NEW ENGLAND NUTRITION CONFERENCE

Bob Blancato

Executive Director

NANASP

April 2, 2015

rblancato@nanasp.org

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25TH ANNIVERSARY – 1990-2015

You’ve been taking a stand for good nutrition since 1990

Even though President George H.W. Bush himself took a stand against broccoli that year… “And I'm President of

the United States, and I'm not going to eat any more broccoli!”

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1990

Year I finished full time work on Capitol Hill The OAA in 1990 was 25 years old and was

between reauthorizations. Sound familiar? Next one occurred in 1992 Year before WHCOA that did not happen Mandatory retirement ended but the Social

Security eligibility age went up to 66 and now it’s 67

Top TV show: Cheers Top news story: East and West Germany

reunited

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FY16 PRESIDENT’S PROPOSED BUDGET

Would increase funding for OAA nutrition programs by $60 million

This includes a $20 million grant for a nutrition demonstration grant program “for the purpose of investing in evidence based models to modernize the home delivered and congregate nutrition programs.”

Would add about $20 million each in direct funding for III C1 and C2.

Would also increase funding for Titles IIIB, VI, and for Family Caregiver Support

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FY16 PRESIDENT’S BUDGET

Includes Elder Justice Initiative again funded at $25 million (received $4 million last year from Congress)

Funding for LIHEAP is down Funding for SSBG, SCSEP, Title VII same Did not assume a resumption of

sequestration

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FUNDING FOR OAA PROGRAMS, FY12-FY16Growth in older population: 43.1 million in 2012; est. 47.5 million in 2016.

Program FY12 Final FY13 Final FY14 Final FY15 Final FY16 Proposed Home and Community Based Supportive Services

$366.9 million $347.7 million $347.7 million $347.7 million $386.2 million

Congregate $439 million $416 million $439 million $439 million $458.1 million Home-Delivered $216 million $205 million $216 million $216 million $236.4 million NSIP $160 million $147 million $160 million $160 million $160 million Nutrition Grant $20 million Totals, IIIC $815 million $768 million $815 million $815 million $874.5 million Preventive Health

$20.9 million $19.8 million $19.8 million $19.8 million $19.8 million

SCSEP $448.3 million $424.8 million $434.4 million $434.4 million $434.4 million Title VI Native Americans Nutrition and Supportive Services

$27.6 million $26.2 million $26.2 million $26.2 million $29.1 million

Native Americans Caregivers Support

$6.4 million $6.0 million $6.0 million $6.0 million $6.2 million

Title VII Elder Abuse

$21.8 million $20.7 million $20.7 million $20.7 million $20.7 million

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FUNDING FOR OAA/OTHER PROGRAMS, FY12-FY16Program FY12 Final FY13 Final FY14 Final FY15 Final FY16 Proposed

ADRCs $16.5 million $20.3 million $6.1 million* (MIPPA not incl.)

$6.1 million*(MIPPA not incl.)

$20 million

Aging Network Support Activities

$7.9 million $7.4 million $7.5 million $10 million $10 million

Alzheimer’s Disease Demos

$4.0 million $3.8 million $3.8 million $3.8 million $3.8 million

National Family Caregivers Support

$153.6 million $145.6 million $145.6 million $145.6 million $153.6 million

Lifespan Respite Care

$2.5 million $2.4 million $2.4 million $2.4 million $5.0 million

Chronic Disease Self Management

$10.0 million $7.1 million $8.0 million $8.0 million $8.0 million

Elder Falls $5.0 million 0 $5.0 million $5.0 million $5.0 millionAPS Demo 0 $2.0 million $6.0 million - -Elder Justice Initiative

- - - $4 million $25 million

Elder Rights Support $4.1 million $3.9 million $3.9 million $3.9 million $3.9 million

SHIPs $52.1 million $52.1 million $52.1 million $52.1 million $52.1 millionLIHEAP $3.472 billion $3.256 billion $3.424 billion $3.424 billion $3.39 billionComm. Services Block Grant (CSBG)

$677 million $635 million $674 million $674 million $674 million

Social Services Block Grant (SSBG)

$1.7 billion $1.6 billion $1.7 billion $1.7 billion $1.7 billion

Section 202 Housing $375 million $355 million $383.5 million $420 million $440 million

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CONGRESSIONAL BUDGET PROCESS

Sequestration is likely coming back in FY16 if the House and Senate adopted budgets are the guide; both adopted budgets that would restore sequestration

The Murray-Ryan agreement that stopped sequestration was only for FY14 and FY15. A vote last week in the Senate to extend the Murray-Ryan budget failed

Precise potential amounts of across the board cuts not known

Budgets provide guidance to Committees and are not binding but have influence over appropriators

The budget reconciliation which follows later in year can make policy changes.

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OAA REAUTHORIZATION

S.192 passed Senate HELP Committee back in January, first bill produced by this Committee. Bipartisan, led by Senators Alexander, Murray, Burr and Sanders.

