The health care reform buzz may be front and center in the news these days, but with so many media outlets and so many opinions, it’s not easy to keep up. And yet it is most certainly an issue that many of us are watching with great concern and curiosity.

A number of senior advocacy organizations are offering valuable resources for the general public to stay current on the latest and greatest, specifically in terms of the impact on seniors. I’ve listed a few of them here:

- The Senate Special Committee on Aging held a briefing on “How Health Reform will impact seniors” on September 17, 2009.  To view the archived webcast of the hearing, visit http://aging.senate.gov/.

- If you’re like me, you want to see things on paper (or read it on a computer screen). To see a comprehensive, side-by-side comparison of major health care reform proposals, check out this excellent tool from the policy experts at the Kaiser Family Foundation (KFF): http://www.kff.org/healthreform/sidebyside.cfm.

- Another great side-by-side comparison from KFF takes a specific look at key Medicare provisions in the health reform proposals. To view the tool, go to http://www.kff.org/healthreform/upload/7948.pdf.

- AAHSA (American Association of Homes and Services for the Aging) explores a number of topics relating to seniors and health reform on their advocacy page – including an overview of the CLASS Act/Affordable Health Choices Act legislation: http://www.aahsa.org/classact.aspx

- You can also visit AARP’s home page to “Get the Facts on Health Reform” (go to http://www.aarp.org/health/articles/health_reform_get_the_facts.html) or to read a feature article on the impact of changes to Medicare at http://bulletin.aarp.org/yourhealth/medicare/articles/medicare_question.html.

- Most likely, your Member of Congress or U.S. Senator has a number of links or articles on their home page, outlining their position on and understanding of the reform debate. Many legislators have and continue to host Town Hall meetings to garner input and feedback from their constituents; some have been met with great success while others have encountered some heated opinions that have certainly made the news. Visit http://www.house.gov and http://www.senate.gov/ to find your elected official’s home page. Visit http://www.thomas.gov/ to access the actual legislation (you can do a keyword search, or get the bill numbers from the KFF’s report above).

Proposals are just that – so they are liable to change as the debate goes on. But for now, you can get up to speed by accessing a few of the above resources.

- Michelle Seitzer

Vice President Joe Biden chairs a task force called A Strong Middle Class that is targeted at raising the living standards of middle-class, working families in America. One of their initiatives is more stable and secure health care for seniors.

The middle class task force recently held a health care reform discussion in Alexandria, VA with the goals of lowering costs, cutting waste, creating stability, and improving quality for seniors. Sounds pretty promising, right?

It couldn’t come at a better time, either, as seniors face rising health care cost increases on a fixed income. And there’s another group that is also profoundly affected by the increase — early retirees (aged 50-64). They are all too familiar with the rising costs of health care and stand to benefit from this reform:

Americans aged 50-64 are often the most at vulnerable and at risk in the current health care system. Too young for Medicare, they experience sky high insurance premiums and costs because of their age. Premiums for 50-64 year olds buying coverage on the open market were three times that of their peers who were lucky enough to have employer coverage. And that’s for people who aren’t automatically excluded because of a pre-existing condition.

Health care reform will lower costs for 50-64-year-old Americans by providing assistance to employer health plans to encourage them to cover recent retirees and by giving individuals access to an insurance exchange where participants will be able to compare prices of health plans ” including a public plan – and decide which option is right for them. Individuals will be eligible for help paying for insurance in the exchange based on their income. And in order to market a plan in the Exchange, insurance companies will have to comply with its rules: no denial of coverage for pre-existing conditions; no discrimination based on age; and fair prices, for good benefits.

While no one can predict what will and won’t work, I think it’s an important step for the government to look at those affected most by increasing costs, and make the effort to provide some stability in the system as Americans age.

–Elizabeth Thielke

What are your thoughts?

Health reform is one of the hottest topics on the federal docket right now, and as to be expected, the range of opinions and proposals on how to do it right further intensifies the debate. And who could forget the $1 trillion price tag from the Congressional Budget Office?

