n 4a 2012 Policy Priorities and Legislative Update

1. n4a 2012 Policy Priorities and Legislative Update April 16, 2012

2. n4a Advocacy in Action • 2012 Policy Priorities • Grassroots • Legislative Updates

3. n4a’s 2012 Policy Priorities • Reauthorization of the OAA • Enhancing Health of Older Adults • Fiscal Year 2013 Appropriations • Livable Communities for all Ages • Senior Mobility Options

4. OAA Reauthorization • Strengthen the Aging Network’s role and capacity in the coordination and provision of long-term services and supports • Expand evidence-based health promotion and disease prevention • Improve community preparedness for an aging population • Set adequate authorization levels

5. Enhancing the Health of Older Adults • Care Transitions/Care Coordination • Medicaid Managed Care • ADRCs • Prevention and Wellness • LTSS Financing Solutions • Preserve the Medicare & Medicaid Safety Net

6. FY 2013 Appropriations • Sustain OAA program by increasing total funding by 12 percent • Focus on III B, III E, Title VI • First-time funding for EJA, $21.5 mil • Increase SHIP funding, move to AoA, continued Part D enrollment assistance for non-SHIP AAAs/Title VIs

7. Livable Communities • Prepare America’s communities to meet the needs of today and tomorrow’s older Americans • Support the Sustainable Communities Initiative grant programs through HUD, DOT and EPA; FY 2013 Appropriations request of $100 million

8. Senior Mobility Options • Reauthorize senior transportation programs to improve the availability and accessibility transportation servicesfor older Americans

9. Challenges • Real Fiscal Woes • Entitlement Reform Mixed with Deficit Reduction • Policy Agenda Meets Political Opportunity • Potential to have long-term effects on federal policy and spending

10. What do we need to do? • Step up our advocacy to protect key programs • Work in coalition on bigger messages • Push ourselves in advocacy (speak up at town halls over recesses)

11. Grassroots Activities • Reach out to all MoCs to educate them about your agencies and the work you do • Stay in regular contact with Members and staff, build those relationships! • Invite your local congressional offices to your Older Americans Month events in May or plan a site visit anytime • Denver, July 7-11: advocacy trainings, policy updates, social media, etc.

12. FY 2013 Budget Process • The Ryan Budget 2.0 • Likely CR through election • Holiday Package = • Expiration of Bush Tax Cuts • SGR Fix (Again) • January 2, 2013 Sequestration

13. AoA FY 2013 President’s Budget • Moves SHIPs, Title V • Virtually all line items level funded • Zeros out Program Innovations in Title IV • Smaller elder justice ask from FY ’12 • Only cut restored is Alzheimer’s grants

14. Senate Labor/HHS bill marked up as early as late May, early June But House starting from different spending level Discretionary Levels Senate -- $1.047 trillion* House -- $1.028 trillion Current Year = $1.043 * Set by Budget Control Act, Summer 2011 Status of FY 2013 Appropriations

15. Sequester! • Budget Control Act: If Congress fails to act by the end of the calendar year, $1.2 trillion in automatic, across-the-board cuts would take effect through a sequestration process • Cuts expected to be 8-9% for programs like OAA • Exempted programs: Social Security, Medicaid and several low-income entitlement programs. (Medicare benefits could not be cut either, but provider payments could be reduced by up to 2 percent.) • Takes effect on January 2, 2013

16. Reauthorization of OAA TIMELINE • AoA Listening Sessions, Winter 2010 • Groups survey members, write recommendations, release by spring 2011 • Senate HELP Subcomm holds listening sessions, summer 2011 • Act “expires” Sept. 30, 2011 • Fall 2011: AoA shares tech asst for Hill

17. AoA Suggestions • Add parent caregiver of adult children with disabilities to NFCSP • Consolidate nutrition programs • Expand the # of programs allowed to cost-share (would still need waiver from AoA to test cost-sharing for nutrition and case management) • Incentive payments to enhance Aging Network capacity • LTCOP updates • Establish minimum Title III funds for State Legal Asst Devel Program; states pick which if any AAAs to fund • Transform Title IV

