Life Happens

May 18th, 2024

Episode Transcript

(00:01):
Good morning everyone, welcome some LifeHappens Radio. Thank you for joining us
this morning on a cloudy but decentSaturday supposed to be a little nicer Sunday
here in the Capital Region. Andif you're outside the Capitol Region, thank
you for joining us as well.We are on the web. You can
listen at wgy dot com. It'ssimulcast there. And if you ever want

(00:22):
to hear a past show, weare on Spotify, so you can go
back through our catalog of prior showsand our wonderful guests that we've had on
Life Happens and you can find themon Spotify under Life Happens Radio. And
we're thankful you could join us today. I hope everyone out there is enjoying
May. In the month of May, we're getting some mayshowers and hopefully you

(00:43):
have some nice blossoms in June.But I hope you're all living your lives
well and that you're maintaining good health, because without health, what do we
have. And it's just part oflife as we age that health tends to
creep in from all angles. AndI'm on my way here and get a
call from a friend who is goingthrough a prostate cancer treatment. And I

(01:07):
get a call from another friend whojust had bypass surgery, and you know,
I'm at that age. I gotmy Medicare card last year, So
I'm at that age where all myfriends are starting to have these issues.
And when you start to have healthissues and you start to need care,

(01:29):
and you start to look around andsay, Okay, if I need help,
where's it going to come from?If I need services, where are
they going to come from? Howwho is going to take care of me?
If I need help with just mybasic activities of daily living if and
that's a term of art ADLs wecall them, but if I need help
getting up in the morning, gettingdressed, taking a shower, getting food,

(01:55):
Who's going to be there for me? And what services are available?
And if I have to go toa doctor's a point, right, I
want to go out and actually gogrocery shopping. Who is going to provide
those services and how do I accessthem? And we are so lucky today
to have two people joining us livethis morning on WGY on Life Happens,

(02:17):
my good friends, Greg Olsen andRebecca Prevy. Good morning, Greg and
Becky, Good morning, how areyou doing today? Thanks? For having
us. With God's help, Iam feeling good. So I'm here and
feeling all right. But the NewYork State Office for Aging Nice SOFA is

(02:37):
an organization that provides services statewide.And then underneath that there is the Area
Agencies on Aging or the Association onAging in New York, which represents all
of the counties across New York State. So I'm going to start with you,
Greg and just to fill it.And you've been on the show before,
and I want to thank you againfor being part of the show.

(03:00):
But just fill our listeners in onthe vast array of things that the Office
for Aging does. And when weget to the second half of the show,
we're going to talk about access andhow to get to these services and
how you find them, but justtalk about in general the nice Sofa platform.
Sure, and again, thank youso much for having me back on

(03:20):
the show. It's a pleasure.So every state has a state Unit on
Aging, which the New York StateOffice for Aging is. The way we're
structured in New York State is everycounty has an Office for Aging as well.
At the local level. That's nottrue everywhere in the country. They're
organized differently. But what our maingoal is simple philosophy not always easy to
achieve. It's help older adults stayis independent for as long as possible in

(03:46):
their homes and communities. That's whereeverybody wants to stay, regardless of age.
So the types of services that wehave available throughout New York State and
the community are some of the thingsthat you had mentioned at the opening.
We run the large just nutrition programin the country that's home delivered meals,
meals and a congregate center like asenior center. We do transportation. We

(04:11):
have a personal care program to helpwith those ADLs and IDLs that you talked
about. It for your listeners,that just means if somebody needs some assistants
getting up in the morning, beating, dressing, toileting, eating, personal
care, paying bills, medication,things like that, we're able to offer
those types of things. We havea small legal assistance program we help people

(04:32):
with their benefits and application assistance,health insurance counseling. So it's really the
community infrastructure to help somebody when andif they need it to get started.
I think one of the things Iwant to leave your listeners with is we
are not selling anything. What weare selling is objectivity, what's in the
best interest of our customer and choice. So we will work with individuals,

(04:57):
their spouses, their families to youknow, kind of assess what somebody may
or may not need, and thenwe can offer a variety of options.
But then it's up to the individualto decide. And I think that's where
we differ from a lot of otherentities. And I just want to put
this in a bit of context forour listeners. Each year, our law
firm, Pierre O'Connor and Straus sponsorsa conference. It's a conference on aging.

(05:19):
We call it the Elder Law Forum, and this was our twenty ninth
annual and Greg and Becky have spokenbefore, but on the panels and as
part of the program, we hadAssemblyman John McDonald, who was on the
show two weeks ago from the AssemblyChamber as they're passing the budget, Senator
Jacob Ashby. We had Senator GustavoRivera from the Bronx. We also had

(05:44):
speak the Lieutenant Governor Antonio Delgado.We had Carol Rodat from the New York
State Department of Health. We hadproviders, we had insurers and folks.
We had over one thousand people attendthis conference on Thursday, and the people
that were recognized the most by andthis is a statewide audience of experts,

(06:04):
legislators, government officials, the peoplerecognize the most were the people on the
radio with me right now, GregOlson and Rebecca Prevy for their insight,
their foresight, their ability to thinkoutside the box. And Greg, one
of the problems that we identified,which we do every year, is the

(06:25):
fact that care and services are siloed. You call one number and they don't
know what anybody else is doing.They have their own services, but you
don't really get an integration. Andwe talked a lot about that. And
I served on a committee twenty yearsago here at the University at Albany and
George Hurst was the chair of thatcommittee and it was on creating an aging

