Proposed $4.1 trillion budget has several senior housing and care provisions

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(Photo: Communications Office, White House Office of Management and Budget)
(Photo: Communications Office, White House Office of Management and Budget)

President Barack Obama released his $4.1 trillion federal budget proposal for fiscal year 2017 on Feb. 9.

Highlights:

Alzheimer's, Parkinson's. The NIH's BRAIN research initiative would receive $195 million, a $45 million increase over fiscal year 2016, to study Alzheimer's disease, Parkinson's disease, depression and other neurologic and psychiatric disorders.

Housing. The budget includes $505 million for the Department of Housing and Urban Development's Housing for the Elderly program, also known as Section 202, to provide continued assistance to more than 91,000 elderly households. The budget would expand the authority of the Rental Assistance Demonstration program to allow for the conversion of Section 202 properties to long-term, project-based contracts that can leverage private financing for needed capital improvements.

HCBS/LTSS. The budget would expand access to Medicaid home and community-based long-term care services and supports by giving states the option to expand eligibility for the Community First Choice and 1915(i) home and community-based state plan options. Also, the budget would establish a pilot program for up to five states to test a comprehensive long-term care state plan option that would allow states to provide long-term care services and supports across the continuum of care.

The budget also would provide $358 million, a $10 million increase above FY 2016, for aging programs such as in-home personal care, respite care and transportation assistance, in addition to a $2 million increase for the Lifespan Respite Care program, designed to help to ease the burdens of caregiving.

Also, the budget includes $8 million in discretionary resources for the Aging and Disability Resource Centers program, designed to make it easier for people to learn about and access their health and long-term services and support options.

Elder abuse. The budget includes $10 million in discretionary resources for Elder Justice Act programs authorized under the Affordable Care Act, to support evidence-based interventions to reduce elder abuse, neglect and financial exploitation. “These resources will support standards and infrastructure to improve detection and reporting of elder abuse; grants to states to implement a national reporting system; and funding to support a coordinated federal research portfolio to better understand and prevent the abuse and exploitation of older Americans,” according to a White House Office of Budget and Management fact sheet (PDF).

The budget also includes $6.25 million for the Enhanced Training and Services to End Violence Against and Abuse of Women in Later Life Program, a program of the Department of Justice's Office on Violence Against Women. The funding would be used to create multidisciplinary partnerships with law enforcement agencies, prosecutors' offices, victim services providers and organizations that assist older individuals.

Nutrition assistance. The budget provides almost $850 million for nutrition services programs, a $14 million increase over the 2016 enacted level, to enable states to provide an estimated 205 million meals to more than 2 million older Americans nationwide.

SNAP. The budget includes a proposal to allow states to streamline application and recertification processes to improve Supplemental Nutrition Assistance Program access for the elderly.

Medicare. The budget proposes to lower drug costs to Medicare beneficiaries by closing the Medicare Part D donut hole for brand name drugs by 2018, rather than 2020. Discounts from the pharmaceutical industry would be increased.

Antibiotic-resistant bacteria. The Centers for Disease Control and Prevention would receive an additional $40 million to prevent, detect and control illness and death related to infections caused by antibiotic-resistant bacteria.

Jim Greenwood, president and CEO of a trade group called the Biotechnology Innovation Organization, said his association supports the budget's request for continued funding for the BRAIN Initiative and some other provisions, although it has concerns about several aspects of the proposal.

The American Society for Biochemistry and Molecular Biology expressed disappointment in the budget's $1 billion cut in discretionary spending at the NIH. “Frankly, this budget does little to capitalize on the enormous bipartisan support for the NIH in Congress,” said Benjamin Corb, the group's director of public affairs. “To propose a funding level that is unable to sustain the biomedical research enterprise is surprising given the president's consistent, strong support for the agency.”

The budget appears to provide a $1 billion increase to the NIH, but the president's proposal relies on Congress to develop a mandatory funding mechanism to supplant proposed cuts to discretionary spending.

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