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Author: John Hanno
Born and raised in Chicago, Illinois. Bogan High School. Worked in Alaska after the earthquake. Joined U.S. Army at 17. Sergeant, B Battery, 3rd Battalion, 84th Artillery, 7th Army. Member of 12 different unions, including 4 different locals of the I.B.E.W. Worked for fortune 50, 100 and 200 companies as an industrial electrician, electrical/electronic technician.
Sobering climate change report says we’re falling way short of Paris Climate Agreement promises
Mike Augustyniak – November 20, 2023
Paul Hennessy/SOPA Images/LightRocket via Getty Images
MINNEAPOLIS — The United Nations has provided a new and stark update on our progress toward mitigating climate change. Simply put, the report says global warming is set to blow well past the goals that countries agreed to in 2015.
The Paris Climate Accord was signed that year with the goal of preventing catastrophic warming. Nearly 200 countries made a legally-binding promise to reduce their greenhouse gas emissions.
Each molecule of greenhouse gas in the atmosphere — like carbon dioxide and methane — is like a feather in a down comforter. The more molecules, the more warming. Human activity, like the burning of fossil fuels, has led to the highest level of greenhouse gases in the atmosphere in at least 800,000 years, and a rate of warming that NASA calls “unprecedented” in human history.
At our current rate of progress, the U.N. predicts that the earth’s average temperature will rise to nearly double the goal by 2030. Even if every country slashed their emissions by 42% overnight, the U.N. says there’s still no guarantee we’d limit warming enough to prevent the worst of natural disasters.
The reality is that not only did we not cut, but emissions from burning coal, oil and gas rose 1.2% last year.
And yet, we have proven that change is possible. In 2015, based on policies in place at the time, greenhouse gas emissions were projected to increase by 16% by 2030. Today, that projected increase is only 3%.
So what’s next? We have no choice but to try harder. This year, the earth got a taste of what’s to come, with extreme weather events including our drought and wildfire smoke. Preparing our homes and infrastructure for more extreme weather and more-frequent extreme weather events is critical.
Energy is the main source of greenhouse gas emissions; it accounts for 86% of global carbon dioxide. The cleanest energy is the energy that’s never produced, so use less energy. Buying local supports your neighbors, and means goods don’t have to travel as far to get to you.
Something as simple as a home energy audit will help reduce waste and save you money. The Inflation Reduction Act has $375 billion in spending on clean energy incentives.
Most importantly, no individual caused climate change, and no individual is going to solve it alone. Transformative change has to happen on city, state, and national levels, so let your voice be heard.
Voting Rights Act ruling is latest attempt by Trump-nominated judges to overturn Supreme Court precedent
Joan Biskupic, Senior Supreme Court Analyst – November 20, 2023
Mandel Ngan/AFP/Getty Images
A US appellate court decision Monday undercutting the Voting Rights Act of 1965 rejects decades of precedent and appears likely to provoke a confrontation at the US Supreme Court, where the milestone law has been increasingly under attack.
At stake are the voting rights of Blacks, Hispanics and other racial minorities that have been vindicated under a section of the VRA prohibiting discrimination based on race. Section 2 has helped ensure that states draw legislative and congressional districts fairly and that minority voters have an opportunity to elect candidates of their choice.
The Supreme Court – as recently as June – has reaffirmed Section 2. But US appellate judge David Stras, the author of the majority opinion in Monday’s case from Arkansas, observed that Justices Clarence Thomas and Neil Gorsuch have called a key provision of the law into question. His ruling Monday could ultimately gut the law’s protections.
Monday’s appellate court ruling – essentially getting out ahead of the high court – seems certain to instigate a new voting-rights showdown as the nation heads into a presidential election cycle.
The decision is the latest example of former President Donald Trump’s influence over the federal judiciary. Stras, one of Trump’s first appellate court appointees, defied Supreme Court precedent to bolster a conservative interpretation of the law backed by Thomas and Gorsuch, who was Trump’s first Supreme Court appointee.
In Monday’s groundbreaking decision, the 2-to-1 panel of the 8th US Circuit Court of Appeals ruled that private plaintiffs, such as the NAACP Legal Defense Fund or American Civil Liberties Union, have no right to bring litigation on behalf of voters under Section 2. Stras was joined in the majority by Circuit Judge Raymond Gruender, an appointee of former President George W. Bush.
Citing Thomas and Gorsuch, Stras said it has been an “open question” as to how far the law goes. Yet that notion has never drawn as Supreme Court majority.
“For much of the last half-century,” Stras, a former Thomas law clerk, acknowledged, “courts have assumed that Section 2 is privately enforceable.”
But, he added, “A deeper look has revealed that this assumption rests on flimsy footing…”
The decision swept back the history of the legislation and longstanding court interpretations, saying Congress had failed to explicitly detail that private parties could challenge VRA violations. Only the US attorney general has that explicit right, the ruling said.
The dissenting judge countered that a foundational principle of American law is that “where there is a legal right, there is also a legal remedy.” Judge Lavenski Smith, an appointee of former President George W. Bush, added that Congress never intended enforcement of the law – “so foundational to self-government” – to be left only to the federal government.
Conservative assault on Voting Rights Act
The justices on the contemporary court have been deeply divided over the reach of the act passed at the height of the Civil Rights movement and only after the March 1965 “Bloody Sunday” attacks on marchers on the Edmund Pettus Bridge in Alabama.
The high court, dominated by conservative jurists, has over the past decade curtailed federal voting protections, giving states more latitude for redistricting and other electoral practices.
But last June, a 5-4 majority reinforced the act’s protections against discriminatory voting lines by invalidating an Alabama map found to have diluted Black voting power. The Alabama legislature had packed much of the state’s African American population into one district and divided the rest among other districts.
Chief Justice John Roberts, who wrote for the slim cross-ideological majority, said Alabama’s arguments flew in the face of precedent. “The heart of these cases,” he wrote, “is not about the law as it exists. It is about Alabama’s attempt to remake our Section 2 jurisprudence anew.”
