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Seniorgram: Sending a Message on Senior Issues

“OTC” bill proposed to improve access to affordable hearing aids

Roseann MartocciaExecutive Director Roseann MartocciaMillions of people in Massachusetts and across the country experience hearing loss as they get older, but they can't get the hearing aids they need because of high costs and complicated regulations. The bipartisan Over-the-Counter Hearing Aid Act, which Senator Elizabeth Warren has reintroduced with Senators Chuck Grassley (R-Iowa), Johnny Isakson (R-Ga.), and Maggie Hassan (D-NH), would make hearing aids less expensive and easier to access. A companion bill has been filed by Representative Joe Kennedy III in the House. The bill has received endorsement from organizations such as AARP, the Gerontological Society of America and the Hearing Loss Association of America.

The bill would make certain types of hearing aids available over the counter (OTC) to Americans with mild to moderate hearing impairment.  It would also require the FDA to write regulations ensuring that this new category of OTC hearing aids meet the same high standards for safety, manufacturing protections and consumer labeling as all medical devices, which would provide consumers the option of an FDA regulated device at a lower cost.

Approximately 30 million Americans experience age-related hearing loss, including over half of adults between the ages of 70 to 79. However, only a small share of Americans with hearing loss (about 14%) use hearing aids, primarily due to the high cost. Hearing aids are not covered by Medicare or most private insurance plans. Out-of-pocket costs for one hearing aid can average $2,400, which is out of reach for many consumers.  People with low or moderate incomes are less likely to have access to hearing aids compared to individuals with higher incomes. 

Some of the key provisions of the Over the Counter Hearing Aid Act of 2017 include:

  • Certain types of hearing aids designed to assist adults with perceived mild to moderate hearing impairment would be available over the counter.
  • The requirement that consumers obtain a medical evaluation or sign a waiver of that examination in order to obtain an OTC hearing aid would be removed.
  • The FDA would be required to issue regulations related to safety and labeling requirements for this new category of OTC hearing aids.
  • The existing safety, labeling and manufacturing protections would be maintained and applied to OTC devices in order to ensure that OTC hearing aids would be held to the same high standards as other medical devices.
  • The FDA would be required to update the existing draft guidance on Personal Sound Amplification Products (PSAPs), consumer electronics products that may use similar technology to hearing aids but are intended for use by individuals with normal hearing.

Find a Fact Sheet on this bill here.

Click here to access a Consumer Guide to Hearing Aids published by AARP.

Economic insecurity and community efforts to help

RoseannMartocciaHeadshotExecutive Director Roseann MartocciaAn article that ran in The Boston Globe on July 29, 2017, titled, “Many of the state’s elderly residents struggle to pay their bills,” talked about Judi, age 74, who lives in elder housing in Boston. Despite working all her life as a flight attendant and library worker, Judi struggles every month to make ends meet on her limited income of $1,860 per month from Social Security and a small pension. The article describes Judi deciding not to fill and use a new medication for a bladder condition as it would have cost her $55 each month. Judi says she is lucky if she has any money left at the end of each month. 

Judi is among nearly 300,000 people over 65 whose incomes aren’t enough to cover basic necessities – food, utilities and healthcare-related expenses (using the 2016 Elder Economic Security Index). Elders like Judi are among the 60% of single older adults in the state who have no reserve after covering essential living expenses each month. Among older couples, nearly 30% fall below the index’s target value. While 19% of older persons in Massachusetts who live alone fall below the poverty line, many more are in the position of not making enough on which to live. Though they may not qualify for public benefits, their financial situation is strained because of the high cost of living in the Commonwealth. 

Governor Baker has put a think tank of 24 members to work as the Council to Address Aging in Massachusetts. The Council will develop a plan to promote healthy aging in Massachusetts, and to achieve the goal of making the Commonwealth the most age-friendly state for people of all ages. Older adults are the fastest-growing segment of the U.S. population and will make up 23% of the Commonwealth’s population by 2035. The Council’s recommendations may address a broad range of issues including current practices that support healthy aging, how to improve public awareness of and access to services for older adults and caregivers, and how to leverage innovation and technology to support aging in communities.  

At a recent listening session of the Council held in Western Mass, there was a wide variety of areas addressed by presenters, including needs related to: affordable housing; workforce capacity; transportation; technology and lifelong learning as two solutions to combat social isolation; as well as the specific needs of persons with dementia, grandparents raising grandchildren, veterans, the deaf and hard of hearing and people with autism who are living longer. 

There are models emerging in communities to work to offer supports to residents including the “Village” model and age- and/or dementia-friendly communities. It will take creativity and innovation to meet the needs of many in our communities. 

