blog posts on the policies that allow elders to close the income gap. WOW will facilitate an online dialogue allowing advocates, service providers, elders, family caregivers and others to learn about the federal programs that build elder economic security and, more importantly, to take action. Each day will focus on a particular aspect of an elder’s budget.

    Make your voice heard by taking part in WOW’s blogging event:

    • Read and comment on blog posts featured on the National Elder Economic Security Initiative blog.
    • Share the blog posts via Facebook, Twitter and e-mail
    Sign and send WOW’s statement of principles for elder economic security.

    Let Congress know that you support federal funding to support elders ability to age in place with dignity. We need your voice to protect all things that build economic security for elders.

    TUESDAY: On Housing, featuring…

    Why All Things Shouldn't Be 'On the Table' for Cuts
    Authored by Stacy Sanders, Director of the Elder Economic Security Initiative at WOW

    “All things are on the table,” is an often-heard mantra in the nation’s capital these days. Lawmakers on both sides of the aisle are looking to slash critical public assistance programs, ranging from housing subsidies to meals programs, and social insurance, including Social Security, Medicare and Medicaid. 

    Drastic spending cuts in these areas are paraded as an essential means of reigning in the nation’s debt. What’s often missing from this dialogue is the fact that these programs support basic economic security for elders and their families. It is increasingly important that advocates, service providers and citizens voice collective support for the many federally funded policies and services that allow elders to make ends meet. Cuts to these programs target vulnerable older adults who have already made disproportionate sacrifices.

    Can I Rent The American Dream?

    Authored by Kate Birnbryer White, Executive Director, Elder Law of Michigan

    An interesting by-product of the housing crisis is the movement away from home ownership as a goal for families and those who aspire to the American DreamEven celebrities are moving toward rentals in the current challenging housing market.

    While renting might be a good idea for some people who need the flexibility to move to follow employment or can’t yet afford to own a home, the glut of housing on the market is hurting families in the third act of the American Dream….retirement.  In my view, at least here in the Mid-west, the first act of the American Dream is buying your first home; the second act is the home where you raise your kids; the third act is where you live in retirement.
    There are pros and cons to renting and a lot depends on your personal situation. Renting property can make a lot of sense for retirees.  Giving up some of the responsibilities and costs to maintain a home is often a good solution for people who want to live in a multi-generational single family home in a neighborhood. But for retirees who are living in a home that they can’t sell, or is not worth much because of the foreclosures on the market, they are victimized again by the recession which has gutted their savings and investments for retirement.
    At the same time older adults and the working poor need to make important decisions about where to live and how to pay for it, Congress has cut funding for the HUD Housing Counseling Assistance Program in fiscal year 2012 federal budget.  Hopefully Congress will think better of it and find a way to restore this vital program that protects property values and communities before they finalize the 2012 federal budget.   

    We desperately need more creative solutions on how to provide affordable housing options for people aspiring to the American Dream, and not reduce funding for the information and infrastructure that could fuel new ideas to solve a problem that is not going away.  Maybe my next job will be as a non-profit rental agent helping middle-class retirees rent out their homes so that they can afford to move into assisted living, apartments or homes that can be modified to support their desire to age in place.  But that leads me back to my original question…can you rent the American Dream—in retirement?  I am not sure.  At this point, I am hoping that the older adults I know who can’t sell their homes at least have the chance to break even and aren’t forced to take a short sale on their retirement.

    Housing: Economic Security and an Essential Part of the Continuum of Care

    Authored by Alayna Waldrum, Housing Legislative Representative, LeadingAge

    Housing is the keystone in the continuum of care for America’s seniors. Without access to stable, supportive, affordable housing seniors cannot age safely with the services that they need.  Housing affordability is essential for all of us, but especially for seniors living on fixed incomes and managing service needs.  Their housing options are few and dwindling every day. There are 3.6 million seniors living below the poverty level. The HUD 2009 Worst Case Housing Needs study includes 1.33 million seniors with worst case housing needs and there is a documented increase in the elderly and near elderly who are homeless.

    Our short-term challenge involves retaining funding for existing housing programs and replacing lost units with new development. Many members of Congress are promoting “solutions” for the federal budget crisis – to be played out in grand proportions shortly in the debate on the debt ceiling. Those solutions involve caps and triggers to slash federal spending with no regard for the impact these cuts will have on affordable housing and other programs serving the poor. The fiscal year 2011 appropriations compromise left the Section 202 supportive housing program with 2,000 + units cut from the fiscal year 2010 production level. Without affordable housing a major segment of our long term care system will not work.

    Seniors rely disproportionately on federal housing programs and comprise a growing percentage of public housing and Section 8 voucher holders. The average HUD Section 202 residents is a woman, in her mid-to-late 70s, with an annual income of just over $10,000 and in need of assistance with a growing list of activities of daily living. If the indiscriminate cuts proposed become law and the HUD budget is cut along with other essential programs, it is this type of resident that will be forced into homelessness, institutional care or substandard and unsafe housing. 

    A comprehensive national policy for affordable housing and services is needed. Whether it’s HUD’s Section 202, public housing, the Low Income Housing Tax Credit program and rural housing, these programs will pay dividends by reducing long-term health care costs and preventing premature entry into institutional settings. Congress must adopt a bipartisan commitment to protecting and serving our seniors and reinvest savings created by a housing + services model back into developing new supportive housing.

    Like many of my colleagues in the aging and housing field I believe that the concern over the growing senior population should be a major policy issue for Congress. Providing less protection and leaving our seniors to the imperfect marketplace for housing and long term services and supports is not policy making. And worse, it ignores what is in the country’s best interest.

