Strengthening The Voice of Older Adults Through Activism and Advocacy Margaret P Norris PhD Geropsychologist Retired Independent Practice Consultant Laws and public policies define regulations and budgets ID: 600944
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Slide1
Reaching Beyond Conventional Roles: Strengthening The Voice of Older Adults Through Activism and Advocacy
Margaret P. Norris, Ph.D.
Geropsychologist
,
Retired, Independent Practice
ConsultantSlide2
Laws and public policies define regulations and budgetsThese determine access, delivery, and financing of services
Only we can inform policymakers of patient needs
See Hinrichsen (2010)
Why must we be advocates of our professions?
4/22/16
Margaret P. Norris, Ph.D.Slide3
Primarily, poor awareness of public policy issuesLess Important:
Disinterest in participating
Lack of timeDoubt in ability or effectiveness
See Heinowitz et al, 2012
Barriers to Advocacy Work
4/22/16
Margaret P. Norris, Ph.D.Slide4
4/22/16Margaret P. Norris, Ph.D.Slide5
Research dollarsAccess to clinical services
Graduate training
Expanding workforceSocial and health programs
Healthcare systems and public healthMost Common Issues in Advocacy
4/22/16
Margaret P. Norris, Ph.D.Slide6
Elimination of cap on mental health servicesMedicare Improvements for Patients and Providers Act of 2008 (MIPPA): eliminated the discriminatory 50% coinsurance for outpatient mental health treatment
Triumphs in Advocacy Efforts
4/22/16
Margaret P. Norris, Ph.D.Slide7
CMS mandate that contractors cannot deny claims solely on the basis of a dementia diagnosis Development of Health & Behavior services
More Triumphs
4/22/16
Margaret P. Norris, Ph.D.Slide8
AMA’s RUC sets the “work value” factor of all feesClosed to
public
Favors high tech services
Price fixingSee Haley Sweetland Edwards, 2013, July/August
Failure in
A
dvocacy
E
fforts
4/22/16
Margaret P. Norris, Ph.D.Slide9
“When a roomful of professionals from the same trade meet behind closed doors to agree on how much their services should be worth… it’s called price-fixing. And in any other industry, it’s illegal”. Haley Sweetland
Edwards, 2013
4/22/16Margaret P. Norris, Ph.D.Slide10
Local levelProfessional organizationsFederal level
Legislators
See Digilio
& Elmore (2015)How can we be advocates for the older adults we serve?
4/22/16
Margaret P. Norris, Ph.D.Slide11
Involvement in organizations that serve older adults, e.g. Alzheimer’s Asso, Area Agency on Aging, senior community services
N
etworking with agencies and colleaguesLocal Advocacy
4/22/16Margaret P. Norris, Ph.D.Slide12
APAPO Stand for ScienceAPA Federal Action Network
APA Committee on Aging
APA Society of Clinical Geropsychology
See handout for other professional organizations’ advocacy workPsychology’s Professional Organizations
4/22/16
Margaret P. Norris, Ph.D.Slide13
National Coalition of Mental Health and AgingGerontological Society of AmericaElder Workforce Alliance
National Alliance for Caregiving
Medicare Rights Center
More Professional Organizations
4/22/16
Margaret P. Norris, Ph.D.Slide14
submit comments on proposed government agency plans, e.g. CMS
White House Conference on Aging
Congressional briefings, (e.g
. “Can We Prevent Dementia? Cutting Edge Research and Interventions.”)Lobby with Congress on pending bills and amendments to laws (e.g. GPE, Older Americans Act)
Federal Level
Advocacy
4/22/16
Margaret P. Norris, Ph.D.Slide15
Letters, emails, calls, town hall meetings, campaign contributionsMeeting in home and national offices
Testifying as the experts in science, best practices in clinical services, population needs
Providing data, personal stories, dispel common myths
Lobbying with Legislators
4/22/16
Margaret P. Norris, Ph.D.Slide16
4/22/16Margaret P. Norris, Ph.D.Slide17
Member of Congress drafts bill; advised by interest groups, private and public agenciesMembers sponsor bill; bill given #Bill assigned to Committee /
Subcommittee
4/22/16Margaret P. Norris, Ph.D.Slide18
Most bills die in CommitteeIf not, Chair schedules a “markup” for formal review and amendments
Committee votes on bill
Bill goes to House or Senate; majority leader may bring bill to floorMany more steps….
And then…
4/22/16
Margaret P. Norris, Ph.D.Slide19
Bill is debated; important time for grassroots advocacyOnce passed, it goes to other chamber; go back to step 1
Similar bill may be passed
Different bill versions are sent to “C
onference Committee”And then…
4/22/16
Margaret P. Norris, Ph.D.Slide20
Compromise bill goes to both chambers for final vote If both pass it, bill goes to President for either signature or veto
Congress can override veto by 2/3 majority in both chambers
And then…
4/22/16Margaret P. Norris, Ph.D.Slide21
In 2013-2015, ~15% of 8,900 bills passed committee and were sent to the floor. Of these 1,333 bills, 21% became law
What’s the odds?
4/22/16
Margaret P. Norris, Ph.D.Slide22
Sponsor and co-sponsor are committee chairsGot past committee in a previous Congress
Referred to Senate and House Appropriations and other important committees
Sponsor is in majority party and 1/3 cosponsors are in minority party
Important Factors
4/22/16
Margaret P. Norris, Ph.D.Slide23
Senator Richard Shelby (Rep, 1987)
Chair
of Comm. on Banking, Housing and Urban Affairs,
Comm. on Rules and AdministrationComm. on
Appropriations
and
several Appropriations
Subcommittees
U.S. Legislators for Alabama
4/22/16
Margaret P. Norris, Ph.D.Slide24
Senator Jeff Sessions (Rep,1997)Comm. On Armed Services,
Comm. on the Judiciary,
Comm on the Budget,
Comm. On Environment and Public WorksU.S. Legislators for Alabama
4/22/16
Margaret P. Norris, Ph.D.Slide25
1) Comm. On Financial Services, Permanent Select Comm on Intelligence
2) Primarily sponsors bills on Civil Rights and Liberties, and Minority Issues
3) first women elected to Congress from Alabama in her own right and first African American woman to ever serve in the Alabama Congressional
delegationRepresentative Terri Sewell
(Dem, 2011, 7
th
district)
4/22/16
Margaret P. Norris, Ph.D.Slide26
4/22/16Margaret P. Norris, Ph.D.Slide27
Authorizes federal assistance to state Adult Protective ServicesFunds training in prevention and services
Establishes a national APS Resource Center
Elder Protection and Abuse Protection Act
S. 27474/22/16
Margaret P. Norris, Ph.D.Slide28
Encourages nutrition providers to distribute information on diabetes, elder abuse, neglect, financial exploitation, and Medicare
wellness
examImprove APS response to abuse, neglect, exploitation in home care and LTC residents and establishes data collection
More on S. 27474/22/16
Margaret P. Norris, Ph.D.Slide29
Mental Health Reform Act of 2016Reducing Disparities Using Care Models and Education Act of 2015 (ReDUCE
Act
RAISE Family Caregivers ActLifespan Respite Reauthorization Act
Other Current Bills
4/22/16
Margaret P. Norris, Ph.D.Slide30
House Committees: Children and Senior Advocacy; HealthSenate Committees: Health and Human Services, Veterans and Military Affairs
Where is higher
ed??Bill to protect vulnerable adults against financial exploitation, passed 04/12/16
Alabama State Legislature4/22/16
Margaret P. Norris, Ph.D.Slide31
4/22/16Margaret P. Norris, Ph.D.