The 40th anniversary of Jacksonville Towers was recently celebrated by residents, staff and local officials in Jacksonville, Arkansas. The 9-story 100-unit building opened March 31, 1979.
In attendance were many residents as well as Bob Johnson, Mayor of Jacksonville; James Reid, former Mayor of Jacksonville; Mark Perry, Jacksonville State Representative; and Fredrick Love, Little Rock State Representative. A time capsule was dedicated to commemorate the occasion.
Despite increased senior poverty the Administration continues to cut and delay funding for Affordable Senior Housing
As reported by the U.S. Administration on Aging 2017 Profile of Older Americans, over 4.6 million people age 65 and over (9.3%) were below the U.S. poverty level in 2016, and another 2.4 million were classified as “near-poor” (income between the poverty level and 125% of this level.) Even though this represents about one of every ten older persons, it underestimates the true burden of poverty since it doesn’t adjust for expenses such as health care and housing.
The U.S. Census Bureau’s Supplemental Poverty Measure (SPM) shows a significantly higher number of older persons below poverty. Under the SPM poverty measurement, the number of persons age 65 and over have a poverty level of 14.5 percent, higher for women, persons living alone and minorities. Most seniors rely on Social Security for their primary source of income. The cost of housing has dramatically increased in recent years resulting in low-income seniors not being able to secure safe and decent housing even if they spend most (if not all) of their Social Security payment on rent and utilities (the 2019 average monthly Social Security is $1,300 and most of our residents receive even less) leaving little funds for food and other necessities.
Between 2006 and 2016, Social Security payments rose just 6 percent in real terms while the median rent for households age 65 and over climbed at twice that rate. As noted in the accompanying article by EHDOC Chairman Chris Sheldon, HUD classifies persons paying more than one-half of their monthly income for rent or living in severely inadequate housing as “worst case” rent burden; and confirmed that there is a growing increase in the number of older Americans with worst case housing needs. We clearly need to assist low-income older persons to quickly obtain affordable senior housing.
I commend our EHDOC residents who joined more than one thousand other seniors from around the country at the U.S. Capitol several years ago to rally for the restoration of Section 202 funds to develop affordable senior housing (Housing with a Heart Summer 2017.) Our residents and others expressed their concerns that Congress had not funded Section 202 development funds for the past few years despite the critical shortage and increasing need for affordable senior housing. It was great that their voices were heard because $105 million for Section 202 development was included in the FY2018 Omnibus Appropriations bill that was enacted on March 23, 2018. While the funding was not as much as the $582 million funded in FY2010 and preceding years, it was the largest funding for Section 202 development since FY2010.
We were pleased and looking forward to the Administration allocating the funds so that EHDOC and other non-profit organizations could again use Section 202 funds to develop affordable senior housing. It was more than a year later, however, including the historic 35 days government shutdown, when HUD finally announced on April 4, 2019 the Notice for Funding Availability (NOFA) for Section 202 development funds.
We were pleased that the funds were finally available, yet annoyed and deeply concerned that HUD was allocating less than half ($50 million) of the $105 million that Congress had appropriated. The Administration indicated they intend to allocate the balance of the FY2018 funds next year in 2020 (as well as the additional $51 million FY2019 funds that subsequently had been passed by Congress on February 14, 2019.) Yet again, further delays.
The Administration justified postponing these Congressionally passed Section 202 development funds to provide more time for non-profit organizations to prepare for HUD’s newly imposed “leveraging” requirement for the very competitive Section 202 funds. EHDOC and other developers of affordable senior housing have already needed to obtain additional public and private funding due to the inadequate and reduced Section 202 funding over the past few years.
While EHDOC is pleased to have positive working relationships with state and local governments regarding securing additional funds to expand, enhance, and expedite our development of affordable senior housing, the Administration’s newly imposed leveraging requirement could make it even more difficult to secure these additional funds since the Administration had also proposed (a couple weeks before the Sec. 202 NOFA) in their FY2020 budget to eliminate or severely cut many of the existing federal programs that state and local governments have used to assist with the development of affordable housing.
On March 11, 2019, the Administration released its proposed FY2020 budget that would impose a 5 percent cut for most non-defense federal programs. For HUD, there would be significantly deeper cuts of $9.6 billion. Cuts include the elimination of all funding for the HOME program, Community Development block grants, and the National Affordable Housing Trust Fund. Not only would the Administration’s proposed FY2020 budget impose deep cuts to affordable housing programs, including zero funding for Section 202 development; but it would also undermine the capacity of state and local governments to have the resources that non-profit organizations need for the new HUD imposed fund leveraging requirement in the Section 202 NOFA.
In addition, the GOP tax cuts enacted last year reduce incentives by corporations and others to invest in the Low-Income Housing Tax Credits program that EHDOC and others have used for affordable senior housing. See my article on the impact of the tax cuts on affordable senior housing in Housing with a Heart Spring 2018. I am proud that our seniors participated in the Section 202 rally in the summer of 2017, however, we are still waiting the full allocation of the $105 million Congress passed for FY2018. This past May, our residents again participated in the “Affordable Senior Housing NOW” rally for FY2020 funding. It is vital that our voices continue to be heard to restore Section 202 development funding to at least $600 million (approximately the funding level provided in FY2011 and earlier years.)
It is especially important this year since there are nearly one hundred new members of the 116th Congress who may not be familiar with the critical need for and benefits of this vital affordable housing program. Please continue to make your voices heard on behalf of low-income seniors nationwide struggling to obtain affordable senior housing!
What is the commitment for Affordable Senior Housing in communities nationwide?
As most communities nationwide know, the cost of housing has been sharply increasing over the past few years. This escalating cost of housing has been particularly harsh for low-income older persons who rely upon Social Security as their primary source of income, including most EHDOC residents. The Census Bureau identifies housing costs in excess of 30 percent of income as an indicator of a housing affordability problem.
The Department of Housing and Urban Development (HUD) classifies persons paying more than one-half of their monthly income for rent or living in severely inadequate housing as “worst case” rent burden; and confirmed in their latest annual report to Congress, HUD’s Worst Case Housing Needs: 2017, that there is a growing increase in the number of older Americans with worst case housing needs. In 2015, 8.3 million households (about 40 percent) controlled by an elderly person had worst case housing needs. This represents a 2.6 percentage increase from 2013.