The cost is spread out over 10 years, but in our present economic state, it’s not easy to think about spending $1 trillion dollars, even for the best of causes.

According to a special edition update from NCOA (National Council on Aging), “lawmakers are working to draft and pass bills in both the House and Senate before the House adjourns on July 31 and the Senate adjourns on August 7 for the August recess.”  A tall order, given the aforementioned range of opinions and proposals, but there seems to be overwhelming support from President Obama for at least taking a step forward. Fiscal crisis or not, the continual sharp increases in health care costs – both for providers and patients – will slowly (or maybe not so slowly) erode any economic stability we acquire.

NCOA’s update gives a thorough and extensive analysis of the legislative process that the numerous bills must go through, along with the provisions that their organization is most focused on as the process moves forward. Of note:

“The Affordable Health Choices Act includes provisions from Senator Ted Kennedy’s CLASS Act (S. 697), which would create a new, voluntary national insurance program with a cash benefit to help individuals remain in their communities if the time comes when they need assistance with activities of daily living (see NCOA’s summary).

S. 434, the Empowered at Home Act, introduced by Senators John Kerry (D-MA) and Grassley, to improve the State plan amendment option for providing home and community-based services under the Medicaid program, and for other purposes.

Project 2020 (S. 1257), introduced by Senators Maria Cantwell (D-WA) and Debbie Stabenow (D-MI),would provide funding through Medicare and Medicaid savings for aging network initiatives on evidence-based health promotion and disease prevention, single-point-of-entry information and referral for long-term services and supports, and nursing home diversion programs.

Senator Jeff Bingaman (D-NM) and a coalition of groups are working to include provisions from the Senator’s bill, the Medicare Financial Stability for Beneficiaries Act (S. 1185).  The bill would significantly improve both the Medicare Part D Low-Income Subsidy (LIS) and Medicare Savings Programs (MSP).”

I understand the need to “do something” about our health care system. I agree that it’s a complicated and expensive undertaking, no matter how you do it. I know that there are many, many pieces to this puzzle, and just as many players. But here’s my beef: Why isn’t there more discussion around managing Medicare fraud? The headline from an MSNBC.com article in 2007 (almost ancient history at this point) shouted “Blatant Medicare Fraud Costs Taxpayers Billions” and there have been a plethora of stories in recent months of fraud rings exposed in Houston, Detroit, and Miami.

A Washington Post article published on June 25^th indicates that the Justice Department, the FBI, and the Department of Health & Human Services are taking this issue seriously.

According to the article, Attorney General Eric H. Holder Jr. said, “We will strike back against those whose fraudulent schemes not only undermine a program upon which 45 million aged and disabled Americans depend, but which also contribute directly to rising health-care costs.”

I would think we could shave a nice chunk off that $1 trillion price tag if we weren’t losing billions of dollars to fraudulent providers preying on vulnerable elders… and regardless of the cost savings, it is the right thing to do.

What are your thoughts about the health care reform debate? What issue(s) do you think are absolutely crucial to making reform a reality?

- Michelle Seitzer

There will come a day when your aging parent may need someone to handle his or her care, and that someone will very likely be you. In fact, many adult children expect that such a day will come when they must assume responsibility for their parents’ well being. After all, that’s the circle of life, and morally the right thing to do. Of course, what happens when you’re not on speaking terms with a parent? Or when you’re already maxed out financially and physically caring for your own family? What if someone was to tell you that it’s too bad — you’re legally responsible to deal with your parents, no matter what?

That could very well happen, believe it or not, as 30 states currently have laws making adult children responsible for their parents’ care if their parents can’t afford to take care of themselves. Though these “filial responsibility” laws are not often enforced, there is some speculation that they will be in order to save Medicaid money. According to the National Center for Policy Analysis (NCPA), those states with filial responsibility laws:

Twenty-one allow some sort of civil court action to obtain financial support (or cost recovery) and 12 specify a criminal penalty for filial nonsupport; three states allow both civil and criminal actions. Of course, in many cases state filial responsibility laws limit children’s liability under a variety of conditions, such as whether the adult child has enough income to actually contribute, or if the adult child’s financial circumstances change, or if they were abandoned or deserted by the parent.

