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. 

    Day 1: Income 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.

    MONDAY: On Income Security, 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.

    One Away and the Older Americans Act

    Authored by Marci Phillips, Director of Public Policy and Advocacy, National Council on Aging

    One in three older adults struggle with economic security, with annual incomes below $22,000, and millions more live right on the edge. They are forced to decide each day whether to pay for medicine, food, rent, or utilities. They live one bad break, one missed rent check, or one health problem away from a financial crisis.
    Despite their struggles, their voices are unheard, and they face a frustrating system ill-equipped to respond to their complex needs.

    In response, the National Council on Aging (NCOA) launched One Away, a national video advocacy campaign that gives voice to older adults who are struggling to make ends meet and mobilizes advocacy for policy change (www.OneAway.org). Through our work with the Senior Community Service Employment Program (SCSEP), the National Center for Benefits Outreach and Enrollment, and the Economic Security Initiative, we have proposed a series of policy goals to help older adults achieve economic security:
    • Fostering development of holistic, person-centered economic case management strategies to provide access to a comprehensive array of financial and social services.
    • Improving access to and coordination of public benefits for older adults in greatest need.
    • Strengthening the efficiency and effectiveness of systems and policies designed to empower and assist vulnerable seniors.
    The primary vehicle we have identified to achieve these goals is the reauthorization of the Older Americans Act (OAA), scheduled to occur later this year. NCOA collaborated with Wider Opportunities for Women (WOW) on “A Blueprint for Increasing the Economic Security of Older Adults: Recommendations for the Older Americans Act”, which details our OAA proposals, including defining economic security and establishing it as a goal of the Act; supporting use of local measures of economic security to plan, evaluate and target services; and supporting research, evaluation and dissemination of best practices in measuring economic security and implementing economic case management.

    The roadmap for moving reauthorization this year is not entirely clear, and the timetable could easily slip. However, the One Away campaign has been designed to be flexible in order to leverage advocacy on a variety of elder economic security vehicles. Each month, we focus on a particular aspect of elder economic security to drive our advocacy and our messaging: this month the theme is health; next month it will be housing.

    Perhaps the most pressing challenge we currently face is the potential for the current deficit reduction debate to turn back investments in key services and benefits for vulnerable older adults. We have already seen SCSEP, the only federal program providing job training and placement services for low-income older adults, slashed by 45 percent, and the Section 202 Supportive Housing for the Elderly program cut by more than 50 percent. Proposals for next year’s funding include cuts to Medicaid, SNAP and LIHEAP.

    Visit www.OneAway.org today to learn how you can join the campaign and lend your voice to protecting and enhancing the economic security of older Americans.

    SSI Must be Strengthened

    Authored by Gerald McIntyre, Directing Attorney, National Senior Citizens Law Center

    The Supplemental Security Income (SSI) program was established to provide critical subsistence income to those older people and people with disabilities who are in greatest economic need.  As Pres. Nixon said on the day he signed the SSI program into law, “For millions of older people, it can mean a big step out of poverty and toward a life of dignity and independence.” Today eight million people rely on this program for survival.  Two out of every three people over the age of 65 who are receiving SSI are women, most often single women.  In order to qualify for SSI, you cannot have more than $2,000 in resources (a home, an automobile and basic household necessities are not counted) and, in most states you cannot have more than $694 in monthly income.  If you qualify, the maximum monthly grant you can receive in most of the country is $674.  For most SSI recipients, that is the only income they have.  For those who do have other income, it is most likely a small Social Security benefit and the SSI grant is reduced to reflect the Social Security benefit.

    Yet even these very modest benefits are at risk in the current budget debate.  For example, if Congress were to enact an across-the-board spending cap, SSI would be severely impacted and the monthly SSI benefit would be reduced from its already inadequate level.  The impact on SSI would be even more severe if, as has been discussed, some major areas of government spending such as defense, Medicare and Social Security were exempt from the cap.  The cuts would soon be reflected in unprecedented levels of homelessness among America’s elderly and disabled population.  A yet worse result might be anticipated from a proposal by the House Republican Policy Committee to dismantle the SSI program and replace it with block grants to the states funded at 2007 funding levels.  Already, without any of the more draconian proposals being adopted, the Social Security Administration (SSA) has seen a decrease in administrative funding at the same time the caseload pressure has been increasing.  Furthermore drastic cuts in administrative funding are threatened.  If these cuts are put into effect, SSA offices will be closed, office staff will be furloughed, already long processing times will be increased and some people will lose access to the program altogether.