In its latest annual report to Congress on the shortage of affordable housing, the National Low-Income Housing Coalition (NLIHC) reported that our country has a shortage of seven million rental homes that are affordable and available to extremely low income renters representing only 37 rental homes for every 100 households. Nearly half (48 percent) of these extremely low income renters (having 30 percent of the area median income) are seniors or persons with disabilities. The federal government provides a number of programs to assist low-income seniors and other eligible families with affordable housing, including public housing (40 percent are seniors) and Section 8 rental assistance (50 percent are seniors). However, the only federal housing program that is specifically for the production of affordable housing for very low-income older persons is Section 202 Supportive Housing for the Elderly.
EHDOC and other non-profit organizations have long used theSection 202 program to develop affordable senior housing; unfortunately, due to severe cuts in recent years, only one in three of eligible (aged 62 and 50 percent of area median income) very low-income seniors are assisted. Nationwide there are ten eligible very low-income older persons on waiting lists for each apartment that becomes available annually, resulting in long multiyear waiting lists. EHDOC and other non-profit organizations also work with state and local governments to secure land, policies and funds to expand and enhance affordable senior housing, including: Low-Income Housing Tax Credits (LIHC), bonds, tax exemptions, HOME, Community Development Block Grants (CDBG) and state and local housing trust funds for seniors. Given the many critical and priority needs in local communities for each of these scarce resources, there is great competition among for-profits and non-profits for these limited resources, including affordable senior housing.
Unfortunately, despite the keen competition for limited funding, in recent years (including the FY2020 federal budget that is now under consideration by Congress,) there have been repeated efforts by the Administration and Congress to severely cut and even eliminate many of these programs that state and local governments have used for affordable housing.
In response to the affordable housing crisis, voters in many communities throughout the country are taking actions at all levels of government to increase the awareness of the critical need, as well as solutions for affordable rental housing. While the current political and funding environments are challenging, it is encouraging that effective advocacy efforts have resulted in positive actions by some state and local governments to expand the supply of affordable housing. As reported in a recent NLIHC study, Affordable Housing Wins, “in 2018, advocates and voters confronted affordable rental housing shortages and skyrocketing rents by taking action at the voting booth…The vast majority of ballot measures to expand funding for housing production and preservation (22 of the 26) passed. Of those that failed, two measures passed with considerably more than 50% of the vote but failed to gain the required two-thirds threshold. Seven obligation bond ballot measures were passed.”
While the NLIHC study is an encouraging indication of potential voters’ support to address affordable housing needs, including senior housing; there were only a few affordable housing measures that were up for
consideration by voters last year.
A key question remains: What is the commitment for affordable senior housing in your state and local community?
It is clear that much needs to be done to educate our elected officials at all levels of government of the critical shortage of affordable and suitable senior housing. The need for affordable senior housing is evident by multi-year waiting lists; increased numbers of seniors becoming homeless; projected doubling of the current 48 million elderly population within the next few decades; and the dramatic loss of existing affordable housing, as mostly for-profit owners opt out of federal contracts and convert existing assisted affordable housing to unaffordable market-rate housing (over 60 percent loss of affordable housing during the past decade.)
When one of its residents needed a helping hand, EHDOC was ready to assist. Guillermo Ramos, a resident at Hugh Carcella Apartments in Reading, Pennsylvania, is a quiet and humble man, well-liked by everyone and known for his kindness.
He drives other residents to the grocery store and medical appointments, never asking for payment. He also delivers Meals on Wheels to his neighbors and helps with the food bank. Guillermo was in disbelief the day he looked out his window and saw that his car was not parked where he had left it the evening before. It had been stolen!
He notified local police and submitted a report but wondered what he would do without his car. His monthly Social Security benefit is his only income. He could not afford to replace his car. As soon as the Hugh Carcella Apartments Residents Association heard of his loss, they immediately launched a fund raiser for Guillermo.
Community Manager Amy Rodriguez and Service Co- ordinator Sheila Rampolla shared Guillermo’s story with EHDOC President and CEO, who was so moved, he requested a check to be issued from EHDOC’s Senior Relief Fund. Guillermo was flabbergasted and appreciative when Melissa Tarrant, Vice President of Field Operations, visited Hugh Carcella and presented him with a check for $1000. Aida Alvarez, president of the residents association, presented Guillermo with an additional check for $300, which were funds donated by his fellow residents.
Guillermo was able to buy a reliable used car and is very happy that he can continue to help his neighbors.
“It is with a heavy heart I inform you of the recent passing of Morton Bahr. As you all know, ‘Morty’ was an exceptionally proud CWA Union leader, a relentless and passionate advocate for seniors, and humbly honored to be a part of the EHDOC Board of Directors. I ask that you join me in expressing heart-felt condolences to his wife Florence, family and friends and to say a prayer for his wonderful soul that is now enjoying the kingdom of heaven. As a dear, dear friend and colleague, Morty will be greatly missed.”
Morton Bahr was Chairman Emeritus of EHDOC, having served our organization with pride, thoughtfulness and dignity for many years. Chairman Emeritus of the Communications Workers of America (CWA), Morton also served as Vice President of Union Network International (UNI) and was former president of UNI’s World Telecom sector, representing 3 million workers in 120 countries. He led the CWA to develop global alliances with counterpart unions in Latin America, Europe and Asia. He was recognized as a leading voice of the labor movement in the United States and internationally.
Looking Back: Steve Protulis Recognized with Friend of The Elderly Award
B’nai B’rith International co-hosted a rally on Capitol Hill on May 8, 2019 to call attention to the need for more affordable senior housing. About 1,000 people attended the “Senior Housing Now” rally, which featured Virginia Sen. Tim Kaine; Missouri Rep. William Clay; California Rep. Katie Hill; and Florida Rep. Donna Shalala, along with residents of affordable housing for low-income seniors.
Safe and affordable housing is a lifeline for so many older adults. Ethel Young, president of the CSI board of directors in Baltimore, said, “Sometimes I learn that a person who calls to check on where they are on the waiting list for housing where she lives is sleeping in their car… The Walker coop apartments are 88 wonderful apartments in a beautiful community but we are only 88 units. I cannot create new units or wipe away the waiting lists, however, Congress can. Members of Congress should answer the leasing office phone for a few hours a week and hear from the people I talk to.”
