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Affiliated with the Rhode Island AFL-CIO “Fighting for the future of our members.” “NOW, more than ever!!!” Publication 2018 Issue 27 Published in house by the RI ARA

July 8, 2018 E-Newsletter

All Rights Reserved RI ARA 2018©

Scammers impersonate the Social Security Administration reports about calls from Here’s some tips to scammers claiming to deal with these be from the Social government Security imposters: Administration. They  Don’t give the say there’s been a caller your computer problem, and information. Never they need to confirm your Social give out or confirm sensitive Security number. information – like your bank Other people have told us that account, credit card, or Social they have come across spoof Security number – unless you websites that look like the place know who you’re dealing where you would apply for a with. If someone has DON’T DO IT!!!! new Social Security card – but contacted you, you can’t be SEE BELOW these websites are actually a sure who they are. Your Social Security number setup to steal your personal  Don’t trust a name or is an important key for an information. number. Con ar tists use identity thief. Scammers want it, If you get a phone call or are official-sounding names to and they think of all sorts of directed to a website other than make you trust them. To make ways to trick you into giving it that is claiming to be their call seem legitimate, away. associated with the Social scammers use internet Here at the Federal Trade Security Administration, don’t technology to spoof their area Commission, we’re getting respond. It’s most likely a scam. code – so although it may Very important consumer information. This is going right now. You received a call from a scammer stating that they are a Social Security agent and that your Social Security number has be compromised and may have been used in a fraudulent manner . They want you to call a phone number and talk to an officer.

seem they are calling from Washington, DC, they could be calling from anywhere in the world.  Check with the Social Security Administration. The SSA has a warning about these scams and suggests you contact them directly at 1-800772-1213 to verify the reason for the contact and the person’s identity prior to providing any information to the caller. If you come across one of these scams, please report it to the Social Security Administration’s Fraud Hotline at 1-800-269-0271, or 1-866-501-2101(TTY), and then tell the FTC about it.

Secret data: Most VA nursing homes have more residents with bed sores, pain, than private facilities Don Ruch’s family thought round-the-clock care would help him recuperate, but he ended up in intensive care in septic shock, suffering from “severe” malnutrition, bedsores on his pelvis and back, a burn on his right thigh and a trauma wound. USA TODAY An analysis of internal documents shows residents at more than two-thirds of Department of Veterans Affairs nursing homes last year were more likely to have serious bedsores, as well as suffer serious pain, than their counterparts in private nursing homes across the country. The analysis suggests large

numbers of veterans suffered potential neglect or medication mismanagement and provides a fuller picture of the state of care in the 133 VA nursing homes that serve 46,000 sick and infirm military veterans each year. More than 100 VA nursing homes scored worse than private nursing homes on a majority of key quality indicators, which include rates of infection and decline in daily living skills, according to the analysis of data withheld by the VA from public view but obtained by USA TODAY and The Boston Globe.

The news organizations reported last week that 60 VA nursing homes received the agency’s lowest quality ranking of one out of five stars last year, but the data didn’t detail how individual facilities scored on specific measures. USA TODAY and The Globe are publishing the full data, outlined in internal documents, for every VA nursing facility as of Dec. 31, 2017. Four VA facilities – nursing homes in Bedford, Massachusetts; Chillicothe, Ohio; Tuscaloosa, Alabama; and

Roseburg, Oregon – lagged private nursing home averages on 10 of 11 indicators. At all four, about a third of residents were given anti-psychotic drugs – almost twice as much as in the private sector. The FDA has said such drugs are associated with an increased risk of death in elderly patients with dementia. The VA, which has argued that its residents are typically sicker than those in private facilities, has tracked the detailed quality data for more than two years but has kept it secret, depriving veterans of potentially crucial health care information….Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