Thomas, one of the dissenters in that case of Allen v. Milligan, specifically noted at the time: “The Court does not address whether Section 2 contains a private right of action.” Only Gorsuch joined that portion of Thomas’ dissenting opinion, which echoed a point Gorsuch made two years earlier that Thomas signed on to.
Ruling against the Arkansas State Conference NAACP, which had contended the state diminished Black voting power in redistricting, Stras said neither the text nor structure of the VRA gives private plaintiffs a clear right to sue under Section 2.
“If the 1965 Congress clearly intended to create a private right of action, then why not say so in the statute?” he wrote.
Referring to other voting-rights advocates that had joined the state NAACP, he added, “The advocacy groups argue that courts have been adjudicating Section 2 claims brought by private plaintiffs for years, so they must be available. But assuming their existence, and even discussing them, is different from actually deciding that a private right of action exists.”
That contradicts longstanding Supreme Court and lower federal court interpretations of the law, Chief Judge Smith wrote in his dissent.
“Rights so foundational to self-government and citizenship should not depend solely on the discretion or availability of the government’s agents for protection,” Smith said, citing research showing that “over the past forty years, there have been at least 182 successful Section 2 cases; only 15 were brought solely by the Attorney General.”
Smith contended the 8th Circuit majority should have left resolution of whether Section 2 can be invoked by private plaintiffs to the justices – rather than trying to “predict the Supreme Court’s future decisions.”
Trump has big plans for a second term. Critics say they pose a threat to democracy.
Ben Adler, Senior Editor – November 20, 2023
Donald Trump in 2020. (Drew Angerer/Getty Images)
Former President Donald Trump’s campaign is developing plans to use the federal government to punish his political opponents if he wins a second term next year, and critics — including some prominent Republicans, even some staffers from his first term — say these plans would imperil American democracy.
On the campaign trail, Trump has made numerous public references to exacting revenge upon detractors and rivals, including promising to appoint a special prosecutor to “go after” President Biden for unspecified crimes. Earlier this month, in a speech and in a post on Truth Social, he referred to left-wing Americans as “vermin.”
Historians said such dehumanizing of one’s political opponents is frequently used by fascist dictators. Trump campaign spokesperson Steven Cheung responded by saying, “Those who try to make that ridiculous assertion are clearly snowflakes grasping for anything because they are suffering from Trump Derangement Syndrome and their entire existence will be crushed when President Trump returns to the White House.”
According to the Washington Post, Trump has privately said he would direct the Department of Justice to investigate officials from his first term who have since criticized his tenure, including:
Former White House chief of staff and retired U.S. Marine Corps Gen. John F. Kelly
Former Attorney General William P. Barr
Former Joint Chiefs of Staff Chairman Mark A. Milley
Former Trump White House special counsel Ty Cobb
Chairman of the Joint Chiefs of Staff Mark Milley in 2022. (Ting Shen/Xinhua via Getty Images) (Xinhua News Agency via Getty Images)
According to his advisers, Trump intends to fire up to tens of thousands of career government professionals and replace them with his allies, and will refuse to spend congressional appropriations on programs he opposes.
The New York Times has reported that Trump’s plans to crack down on illegal immigration will include:
Using military funds to erect detention camps
Using a public-health emergency law to shut down asylum requests at the border
Ending birthright citizenship for babies born in the U.S. to undocumented immigrants
Trump also reportedly plans to send the military into Mexico to combat drug cartels, with or without the Mexican government’s permission.
A number of high-profile Republican elected officials, conservative legal scholars and veterans of Trump’s first term in office have said Trump’s intentions would weaken the justice system and threaten the rule of law. Here are some of the most notable criticisms:
Former Rep. Liz Cheney. (Chip Somodevilla/Getty Images) (Chip Somodevilla via Getty Images)
“He cannot be the next president, because if he is, all of the things that he attempted to do, but was stopped from doing by responsible people around him at the Department of Justice, at the White House Counsel’s Office, all of those things, he will do. There will be no guardrails.”
“His policies are not centered around improving the lives of his supporters or Americans in general, it’s centered around consolidating power for Trump, and that way he can wield it to enact that revenge on anyone he deems as an enemy. And that is what is scary.”
“Making prosecutorial decisions in a nonpartisan manner is essential to democracy. The White House should not be meddling in individual cases for political reasons.”
National security adviser John Bolton in 2018. (Evan Vucci/AP) (ASSOCIATED PRESS)
“He doesn’t think in policy directions when he makes decisions, certainly in the national security space. It’s all connected with how things benefit Donald Trump. … In a second Trump term, we’d almost certainly withdraw from NATO.”
“Donald Trump represents a failure of character, which is changing, I think, in many respects, the psyche of our nation and the heart of our nation. And that’s something which takes a long time — if ever — to repair.”
When It Comes to Disdain for Democracy, Trump Has Company
By Jamelle Bouie – November 17, 2023
Credit…Maddie McGarvey for The New York Times
It makes perfect sense to treat Donald Trump as the most immediate threat to the future of American democracy. He has an ambitious plan to turn the office of the presidency into an instrument of “revenge” against his political enemies and other supposedly undesirable groups.
But while we keep our eyes on Trump and his allies and enablers, it is important not to lose sight of the fact that antidemocratic attitudes run deep within the Republican Party. In particular, there appears to be a view among many Republicans that the only vote worth respecting is a vote for the party and its interests. A vote against them is a vote that doesn’t count.
This is not a new phenomenon. We saw a version of it on at least two occasions in 2018. In Florida, a nearly two-thirds majority of voters backed a state constitutional amendment to effectively end felon disenfranchisement. The voters of Florida were as clear as voters could possibly be: If you’ve served your time, you deserve your ballot.
Rather than heed the voice of the people, Florida Republicans immediately set out to render it moot. They passed and Gov. Ron DeSantis signed a bill that more or less nullified the amendment by imposing an almost impossible set of requirements for felons to meet. Specifically, eligible voters had to pay any outstanding fees or fines that were on the books before their rights could be restored. Except there was no central record of those fees or fines, and the state did not have to tell felons what they owed, if anything. You could try to vote, but you risked arrest, conviction and even prison time.