Evelyn Hudson, a resident of St. Mary’s Court in Washington, D.C., said, “The reason I’m here today is because senior citizens can be displaced quickly because they don’t make enough money. Some of us retired and we didn’t get the retirement we thought we would get. The American Dream seems like an illusion, and so we need affordable houses. Safe,
affordable houses where we can have food, medicine and housing without
scrimping and scraping.”
Lawmakers attending the rally said they understood how vital funding is. Shalala told the crowd, “I started my career at HUD, working on 202s as a policymaker at HUD in the Carter administration, a long time ago. I’m a senior, too. But I came to tell you that the Congress is committed; that we understand what you’ve contributed to this country. And we know what we have to do to honor that contribution. Seniors all over our country are desperate for affordable housing. And 202 and Section 8s are the best vehicles to provide first-class housing to seniors. Housing is a right in this country, and quality housing for seniors ought to be a right.”
B’nai B’rith’s long history with Section 202 housing started in 1971, when they formed a partnership with the Department of Housing and Urban Development (HUD) to sponsor housing for low-income seniors. B’nai B’rith International is the largest national Jewish sponsor of non-sectarian low-income housing for seniors in the country.
Attending the rally on behalf of the B’nai B’rith Center for Senior Services were Associate Director Janel Doughten and Assistant Director for Aging Policy Evan Carmen. They noted, “It’s so exciting being at the Senior Housing Now rally on Capitol Hill. Affordable HUD senior housing is so important throughout our country, and we call on Congress to appropriate more money for the Section 202 program.
Just look to our B’nai B’rith housing communities where often waiting lists to get into our sponsored Section 202 properties can be a year or longer, or even closed. This rally was critical to highlight the importance of creating more senior housing.”
The rally was sponsored by Leading Age, an association of non-profit aging services.
Rightsizing For Seniors Doesn’t Have To Be Painful
Even though aging in place has never been more possible, some health conditions will prevent older adults from remaining at home throughout their lives.
According to a survey of North American homeowners between the ages of 55 and 75, conducted by Home Instead, Inc., 85 percent have taken time to consider the age-friendly features they will want in a new home, while 64 percent wishing to remain in their current home have thought about necessary age-friendly modifications they will need to make.
“Downsizing – or rightsizing – can be gut-wrenching,” noted Dan Bawden, founder of the national Certified Aging in Place Specialists (CAPS) program for the National Association of Home Builders. Nevertheless, that does not have to be the case if you need to leave home for a smaller place or care community. “All of us treasure and love our stuff,” Bawden added.
What are the most important memories of home? According to the Home Instead survey of older homeowners, gatherings with family and friends led the list at 65 percent, followed by celebrating holidays at 61 percent.
Home isn’t just about the physical space. When asked what it would take to build the feeling of home elsewhere, 66 percent of those in the Home Instead survey said the people in my life; 36 percent said my mementos; 35 percent said my personal décor, and 30 percent said a sense of community.
Here are ways to take home with you, according to Bawden, Danise Levine, architect and assistant director of the IDEA Center (Center for Inclusive Design and Environmental Access at Buffalo University), and Home Instead Gerontologist and Caregiver Advocate Lakelyn Hogan:
Collect the best family photos — Add the names of the people on the photo with a label gun. Put up a bulletin board in their new place with all the names and photos of the family, so they have a family connection board.
Schedule regular visits with families and their pets — “When my mother-in-law fell so many times, she had to move to an assisted living community,” Bawden said. “She had a Bichon-poodle mix named Murphy. We would take Murphy there, and he would be passed around among the residents. The dog had a wonderful connection with home for my mother-in-law.”
Hire professionals to help you move — The National Association of Senior Move Managers assists families with this very thing. Bawden said. “They help seniors move from home to assisted living and they will do all the packing. They set up everything and handle the entire move. When you’re downsizing, it’s helpful to have someone not personally attached to your stuff.”
Personalize your space — Take a cozy blanket and/or any item that means the most with you. “I think it’s important for people to be able to personalize their own spaces so they will feel at home,” Levine said. “Regardless of where they are, there will be some sense of familiarity. Not everyone has the same needs and wants. The option to personalize a space provides comfort. Environments that allow for flexibility are really great.” One family caregiver agreed: “When we brought my mom home to live with us, we put up some of her pictures and brought her lap blankets and familiar things.”
Recreate the appearance of home — There’s a variety of ways to make your new home have the feel of what you knew to be home, Hogan noted. Take your favorite pieces of furniture and set up those pieces in a similar way to home, including the way the pictures are hung on the wall. One family caregiver concurred: “I brought in as much of my mom’s own furniture, lamps, wall pictures, curtains, bedding and books as was allowed, and set it up the best I could to look like home. I even put the name plaque and door knocker from her house on the door to her room.”
Create a photo album of the old home before you move —”Before our family left my childhood home, we took pictures of every room of the house along with the back and front yard,” Hogan explained. “To the album we added pictures of the house during each season and during holidays where people are celebrating. Photos of memories of that home can be meaningful as well.”
About the author:
Julie Ann Soukoulis is the owner of Home Instead Senior care office in Rohnert Park, mother of two and passionate about healthy living at all ages. Having cared for her own two parents, she understands your struggles and aims, through her website www.homeinstead.com/sonoma to educate and encourage seniors & caregivers.
ALBUQUERQUE, N.M. — A recently awarded grant of nearly $2.1 million gets the Elderly Housing Development and Operations Corp., or EHDOC, halfway to building another 40-unit apartment complex for low income elderly people in Albuquerque.
The building will be located on a vacant piece of property adjacent to its Ed Romero Terrace at Texas and Central SE, just down the block from the Albuquerque Indian Center and the site of the now-under-construction Tiny Homes Village for the homeless.
The grant for $2,096,945 from the federal Department of Housing and Urban Development was part of a larger allocation of $51 million in housing assistance awarded to nonprofit organizations nationwide to help finance the construction of affordable housing, as well as provide rental and supportive services assistance for low income seniors.
