Life Happens 03-08

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Episode Transcript

Speaker 1 (00:01):
Good morning everyone, Welcome to Life Happens Radio, and hopefully
after today's show you will be prepared for what's coming
and what's happening. There's a massive amount of change that's
in the wind, and it's very windy out so it's
bringing change from Washington to Albany and all across our
country and around the world for that matter. It's very

(00:23):
hard to keep up with. And if you're like me,
I'm kind of a news junkie. I try to follow
the news, follow the headlines, but it's dizzying. You just
don't know what to grab onto. What is truth, what
is accurate information? Where do you get the truth about
what's going on around us, what change is happening, and
what the change will mean to you. And let's face it,

(00:45):
change that affects other people is an academic exercise. But
change that affects you, the service is available to you,
what your government does for you is something that you
need to pay attention to. And one of the areas
that going to be changing potentially and is now being
debated in Washington and it's coming to the surface, is

(01:07):
the idea of all of our social service programs that
have been supporting us since nineteen thirty four, for Social
Security since nineteen sixty five, for Medicare and medicaid. Institutions
in our society that provide things that you may not
even think about, and provide services to you that you
may not even think about. How are they going to

(01:30):
be impacted by the budget cuts that are proposed and
in fact passed in the House of Representatives in Washington.
What does it mean to you, your family, your loved ones,
yourself as you age? And today's topic is going to
be focused on aging services. Now, healthcare is a whole

(01:51):
broader realm which covers aging but also covers everyone, and
we'll talk a little bit about that, but we're going
to try to focus our energy and our attention because
we have a guest with us today, the director of
the New York State Office for the Aging Greg Olsen.

Speaker 2 (02:06):
Good morning Greg, Good morning Loo. Thanks for having me.
It's always good to see you.

Speaker 1 (02:09):
It's always great to have you on the show because
you are a wealth of information, and you are in
a seat where you are not only seeing what's going
on out there and down in Washington, but you're seeing
how it's impacting the state, the counties, the households that
you serve through the New York State Office for the Aging.
Just give our listeners a little bit about the agency first,

(02:32):
what your scope and reaches, and then we'll dig into
some of these issues with regard to the budgets.

Speaker 2 (02:37):
Yeah, and I appreciate the opening question because a lot
of people receive services but they don't know how it works.
So the structure in New York State is there's a
state unit on aging. That's my office, New York State
Office for Aging. We work with fifty nine county Offices
for the Aging, so there's one in every county. They
then also not only provide direct services to hold their
adults in their families, but they contract with one thousand,

(02:59):
two huns and fourteen not for profit community based organizations.
What are the types of services I'm talking about. We
run the largest nutrition program in the country. We're doing
about twenty two million meals a year this is National
Nutrition Month, to about three hundred thousand people. So we're
talking about if you are receiving a home delivered meal,
if you're going to a congregate site or a senior

(03:21):
center to get meals, if you have somebody coming into
your house to help you bathe dress shop, cook clean nutrition, counseling, transportation,
legal services. All of those things that older adults are
receiving come from funding not only at the federal level,
but the state level. And that's really what's at risk

(03:42):
at the federal level, not the state. Yeah, and I'm
going to give you a perspective of the average client
who comes into our office and maybe in a certain
stage of life where they're working hard, they're paying tax
they have a young family, they're growing, everybody's healthy, and
they're saying, Wow, why should I be paid all this
in taxes? And then they find out that their parent

(04:04):
just got diagnosed with Alzheimer's and that they have to
take care of that parent. And they're saying, well, where
are all the services that I'm entitled to because I've
paid these taxes?

Speaker 1 (04:13):
Where is medicare? Where is Medicaid? Where are the meals
on wheels that my mom needs to stay.

Speaker 3 (04:18):
In her home?

Speaker 1 (04:19):
And there's a complete transformation once you need those services.
But we have as a society to look beyond our
own self interest and look at what's for the common good.
And that's kind of where this discussion falls apart.

Speaker 2 (04:31):
Well, no question and you know, the things that we
provide are really preventive in nature. You talked about medicaid.
Medicaid is not the first line of defense. You can
remain in your home and community with a package of
services that we provide that also support the family that's
providing services to their loved one for very very small
amounts of money for a very very long time. And

(04:51):
I think that there's a myth, Lou, and we've talked
about this before. You know, we live in a society
that has a idea of what an older person is
and the right vision. Seventy five percent of older adults
consider themselves healthy, very healthy, active, engaged, they're still working,
they're paying forty percent of state and local taxes seventy
two billion dollars, have a million volunteers holding up the

(05:13):
not for profit sector.

Speaker 3 (05:15):
So you're absolutely right.

Speaker 2 (05:16):
You don't need to know what you need to know
until you need it, which is kind of your point exactly.

Speaker 3 (05:22):
But there's a bigger picture here. These are folks that
have worked or have raised.

Speaker 2 (05:26):
Families, and they don't always need a lot of support,
but a little bit will make a tremendous difference in
terms of hospital utilization, Medicaid spend down nursing home placement
and so on.

Speaker 1 (05:37):
And let's go right to that, because if your emergency
room is flooded with seniors who aren't getting their meals,
aren't getting nutrition, aren't getting medications, and all of a
sudden they have to dial nine to one to one
and the ambulance is picking them up and they're all
sitting in the er and gurney's and we've seen this
absolutely locally. Ambulance is not even being able to discharge
patients into the er to sit in the parking lot

(05:58):
for four or five six hours before they can just
you know, unload a patient.

Speaker 3 (06:03):
And that's because.

Speaker 1 (06:04):
They're not getting the treatment that they need out in
the community, in the home. And so the money that
goes to, as you said, pay pennies to keep that
person healthy as opposed to dollars to treat them in
the emergency room, it gets lost, and the prioritization of
those needs gets lost.

