Barbara Searles Squire is another one of these courageous women pioneers. She became a WASP in 1944 and did everything  from test-fly planes to help with combat training. Now, she’s a resident The Terraces of Los Gatos  who spends more time sailing than flying. But she’s still a pilot at heart:  ”When I get on a commercial flight, I ask if there are any female pilots. If there are, I talk to them and say, ‘You’re here because we were here.’ It’s just such a special thing.”

Yesterday, thousands of WASPs like Stella and Barbara got the recognition they deserved when they received a Congressional Gold Medal for their service. More than 200 WASPs, including Barbara, attended the ceremony. Along with the usual fanfare, the group honored the 37 women who died while serving as WASPs. I think Rep. Nancy Pelosi (D-Calif.), also the first women to serve as  leader of the House of Representatives, said it best: “Women Airforce Service Pilots, we are all your daughters; you taught us how to fly,”"Women Airforce Service Pilots, we are all your daughters; you taught us how to fly.”

There are Barbaras and Stellas living in communities across the country. You may know them as friendly grandmothers, retirement community residents or active volunteers. But whatever the case, be grateful for the role these women’s service played in protecting, and changing, our country. I know I am.

The current exception, which was included in the Temporary Extension Act of 2010 passed at the end of last month, is set to expire on March 31. If H.R. 4213 doesn’t become a law, the cap on payments for therapy outside of a hospital will be set at $1860 per year.

“We are extremely pleased that tax and jobs legislation now under consideration in Congress would extend the Medicare therapy caps exceptions process until the end of this calendar year,” said Barbara Gay, director of advocacy information here at AAHSA. “This will ensure that beneficiaries will have coverage for the full amount of therapy they need to recover from a stroke, broken hip, or other serious illness or injury.”

Barbara noted that the legislation also would extend the increased Federal Medical Assistance Percentages (FMAP) funding that states have received under the economic stimulus package passed last year. This extension through June of 2011 would help states still struggling with the effects of the recession to avoid making draconian cuts in their Medicaid programs.

Finally, the latest bill also extends unemployment insurance benefits under the COBRA program and pushes back 7 months the implementation of a 21% cut in Medicare payments for physicians. Those cuts are schedule to take effect on April 1.

The bill now heads back to the U.S. House of Representatives, which could either schedule a conference with the Senate, or simply vote on the Senate’s version of the bill.

We’ll keep you updated.

With Congress expected to move forward on a health reform bill vote in the next week, we’re hosting a congressional outreach today to encourage legislators to pass a bill that benefits seniors, persons with disability and those that offer care or assistance.

Please call (866) 281-7219 from 8:30 a.m. to 6 p.m. Eastern. Tell your legislators that now is the time for Congress to pass health care reform because it includes:

• The Medicare payment updates for nursing homes and home health providers
• Improvements in Medicaid home and community-based services
• The CLASS provisions, a national insurance trust that provides a cash benefit to help obtain services and supports.

American families cannot wait any longer for relief. We need health reform now.
We’ve also set up our Contact Congress system so that you can fax your representatives a letter urging them to pass health reform.

The stories are both heart-breaking and inspiring.  So many people write that they don’t know what they would do without their subsidized apartment.  They must survive only on Social Security and could not afford both rent and food.  Many say they would be homeless, they don’t have family who could take them in.  These retirees — almost all of them had long careers — could not live safely without these apartments.  They know it and they are grateful.

I think we should be grateful too.  Caregiving and support are woven into the fabric of who we are.  A program like HUD 202 housing helps us be the country we want to be — respectful of our elders, mindful of our responsibility to others and careful to find solutions that give people choice while also using resources wisely.

We are planning to deliver these stories to members of Congress so they can understand from the people who matter — the seniors — why funding for new affordable senior housing construction must be restored.  We believe that $2 billion can help turn the tide against the shortfall we have experienced for years.

We continue to collect stories and we need them to make this case.  You can download our story form for people to complete or submit stories online.

Carol Galante

On Feb. 22, 2010, Carol Galante, deputy assistant secretary for multifamily housing at the U.S. Department of Housing and Urban Development (HUD), spoke openly and forthrightly about HUD policy, programs, and the president’s 2011 budget at the Housing Policy Forum held during AAHSA’s Future of Aging Services Conference (FASC) in Washington, D.C.

Standing at the podium for two hours, Galante first addressed the accomplishments of the first year of the Obama administration, including the Green Retrofit Program (GRP), the Tax Credit Assistance Program (TCAP), and the full funding of the Section 8 project based assistance contract renewals as well as renewals of tenant based assistance. Section 202 properties represented nearly 50% of the projects that have been selected under the GRP. Galante pointed out that of the 2.3 million families including seniors assisted under both programs, more than 50% are seniors.