In Wisconsin the same year, voters put Tony Evers, a Democrat, into the governor’s mansion, breaking eight years of Republican control. The Republican-led legislature did not have the power to overturn the election results, but the impenetrable, ultragerrymandered majority could use its authority to strip as much power from the governor as possible, blocking, among other things, his ability to withdraw from a state lawsuit against the Affordable Care Act — one of the things he campaigned on. Wisconsin voters would have their new governor, but he’d be as weak as Republicans could make him.
It almost goes without saying that we should include the former president’s effort to overturn the results of the 2020 presidential election as another example of the willingness of the Republican Party to reject any electoral outcome that doesn’t fall in its favor. And although we’ve had only a few elections this year, it doesn’t take much effort to find more of the same.
I’ve already written about the attempt among Wisconsin Republicans to nullify the results of a heated race for a seat on the state Supreme Court. Voters overwhelmingly backed the more liberal candidate for the seat, Janet Protasiewicz, giving the court the votes needed to overturn the gerrymander that keeps Wisconsin Republicans in power in the legislature even after they lose a majority of votes statewide.
In response, Wisconsin Republicans floated an effort to impeach the new justice on a trumped-up charge of bias. The party eventually backed down in the face of national outrage — and the danger that any attempt to remove Protasiewicz might backfire electorally in the future. But the party’s reflexive move to attempt to cancel the will of the electorate says everything you need to know about the relationship of the Wisconsin Republican Party to democracy.
Ohio Republicans seem to share the same attitude toward voters who choose not to back Republican priorities. As in Wisconsin, the Ohio legislature is so gerrymandered in favor of the Republican Party that it would take a once-in-a-century supermajority of Democratic votes to dislodge it from power. Most lawmakers in the state have nothing to fear from voters who might disagree with their actions.
It was in part because of this gerrymander that abortion rights proponents in the state focused their efforts on a ballot initiative. The Ohio legislature may have been dead set on ending abortion access in the state — in 2019, the Republican majority passed a so-called heartbeat bill banning abortion after six weeks — but Ohio voters were not.
Aware that most of the voters in their state supported abortion rights and unwilling to try to persuade them that an abortion ban was the best policy for the state, Ohio Republicans first tried to rig the game. In August the legislature asked voters to weigh in on a new supermajority requirement for ballot initiatives to amend the state Constitution. If approved, this requirement would have stopped the abortion rights amendment in its tracks.
The supermajority requirement failed. And last week, Ohioans voted overwhelmingly to write reproductive rights into their state Constitution, repudiating their gerrymandered, anti-choice legislature. Or so they thought.
Not one full day after the vote, four Republican state representatives announced that they intended to do everything in their power to nullify the amendment and give lawmakers total discretion to ban abortion as they see fit. “This initiative failed to mention a single, specific law,” their statement reads. “We will do everything in our power to prevent our laws from being removed upon perception of intent. We were elected to protect the most vulnerable in our state, and we will continue that work.”
Notice the language: “our power” and “our laws.” There is no awareness here that the people of Ohio are sovereign and that their vote to amend the state Constitution holds greater authority than the judgment of a small group of legislators. This group may not like the fact that Ohioans have declared the Republican abortion ban null and void, but that is democracy. If these lawmakers want to advance their efforts to restrict abortion, they first need to persuade the people.
To many Republicans, unfortunately, persuasion is anathema. There is no use making an argument, since you might lose. Instead, the game is to create a system in which, heads or tails, you always win.
That’s why Republican-controlled legislatures across the country have embraced partisan gerrymanders so powerful that they undermine the claim to democratic government in the states in question. That’s why Republicans in places like North Carolina have adopted novel and dubious legal arguments about state power, the upshot of which is that they concentrate power in the hands of these gerrymandered state legislatures, giving them total authority over elections and electoral outcomes. And that’s why, months before voting begins in the Republican presidential nomination contest, much of the party has already embraced a presidential candidate who promises to prosecute and persecute his political opponents.
One of the basic ideas of democracy is that nothing is final. Defeats can become victories, and victories can become defeats. Governments change, laws change, and most important, the people change. No majority is the majority, and there’s always the chance that new configurations of groups and interests will produce new outcomes.
For this to work, however, we — as citizens — have to believe it can work. Cultivating this faith is no easy task. We have to have confidence in our ability to talk to one another, to work with one another, to persuade one another. We have to see one another, in some sense, as equals, each of us entitled to a place in this society.
It seems to me that too many Republicans have lost that faith.
Medical experts are worried about climate change too. Here’s how it can harm your health.
Karen Weintraub and Dinah Voyles Pulver – November 16, 2023
As the world nears the end of what could be the hottest year in recorded history and heads into one predicted to be hotter still, a report underscores the health consequences of the warming climate.
The 8th annual report of the Lancet Countdown on Health and Climate Change, released Tuesday, describes a “grave and mounting threat” if we fail to reduce greenhouse gas emissions, especially given the evidence of worsening world health as the planet warms.
It outlines many ways this warming trend is already impacting the health of Americans. They include heat waves that stress young and old bodies and threaten to overwhelm hospitals; droughts and floods that endanger the food supply; the spread of disease to new areas, the extension and altered timing of allergy seasons; increases in air pollution and the growing scale of lethal fires.
“As we see temperatures continuing to rise and wildfires continuing to get worse, we’re just seeing these really stark increases in impacts to health,” said Naomi Beyeler, the lead author of the U.S. section of the report.
“We have the tools at hand. We have the money at hand. We can do this,” said Dr. Kari Nadeau, chair of the Department of Environmental Health at the T.H. Chan Harvard School of Public Health. Nadeau was not involved in the Lancet report, but praised its analysis and priorities. “It’s really a matter of the political will.”
Nadeau said she doesn’t want to be a purveyor of doom, but climate change and its health impacts are no longer something coming in the future, it’s something that is happening now.
“I hope people realize it’s going to affect them, their children, their grandchildren and their friends,” she said.
There is room for hope, and for improving public health if countries take action, according to Beyeler, of the University of California, San Francisco.
The Lancet report is one of several arriving ahead of COP 28, a meeting of the United Nations Framework Convention on Climate Change that begins Nov. 30 in Dubai.
