Washington Update - April 2011

AGS Continues to Advocate for Quality Elder Healthcare
As of mid-March 2011, it was unclear whether there would be funding cuts to the National Institute on Aging (NIA) and to the geriatrics training programs under Title VII and Title VIII of the Public Health Service Act in the FY 2011 Labor‐HHS‐Education Appropriations bill. In mid-month votes, the Senate rejected two proposals to cut billions in discretionary funding, including funding for the NIA and Title VII and Title VIII training programs. On the heels of those votes, the House began debating a short-term continuing resolution to temporarily fund government programs that called for $6 billion in cuts. The AGS continues to advocate for adequate funding for the NIA, Title VII and Title VIII training programs, and other programs integral to the provision of quality healthcare for older adults, building on its earlier public policy advocacy efforts. In February 2011, AGS leaders met with more than 30 lawmakers and their staff at the Capitol, urging full funding for the NIA, the Veterans Affairs Office of Research & Development, and the Title VII and Title VIII training programs. Society members also urged Congress to address ongoing problems related to the sustainable growth rate formula, which mandates untenable cuts in Medicare payments to physicians each year. “We found the Hill staff and those members whom we met with to be very receptive to our requests,” said Peter Hollmann, MD, chair, AGS Public Policy Committee. “There is support on Capitol Hill for programs that will lead to improved care of older adults. Having said that, it was clear that this will be a difficult budget year for everyone as Congress and the Administration look for ways to reduce the federal deficit. I am encouraged by the interest that Democrats and Republicans have in working with us in a bipartisan manner to ensure that we are providing the best possible care to older adults.” Members of Congress who met with AGS leaders and staff included: Sens. Michael Bennet (D-CO), Al Franken (D-MN), Ron Johnson (R-WI), David Vitter (R-LA), and Reps. Roscoe Bartlett (R-MD) and Andy Harris (R-MD). AGS leaders also met with key members and committee staff of the Senate and House appropriations committees; the Senate Finance Committee and Special Committee on Aging; the Health, Education, Labor, and Pensions Committee; the House Energy and Commerce Committee; and the Ways and Means Committee. “At the end of the day, we felt our efforts were successful [in] helping both key members of Congress and staffers for committees that oversee our funding understand why these programs are so important toward ensuring high-quality care for older Americans,” said Sharon Brangman, MD, AGS president. “We were encouraged that the President’s budget included funding for these programs and will continue to educate Congress on their importance to the field and to the older patients who we serve.”

AGS and Iconic Elderly Actor Advocate for the Elder Abuse Victims Act
Mark Lachs, MD, an AGS member and director of geriatrics, New York Presbyterian Health System, and co-chief, Division of Geriatric Medicine and Gerontology, Weill Medical College, Cornell University, testified at a March 2011 Senate Special Committee on Aging session, which focused on the rising incidence of abuse and financial exploitation of the elderly. Joining Lachs was actor Mickey Rooney, now 90 years old, who described his experiences as a victim of both emotional abuse and financial exploitation. Rooney reported being deprived of food and medications and being forced to stay in his home by a family member whom he had trusted. Sen. Herb Kohl (D-WI), chair, Special Committee on Aging, reintroduced the Elder Abuse Victims Act during this emotionally charged session. If passed, this legislation would establish an Office of Elder Justice within the Justice Department. The committee session followed the release of a new Government Accountability Office report that noted that the rising incidence of elder abuse threatens to overwhelm inadequately funded and understaffed adult protective services agencies. “People move from system to system, from housing to law enforcement, to any number of venues, and no one has ownership of the entire case,” said Lachs. The AGS is a member of the Elder Justice Coalition and strongly supported the Elder Justice Act, which was part of the health reform law that took effect in 2010. The AGS also supports the Elder Investment Fraud and Financial Exploitation Prevention Program, a multidisciplinary collaboration between investor protection groups, medical associations, adult protection services, and regulators in 22 states.

Senator Addresses AGS Leaders Attending the Society’s Annual Public Policy Summit
Sen. Robert Casey (D-PA), a member of the Senate Special Committee on Aging, and an advocate for efforts to better prepare the healthcare workforce to meet the unique care needs of the elderly, met with AGS leaders during the Society’s annual February Public Policy Summit. During the all-day summit, leaders discussed the organization’s public policy priorities for 2011. Sen. Casey shared the story of his late father—a state Senator and, later, Governor of Pennsylvania—who was cared for by direct care workers toward the end of his life. Sen. Casey explained that he was inspired by these workers to introduce the Direct Care Workforce Empowerment Act, which would guarantee fair pay for direct-care workers. AGS member Chad Boult, MD, now a senior advisor to the Centers for Medicare & Medicaid Services (CMS) Innovations Center also met with AGS leaders and discussed the Center’s role. Boult noted that CMS was strongly committed to making the testing of innovative payment and service delivery models a priority, with the goal of reducing expenditures while enhancing quality of care. Summit attendees also discussed key policy issues on which the AGS will focus its policy advocacy efforts in 2011. These include sustainable growth rate reform, advising CMS on structuring accountable care organizations, examining ways to restructure graduate medical education, and increasing funding for Title VII and Title VIII geriatrics health professions programs. “AGS was truly effective in its advocacy around integration of programs which seek to improve care of older adults and also help geriatrics health professionals,” said Michael Malone, MD, vice chair, Public Policy Committee. “Relative to our size, we had a large footprint in health reform and I am convinced that we will be equally successful as we continue to work to ensure that older Americans receive safe, high-quality care that is cost-effective.”

Bill Introduced to Enhance Seniors’ Access to Mental Health Services
One in five Americans 65 years and older are estimated to have a mental illness, and 80% of nursing home patients suffer from some form of mental impairment. In March 2011, Sens. Susan Collins (R-ME) and Barbara Mikulski (D-MD) introduced legislation to enhance older adults’ access to quality mental health screening and treatment in community-based care settings. This legislation, dubbed the 2011 Positive Aging Act, has been hailed by the AGS and has been endorsed by the American Association for Geriatric Psychiatry, the Alzheimer’s Association, the American Psychiatric Association, the American Psychological Association, and the National Council on Aging. The 2011 Positive Aging Act would authorize the Substance Abuse and Mental Health Services Administration to fund projects to support integration of mental health services in primary care settings. This legislation would mandate the designation of a deputy director for older adult mental health services in the Centers for Medicare & Medicaid Services, and include representatives of older Americans and geriatric mental health professionals on the advisory council for the Center for Mental Health Services.