Galante then tackled the “elephant in the room” — the proposal to cut the Section 202 capital advance program. The 2011 budget proposal does not include funding for new development in 2011. Galante explained that from HUD’s perspective, significant reforms are needed in the program to better target the funding and to make the program more effective and efficient in the development process. She also stated that PRAC renewal funding will eat up the entire 202 allocation within five or six years, if nothing is done to change the way renewals are funded and if nothing is done to improve the performance of the Section 202 program.

Galante acknowledged that many of the changes can be accomplished administratively. HUD already is working on changing the 2010 NOFA to implement some of the changes it believes will reform the program including changing the points system for selection to:

• Reward experienced and competent users.
• Reward most cost effective proposals.
• Encourage mixed finance projects with leverage already identified.
• Reward projects that are further along.
• Reward projects with green and energy efficiencies in the design.
• Reward projects that serve the elderly.

AAHSA will be working with HUD to address these issues and provide stakeholder input to be certain that the modernized 202 program is in place for the funding that Congress will provide for FY2011. However, AAHSA’s and AAHSA members’ advocacy cannot stop now.

Please Contact Congress and let your legislators know how important the Section 202 development program is to your community

America’s seniors should hope so, too. The health care proposal under consideration would increase funding for the Medicare drug benefit, create more options for seniors who rely on home and community-based care and strengthen the safety net for those who require long-term services and supports. These initiatives would benefit seniors enormously.

Consider the Medicare drug benefit’s notorious “doughnut hole.” Today, once seniors have spent $2,830 on drugs, they’re forced to cover the full cost of their medicines until their out-of-pocket expenses have reached $4,550. This coverage gap can make prescription drugs prohibitively expensive for many seniors. For many, it means the choice between food and medicine. The health care proposal would shrink the doughnut hole.

The proposal contains numerous provisions to provide more resources for nursing homes to offer quality care, reduce rehospitalization rates, improve the health care work force and make sure Medicare beneficiaries can get the physical, occupational and speech therapy they need. The bill would also provide Medicare beneficiaries with access to a comprehensive health risk assessment and creation of a personalized prevention plan.

The health reform plan would create a voluntary public long-term-care insurance plan open to all Americans. This wouldn’t just benefit current seniors, it would help everyone who may one day need long-term services and supports, whether because of disability, chronic disease or old age.

Those who choose to participate in this new program – called the Community Living Assistance Services and Supports (CLASS) plan – would have insurance premiums deducted from their paychecks. After contributing to the program for five years, they’d be entitled to a cash benefit of about $75 a day if they became disabled or otherwise unable to complete basic activities of daily living, like getting dressed or driving to work. This would enable CLASS beneficiaries of all ages to live productive, financially secure lives despite their physical limitations.

Such a safety net has been needed for some time. Today, Medicaid is the only option for seniors or the disabled who require long-term services and supports but can’t afford them. Even then, they must deplete their assets in order to qualify for the program. The CLASS Act provisions would eliminate the need for pointless impoverishment.

Congress has never been closer to advancing meaningful health reforms that would dramatically improve the lives of millions of Americans. On Tuesday, March 9, 2010, AAHSA is hosting a Congressional Contact Day, which will include both phone and fax campaigns. We hope you’ll mark your calendar and join us in telling Congress to pass health care reform now!

Ted Goins with his granddaughter, Addy.

Even though I haven’t met her, I’d like to thank 2-year-old Addy. She got her grandpa (and AAHSA member) Ted Goins started on the social media journey…and now he’s leading his organization, Lutheran Services for the Aging in Salisbury, N.C.

It started because Ted’s daughter refused to send more photos of Addy and urged her dad to join Facebook. Then, he started to realize the potential making Facebook “friends” could offer his organization. Almost a year later, Ted’s helped his LSA develop a blog, a Twitter feed and a Facebook page.

If you didn’t hear him speak at our conference last week, check out this blog post. Reading it will help you learn a little more about Ted and Addie, as well as the need for making social media a part of our work in aging services. Enjoy!

“The American people want to know if it’s still possible for Washington to look out for their interests and their future,” the president said. “They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership. I do not know how this plays politically, but I know it’s right.”

At AAHSA, we think the president is correct. Helping people should take priority over politics. There are still seniors who choose between food and medicine because of the Medicare doughnut hole problem. Medicaid is still inadequate and unsustainable, and is biased toward institutional care and rations home and community-based services. The services AAHSA members provide are still under-reimbursed.

We’ve been pushing hard for meaningful reform, encouraging members to participate in call-in days, letter campaigns and various other advocacy efforts.

While there has been a lot of rhetoric surrounding the reform and aging services, much of it has been misleading and just plain wrong. AAHSA members and the people they serve stand to gain a lot from health reform:

• The CLASS Act.
• Medicaid Home and Community-Based Improvements.
• Medicare Payment Updates.
• Improvements to the Medicare “Doughnut Hole.”
• Transition pilot programs.

