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Issues |
Publications from the National Alliance for Retired Americans |
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Health care related
issues submitted and passed at the
RESOLUTION ON NATIONAL UNIVERSAL HEALTH CARE
The Alliance for Retired Americans is a powerful voice for older and retired Americans on critical legislative and policy issues. Learn more about some of these issues Florida Alliance for Retired Americans Proposed Plan to Provide Older Floridians With Self-Sufficiency, Quality Health Care and Security
The Role of FLARA
The Florida Alliance for Retired Americans (FLARA), a non-profit organization based in Wellington, Florida, actively pursues and promotes legislation and public policies that are in the best interest of current and future retired Floridians. Through the active civic involvement of it’s over 200,000 members, FLARA advocates programs and activities at all levels of government to prepare for the growing population of older Floridians who desire to remain self-sufficient. This document, developed in consultation with many other Florida-based and national organizations representing retirees, as well as working people, presents FLARA’s priority issues and proposals to assist older Floridians.
The Need for Strong Action Now
Public and private programs that support current and future needs of retirees have been under an increased level of attack, both nationally and in Florida, undermining their effectiveness and threatening the very survival of these vital programs. For example, proposals have been advanced by the Administration and by some national leaders to privatize Social Security and Medicare. FLARA is concerned that privatization of Social Security would jeopardize the survival of this critically needed program and would shift investment risks from the federal government onto the backs of individual workers. The problems of privatizing of Social Security are further compounded by the fact that many employers have increasingly abdicated their responsibilities to provide retirement and health security for their employees. Private employers have all but eliminated guaranteed pension programs and have substituted them with individual retirement savings programs, such as 401(k) accounts, that put workers’ future retirement security at the mercy of the stock market.
Community Based Elder Care
While there is no substitute for quality nursing home care for frail elderly who truly need this level of care, most older persons want to remain in their homes and in their communities for as long as possible. A priority mission of FLARA is to assist older Floridians to achieve their goal to age in place for as long as it is socially and medically possible through affordable community-based options. FLARA believes that there is a need to review current public policies and programs to ensure that they focus on the present and future needs of elder Floridians seeking self-sufficiency. For example, programs that provides home-based services such as, Community Care for the Elderly, and the Aging and Disabled Adult Medicaid Waiver Program, have enabled many thousands of elder Floridians to remain self-sufficient in their own homes. FLARA believes that these community-based programs provide a focus and vision in the right direction and deserve continued support. We need to restore the national leadership that Florida once held in pursuing this mission to promote community-based care and self-sufficiency. To continue this effort, we need to restore Medicaid eligibility to 100% of the poverty level. We need a commitment to fund programs to support caregivers of seniors. We need stronger nursing home reforms at the national and state levels to ensure quality and affordable nursing home care, including adequate staffing for nursing homes. In addition to efforts to improve nursing homes, we also need a dual strategy that provides community-based options. Since an assisted living facility can cost $2,000 a month or more and a nursing home $5,000 a month and more; it is in the taxpayers, as well as elder Floridian’s best interest to recognize that the costs borne by these programs, particularly Medicaid, may be more cost effective and consumer preferred in community-based settings, such as supportive services linked with senior housing and caregiver programs. FLARA supports the expansion of community-based services, such as transportation, congregate and home delivered meals, counseling, house keeping and chore services, escort, education and training. Many of these programs have been developed and funded through the Older Americans Act and administered through State and Area Agencies on Aging.
FLARA urges prompt implementation of the recently enacted Older Americans Act Amendments with full funding; and increased collaboration between the various programs assisting elder Floridians, including housing, services and health care.
Suitable and Affordable Senior Housing
A basic need of self-sufficiency for elder Floridians is suitable and affordable housing. Secure affordable housing for seniors can mean the difference between poverty and well being, as well as between illness and health, and between anxiety and piece of mind.
The image of affluent retirees living in luxurious golf communities is far from the reality faced by most aging Americans. In fact, one-third of America’s households are not well housed. Either they are paying too much of their income for shelter or living in substandard conditions. Nearly twice as many people in this country face housing problems as lack of health insurance. According to the federal Department of Housing and Urban Development (HUD), 4.9 percent of Americans have what is considered “worst case housing needs” - - either they are earning less than 50 percent of median income, pay more than 50 percent of income for shelter, or live in substandard housing. Of the 5 million Americans that HUD classifies as “worst case”, over one million are elderly.