Countries that committed to the Paris Agreement have pledged to try to keep global temperatures from rising more than 2.7 degrees above pre-industrial times.
That goal is still achievable, but only if governments, companies and banks stop “negligent” investments in oil and gas, according to the Lancet report. “Without profound and swift mitigation to tackle the root causes of climate change, the health of humanity is at grave risk,” it says.
“The climate crisis is not just changing the planet – it is changing children,” according to a report from the United Nations Children’s Fund, released on Monday.
A woman is silhouetted against the setting sun as triple-digit heat indexes continued in the Midwest Sunday, Aug. 20, 2023, in Kansas City, Mo.
This year, more than nine in 10 people worldwide encountered high temperatures made much more likely because of human-caused climate change, the Lancet report found. It represents the consensus of more than 100 experts from dozens of research institutions and UN agencies. Topics include 47 indicators of household air pollution, financing of fossil fuels and engagement from international organizations on the health benefits of limiting climate change.
Among its findings:
The heat was most extreme in the tropics, concentrating the impact on developing countries.
Every country experienced some level of climate-driven heat, including the U.S.
Heat-related deaths of people older than 65 years increased by 85% from 1990–2000, above the 38% increase that was expected if temperatures had not changed.
The unprecedented heat this year has sparked widespread alarm among many climate scientists. The global average temperature through October was the highest on record, nearly 2.6 degrees Fahrenheit above the pre-industrial average, the European Union’s Climate Change Service said last week.
If the global average temperature rises by 3.6 degrees Fahrenheit above pre-industrial times by mid-century, the world could see a 370% increase in heat-related deaths and increasing food insecurity for more than a half-billion people, the report states.
Health consequences of climate change
Health consequences of climate change come directly from warming temperatures, melting ice that can lead to floods and expose new pathogens and droughts that affect the food supply and the likelihood of forest fires. Contagious diseases are likely to spread more, too, experts said, either through vectors like mosquitoes that can survive in new, warming regions or because people searching for new food sources are coming into closer contact with wild animals, passing on diseases like Ebola.
The increased intensity and frequency of wildfires have undermined air quality improvements since the passage of the Clean Air Act in 1970, Beyeler said, and have even led to reversals in some areas. “There’s emerging evidence that smoke may be even more harmful to health than non-smoke particulate pollution,” she added.
The scale of the exposures was greater this year than ever before, with tens of millions of Americans breathing in unhealthy air from Canadian wildfires.
This, combined with extreme heat events which especially harm older adults, placed an added burden on the health system, Beyeler noted.
Heat waves occur when temperatures remain elevated for several days in a row, including overnight. They’re particularly dangerous because the overnight warmth doesn’t give people, animals or crops any chance to recover, Karin Gleason, chief of the monitoring section at the National Centers for Environmental Information, told USA TODAY.
“If you don’t cool down several nights in a row there are higher mortality rates,” Gleason said. “Crops and plants and animals need that recovery overnight so they can deal with the intensity of the daytime highs the next day.”
As countries in parts of Europe faced sweltering temperatures this summer, hospitals were “quite stretched,” in treating victims of heat-related illness, said Joyce Kumutai, a research associate and climate scientist at the London-based Grantham Institute.
“We saw something close to COVID-era stretching of hospital facilities,” Kumutai said.
Julia Marturano, of the City of Phoenix Heat Response Program, places a sign out on a sidewalk in July 2023 directing those who needed water and other items to a hydration station as temperatures reached 119-degrees.
What individuals can do
Everyone has a role to play in fighting climate change and safeguarding human health, said Titus Schleyer, a research scientist at the Regenstrief Institute, in Indianapolis, who is leading a summit this week focused on using data to fight the medical consequences of climate change.
“It’s easy to be hopeless, but that’s not going to get us anywhere. That just seals our fate,” he said.
He hopes to use medical informatics to reduce the negative effects of climate change, by providing and analyzing large-scale data about the impacts.
“Data is crucial to understanding where is global warming going and what we can do short-term and medium-term,” said Schleyer, whose conference this week is part of the American Medical Informatics Association’s annual meeting in New Orleans. “We have only one big try and we’ve got to succeed.”
People can consume fewer resources, cut back on airplane travel, recycle, compost and talk to public officials about taking climate action, Schleyer said.
At the community level, switching a single school bus from diesel gasoline to electric power “can improve a child’s asthma who rides that busy every day by about 30%,” Nadeau said. Within a month after the switch, the child will be 30% less likely to have an asthma attack and also less likely to end up in an emergency room.
Trees combat the “heat island effect” of so much concrete in cities. Investing $1 in planting city trees saves about $5 in emergency room costs, she said. “And you don’t have to wait a lifetime to see those economic benefits.”
Beyeler added that people can also help reduce pollution from cars by supporting safe walking and biking in their communities.
The Lancet report, Beyeler said, pushes people to see the connections as it tries to “highlight places where we can make progress on both (climate and health) goals at the same time.”
Although a lot has gone wrong in the last 18 months, with heat waves and forest fires, Beyeler said, a lot has gone right, too. There has been more investment in renewable energy and away from fossil fuels, she said. At the same time, the federal government has renewed its commitment to COP28’s climate goals and to reducing health and climate inequities.
“There is momentum to be built on,” Beyeler said. “At the same time, even with that progress, the scale of implementation and action that’s needed to get us from where we are now to where we need to be is still tremendous.”
Contact Karen Weintraub at kweintraub@usatoday.com and Dinah Voyles Pulver at dpulver@gannett.com
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
Older people are using cannabis more than ever. Here’s what to know about its potential medicinal benefits and side effects as we age.
By Christina Caron – November 16, 2023
Steve Hickerson, 79, was bused to a cannabis event in Santa Ana, Calif., along with about 50 other seniors, where they spoke with different vendors and purchased products. “It was a fun day,” he said.Credit…Jackie Russo for The New York Times
Seniors are one of the fastest-growing populations of cannabis users in the United States. While some older adults have used pot for decades, studies suggest that others are turning to the drug for the first time to help them sleep better, dampen pain or treat anxiety — especially when prescription drugs, which often come with unwanted side effects, don’t work as intended.