All of these provisions are essential to ensure appropriate resources for care and services today and for the future. Right now, Congress is working on the exact details of the final bill. We hope you’ll Contact Congress during this crucial time and explain that health reform is vital for seniors and providers of aging services.

Recently, Coldwell Banker conducted a survey among their sales staff which found that  multi-generational living is a burgeoning trend in real estate.  More than 35% (37%)  of rea;tors stated they saw an increase in homebuyers looking for homes that could accommodate more than one generation of their family. Why? Realtors report that four in 10 clients cited financial reasons, while 29% said the housing change was in response to care needs. Just six percent cited a “strong family bond.”

These statistics don’t surprise me. I know many a person who grew up with a grandparent in the home because the older loved one needed help getting around or the parents needed help making mortgage payments. But what I’m wondering is how this trend affects people’s personal dynamics and our country’s political dynamics. As more baby boomers age, will they soon start knocking on their children’s doors asking for help and a place to live? What will this mean for their children (and their children’s children)?

How will legislators respond as more people have multi-generational households because of health and financial needs? I can think of lots of policy decisions that could help:  Build more affordable senior housing. Provide caregivers with support through a long-term services and supports insurance trust. Have Medicare and Medicaid cover some of the costs of home modifications. But the real question is, will policy makers choose to support these policies?

In this situation, I think the real experts are the people who are living in multi-generational households. What’s the experience been like for you? And what can both the private and public sector do to improve it for everyone living in your home?

We asked if the HUD staff was willing to meet with U.S. Department of Health and Human Services (HHS) to discuss coordination of efforts. Such a meeting would not be possible, we were told. Why? Because HHS was “in another building.”

Fast forward to today. The costs of health care, the need for new jobs, and the pent-up demand for affordable senior housing have the attention of the administration and Congress.

HUD Secretary Shaun Donovan has stated he wants to overhaul HUD senior housing programs to improve program coordination, cut red tape and improve access for elders.

HHS Secretary Kathleen Sebelius sees senior housing communities as venues to help people stay healthier and happier longer while avoiding high-level institutional placement. Congress is holding hearings about funding senior housing programs.

So, where are we now? Here’s the situation and what AAHSA and our members need to do about it.

What AAHSA is doing:

1. The HUD secretary proposed in his budget to Congress a full funding to renew rent subsidies, but no new funding for capital for 2011. Good news, bad news. The rationale is that the current people being served need help with rent, and the secretary needs a year to work on his senior housing reform plan. Naturally, AAHSA is sympathetic to the need for reform and appreciates the rent subsidies. Yet, the need for new construction is dire to meet the growing need for housing.
2. There are congressional leaders who want to appropriate new construction funds. AAHSA is proposing $2 billion and is advocating strongly for it. We are optimistic that there will be new construction money made available in the FY2011 federal budget.
3. Both the HUD and HHS secretaries are interested in the potential that large scale “housing with services” models have for helping seniors stay home at reduced health care costs. So, AAHSA has a blue ribbon task force composed of members, government leaders from HUD and HHS, and foundation leaders to plan and initiate a multi-state, large scale pilot program to evaluate the efficacy of service-enriched housing for seniors. We are very encouraged to date about the interest of all parties. We will keep you posted about our progress.

Here’s what AAHSA members can do:

1. Write Congress today about the restoration of the HUD 202 funding for 2011. (Many of our Hill visits focused on key members of Congress or the committees that appropriate funds.) Also, tell your legislators that health reform must include CLASS and Medicaid modifications for home and community-based services.
2. Send us your stories of the impact of your housing program on the lives of seniors and their loved ones. Make it real and personal. Especially tell us about the plight of those long waiting lists.
3. Invite your local and regional HUD and HHS officials to your organization and show them how the coordination of their efforts can make it easier for you to serve. Tell them how your programs have a positive impact on the cost of health care and the economy of your local community — and on the enriched lives of your residents.
4. In your strategic planning, no matter what services you offer today, spend time and thought on your “housing with services” model for the future. This will be the dominant institutionally based model of the future.

“Housing with services” will become the dominant model of the future because it makes sense. People want to stay in a place they call home as the age.

Living together in congregate settings has many quality-of-life, security and economic advantages for consumers on a tight budget. Senior housing generates short-term jobs during construction and long-term jobs during the life of a facility, while returning many dollars back to a community for every dollar invested.

I believe we are on the precipice of a renaissance in senior housing as it is coupled with services. We need more capital, less regulation, hard data, and personal stories to make our case to the administration and Congress. Let’s capitalize on that opportunity.

It doesn’t happen very often.