Photo from Whitehouse.gov
This past Monday, on the cusp of the 50th anniversary of the creation of Medicare and Medicaid and the 80th anniversary of Social Security, the once-a-decade White House Conference on Aging was held. During the conference, 200 advocates, health care workers, and government officials discussed caring for seniors, addressing topics such as health care policies, dementia research, nursing home safety, leave for caregivers, enhanced geriatric training for health care workers, and more.
In preparation for the rapid growth of the senior population, the White House unveiled several initiatives aimed at improving health outcomes among older adults. Below are a sampling of the issues that were discussed:
Supporting Elder Caregiving
-A major priority: The conference’s planners made it clear that improving the caregiving infrastructure in the country would be a major priority when it released a “policy brief” on the topic leading into the conference. Conference panelist Ai-Jen Poo, Director of the National Domestic Workers Alliance and Co-Director of Caring Across Generations, stressed the importance of establishing systems to support and value the nation’s 50 million professional and family caregivers, whose numbers will double by the year 2050. We need “to see caregivers as a huge part of the solution for the future, as a huge part of the equation for quality of life” for our elders, she said.
–Improving family leave for caregivers: A recent study by University of California-San Francisco researchers estimated that at least 2.5 million more home health and personal care aides will be needed to provide long-term services to seniors between now and 2030. Part of addressing the issue, the President said, is improving family leave for workers and giving them more flexible hours.
–Resources for caregivers: New resources have been developed to educate and inform caregivers, including:
–Handbook for federal employees: The Office of Personnel Management (OPM) will issue the “Enhancing Workplace Flexibilities and Work-Life Programs” handbook, which explains the workplace flexibility and work-life programs for federal employees supporting the elder care needs of their family members.
–Private Sector Actions: The SCAN Foundation is investing $2 million in assisting community-based aging networks in developing the skills and capacity necessary to build collaborative partnerships with the health care sector. Bank of America announced the introduction of the Bank of America Merrill Lynch Longevity Training Program for human resources and benefit plan professionals.
Training, Education and Research about Alzheimer’s and Other Dementias
–Training for health care workers: HHS announced that it will develop an Alzheimer’s disease and related dementias training curriculum next year to build a health care workforce with the necessary skills to provide high quality dementia care and ensure timely and accurate detection and diagnosis of dementia.
–Training for caregivers: The HHS Office of Women’s Health will develop related training to help family caregivers maximize their own health and address specific care needs of persons with dementia.
–Education for seniors: The HHS Administration on Community Living is launching a $4 million Brain Health Awareness Campaign to help older adults better understand changes that occur in the brain as people age and reducing the fear of discussing concerns with family members and clinicians.
–Dementia-friendly communities: The Dementia Friendly America Initiative announced plans to support dementia friendly communities and to expand to 15 additional pilot sites across the country. This work is based on a model implemented in Minnesota through which communities across the state are actively working to increase dementia awareness and implement strategies to help support individuals in the community with dementia and their family caregivers.
Making it Easier to Age-in-Place
–Accessibility in the home: As the older population grows, housing that meets their needs is increasingly important. To help address these needs, the U.S. Department of Housing and Urban Development released a guide to help older homeowners, families and caregivers make changes to their homes so that older adults can remain safe and independent.
–Transportation: The U.S. Department of Transportation will launch the National Aging and Disability Transportation Center in fall 2015. This $2.5 million investment will provide technical assistance to improve the availability and accessibility of transportation options that serve the needs of people with disabilities, seniors and caregivers.
–Private sector actions: Home Depot also released a tip sheet and “how to” video highlighting simple home modification steps to help individuals age in place. Washington State University will test new models of using technology to keep older adults safe and healthy as they live independently in their own homes, including a partnership with the Good Samaritan Society to equip 1,500 homes across the country with wireless sensors to help clinicians monitor those older adult residents who voluntarily chose to participate for health concerns.
Utilizing Technology to Support Older Americans
–Availability of Federal data sets: As part of the President’s commitment to making Federal government data open and more easily usable, the Administration announced that by September 2015, federal data sets relevant to aging and to elderly Americans will be made easily available on Data.gov. This resource will continuously be updated with datasets on aging, much like it is for other important Administration priorities such as climate, public safety, and education.
–Private sector: Private sector leaders announced new actions to use technology to improve support for older Americans.
–Accessibility: Peapod has adopted “best in class” web accessibility standards to ensure that all individuals, including those with disabilities and those who are unable to shop at traditional stores, can use its website and mobile applications.
–Matching seniors with caregivers: Honor, a tech-enabled company that matches seniors with care professionals, will offer $1 million in free home care across 10 cities in the country and work with established care providing organizations in those communities to ensure this care goes to helping older Americans.
Launching Aging.gov:
-Access to information and resources: The Administration launched Aging.gov to provide older Americans, their families, friends, and other caregivers, a one-stop resource for government-wide information on helping older adults live independent and fulfilling lives. The Web site links to a broad spectrum of Federal information, including how to find local services and resources in your community for everything from healthy aging to elder justice to long-term care, as well as how to find key information on vital programs such as Social Security and Medicare.