In 2007, only about 0.4 percent of people age 65 and older in the United States had reported using cannabis in the past year, according to the National Survey on Drug Use and Health. That number rose to almost 3 percent by 2016. As of 2022, it was at more than 8 percent.
Nancy Herring, 76, has been using cannabis recreationally for her entire adult life — she describes herself as “one of the hippies from the ’60s.” But it wasn’t until her husband was diagnosed with Parkinson’s disease and dementia two years ago that she began to wonder about pot’s medicinal use.
During the course of his illness, her husband, now 79, had developed insomnia. Soon, neither of them was sleeping.
Doctors prescribed pills to help him rest, but “nothing really worked,” she said. At one point, he reacted so negatively to a medicine he ended up in the hospital.
Then they tried an indica strain from a dispensary near where they live in Clearwater, Fla. Now, after one gummy and a hit on a pipe, her husband “can sleep at night, which is a huge thing,” she said.
Marijuana’s medicinal properties have not been well studied, particularly among older users, making it difficult for doctors to counsel their patients on the benefits and risks. Cannabis companies have rushed to fill the void, offering tips to older adults about doses or formulations and even creating products meant to appeal to them. Meanwhile, as more seniors experiment with cannabis, they are evangelizing to one another about its benefits, and sharing the problems they’ve encountered along the way.
“People are just desperate,” said Dr. Aaron Greenstein, a geriatric psychiatrist in Denver. “They’re willing to try anything.”
When his own grandmother became convinced that she was reliving the Holocaust during the later stages of her dementia, taking a dissolvable strip with a small amount of THC — the psychoactive component in marijuana — put an end to her flashbacks and helped her feel at peace.
“I have had dozens of patients who tell me that it has cured their various ailments,” said Dr. Haley V. Solomon, a geriatric psychiatrist in San Diego who, along with Dr. Greenstein, has written about the promise and risks of seniors using cannabis. “I think that it’s really important to listen to them, to acknowledge that and then to study it further.”
Older adults need to be aware of potential drug interactions, she added, and also consider how cannabis can affect cognition, coordination and balance.
Carminetta Verner, 88, started a cannabis club in her Maryland retirement community. She recently used ChatGPT to produce an 89-page manual about medical cannabis for her members. Credit…Greg Kahn for The New York Times
‘Medicine isn’t working.’
Without a North Star guiding older adults on how to use cannabis, there is a grass-roots effort among some seniors to teach one another.
Carminetta Verner, 88, has become the go-to source for cannabis information at her retirement community, the sprawling Leisure World complex in Montgomery County, Md., which houses about 8,000 older adults.
More About Cannabis
With recreational marijuana becoming legal in several states, cannabis products are becoming more easily available and increasingly varied.
In Limbo: Since New York legalized marijuana two and a half years ago, its effort to set up the industry has been a slow and bumpy ride. Here’s why.
A Boom Fuels Envy: Tax revenue has surged since cannabis stores opened in Ontario, Ore., fueling a push in neighboring Idaho to legalize sales and get in on the action.
Weed Addiction: Though the consequences of cannabis use disorder are not as severe as with other drugs, it can affect your quality of life.
In 2018, she founded a club devoted to educating residents about medical cannabis. The club’s membership, which has now grown to about 100 people, might be higher if it weren’t for the stigma still associated with the drug, Ms. Verner said.
“There are a lot of people up here that are suffering and in pain, and medicine isn’t working for them,” she said.
Damien Cornwell, the owner of a dispensary in Binghamton, N.Y., that opened in February, said his business has attracted customers who are “seeking relief they can’t find at the doctor’s office.” They have ailments such as rheumatoid arthritis, anxiety and insomnia, he said.
As more states legalize cannabis — it is now permitted for recreational use in more than 20 states and Washington, D.C., and for medical use in 38 states and D.C. — the number of seniors who turn to marijuana will only continue to grow, experts said. An October Gallup poll found that about two-thirds of adults 55 and older think the use of marijuana should be legal.
Cannabis brands are courting seniors.
Steve Hickerson, who lives in Laguna Woods, Calif., wants to sleep better.
He used cannabis sublingual drops but said they didn’t help, so he’s trying gummies, “which seem to work much better.” In the past, he felt using mind-altering drugs was morally wrong — “I’m a Christian,” he explained — but now, he said, “I’m 79, things are different.” He is willing to explore products that have a medical use.
Companies are capitalizing on the newfound interest. Earlier this year, Mr. Hickerson was bused to an event organized by Glass House, one of the biggest cannabis brands in the country, along with about 50 other people from his retirement community who were offered cannabis products at a substantial discount.
The company Trulieve, which has the largest retail footprint for cannabis products in the United States and a 750,000-square-foot cannabis cultivation facility in north Florida, is also connecting with older people through educational sessions at senior living communities.
Kim Rivers, the co-founder and chief executive of Trulieve, said their “wisdom” customers — those 55 and older — are growing year over year. In Florida, she added, these adults represent 20 percent of their customer base.
Bristol Extracts, which manufactures cannabis in New York, has created a brand called Senior Moments — a collection of tinctures, gummies and mints that debuted in March.
“IT’S TIME TO SPICE THINGS UP A LITTLE!” proclaims the company’s website. “Growing older doesn’t have to be mundane.”
The brand’s edibles also have ingredients like ginkgo biloba that are advertised as supporting “memory and mood.” Soon the line will include body balms and gummies that function as both a sleep aid and an aphrodisiac, said Eric Blazak, the company’s founder and chief executive.
What should older people know about cannabis?
Because cannabis is not federally legal, doctors don’t have enough research to guide them on what conditions it is helpful for, who might be at higher risk for potential harms, how to dose it properly or which strains to recommend, said Dr. Benjamin Han, an addiction medicine specialist at the University of California, San Diego, and one of the few geriatricians in the United States who studies older adults and substance use.
“What makes it even more complicated is cannabis is a very complex plant,” he added, and there are more than 100 cannabinoids — the biologically active components in the cannabis plant — as well as products with different ratios of THC to cannabidiol, or CBD.
Start low and slow. If a patient wants to try cannabis products containing THC, Dr. Han recommends starting at a low dose (generally 1 milligram to 2.5 milligrams) and then “give it one week” before making the decision to increase it.