“We’re absolutely ecstatic to get this grant, primarily because there have been so few dollars made available in the last several federal legislative sessions for low income housing, especially for low income senior housing,” said Les Swindle, community manager for Ed Romero Terrace, the managing entity for EHDOC.
“We’re looking to the city and other funding sources to secure the balance of what’s needed in the next 12 to 14 months, after which construction will start,” Swindle said. He estimated the cost of the project at around $4 million. The 0.62-acre property is already owned by EHDOC.
Ed Romero Terrace is named for former U.S. Ambassador to Spain, Ed Romero, who is the vice president of the EHDOC Board of Directors and a native of Albuquerque. Of 58 EHDOC facilities around the country, the four-story Ed Romero Terrace is the only EHDOC property in New Mexico.
“Our mission is ‘housing with a heart,’ so we’re obviously most interested in taking care of low-income senior citizens, which is why we partnered with HUD to make low-income facilities available across the United States,” Swindle said.
EHDOC was formed in the late 1990s, “at a time when HUD had been mandated by Congress to throw off ownership of residential properties and concentrate on administration,” as well as establish a mechanism for building and supplying new properties for seniors, he said. With the assistance of HUD and other federal funding made available from the city, EHDOC bought the property at Central and Texas SE from the city about 10 years ago and built Ed Romero Terrace.
Under provisions of the federal Housing Act, the grants target low-income people age 62 and older so they can live independently and have access to support services. To qualify they must earn less than 50% of the median income for their area.
In April 2019 HUD released a Notice of Funds Available (“NOFA”) encouraging 501(c)3 non-profit organizations across the country to apply for $50M of Section 202 Funds out of the total $251M appropriated by Congress in recent years. EHDOC submitted its application in late August 2019 for 40 additional units in Albuquerque New Mexico, Edward Romero Terrace Phase II. On Friday, February 7, 2020, HUD announced $51.5 million in awards to 18 organizations to build and operate affordable housing for very low income older adults. Of the 18, EHODC was one of them!
Congratulations to Roland Broussard for his outstanding efforts and to the EHDOC team in celebrating this victory as we continue to work tirelessly for more affordable housing. Thankfully, programs like HUD’s Section 202 program exist to provide affordable, quality housing with on-site Service Coordinators to help residents age in their community. Since the program’s revival in the fiscal year 2017 HUD appropriations bill, Congress has provided a total of $251 million for new Section 202 homes (FY17, $5 million; FY18, $105 million; FY19, $51 million; FY20, $90 million). This first $51.5 million released is expected to result in 575 new homes with Project Rental Assistance Contracts (PRAC) as their operating subsidy. Because the communities also use other funding sources, these 575 Section 202 homes will be in developments that comprise a total of 1,100 homes. HUD expects to announce the competition for the remaining Section 202 dollars in Spring 2020.
Congratulations to all the recipients:
Connecticut: New Samaritan Corporation
Georgia: National Church Residences
Maryland: Comprehensive Housing Assistance, Inc.
Maryland: CSI Support & Development Services
Massachusetts: 2Life Communities
Minnesota: Volunteers of America
New Mexico: Elderly Housing Development and Operations Corporation
Ohio: The McGregor Foundation
Ohio: National Church Residences
Pennsylvania: Catholic Housing and Community Services
Washington: HumanGood Affordable Housing
Is it Time to Change the Federal Budget Process for Affordable Senior Housing?
For too many years, the federal budget process has been dysfunctional for funding affordable senior housing and most other federal programs. While the annual budget process should be complete by the end of September in time for the next fiscal year that begins on October 1st, unfortunately, this rarely happens.
In recent years, the annual budget rush has resulted in either last-minute intense partisan brinkmanship threatening or actual government shutdowns, or a series of delaying tactics through Continuing Resolutions (CR), or by consolidating many (if not all) appropriations bills into an omnibus appropriations bill that risks possible vetoes. It has also resulted in presidential rescissions seeking to send the money back or shift the use of the funds for other purposes, such as recent shifts from defense and disaster aid to the construction of the southern border wall.
Rather than having routine, dependable annual federal funding that EHDOC and other non-profit organizations can rely upon to develop and operate affordable senior housing for low-income seniors, we too often experience uncertainty of when and if funds will be provided. This uncertainty with funding level and time frame also makes it difficult to align these federal funds as part of a multi-funding development process, including state time frame for tax credits. As stated in my earlier article (Housing with a Heart, Spring, 2019), this is no way to run a government.
Yet, here we go again. Prior to their August recess, the House had passed ten of its twelve FY2020 appropriations bills (including HUD that provides funding for affordable housing). Unfortunately, the Senate had not passed a single bill. The Senate strategy was not to proceed with their appropriations bills until after an agreement was reached with the White House on the overall budget caps, which was passed on August 1st. The next day, President Trump reluctantly signed the comprehensive two-year budget bill (PL 116-37) that would not only raise the budget caps that were imposed by the Budget Control Act of 2011 (BCA), but also suspend the federal debt ceiling caps until July 31, 2021 (after the 2020 election.) The budget bill would increase military and domestic spending levels by approximately $160 billion for FY2020 and again for FY2021, significantly above the Administration’s fiscal 2020 budget request. The 2011 Budget Control Act will expire at the end of FY2021.
The House needed to reduce appropriations bills by $15 billion to reflect the budget caps agreement. Most of their appropriations bills had higher budget cap levels, including the House-passed HUD bill (part of a 5-bill omnibus appropriations) that would have provided $803 million for Section 202 senior housing, including $140 million for new development.
The Senate passed funding for HUD in October that would have provided $696 million for Section 202, but no additional funds for new development. The House and Senate resolved differences between their bills only a few days before the December 20th deadline provided by the 2nd continuing resolution. The consoli-dated FY2020 Appropriations provided $793 for Section 202, including $90 million for new construction.
After threatening another veto that would have shut down the federal government, President Trump signed the bill just before the midnight deadline. Last year, disagreement over funding border wall construction was a key factor to the veto of in the omnibus appropriations bill that led to the historic 35-day government shutdown that began shortly before last Christmas. Congress passed the Consolidated FY2020 Appropriations the same week that the House voted to impeach President Trump, and then recessed for the holidays to return only a few weeks before the Administration was scheduled to release its proposed FY2021 budget the first week of February when the annual process starts all over again.