As Federal Deficits Increase, so Do Threats to Medicare editor of the Washington Post, noting, in part, that “Placing the burden Last week, the Medicar e of paying for the tax Rights Center explained how the bill onto older adults and people House majority’s budget with disabilities who rely on plan for 2019 would Medicare and Medicaid is fundamentally restructure unconscionable.” Medicare and Medicaid, Days later, the nonpartisan slashing more than $2.1 trillion Congressional Budget Office from the programs over 10 (CBO) confirmedthat last years. Though this approach is year’s tax bill will add $1.84 not unexpected—as trillion to the federal deficit over lawmakers promised to use the next decade, ensuring that deficits created by last year’s tax Medicare will remain under bill as an excuse to pursue such threat for years to come. cuts—it is extremely troubling. In its long-term budget This week, Medicare Rights outlook, CBO projects that over and the Center for Medicare the next 30 years, debt levels Advocacy highlighted our will rise to “the highest in the concerns in a letter to the nation’s history by far.” The

agency notes that if Congress extends the individual tax cuts that are set to expire at the end of 2025— as Republican leaders have said they plan to do—debt would grow even faster. Lawmakers set those rates to expire to bring the tax bill into compliance with Senate rules that allowed it to pass using the fast-tracked, filibuster-proof reconciliation process. This outlook, CBO writes, “poses substantial risks for the nation and presents policymakers with significant challenges.” While we recognize the need to address our nation’s fiscal and demographic realities, we caution that undermining critical

programs on which older adults and people with disabilities rely—including Medicare and Medicaid—will only leave us less prepared for the challenges that lie ahead. Rising deficits must not provide cover for drastic changes to these programs, or for shifting costs onto beneficiaries. Instead, we urge policymakers to pursue balanced, fiscally responsible solutions that seek to build and maintain the health and economic security of all Americans. Read CBO’s 2018 LongTerm Budget Outlook. Read our letter to the editor of the Washington Post. Read the House Republicans 2019 budget proposal.

Kaiser Family Foundation Places Medicare Spending Trends in Historical Context This week, the Kaiser Family Foundation released a new issue brief on Medicare spending. The brief analyzes the most recent historical and projected Medicare spending data published in the 2018 annual report of the Boards of Medicare Trustees and the 2018 Medicare baseline and projections from the Congressional Budget Office (CBO). In 2017, Medicare spending accounted for 15% of the federal budget, and for 20% of total national health spending in 2016. It also accounted for 29% of spending on retail sales of prescription drugs, 25% of spending on hospital care, and 23% of spending on physician services. The brief finds that while benefit payments for each part of Medicare increased in dollar terms over these years, the share of total benefit payments represented by each part changed. Spending on Part A benefits (mainly hospital inpatient services) decreased

accountable care organizations (ACOs), medical homes, bundled payments, and value-based purchasing initiatives. In addition, they find that although Medicare enrollment has been growing around 3% annually with the aging of the baby boom generation, the influx of younger, healthier beneficiaries has contributed to lower per capita spending and a slower rate of growth in from 47% to 42%, spending on faster growth in enrollment overall program spending. Part B benefits (mainly since 2011 when the baby boom The brief also examines physician services and hospital generation started becoming longer-term spending outpatient services) increased eligible for Medicare. projections, beyond the next 10 from 41% to 44%, and spending Kaiser Family Foundation years, and financing challenges, on Part D prescription drug attributes the slower growth in and concludes that Medicare benefits increased from 11% to Medicare spending in recent spending is likely to trend 14%. years to policy changes adopted higher because of growth in They also note that “recent as part of the Affordable Care both enrollment and per capita years have seen a notable Act (ACA) and the Budget costs. In addition, the report reduction in the growth of Control Act of 2011 (BCA). points to recent legislative Medicare spending compared to These changes reduced changes, including repeal of the prior decades, both overall and Medicare payments to plans and ACA’s individual mandate, as per beneficiary,” with average providers, increased revenues, contributors to this growth in annual growth in total Medicare and began delivery system spending. spending at 4.5% between 2010 reforms to improve efficiency Read the Kaiser Family and 2017. This is down from 9% and quality of patient care and Foundation issue brief. between 2000 and 2010, despite reduce costs, including

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 • provides comprehensive resources on various senior living options, including: assisted living facilities, senior living communities, nursing homes, independent living communities, continuing care retirement communities (CCRC) and all other long term senior care options, including memory care such as Alzheimer's or Dementia.