Speaker 2 (06:22):
Absolutely, we talk about this all the time. You know,
the problem is not getting older, it's how we've organized
our caring economy. Three percent of all funds are spent
in the community, ninety seven percent are spent being reactive,
waiting for somebody to get sick and showing up in
the most expensive places when we could be doing more.
And that's what's kind of been changing over the last
what five six years. That is really at risk at

(06:45):
the federal level now with Medicaid cuts, that's going to
impact Medicare. We heard Social Security is apparently the biggest
ponzi scheme ever.

Speaker 3 (06:53):
That is absolutely ridiculous.

Speaker 1 (06:55):
It is, and anytime they want to cut a program,
they demonize it. They find, oh, there's somebody at three
hundred and sixty years old getting a Social Security check
and then you fact check.

Speaker 2 (07:06):
Yeah, so let's take that, right, that's exactly right. We
heard that in the State of the Union. So what
people may not know is even though we're celebrating the
ninetieth anniversary Soul Security from nineteen thirty five, the first
payment went out in nineteen fifty one, So you can't
have somebody two hundred years old who's receiving benefits. And oh,
by the way, funeral homes are required by law when

(07:28):
somebody dies to fill out a form to submit to
sol Security to.

Speaker 3 (07:32):
Stop those payments. Right, And.

Speaker 1 (07:36):
We can talk about statistics, and we can talk about facts.
But when you have fraud, alleged fraud, and let's face it,
sometimes things get unreported. But it's a fraction of one percent.

Speaker 2 (07:50):
Yeah, it's just a cover fraud, waste and abuse. Right,
that's the cover for let's make deep cuts. So what
are we talking about. You mentioned medicaid. That's going to
impact our hospitals, that's going to impact our home care, hospice,
palliative care. We got nine million people in New York State, children, families,
older adults that are receiving medicaid. Thirty percent of Medicare
recipients also receive medicaid. You know, there's a proposal to

(08:13):
cut soil security staff by fifty percent.

Speaker 3 (08:16):
There's already a four hour wait just.

Speaker 2 (08:18):
To get to talk to somebody, which means benefits are
going to be delayed.

Speaker 3 (08:23):
That's really just the beginning.

Speaker 2 (08:24):
You've got SNAP, a supplemental nutrition assistance program. The average
benefit for an older adult is twenty two hundred dollars
a year. And you mentioned earlier food is medicine, so
you know the impacts are going to be really heartfelt,
regardless of age for families. So you've been dealing with
this at the state level, and you represent all the

(08:47):
counties in New York State. You've been dealing it within
also on the federal level. Just talk a little bit
about the work that you yourself are doing with regard to
your other counterparts, because all fifty states have some aging
service like yourself. Yeah, every state has a state unit
and aging like ours and contract out with counties. And

(09:07):
you know, in my past life, lou I was a
community organizer. So my philosophy is, you don't wait for
something to happen and then try to scramble to figure
out what you're going to do.

Speaker 3 (09:18):
You have to be proactive.

Speaker 2 (09:20):
So I spent a couple of days crunching numbers on
our federal dollars, what programs and services they fund, who
they fund them to, and did an analysis, a state
wide analysis, a county by county analysis, and a congressional
district analysis.

Speaker 3 (09:34):
So this is data, this is data, These are facts. Yep.

Speaker 2 (09:37):
I can tell you how much money we spend for
a home deliver meal client for a year, how many
people if we lose federal funding will no longer receive that,
And so last Tuesday we could go Tuesday.

Speaker 3 (09:49):
So almost two weeks ago, I.

Speaker 2 (09:51):
Trained my counterparts across the country on how to do
our analysis. And the message is really simple and it's
simple for your listeners as well. Just reach out to
your Congress people and ask them to hold the Older
Americans Act harmless.

Speaker 3 (10:05):
Let's break that down.

Speaker 1 (10:06):
There are two things you just said that yep, how
many Congress people actually know what that is? And what
is the Older Americans Act.

Speaker 2 (10:13):
Most people don't know what any of this is, which
is why we wanted to be proactive. They know what
the service is, but they don't know where it comes from.
So to your question, how many people know about this,
whether it's Congress, even the legislature in general public, they don't,
which is why I appreciate you having me on today.
The Older Americans Act was passed in nineteen sixty five,
alongside Medicare and Medicaid to be the community based solution

(10:36):
to prevent hospitalizations, ED visits, nursing home placement. But on
the flip side, if you're in one of those settings
and you're going to be discharged back into the community,
you're not going to succeed unless you have those services.

Speaker 1 (10:49):
Unless you've been living in a cave. You know that
our population is aging, You know that people are into
their eighties, nineties, one hundreds. I talk about my aunt
who's one hundred and two. She's still doing extremely well.
For one hundred and two. People do live into their hundreds, folks.
It does happen. It's happening more and more. Willard Scott
used to be the weatherman who used to point people out,

(11:11):
Oh she's celebrating her hundreds. Now it's thousands of people.
So he couldn't do that in a month of Sundays.
So as our population ages the needs of that population.
We've known this for you and I have been doing
this for thirty plus years. We've seen it, we've looked forward,
but nobody would take it seriously.

Speaker 3 (11:30):
Now we have to, Well you do have to.

Speaker 2 (11:32):
And I think one of the flaws structurally is if
you're eligible for Medicare and Medicaid, you get the benefit.
If you're eligible for older American ZACH services, you don't.
Because we're on the discretionary side of the ledger. And
literally what that means is we have a fixed budget
and we stretch that as far as we can. There
is no fraud, waste, or abuse anywhere on our network.

(11:55):
I can tell listeners again, how many people we serve.
How much it costs to serve some for a year,
what the unit costs for a meal, is on and
on and on to the penny, to the penny, and again, Lou,
you've been interacting with our network, like you said, for
over thirty years.

Speaker 3 (12:11):
They stretch their dollars as far as they can.