18. AoA Suggestions • Increase min amt of state admin from $500k to $750k, affects low-population states • Transfers Title V Senior Community Service Employment Program to AoA from Dept. of Labor • Establish Senior Medicare Patrol within Title VII; from competitive grants to formulas to states • III D: Allow states to fund disease prevention and health promotion services directly by grant/contract (aka not all AAAs will be funded); all programs must be evidence-based

19. n4a’s OAA Reauthorization Priorities • Preserve the Act’s flexibility and person-centered approach • Strengthen the Aging Network’s role and capacity in the coordination and provision of home and community-based services • Expand evidence-based health promotion and disease prevention • Improve community preparedness for an aging population • Set adequate authorization levels

20. What are the issues under discussion? • Cost-sharing • Coordination (e.g., ADRCs, community health centers) • Smaller programs shifting to be state-run (e.g., legal services, III D) • Elder justice: APS, LTCOP

21. What are the issues under discussion? • Investment in workforce, specifially home care, direct care workers • Caregiver assessments • Financial exploitation • Home care ombudsmen programs and home care consumer bill of rights

22. S. 2037 • Consolidates $ for C1 and C2 but sets floors: 40/35/25 • Recommends increases of 50% in funding for nutrition, supportive services, SCSEP and HPDP • Encourages collaboration with Federally Qualified Health Centers • Add “economic security” to objectives, redefine “greatest economic need” to 200% FPL • Redefines “greatest social need” to include LGBT individuals and older adults with HIV/AIDs or Alzheimer’s • Senior Center Modernization encouraged • Legal services: establishes new definition “integrated legal assistance delivery system”; boosts state’s role over current local role for AAAs And more…

23. OAA Reauthorization Timeline • Senate Democratic Bills • June Mark-Up in Senate HELP Comm? • House still busy with other bills • Forecast is unclear • We will need strong advocacy to make Congress pay attention, get it right and keep it moving!

24. Transportation • Reauthorization of the Surface Transportation Act on 90-day extension • House wants 5-year bill; doesn’t have votes; Senate passed 2-year bill • Slightly different approaches to merging Section 5310, NF and JARC programs, $ • Senator Kohl’s “Senior Transportation and Mobility Improvement Act” (S. 1942/HR 4028)

25. Livable Communities • Livable Communities Act has not been reintroduced yet • Sustainable Communities Initiative grants not funded in FY 2012 • HUD keeping the office open • New funding will be needed soon!

26. Questions? Call on n4a Staff! Amy E. Gotwals Director, Public Policy and Legislative Affairs agotwals@n4a.org www.twitter.com/n4aACTION www.twitter.com/amygotwals

27. Optional Advocacy Training: Taking Our Message to the Hill, and Beyond

28. Capitol Hill Day Tips • When you walk into that office, you’re their boss • MoCs and staff are there to serve you and they need your expertise and guidance • Use talking points but say it in your own words so they know you believe it • Tell stories of real people

29. How to Prepare • Meet with your group to decide who will say what • Have local information at your fingertips, as well n4a packets • Read over n4a tips sheet and talking points • Be clear in your goal

30. What to Expect • Being kept waiting • Meeting in the lobby, hallway, cafeteria • Meeting with a different person • Bells ringing, lots of activity • Anything from gracious, sincere attention to your presentation to….

31. What NOT to Do • Be late • Be inflexible • Assume the staffer knows your issues or even what your agency does • Feel you have to answer every question on the spot • Forget who you are representing!

32. Tools to Help You • Advocacy Cards say it quick • n4a Policy Priorities make the case • Hill Visit Tips for a refresher • Talking Points for FY 2013 to help you craft your message • n4a staff

33. Afterwards… • Send thank you emails/faxes to those you met with • Answer any questions you couldn’t on site • Follow up on your requests to Member • Go to the next level (site visit, district mtg, ??)

34. Questions? Call on n4a Staff! Amy E. Gotwals Director, Public Policy and Legislative Affairs agotwals@n4a.org www.twitter.com/n4aACTION www.twitter.com/amygotwals