    Yes, the SSI program needs changes.  It needs changes to bring it up to date, not changes to return to the time of the Elizabethan Poor Law.  Unfortunately, over the years SSI has been all but forgotten in Washington, except when it comes time to look for ways of saving money.  This emphasis needs to change.  To begin with, the Federal Benefit Rate of $674 needs to be increased.  Also, at present, you cannot have more than $2,000 in resources (not counting your home, automobile or household furnishings) in order to be eligible for SSI.  This amount has increased only 33% since the program was put into law 39 years ago. 

    During that same time, the cost of living has increased over 400%.  The resource limit needs to be increased to $10,000 so that those who are trying to stay in their own homes, can afford to pay for some inevitable and necessary repairs.  Another outmoded provision is one which reduces the maximum federal benefit to $449 a month for someone living in the household of another person.  Often that other person is a relative, also with limited income, who cannot afford to subsidize the SSI recipient.  Finally, as in any program of this size and complexity, it is inevitable that mistakes will be made in determining eligibility or amount of benefits.  The U.S. Constitution requires that there be an effective means of appealing these determinations.  Unfortunately, the appeals system at SSA is a shambles and SSI recipients are left with no effective means of appeal.  The integrity of the appeals process must be restored as part of any SSI modernization.

    Social Security: Keeping it Strong Now and for the Future

    Authored by Cindy Hounsell Executive Director, Women's Institute for a Secure Retirement (WISER)

    Social Security is a hot topic in the news today. Many are publicly asking: will the system still be here for future generations? While there is a lot that can be done to strengthen the solvency of Social Security, the truth is that it’s not going broke and there are plenty of reasons to maintain it as a strong and sound social insurance program. In fact according to the most recent Trustees Report there was an annual surplus of $69 billion in 2010.

    So here’s the big question: What exactly is the Social Security shortfall and how urgent is the need to fix the system? Key demographic changes do put a more immediate strain on Social Security’s financing:
    • The large boomer generation is beginning to retire, so more people will be collecting benefits. People are not only living longer and collecting benefits for longer periods. For these reasons, Social Security faces a shortfall in about 2036.
    • Without any change, Social Security would only have enough revenue to pay about 75-78% of promised benefits in 2036. The short-fall is about 22-25%.
    • So the system is not “totally broke” or “running out of money”. When people say the system is “totally broke” they are incorrect.
    • However, many agree that although there is no immediate crisis, the longer we delay putting the program into long-term financial balance, the more drastic the changes that will have to be made in the future.
    So what are the current reform proposals currently on the table?
    Current reform proposal options run the gamut from simply tweaking proposals to change revenues and benefits to more dramatic changes of partially privatizing the system into individually invested private accounts. 

    The National Commission on Fiscal Responsibility and Reform plan calls for:
    • changing the benefit formula to slow the growth of benefits for many workers,
    • an increase in the retirement age to 68 by 2050,
    • an increase in the payroll tax on upper income Americans,
    • a cut in the annual cost of living increases for Social Security benefits,
    • a resulting reduction in the monthly benefits for most beneficiaries, and
    • a requirement that newly hired state and local government employees be required to pay Social Security taxes.
    Other reform options

    There are others who support a mix of options including tax increases and benefit cuts to put the system on sounder financial footing.
    • Social Security payroll taxes apply to a worker’s earnings only up to a cap—$106,800 in 2011. Others suggest raising the cap so that the payroll tax is applied to 90% of all earnings as was intended when the program was started.
    • Another option is to raise the payroll tax on everyone. A tax increase of about 1% on employees and 1% on employers would eliminate the shortfall.
    • Partial privatization would allow workers to divert a portion of the current payroll taxes into accounts invested in the stock market. The guaranteed benefit under Social Security would be reduced and workers would rely on their accounts to make up the difference.
    • Extend coverage to new workers in state plans.
    Only time will tell how the shortfalls of Social Security will be strengthened. However, it’s important to keep in mind that this is a program that currently provides benefits to over 54 million Americans today. Social Security is the nation’s single most successful social program. Making sure that it continues to provide a foundation of retirement security to American workers should guide any future reform.