Reauthorizing the Older Americans Act
–The White House Conference was established under the Older Americans Act: The Conference on Aging was established in 1961 and has been organized under statute by the Older Americans Act, passed in 1965. Congress has not reauthorized the law, and the pending bill does not include a statutory requirement or agenda for the conference. Nevertheless, the White House convened yesterday’s gathering.
–Reauthorizing the Act: The Department of Health and Human Services Secretary, Sylvia Burwell, told the conference that another way to help the aging population would be for Congress to reauthorize the Older Americans Act, which would provide funding for meals and job training for seniors and for senior centers. The law has not been reauthorized since it expired in 2011.
Upgrading Nursing Home Care
–Improvements to nursing home care: CMS aims to improve meal delivery, overhaul quality and safety requirements and make sure nursing home staff members are trained on caring for residents with dementia.
Senior Health
–“A culture of prevention in America”: The U.S. Surgeon General, Vice Admiral Vivek Murthy, called for a “culture of prevention in America.” The nation has a high rate of obesity; almost half of adults have some chronic condition. The solution is a combination of healthy nutrition, physical activity and mental health care, he said.
–Exercise: NIH issued a call to all state and territorial health departments to support physical activity events for older adults beginning with Go4Life Month in September 2015. In addition, the Surgeon General joined with the YMCA in issuing a challenge to the 850 YMCA associations across the country to host intergenerational physical activity events during the first week of August to promote opportunities for young and older Americans to be active together.
–Fall prevention
–HHS monetary awards: The HHS Health Resources and Services Administration announced $35 million in awards to health professions’ training programs to expand geriatrics education to prepare the health care workforce to respond to the needs associated with advancing age.
–Education on Medicare’s preventative benefits: CMS is working with AARP and other partners to disseminate information to patients and members on Medicare’s preventive benefits. Efforts to increase use of recommended preventive services will include, for example, co-branding CMS publications on preventive services and distributing a user-friendly check list to help Medicare beneficiaries understand and use their Medicare preventive benefits.
–Fall prevention tool: Kaiser Permanente will implement the CDC’s evidence-based falls prevention tool, known as STEADI (Stopping Elderly Accidents, Deaths & Injuries) across all of its regions and make Kaiser’s evidence-based falls prevention program widely available to other health systems and health plans.
Retirement Planning
–Automatic enrollment in 401(k)-type plans: About a third of the workforce lacks access to a workplace retirement plan. By the end of the year, the U.S. Department of Labor will publish a proposed rule clarifying how states can automatically enroll employees in 401(k)-type plans to save for retirement.
–Improving the Retirement Security of Federal Workers: 55% of employees leaving government transfer their money out of the Thrift Savings Plan (TSP) within a year. To help encourage more employees to keep their money in the TSP, the independent Federal Retirement Thrift Investment Board will soon begin to make age-appropriate lifecycle funds the default investment for newly hired federal workers who are automatically enrolled in the plan.
–TSP for military service members: Unlike civilians, military service members are not currently automatically enrolled in the TSP. Congress is currently considering proposals by the Department of Defense and the bipartisan Military Compensation and Retirement Modernization Commission to automatically enroll service members in the TSP at 3% of basic pay.
–Protecting Defined Benefit Pensions: To ensure that more retirees continue to enjoy a steady, reliable stream of income in retirement, the U.S. Department of the Treasury has recently issued guidance clarifying that employers sponsoring defined benefit pension plans generally may not offer lump sum payments to retirees to replace their regular monthly pensions.
–Better access to Social Security benefit information: To assist Americans in their financial planning, the Social Security Administration is providing individuals with an easily transferrable data file with the information contained in their monthly Social Security benefit statement, and has released a guide to help developers understand how they could incorporate the data into new software.
I hope this information is helpful in summarizing some of the key points from the Conference. For more details, please visit the 2015 White House Conference on Aging website and check out this fact sheet.
Paying for Long-Term Care
At the Conference, Mirian Rose, a senior research analyst at the Benjamin Rose Institute on Aging in Cleveland, indicated that “Most people don’t have long-term care insurance. They think Medicare is going to pay for a nursing home or long-term home health services, and that is not true. So there’s a lot of education and more thinking at the policy level that needs to happen.”
In reality, most people needing long-term care — and their families — sadly wind up shouldering these costs alone because Medicare does not pay one penny for long-term care bills and the private long-term care insurance market is getting pricier and shrinking.
Medicaid Planning in Virginia, Maryland, and Washington, DC
Medicaid planning is what is needed to overcome the fact that our country’s health insurance system does not cover long-term care. Medicaid planning can be started while you are still able to make legal and financial decisions, or can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care. In fact, the majority of our Life Care Planning and Medicaid Asset Protection clients come to us when nursing home care is already in place or is imminent.
Generally, the earlier someone plans for long-term care needs, the better. But it is never too late to begin the process of Long-term Care Planning, also called Life Care Planning and Medicaid Asset Protection Planning.
Planning for long-term care will enable you to evaluate your options and make smarter decisions ahead of time. As a result, you’ll have the peace of mind that no matter what happens, you will know what to do as a family. If you or your loved ones have not yet done Long-Term Care Planning, please call us as soon as possible to make an appointment for a consultation:
Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797
About Evan H Farr, CELA, CAP