Congressman McGovern held a field hearing in Greenfield in early August, and one person’s comments regarding health care rang true when she stated, “Balancing the budget on the backs of those who are disabled, poor and elderly… It’s appalling.”

Advocacy for SHINE needed now

Roseann MartocciaExecutive Director Roseann MartocciaUncertainty about Federal funding continues. It appears that part of the plan is to reduce many programs which help older people. Congressional committees are working on responding to the President’s FFY 18 budget proposal for the year beginning October 1, 2017. Significant spending cuts will be needed to achieve the savings and tax cuts which have been proposed.

The federal administration has again proposed eliminating a popular federally-funded health counseling program known as SHINE: Serving the Health Information Needs of Everyone. As I write this article, the House Appropriations Committee will be voting on their version of the FFY18 to send to the full House of Representatives for a vote.

In Massachusetts, SHINE annually helps more than 77,000 Massachusetts residents – many of them seniors and their families – get free health counseling to sort through the maze of information about basic health plans, like Medicare, Medicare Advantage, Medicaid, Prescription Advantage, Health Safety Net and other programs. More than 700 well-trained volunteers across the state provide this much-needed service as the only real source of objective health insurance information. Insurance carriers will pitch their own plans – but SHINE volunteers give you independent advice. Medicare has a toll-free number – but can’t possibly get into all the complex details of which health plan makes the most sense for you. In the 54 communities served by LifePath’s SHINE program, over 40 volunteers assist nearly 4,000 consumers each year saving $4,801,070 across all Medicare beneficiaries in Western Mass communities. Through counseling and review of their options, the SHINE program saved each beneficiary an estimated $1,733.24 per year in health insurance costs. That’s $144 per month that a person on a fixed income can use on other essentials. Statewide in Massachusetts, SHINE counseling resulted in a savings of $105,116,080 in 2016 as consumers made informed choices about their specific health insurance needs and what was most cost effective for them.

SHINE relies on the time and skills of many trained volunteers to help new retirees going onto Medicare, younger persons with disabilities on Medicare and family members helping a loved one to navigate the complexities of health insurance. Counselors compare plans taking into account a person’s prescription drug needs, income and individual situations. They provide information to consumers to choose among their options so that they are making the most cost-effective choice that will serve both their wallet and wellbeing.

The program was proposed to be eliminated in the FFY 17 budget and sustained a 10% funding cut. Just a few months later, we are in the same position of needing to advocate for SHINE. Contact your Representative and Senator in Washington and let them know that SHINE is a needed program that warrants funding increases not elimination. Contact information for lawmakers can be found at here. Thank you for your advocacy.

Financial exploitation can happen to any elder

RoseannMartocciaHeadshotExecutive Director Roseann MartocciaJune 15 marked the annual recognition of World Elder Abuse Awareness Day. Elder abuse means different things, including physical, emotional or sexual abuse, and self-neglect as well as financial exploitation. Financial exploitation of an elder by another person is perhaps one of the most underreported types of elder abuse.

What is elder financial exploitation?

Financial exploitation often involves a person the elder knows such as a family member or a person the elder has grown to trust such as a caretaker. It may also involve a person who holds legal authority such as a power of attorney. Elders themselves may be reluctant to tell others about financial exploitation as they feel ashamed, trapped, scared, frustrated or helpless.

Financial exploitation can impact an elder in many ways, including access to food, their medications, and utilities, ability to maintain their home, pay their taxes or get the care they need in their home or in a nursing facility.

What are some signs that an elder is being abused financially?

There are some places in the community where clues to financial exploitation may come to light. Changes in behavior, spending patterns, or going to the bank with a new person to make transactions may be signals that something unfavorable to the elder and their finances is occurring. Likewise, if the elder describes falling on hard times financially or if their home is falling into disrepair when money has not previously been a problem can indicate that someone is having undue influence. Cognitive impairment or dementia can complicate the elder’s understanding of their finances or if the person helping them to manage their bills and money is doing so in their best interest.

What can I do about elder financial exploitation?

If you know of an elder who you think is being taken advantage of financially by another party, make a report to Elder Protective Services. Protective Services, first and foremost, works with the elder to alleviate risk, protect their remaining assets and maintain their independence in the community. Should the matter involve criminal activity, Protective Services will work with law enforcement or the District Attorney’s office. If you see red flags, circumstances that don’t seem right or observations that make you or the elder uneasy, don’t hesitate to make a report. By making a report, you may be helping to keep an elder safe or prevent them from losing any more of their financial resources. Prevention is the best way to avoid the start or continuation of elder financial exploitation. If Protective Services becomes involved, they will work with the elder to provide interventions and minimize further financial risk.

How do I report elder abuse?