Rhode Island Senior Living Rhode Island, officially called “The State of Rhode Island and Providence Plantations” is a state in New England in the northeastern part of the United States. Rhode Island is the smallest state in the U.S. with only 1,214 square miles, and is ranked 43rd in population with around 1,056,000 residents. The small size and large population make it the 2nd most densely populated state with 1006 people per square mile. Rhode Island is bordered by Massachusetts to the north and the east, the state of Connecticut to the west, and the Atlantic Ocean to the south through Block Island Sound and Rhode Island Sound. There is also a small maritime border that Rhode Island shares with New York. Due to the amount of water that makes up the state of Rhode Island, 14% of the state is water - mainly bays, inlets and oceanfront beaches. Its official nickname is “The Ocean State.” The state is mostly flat with few to no mountains and the highest point in the state is Jerimoth Hill, which is only 812 feet above sea level. There are only five counties in the state of Rhode Island and only 39 recognized cities and towns. Providence is both the capital as well as the largest city and largest Metropolitan Area. You may be wondering if

Rhode Island is considered as popular state for retirees. It rates 11th out of the 50 states with 15.84% of residents of Rhode Island who are age 65 or older. On this page, we’ve prepared all the information you need in order to make an informed decision when choosing senior living communities in Rhode Island, or when selecting the best assisted living facility in the state. Costs of Assisted Living in Rhode Island Most people do not want to be in a senior living facility, nor do they want to put their loved ones in one, yet in some cases there comes a point where a person may not be able to care for themselves at home or their safety may be compromised if they stay at home. It is also very hard on the caregiver to provide 24-hour care to someone and can be emotionally and physically taxing or even, in dementia cases, abusive. Rhode Island assisted Living provides 24-hour care, housekeeping, meals, housing, medical care, and a safe environment for the residents. In America, the average cost for a monthly stay in an Assisted Living Facility is $3,628. In Rhode Island, the state median cost for a month of care in an Assisted Living Facility is $4,931 which is over $1,300 more expensive than the average cost of Assisted Living nationwide. The difference in cost is due, in part, to the cost of housing and health care being higher in Rhode Island than they are across the country. The cost of assisted senior living care also varies across the state, with $5,200 per month in

the Providence Area. As the population ages and more people need care, Rhode Island senior living facilities have started to use tierbased systems where the resident or prospective resident is charged based on the level of care that they need individually for them to live safely in an Assisted Living Facility or in a senior living community that provides assisted living care. Adult Day Health Care and Home Health Aides are other senior living options in Rhode Island to help care for the elderly and these options are sometimes preferred, whenever it is possible for the senior to stay at their own home. However, these costs are high as well and there are nonmonetary, emotional and psychological costs on the caregiver that can’t be ignored. A Home Health Aide in Rhode Island costs, on average, $4,814 a month – almost $58,000 per year. Adult Day Care in Rhode Island costs on average $1,517, or $18,200 annually. It is important to remember that the cost of Adult Day Health Care is based on 5 days a week and usually is only for no more than 60 hours per week. To provide the care at home that is typically found in a Rhode Island Assisted Living Facility you would need 3.8 Home Health Aides weekly which would cost almost $18,300 per month. The high cost of Home Health Aides in Rhode Island may be related to the higher cost of health care as well as the low rate of unemployment. Experts forecast that over the next five years, the prices of Home Health Aides costs will increase

2%, and Adult Day Health Care will increase 1%. For seniors with higher level medical needs, Rhode Island Nursing Facility Care is necessary. This is also true for those with severe dementia or Alzheimer’s disease as the mid to end stages of dementia make it nearly impossible to care for someone in their home. It is estimated that a semi-private room in a Nursing Facility in Rhode Island costs almost $9,277 per month – $111,325 per year, and a private room will cost around $9,733 monthly – $116,800 annually. Experts project that the costs of Nursing Facility care will increase only 1% for semi-private rooms and will stay the same for private rooms in the next five years. By the year 2030, as the number of seniors needing care increase substantially, the regulations on Rhode Island senior living facilities will also increase, as will the staff salary necessary to care for these people. It is projected that the cost of Assisted Living in Rhode Island will be close to $94,300 per year in 2030, and the cost of Nursing Home Care will increase to almost $168,400 for a semi-private room and almost $176,700 for a private room. The costs of Adult Day Care will be around $27,500 and a Home Health Aide cost almost $87,400 annually. Read More about Rhode Island

Pros and Cons of Senior Living in Rhode Island Places of Interest for Seniors Living in Rhode Island Some cities to consider for Rhode Island Senior Living Live outside of Rhode Island Search by City & State