Speaker 2 (12:13):
And what's great about our network it's the ultimate public
private partnership. It's federal funding, it's state funding, it's county funding.
And what people don't know is through contributions of the clients,
our older adults that are actually receiving services, they generate
another eighteen million dollars, which goes right back in to
the pot to serve people who can't afford, not to

(12:34):
mention all the volunteers million volunteers who are providing five
hundred million hours of service at a value of thirteen
point eight billion dollars. So the cost of prevention is
really what we're talking about, and that's at risk right now.
We're gonna come back after a short break with Greg Olsen,
the director of the New York State Office for Aging.

(12:55):
I'm Lupiro, your host for this morning from Pier O'Connor
and Straus, and we're gonna be talking about the older Americans,
the services that we rely on as individuals, as families,
and as a society.

Speaker 3 (13:06):
Because society goals are great.

Speaker 1 (13:08):
But what happens to you? What happens to mom and
dad when those services get cut. We're gonna come right
back after this short break. You're listening to Life Happens
Radio on Talk Radio WGY. Before we jump back in
with Greg Olsen, director of the State Office for Aging.
I want to give our listeners an opportunity to learn
a little bit more about how to plan for all
of this. It's your home or the nursing home. How

(13:30):
do you plan now for those eventual days when you
will need some assistance when you want to stay in
your own home? A state and care planning for successful aging.
It's this Tuesday, March twelfth, from one to two pm
at the Colony Town Library. I'll be speaking along with
Diane mikkelg Gottabiewski, who is with ever Home Care Advisors,

(13:50):
talking about how to prepare yourself for care needs in
the future.

Speaker 3 (13:54):
Is your home.

Speaker 1 (13:55):
Adaptable to care? Is your family aware of what those
needs be? Are you aware of a plan and a
financing plan to pay for care. Come join us Tuesday
March twelfth, one pm the Colony Town Library And as always,
you can sign up by calling our office at five
one eight four five nine twenty one hundred and four

(14:16):
five nine twenty one hundred or just go to perro
Law dot com. It's p I E r r O
Law dot com. We'd love to see you at the
Colonytown Library Tuesday March twelfth at one pm. So, Greg,
back to this, and you've been educating people around the
country because of your work and your passion, and you

(14:38):
are a trained social worker. I am just to disclose that.
And then he's risen to the director of the New
York State Office for Aging, so he knows what this
looks like at the street level and taking it from
the street to the White House is kind of a
big path. So how do you get this knowledge, this information,
all the things that you have collected in terms of

(14:58):
information and data to the right people.

Speaker 2 (15:02):
Yeah, and you're right, I mean this country, the state,
this community, it's all about the grassroots. If people aren't
educated on whether it be this or anything else. Again,
you don't know what you don't know. And so we
have a lot of partners, folks like yourself. We work
with Becky Prevy and the Association on Aging. We've had

(15:22):
Becky on the show.

Speaker 1 (15:23):
She's done Medicaid Mondays for us, talking about all the
services at the Office for Aging provides county by county.

Speaker 2 (15:30):
YEP, we engage all fifty nine offices for the aging.
We have mailing lists for our community based providers' work
very closely with Steve Aquario and the New York State
Association of Counties. We have a really large social media
presence public presentation, so this isn't something where you just
crunch numbers and shoot it out. You got to be

(15:51):
on people to let them know what the message is
and really what's at stake.

Speaker 1 (15:54):
Yeah, and I saw Steve on the news Thursday. He's
down in Washington with his counterparts from all around the
country of the Association Agent on Counties. And if the
government doesn't fund these programs, it fell to the counties.
And in New York State they have a huge county
share of Medicaid. That has been an issue for a
long time. And where does that county share come from?

(16:17):
Property taxes? Right and sales taxes? Those are the two.
So these are regressive taxes. Folks, when your property tax
bill goes up, it's because the federal government is cutting
funding for the programs that the counties are obliged. These
are mandatory programs, unfunded mandates that the county then has
to balance their budget with.

Speaker 2 (16:37):
Right, and the hardest if we're going from top down
or bottom up to raise revenue is at the municipal level,
then the county level, then the state.

Speaker 3 (16:47):
The easiest is at the federal level.

Speaker 2 (16:49):
So you're absolutely right when you start to have an
impact in federal funding, whether it be block ranning reducing,
you know, any particular program, you can pick it, whether
it's farm subsidies and agriculture or the things that we're
talking about today, the counties in the state are not
going to be able to make that whole They're just
not And so you know, again, I don't want to

(17:12):
sit back and just hope right and then have to
deal with the aftermath. We have to be proactive on
these things, whether they impact me directly or they impact
the people that I care about.

Speaker 1 (17:24):
So let's kind of take it programmed by program And
I served on a number of boards over my career.
One was the Albany Senior Service Board, and we did
meals on wheels in Albany County, ran the kitchen for
very little money, if any money, and I believe back
then the cost per meal was about two dollars and

(17:44):
twenty cents per meal to put a meal out into
someone's home two dollars and twenty cents and that's all
the money we had. What does it cost to serve
someone who is homebound who can't get out and needs nutrition.

Speaker 3 (18:00):
So to feed.

Speaker 2 (18:01):
Somebody for an entire year with a home delivered meal
costs US less than two thousand dollars. So you talked
about Albany County. Life Path does a tremendous job in
partnership with.

Speaker 3 (18:13):
Albany County Office for the Aging.

Speaker 2 (18:15):
If we lose federal funding in Albany County, if you're
listening in Albany County, we will be able to provide
seventy two thousand less meals that will impact almost one
thousand people in Montgomery County, fourteen nine hundred less meals
in Saratoga County, almost one hundred thousand less meals.

Speaker 3 (18:35):
So that is what we're talking about is at stake.

Speaker 2 (18:38):
Now here's the other thing because you know, I'm so
glad you open the segment with why it's so important
a plan for your future. We do not do that
as a society, and it's a huge mistake because you
get caught in a crisis and you're flat footed. For
the clients that we serve that have a family, friend,
or neighbor that's helping them, we call them caregivers.

Speaker 3 (18:58):
Right, forty five percent of them are working.