(06:46):
prepared community. And George recognized thisand I loved his line. He said,
there are islands of excellence in care, in healthcare and in long term
care, but there are no bridges. So just talk a little bit about
how the Office for Aging is attemptingto break down those silence. Yeah,
and I'm glad you mentioned that,and I just want to thank you,

(07:08):
I mean, your your event,is always spectacular, and it was only
two days ago. So to hearthat you know what we brought to the
table, which is a little bitdifferent, is something that people embrace.
So I appreciate you saying that,you know, Lou, you are absolutely
right. I have noticed in mythirty three years of working in this field,
but seventeen of it in state government, is there are so many different

(07:31):
programs and services that affect not onlyolder adults but families littered throughout different agencies,
and people don't know how to accessthem. They don't know they exist,
right, You don't know what youdon't know until you need to know
it. And we really do feellike we're the bridge. And I know,
Becky, you'll talk a little bitabout this, but you know our
structure at the local level, becausewe're part of county government, you have

(07:54):
relationships and you can do warm handoffstoo, for example, local veteran services,
local public health, local mental health, transportation providers. Right the whole
infrastructure a county government kind of mirrorsstate government. So one of the things
that I'm really hoping we get outof this process we've begun with the master
plan for aging is to do exactlywhat you just mentioned. How do you

(08:16):
pull the things together to let thecommunity know the islands of excellence that do
exist in how to access them.And we feel like we are really leading
the charge in that. And I'llgive you an example. We work very
closely with our Division of Veterans Servicesat the state level. And here's why.
Four hundred and forty thousand, orseventy percent of the state's veterans are

(08:39):
over the age of sixty. Ihave twenty four thousand veterans that we serve
on our caseload. So we assessfor veteran status. And the reason why
is because then we can make areferral to DVS or a local veteran service
organization where veterans are eligible for onehundred and fifteen federal, state, and
local benefits that many of them haveno idea even exist. So we take

(09:03):
it upon ourselves because we recognize thatolder adults don't live in the state Office
for agent. They touch every singlesystem. So I at the state level
and BECK at the local level,and US collectively with community partners, need
to be able to break down thosesilos because individuals may come with a particular
problem. When you get to knowthem and build the rapport and the trust.

(09:28):
You're going to find out there's manyother things, and it's our jobs
to cross those barriers. So we'vebeen kicking this can down the road for
thirty years and here we are kindof at the not even at the apex
yet of the aging out of NewYork State. We'll get back to that
in a minute. And you haveall of these services, and you have
a whole medicaid program that I dowant to come back to, but I

(09:50):
want to just mention one of ourspeakers, and then I'm going to go
to Becky Dan Reinhold, who isthe president and chief executive officer of River's
Edge Vers down in the Bronx.It's eighteenth that they serve eighteen thousand seniors
in the Bronx and related areas.They are innovative, they get a lot
of funding, they have an innovationcenter, a technology center. But Dan

(10:11):
has been the CEO of that organizationserving seniors within the system for thirty years.
And Dan's takeaway is we need toburn it all down. And it
was kind of shocking, and Becky, he came back to you because the
things that you were talking about arelooking at the system and saying why is

(10:33):
it so complicated, why is itso segmented, and why do people have
such a struggle navigating it? Andwhat it comes down to is that all
care is local. You need toknow what's going on in your county and
in some cases in your town andsome cases in your neighborhood. But talk
about the agencies on aging and thecounties and what they're doing at the local

(10:54):
level. Sure, lew and thanksso much for having me. And I
think he is a really good point. So not only do we have a
siloed system, we also have asystem that's very cumbersome to use. And
to Greg's point, a lot ofpeople don't know that they need to reach
out for services until they're at apoint of crisis, whether that be you
know, they're in an emergency department, they're bitted to an acute care facility,

(11:16):
or caregiver breakdown has caused the situationthat's that's no longer stafe at home.
And so really what the area agencieson aging throughout the state do is
they do an unbelievable job with verylimited resources to really try to make sure
that that journey for an older personor a family member is as you know,
least cumbersome as possible. And we'rereally proud of the fact that we

(11:39):
run the New York Connects program,which is really a way within each and
every county that if someone calls witha need, whether that be you know,
early intervention services for a child allthe way up to placing mom and
a nursing home, that you havesomeone that's trusted and objective that's going to
help you through that process. AndI think objective is something that we focused

(12:01):
on at the forum, but it'salso something we really try to educate the
general public about. If you goto a trusted local office for the aging
or community based organization, we're notselling a product. We're going to advise
you for the best outcome for youor your family member, and we're going
to marry in all those service infrastructuresto really make sure that you're getting the

(12:22):
best service possible. And that looksdifferent depending on what your income is,
where you live in the state,what resources are available. But the takeaway,
Lou really is to reach out toyour local office for the aging for
that assistance, because again, you'regoing to get objective information, you're going
to get put into an appropriate plan, and you're going to get appropriate services

(12:43):
to meet your needs. We're goingto come back in just a moment after
a short break and look at thoseservices, how to access them, and
what else is out there on thelandscape and what's being developed, because the
bright light on the horizon is theinnovation that's being fostered within New York State
and that is running through the twopeople that are on the radio with me