Given these delays and disruptions, is it time to explore whether there is a better way to provide timing and steady funding for crucial federal programs such as affordable senior housing? There are several legislative efforts being considered to reform the federal budget process. One could be to revise and strengthen the use of the annual Congressional Budget Resolution that sets limits on total spending and revenue (including Social Security, Medicare and Medicaid – about two-thirds of the federal budget.) Under a Budget Resolution, the House and Senate Budget Committees each pass a budget resolution setting spending targets for the upcoming fiscal year. After a compromise budget resolution is reached, changes to existing laws can be made through an expedited reconciliation process to conform tax and spending levels to the levels set in the budget resolution.
Unfortunately, Congress has had difficulties adopting budget resolutions because of partisan differences between the House and Senate. The Budget Resolution was used only three times in the past nine years, and then for the sole purpose of achieving partisan GOP objectives through use of the reconciliation process: 1) attempts to repeal Obamacare in FY2016 and FY2017; and 2) tax cuts in FY2018. With the budget process broken and overdue for changes, there is an opportunity to reform and use the Budget Resolution, including multi-year budgets to address cross-cutting issues, such as affordable senior housing linked with health care and supportive services.
During this time of possible changes to the budget process, it is critical that members of Congress, especially congressional and presidential candidates, understand the need for affordable senior housing, as well as the cost-effectiveness of investing in affordable senior housing as part of a health and long-term care strategy that may be achieved through a reform budget process that includes mandatory (Medicare and Medicaid) and discretionary funding for affordable senior housing.
Excerpts from blog published by Peter Lawrence on Wednesday, December 18, 2019
On Dec. 17, the House passed H.R. 1865 and H.R. 1158, the two comprehensive fiscal year (FY) 2020 spending bills covering $1.3 trillion in funding for all federal agencies, including Treasury and the U.S. Department of Housing and Urban Development (HUD), averting a potential federal government shutdown that would have begun after the temporary stop-gap funding bill, the Continuing Resolution (CR) was scheduled to expire on Dec. 20. The Senate is expected to pass both FY 2020 spending bills soon and the president is expected to sign the legislation before the CR expires at the end of the week.
For HUD, H.R. 1158 provides gross appropriations of $56.5 billion, a $2.77 billion (5.1 percent) increase from FY 2019, a $12.4 billion (28.1 percent) more than the FY 2020 request, $969 million (1.7 percent) less than the FY 2020 House THUD bill passed before the budget agreement, and $482 million (0.9 percent) more than the Senate FY 2020 THUD bill. In general, the bill’s funding level rejects most of the administration’s cuts and sustains the major HUD funding increases enacted in FY 2018 and FY 2019, as well as providing a few programs with increases.
This overall funding allocation was made possible by the Bipartisan Budget Act of 2019 (BBA19), which set a cap of $622 billion for FY 2020 non defense spending, which is $25 billion (4.2 percent) more than the FY 2019 cap, but $79 billion (14.5 percent) more than the FY 2020 non defense cap prior to the BBA19. As noted above, this budget agreement was finalized after the House set its FY 2020 spending allocations for each bill, so it was not surprising that the final program funding levels were closer to the Senate bill rather than the House bill.
The final bill provides $793 million for the Housing for the Elderly (Section 202) program, $115 million (17 percent) more than FY 2019, $149 million (23.1 percent) more than the request, $10 million (1.2 percent) less than the House bill, and $97 million (13.9 percent) more than the Senate bill. The bill also provides $90 million for new capital advances or rental assistance contracts (SPRACs), which is $39 million more than FY 2019, but only the third time Congress has provided such funding since 2011.
Choice Neighborhoods Initiative
The final bill does not agree to eliminate the Choice Neighborhoods Initiative, which is designed to comprehensively revitalize high-poverty public and assisted housing communities, as proposed by the administration’s request. Instead, the bill provides $175 million, $25 million (16.7 percent) more than FY2019, $75 million (75 percent) more than the Senate bill, but $125 million (41.7 percent) less than the House bill.
That being said, House Ways and Means Committee Chairman Richard Neal, D-Mass., has expressed his intent to consider comprehensive infrastructure legislation in 2020, which could provide an opportunity to advance affordable housing and community development-related tax incentives, including a new federal infrastructure tax credit, permanence for the NMTC, and many, if not all, AHCIA provisions, through the House floor and represent the opening bid for such legislation in early 2021, when it likely would have a better chance at enactment in the first term of a new Democratic president or second term of a newly re-elected president Trump.
AASC Conference and Service Coordinator of the Year Award Recipient Cherene
The EHDOC Service Coordinators attended the annual American Association of Service Coordinators Conference in Colorado this year for training and networking.
EHDOC always holds a reception for their service coordinators during the AASC conference and chooses the Service Coordinator of the Year.
This year’s recipient was Cherene McFadden from Steelworkers Tower in Pittsburgh, PA. Cherene has been the Service Coordinator at Steelworkers for five years, providing many services and excellent programs to EHDOC residents. At the young age of 10, Cherene knew she wanted to work with seniors and started volunteering at a local nursing home where she read, wrote letters and gave companionship to the patients there.
Cherene continued to work with the elderly as an administrator of several assisted living facilities, where for more than 30 years she supervised staff, managed patients and provided direct care services.
A few weeks before the AASC conference, Cherene was also awarded the 2019 Partnerships Reaching the Organization Mission (PROM) Distinguished Community Service Award. This award was for her contributions, achievements and service to the community.
The residents of Steelworkers Towers truly appreciate all that Cherene has done for them, and EHDOC is very fortunate to have Cherene on staff. Her compassionate leadership has created an environment of care and trust that truly makes a difference in the lives of all those she touches.
Preventing the Spread of COVID-19 in Retirement Communities and Independent Living Facilities
A retirement community or independent living facility is a residential or housing community that is usually age-restricted (e.g., aged 55 and older) with residents who are partially or fully retired and can generally care for themselves without regular nursing or other routine medical assistance. Communal facilities, community activities, meals, transportation, and socialization opportunities may be provided. Different types of independent housing with support services for older adults include:
Public housing for low- to-moderate income elderly
Assisted living homes that do not provide medical services
Continuing Care Retirement Communities, which include a range of housing options including independent living.