    Reverse Mortgage Counseling - A "Teachable Moment" for Financially Vulnerable Older Homeowners

    Authored by Barbara R. Stucki, Ph.D., Vice President, Home Equity Initiatives, National Council on Aging

    Role of HECM reverse mortgage counseling in building elder economic security

    Ensuring financial security can be challenging in times of economic uncertainty. As they search for solutions, older homeowners are realizing that they many need to tap home equity to fill financial gaps. Some are deciding to take out a reverse mortgage. With little guidance, however, they are unsure about whether these loans are appropriate to manage cash flow and stay independent.

    Today, nearly all reverse mortgages are HUD HECM (Home Equity Conversion Mortgage) loans. Under this government program, all potential borrowers must meet with one of the 800 independent, HUD-approved counselors who offer assistance in person or by phone. The goal of this counseling is to educate and empower older homeowners to make their own decision. Reverse mortgage counselors look at the person’s entire situation—from a budgetary, health, and lifestyle perspective—to see whether this financing option can help them to age in place. HUD requires counselors to discuss:

    • Client goals for using a reverse mortgage.
    • Life factors that could affect their ability to stay at home and benefit from a reverse mortgage.
    • An overview of different reverse mortgages and loan features.
    • The  amount of money that may be available and how much this loan could cost.
    • Other housing, services, and financial options that could help them meet their goals.

    For clients with incomes under 200 % of poverty, the conversation must include a BenefitsCheckUp® screening, so that they are aware of public programs that can serve as a supplement or alternative to a reverse mortgage. HUD also requires counselors to send each client a customized review of different loan options and costs, the National Council on Aging (NCOA) Use Your Home to Stay at Home booklet, and other consumer information about reverse mortgages, In addition to their counseling certificate.

    Immediate threats to funding the HECM counseling program

    Congress defunded the HUD Housing Counseling Program in the fiscal year2011 federal budget, including about $11 million for reverse mortgage counseling. As a result of these cuts, all seniors who are considering these loans will soon have to pay an upfront fee for counseling. This is a significant change from recent HUD policy, where counselors could only charge clients with incomes under 200 % of poverty if they decided to take out a reverse mortgage, at the time of loan closing.

    The fiscal year Y2012 federal budget could restore funding for the HUD Housing Counseling Program. However, in these times of fiscal belt-tightening, nothing is certain. NCOA, housing counseling agencies, and other organizations are working hard to ensure continued funding of this critical program. It is vital that  older Americans  get unbiased information, ideally before they talk to a lender, so they do not misuse the home equity they have spent a lifetime to accumulate.

    Improving Counseling

    For many older people, it is no longer a question of if they will tap home equity, but rather when and how. Home equity can augment a person’s  income to meet basic expenses. With limited savings, older homeowners can also use this asset to cope with unexpected health and household expenses. For many seniors, these decisions are driven by the need to manage growing consumer debt.
    A reverse mortgage, when used appropriately, can be a powerful tool for many older adults to remain economically secure and independent. However, there are many unresolved issues and unanswered questions, on how best to use these loans to assist financially vulnerable older homeowners who struggle to remain at home. We can improve reverse mortgage counseling and loans by:

    • Increasing the knowledge base – More research is needed to evaluate the benefits and risks of products and polices, and to develop safer and more effective solutions for seniors.
    • Increasing accessibility to consumer education– The Aging Services Network should become a focal point for reverse mortgage education. Policymakers, senior advocates, and financial planners also need to broaden the conversation from “reverse mortgages” to “how to appropriately unlock home equity.”
    • Strengthening consumer protections and products – HUD, aging organizations, and the industry should work together to find ways to reduce loan costs, improve loan products, and advance public policy, especially for frail and impaired elders, and those with modest value homes.

    NCOA is working to foster these collaborative partnerships to make home equity work better as a financing option and enhance the economic security of older homeowners.

    Monday, May 23, 2011

    When The Grandparents Lose Economic Security, So Do Children And Grandchildren

    Authored by Kate Birnbryer White, Executive Director, Elder Law of Michigan

    There may be glimmers of an economic recovery, but for many families ravaged by unemployment, a secure income and a middle class lifestyle are lost for the foreseeable future. Families are increasingly turning to one another for financial help. A new survey, Baby Boomer Moms Keep Supporting Grown Kids completed last month confirms trends that many of us in human services have seen for awhile.

    As the leading edge of the baby boomers turn 65 this year, we need to think about how policies that impact the income of older adults will affect dependent family members. Older adults are key familial supports for their grown children and grandchildren, particularly in these hard economic times. Last year the Pew Research Center released several recent reports that highlight the return to multi-generational housing and the rise of grandparents taking care of grandchildren.

    It may be that Michigan is once again the canary in the economic coal mine. At Elder Law of Michigan we are seeing more families calling us with financial concerns because they are the primary financial support for multiple generations. The duration of the recession may mean that affected families have very little cushion for the things that come up in life like car repairs, medical expenses, home repairs, and rising gas prices.The Michigan Elder Economic Security Standard™ Index shows that a single elder renter needs $19,058 a year to make ends meet. The many elders do not have enough income to meet their basic expenses for food, housing, medical care and transportation in retirement. Despite their hard times, they are doing something that has been true since the beginning of civilization—they will use whatever they have to support their children and grandchildren. 

    Preserving Social Security and Medicare for the grandparents, including all us future grandparents is critically important to ensure that multi-generational families survive the recession and claw their way back to the middle class.