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

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Home Health Care The Center has been hearing from people unable to access Medicare-covered home health care, or the appropriate amount of care, despite meeting Medicare coverage criteria. In particular, people living with long-term and debilitating conditions find themselves facing significant access problems. For example, patients have been told Medicare will only cover one to five hours per week of home health aide services, or only one bath per week, or that they aren’t homebound (because they roam outside due to dementia), or that they must first decline before therapy can commence (or

recommence). Consequently, these individuals and their families are struggling with too little care, or no care at all. Home health access problems have ebbed and flowed over the years, depending on the reigning payment mechanisms, systemic pressures, and misinformation about Medicare home health coverage. Regrettably, if recent policies and proposed rules are fully implemented, it appears these access problems will only get worse. To respond to this crisis, the Center is building a coalition to

support a Home Health Access Initiative. This Initiative is working to oppose inappropriate restrictions on Medicare to open doors to Medicare-covered, necessary home care, but we need your help. In addition, it is important for beneficiaries and advocates to know what Medicare home health coverage should be under the law, especially for those with long term, chronic, and debilitating conditions. See our detailed information below, and download our Infographic, Fact Sheet, and Toolkit: Medicare

Home Health Coverage & Jimmo v. Sebelius. Click on the links below for more information  When does Medicare cover home health care?  What services are covered?  What if I attend religious services once a week; am I still considered "homebound" for the purpose of Medicare coverage?  The home health agency told me my aide services would be reduced. My doctor hasn’t given me this information. What are my rights?

As the Eyes Go, So May the Mind A new study sheds light on how vision loss is linked to mental decline in seniors. For the study, University of Miami researchers analyzed health data from more than 2,500 adults, aged 65 to 84, who were followed from about 1993 to 2001. The investigators found that the rate of vision loss was associated with the rate of declining mental (cognitive) function. But mental function

did not have a strong effect on vision, according to the report. The study is the first to show that eyesight is the dominant factor in the link between vision loss and mental function, according to lead author D. Diane Zheng, a doctoral candidate in the university's department of public health sciences. However, the study couldn't

prove that vision loss was the cause of the mental decline. Vision loss and mental decline are common in aging Americans, and this study suggests that preventing or treating eye problems may help protect against mental decline. "The takeaway is that we need to pay more attention to preventing and treating vision loss to possibly reduce the rate

of cognitive decline," study coauthor David Lee said in a university news release. Lee is a professor in the department of public health sciences. The new report was published June 28 in the journal JAMA Ophthalmology. More information The U.S. National Institutes of Health has more on aging eyes. SOURCE: University of Miami, news release, June 28, 2018

Sitting increases frailty risk for women Sedentarism is known to have adverse health effects, but a new study looked at how it affects women, specifically, and their ability to recover after illness or injury. Prolonged sitting harms our health in various ways. The more time you spend sitting down, the likelier you are to die prematurely, studiesshow. And, sadly, exercising does not cancel out these pernicious effects. Too much sitting impairs our cardiovascular health and raises

the risk of diabetes, researchers warn. Some studies have even suggested that it may cause the brain to shrink. With age, sitting becomes even more dangerous, as increased sedentarism heightens the risk of walking disability, as well as dementia, among seniors. Now, a new study looks at the effects of sedentary behavior on aging women. Researchers at the University of Queensland (UQ)

in St. Lucia, Australia, studied the impact of prolonged sitting on 5,462 middle-aged women who were clinically followed for

of Women's Health. The women enrolled in the study were born between 1946 and 1951, and they self-reported their daily sitting time. The researchers assessed the 12 years. women's frailty using the FRAIL The findings were published scale, ranging from 0 (healthy) in the American Journal of to 5 (frail) and broke down Epidemiology. sitting time into three categories: low (3.5 hours each day), What is frailty? How does it affect women? medium (5.5 hours per day), and Researchers Maja Susanto, Ruth high (10 hours per day)….Read Hubbard, and Paul A Gardiner More analyzed data from the Australian Longitudinal Study