Taking too many edibles can cause dizziness, confusion, changes in heart rate and blood pressure, panic attacks, anxiety, nausea, vomiting, and can even land some people in the emergency room.
There’s also the potential for cannabinoid hyperemesis syndrome, a condition that causes recurrent vomiting in heavy marijuana users.
One study, led by Dr. Han, found that emergency department visits associated with cannabis use among older adults rose more than 1,800 percent in California — from 366 in 2005 to 12,167 in 2019.
Older users may lean on their prior experience with the drug, but “the cannabis today is very different,” he said. “It is stronger. And then on top of that, there are all these physiological changes with aging that make you more sensitive than you would have been 40 years ago.”
Mr. Hickerson is experimenting with gummies to help him sleep longer. He often wakes up too early, around 4 a.m. Credit…Jackie Russo for The New York Times
Discuss the risks and benefits with your doctor. “It’s important to talk with a clinician or health provider, especially if you’re using it for medical reasons to treat chronic disease or chronic symptoms,” Dr. Han said.
Cannabis can interact with certain medications, like warfarin, a drug used to treat blood clots. And seniors who take sedative-hypnotics like Ambien or benzodiazepines like Xanax — or who drink alcohol — should consider avoiding cannabis, Dr. Solomon said, because when paired with those drugs, it can cause dizziness and confusion and make seniors more susceptible to falls and injuries.
And smoking cannabis can trigger respiratory symptoms in those with chronic lung disease, Dr. Han added.
Educate yourself. Ms. Verner recommended going to licensed dispensaries that sell products that have been tested by a third party. Familiarize yourself with state regulations, too, she said.
“You just need to educate yourself, not be afraid of things — learn for yourself,” Ms. Verner said. “You need to know what may work for you — and you go from there.”
Through trial and error, she discovered that cannabinol, or CBN, which is not psychoactive, was most helpful for her insomnia.
Now she takes fewer pills: just one for her thyroid levels and another to reduce her blood pressure.
Many older adults “end up with all these bottles of medicine,” she said. “And I don’t think that’s necessary.”
A correction was made on Nov. 16, 2023: An earlier version of this article misstated the nature of Trulieve’s outreach to seniors. The company does not offer tours of dispensaries, but travels to senior living communities to provide educational information.
Facing Financial Ruin as Costs Soar for Elder Care
Reed Abelson and Jordan Rau – November 14, 2023
A photo of Annie Reid and mother whom she now cares for through dementia, at her mother’s home in Silver Spring, Md., on Dec. 16, 2022. (Shuran Huang/The New York Times).
Margaret Newcomb, 69, a retired French teacher, is desperately trying to protect her retirement savings by caring for her 82-year-old husband, who has severe dementia, at home in Seattle. She used to fear his disease-induced paranoia, but now he’s so frail and confused that he wanders away with no idea of how to find his way home. He gets lost so often that she attaches a tag to his shoelace with her phone number.
Feylyn Lewis, 35, sacrificed a promising career as a research director in England to return home to Nashville, Tennessee, after her mother had a debilitating stroke. They ran up $15,000 in medical and credit card debt while she took on the role of caretaker.
Sheila Littleton, 30, brought her grandfather with dementia to her family home in Houston, then spent months fruitlessly trying to place him in a nursing home with Medicaid coverage. She eventually abandoned him at a psychiatric hospital to force the system to act.
“That was terrible,” she said. “I had to do it.”
Millions of families are facing such daunting life choices — and potential financial ruin — as the escalating costs of in-home care, assisted-living facilities and nursing homes devour the savings and incomes of older Americans and their relatives.
“People are exposed to the possibility of depleting almost all their wealth,” said Richard W. Johnson, director of the program on retirement policy at the Urban Institute.
The prospect of dying broke looms as an imminent threat for the boomer generation, which vastly expanded the middle class and looked hopefully toward a comfortable retirement on the backbone of 401(k)s and pensions. Roughly 10,000 of them will turn 65 every day until 2030, expecting to live into their 80s and 90s as the price tag for long-term care explodes, outpacing inflation and reaching $500 billion a year, according to federal researchers.
The challenges will only grow. By 2050, the population of Americans 65 and older is projected to increase by more than 50%, to 86 million, according to census estimates. The number of people 85 or older will nearly triple to 19 million.
The United States has no coherent system of long-term care, mostly a patchwork. The private market where a minuscule portion of families buy long-term care insurance has shriveled, reduced over years of giant rate hikes by insurers that had underestimated how much care people would actually use. Labor shortages have left families searching for workers willing to care for their elders in the home. And the cost of a spot in an assisted-living facility has soared to an unaffordable level for most middle-class Americans. They have to run out of money to qualify for nursing home care paid for by the government.
For an examination of the crisis in long-term care, The New York Times and KFF Health News interviewed families across the nation as they struggled to obtain care; examined companies that provide it; and analyzed data from the federally funded Health and Retirement Study, the most authoritative national survey of older people about their long-term care needs and financial resources.
About 8 million people 65 and older reported that they had dementia or difficulty with basic daily tasks like bathing and feeding themselves — and nearly 3 million of them had no assistance at all, according to an analysis of the survey data. Most people relied on spouses, children, grandchildren or friends.
The United States devotes a smaller share of its gross domestic product to long-term care than do most other wealthy countries, including Britain, France, Canada, Germany, Sweden and Japan, according to the Organization for Economic Cooperation and Development. The United States lags its international peers in another way: It dedicates far less of its overall health spending toward long-term care.
“We just don’t value elders the way that other countries and other cultures do,” said Dr. Rachel M. Werner, the executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania. “We don’t have a financing and insurance system for long-term care,” she said. “There isn’t the political will to spend that much money.”
Despite medical advances that have added years to the average life span and allowed people to survive decades more after getting cancer or suffering from heart disease or strokes, federal long-term care for older people has not fundamentally changed in the decades since President Lyndon Johnson signed Medicare and Medicaid into law in 1965. From 1960 to 2021, the number of Americans age 85 and older increased at more than six times the rate of the general population, according to census records.