(13:05):
today. So stay with us.You're listening to Life Happens Radio. I'm
Loup Piro, your host for thismorning from Pierre O'Connor and Strauss, Greg
Olsen, director of the New YorkState Office for the Aging, Rebecca Privy,
director of the Association on Aging inNew York, and stay with us
with more Life Happens Radio. We'llbe right back. Oh here we go,

(13:30):
man Zach, Will you still needme? Will you stillfied when I'm
sixty four? I'm already sixty five. Who's gonna take care of me?
Now? So thanks for that.Welcome back. I'm lu Piero, your
host of Life Happens Radio, andyou're listening live with Greg Olsen Rebecca Prevy.
We're talking about services and aging inNew York, and Greg, I

(13:50):
just want to before we go toofar down the road and delve into all
of the programs and different pilots thatyou guys are doing, from animatronic pets
to technology and AI and all kindsof things. So folks, you don't
want to miss any of this.And by the way, if you do
want to view any portion of theElder Law Forum, it was video cast

(14:11):
and it is recorded and it willbe it's being edited, and at some
point over the next week we willbe putting up up on our website,
so you can view segments or theentire Elderlaw Forum at pierolaw dot com.
So keep an eye on that andit will be up as soon as our
editors are completed. So going backto it, we're looking at something and

(14:33):
this goes back to what was tryingto be created twenty years ago, the
age friendly community, and New Yorkis designated an age friendly state. So
how do we keep people well andjust throw out some of the and I
know you rattle these off, someof the statistics and data that people should
know and why today we're still kindof not in the heavy wind. It's

(14:58):
the headwind is coming as the babyboomer's age out. Just talk a little
bit about what New York State isfacing and how being well and aging well
can be accomplished. Yeah, andyou're right. We became the first age
friendly state in twenty eighteen, isdesignated by the World Health Organization in ARP.
But as you know, Lou,we've been doing this work since two

(15:18):
thousand and seven, before there everwas ever such a term called age friendly
and starting to build liverable communities.Here's what we know. We know that
more than seventy percent of all healthcarespending has nothing to do with your health
diagnosis. It has to do withthe environments that you grew up in,
poverty, educational status, things likethat, as well as the personal choices

(15:41):
we make. Do I eat well, do I exercise? Do I have
access to healthy food? Do Ismoke? Things like that. So I
think the shift in thinking is recognizingthat there's more too good health than health
care. Now, I'm not minimizingthat in any stretch of the imagine,
access to healthcare and quality healthcare iscritically important. But it's the things that

(16:04):
we do in the community that dictate, you know, whether we're in the
emergency room, whether we develop andget worse with chronic conditions, et cetera.
So I think what the big takeaway, at least from Becky's in mind
presentation that you know you've heard manymany times, is we actually have to
look at who the older population is. You know, I talk a lot

(16:26):
about agism stereotypes that older adults areseen as expensive takers, you know,
and that we need to take careof them, and that's that's kind of
a global look at the older population, and that's not true at all.
There are pockets of every single agecohort that may need some assistance, and

(16:48):
it's our jobs in the caring economyto care for those. But we just
did our first ever statewide needs assessmentsurvey where we got twenty seven thousand responses
from people between the ages of sixtyand one hundred and five. And the
data that we saw are things thatwe already knew, but this was validated.
Seventy five percent of people over theage of sixty consider themselves very healthy,

(17:14):
active and engaged, and so ourjobs as a society for age friendly.
And now the under the Governor Hocalsleadership, the master Plan for Aging
is how do we keep those individualshealthy if they still want to work,
how do we connect them with jobs, to volunteer opportunities, to mentorship opportunities,
to keep their capital, social,intellectual, and economic capital in our

(17:36):
state. We don't want them leavingour state because they bring so much to
our state. And then focusing onthat twenty five percent that may need assistance
or do need assistants right now,and what are the best ways to do
that. So when Dan said burnit all down, I will byline that
and say what he was really sayingwas that how we'd structured the caring economy

(17:56):
with Medicare and Medicaid since nineteen sixit has not worked out. And now
what we need to do is shiftgears to a more robust community based model
that will prevent ed visits, hospitalizations, rehab, nursing, home placements.
And if you're in those settings,you need a set of services when you

(18:21):
return back into your home and communityso that you can succeed. And this
is really one of the deepest silosthat we have, and that is Medicaid.
And Medicaid is a program in NewYork and you mentioned back in nineteen
sixty five these two programs came uptogether. We've talked about them on the
show many many times. And Medicarein nineteen sixty five was designed to provide

(18:41):
seniors with all the care that theywould ever need. Lyndon Johnson's preamble to
the Medicare Act was that never againwill seniors in America have to worry about
healthcare. Well, that hasn't pannedout so well. And what has happened
is the Medicaid program, which innineteen sixty five was designed for babies and
young mothers to provide them with necessaryhealth care and food and nutrition. That

(19:04):
has morphed into a universal health careplan for people. So in long term
care. And when I say longterm care, it's home health care,
it's assisted living care, it's nursinghome care. When you need help with
those activities of daily living. Theonly government program that steps in in a
big way is Medicaid, and that'swhere all the dollars go. But your

(19:26):
job, and Becky, you wantto jump in here. Your job is
to keep people off Medicaid, whichis the big budget item. It is,
Lou and that's you raise a verysignificant point. So we have a
personal care program where home Health Aidswill go into the home of an older
individual, help them with bathing,toileting, dressing, meal preparation, et

(19:48):
cetera. And we fund that programthrough New York State Office for the Aging
for Non Medicaid eligible individuals. Andwhen we talk about non Medicaid eligible individuals,
a lot of people don't realize thatyou can be above income for Medicaid,
but you don't make enough money toprivately pay to the tune of thirty
five or forty dollars an hour foran eight to come into your home.