If filial responsibility laws are enforced, it will affect the common practice of exhausting or transferring a senior’s assets so that a senior may qualify for Medicaid, often prior to entering long term care. Currently, Medicaid only looks at the assets of the individual, but since Medicaid is in financial trouble, the government is looking at the filial responsibility laws to help deal with the crisis.

The New Old Age Blog looks at the filial responsibility topic as well, and there is some interesting discussion in the comments. It’s a tough topic to legislate because so many people are taking care of their own families, but then again, many adult children are able to contribute toward their parents care and they don’t, even when their parents’ situation is less than desirable. I also know that government resources aren’t unlimited, either, it’s a complicated topic.

Someday, I will be responsible for my dad. I will do everything that I can, but I also have my own family to consider. I’m fortunate that he has planned very well, but I can’t help but feel for others who might not have that luxury. Especially now that the government may be putting all of the burden on them.

What do you think — should your aging parents be your responsibility no matter what?

-Elizabeth Thielke

By now, many senior citizens have received their $250 stimulus checks from the U.S. Government in the mail.

The American Recovery and Reinvestment Act of 2009 provides for a one-time payment of $250 to adult Social Security beneficiaries, and to SSI recipients, except those receiving Medicaid in care facilities.  To receive the payment, the individual must have been eligible for Social Security or SSI during the months of November 2008, December 2008 or January 2009.

Though the payment is separate from the regular monthly Social Security payment, it is being sent in the manner the senior normally receives the regular Social Security payments -– by direct deposit or check.

If you didn’t receive payment yet (the “target” date was June 4, 2009), contact your local Social Security office to tell them your payment has not arrived.

Check the Social Security website for answers to more question about the stimulus check.

-Elizabeth Thielke

“Older Americans have carried our Nation through great challenges and triumphs. They have enriched our national character and strengthened the Republic for those who have followed. During the month of May, we pay tribute to the wisest among us.”

From a proclamation by President Barack Obama, May 2009

Established in 1963 by President John F. Kennedy, Older Americans Month (initially called “Senior Citizens Month” before President Jimmy Carter changed the name) is an annual tradition sponsored by the Administration on Aging (AoA). This year, the theme of “Living Today for a Better Tomorrow” highlights the importance of prevention efforts and programs for older Americans. Chronic disease, disability and injury plague our nation’s elders; therefore, the national network of aging services and other community providers must include a focus on prevention in the programs/services they offer. Across the country, area agencies on aging and other aging service providers will participate in a number of activities (community events, fairs, ceremonies, etc.) during the month of May to honor those in the 65+ bracket.

When JFK designated May as Senior Citizens Month,” about 1/3 of older Americans were living in poverty. Few programs were available to meet their needs, and senior issues were moving up on the national agenda and onto the public’s radar screen, hence the dedication of an entire month for a national focus on these challenges. Now, although there is still much work to be done in terms of strengthening programs/services, raising awareness, and defying myths/stereotypes, aging is a hot topic. You can’t go very far without hearing about some issue that relates to seniors. Even aging-related terms have become a part of our day-to-day vocabulary (i.e. sandwich generation, aging in place, caregiver burnout, etc.).

It is truly amazing to think about how fast our country has “grayed.” When Older Americans Month was established in 1963, there were a mere 17 million Americans who were over 65. I say “mere” because the most recent estimate (from 2006) indicated that 37.3 million Americans – that’s about 12.4% of the population, or 1 in 8 persons – had blown out 65 candles on their birthday. But wait, there’s more! By 2030, there will be 71.5 million older citizens, representing 20% of the population (for more aging statistics, http://www.aoa.gov/AoARoot/Aging_Statistics/index.aspx). Wow!

I recently attended a meeting of the Pennsylvania Bar Association’s Elder Law Section, where the state Secretary of Aging, Mike Hall, gave a presentation on the status of aging affairs in the Commonwealth. He spoke about the challenge of rebalancing the state’s long-term care system to include more equal funding for home & community-based services and skilled nursing care. According to Hall, achieving this balance is a huge paradigm shift just by nature of the aging demographic explosion (thanks to increased longevity). Toward this end, Hall shared that when he started working in the aging services network about 30 years ago, most nursing home residents were about 60 years old.

