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On July 16, I attended a special community leaders briefing on senior issues at the White House with Peter Notarstefano, LeadingAge's director of home and community-based services, and LeadingAge members Jackie Harris from EMA in Eldersburg, MD, Igal Jellinek from the Council of Senior Centers and Services of NYC. Don Schulman, CEO of AJAS, also joined us.
Kathy Greenlee, the assistant secretary for aging and the administrator of the Administration for Community Living in the U.S. Department of Health and Human Services, spoke of the importance of independence to seniors, and how ACL is working to integrate the various programs that seniors navigate to enhance participation and independence.
She noted how new programs like the Balancing Incentive Program and Community First Choice from the Affordable Care Act will increase opportunities for seniors to remain independent, as will implementation of medical homes, Accountable Care Organizations and the Care Transitions program. The Aging and Disability Resource Centers have been expanded to provide seniors and caregivers a one stop shop for finding needed services. She noted that the State Dual Eligible Demonstration is a way for the federal government and the states to work together to provide cost effective quality programs that cross funding streams.
In pointing out the complexities associated with Medicare and Medicaid’s different funding streams, she told a story about how in Kansas she had tried to promote a telehealth program that saved Medicare dollars, but did not show initial savings in Medicaid.
As a result, the state had no incentive to move forward.
She also emphasized the importance of re-authorizing the Older Americans Act that funds important programs such as the National Family Caregiver Support Program.
Gene Sperling, director of the National Economic Council, spoke about the president’s budget as a reflection of the belief that everyone should have dignity in the workplace, in raising their children and in retirement.
He reiterated the administration’s position that two wars and 2 major tax cuts has left our nation with this budget deficit, and that we must discuss the revenue side to solve the budget deficit. Sperling noted that when he was director of the National Economic Council in the Clinton administration, they had a balanced budget. He noted that Medicaid serves children and persons with disabilities, and seniors who need care in nursing homes as well as in their own home.
He said that the Ryan budget would impact these groups the most.
Portia Wu, special assistant to the president on workforce training and technology, mentioned the U.S. Department of Labor companionship rule, and the need to have more workers available to help seniors at home.
Wu also talked about efforts to help seniors who are in the workforce or who want to remain in the workforce.
Keith Fontenot, associate director for health in the Office of Management and Budget, said the Obama administration put a high value on balance in creating a budget that “preserves what’s good in what we have.”
Fontenot noted that there has to be balance (i.e., revenues as well as cuts) to do large deficit reduction (otherwise all the cuts come from domestic programs and health care).
He too talked about the impact of the Ryan budget, which would turn Medicaid into a block grant program that would result in a $800 billion cut. In addition to key members of the administration, four seniors who are part of a Medicare Truth Squad, a national tour to raise awareness of the critical importance of the Medicare program, spoke.
The conference closed with remarks from Vice President Joe Biden. He told the audience that “the question is what are we going to do to strengthen and sustain these programs [Medicare, Medicaid, Social Security] now and for the future.” The vice president both opened and closed with very personal stories about how he and his brothers and sisters cared for their elderly parents.
One story that was particularly revealing was how they figured out that their mother was not taking all her medications, that she felt she could not afford them, and as with many prideful elders would not ask her children for help. The vice president’s stories remind us of the universality of the impact of seniors’ issues.