(20:08):
And that's where we come in throughoffices for the agent to subsidize that care
through our in home program. Andyou know, Louis raised this at the
at the Elder Lot Forum, somethingthat I think is a significant statistic when
you talk about the sixty and overpopulation. You know, we have four point
eight million people over the age ofsixty in the state of New York,

(20:29):
where we are losing population in everydemographic outside of the sixty left population.
And to Greg's point, that's agood thing. Older people contribute very significantly
to the economy. There are volunteerblock but there is a subset of that
population that needs care and the fastestgrow exspective of the population in the state
of New York are actually individuals overthe age of eighty, and we know

(20:51):
about seventy percent of those over theage of eighty are going to need some
form of care in their lifetime.We only have one hundred and eleven one
hundred one licensed skilled nursing facility beds. They had number how many million people
over the age of sixty? Fourpoint eight million over the age of sixty
and the fastest growing segment of thatis over eighty five absolutely and one hundred

(21:14):
and eleven one hundred and one skillednursing facility beds that are licensed, but
only ninety seven thousand of those bedsare actually filled due to a variety of
staffing issues, nursing comeclosures, etcetera. So we know that the game
is at the home and community basedlevel, not only from a fiscal standpoint,
but it's where people want to reside. Absolutely, we never see a

(21:34):
client across the table and say,okay, so which nursing home are you
planning to go into? That isn'tthe wildest dream? They say, shoot
me first, you know, takeme out back in the woods and leave
me there. I don't want togo to a nursing home, but nonetheless,
ninety seven thousand people live there,and it's necessary, it has to
be there. It is necessary,and I, you know, I'm going

(21:56):
to take this opportunity. Obviously,I run an advocacy organization, and we
know the value of the office forthe aging services. So we serve our
average clients statewide through home delivered deals, personal care services, et cetera.
Is an eighty three year old lowincome female who lives alone, has four
or more chronic conditions like diabetes,caustive heart failure COPD, and needs assistance

(22:18):
with those activities of daily living thatwe talked about. We serve them statewide
for less than ten thousand dollars peryear, and we keep them on our
caseloads between six and seven years inaggregate. And so we know that that
individual statutorily could qualify to go toan assistant living or to a skilled nursing
facility where we would impoverish them toMedicaid and it would cost you know,

(22:41):
one hundred and forty to one hundredand fifty thousand dollars versus ten thousand dollars
in the community. If we werefunded to actually provide the services at a
level that people need and to alleviateour waiting list. And that's you know,
Lew, It's something I brought upwith the elected officials that were at
your forum. It's something that wework really diligently through the budget process on

(23:03):
that we know if people are waitlistedfor a service from our own data,
ten percent of them go directly toa skilled nursing facility without ever touching another
service infrastructure. Another seven percent impoverishthemselves to community based medicaid to get the
services, and it costs the statehundreds of million dollars per year that we
could alleviate if we were funded toprovide those services at a level necessary in

(23:23):
the community. And if somebody comesto you and they come through the counting
office for aging and they get theservices the bundle of services that you provide,
we'll dig more into that. Howlong can you keep them independent in
the community. What's kind of theaverage is right around seven years, but
in a lot of cases, dependingon what the service is, we can
have keep people on a case upwardsof fifteen years depending on what service they're

(23:47):
receiving. In addition to that,loop. Not only do we provide those
more hands on services, we alsoprovide volunteer opportunities for decades for older people
that want to deliver meals or volunteerat a senior center site. We have
forty one of the highest level evidencebased interventions like product disease, self management
programs, high cheap for arthritis.So really we're able to serve people all

(24:10):
the way from giving them a volunteeropportunity all the way up to our home
care program. It's really that robustof an array of services. And we
tend to focus on this show onMedicaid because it's the program that when when
they hit the wall, because theycome into the system not knowing what other
services are out there and how theycan have some wellness provided to them,
some wellness services, transportation, meals, et cetera. They hit the wall

(24:33):
because they go to the hospital,they end up getting discharged to a rehabilitation
center, and then the rehab facilitysays, well, you can't go back
home because there's no safe discharge becauseyou don't have any infrastructure in your home
or an ability to go back home. Folks, you don't want to be
that person. We're going to takea short break for the news. When
we come back, we're going tounwrap this rag Olsen, Rebecca Prevy,

(24:55):
and myself. We're going to talkabout the services available, how you access
them, and how you stay well. I'm so time. Welcome back Life
Happens Radio, and I'm Lupiro yourhost for this morning. We have Greg
Olsen Rebecca Prevy, Greg from theOffice State Office for Aging, Rebecca from
the Area Agencies on Aging, andwe're talking about staying well as we age.

