May is Older Americans Month, and a new report shows the Volunteer State is among the bottom of states when it comes to caring for its most vulnerable adults.

America's Health Rankings 2023 Senior Report from UnitedHealthcare ranks Tennessee 42nd in health outcomes for those age 65 and older. Notable challenges include a high prevalence of frequent mental distress, drug deaths, smoking, lack of physical activity, and increased poverty.

Michele Johnson, executive director of the Tennessee Justice Center, said elected leaders are not focused on creating policies to serve all Tennesseans.

"We need to have elected officials to roll up their sleeves and address the health care infrastructure," Johnson asserted. "Expanding Medicaid is vitally important not just for people who are in the coverage gap, which it is important for them, but it's important for older Tennessee because we have health care deserts."

Tennessee is among 11 states to not expand Medicaid. Johnson noted some states are six times more likely to lose a hospital when they have not expanded Medicaid, and she believes expanding Medicaid would strengthen the state's health care infrastructure and economy.

Johnson is also concerned about the unwinding of the public health emergency, which is in the process of redetermining health care for older Tennesseans. She contended state leaders should make it simple and ensure it protects seniors.

"This should be a fair process that is simple and lacking in bureaucracy as possible," Johnson argued. "And unfortunately that right now we're really concerned like hundreds of thousands of people, including seniors, will go without health care, not because they're not eligible but because the process is just so daunting."

The report found about 10% of Tennessee adults age 65 and older are living in poverty.

Dr. Rhonda Randall, chief medical officer of Employer and Individual for UnitedHealthcare, said the comprehensive report found poverty increased overall by 10% between 2019 and 2021.

"We know that's really important because it has impacts on how much of their dollars are they spending on housing, food, medical care and more," Randall explained. "We want to make sure that not only are we seeing that number decrease, where seniors are living in poverty that the communities are aware of it."

Randall noted because of the pandemic, they saw more seniors receive access to home-delivered meals and seniors who were eligible for the Supplemental Nutritional Assistance Program signed up. She added as we age, nutrition is very important and a decrease in food insecurity by 6% was an improvement, as fewer worried about accessing nutritious food.

A Nevada bill would make changes to adult guardianship by prioritizing less restrictive approaches.

Sen. Melanie Scheible, D-Las Vegas, the bill's sponsor, explained Nevada law promotes "supportive decision-making," a contract between a protected person and a supportive partner. She said the approach allows people to keep a level of independence and power when making important legal, financial and health care decisions.

Scheible pointed out the new measure would require Nevada courts to first explore the option or other less restrictive alternatives before a guardian is appointed.

"It requires the judge to put on the record, why, if they are going to appoint a guardian, they are doing that in lieu of a supportive decision-making agreement," Scheible outlined. "What about this person's capabilities makes them unfit to be in a supportive decision-making arrangement?"

The legislation would also require the review of guardianships being transferred from outside the state into Nevada. Backers of the bill said state standards are not all the same and want to ensure guardianship is truly warranted. The bill was heard in the Assembly Judiciary Committee this week and has not faced opposition so far.

Jonathan Norman, advocacy, outreach and policy director for the Nevada Coalition of Legal Services Providers, said he supports the measure because he wants people in the state to retain as many rights as they can when receiving medical care.

"SB 346 will lead to fewer unnecessary guardianships," Norman contended. "Many adults and seniors with disabilities find themselves facing the rest of their lives in a court-ordered guardianship, not because they need it but because less restrictive alternatives were not fully explored."

Ellen Marquez is the mother of Alysa Marquez, 22, who has Down syndrome. She said guardianship has been "the default" for too long. She believes while guardianship has its place, it can also strip people of their rights.

"If we all rely on guidance from trusted sources, why shouldn't individuals with disabilities and older adults have the same opportunity?" Marquez asked.


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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.