These days, with 60 being the new 50, it’s hard to imagine someone at that age needing skilled care. Most nursing home residents in the year 2009 are in their eighties or beyond. Hall also made the point that just a few decades ago, it was quite uncommon to hear about centenarians. But now, Willard Scott can barely fit all the 100+ birthdays into his short time slot on the Today Show.

America is aging rapidly, and it’s going to take more than one month of every year to solve the problems and celebrate the successes of this gold & silver generation. Let’s get to work!

Visit www.aoa.gov for more information on Older Americans Month, and be sure to celebrate the elders in your life year-round.

- Michelle Seitzer

Maria Shriver. Newt Gingrich. Sandra Day O’Connor. These high-profile advocates testified before the Senate Special Committee on Aging on Wednesday, March 25th with one common goal: Congress must act now to address the public health crisis of Alzheimer’s. And for a disease as devastating (and with effects as far-reaching) as Alzheimer’s, it will take more than just the efforts of Congress and all the high-profile leaders in the country to do it. Shriver, Gingrich, O’Connor and a number of other testifiers confirmed that that reality as they spoke to the Committee.

On that morning, the Senate Dirksen hearing room was filled not only with members of the press wanting to catch a glimpse or get a quote from Shriver or Gingrich, but also with a strong contingent of Alzheimer’s Association staff and volunteers donning purple sashes and armed with data from the Association’s newly released (as of March 24th) Facts & Figures report. This grassroots network had also been inspired and empowered by educational sessions at the two-day Public Policy Forum (sponsored by the Alzheimer’s Association) that preceded this Senate hearing, and everyone in the room was exhilirated by the passion and commitment set forth by Shriver and her colleagues on the Alzheimer’s Study Group (ASG, a high-level, bi-partisan task force co-chaired by Gingrich and former Senator Bob Kerrey from Nebraska).

Shriver shared her personal experience with Alzheimer’s in the shape of her father, Sargent Shriver, who is still battling the disease at age 93 (diagnosed in 2003).  Recommendations laid out by the ASG were shared by Gingrich, Kerrey and O’Connor, and included the need for public-private partnerships and better coordinated care for those with Alzheimer’s.

During the hearing, hundreds of Alzheimer advocates met with their individual members of Congress, seeking their support on three priority policy issues. It was truly a banner week in terms of awareness, media coverage, and attention from legislators and the public on all things Alzheimer’s; I was thrilled to be right in the middle of it all, thanks to my position as an Alzheimer’s Association staff member.

I was inspired by Maria Shriver, but I also found great inspiration in mentoring first-time advocate attendees from my home state of Pennsylvania – many of whom had never before made a legislative visit. Although exhausting, it was a phenomenal three days, and I returned from our nation’s capital invigorated and ready to take the Alzheimer cause to the next level.

For a compilation of the week’s events (including a link to the Facts & Figures report, Forum photos, and a webcast of the Senate hearing), visit www.alz.org. To find out more about Alzheimer’s Care options near you, click into our Alzheimer’s Care portal.

-Michelle Seitzer

Helen Thomas is an extraordinary woman. At 89 years old, she has attended every White House press conference since the Kennedy Administration, and she doesn’t appear to have any plans for slowing down.

I recently became her biggest fan. My husband and I visited family in Washington, DC, over the Easter holiday, and one of our tourist stops included the Smithsonian Museum of American History. The place was packed –- almost every exhibit had a 30+ minute wait! We had already spent most of the day trekking around the city, so we decided to skip the lines and crowds and head home. As we walked past the gift shop, we noticed another fairly long line. Helen Thomas was signing copies of her children’s book, The Great White House Breakout. I will admit that when I first saw her, I couldn’t recall her name or place how I knew her, but as soon as her agents mentioned that “she’s in the front row at every press conference,” it clicked. I immediately bought a copy of the book and grabbed a place in line.