Who is this guidance for?
This guidance is for owners, administrators, operators, workers, volunteers, visitors, and residents of retirement communities and ILF that are not healthcare facilities. Guidance for long-term care facilities (LTCF) that offer medical services, i.e., nursing homes, skilled nursing facilities, assisted living facilities, and adult day care programs to older adults can be found here.
Additionally, a checklistpdf icon is available for use by long-term care facilities and assisted living facilities to assess and improve their preparedness for responding to COVID-19. Retirement communities and ILF can adapt this checklist to meet their needs and circumstances.
COVID-19 is being increasingly reported in communities across the United States. It is likely that the novel coronavirus is circulating in most communities even if cases have not yet been reported. Residents in retirement communities and ILF are considered to be at higher risk of severe COVID-19 outcomes because of older age and because they may have underlying health conditions, such as chronic heart disease, diabetes, or lung disease. They also may be at higher risk of getting and spreading the virus because of community characteristics, such as frequent social activities, and shared dining facilities and communal spaces. Guidance specific to retirement and independent living communities can help the residents, and those who help serve them, slow the spread of the virus and prevent serious illness.
This guidance takes into account that residents in retirement communities generally care for themselves. Retirement communities and ILF can also consider adopting the more stringent recommendations for long-term care facilities or nursing homes, especially if they are a continuing care retirement community that includes a long-term care facility. Either way, retirement community and ILF owners, administrators, or operators have an important role, working together with residents, workers, volunteers, and the local health departments in slowing the spread of diseases and helping ensure residents are safe.
What owners, operators, or administrators can do:
Owners, administrators, operators and can help slow the spreading of the virus and prevent severe illness within communities by following the guidance below.
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Cancel all public or non-essential group activities and events.
For essential group activities that cannot be canceled, implementing the following social distancing measures can help:
Alter schedules to reduce mixing (e.g., stagger meal, activity, arrival/departure times)
Limit programs with external staff
Limit the number of attendees at a given time to fewer than ten people and ask participants to maintain a distance of at least six feet from one another.
Place chairs and tables at least 6 feet apart during communal dining or similar events.
Because canceling social interaction may increase risk of adverse mental health outcomes, particularly during a stressful event of a disease outbreak, administrators can provide information to help support residents in managing stress and anxiety during this COVID-19 outbreak.
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Clean and disinfect all common areas and shared facilities.
Give special attention to high-touch surfaces, including, but not limited to, door handles, faucets, toilet handles, light switches, elevator buttons, handrails, countertops, chairs, tables, remote controls, shared electronic equipment, and shared exercise equipment.
Ensure staff follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, necessary personal protective equipment, etc.). A list of products that are EPA-approved for use against the virus that causes COVID-19 is available hereexternal iconexternal icon.
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Inform residents, workers, volunteers, and visitors about COVID-19.
Workers, contractors (such as barbers, hairdressers, sitters, and housekeepers), and volunteers providing care in multiple homes or facilities can serve as a source of coronavirus transmission between residences in these facilities. These persons should be advised to limit the number of people they interact with who are at higherrisk of serious complications from COVID-19, and retain distance of >6 feet when interacting.
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Help residents establish a “buddy” system to ensure they stay connected.
Owners, administrators, and operators of retirement communities and ILF may want to identify residents who have unique medical needs (including behavioral health needs), and access and functional needs to encourage them to develop a plan if they or their primary caretaker(s) become ill.
They can assist in finding volunteers to assist residents who may need extra assistance in getting the medical help they need and train these volunteers in following personal protective measures. These volunteers should not be persons who are at higher risk for serious illness from COVID-19. Volunteers can also consider checking up on residents via electronic means if appropriate.
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Consider limiting the number of non-essential visitors.
Retirement communities and ILF may want to consider limiting visitation (e.g., maximum of one visitor per resident per day, restricting visitors with recent travel and those with symptoms of COVID-19), especially in common areas, to workers, volunteers, and visitors who are essential to preserving the health, including mental health, well-being, and safety of residents. Advise persons that maintaining social distancing (at least 6 feet) can help reduce coronavirus transmission.
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Screen, when possible, and advise workers and essential volunteers.
When possible, administrators may want to consider screening workers and essential volunteers who will be interacting with residents for signs and symptoms of COVID-19. This includes actively taking each person’s temperature using a no-touch thermometer, and asking whether or not the person is experiencing shortness of breath or has a cough. They should be advised that if they develop fever or symptoms of respiratory infection while at work, they should immediately put on a facemask, inform their supervisor, and leave the workplace.
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Follow guidance for businesses and employers
This guidance also can be helpful for owners, administrators, and operators of retirement communities and ILF and is found here. It includes:
Actively encouraging sick employees to stay home
Implementing flexible sick-leave policies and to the extent possible flexible attendance policies (e.g., telework, staggered shifts)
Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place/common area.
If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
Wash your hands after touching surfaces in public places.
Avoid touching your face, nose, and eyes.
Additionally, they can avoid close contact:
Stay in your homes or outdoors away from groups of people, as much as possible.
Limit visitors to persons essential to maintaining their health, well-being, and safety. Social interaction is important; however, in-person social interactions are associated with increased risk of infection.
Learn and practice alternative ways to interact, including replacing in-person group interactions with video or telephone calls.
Ensure continuity of the regular care and medical services they receive.
Residents can work with their primary caretakers to identify alternative caretakers to ensure continuity of care should there be any interruptions to the regular services they receive. Telemedicine services may be available to them. They can work with their medical providers to determine if any elective procedures or non-emergent services can be delayed without negatively impacting their health. They can ask their medical providers if they have a formal “telehealth” system for their regular appointments and, if not, ask if they can still communicate by telephone (instead of visits) to reduce the number of face-to-face interactions.
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Have medication and supplies on hand.
Residents may want to consult with their healthcare providers and, if possible, plan to keep an extra supply of their regular prescriptions. Mail-order medications also could be considered as an alternative for those unable to get longer supplies of medication. They can ensure that they have an adequate supply of food and everyday essentials in their homes should a disruption occur for an extended period.