(25:21):
How do we do it? Zachplayed for me and had did for
about a year while I was sixtyfour, the Beatles song Willia Still Need
Me? Will You Still feed Me? When I'm sixty four? Greg,
you were talking about Medicare and Medicaidand the enactment of both of those.
Medicare is something that is universal.At age sixty five, we all get
it. I got my card,thank you very much. But there is

(25:44):
this vast array of private insurance thatgoes supplemental to Medicare because there are so
many gaps. Where is Medicare inall of this? And we had we
were very fortunate to have two ofthe leading professionals locally from the Insurance World,
and one from CDPHP and one fromMVP Alicia Kelly, who has actually

(26:04):
been on this show. So backwhen it was open enrollment for Medicare Advantage,
Alicia went through the Medicare plan thatis an excellent plan from CDPHP and
MVP. We had Bob Hartman,who's the vice president of Product Design and
Strategy. So two of our leadinglocal health insurance companies. Where does Medicare,

(26:26):
Medicare Supplement, Medicare advantage fit intoall this, because that's just another
silo to me. Yeah, Imean, I mean Medicare is absolutely critical,
and I just want to educate thelisteners that, in addition to Medicare
and Medicaid passage in nineteen sixty five, so is the Older Americans Act that's
our federal charter. And the differencebetween the three, I mean they were

(26:48):
passed together to have, you know, to make sure you had a robust
community based infrastructure to help people stayhealthy and be on the receiving end if
you're coming out of a hospital ora reha. The difference is we're on
the discretionary side of the ledger.And so while Medicare and Medicaid as entitlements
grew, we did not. Andyou know, we drafted an older Americans

(27:10):
aconomization proposal early on in the pandemic. And so for those listeners, you
know, your people that are goingto try to be elected to offices fall
always wind up showing up at seniorcenters and other places. You need to
ask them. The least amount ofmoney that we get for our service infrastructure
comes from the federal government, yetthey're the ones directing us on what it

(27:30):
is that we need to do.And so it's been up to the counties
and the state to pick up topick up the brunt of the costs.
And that's not fair. So Idon't mean to make a statement there,
but I want to let you knowthat if the federal government funded us with
the expansion over the course of thelast fifty years, you know, we
may not have the issues that wehave today. Yeah, And when Dan

(27:52):
Reinhold, who's one of the leadersin this area nationally, when he said
burn it all down, he waslooking at the two of you and saying,
from the ashes rise this phoenix.Because the network of local service providers
is there, it just needs tobe funded well. And that's right.
And you know, while we're thelargest game in town, meaning the offices
for the aging, we're not theonly ones. I mean, we've got

(28:15):
over five thousands based organizations, manyof them provide services to older adults.
You have, you know in thecapital district, you got Town of Colony,
Town of Bethlehem, Town of Guildeland all have a senior resource departments
that also offer additional services. You'vegot community action agencies. So the beauty
with our network is every all careis local and our folks at the local

(28:40):
level know who to go to.People are at the local level. So
on the Medicare front, I thinkwhat I'm I'm most pleased with the direction
and let's see if it actually comesto fruition. As you mentioned, they're
gaps right traditional medicare no eyeglasses,hearing in dental. That's ridiculous for any
population, let alone an older population. I think the work about is that

(29:04):
Medicare advantage plans now have the optionto provide additional services called social determinants of
help. I love these new buzzwordsbecause that's what our network has been doing
for fifty years and people are justbeginning to understand that provide funding for example,
under a Medicare advantage for groceries orfor transportation, or for hearing or

(29:27):
dental or a gym membership or whateverit might be, that you're going to
see positive outcomes and benefits. Theacute care setting is just that it's episodic
based on what you show up therefor. But then you want to go
back to your community and there maybe other things that somebody needs. And

(29:47):
let's not underestimate the huge impact thatloneliness and social isolation has. So when
you transition from our service package toMedicaid, those things that we talked about
earlier on comprehensive case management, transport, transportation, home delivered meals, congregate
meals, the ability to volunteer,the ability to get to you know,

(30:12):
uh, something that might be goingon in the community or congregate center to
combat loneliness and isolation. All ofthese things thoes go away when you shift
over to Medicaid, and all thoseare the difference. I want to slow
it down because Greg, you talkedvery fast. Sorry, I just want
to slow it down for our listeners. And Becky just explain how absurd that

(30:36):
is that you have this bundle ofservices that you can get without being impoverished,
which you have to be to getMedicaid with all of this richness and
this counseling and all of these ancillaryservices, and you flip over to Medicaid
and you go through this assessment processand you get something called a managed long
term care company. And boy,they were talked about a lot on Thursday

(30:57):
as well. Why don't they mutuallycoexist and just talk about the things that
the counties are doing and then whathappens when that person loses those county services.
So, you know, I thinkto Greg's point, because care is
local and we have local offices forthe aging. Not only does our service

(31:19):
bundle include way more than an MLTCplan, but we're also localized. And
so you have a trusted individual that'sdoing a home visit in your home.
You know, lou I reside inthe North Country. If you go on
an MLTC plan in the North Country, you might get a phone call from
a different area code case management overthe telephone. And so let's just take

(31:41):
the next thing to talk about sinceyou brought it up, and that is
they're changing a lot of the waythings are being administered, including another program
that has become vital, especially inthe North Country and more rural areas,
which is called the Consumer Directed PersonalAssistance Program. And right now you have
an mlt this is all the stuffyou have to go through for you have

