1. Washington Update: Public Policy and Advocacy Meredith Ponder Senior Associate Matz, Blancato and Associates June 2, 2014

2. Introduction  Second session of the 113 th Congress halfway done  Sixth year of the Obama presidency  Where do things stand?  With the president: not so much power  Key people are leaving Administration  Headed into lame-duck period  November election and possible changes

3. Congressional Overview  Started with strong bipartisan activity  Omnibus FY 2014 Appropriations bill, Farm Bill, increase in debt ceiling SGR patch  Only “must do” left: FY 2015 appropriations  Could do:  Permanent fix to SGR  Tax extenders  Workforce Innovation and Opportunity Act monitor for possible implications for I and R  Might or might not do:  Immigration reform  Older Americans Act  Tweaks to Affordable Care Act

4. Congressional Overview (cont.)  More not on table than on table  Not on table:  Social Security (chained CPI gone)  Medicare reform (other than SGR)  Medicaid reforms (other than Medicaid expansion in states)  Long term care

5. Older Americans Act  D.C. still stalled on the OAA reauthorization  3 key bills in play  Farthest along is the Sanders bill (S. 1562)  Awaiting consideration on Senate floor  Stalled by formula changes  Has to be resolved

6. S.1562 – OAA Amendments of 2013  Strengthens and reauthorizes core programs of the OAA  Updates definitions of “greatest economic and social need”  Addresses economic security  Authorizes new demonstration projects  Increases focus on elder abuse

7. OAA (cont.)  Related to this bill is H.R. 4122 (Bonamici)  Bonamici bill is a modest but progressive reauthorization which expands on the Sanders bill  Pending; no action scheduled  3rd bill is H.R. 3850 (Gibson, NY) a bipartisan straight reauthorization for five years starting in FY14  No action yet on this either  The existing provisions related to I&R in the current law are maintained in all three bills. Ongoing work to get the AIRS standards recognized in law

8. Prospects for the OAA?  Appear not good as of today  No one wants to make next move  Everyone is passive  Buzz has to be generated from grassroots  AARP did lobby day with more than 250 visits and had OAA on agenda

9. Affordable Care Act  Now in its 5th year  Controversial from the start. Will continue to be a defining issue in November  Future of big ticket items such as individual mandate remain unclear  Medicaid expansion key state by state issue  AIRS is a “Champion for Change” of the ACA  Some AIRS interests include navigators program, care transitions and Part D issues  Navigators program: a lot of bang for a little benefit?  Millions spent on the program, but unclear how much it has helped consumers enroll  Still will be a window of opportunity for I&R network

10. Affordable Care Act  Care transitions (lowering hospital readmissions)  Aging network heavily involved  Renewal of grants under way but programs have had issues meeting metrics  A strong feature of the ACA for seniors is lowering of prescription drug costs in Medicare Part D  Gradual closing of donut hole  Already achieved savings averaging $1300 per senior  Add to that new emphasis on preventive benefits  Will help to bend cost curve for health care  New and emerging issue relates to problems enrolling new Medicaid people and need for information

11. Long Term Care  Another health issue to consider when discussing ACA  America’s denial issue continues  Effort in Affordable Care Act (CLASS Act) failed  New ideas are developing  Switch emphasis from long term care to long term services and supports  Greater emphasis on home and community based care  Must address financing (public/private)

12. Elder Justice  Elder abuse is a growing problem  Estimated that 1 in 10 seniors are victims of abuse, neglect and/or exploitation  Federal response is not adequate to say the least  $25 million Elder Justice Initiative proposed in the President’s budget  $13.8 million to enhance APS, including databases and program standards  $11.2 million for research, including screening tools and foundational research  Important first step  Information is the business of what you do, and elder abuse prevention is about people being aware of the problem  World Elder Abuse Awareness Day is June 15

13. White House Conference on Aging  We continue to monitor possible 2015 White House Conference on Aging  Included in President’s budget is $3 million for WHCOA  Very appropriate to do in 2015: 50 th anniversaries of Medicare, Medicaid and OAA  Look for opportunities for AIRS to get involved

14. The Five B’s of Advocacy  Remember the 5 B’s of advocacy  Be Prepared  Be Persistent  Be Persuasive  Be Personable but most of all  Be Engaged!

15. Action at Home  What can you do as a community? Key component of advocacy  Forums  Phone/email campaigns  Visit local offices  Neighborhood/community awareness  Letters to the editor  Tweeting

16. Advocacy vs. Lobbying  This is advocacy:  Telling your member of Congress how a federal grant your organization received has helped your constituents  Educating a member of Congress about the effects of a policy on your constituency  Inviting a member of Congress to visit your organization so that he/she may see firsthand how federal funding or a policy affects day-to-day operations and the difference it makes http://www.ncoa.org/public-policy-action/policy-news/are-nonprofits-allowed-to.html

17. Conclusions  We are coming up on what will likely be a brutal midterm election  Advocacy before the distraction of the midterms is more crucial than ever, especially on issues like the OAA  Take action at home and if you visit DC to take action there, let us know you’re in town!  mponder@matzblancato.com mponder@matzblancato.com