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Keep their homes clean and disinfected.
It is important that residents keep their homes clean and disinfected by following these instructions. If they become ill or if they are caring for someone who is ill, they can follow the guidance found here.
What volunteers and visitors can do:
There are many ways volunteer or visitors can reduce the spread of illness:
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Avoid entering the facility, the premises, or private residences unless your presence is essential to preserving the health, including mental health, well-being, and safety of residents.
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Follow personal protective measures found here and the recommendations set forth by the facility they are visiting.
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Maintain social distance of at least six feet from residents can reduce transmission. Do not visit if you recently had contact with persons who have symptoms of COVID-19 or if you recently traveled. Most importantly, do not enter the retirement community or ILF if you are sick.
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Avoid large groups and travel, especially on planes and cruise ships.
If you, as a volunteer, regularly visit the retirement community and ILF, consider taking greater precaution to protect the residents because they are higher-risk persons. These precautions include avoiding large group gatherings and crowds, delaying non-essential travel including plane trips, and avoiding embarking on cruise ships. Volunteers and visitors who have recently traveled should avoid visiting the retirement community and ILF.
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Watch for symptoms of illness and follow the recommended steps if you get sick.
If you develop respiratory illness symptoms while at the retirement community or ILF, immediately put on a facemask when possible, leave if possible, self-isolate, and notify the residents you visited and administrators. If you were there with a volunteer organization, notify the organization. Additional guidance on what you can do if you get sick can be found here.
What workers can do:
As a worker, you can follow the same recommendations as for volunteers and visitors, plus:
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Follow standard infection prevention and control practices, basic personal protective recommendations and any other site- and task-specific infection prevention and control measures implemented by their employer.
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Maintain social distance of at least six feet from residents whenever possible. Outside of work, avoid contact with persons who have symptoms of COVID-19.
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Watch for symptoms of illness and follow the recommended steps if you get sick.
Stay home if you are sick and notify your supervisors if you become sick outside of work hours. If you become sick while at the facility or on the premises, put on a facemask, leave immediately, and notify your supervisor. Additional guidance on what you can do if you get sick can be found here.
When a case has been confirmed in the retirement facility or ILF
If a person with COVID-19 resides in or recently has been to a retirement community or ILF, CDC recommends the following additional measures:
Owners, administrators and operators can take the following additional measures to help prevent or slow further spread of COVID-19:
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Coordinate with local health officials.
Upon learning that a resident, worker, volunteer, or visitor of the retirement community or the ILF has COVID-19, ask the person to self-isolate and contact local health officials.
Notify the local health department about any clusters of residents or workers with respiratory illness (e.g., 3 or more persons with onset of respiratory symptoms within 72 hours).
Communicate with residents, workers, volunteers, and visitors.
In coordination with local health officials, communicate the possible COVID-19 exposure to all residents and workers, volunteers, and visitors. This can be done by placing signage in common areas and entrances/exists and by letter to all residents. Residents could be advised to inform their recent personal visitors of potential exposure.
Maintain confidentiality as required by the Americans with Disabilities Act (ADA) and Health Insurance Portability and Accountability Act (HIPAA.
Ask residents to self-monitor for 14 days and take action, if sick.
Self-monitoring means a person takes his/her temperature twice a day and pays attention to cough or difficulty breathing. If a resident feels feverish or their temperature is 100.4°F/38°C or higher, they have a cough, or difficulty breathing during the self-monitoring period, the following actions will help prevent spreading further illness:
Limit contact with others
Report their illness to retirement community and ILF administrators
How you can help staff streamline external communication efforts during COVID-19.
By Michael Eidsaune, CEO, Carely
It’s been more than five weeks since family members have been able to visit their loved ones in senior living facilities due to coronavirus, creating a sense of helplessness and worry among spouses, children and other loved ones.
Quality relationships are just as important as quality care, but fielding phone calls from each member of the family not only takes precious time, but also takes time away from the residents themselves. It’s a hard balance to achieve. While managing a senior living community is a demanding job, proactive communication goes a long way toward building a sense of caring and trust, especially in unknown times like these.
Luckily, advanced technology can be a force multiplier for any organization, especially in long-term healthcare. With shrinking margins and tighter CMS restrictions, technology can be a saving grace for the organizations that utilize it.
With the right technology, staff can provide regular updates and give families peace of mind — all while doing their best work and keeping residents safe and healthy.
Ensure family concerns are received and attended to
Normally when a drop-in visit from a family member leads to a concern about a resident, too often that concern has either no one to be directed to, or it ends up on a post-it note on an executive director’s desk. With a simple technology platform, these messages are not only easier for the family to deliver, especially when they are offsite, but they are much easier to track and deliver to the appropriate staff member.
Calls are dramatically reduced
As senior living communities continue to quarantine their residents to prevent coronavirus spread, family members who have been physically cut off have become increasingly worried about their loved one’s well being. Many of them will call the facility and ask for updates. However, by adopting a social technology solution — and encouraging family members to use it — families are empowered to communicate better amongst themselves. This leads to fewer instances of multiple family members calling for the same update.
Some solutions are low cost or free
In the past, most long-term care software was complex and expensive. In many cases that is still true today (just look at your electronic medical records invoice). However, there are many solutions that have become mainstream outside of the long-term care industry that can be quickly adopted and easily implemented at negligible cost compared to the older, legacy systems.
Take Slack, for example. Many organizations have adopted this text chat solution to use with administrative staff across multiple communities. This software is intuitive and can be utilized for free.
Technology is increasingly supplementing our day-to-day communication. Zoom became a household name almost overnight since the stay-at-home orders were put in place, and the rate of smartphone adoption gets closer to 100 percent everyday. As a result, families have become more reliant on technology as a means to receive information and connect.
In long-term care settings, adoption of tech-based communication tools can have a tremendous impact, especially with most organizations on mandatory lockdowns nationwide.
Families who were once able to visit and see their loved ones in person are able to utilize video conferencing technology, like FaceTime and Google Duo, to talk to their loved ones and show support. Additionally, with CMS lifting restrictions on teleconferencing and telehealth, staff members at senior living facilities have been able to leverage personal devices to connect with families on the outside.