(32:02):
a managed long term care company thatkind of doles out the money. But
then these local organizations grew up andthere are probably more than we need.
They're six hundred and fifty, butthey're going to go to one statewide organization
that's going to deal with every individualin New York State over what twelve months
They're going to do this transition allto twenty four months, Lou And I

(32:25):
think you know, one of theconcerns that we've had as an advocacy organization
through the last couple of years iswe've asked for transparency on the MLTC side
and we have not been able towin that. And then to have the
Consumer Directed Personal Care Assistance Program singledout and to go from over six hundred

(32:47):
providers down to one, we havereally significant concerns for a variety of different
reasons that I want to be asdo we. Being the Bar Association,
I'm part of the Elder Loss sectionof the New York State Bar. We
had one of our champions, ValerieBogart, who addressed all of the Medicaid
issues from the consumer perspective at theElder Law Forum. And again you can
get the Elder Law Forum. Youcan listen and watch all of this when

(33:10):
it comes online at puro law dotcom. So take a look and we'll
let you know when it's going tobe up. But when we look at
this and you look at the Medicaidand all the cuts that have to happen
in Medicaid, it's because it's ahuge budget, but they're not looking at
saving dollars. So go back toyour local services and what the results are.
And I'm going to talk about acouple specific pilot programs that you have

(33:31):
pioneered that have brought art what's calledROI folks. So here's a business concept
in the state. Go figure returnon investment, but go ahead with the
local services. Well, I thinkthe local services it's very easy to draw
a line, right, So wediscussed how much it costs for offices to
the agent to provide these services.We know that those individuals could go to

(33:53):
assisted living or skilled nursing facility,or we could easily do what's called impoverishing
down to medica which is, ifI have a client I do a home
visit with and they're making, saytwo thousand dollars a month as of single
individuals, they're over income for Medicaid. But if I can't get them the
services locally through the Office for theAging due to a wait list, I'm

(34:13):
going to do a Medicaid application anda pool trust for that individual and I'm
going to get them on Medicaid.Why why is that bad? Because we
want to keep people off Medicaid.We want to protect Medicaid for those individuals
that need those services, but wewant to support anybody that we can with
those preventative services that are lower costsand higher yield to save this ballooning Medicaid

(34:35):
issue that's, you know, rapidlyapproaching one hundred billion dollars. And the
reason I'm still passionate to say thatnumber one more time. One hundred billion
with a bee with a bee.That's annual budget for medicaid folks in New
York State. The entire budget wastwo hundred and thirty seven billion, ninety
six of it was Medicaid. Andmy statement is, lou we could solve
the Medicaid problem very simply by investingin aging services. And we know that

(35:00):
from our own data, we knowthat from the population in the State of
New York, and we know thatwe can serve people in homes and communities
for a lot less. I lookat this the same way when you talk
about prevention services for use. Rightmy kids are in school, it doesn't
matter what their health insurance is.They're counseled on never smoking, never vaping,

(35:20):
not drinking, because we know that'sgoing to stay long term healthcare costs.
I look at the aging Services networkin the same exact way. If
we can serve people, reach themearlier, provide this type of care,
we're going to keep them off Medicaid, and we're going to save the state
an enormous amount of money and toput and again I referenced this at the
other Law forum. We have almosttwenty million people in the state of New

(35:40):
York. We're rapidly approaching five millionover the age of sixty. We have
four point one million caregivers, soyou're talking about half of the state is
impacted by aging or caregiving. Andyet the New York State Office for the
Aging Budget is less than eight tenthsof one percent of the overall state budget
at less than two hundred million dollarsthat goes to the localities and the older

(36:01):
population in the state of New Yorkpiece seventy two billion with a b in
state and local taxes each year.So it's time that we invest in our
infrastructure to be able to serve peopleand save to stave these Medicaid dollars.
And I just want to talk aboutone program that because I heard about this
for the first time and it wassomething you did. I think it was
in Western New York, dealing withMedicare supplement policies and something as simple as

(36:23):
counseling people on which one was right. Can you talk a little bit about
that? Sure? So in WesternNew York, we worked with Life stand
of Greater Rochester, which is awonderful community based organization that actually ran a
care transitions program through primary care positionsoffices where they embedded our staff to work
on care transitions and navigation. Andagain we talked about return on investment,

(36:46):
Lou there was over four dollars savedfor every one dollar invested in that program.
And the number one service that drovedown emergency department and acute care admissions
was hel health insurance counseling. Andagain when we talk about objective information,
we are not commissioned sales representatives.We are States certified health insurance counselors that

(37:09):
are able to go in look atwhat plan is appropriate for what diagnoses,
and we're able to enroll people inthat appropriate plan. And just making sure
that they had the appropriate coverage andthe appropriate medications was the number one driver
that drove down those hospital utilizations.So again, very low cost, very

(37:29):
high yield service. Yeah, Greg, this is a lot to take in
for our listeners. And we're lookingat Medicaid, Medicare New York State Office
for Aging Services. What's going onwith the master plan. We've heard about
it. It's something that's been goingon. There are committees, there are
I think are one hundred and elevenreports that have been submitted, and the

(37:52):
director of the master plan was atthe elder Loft Forum, a very nice
gentleman and seems to be very engagedin taking all of this in and data.
So where do we stand with theGovernor's master plan? Because you're one
of the two heads of the masterplan, as I understand it. Where
are we? Yeah, so Ithink there's some important context because you guys
are you know, we're having aconversation about you know, Medicare, Medicaid,