Speaker 2 (19:01):
And so what we saw at the end of the
pandemic was a lot of people did not re enter
the workforce because they were caring for somebody at home
for a couple of years. What happens when these types
of things go away, You don't have somebody to come
in and help you bathe and dress and eat and
go to the bathroom. Either somebody's going to leave their
job or they're going to wind up going into another setting.

(19:21):
Is that other setting going to be there if you
have nine hundred billion dollars worth of Medicaid cuts.

Speaker 3 (19:26):
And let's talk about what those other settings are. Nursing home, which.

Speaker 1 (19:30):
Is the highest seventy thousand a year, that's the Medicaid rate, yep,
not the private pay The private pay rate is closer
to two hundred thousand a year. So do you have
two hundred thousand dollars a year that you're ready to
write checks for? You know, sixteen seventeen thousand dollars a
month checks? And I can tell you that we sit

(19:51):
with clients and they're writing the deposit check, which is
two months thirty four thousand dollars. How long do I
have to do this for the next five years? What
am I going to You're going to spend a million dollars?
Who has that on that care? How many of us
and you know the numbers on this, how many people
have that kind of a cash reserve that they can
afford that care?

Speaker 2 (20:13):
So that type of care, so that's what we call
personal care level too, cost us less than ten thousand
dollars a year to keep somebody in their home in community.

Speaker 3 (20:20):
As opposed to one hundred and seventy thousand. That is correct.

Speaker 2 (20:22):
Now, our average client is an eighty three year old
low income female lives alone, has four to ten chronic
conditions and multiple needs like I said, bathing, dressing, shopping,
et cetera. Because of the package of services and our
connections with other services, people don't just live at the
State Office for Aging. They touch every other system. We

(20:43):
can keep them home for five to seven years where
they want to be. Their economic impact is still benefiting
the economy.

Speaker 3 (20:50):
Just like you said, we're a home rule state.

Speaker 2 (20:53):
We pay for medicaid, schools, local taxes, and local businesses.
Here in New York State. A lot of that activity
comes from older adults. And it's amazing how many people
don't have this knowledge until it hits home. Absolutely until
oh my goodness, I have to go to mom's doctor's appointment.

(21:13):
I have to now get go get her prescriptions filled.
I have to take her to the doctors.

Speaker 1 (21:19):
And you know, Dad's now failing too, and now we
have to deal with his health issues. It comes like
a lightning bolt and all of a sudden, you have
to deal with all these crisis situations. So for you know,
ten thousand dollars a year, getting a bundle of services
that are available, combinations of funded and volunteer services. And

(21:42):
we work with some amazing volunteer groups. And I'm sure
you do too. You mentioned I don't know how many
organizations the State Office for Aging networks well of thousands.

Speaker 3 (21:50):
So what kinds of things do they do?

Speaker 2 (21:52):
And what do you see around the state. Well, volunteers
are critical. We would not have the infrastructure, not only
in New York but elsewhere. So they're doing everything from
direct service to indirect meal preparation, transportation, delivering home delivered meals.
They are the ones that are in nursing homes with
our long term care and Budsman program being the eyes
and ears and advocates for the residents. Our health insurance

(22:15):
Counseling and Assistance program which puts hundreds of millions of
dollars back into the pockets of older adults every year
by helping them access benefits, are in time, a high
cap the high Cap program.

Speaker 3 (22:26):
Right, these are all the things.

Speaker 2 (22:28):
If any of your listeners or their families recognize any
of these things we're talking about, that is what we're
trying to protect right now.

Speaker 1 (22:35):
And does that all come back to the Older Americans
Act funding, the.

Speaker 2 (22:38):
Federal funding funds those things. We are very fortunate in
New York State under this governor and past governors that
we have a sizable amount of state funding that goes
in and then as you were talking about with Medicaid,
there's a county match for federal and state funding. For
these programs, and then the contributions we get from the
people themselves because they value and want to say thank you.

Speaker 1 (23:00):
So we're going to talk about the state budget when
we come back, because that's bubbling right now as we
speak here in Albany, and a lot of issues that
we're dealing with and addressing. And we have a Medicaid
Monday coming up Monday, March tenth, where we're going to
talk about the Consumer Directed Personal Assistance Program. Valerie Bogart

(23:20):
is going to be our guest speaker for that, and
that's a Medicaid program that the governor has done a
tremendous shift on, going from six hundred local agencies to
one statewide agency. So we're going to cover the changes
and the re enrollments and all the rules for that
cd PAP. But beyond Medicaid, Medicaid is an impoverishment program.

(23:40):
You have to get poor or look poor in order
to qualify. We talk about that on this show all
the time. It's part of what we do as attorneys
and planning for our clients. But what Greg's going to
bring you in the second half of the show is
what New York State is providing, what the budget has
just put in place for New Yorkers and what's going
to be available to you here and the flip side

(24:01):
of the coin. It's kind of like a yin and yang.
We have New York with a nice budget, almost a
surplus based upon tax collections, and the federal government looking
to cut. So come back, stay with us, Greg Olsen,
Lupiro here in studio.

Speaker 3 (24:15):
We'll be back right after the news.

Speaker 1 (24:17):
We have some confusing dates and I'm going to sort
out for you in.

Speaker 3 (24:21):
Just a minute.

Speaker 1 (24:22):
March twelfth, I was reading off of one flyer and
March twelfth. We're actually at the college or at the
Chatham Library on March twelfth at ten am, and I'll
give you the date for the Colony Town Library in
just a moment. But I want to come back with
Greg Olsen and really dig into what happened in New
York and what the budget. Usually we're talking about the

(24:43):
state budget this time of year, Greg, but the federal
issues have just overshadowed that somewhat. But talk to us
about what's going on in the state, the state budget,
the revenues that they have found and how that's impacting
your agency and medicaid and the other things at the
state fund.

