Washington Update: Public Policy and Advocacy

1. Washington Update: Public Policy and Advocacy Meredith Ponder Senior Associate Matz, Blancato and Associates June 2, 2014

2. Introduction • Second session of the 113thCongress halfway done • Sixth year of the Obama presidency • Where do things stand? • With the president: not so much power • Key people are leaving Administration • Headed into lame-duck period • November election and possible changes

3. Congressional Overview • Started with strong bipartisan activity • Omnibus FY 2014 Appropriations bill, Farm Bill, increase in debt ceiling SGR patch • Only “must do” left: FY 2015 appropriations • Could do: • Permanent fix to SGR • Tax extenders • Workforce Innovation and Opportunity Act monitor for possible implications for I and R • Might or might not do: • Immigration reform • Older Americans Act • Tweaks to Affordable Care Act

4. Congressional Overview (cont.) • More not on table than on table • Not on table: • Social Security (chained CPI gone) • Medicare reform (other than SGR) • Medicaid reforms (other than Medicaid expansion in states) • Long term care

5. Older Americans Act • D.C. still stalled on the OAA reauthorization • 3 key bills in play • Farthest along is the Sanders bill (S. 1562) • Awaiting consideration on Senate floor • Stalled by formula changes • Has to be resolved

6. S.1562 – OAA Amendments of 2013 • Strengthens and reauthorizes core programs of the OAA • Updates definitions of “greatest economic and social need” • Addresses economic security • Authorizes new demonstration projects • Increases focus on elder abuse

7. OAA (cont.) • Related to this bill is H.R. 4122 (Bonamici) • Bonamici bill is a modest but progressive reauthorization which expands on the Sanders bill • Pending; no action scheduled • 3rd bill is H.R. 3850 (Gibson, NY) a bipartisan straight reauthorization for five years starting in FY14 • No action yet on this either • The existing provisions related to I&R in the current law are maintained in all three bills. Ongoing work to get the AIRS standards recognized in law

8. Prospects for the OAA? • Appear not good as of today • No one wants to make next move • Everyone is passive • Buzz has to be generated from grassroots • AARP did lobby day with more than 250 visits and had OAA on agenda

9. Affordable Care Act • Now in its 5th year • Controversial from the start. Will continue to be a defining issue in November • Future of big ticket items such as individual mandate remain unclear • Medicaid expansion key state by state issue • AIRS is a “Champion for Change” of the ACA • Some AIRS interests include navigators program, care transitions and Part D issues • Navigators program: a lot of bang for a little benefit? • Millions spent on the program, but unclear how much it has helped consumers enroll • Still will be a window of opportunity for I&R network

10. Affordable Care Act • Care transitions (lowering hospital readmissions) • Aging network heavily involved • Renewal of grants under way but programs have had issues meeting metrics • A strong feature of the ACA for seniors is lowering of prescription drug costs in Medicare Part D • Gradual closing of donut hole • Already achieved savings averaging $1300 per senior • Add to that new emphasis on preventive benefits • Will help to bend cost curve for health care • New and emerging issue relates to problems enrolling new Medicaid people and need for information

11. Long Term Care • Another health issue to consider when discussing ACA • America’s denial issue continues • Effort in Affordable Care Act (CLASS Act) failed • New ideas are developing • Switch emphasis from long term care to long term services and supports • Greater emphasis on home and community based care • Must address financing (public/private)

12. Elder Justice • Elder abuse is a growing problem • Estimated that 1 in 10 seniors are victims of abuse, neglect and/or exploitation • Federal response is not adequate to say the least • $25 million Elder Justice Initiative proposed in the President’s budget • $13.8 million to enhance APS, including databases and program standards • $11.2 million for research, including screening tools and foundational research • Important first step • Information is the business of what you do, and elder abuse prevention is about people being aware of the problem • World Elder Abuse Awareness Day is June 15

13. White House Conference on Aging • We continue to monitor possible 2015 White House Conference on Aging • Included in President’s budget is $3 million for WHCOA • Very appropriate to do in 2015: 50th anniversaries of Medicare, Medicaid and OAA • Look for opportunities for AIRS to get involved

14. The Five B’s of Advocacy • Remember the 5 B’s of advocacy • Be Prepared • Be Persistent • Be Persuasive • Be Personable but most of all • Be Engaged!

15. Action at Home • What can you do as a community? Key component of advocacy • Forums • Phone/email campaigns • Visit local offices • Neighborhood/community awareness • Letters to the editor • Tweeting

16. Advocacy vs. Lobbying • This is advocacy: • Telling your member of Congress how a federal grant your organization received has helped your constituents • Educating a member of Congress about the effects of a policy on your constituency • Inviting a member of Congress to visit your organization so that he/she may see firsthand how federal funding or a policy affects day-to-day operations and the difference it makes http://www.ncoa.org/public-policy-action/policy-news/are-nonprofits-allowed-to.html

17. Conclusions • We are coming up on what will likely be a brutal midterm election • Advocacy before the distraction of the midterms is more crucial than ever, especially on issues like the OAA • Take action at home and if you visit DC to take action there, let us know you’re in town! • mponder@matzblancato.com