(38:15):
our services, et cetera. Andthe state has a difficult charge because
the two most expensive things in budgetor education and Medicaid. And so I
think the Governor holkals leadership around organizinga master plan. I think is it
really takes the AH friendly concept andbrings it into the future. I think

(38:36):
it allows us an opportunity to correctthe mistakes that we made in the past
administration in our age friendly work andto really connect the dots. Right that
was the de siloing that you're talkingabout. We do not really have a
system of care right now. Wehave a payer source that drives where people
go. And so I think whatthe governor is really interested in doing is

(38:58):
how we began in the beginning withall the assets that we have and all
the various state agencies and then ofcourse county government works on the cast of
the state. I mean that's inthe state constitution to deliver services on behalf
of the state for individuals. Sothe master plan, you know, we've
been working now for about eighteen months. There's been over four hundred stakeholders from

(39:21):
a variety of different industries and settingsand stakeholder groups that have been involved.
There's been almost twenty public hearings andtown halls. There was a preliminary report
that was released several months ago,and a secondary report that's going to be
coming out shortly, and then ofcourse there will be the final report and

(39:43):
I put an asterisk next to thatthat'll be in the spring of twenty five,
because the final report is not aone and done. It can't be
a one and done. Everything isevolving all the time and we can't be
stagnant and working in business models fromthe eighties and nineties and even the two
thousand and so it's going to bea living, breathing document. And you
know, Lou, at the endof the day, what I hope comes

(40:05):
out of this is recognizing, youknow, some of the things that came
out at the old law form orthings that we know we are able to
show certain benefits. We don't doa good job in this country or in
this state. Although it's changing onreally focusing on prevention, we are we
are much more reactive as a caringsystem than we are proactive. So I

(40:30):
think again the Governor wanted to bringtogether not only the state agencies, but
really the experts at the community levelwith any ideas that they have that can
change the way that we do businesshere in New York State. So I'm
really really looking forward to continuing thisdialogue, not only the end product,

(40:51):
but recognizing again that we have tomake some structural changes for the way the
system has been designed and evolved ofthe last years that is extensive and really
doesn't yield positive results for individuals andfamilies. All Right, we're gonna take
another short break when we come back. We got about ten minutes, and
I want to go into the innovationthat the New York State Office for Aging

(41:12):
and the area agencies on Aging havebrought to bear, because I can tell
you from my experience, and I'ma medicaid attorney, that there is no
innovation in medicaid that just doesn't happenthere. There's just spending of money in
the old traditional ways. But theexcitement of innovation is something that the Elder
Law Forum benefited from. And GregOlson Rebecca preview our two guests today on

(41:36):
Life Happens brought that to us,So stay with us. We're gonna come
back after a short break. You'relistening every Saturday morning at eleven am the
Life Happens Radio on Talk Radio WGYtwenty one hundred. All right, we're
back. We're gonna play a littleclip for you folks. You're ready,

(42:02):
human be I'm mad as hell andI'm not going to take it anymore.
And I think that's what Dan Rengeldwas saying at the Elder Law for them.
We need to bring these services tothe surface. We need to let
people know they're there, and weneed to deliver them in a way that's
meaningful to them. And Greg andBecky. I just want to start with

(42:25):
Greg and some of the things,maybe the animatronic pats, the loneliness isolation
that you mentioned earlier, l eQ, and then some of the other
just a highlight, and then Iwant to get into a couple of Becky's
BIPs and some of the other thingsshe's been doing. Yeah. Sure,
I mean this has been really exciting, you know, sake, government traditionally

(42:46):
is not innovative and proactive. Youknow, I'm really proud that we've been
able to do that. We havelaunched since twenty eighteen over twenty one public
private partnerships and tech companies. Thereason being is older adults use technology at
the same rate as the general population. And that was a new report AARP

(43:08):
put out as a February of twentytwenty four. And all we have to
do is look in our own familiesand look around and we know that that's
true. And so what we're nottrying to do is supplant face to face
or human beings interacting with others.What we're trying to do is, you
know, vet test tools that aregoing to enhance people's lives. Some of

(43:31):
the things that we've done, whetherit be the animatronic pets or l EQ
or the Virtual Senior Center again getset up these virtual ways to connect to
combat isolation and loneliness. Isolation andloneliness costs medicare over seven billion dollars to
treat. Loneliness is equivalent to smokingalmost a packet cigarette today and has been

(43:53):
shown to increase anxiety. Depression willliterally kill you. And so we started
the journey really on the social isolationcombating but have seen just amazing results.
LIQ is a for example, it'san AI companion that was really designed by
older adults to combat isolation and loneliness. And what I mean by AI proactive

(44:15):
companion is it engages you. First, you don't have to get in front
of your computer, log on tosomething, you know, pick a class,
et cetera, and it remembers anddevelops a relationship that's very unique to
the user. What we've seen isa ninety seven percent decrease in loneliness and
isolation and a ninety six percent increasein overall health and wellness because of many

(44:37):
of the features connecting with families andfriends, exercise, art taking, virtual
visits, book reading, you know, audio books. So we have a
lot of those types of things wherewe're trying to fill certain gaps. The
animatronic pets loneliness and isolation gets setup combating loneliness, isolation, helping individuals