Now it’s stuck on Senate floor Other priorities have taken precedence—DHS

funding, Lynch AG nomination, human trafficking, SGR discussions

It’s time to get the bill “unstuck” The House is waiting to see what the Senate

will do so it is crucial to get this done in the Senate now

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S.192 SUMMARY

Three year renewal of the Act Came to a compromise on the funding

formula Otherwise, fairly identical to Sanders-Harkin-

Alexander bill which passed HELP last Congress, including: Keeps nutrition provisions intact, including

separate titles for C1 and C2 as well as keeping voluntary contributions and transfer authority

Elder abuse training for volunteers/staff who come into contact with seniors

Modernization of senior centers Develop guidance on Holocaust survivors

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SOCIAL SERVICES BLOCK GRANT

Perpetually under fire But in a Republican-controlled Congress,

exceedingly so $30 million in funding for senior nutrition at

stake Only source of federal funding for Adult

Protective Services; funds other important services for seniors including case management and day care

Could be up for elimination as an “offset” or for deficit reduction.

WHITE HOUSE CONFERENCE ON AGING

Scheduled for 2015, 6th in history 2 of the 4 priority topics are Healthy Aging

and Long-Term Services and Supports Both are relevant to nutrition

Encourage you to engage in conference at state and regional levels—Boston forum coming up May 28

NANASP as part of LCAO submitted names to the forums for participation

For more information, go to the website: http://whitehouseconferenceonaging.gov/

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WHITE HOUSE CONFERENCE ON AGING

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The WHCOA hosted a listening session on nutrition and its role in healthy aging and LTSS, sponsored by NANASP, the Academy of Nutrition and Dietetics, and Abbott Nutrition

http://tiny.cc/nutritionls

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PART D

Medicare Part D continues to enjoy great support among seniors. 9 out of 10 support it

Premiums have stayed constant Overall cost of program under estimates Preventive in nature, access to and adherence

to medications can and does lower hospitalizations

Always concerns about Part D being tapped in Medicare reform

So far not the case in big SGR bill NANASP supports Part D and opposes proposals

to raise out of pocket costs for seniors, especially low income seniors

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MALNUTRITION: A SILENT EPIDEMIC

87% of all seniors have diabetes, hypertension, high cholesterol and/or some combination of these

Can be treated with nutrition interventions Malnutrition is different than hunger or food

insecurity—can have enough to eat but still not be getting proper nutrition

Malnutrition leads to the breakdown of protein in muscles for fuel. This can leave older adults feeling weak and lead to weight loss, which can: Make it harder to recover from surgery and disease Make it more difficult to heal wounds Increase risk for infections Increase risk for falls Decrease strength needed to take care of themselves

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THE STATISTICS 1 in 3 patients admitted to the hospital is

malnourished Drives up healthcare costs 300% per malnourished

patient We spend $157 billion per year on disease-related

malnutrition in the US Malnutrition among older adults is as high as 50% in

rehab settings, 13.8% in nursing homes, and 5.8% in the community

Advanced age alone is a risk factor for malnutrition, especially low-income seniors and isolated older adults

This highlights the importance of OAA nutrition programs—provide healthy meals, socialization, wellness checks, and more, all at low/no cost for the senior!

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HOW ELSE CAN WE WORK TO TREAT MALNUTRITION?

Affordable Care Act Emphasize malnutrition screening and

intervention in care transitions grants and other relevant grants

Hospital Readmissions Include malnutrition screening and intervention

in electronic health record templates visible to all healthcare professionals

Federal and State Health Goals Add malnutrition into the Healthy People 2020

goal for nutrition and weight status Address malnutrition in state obesity plans

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ADVOCACY TAKE-AWAYS

Simple messages to House and Senate members No sequestration. Our programs cannot afford it! Support the President’s budget and its $60

million investment in senior nutrition Oppose cuts to SSBG Pass S.192, the Older Americans Act

reauthorization Oppose cuts to Medicare Part D that impact low

income seniors Urge the WHCOA to feature strong nutrition

recommendations in healthy aging and long term services and supports priorities

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MEMBERS OF CONGRESS TO MESSAGE: YOURS!

CT: Sen. Blumenthal: Aging Sen. Murphy: HELP (Primary Health/Ret. Sec.) Rep. Courtney: Ed/Workforce (Higher Ed/Wkforce) Rep. DeLauro: Appropriations (Ranking, L-HHS)

MA: Sen. Warren: Aging; HELP (Primary Health/Ret.

Sec.) Rep. McGovern: Agriculture (Ranking, Nutrition) Rep. Clark: Ed/Workforce

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MEMBERS OF CONGRESS

ME: Sen. Collins: Chair, Aging; Appropriations; HELP

(Primary Health/Ret. Sec.) Rep. Pingree: Appropriations

NH: Sen. Shaheen: Appropriations (L-HHS)

RI: Sen. Reed: Appropriations (L-HHS) Sen. Whitehouse: Aging, HELP (Primary

Health/Ret. Sec.)

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RESOURCE PAGE NANASP: www.nanasp.org; for more info/slides:

rblancato@nanasp.org WHCOA:

www.whitehouseconferenceonaging.gov ACL Nutrition Programs:

http://www.aoa.acl.gov/AoA_Programs/HPW/Nutrition_Services/index.aspx

ACL Congressional Justification FY2016: http://www.acl.gov/About_ACL/Budget/docs/FY_2016_ACL_CJ.pdf

NANASP WHCOA Listening Session: http://tiny.cc/nutritionls

OAA Reauthorization: https://www.congress.gov/bill/114th-congress/senate-bill/192