Speaker 2 (25:00):
Well, I'll start out by saying, for us, this is
the best budget year since I've been around, and I've
been doing this for thirty three years, so I really
have to thank Governor Hokel and her team Blake Washington
Division of the Budget. So according to Blake, we do
have a surplus due to additional tax revenues. There's been
an effort to really build the Rainy Day Fund and

(25:23):
that's hopefully to stave off anything bad that's happening. But
as I had mentioned to you earlier, you know, we
look at the budget not only from our perspective at
the State Office for Aging, but all the other policies
that are proposed within the Governor's executive budget. They're going
to have a positive impact on older adults, you know,
And it's almost like you're living in a different universe

(25:46):
with what's happening at the state and what's happening at.

Speaker 3 (25:48):
The federal level.

Speaker 2 (25:49):
So we have a historic forty five million dollar investment
in our agency to address people who are eligible for
services right now that can't receive them. In addition, will
get another five million dollars and what's called Kola's cost
a living adjustment to deal with some inflation. They've maintained
funding from last year, which is great news for the

(26:09):
long term care on Budsman program. And what that's allowing
us to do, because volunteerism is changing, is to actually
hire people to do that job we were born kind
of on, you know, partially paid staff but mostly volunteers.
That's not a model anymore that works. It's sixty you know,
we're sixty years beyond that.

Speaker 3 (26:27):
You know, you need bodies.

Speaker 1 (26:28):
COVID taught us how serious that position is because no
one could get into nursing homes right and so, and
we don't have to dissect all of the issues that
arose during COVID in the nursing home field, in the
state and in the country. But the Onmbudsmen program is
there to protect people who don't maybe have family members

(26:48):
who can show up every day and check on them
and make sure that they're well cared for, or even
if they do, if things go awry, it's someone that
they can contact and just talk a little bit more
about that. Because it is such an important position and
you've you and Becky have been stumping to get this
fundage for a very long time. And now it sounds
like it's starting to take shape.

Speaker 2 (27:07):
It is, and there's been a lot of Uh, there's
been a lot of support from a lot of organizations
to do that. Recognizing that that volunteers change. It's pretty intense.
You have to go through a four day training and
most of the volunteers are are older adults.

Speaker 3 (27:21):
It's just the face of volunteering is changing. That's really
the deal.

Speaker 2 (27:26):
But as we know across the state and across the country,
within healthcare and long term care, the number one issue
is the workforce shortage, Yes, and so that has an
impact on.

Speaker 3 (27:36):
Quality of care.

Speaker 2 (27:37):
And so what our folks do, both paid and volunteer
visit facilities, you know, talk with residents, resident councils, their families,
and they're identifying quality of care issues that number one
they could resolve with the administration of that facility, which
which is the ideal or those that are really affecting
health and safety. Then they go to the health department

(27:57):
for an inspection.

Speaker 1 (27:58):
Yeah, and I'll give you a little behind the scenes
from from an advocates perspective. When I started doing this
forty years ago, really seriously, thirty years ago, the nursing
home industry was largely not for profit, and we dealt
with a group called NIYASA, the New York Association of
Homes and Services for the Aging, which is now leading age.

(28:20):
But over time the reimbursements to those not for profit
nursing homes didn't keep pace with their standards of care,
and so many of them have now sold to for
profit nursing homeowners, which are large national conglomerates that are
not looking out necessarily as a not for profit would,

(28:41):
which has a mission. Their mission is to make profit.

Speaker 3 (28:44):
Right.

Speaker 2 (28:44):
When you're an investor, that's your goal, right. We're seeing
the same thing nationally in agriculture, small farms that are
going bankrupt being bought by big agriculture.

Speaker 1 (28:53):
Private equity comes in. We need a twenty percent margin
and you don't even.

Speaker 3 (28:57):
Know who they. Some of these folks are rail.

Speaker 1 (29:00):
When you're a family member of a nursing home patient
and you don't have any access to ownership, this role
becomes even more important.

Speaker 2 (29:09):
It does, and anybody who's listening that is interesting in
becoming a volunteer to be the eyes and ears, especially
if you have a personal experience of a loved one
in a nursing home as sisted living family type home,
et cetera.

Speaker 3 (29:23):
We always could use volunteers.

Speaker 1 (29:25):
Yeah, So the onmbudsman program, YEP couldn't couldn't support it
more so necessary. It's been kind of a I don't
want to call it a lame duck, but it's been
a very difficult program because of all the pressure on
that position. And now you've got some funding and some
some training and some staff.

Speaker 2 (29:40):
Yeah, and a shout out to Claude dett Royal who's
our long term care state on Budsman and her staff.
They do a tremendous job, as well as the fifteen
organizations regionally that we partner with. But what's so interesting, like,
you know, at the state level, we're looking at, you know,
middle class tax cuts and they literally are middle class.
Where what's happened at the federal level is to try

(30:02):
to cut two trillion dollars to give four point five
trillion dollars primarily to the wealthiest earners. They want to
raise the debt by four trillion over the next two years.
Three trillion added to the deficit. So when we talk
about who's in charge right now, they're always about small government,
no deficits, et cetera. But that's not what they're doing.

(30:22):
So here in New York State, we've got inflation rebate proposal,
middle class tax cuts, expansion of the child tax credit.

Speaker 3 (30:29):
And free school meals.

Speaker 2 (30:30):
Why would I raise that in the context of older
people because we have hundreds of thousands of grandparents who
are the primary caregivers of their grandkids due to a
lot of things incarceration, fentanyl, et cetera. They are eligible
for those credits and the free lunch if they are
putting their grandkids on their taxes because they are the

(30:51):
primary caregivers. So there's lots of things like that within
this budget that the governor has proposed that are going
to be so beneficial to older people.

Speaker 1 (30:59):
Yeah, and I know that Medicaid is not your field.
You're the pre Medicaid services, correct, So this isn't impoverishment.
This isn't for people who have spent down or don't
have any money. It's for people that could have resources
and still access the services we're talking about.

