November is National Family Caregivers Month, which focuses attention on the unpaid care work of family members.

The care provided by families often is enabled and supported by state-funded wrap-around services.

Over the last few decades, Missouri and other state governments around the nation have funded Home and Community Based Services - or HCBS - as a cheaper alternative to nursing-home care.

The turn towards HCBSs has meant that aging Americans are more often able to stay in their homes.

The kind of support they provide is broad, and includes visiting and live-in nursing care, in addition to other services such as transportation, home repair, and remodeling to ensure accessibility.

Recent state budget cuts to these programs threaten the availability of in-home care. Jay Hardenbrook, advocacy director with AARP Missouri, said funding HCBS sufficiently benefits all involved.

"It winds up saving the state a lot of money," said Hardenbrook. "It makes families stronger, especially if it's an unpaid family caregiver who's doing that, and it keeps that person receiving the services in the place that they want to be."

Hardenbrook said in Missouri alone, unpaid family caregivers are providing more than $8 billion worth of care. He called them an essential part of the system that doesn't get enough attention.

Funding for HCBSs in the state has declined over the last decade, with the nonprofit Missouri Budget Project reporting a 40% cut in community-based programs in 2018.

Last year the General Assembly injected $200 million from the American Rescue Plan into the system as a one-time payment to support care workers' wages.

Hardenbrook said the state needs to fully fund these programs.

"The state decides how much money goes into these programs," said Hardenbrook. "And if we let them stagnate for a long time as we did until last year, then fewer and fewer people will provide those services. Now that we've done this increase, if we can just keep it up, really we'll have a larger workforce and we'll have more people who are able to stay in their homes because they're able to get the services they need."

Hardenbrook said when aging seniors can't get the care services or home repairs they need, the state often ends up paying more for them to live in a nursing home.

He said while some people utilizing HCBS programs are doing so daily, others may only need occasional help.

"One of the things that has been very helpful, especially among our dementia enrollees, is that a family caregiver can get a day off," said Hardenbrook. "One day of respite is what we call it. But really, 'Can I just have a day where I don't have to be a caregiver all day long?' "

The Missouri Budget Project reports that on average HCBS support costs less than one third of institutional care.

Oregonians have saved nearly $350 million for retirement through OregonSaves, a program allowing employees without workplace plans to automatically contribute to an individual retirement account.

Now, more than 60% of Oregon workers have access to a retirement savings plan, one of the highest rates in the country.

Bandana Shrestha, state director of AARP Oregon, said the group helped launch OregonSaves in 2017, the first program of its kind in the nation.

"It really is very wonderful that we were able to innovate and lead the country in a program that's so meaningful and so impactful," Shrestha emphasized. "I hope that people really take advantage of it."

Although more than 1 million private sector workers across the country have enrolled in state retirement savings programs, research shows nationwide one in five Americans over age 50 has no retirement savings.

Ryan Mann, executive director of the Oregon Treasury Savings Network, which oversees OregonSaves, said research shows people are 15 times more likely to save when it happens through a payroll deduction at their job.

"OregonSaves is attempting to fill that gap by providing a free way for employers to help their employees save," Mann explained. "Once they're enrolled in the program, an easy way for the workers to have it happen automatically."

Shresthra said retirement savings are not only important for individuals, they can also alleviate some of the financial pressures extended family or friends may feel who are providing care as people age, which can be costly.

"It gives you choices," Shresthra pointed out. "Both in terms of how you lead your life, but also how you are able to extend generosity and to give to your community, to your family. "

Research shows women, people of color and lower-wage workers are all less likely to have access to a traditional retirement account, and Mann said OregonSaves is designed to help close intergenerational wealth gaps. State residents can sign up and find more information at OregonSaves.com.

Pennsylvanians over age 50 are voicing concerns about the Department of Government Efficiency plans to cut 7,000 jobs from the U.S. Social Security Administration as part of its efforts to shrink the federal government and curb what it describes as waste and fraud.

More than one in five Pennsylvanians get monthly Social Security payments, according to AARP, almost 3 million people.

Nora Dowd Eisenhower, volunteer state president of AARP Pennsylvania, said all the changes have left many beneficiaries confused and worried about potential office closures, employee layoffs and reduced services.

"We are working to make sure that Americans receive the Social Security they have worked hard for and paid for over their entire working lives," Dowd Eisenhower emphasized.

Social Security benefits contribute almost $63 billion a year to Pennsylvania's economy through retirement, survivors and disability payments, according to AARP, all of which boost consumer spending, business sales, and job creation across the state.

Dowd Eisenhower pointed out the Social Security Administration had planned big changes to its phone services in March that would have caused delays and hassles but the decision was reversed this month after intense pushback. She noted AARP members have long been vocal about the need for better customer service from the Social Security Administration.

"Last year, four out of five older Americans, across party lines, supported increased funding for the Social Security Administration as a way to improve customer service," Dowd Eisenhower reported.

President Donald Trump's senior adviser Elon Musk claims Social Security could be cut by $500 billion to $700 billion without reducing benefits.

Dowd Eisenhower added AARP is urging Congress to make sure the Social Security Administration makes payments on time, as it has for nearly 90 years, and provides quality customer service by phone, online and in person.

Back-and-forth decisions on Social Security policies have created confusion, which may leave some Virginians more vulnerable to scams.

Last month, the Social Security Administration announced in-person or online appointments would be required to sign up for benefits, instead of customer support by phone. The decision has now been reversed.

Jim Dau, state director of AARP Virginia, said the changes give con artists room to come up with new scams. He noted they often start with a phone call, text or email about something "urgent." If you receive such communication saying it is from the Social Security Administration, Dau warns, it is a scam.

"This is the perfect kind of recipe for financial predators to step in and escalate Social Security scams to defraud beneficiaries of their money," Dau stressed. "Social Security scams are effective in this kind of environment -- where people are getting information from here, and bits of information from here -- where we are going to see more and more Social Security scams."

Trump's billionaire adviser Elon Musk has said Social Security has "massive" amounts of fraud, but a review by the Social Security Administration's Inspector General has found the agency has made improper payments less than 1% of the time.

More than 1.6 million Virginians receive Social Security benefits. Dau emphasized the monthly income is a lifeline to people across the Commonwealth. He added the administration's initial changes which would have required people to sign up for benefits in person would have negatively affected seniors.

"The prospect of having to go to an in-person meeting at your local Social Security office, hopefully get there on time at a point where the line isn't too long and you have a reasonable chance of actually seeing somebody that day," Dau outlined. "And of course, hopefully your Social Security office is open that day - or at all anymore."

The administration has announced lease terminations of nearly 4% of Social Security field offices. An analysis by the Center on Budget and Policy Priorities finds nine percent of Virginia seniors already live more than 45 miles from the nearest office.