As we waited behind parents with young children (Ms. Thomas wrote a two-paragraph personal message inside everyone’s book), I grew more and more excited about meeting her, taking a photo together and shaking her hand. I have always had a soft spot for seniors, and it really inspires me when I see an elder doing amazing things even in their later years. The fact that she is also an award-winning journalist and a woman of many firsts who doesn’t stand much taller than 4’11” had me positively swooning. My husband couldn’t believe how tickled I was, considering I couldn’t even place her name right away, but I was truly inspired by this petite powerhouse and eager to read more about her lifetime of accomplishments.

I will forever treasure those five minutes of meeting Helen Thomas, both for her inspiration as a successful woman (in fact, she has been named one of the 25 most influential women in America!) who is truly a pioneer of political journalism, and as a mature adult who is not letting her age get in the way of what she loves to do.

Her children’s book, The Great White House Breakout, would make a fabulous gift for anyone who is interested in Washington, DC, and a little bit of politics. This entertaining story features the son of the first female president of the United States and his “escape” from his new home on Pennsylvania Avenue, the place where “people with wires in their ears” follow his every move. It is a book that children will enjoy, but adults can certainly appreciate Thomas’ sharp wit and keen sense of humor, richly complimented by the illustrations of award-winning political cartoonist, Chip Bok.

To order the book, or to read more about this extraordinary lady and her interesting views on modern-day reporters (let’s just say she uses the phrase “subdued, compromised lapdogs”), visit www.helenthomas.org.

-Michelle Seitzer

What “senior celeb” inspires you?

Some Relief for Social Security Beneficiaries

The passage of the economic recovery bill means just a little bit of cash ($250 for individuals, $500 for couples who receive Social Security benefits) will go to seniors in May.  According to a recently published AARP Bulletin, the “so-called senior payment” does not require any additional paperwork; beneficiaries will receive the money in the same way they get Social Security (direct deposit or mailed check).

This payment was not included in the House’s version of the bill but was championed in the Senate by Max Baucus (D-Montana, chairman of the Senate Finance Committee) and Sheldon Whitehouse (D-RI).  AARP supported this provision in the legislation, citing research “showing that older people tend to spend such payments immediately.”

Visit the Social Security Administration website for more information.

Highlights of the Stimulus bill for older Americans, as per the National Council on Aging:

The act includes:

· $100 million for senior nutrition programs;

· $120 million for the Senior Community Service Employment Program (SCSEP);

· $87 billion to increase the federal Medicaid match to states (a 6.2 percent increase from Oct. 1, 2008 through Dec. 31, 2010);

· a one-time payment of $250 to Social Security, Supplemental Security Income (SSI) and certain veterans by the end of May; and

· the package also extends the Medicare Savings Program Qualified Individual (QI-pays Part B premiums for eligible beneficiaries) program through Dec. 31, 2010.

Elderly at Risk?

The rebate check and the boost in program funding is not enough to outweigh the other provisions in the stimulus package that may hurt vulnerable seniors, according to an opinion piece by Betsy McCaughey.

Her piece outlines the “hidden” health provisions in the legislation that could mean many seniors will not get the help they need.  For example:

“Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost-effectiveness standard set by the Federal Council (464).

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.”

McCaughey, a former Lieutenant Governor of New York and an adjunct senior fellow at the Hudson Institute, asserts that there was not enough scrutiny of the legislation before final passage, stating the stimulus is “dangerous to your health and the economy” and “the elderly will bear the brunt”.

While I understand that this is an opinion piece, I am concerned for the possible implications these system changes could bring, particularly to vulnerable seniors. We’ve all heard the sound bytes in the news this past week – we know there are a wide range of opinions on the bill and whether it will help or hurt the struggling economy and the American people. I imagine the 1000+ page document, formally called the American Recovery and Reinvestment Act of 2009, is full of items that probably needed further scrutiny. In my opinion, seniors are already marginalized in our society, so I am curious to see what the outcome of these provisions will be. I hope for the best, but in the meantime, I hope that senior-focused advocacy and service organizations will be prepared to carry the load in times of need.