Speaker 2 (31:16):
It, there's no question about that, lou And for our
core services, things like home delivered meals, Personal Care Level
one and two, Social Model Adult Day, they on paper
and due to their medical conditions, right now are eligible
for Medicaid, and we keep them off Medicaid for years.
And so if these funds go away, what we would

(31:36):
wind up doing is helping individuals who didn't need to
be on Medicaid apply and receive Medicaid, furthering the cost.

Speaker 3 (31:46):
And the state. YEP.

Speaker 1 (31:46):
And I got a text message from my partner, Peter Strauss, So, Peter,
how are you? Peter's out there listening and he said,
I can't. I haven't opened up the phone lines because
you have too much content. I don't want to get sidetracked.
I want to get everything out that you brought with
you today. But Peter asks about New York State's taxation
of high net high income earners. And I know the
governor has talked about taxing the highest income earners and

(32:11):
having a cert tax that would fund some of these
cuts that may be coming from the federal government. Is
there anything like that going on in the budget negotiations?

Speaker 2 (32:18):
You know, I can't speak to that. I know that
the legislature, certain members of the legislature for years have
talked about that. It's going to be around for a while,
because you know, I think the idea is, are people
really paying their fair share. You know, let's look at
sol security, right, there's an earnings cap. There's a cap
on how much taxes are paid, how much you earn

(32:41):
for tax.

Speaker 3 (32:42):
One of the easiest.

Speaker 2 (32:43):
Ways to shore up solid security is to raise that cap.
So millionaires are not just paying tax on the first
one hundred and fifty thousand dollars of their income.

Speaker 3 (32:52):
Right.

Speaker 2 (32:52):
So there's things like that, But I can't really speak
to tax policy. Yeah, we don't want to get political
with this, although it is.

Speaker 1 (33:00):
We're going to talk about the programs and the services
and how those programs and services are currently funded in
the New York state funding and budget. So let's go
back to New York and just talk a little bit
about the dynamic of money coming in. I know your
agency had funding that was sitting on the sidelines for
a while and came through, and other money that has

(33:22):
come through to fund programs. What does the budget look
like right now in terms of the overall impact on
your agency and the Department Health and Other Service state budget?

Speaker 2 (33:32):
Yes, very good for us. As I mentioned, historic investment
in our agency.

Speaker 1 (33:36):
Now, when you say investment in your agency, I know
there are projects that you work on and we can
talk a little bit about those in just a moment
because your innovation and we share this passion to innovate
this industry, to bring technology in, to bring services in
in a way that isn't available to people right now,
and that's a big part of what we're working on
as you are. And the twenty nine projects that you

(33:59):
have out there, anything from animatronic pets to you know,
talking devices that learn through AI how to speak to
someone in their own home.

Speaker 3 (34:10):
Talk a little bit about that and how that now
is bolstered a little bit.

Speaker 2 (34:15):
Yes, I appreciate that, as lou had said, and I
know you've been very involved also in some tech projects.

Speaker 3 (34:21):
We know they work.

Speaker 2 (34:22):
We're the only state in the country, especially state Office
for Aging, doing anything remotely close. So we have twenty
nine public private partnerships with tech companies. We're serving a
million more people for pennies on the dollar. So we
have three free things for anybody in New York State.
So one is called get set Up and you can
go to aging dot NY dot gov. This is a

(34:44):
platform that for people fifty and over. All the classes
and courses are taught by fifty and old or four
fifty and over They will first teach you how to
use in depth any of.

Speaker 3 (34:55):
The tools you use like a smartphone, a tablet, a PC.

Speaker 2 (34:59):
Then you have an at access to over five thousand
courses in classes, lifelong learning, exercise and so on. And
it's a way to combat social isolation and loneliness, which
is a public health epidemic that costs US fifty cents
per person per year. We have seven hundred thousand users
now just hit our millionth class. The other two are

(35:21):
for caregivers, individuals who are providing uncompensated care to somebody
else regardless of age. One is called arch Angels and
they created the Caregiver Intensity Index as well as Trualta.
That's our caregiver platform. You can find that all on
our website.

Speaker 3 (35:34):
But we have.

Speaker 2 (35:35):
Projects that are serving people with Alzheimer's and their caregivers.
We have a strength project where if you're building muscle
mass right, you're reducing the.

Speaker 3 (35:44):
Risk and the fear of falls.

Speaker 2 (35:46):
We had an individual who wasn't able to leave her house,
went through our Vivo platform, which is strength training. She
sent me a picture and a personal note of her
skydiving at ninety five years old. Getting things work and
they don't cost a lot of money. Yeah, we are
doing a lot of things that are filling those gaps.
The animatronic pats as you talked about, l e Q

(36:07):
is the proactive AI companion for individuals who are lonely
and isolated.

Speaker 3 (36:12):
We could go on and on and on.

Speaker 1 (36:14):
So I'm going to give the right dat out for
the seminar that I cotched earlier, and that is Nursing
Home or your home or the nursing home tools to
keep you at home and how to prepare for that.
And you have a little more time, folks. So it
isn't this week. It is actually April seventeenth at the
Colony Town Library. So we'll be promoting that more as
we go forward. This Wednesday, we are at the North

(36:37):
Chatham Library and that is at ten am and Diana
and I Diane Mikkel Gottabiowski, and she is the director
of ever Home Care Advisors, And we have a company
called Viva Links that has brought technology and Trualta is
available through our app through Viva Links as is get
set up. So we've integrated those two into this platform

(36:59):
that's available to anyone. What we're looking for obviously is
an ability to bring that into the mainstream, and healthcare
has been very reticent to automate and to bring innovation in.
So that's what we're trying to do. And now you
are as well, Well, you're exactly right, lou. You know,
I think what you're doing.

Speaker 2 (37:22):
And I appreciate you integrating because some of our stuff
within your platform is not going to be complicated for
people to understand. It brings together healthcare, monitoring, technology, and
social services together. That's what we ought to be doing.
That's where the change is starting that I'm hoping does
not get derailed with some of the federal cuts. We're

(37:42):
doing exactly the same thing, but a couple things need
to happen. You've got to try it, you got to
measure it, you got to test it, and then we
can go.