Most Americans spend between 20 and 25 percent of their incomes for housing. Therefore, when an older person on a limited and fixed income or a working family spends more than half of their income on housing, there is little left for food, clothing, medicine, and other basic needs. While many elderly persons are homeowners, many have older homes that require repairs or modifications to accommodate their changing physical needs. Yet, many seniors may have limited resources necessary for home maintenance or modifications. In addition, many seniors reside in housing that no longer meets their need. There are many seniors who are trapped in their current homes that may now be too large for their need since their children and/or spouse may no longer live there. Yet these older homeowners cannot downsize to a more suitable smaller condo or home due to disincentives with existing real estate tax policies.
FLARA believes that there is a need to develop intergenerational housing policies that promote incentives and programs to encourage older homeowners to sell their existing home to younger working families and to promote the development of suitable and affordable senior rental and condos with special senior real estate taxes. A proposed intergenerational homeownership program would be mutually beneficial to older persons (who no longer need a large home, have limited means for house maintenance, or need increased supportive services not easily accessible) and to younger working families (who need access to affordable housing and may be more capable of making home repairs and modernization).
Older persons on fixed and limited income cannot compete with the rapidly escalating housing market; and there is a severe shortage of affordable senior housing. There are many seniors living in Florida who are in the very low to extremely low-income levels needing affordable housing. A low-income family in Florida is earning less than 80 percent of median income ($47,680); a very low-income is earning less than 50 percent of the median income ($29,800); and an extremely low income is less than 30 percent of median income ($17,880).
As documented by the Congressionally established Senior Commission, there is a silent crisis with the critical shortage of affordable senior housing. Not only is the development of new affordable senior housing inadequate to meet the needs of the current and rapidly increasing elderly population, but also the existing supply of affordable housing is being lost due to substandard conditions and the conversion of existing rentals units to high cost condominiums. “As documented by a study of the Section 202 elderly housing program released by AARP in December 2006, there are 10 persons on the waiting list for each available Section 202 apartment that becomes available each year. This represents a sharp increase over the past few years with the need for affordable senior housing.”
In addition to the critical shortage of affordable housing, many older persons have an increased need for supportive services as they age. The average age in federally assisted senior housing buildings is over 80 and many have a need for services as they age to enable them to remain in their home. Yet, many of these services are not available or are difficult to access since they are fragmented or have complex administrative systems. Without timely access to essential supportive services, many frail elderly may be forced to move prematurely to facilities with higher level of care, such as a nursing home.
Fortunately, service coordinators staffed in senior housing have the skills and mission to assist older persons to access a wide range of supportive services that may be available in the community to enable many frail elderly to remain self-sufficient and to delay or avoid admission to more costly nursing homes. However, there is a critical need to increase the number of service coordinators in federally assisted and other senior housing, as well as to assist seniors in the surrounding community. FLARA recommends a significant increase in the number and training of service coordinators to assist seniors to access services and to be more self-sufficient. If upon retiring, seniors cannot maintain their house or are unable to downsize or obtain more suitable and affordable housing in their local community, they may sadly, be forced to move away from their children, friends and community; and possibly to a more costly nursing home. Support Mission Based Non-profit Organizations
While the private sector provides many valuable goods and services essential for older consumers, it is important to recognize that many seniors with limited and fixed income cannot compete in the market place. Therefore, it is vital that effective partnerships be developed between the public and non-profit sectors to ensure that elder Floridians of all income groups are able to obtain choices with suitable and affordable housing, supportive services and health care. For example, the Elderly Housing Development & Operations Corporation (EHDOC), a Florida based non-profit organization has a mission and capacity to develop and operate affordable senior housing. EHDOC has been nationally recognized as a leader in the development and operation for quality affordable housing for low-income elderly.
FLARA urges that the State of Florida, in collaboration with federal and local governments and local communities develop effective partnerships with non-profit organizations, such as EHDOC, to ensure that all elder Floridians have access to affordable housing, health care and services. Currently, there are 35 million elderly aged 65 years and older with projections that the elderly population will double by the year 2030. This is the time that the public and private sectors need to work with mission based non-profit organizations and to make serious economic commitment and investments in affordable housing and services to prepare for the rapid increase in the elderly population. Maximizing the Use of Volunteers
Senior volunteers provide millions of dollars worth of services to elder programs. This does not take into account the resources that older Floridians give to schools, hospitals, libraries, recreational youth programs and dozens of other institutions. There are many successful senior volunteers programs in local communities throughout the State of Florida and counties. For example, the SHINE (Serving Health Insurance Needs of Elders) program is one example of many ways volunteers are assisting elders. SHINE operates statewide, providing free person-to-person insurance counseling for elder Floridians on difficult Medicare and Medicaid questions.
Another example is respite services for the caregivers of Alzheimer patients. Respite services have more than tripled since the Department of Elder Affairs' creation and should continue to be a strong focus of the Elder Affairs agenda in the State of Florida.