What’s your read on the stimulus package as it pertains to seniors?  Share your thoughts here.

- Michelle Seitzer

Currently, approximately 500,000 Americans under the age of 65 have early-onset Alzheimer’s disease or a related dementia. Equally striking is the number of young Americans who are providing care for an afflicted parent: an estimated 250,000 children between the ages of 8 and 18.

“My Name is Lisa” (embedded below) is a short film about a 13 year-old girl dealing with her mother’s Alzheimer’s disease. The poignant piece has won nearly a dozen awards and nominations. Brilliantly acted, it reveals a painful truth about this awful disease which as yet has no cure: even the very young are deeply affected and are often closely involved with their loved one’s care, all the while watching their decline.

At any age, losing a loved one to Alzheimer’s is extremely painful. I am currently grieving the loss of my beloved grandfather, who died on January 21, 2009, from complications of Alzheimer’s. It does not matter how old your loved one is – it’s terrible to lose someone you love. And, with Alzheimer’s disease, you lose your loved one twice: once to the disease, and once to their subsequent death after the disease advances.

But a completely different set of issues and challenges emerge when young children with young parents begin the Alzheimer’s journey.  In many cases, the diagnosis means the loss of a job, and that can be absolutely devastating if that person is the primary breadwinner, who is perhaps in the prime of her career. Imagine the ripple effect: loss of health insurance, loss of income to put towards a college savings fund, loss of that person who dreamed of walking his daughter down the aisle…and the losses continue. Imagine having to explain to your fifteen-year-old friends why your Dad keeps asking the same questions over and over, or why he comes into the room with his clothes on backwards. Imagine being a stay-at-home mom and being forced to find a job when your husband loses his – and seeking for adult and child day care services at the same time. Imagine the woman who has her own law firm but cannot remember that the milk goes in the refrigerator, and not the oven.

And it may not always be a parent’s dementia that a child must confront on a daily basis. Many baby boomers find themselves in the “sandwich generation” – having to care for an aging parent while raising their young children, and many choose to either move in with that needy parent or bring them into their own home. This creates a completely new and challenging dynamic for all parties involved, and no one tells that story better than Julie Winokur of Talking Eyes Media, who shares her family’s deeply personal experiences and struggles in “The Sandwich Generation: Parts 1 & 2 – Life with Herbie.”

So many people are not even aware of the fact that you can get Alzheimer’s at any age: it is not “old-timers” disease as some mistakenly say. It is not senility, or hardening of the arteries; it is a disease that is terminal, although it can linger for many years. It is a disease that robs the individual of his essence, his health and vitality, his ability to make decisions: many diseases ravage the body, but Alzheimer’s ravages the mind and the body simultaneously, though not always in the same proportion.

There are a number of excellent resources for young people who are dealing with Alzheimer’s or a related dementia in their home or family…

The Alzheimer’s Association has a page full of downloadable PDFs and links just for kids and teens. The page also links to information about Camp Building Bridges, a special summer camp getaway for children ages 13-16 who have a parent or grandparent with the disease.

For adults who have just received the diagnosis for either their spouse or parent and now must share the news with their children, an excellent article on Care2.com gives sound advice on dealing with this delicate situation:

A number of children’s books have been written on the subject, including “What’s Happening to Grandpa?” by Maria Shriver, or one of my favorites, “Wilfrid Gordon McDonald Partridge” by Mem Fox. Information on Shriver’s book and other similar stories can be found on the Alzheimer’s Association website or on sites like amazon.com.

Alzheimer’s never minds age. It is a disease that demands attention, awareness, and action: if you know someone at any age who is struggling with some type of cognitive impairment, get help. The Alzheimer’s Association’s Helpline is a toll-free number – 1.800.272.3900 - staffed by live representatives 24 hours a day, 7 days a week, 365 days a year. Call to be connected with resources in your area. Call if you are 10 years old and concerned about your Mom. Call if you are 60 years old and concerned about your Dad. Don’t try to go it alone at any age.

- Michelle Seitzer