During this time of increased isolation, families are more dependent than ever on the collaboration of their loved one’s care team. That’s why it’s important to consider incorporating this technology now, as it will help streamline communication, save staff time and help alleviate some of the worries of family caregivers.
Michael Eidsaune is the founder and CEO of Carely, a platform of resources that helps families and seniors housing professional care providers collaborate.
White House Offers ‘Practically Nothing’ to Assisted Living, Pledges Nursing Home Aid
President Donald Trump praised his administration’s efforts in protecting older adults from Covid-19 — but LeadingAge, an association of non-profit senior service providers, believes far more must be done.
Trump announced the federal government’s newest move to aid older adults living in nursing homes during a White House event titled “Protecting America’s Seniors” Thursday. Included in those plans are the formation of a special nursing home task force, and an initiative from the Federal Emergency Management Agency (FEMA) to deliver two “care packages” consisting of one week’s worth of personal protective equipment (PPE) to 15,400 nursing homes across the country.
“We are deploying every tool, resource and power at our disposal to protect our seniors and Americans of every age and background,” Trump said during the event.
Responding to Trump’s remarks, LeadingAge President and CEO Katie Smith Sloan’s message was clear: talk less and do more. Specifically, Sloan said that little was being done to protect older adults who live in settings other than nursing homes.
“For the millions of other older Americans being cared for outside of nursing homes—in assisted living, HUD-assisted housing for low-income older adults, life plan communities, hospices, and in our homes and communities—the government offered practically nothing today,” said Sloan.
Sloan took issue with the fact that, as state economies reopen, little is being done to prioritize older adults, “who must now compete with nail salons and gyms for life-protecting supplies on the open market.” And, older adults are not given the same priority as hospital patients when it comes to Covid-19 testing, a fact that is worrisome given the disease’s history of spreading asymptomatically, Sloan said.
With regard to PPE — which has been in short supply since the outset of the pandemic — Sloan believes that the government’s plan to send two one-week shipments of gowns, masks, and gloves is “wholly insufficient.” Some nursing homes stand to receive just eight masks per staff member under the plan. And, the equipment is only set to go to nursing homes, leaving out many other places where older adults reside, including senior living communities, she added.
“Pretending a symbolic one-week supply of PPE for select nursing homes is a meaningful solution is an insult to millions of vulnerable Americans, their families, and their caregivers,” Sloan wrote. “Life-saving equipment that was promised weeks ago has been further delayed, leaving caregivers to keep fighting and scrounging for every mask and gown they can muster.”
James Balda, President and CEO of senior living trade association Argentum, said that, while the organization is grateful for new attention on the issue, there is still much more that needs to be done for senior living communities.
“Like nursing homes, senior living communities have critical needs right now, including expanded testing, PPE and financial relief,” Balda said in a statement. “We are urging the administration not to overlook senior living communities, which are a critical part of the health care continuum and are acting right now as a critical backstop to hospitals.”
American Health Care Association (AHCA) president and CEO Mark Parkinson praised the administration’s moves as an “important step forward to ensure long term care facilities receive the vital support needed during this unprecedented public health crisis.”
Parkinson also acknowledged that the industry faces an “uphill battle” in mitigating the effects of Covid-19.
“What we need now is for everyone to rally around nursing homes and assisted living communities the same way we have around hospitals,” Parkinson said. “And that means continuing our focus on testing, PPE, staffing and funding just as health care providers have received.”
Much has been written about the retirement crisis facing Americans—how people are living longer but saving less. NCOA worked with the LeadingAge LTSS Center @ UMass Boston and Nationwide to examine both the challenge and potential solutions.
The 80%: The True Scope of Financial Insecurity in Retirement
New analysis by researchers at NCOA and the LeadingAge LTSS Center @ UMass Boston sheds a surprising new light on the full extent of this societal challenge.
To better understand the financial landscape of older Americans, NCOA and UMass researchers analyzed the latest data from the Health and Retirement Study, a longitudinal panel study that surveys a representative sample of approximately 20,000 people in America, supported by the National Institute on Aging and Social Security Administration.
The analysis discovered that 80% of households with older adults—or 32 million—are financially struggling today or are at risk of falling into economic insecurity as they age. Moreover, this trend is worsening over time, as 90% of older households experienced decreases in income and net value of wealth between 2014 and 2016.
The 80%: Four Ways to Help Retirees Make Their Money Last
Today’s 65-year-old can expect to live another 20 years, according to the Social Security Administration. This unprecedented gift of longevity brings with it exciting opportunities—and a price tag. Unlike their parents and grandparents, today’s pre-retirees and retirees face a vastly different retirement security landscape. The traditional three pillars of retirement income are changing.
Combined together, longer lives and lower savings are fueling a retirement security crisis for millions of Americans. It is exacerbated by inflation, rising health care costs, and the fact that someone turning age 65 today has almost a 70% chance of needing some type of long-term care services and supports in their lifetime. Long-term care is expensive and not covered by Medicare.
This white paper by NCOA and Nationwide offers four ways to help retirees make their money last in retirement.
During the current crisis, the elderly are not only the most vulnerable to the virus but could also be the most vulnerable to coronavirus related scams. Once again, an old scam has been repurposed for the global pandemic and it involves seniors’ healthcare.
According to the Better Business Bureau, scammers are posing as Medicare employees offering coronavirus home testing kits. They ask their victims for personal information including seniors’ Medicare information. Tests are sent to the victims but again, no home test has been approved for use by the FDA. The BBB says that these scammers are more than likely committing Medicare fraud and are billing these tests to Medicare. If Medicare is paying the scammers for these tests, this could affect Medicare coverage for future coronavirus testing by doctors.
If you receive one of these calls or possibly an email from someone claiming to be from Medicare offering you a test kit, either hang up on the call or delete the email. Whatever you do, please do not respond to any of these offers. Keep in mind that if Medicare was actually calling you, they wouldn’t need to ask for your Medicare number.
This also goes for people on private health insurance as well. Your insurance company isn’t going to offer you an at-home test kit and won’t ask you for your ID number. If your insurance company ever does need to call you, they’ll already have that information on hand.
Both Medicare and private insurances mostly communicate with patients by postal mail. Anybody claiming to be them with some kind of offer is either an identity thief or an insurance fraudster.