As of June 30, 2017, all reports will be taken by calling 1-800-922-2275 anytime (24/7). The Executive Office of Elder Affairs has moved to a centralized system for reporting. Once a report is made, all Protective Services work will be done locally by a Protective Services Agency such as LifePath.

House-passed healthcare bill dangerous for millions of older Americans

RoseannMartocciaHeadshotExective Director Roseann Martoccia

Sandy Markwood, CEO, National Association of Area Agencies on Aging (n4a), released the following statement on May 4, 2017, after the passage of the American Health Care Act (AHCA) by the House of Representatives. N4a is a membership association representing America’s national network of 622 area agencies on aging (AAAs).

The bill as passed represents a grave risk to millions of older adults, caregivers, and people with disabilities, as this bill would negatively impact their access to the affordable health care and accessible long-term care they need to maintain their health and independence.

As advocates for quality long-term services and supports provided at home and in the community, as well as a range of evidence-based healthy aging programs, n4a is deeply concerned by the passage of AHCA.

The measure:

  • cuts $839 billion from the Medicaid program
  • would allow insurers to significantly increase premiums based on a consumer’s age
  • shortens the solvency of the Medicare Trust Fund by four years
  • eliminates a key prevention program that funds local falls prevention and chronic disease self-management efforts that are critical to preserving the health of older Americans

The bill’s recent updates to allow states to waive essential health benefits and community rating rules, which put anyone with a preexisting condition at risk of being unable to secure affordable health care, only add to our long list of concerns about the negative effects this legislation will have on older adults and all Americans.

An article published on May 4 in the LA Times also emphasized the point that those with preexisting conditions could be placed in high-risk pools depending on what a state elected to do.  High-risk pools were tried by 35 states prior to the Affordable Care Act.  In almost every case, they failed because of underfunding.  California’s experience is worth recalling.  When California’s high-risk pool, known as the Major Risk Medical Insurance Program (MR. MIP), was started in 1990, it was funded with a $30 million budget.  By 2009, enrollment in the high-risk pool was capitated at 7,100 enrollees and premiums were set as much as 37% higher than market rates for individual policies.  These plans also capped benefits at $75,000, not enough to cover treatments for some diseases and conditions.  As people age, serious illness increases and this further puts elders at risk with such a provision in the AHCA.  

As the healthcare action moves to the Senate, there will be much work ahead, but for now, we urge older adults, caregivers, people with disabilities, and other consumers to raise their concerns with their representatives who voted in favor of this bill, which will have dangerous consequences for millions of Americans.

Sandy Markwood, CEO, National Association of Area Agencies on Aging (n4a), released the following statement on May 4, 2017, after the passage of the American Health Care Act (AHCA) by the House of Representatives. N4a is a membership association representing America’s national network of 622 area agencies on aging (AAAs).

The bill as passed represents a grave risk to millions of older adults, caregivers, and people with disabilities, as this bill would negatively impact their access to the affordable health care and accessible long-term care they need to maintain their health and independence.

As advocates for quality long-term services and supports provided at home and in the community, as well as a range of evidence-based healthy aging programs, n4a is deeply concerned by the passage of AHCA.

The measure:

  • cuts $839 billion from the Medicaid program
  • would allow insurers to significantly increase premiums based on a consumer’s age
  • shortens the solvency of the Medicare Trust Fund by four years
  • eliminates a key prevention program that funds local falls prevention and chronic disease self-management efforts that are critical to preserving the health of older Americans

The bill’s recent updates to allow states to waive essential health benefits and community rating rules, which put anyone with a preexisting condition at risk of being unable to secure affordable health care, only add to our long list of concerns about the negative effects this legislation will have on older adults and all Americans.

An article published on May 4 in the LA Times also emphasized the point that those with preexisting conditions could be placed in high-risk pools depending on what a state elected to do.  High-risk pools were tried by 35 states prior to the Affordable Care Act.  In almost every case, they failed because of underfunding.  California’s experience is worth recalling.  When California’s high-risk pool, known as the Major Risk Medical Insurance Program (MR. MIP), was started in 1990, it was funded with a $30 million budget.  By 2009, enrollment in the high-risk pool was capitated at 7,100 enrollees and premiums were set as much as 37% higher than market rates for individual policies.  These plans also capped benefits at $75,000, not enough to cover treatments for some diseases and conditions.  As people age, serious illness increases and this further puts elders at risk with such a provision in the AHCA. 

As the healthcare action moves to the Senate, there will be much work ahead, but for now, we urge older adults, caregivers, people with disabilities, and other consumers to raise their concerns with their representatives who voted in favor of this bill, which will have dangerous consequences for millions of Americans.