(44:59):
you know, stand their computers inthe digital divide, and then having access
to forty five hundred lifelong learning exerciseclasses. We have pilots that are having
a positive impact on older adults withAlzheimer's disease and their caregivers. We have
platforms that are evident space to supportthe four point one million family, friends,

(45:21):
and neighbors who are helping another lovedone, regardless of age. We
have a partnership with Discovery Live.I mean, this is a great one.
You can go on a virtual onehour visit to over two hundred cities
in two hundred countries around the world. We've embedded that into fifty one senior
centers so individuals can get together andtake a trip. They do that once

(45:45):
a week for an entire year.And like I said, not only are
we testing these things, but we'remeasuring them and the measurements again are just
showing unbelievable results. Very very lowbudget or no budget set up. Our
Trulta and Caregiver Intensity Index, allof them are on our website. Those

(46:06):
are free to anybody who's over theage of fifty. And then the rest
of them we are piloting and measuringto test their efficacy, and then we
will share them with anybody that wantsthem, mainstream insurance, the general public,
Medicare, Department of Health, anybody. Because I think that these things
can be replicated and expanded, andwe know that to be true because much

(46:28):
of the things that we're doing inNew York are being replicated in over thirty
or forty states across the country.Yeah, this gets very personal, folks,
because you know, I'll bring itback to me. It's all about
me. My mom had Alzheimer's.And when my mom had Alzheimer's, we
were trying to get her services andshe was down in Columbia County, New
York, in Hudson, and therewere very few services available to her.

(46:50):
We went to the Alzheimer's Association.There was no staff yet there is now
we got it put into Columbia County. But she would use these mechanical pets
and just play with them for anhour two hours. It would keep her
mind and her calm and occupy.And the animatronic pets are way beyond that,
and so is elie Q, whichis now an interactive AI based program

(47:14):
which is communicating with those folks.And just take it to what it means
to somebody in their home isolated inan apartment. You don't have human caregivers
coming in. Meals on wheels isvery often the only human interaction that they
have on a day to day basis. That's right, And how does this
impact them? And the data isas you said, burying it out.

(47:35):
Yeah, and you know, unfortunatelywe have to show data, but I
like data. As you were describingit, I literally, Lou have the
chills. We started with our AnimatronicPet Project twenty eighteen with sixty pets.
We have now put out thirty onethousand, five hundred pets and have worked

(47:55):
with the Veterans Association, Federally QualifiedHealth Centers Office and Mental Health Veterans.
I mean, it's amazing when yousee and it's palpable. Right. We
know through the course of our livesof things that matter to us, they
just don't stop at a certain age, whether it be sports or the news,
or politics, arts and culture,animals. So when you see and

(48:20):
we've been capturing stories and videos ofthe animatronic pets l eq et cetera,
when you see somebody actually receive one, it just it gives you chills.
How beneficial it is. And it'snot one of those things. Because we
studied it over a year. Wedid the first nationwide or this first study

(48:40):
ever and there's been thirteen that havefollowed up on that. The engagement with
the pets actually increases over time.And if you have one of these pets
in somebody who has dementia. We'veseen the agitation significantly go down people come
off of psychotropic medication. I mean, you know, if you can change
somebody's life for one hundred dollars,it's amazing. Why wouldn't you do it?

(49:04):
And that's what we do. That'swhat we've been doing because because Medicaid
would never think of it. Great, that's why. So it has to
be done outside of that Medicaid box. And Becky, thanks for all of
that. Beg, I want tojust flip it over to you about three
minutes left. You have pioneered anumber of pilots and I've been very lucky.
And this goes back to my mom. Down in Columbia County. We

(49:24):
try to take care of the caregiversin our law firm and we just felt
feeling that we were feeling short.So we developed a program called Everhome.
And there's a pilot ever Home Columbiathat uses technology we've been working on called
Viva Links and you are the chairpersonof that board, so just talk a
little bit about what's going on there. So it's really an incredible program,

(49:45):
Lou and it's something you know,I want to see replicated, not only
across New York State but also nationally, and so we know that we have
and influx of caregivers that don't havea lot of tools and resources. We
know that technology is completely and everevolving, and how we can marry caregiver
supports and technology to really move clinicaloutcomes is exactly what the ever Home pilot

(50:07):
is doing. So the marriage ofyou know, in home monitoring tools,
case management, care coordination, constantcommunication between clinical providers and the home environment
and the client is really what thepilot is doing. And you know,
we raise this at the Older LawForum. The use of artificial intelligence and

(50:28):
in home monitoring is so amazing onhow it's going to change clinical outcomes.
And so if you're monitoring someone intheir home and their normal pattern at night
times, they get up once anight to use the bathroom, and then
you see that they've gotten up fivetimes two nights in a row, the
AI is actually going to alert youand the caregiver to the fact that you
might have a urinary track infection.It also provides the use of telehealth services,

(50:52):
so someone does not have to goto urgent care or the emergency department.
They can access those services in theirhome and community. And so these
are the types of things that arereally going to change the issues that we
have in providing care across the stateby using innovations to support individuals. Well,
that hour always goes so fast.So here we are, Greg Olsen,

(51:12):
Rebecca Preevie. Thank you so muchfor all that you do and for
serving the people in the state ofNew York. And the nisofa website has
rich information on it, so checkthat out. If you want to get
the ELF Theelder Law Forum, goto purolaw dot com. We will connect
you and we hope to see youback next week.