Speaker 3 (37:51):
You can go.

Speaker 2 (37:51):
We can go collectively to mainstream insurance, mltcs, medicare, advantage,
the state Department of Health and other agencies to say
we did this, here's what the outcomes are. And so
we've been doing that now literally since twenty eighteen to
be able to I don't think it's risky. Somebody has
to do it. If it doesn't work, well, then you

(38:12):
learn something, but guess what, they're all working. Yeah, and
the data is incredible and we know it does work.
And for the caregivers, and you think about meals on
wheels and things. It keeps the caregiver from having to
be involved. But the technology, the Viva Links app allows
the caregiver to be involved and to stay involved and

(38:33):
to manage care in the home and to get information
and manage medications and transportation and doctor's visits and to
do it all through an app. We have caregivers three
thousand miles away who are managing their parents care in
the home using the tablet that they get installed in
the home, which is where Trulta and get set up
come through. Very easy, very simple. So those things are

(38:56):
all out there.

Speaker 1 (38:56):
April seventeenth at the Colony Town Library, we'll be talking
about that. But if you want to get more information
on it, give us a call. Diane Mikkelgttabiowski Ever Homecare Advisors.
It's everhomecare dot com, so you can look them up.
And we're gonna take a short break and when we
come back, we want to talk about what's going to
happen now at the federal level. What the advocacy is
going to be and what Greg Olsen predicts is the

(39:18):
future of the Older Americans Act and the services that
we rely on as we age. We'll be right back
after the short break.

Speaker 3 (39:26):
It took a breath. We're back.

Speaker 1 (39:28):
We're going to finish up the segment with what's happening
and what you can do about it. Because there's a
process going on in New York State and it's not
widely publicized unless you're in Albany. You know, most people
around the state don't really know the state budget process.

Speaker 3 (39:45):
And I happen to belong to.

Speaker 1 (39:47):
A couple of clubs with a whole host of lobbyists,
so I hear. I hear about the things that are
going on and the push and pull and the debates
about what programs are on the block and what's going
to be promoted and what's going to be be cut.
But right now, as you said, Greg, the state budget
is in pretty good shape.

Speaker 2 (40:05):
Yeah, and there's thanks for the question. There's really two processes.
And the one thing I guess for listeners is most
people don't know what's going on in Washington or how
things work, or again at the state level, or even
in county government because you're trying to get by, You're
trying to do things with your family, put food on
the table, work, you're not engaged in politics like we

(40:27):
are because we do this for a living.

Speaker 3 (40:29):
So it's start at the federal level.

Speaker 2 (40:31):
The process is traditionally that the fiscal year starts October first,
so that would be October first, twenty twenty four. What
Congress did was past what's called a continuing resolution that
expires this week on March fourteenth. And what a continuing
resolution does is it keeps funding government at last year's

(40:51):
level for US, that would stave off any federal cuts.
What I'm hearing now is that they are thinking of
passing a continuing resolution through the end of this state
fiscal year, which would be September thirty first, and then
all of these cuts that you were talking about, the
eight hundred and eighty billion dollars, right, they're going to
figure all that out probably starting October.

Speaker 3 (41:12):
Yew, that's a medicaid, just medicaid. That's just medicaid.

Speaker 2 (41:14):
They got to find two trillion dollars and the math
just doesn't work. So, you know, the first thing we
have to do is make sure we hold the old
Americans act harmless in this process.

Speaker 3 (41:24):
How do you do that?

Speaker 2 (41:25):
That's your congress people, that's your senators at the at
the federal level, the state, the governor puts out her
proposal early in the year January, and it's that's the
start of the process of where her priorities and the
administration's priorities are. Then we go through a process with
the legislature where we do budget hearings. I have to
testify every agency head does on what's in our budget.

(41:48):
On Monday, the House or the Assembly New York State
Assembly will put out what's called their one House bill,
and so that's their priorities. Then the Senate will put
out their one House build both expected Monday, which is
their priorities. And then between now and the end of March,
they will negotiate what's in the final budget, hopefully to

(42:09):
be on time on April first.

Speaker 3 (42:11):
So April first.

Speaker 1 (42:12):
Used to be a date that just got bulldozed, and
you know the budget was being negotiated in June, I
remember August. Yeah, and it hurts your credit rating. You know,
New York's credit rating got downgraded because they couldn't pass
a budget.

Speaker 2 (42:24):
But for several years we were on time April first,
many many years. Yeah, really since I'd say, well, over
a decade. Yeah, So what are the odds this year
comes in on time? You know, I think everybody understands
the importance of an on time budget.

Speaker 3 (42:39):
So I think the anticipation is it will be okay.
So follow it, folks. Follow it.

Speaker 1 (42:45):
Talk to your assembly people, your Assembly members, talk to
your state senators, find out what's going on. We have
a forum that we do every year that's coming up
May fifteenth, if anybody would like to join that. But
Greg will be speaking along with a number of other
speakers in three legislators who are going to join us.
We invite people from the New York State Senate and
Assembly to talk about that budget process and what the

(43:07):
results were and what their programs are looking like. And
then we have a whole host of other speakers from
all of the different aspects that we're talking about here,
private insurance companies, providers, nursing homes, home health agencies. We're
going to focus on the PACE program this year, so
we have a whole panel on PACE, which is the
program of all inclusive Care for the elderly, which is
a wonderful model, but it's an expensive model, so we're

(43:30):
gonna look at pace and pace alternatives. That's May fifteenth,
so that's a little bit off in the future.

Speaker 2 (43:33):
Well, I do want to plug this little because an
amazing event. I've been fortunate enough to have an invitation
from you guys for years and years. But people can
come both in person and virtually.

Speaker 3 (43:44):
That's correct.

Speaker 2 (43:45):
So you know again, I know this station is gets
blasted out pretty wide, but you guys should check this out.
It's really amazing. The people that come are very knowledgeable
cover a lot of topics.