EHDOC has received national recognition for its Community Action Program (CAP) that seeks to empower older persons in each of its housing communities through a wide range of civic involvement by older residents, including voluntarism and advocacy efforts. These volunteer efforts not only taps the skills and interest of older persons, but also promotes their self-sufficiency and develop a wealth of community resources to assist their residents, other seniors, and their local community.
FLARA urges that these volunteer programs must be expanded and replication encouraged through more adequate financial support in order to assist our seniors, promote self-sufficiency, tap community resources and involve effective partnership and collaboration with families, friends businesses, schools and others to expand services and care for elder Floridians. Affordable Elder Health CareAffordable health care for all elder Floridian is a major priority of FLARA. Single Payer National Health Care remains our single most important health issue, along with comprehensive and affordable prescription drug coverage, under Medicare part D. Medicare and Social Security protection are essential to provide security and needed services for current and future generations of elder Floridians. FLARA supports the continued efforts of the Florida Department of Elder Affairs to provide timely and accurate information on health care services, including actions to alert elders of such chronic long-term disabling conditions as osteoporosis and Alzheimer's disease. FLARA supports wellness programs and other means to provide early detection of health issues affecting older persons that would have saved lives, such as prostate, breast and other forms of cancer. Early detection saves money and saves lives. FLARA urges an expansion of elder health care resources to ensure that elders understand critical and timely wellness programs, such as the importance of a sound diet to maintain good health and independence. FLARA also urges that policies and programs promote effective collaboration between housing, services and healthcare. Patient's Bill Of RightsAn effective Patient's Bill of Rights should address the concerns that elder Floridians and working families have to restore consumer confidence and trust in health care. With safeguards in place, the goal of a Patient Bill of Rights should reinforce a positive doctor-patient relationship and once again make the doctor the patient’s advocate. Patients must have the right to be referred to specialists in or out of their Health Care network. "Gag Rules" must be banned. HMOs provide a valuable service, however they should be subject to all of the same requirements that traditional health care plans are.
Those who will not agree to those requirements should not be accredited to get licenses in the State of Florida. Managed care grievances must be immediately appealed to an independent panel in a manner that would not delay needed medical treatment, this process should be subject to legal scrutiny and litigation. Strong Federal-State Relationship
To address health, housing and services needs of the elderly, a cooperative agenda must be put in place to promote an effective and positive partnership between the State of Florida and the federal government. It is especially important to pursue fairness in federal funding formulas, including litigation, if necessary. With the devolution of federal programs, the federal government is increasingly requiring states to cover 100% of the costs of helping elders stay out of nursing homes and in their own home. No state has a greater stake in decisions on Social Security, Medicare, and Medicaid and SSI proposals than Florida. While Medicare is federally funded and pays much of elders' medical bills, Medicaid that pays 70 percent of all nursing home costs and some of their care costs is funded jointly by the federal and Florida state budgets. Clearly, the federal government, as well as the state and county governments have a huge financial stake in efficient and cost effective policies and programs assisting the elderly, as well as a social and personal interest in helping elders with their desire to stay in their own homes and communities for as long as feasible.
Senior Investment Strategy
The current and projected increase in the elder population of Florida has a profound impact on the state’s present and future economy and budget. Florida's retirement “industry” generates more revenue than any other industry except tourism. Elder consumers have a significant impact in the marketplace of goods and services; however special needs accompany Florida's elder population. FLARA recognizes that the State has an extensive aging service network; yet, we believe that Florida can significantly improve the lives of its seniors and get "more bangs for its buck" by adopting these proposed policies and programs as part of a comprehensive Senior Investment Strategy.
What is a Senior Investment Strategy? Essentially, it is a public and private policy commitment to offer all elder Floridians, including those on Medicaid, meaningful and unimpeded community based choices. Among those included in a Senior Investment Strategy would be non-profit and local government community-based providers; programs for which they are eligible; services within those programs; and community based long-term care.
FLARA and the Alliance for Retired Americans (ARA) have a commitment to assist with the development of these proposed policies and programs to assist elder Floridians. We plan to participate at all levels of government to address these priority issues. In addition to separate advocacy initiatives for specific programs and issues affecting seniors, such as mobility options, emergency preparedness, affordable housing and others, FLARA will collaborate with other state and national organizations to endorse and to promote the State's adoption of a Senior Investment Strategy. Elder Floridians are the foundation and focus of FLARA proposed policies and will be an essential part of our advocacy efforts. One must realize that there is a certain "Wisdom That Comes With Age and Experience".
Further information on these issues and priority concerns are available from FLARA (please see www.flara.com).
Tony Fransetta, President FLARA Tony Kiwak, Legislative Director |
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