Life Happens

March 8th, 2025

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

(00:22):
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's 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.
Good morning, Greg, Good morning Loo. Thanks for having me.
It's always good to see you. It's always great to
have you on the show because you are a wealth

(02:13):
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, what your scope
and reaches, and then we'll dig into some of these

(02:35):
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 two hundred

(03:00):
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.

Speaker 1 (03:16):
So we're talking about if you are receiving a.

Speaker 2 (03:18):
Home delivered meal, if you're going to a congregate site
or a senior center to get meals, if you have
somebody coming into your house to help you bathe, dress shop,
cook clean.

Speaker 1 (03:29):
Nutrition, counseling, transportation, legal services.

Speaker 2 (03:33):
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 at the
federal level, not the state.

Speaker 1 (03:44):
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 just got diagnosed with Alzheimer's and that

(04:06):
they have to take care of that parent, and they saying, well,
where are all the services that I'm entitled to because
I've paid these taxes? Where is medicare? Where is medicaid?
Where are the meals on wheels that my mom needs
to stay in her home? 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

(04:27):
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 1 (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.
But there's a bigger picture here. These are folks that
have worked or have raised 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.

Speaker 1 (05:34):
Medicaid spend down nursing home placement and so on, 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 gurneys. And we've seen this absolutely locally.
Ambulance is not even being able to discharge patients into

(05:57):
the er to sit in the parking lot for four
or five six hours before they can just you know,
unload a patient. And that's because 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,

(06:19):
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 1 (06:53):
That is absolutely ridiculous. 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. Yeah,
so let's take that, right, that's exactly right. We heard
that in the State of the Union.

Speaker 2 (07:12):
So what people may not know is, even though we're
celebrating the ninetieth anniversary soil 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 somebody dies to fill out a form to
submit to Soil Security.

Speaker 1 (07:32):
To stop those payments. Right, And 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 sold security staff by fifty percent. There's already a
four hour wait just to get to talk to somebody,
which means benefits are going to be delayed. That's really
just the beginning. 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,

(08:36):
so you know the impacts are going to be really heartfelt,
regardless of age for families.

Speaker 1 (08:42):
So you've been dealing with this at the state level,
and you represent all the counties in New York State,
you've been dealing it with with it 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.

Speaker 2 (09:01):
Yeah, every state has a state unit and aging like ours,
and a contract out with counties. And 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 1 (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 1 (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.

Speaker 1 (09:46):
That, And so last Tuesday we could go Tuesday.

Speaker 2 (09:49):
So almost two weeks ago, I 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 1 (10:05):
Let's break that down. 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 to 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've been doing this
for thirty plus years. We've seen it, we've looked forward,
but nobody would take it seriously. Now we have to,

(11:31):
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 somebody 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. They stretch their dollars as far as
they can. And what's great about our network it's the

(12:15):
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 mention all the volunteers million volunteers

(12:37):
who are providing five hundred million hours of service at
a value of thirteen point eight billion dollars.

Speaker 1 (12:43):
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. I'm Luperr, 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

(13:05):
a society. Because society goals are great, 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 and we are back. And before we jump

(13:26):
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 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

(13:50):
two pm at the Colony Town Library. I'll be speaking
along with Diane Mikkel Gottabiewski, who is with Ever Home
Care Advisors, talking about how to prepare yourself for care
needs in the future. Is your home adaptable to care?
Are you? Is your family aware of what those needs
might be? Are you aware of a plan and a
financing plan to pay for care. Come join us Tuesday

(14:14):
March twelfth, one pm the Colonytown Library And as always,
you can sign up by calling our office at five
one eight four five nine twenty one hundred and four
five nine twenty one hundred or just go to Perro
law dot com. It's p I E. R r O
Law dot com and we'd love to see you at
the Colonytown Library Tuesday March twelfth at one pm. So, Greg,

(14:38):
back to this, and you've been educating people around the
country because of your work and your passion, and you
are a trained social worker. I am just to disclose that.
And 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.

(15:00):
So how do you get this knowledge, this information, all
the things that you have collected in terms of information
and data to the right people.

Speaker 2 (15:09):
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.

Speaker 1 (15:29):
We've had Becky on the show. She's done Medicaid Mondays
for us, talking about all the services at the Office
for Aging provides county by county.

Speaker 2 (15:37):
YEP, we engage all fifty nine offices for the aging.
We have mailing lists for our community based providers. We
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

(15:58):
be on people to let them know what the messages
and really what's at stake.

Speaker 1 (16:02):
Yeah, and I saw Steve on the news Thursday. He's
down in Washington with his counterparts from all around the country.
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

(16:22):
where does that county share come from? 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

(16:43):
budget with.