Medicare, the federal health insurance program for Americans 65 and older, covers the costs of medical care, but generally pays for a home aide or a stay in a nursing home only for a limited time during a recovery from a surgery or a fall or for short-term rehabilitation.
Medicaid, the federal-state program, covers long-term care, usually in a nursing home, but only for the poor. Middle-class people must exhaust their assets to qualify, forcing them to sell much of their property and to empty their bank accounts. If they go into a nursing home, they are permitted to keep a pittance of their retirement income: $50 or less a month in a majority of states. And spouses can hold onto only a modest amount of income and assets, often leaving their children and grandchildren to shoulder some of the financial burden.
“You basically want people to destitute themselves and then you take everything else that they have,” said Gay Glenn, whose mother lived in a nursing home in Kansas until she died in October at age 96.
Her mother, Betty Mae Glenn, had to spend down her savings, paying the home more than $10,000 a month, until she qualified for Medicaid. Gay Glenn, 61, relocated from Chicago to Topeka, Kansas, more than four years ago, moving into one of her mother’s two rental properties and overseeing her care and finances.
Under the state Medicaid program’s byzantine rules, she had to pay rent to her mother, and that income went toward her mother’s care. Gay Glenn sold the family’s house just before her mother’s death. Her lawyer told her the estate had to pay Medicaid back about $20,000 from the proceeds.
A play she wrote about her relationship with her mother, titled “If You See Panic in My Eyes,” was read this year at a theater festival.
At any given time, skilled nursing homes house roughly 630,000 older residents whose average age is about 77, according to recent estimates. A long-term resident’s care can easily cost more than $100,000 a year without Medicaid coverage at these institutions, which are supposed to provide round-the-clock nursing coverage.
Nine of 10 people said it would be impossible or very difficult to pay that much, according to a KFF public opinion poll conducted during the pandemic.
Efforts to create a national long-term care system have repeatedly collapsed. Democrats have argued that the federal government needs to take a much stronger hand in subsidizing care. The Biden administration sought to improve wages and working conditions for paid caregivers. But a $150 billion proposal in the Build Back Better Act for in-home and community-based services under Medicaid was dropped to lower the price tag of the final legislation.
“This is an issue that’s coming to the front door of members of Congress,” said Sen. Bob Casey, D-Pa., chair of the Senate Special Committee on Aging. “No matter where you’re representing — if you’re representing a blue state or red state — families are not going to settle for just having one option,” he said, referring to nursing homes funded under Medicaid. “The federal government has got to do its part, which it hasn’t.”
But leading Republicans in Congress say the federal government cannot be expected to step in more than it already does. Americans need to save for when they will inevitably need care, said Sen. Mike Braun of Indiana, the ranking Republican on the aging committee.
“So often people just think it’s just going to work out,” he said. “Too many people get to the point where they’re 65 and then say, ‘I don’t have that much there.’”
Private Companies’ Prices Keep Climbing
The boomer generation is jogging and cycling into retirement, equipped with hip and knee replacements that have slowed their aging. And they are loath to enter the institutional setting of a nursing home.
But they face major expenses for the in-between years: falling along a spectrum between good health and needing round-the-clock care in a nursing home.
That has led them to assisted-living centers run by for-profit companies and private equity funds enjoying robust profits in this growing market. Some 850,000 people age 65 or older now live in these facilities that are largely ineligible for federal funds and run the gamut — with some providing only basics such as help getting dressed and taking medication, and others offering luxury amenities including day trips, gourmet meals, yoga and spas.
The bills can be staggering.
Half of the nation’s assisted-living facilities cost at least $54,000 a year, according to Genworth, a long-term care insurer. That rises substantially in many metropolitan areas with lofty real estate prices. Specialized settings, like locked memory care units for those with dementia, can cost twice as much.
Home care is costly, too. Agencies charge about $27 an hour for a home health aide, according to Genworth. Hiring someone who spends six or seven hours a day cleaning and helping an older person get out of bed or take medications can add up to $60,000 a year.
As Americans live longer, the number who develop dementia, a condition of aging, has soared, as have their needs. Some 5 million to 7 million Americans older than 65 have dementia, and their ranks are projected to grow to nearly 12 million by 2040. The condition robs people of their memories, mars the ability to speak and understand, and can alter their personalities.
In Seattle, Margaret and Tim Newcomb sleep on separate floors of their two-story cottage, with Margaret Newcomb ever-mindful that her husband, who has dementia, can hallucinate and become aggressive if medication fails to tame his symptoms.
“The anger has diminished from the early days,” she said last year.
But earlier on, she had resorted to calling police when he acted erratically.
“He was hating me and angry, and I didn’t feel safe,” she said.
She considered memory care units, but the least expensive option cost around $8,000 a month, and some could reach nearly twice that amount. The couple’s monthly income, with his pension from Seattle City Light, a utility company, and their combined Social Security, is $6,000.
Placing her husband in such a place would have gutted the $500,000 they had saved before she retired from 35 years teaching art and French at a parochial school.
“I’ll let go of everything if I have to, but it’s a very unfair system,” she said. “If you didn’t see ahead or didn’t have the right type of job that provides for you, it’s tough luck.”
In the last year, medication has quelled Tim Newcomb’s anger, but his health has also declined so much that he no longer poses a physical threat. Margaret Newcomb says she’s reconciled to caring for him as long as she can.
“When I see him sitting out on the porch and appreciating the sun coming on his face, it’s really sweet,” she said.
The financial threat posed by dementia also weighs heavily on adult children who have become guardians of aged parents and have watched their slow, expensive declines.
Claudia Morrell, 64, of Parkville, Maryland, estimated that her mother, Regine Hayes, spent more than $1 million during the eight years she needed residential care for dementia. That was possible only because her mother had two pensions, one from her husband’s military service and another from his job at an insurance company, plus savings and Social Security.
Morrell paid legal fees required as her mother’s guardian, as well as $6,000 on a special bed so her mother wouldn’t fall out and more on private aides after she suffered repeated small strokes. Her mother died last December at age 87.