    Sources:
    • “The 2010 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds.” The Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds. Referred to the Committee on Ways and Means. 9 August 2010. <http://www.ssa.gov/OACT/TR/2010/tr2010.pdf>.
    • The Moment of Truth. Washington, D.C.: The National Commission on Fiscal Responsibility and Reform, 2010.

    Expand Social Security, Don't Cut It

    Authored by Nancy Altman, Co-Director, Social Security Works

    Social Security has transformed the nation, eradicating what once was a primary anxiety of the vast majority of workers -- the terror of growing old.   A writer in 1912 described the attitude people had about growing old:

     “After the age of sixty has been reached, the transition from non-dependence to dependence is an easy stage – property gone, friends passed away or removed, relatives become few, ambition collapsed, only a few short years left to live, with death a final and welcome end to it all – such conclusions inevitably sweep the wage-earners from the class of hopeful independent citizens into that of the helpless poor.”
    Before the enactment of Social Security, people worked as long as they could hold jobs.   But this was an insecure state of affairs.   The fast pace of many jobs “wears out its workers with great rapidity,” a commentator noted in 1912.  “The young, the vigorous, the adaptable, the supple of limb, the alert of mind, are in demand,” he explained, adding, “Middle age is old age.”  
       
    Once a job was lost, an older worker could seldom find a new one. Older people almost never had sufficient savings to last until death.  Indeed, though individual savings accounts are in vogue these days, their shortcomings have been shown time and again. What is needed in the event of lost wages as the result of old age, disability or death is insurance, not individual savings.
     
    Older people invariably were forced to move in with their children.  Those who had no children or whose children were unable or unwilling to support them typically wound up in the poorhouse.  The poorhouse was not some ancient Dickensian invention; it was an all-too-real means of subsistence for the elderly in the world immediately preceding Social Security.  The vast majority of the residents were elderly.  Most of the “inmates,” as they were often labeled, entered the poorhouse late in life, having been independent wage earners until that point.
    Destitute senior citizens were a fact of life before the enactment of Social Security.  Studies at the time found that nearly half of all those 65 or over had incomes below the subsistence level, even well before the Great Depression.  In contrast, the poverty rate among the elderly today is around 10 percent.  The reduction in the poverty rate of the elderly is directly due to Social Security.  The Center for Budget and Policy Priorities has found a strikingly similar percentage of seniors today have incomes below the poverty level, when Social Security is disregarded. 

    Social Security is the difference.  About one-third of older Americans receive 90 percent or more of their income from Social Security, and a full two-thirds receive half or more of their income from Social Security.   The benefits are particularly important to women and minorities.   Social Security provided 90 percent or more of the income of almost half of all unmarried (including widowed) women aged 65 or over, in 2008.and for more than half of unmarried (including widowed) male and female African-Americans aged 65 or over.

    Furthermore, Social Security is much more than a program for the elderly.   It also provides extremely important life insurance and disability insurance protection for workers and their families.  In that way, it has also transformed the world with respect to workers who become disabled or who die leaving spouses and dependent children. 

    Nearly nine percent of the nation’s children either receive Social Security themselves or live in families where part of the household income is from Social Security.  It is of particular importance to children in low-income and in minority families.  It is the nation’s largest disability program.   It provides half or more of the income to 70 percent of those with disabilities.  Without that monthly check, 55 percent of disabled workers and their families would live in poverty. 

    Despite its importance and its efficiency – it returns in benefits more than 99 cents of every dollar spent – too many policymakers are proposing to scale it back and increase its retirement age.  They fail to realize that future workers and their families will need its protections even more, given the termination of traditional private sector pensions and the failure of private accounts to do the job. 

    The current focus on budget deficits has provided an excuse for proposed cutbacks in Social Security, despite the fact that by law Social Security does not add a penny to the deficit nor the federal debt.  Indeed, dispassionate policy analysis calls out for increasing Social Security’s benefits.  Its proven track record, widespread support, efficient administration, and clear superiority over private sector counterparts makes increasing Social Security the best way to go, if our goal is to improve the economic security of the nation’s workers and their families.  Let’s hope that sometime in the not-to-distant future our elected officials will recognize that increasing Social Security would not only be overwhelmingly popular but also the best possible policy, for women, families, those of low-income, younger Americans, and every other demographic one can imagine.

    Portions of this blog post were excerpted from Nancy Altman’s book, The Battle for Social Security.