Speaker 2 (16:44):
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 1 (16:55):
The easiest is at the federal level.

Speaker 2 (16:56):
So you're absolutely right when you start to have an
impact and funding, whether it be block ranting, 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

(17:17):
you know, again, I don't want to 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 (17:31):
So let's kind of take it program by program. And
I served on a number of boards over my career.
One was the Albany Senior Service Board. Yep. 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

(17:52):
and twenty cents per meal to put a meal out
into someone's home two dollars and twenty cents, right, 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. So to feed.

Speaker 2 (18:08):
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 Albany County Office for the Aging. 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 a one thousand

(18:33):
people in Montgomery County, fourteen nine hundred less meals in
Saratoga County, almost one hundred thousand less meals. So that
is what we're talking about is at stake 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,

(18:54):
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 1 (19:05):
Right, forty five percent of them are working.

Speaker 2 (19:08):
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.

Speaker 1 (19:24):
Either somebody's going to leave their job or they're going
to wind up going into another setting.

Speaker 2 (19:29):
Is that other setting going to be there if you
have nine hundred billion dollars worth of Medicaid cuts, and.

Speaker 1 (19:34):
Let's talk about what those other settings are. Nursing home
which is the highest seventy thousand a year, that's the
Medicaid rate, yep, not the private pay the private pay
rate is close 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

(19:57):
that we sit with clients and they're writing the deposit,
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 gonna 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

(20:18):
afford that care?

Speaker 2 (20:20):
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 1 (20:27):
As opposed to one hundred and seventy thousand. That is correct.

Speaker 2 (20:30):
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

(20:50):
can keep them home for five to seven years where
they want to be. Their economic impact is still benefiting
the economy. Just like you said, we're a home rule state.
We pay for Medicaid, schools, local taxes, and local businesses
here in New York State.

Speaker 1 (21:06):
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. I have to now
get go get her prescriptions filled. I have to take
her to the doctors. And you know Dad's now failing too,

(21:28):
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 we work with some amazing volunteer groups.

(21:51):
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. So what kinds of things do they
do and what do you see around the state.

Speaker 2 (22:01):
Well, volunteers are critical. We would not have the infrastructure,
not only in New York but elsewhere. So they're doing
everything from direct services 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.

(22:21):
Our health insurance 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 entitled
a high cap the High Cap program. Right These are
all the things. 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 (22:42):
And does that all come back to the Older Americans
Act funding, the.

Speaker 2 (22:45):
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.

Speaker 1 (23:05):
They value and want to say thank you. 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

(23:25):
Assistance Program. Valerie Bogart 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. You have to get poor or

(23:49):
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 of the coin. It's kind of

(24:09):
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. We'll
be back right after the news. Welcome back Life Happens Radio.

(24:41):
I am Lupiro, your host for this morning, and we
have some confusing dates and I'm I'm gonna sort out
for you in just a minute. 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 day
for the Colony Town Library in just a moment. But

(25:04):
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 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
and the state budget, the revenues that they have found
and how that's impacting your agency and medicaid and the

(25:26):
other things at the state funds.

Speaker 2 (25:27):
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 Hochal 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

(25:50):
that's hopefully to stave.

Speaker 1 (25:52):
Off anything bad that's happening.

Speaker 2 (25:55):
But as I had mentioned to you earlier, you know,
we look at the budget not only from our personspective
at the State Office for Aging, but all the other
policies that are proposed within the Governor's executive budget.

Speaker 1 (26:07):
They're going to have a positive impact.

Speaker 2 (26:08):
On older adults, you know, And it's almost like you're
living in a different universe with what's happening at the
state and what's happening at the federal level. 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, we'll get another
five million dollars and what's called KOLA, it's cost a

(26:30):
living adjustment to deal with some inflation. They've maintained funding
from last year, which is great news for the 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

(26:51):
a model anymore that works. It's sixty you know, we're
sixty years beyond that.

Speaker 1 (26:54):
Now you need bodies. 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 Ombudsman program is there to protect people who don't

(27:15):
maybe have family members 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 funded for a very long time, and
now it sounds like it's starting to take shait.

Speaker 2 (27:35):
It is and there's been a lot of there's been
a lot of support from a lot of organizations to
do that, recognizing that that volunteers change.

Speaker 1 (27:43):
It's pretty intense. You have to go through a four
day training and most of the volunteers are are older adults.
It's just the face of volunteering is changing. That's really
the deal.

Speaker 2 (27:53):
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.

Speaker 1 (28:03):
On quality of care.