Speaker 1 (43:57):
We had fourteen hundred people attend last year, one hundred
to hear at the Desmond in Albany, and another thousand
people joined us online. And it is our thirtieth annual
Elder Law Forum, which is which is pretty amazing in
and of itself. So that's on May fifteenth. You can
get a lot more information. You can actually watch last
year's forum on our website at purolaw dot com. Let's
turn to Washington and mister Olsen goes to Washington. So

(44:21):
you've been talking to your colleagues around the country. What
are you telling them.

Speaker 2 (44:25):
I'm telling them that you can't wait for something bad
to happen, and react when you can stop it before
it happens.

Speaker 3 (44:34):
That's the key.

Speaker 2 (44:35):
Like you don't want to be sitting home one night
and you know, opening your mail and you get a
letter that says this benefit you've been relying on or
what have you is no longer there. So it's it's
the message is simple. These programs and services are really
important to members of Congress, regardless of whether you're in
the Senate or the House. These are their constituents. These

(44:57):
are the people that they see every day, the people
that come in and interact with them.

Speaker 1 (45:02):
And recently the phenomenon of town hall meetings and demonstrations.
We haven't seen this in many years. Never have we
seen it like this.

Speaker 2 (45:11):
No, and really what the messages from these folks to
their members is we did not know or didn't realize
that this is what we voted for. And so it's
gotten so bad that the Speaker of the House had
to send a message to his colleagues not to hold
town hall meetings.

Speaker 3 (45:29):
These are your elected representatives. How did you do that?
Can't represent if.

Speaker 2 (45:34):
You're not meeting with people, right, if people are upset,
don't you want to hear that so you can try
to fix it.

Speaker 1 (45:39):
So there's a word that's been bandied about recently, common
sense towards and I have a t shirt at home
that says common sense on the front and it says
no Labels on the back, and no Labels is an
organization that I've belonged to for about ten years now.
I flew to Washington in December for two days of
meetings with representatives of both parties. So we had there

(46:01):
are not many independents left, but we had equal numbers
of Republican representatives senators, House members, and equal numbers of Democrats.
Panels split evenly between Republicans and Democrats. And when you
listen to what they say, common sense is in every thread.
But then they get back to their own caucuses and

(46:24):
common sense goes out the window. So how do we
bring common sense into this process? Because if you don't,
it's gonna hurt people.

Speaker 2 (46:33):
It is, and I think you know, for us, it's
really pointing out what exactly it is. We're talking about
educating people again from my lens, only, what these services are,
what they do, who they do it for, what the
cost is. Because when you again, people know about some
of these services how important transportation is, how important a

(46:55):
meal is, but they may not know where where it
comes from. And Lou, you're you're absolutely right. Aging has
never been a partisan is shoe shouldn't be. It hasn't
been in New York, and it traditionally hasn't been in Washington,
and we just need to keep it that way. These
are not people that are sitting home doing nothing that
never work. These are folks like you and me. Just
to add fifteen twenty years.

Speaker 1 (47:13):
Right, so you know, looking at it federally, people have
to go and pick up the phone, call their representative,
let them know what your voice told the.

Speaker 2 (47:25):
Older Americans act harmless in budget cuts.

Speaker 1 (47:28):
Yeah, because what we're talking about here is not welfare fraud.
You know, it's not people gaming or scamming the system.
It's people receiving essential services that as you said, Greg,
in your case, you stayed it better than anyone I've
ever heard. You're spending three cents to save a dollar.

Speaker 3 (47:48):
And who wouldn't do that? I mean, that's just common sense.

Speaker 1 (47:51):
If you could invest three cents and get back a dollar,
who wouldn't do that?

Speaker 3 (47:55):
Agreed?

Speaker 2 (47:55):
And you know, we have a lot of data that
we've crunched over the years that show them our services
save state Medicaid and federal medicaid hundreds of millions of
dollars a year because the folks that we're serving are
at risk of that Medicaid spend down nursing home placement
and we can keep them home.

Speaker 3 (48:13):
That's where they want to be.

Speaker 2 (48:14):
What's always been interesting is the studies that show that
nine out of ten people want to remain in their
home and community.

Speaker 3 (48:19):
I want to know who the one person is that doesn't.
I've talked to them. They want community.

Speaker 1 (48:26):
We have a lot of seniors that don't have a family,
that don't have neighbors, that don't have socialization. So there
is room certainly at the table for the adult home
for independent living, and there's some wonderful options out there.

Speaker 3 (48:39):
We've had the idea on here support services.

Speaker 1 (48:42):
Yes, so it isn't always just your home, but nine
out of ten yeah, yeah, you develop another sense of
community because you're in with other people. So that's an
individual choice, but nine out of ten people. And that's
why your Home or the nursing home is coming up
April seventeenth, and we're going to explore how to plan,
how to prepare how to be cognizant of all the

(49:03):
things that are available to you and the great services
that the Office for Aging provides. And yes, if you
do need healthcare services, sometimes Medicaid is necessary. Absolutely, And
that's just out there. So we've got about a minute left.

Speaker 2 (49:17):
Final words, the follower words is just a clarification on
assisted living, right.

Speaker 3 (49:21):
I think there's confusion there.

Speaker 2 (49:22):
We have what's called an ALP program and that's a
very small Medicaid funded assisted living. But if people are thinking, well,
I'll just go to assisted living, you're talking about a
very very expensive private pay model that is really not
available to the masses. And what these types of programs
and services do that we're talking about, whether it be
Medicare dual eligible. Services we provide are for regular, middle

(49:46):
income and low income individuals. Greg Olsen, we could do
another hour with no problem. Thank you so much for
joining us today, taking time out of your busy day
to share your insights on New York State's aging services
and what's going on here in the state in Washington.

Speaker 1 (50:01):
We hope that it was a good show for all
of you listening. We hope you can join us again
next week. Right here back on Life Happens Radio as always.
You can call us at the office at four five
nine twenty one hundred or check us out online.

Speaker 3 (50:15):
We'll be back next week.