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-480-8381 •

Low B-12 and folate levels in mature adults 'of concern' A large population study conducted in Ireland has found that a worrying number of adults aged 50 and over have vitamin B-12 and folate deficiencies, which may expose them to poor health in the long run. Researchers from the Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin in Ireland have analyzed the medical information of 5,290 adults from Ireland aged 50 older. They did this to establish whether the general levels of two key nutrients — vitamin B12 and folate — were adequate among the mature population. B-12 and folate

deficiencies can be a significant risk factor in the long run, as these nutrients have been associated with various anemia-related health issues, including fatigue, headaches, weight loss, and impaired memory. Public health policies across many countries suggest that various products, such as cereals, should be fortified with folate and B-12 in order to try to ensure that the population at large has access to these nutrients on a day-to-day basis. The findings of the new study — which have now been published in the British Journal

of Nutrition— suggest that official health policies should take these concerns more seriously. "This is the largest representative and most comprehensive study of vitamin B-12 and folate status in older adults ever conducted in Ireland," notes lead study author Dr. Eamon Laird. Older adults at significant risk Dr. Laird and colleagues note that both folate and vitamin B12 are crucial elements in brain health, nerve functions, and red blood cell production, as well as the synthesis and repair of DNA. That being the case, they

argue that we should take vitamin B-12 and folate deficiency much more seriously. After analyzing the data collected from the more than 5,000 participants, the researchers found that as many as 1 in 8 older adults had low levels of vitamin B-12 or a B-12 deficiency, and 1 in 7 had low folate levels or were folate deficient. Moreover, prevalence of inadequate folate levels seemed to increase with age, with percentages raising from 14 percent among people aged 50– 60, to 23 percent among participants older than 80. ...Read More

Treatment for Opioid Abuse Grows, but Many on Medicaid Don't Receive It Approval of the drug buprenorphine led to a rise in the number of Medicaid patients getting medication to treat opioid addiction. But the rates were lower among poor, black and Hispanic patients, a new study says. Methadone or buprenorphine are recommended treatments for opioid-abuse disorders. Methadone must be dispensed in special clinics and often requires daily visits, while buprenorphine can be prescribed by any specially certified physician, the researchers noted.

They analyzed Medicaid claims in 14 states between 2002, when buprenorphine was approved in the United States, and 2009. That period saw a 62 percent increase in Medicaid patients getting medicationaided treatment for opioid abuse. By 2009, buprenorphine accounted for nearly one-third of medication-aided treatment, according to investigators at the RAND Corp., a nonprofit research organization.

Despite the overall increase, patients in counties with more poverty and higher percentages of blacks and Hispanics were much less likely to receive medication-aided treatment as of 2009. While patients in urban counties were much more likely to get medication-aided treatment than those in rural counties, the gap narrowed during the study period. Opioid abuse affects about 9

out of every 1,000 Americans, and opioid overdose-related deaths have quadrupled over the past 15 years. Medicaid is the payment source for more than one-third of all opioid treatment cases, according to the researchers. "These findings highlight the good news that medication therapy is being used more widely to combat the nation's opioid epidemic," study lead author Dr. Bradley Stein said in a RAND news release….Read More

Aging, obesity may prime the brain for Alzheimer's According to a new study, the effects of natural aging processes, combined with those of obesity and a poor diet, affect certain brain mechanisms, thereby boosting the risk of Alzheimer's. Alzheimer's disease is a neurodegenerative condition that is characterized primarily by memory loss and impaired cognition. Some risk factors for the development of this disease are aging and metabolic conditions such as obesity and diabetes.

However, many of the biological mechanisms underlying the onset and progression of this disease remain unknown. This is despite the fact that our understanding of the predisposing risk factors is growing all the time. Now, Rebecca MacPherson, Bradley Baranowski, and Kirsten Bott — of Brock University in Ontario, Canada — have conducted a study that has allowed them to uncover

some more of the mechanics at play in the development of this type of dementia. The team worked with aging mice to investigate how a high-fat, high-sugar (HFS) diet that fuelled obesity might also prime the brain for neurodegeneration in this sample. Their findings are described in a paper now published in the journal Physiological Reports. How unhealthful diets impact the brain

Specifically, the researchers examined how an HFS diet, in conjunction with the effects of normal biological aging, would affect insulin signaling, which helps to regulate the amount of glucose (simple sugar) absorbed by muscles and different organs. They also looked at how this obesity-inducing diet might alter biomarkers relating to inflammationand cellular stress…..Read More

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RI ARA July 8, 2018 E-Newsletter


RI ARA July 8, 2018 E-Newsletter

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