Speaker 2 (28:04):
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

(28:24):
for an inspection.

Speaker 1 (28:25):
Yeah, and I'll give you a little behind the scenes
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 NIYASSA, the New York Association of Homes
and Services for the Aging, which is now leading age.

(28:48):
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,

(29:08):
which has a mission. Their mission is to make profit. Right.
When you're an investor, that's your goal. Right.

Speaker 2 (29:14):
We're seeing the same thing nationally in agriculture, small farms
that are going bankrupt being bought by big agriculture.

Speaker 1 (29:20):
Private equity comes in. We need a twenty percent margin
and you don't even know who they Some of these
folks are. Right, So, 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 (29:36):
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, sisted living, family type home, et cetera.

Speaker 1 (29:50):
We always could use volunteers. Yeah, So the Ombudsman program,
YEPUT 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 training and some staff.

Speaker 2 (30:07):
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 happening at the federal level is to try

(30:29):
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.

(30:49):
So here in New York State, we've got inflation rebate proposal,
middle class tax cuts, expansion of the child tax credit.

Speaker 1 (30:56):
And free school meals.

Speaker 2 (30:57):
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 grand kids 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

(31:18):
the 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 (31:26):
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 it.

Speaker 2 (31:44):
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 wind up

(32:04):
doing is helping individuals who didn't need to be on
Medicaid apply and receive Medicaid, furthering the cost in the state.

Speaker 1 (32:13):
YEP. 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

(32:36):
highest income earners and 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 (32:46):
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

(33:07):
earn for tax.

Speaker 1 (33:10):
One of the easiest ways to shore up SOLI security
is to raise that cap.

Speaker 2 (33:13):
So millionaires are not just paying tax on the first
one hundred and fifty thousand dollars of their income.

Speaker 1 (33:19):
Right. 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. 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

(33:41):
money coming in and now your agency had funding that
was sitting on the sidelines for a while and came through,
and other money that has 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 (33:59):
Yes, very good for us as I mentioned historic investment
in our agency.

Speaker 1 (34:04):
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

(34:26):
have out there, anything from animatronic pets to talking devices
that learn through AI how to speak to someone in
their own home. Talk a little bit about that and
how that now is bolstered a little bit.

Speaker 2 (34:42):
Yes, I appreciate that, as lou had said, and I
know you've been very involved also in some tech projects.

Speaker 1 (34:48):
We know they work.

Speaker 2 (34:50):
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 pe 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

(35:12):
platform that for people fifty and over. All the classes
and courses are taught by fifty and old or four
fifteen over.

Speaker 1 (35:18):
They will first teach.

Speaker 2 (35:19):
You how to use in depth any of the tools
you use like a smartphone, a tablet, a PC. Then
you have an access to over five thousand courses and
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

(35:41):
per year. We have seven hundred thousand users now just
hit our millionth class.

Speaker 1 (35:47):
The other two are.

Speaker 2 (35:48):
For caregivers, individuals who are providing uncompensated care to somebody
else regardless of age. One is called Archangels and they
created the Caregiver Intensity Index as well as Tualta. That's
our caregiver platform. You can find that all on our website.
But we have projects that are serving people with Alzheimer's
and their caregivers. We have a strength project where if

(36:08):
you're building muscle mass right, you're reducing the risk and
the fear of falls. 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.

Speaker 1 (36:28):
We are doing a lot of things that are filling
those gaps. The animatronic pats as you talked about, l
EQ is the proactive AI companion for individuals who are
lonely and isolated. We could go on and on and on.
So I'm going to give the right dat out for
the seminar that I boxed earlier, and that is nursing
Home or your home or the nursing home tools to

(36:50):
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 it will be promoteving that more
as we go forward. This Wednesday we are at the
North Chatham Library and that is at ten am and
Diane and I Diane Michel Gottabiowski, and she is the

(37:11):
director of every 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,
and that's available to anyone. What we're looking for, obviously,

(37:31):
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.

Speaker 2 (37:43):
Well, Well, you're exactly right, lou You know, I think
what you're doing and I appreciate you integrating because are
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.

Speaker 1 (38:01):
That's what we ought to be doing.

Speaker 2 (38:03):
That's where the change is starting that I'm hoping does
not get derailed with some of the federal cuts. We're
doing exactly the same thing, but a couple things need
to happen. You got to try it, you got to
measure it, you got to test it, and then we
can go. You can go. We can go collectively to
mainstream insurance, mltcs, medicare, advantage, the state Department of Health

(38:27):
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 learn something. But guess what,
they're all working. Yeah, and the.

Speaker 1 (38:42):
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 day involved and to manage
care in the home and to get information and manage

(39:04):
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 Trualta and gets set up come through.
Very easy, very simple. So those things are all out there.
April seventeenth at the Colonytown Library, we'll be talking about that.

(39:27):
But if you want to get more information on it,
give us a call. Diane Miklgttabiowski Ever Homecare Advisors. It's
everhomecare dot com, so you can look them up. And
we're going to 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
future of the Older Americans Act and the services that

(39:49):
we rely on as we age. We'll be right back
after the short break. All right, Greg and I both
took a break, took a breath. We're back. We're going
to finish up the segment with what's happening and what

(40:11):
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. And I
happen to belong to a couple of clubs with a
whole host of lobbyists, so I hear about the things
that are going on and the push and pull and

(40:33):
the debates about what programs are on the block and
what's going to be promoted and what's going to be cut.
But right now, as you said, Greg, the state budget
is in pretty good shape.

Speaker 2 (40:44):
Yeah, and there's a 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

(41:06):
we are because we do this for a living.

Speaker 1 (41:08):
So it start at the federal level.

Speaker 2 (41:09):
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

(41:30):
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 1 (41:51):
Yew, that's a medicaid, just medicaid, that's just medicaid.

Speaker 2 (41:53):
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 1 (42:03):
How do you do that.

Speaker 2 (42:04):
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 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. On Monday,

(42:28):
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 bill. They're 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 be

(42:48):
on time on April first.

Speaker 1 (42:50):
So April first 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 hurt. It
hurts your credit. You know, New York's credit rating got
downgraded because they couldn't pass a budget. But for several
years we were on time April.

Speaker 2 (43:06):
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 1 (43:18):
So I think the anticipation is it will be okay.
So follow it, folks. Follow 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

(43:38):
with a number of other speakers and 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 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

(43:59):
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 gonna look at PACE and PACE alternatives. That's
May fifteenth, so that's a little bit off in the future.

Speaker 2 (44:12):
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. That's correct, So you
know again, I know this station is gets blasted out
pretty pretty wide, but you guys should check this out.
It's really amazing. The people that come are very knowledgeable,

(44:35):
cover a lot of topics.

Speaker 1 (44:36):
We had fourteen hundred people attend last year, four 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 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

(44:58):
and mister Olsen goes to Washington. So you've been talking
to your colleagues around the country. What are you telling them.

Speaker 2 (45:04):
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 1 (45:13):
That's the key.

Speaker 2 (45:14):
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 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 are

(45:36):
the people that they see every day. These are the
people that come in and interact with them.

Speaker 1 (45:41):
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 (45:50):
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 1 (46:08):
These are your elected representatives. How did you do that
can't represent.

Speaker 2 (46:13):
If 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 (46:18):
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

(46:40):
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

(47:03):
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 (47:12):
It is, and I think you know, for us, it's
really pointing out what exactly it is.

Speaker 1 (47:16):
We're talking about educating people.

Speaker 2 (47:19):
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 meal is, but
they may not know where where it comes from.

Speaker 1 (47:36):
And Lou, you're absolutely right. Aging has never been a
partisan issue. Shouldn't be.

Speaker 2 (47:41):
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.

Speaker 1 (47:52):
Years, right, so you know, looking at it federally, people
have to go and pick up the phone their representative.
Let them know what your voice hold.

Speaker 2 (48:04):
The older Americans act harmless in budget cuts.

Speaker 1 (48:07):
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 stated it better than anyone I've
ever heard. You're spending three cents to save a dollar,
and who wouldn't do that. I mean, that's just common sense.

(48:29):
If you could invest three cents and get back a
dollar who wouldn't do that? Agreed?

Speaker 2 (48:34):
And you know, we have a lot of data that
we've crunched over the years that show that 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 1 (48:51):
That's where they want to be.

Speaker 2 (48:53):
What's always been interesting is the studies that show that
nine out of ten people want to remain in their
home and community. I want to know who the one
person that doesn't. I've talked to them. They want community.

Speaker 1 (49:05):
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.
We've had the idea on here support services. Yes, so
it isn't always just your home, but nine out of ten, yeah, yeah,

(49:26):
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 things that are available to you,
and the great services that the Office for Aging provides.

(49:47):
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. Final words. The following words
is just a clarification on assisted lift. I think there's
confusion there.

Speaker 2 (50:01):
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

(50:24):
income and low income individuals.

Speaker 1 (50:26):
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 and in Washington. 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

(50:49):
us at the office at four or five nine twenty
one hundred, or check us out online. We'll be back
next week