“I will never have those kinds of resources,” said Morrell, an education consultant. “My children will never have those kinds of resources. We didn’t inherit enough or aren’t going to earn enough to have the quality of care she got. You certainly can’t live that way on Social Security.”
Women Bear the Burden of Care
For seven years, Annie Reid abandoned her life in Colorado to sleep in her childhood bedroom in Maryland, living out of her suitcase and caring for her mother, Frances Sampogna, who had dementia. “No one else in my family was able to do this,” she said.
“It just dawned on me, I have to actually unpack and live here,” Reid, 61, remembered thinking. “And how long? There’s no timeline on it.”
After Sampogna died at the end of September 2022, her daughter returned to Colorado and started a furniture redesign business, a craft she taught herself in her mother’s basement. Reid recently had her knee replaced, something she could not do in Maryland because her insurance didn’t cover doctors there.
“It’s amazing how much time went by,” she said. “I’m so grateful to be back in my life again.”
Studies are now calculating the toll of caregiving on children, especially women. The median lost wages for women providing intensive care for their mothers is $24,500 over two years, according to a study led by Norma Coe, an associate professor at the Perelman School of Medicine at the University of Pennsylvania.
Lewis moved back from England to Nashville to care for her mother, a former nurse who had a stroke that put her in a wheelchair.
“I was thrust back into a caregiving role full time,” she said. She gave up a post as a research director for a nonprofit organization. She is also tending to her 87-year-old grandfather, ill with prostate cancer and kidney disease.
Making up for lost income seems daunting while she continues to support her mother.
But she is regaining hope: She was promoted to assistant dean for student affairs at Vanderbilt School of Nursing and was recently married. She and her husband plan to stay in the same apartment with her mother until they can save enough to move into a larger place.
Government Solutions Are Elusive
Over the years, lawmakers in Congress and government officials have sought to ease the financial burdens on individuals, but little has been achieved.
The CLASS Act, part of the Obamacare legislation of 2010, was supposed to give people the option of paying into a long-term insurance program. It was repealed two years later amid compelling evidence that it would never be economically viable.
Two years ago, another proposal, called the WISH Act, outlined a long-term care trust fund, but it never gained traction.
On the home care front, the scarcity of workers has led to a flurry of attempts to improve wages and working conditions for paid caregivers. A provision in the Build Back Better Act to provide more funding for home care under Medicaid was not included in the final Inflation Reduction Act, a less costly version of the original bill that Democrats sought to pass last year.
The labor shortages are largely attributed to low wages for difficult work. In the Medicaid program, demand has clearly outstripped supply, according to a recent analysis. While the number of home aides in the Medicaid program has increased to 1.4 million in 2019 from 840,000 in 2008, the number of aides per 100 people who qualify for home or community care has declined nearly 12%.
In April, President Joe Biden signed an executive order calling for changes to government programs that would improve conditions for workers and encourage initiatives that would relieve some of the burdens on families providing care.
Turning to Medicaid, a Shredded Safety Net
The only true safety net for many Americans is Medicaid, which represents, by far, the largest single source of funding for long-term care.
More than 4 of 5 middle-class people older than 65 who need long-term care for five years or more will eventually enroll, according to an analysis for the federal government by the Urban Institute. Almost half of upper-middle-class couples with lifetime earnings of more than $4.75 million will also end up on Medicaid.
But gaps in Medicaid coverage leave many people without care. Under federal law, the program is obliged to offer nursing home care in every state. In-home care, which is not guaranteed, is provided under state waivers, and the number of participants is limited. Many states have long waiting lists, and it can be extremely difficult to find aides willing to work at the low-paying Medicaid rate.
Qualifying for a slot in a nursing home paid by Medicaid can be formidable, with many families spending thousands of dollars on lawyers and consultants to navigate state rules. Homes may be sold or couples may contemplate divorce to become eligible.
And recipients and their spouses may still have to contribute significant sums. After Stan Markowitz, a former history professor in Baltimore with Parkinson’s disease, and his wife, Dottye Burt, 78, exhausted their savings on his two-year stay in an assisted-living facility, he qualified for Medicaid and moved into a nursing home.
He was required to contribute $2,700 a month, which ate up 45% of the couple’s retirement income. Burt, who was a racial justice consultant for nonprofits, rented a modest apartment near the home, all she could afford on what was left of their income.
Markowitz died in September at age 86, easing the financial pressure on her. “I won’t be having to pay the nursing home,” she said.
Even finding a place willing to take someone can be a struggle. Harold Murray, Sheila Littleton’s grandfather, could no longer live safely in rural North Carolina because his worsening dementia led him to wander. She brought him to Houston in November 2020, then spent months trying to enroll him in the state’s Medicaid program so he could be in a locked unit at a nursing home.
She felt she was getting the runaround. Nursing home after nursing home told her there were no beds, or quibbled over when and how he would be eligible for a bed under Medicaid. In desperation, she left him at a psychiatric hospital so it would find him a spot.
“I had to refuse to take him back home,” she said. “They had no choice but to place him.”
He was finally approved for coverage in early 2022, at age 83.
A few months later, he died.
Methodology for Analysis of the U.S. Health and Retirement Study
The Times/KFF Health News data analysis was based on the Health and Retirement Study, a nationally representative longitudinal survey of about 20,000 people older than 50. The analysis defined people ages 65 and older as likely to need long-term care if they were assessed to have dementia, or if they reported having difficulty with two or more out of six activities of daily living. The six activities are bathing, dressing, eating, getting in and out of bed, walking across a room and using the toilet. The Langa-Weir classification of cognitive function, a related data set, was used to identify respondents with dementia. The analysis’ definition of needing long-term care assistance is conservative and is in line with criteria most long-term care insurers use in determining whether they will pay for services.
People were described as recipients of long-term care help if they reported receiving assistance in the month before the survey interview or if they lived in a nursing home. The analysis was developed in consultation with Norma Coe, an associate professor of medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania.
The financial toll on middle-class and upper-income people needing long-term care was examined by reviewing data that the Health and Retirement Study collected between 2000 and 2021 on wealthy Americans, those whose net worth at age 65 was in the 50th to 95th percentile, totaling from $171,365 to $1,827,765 in inflation-adjusted 2020 dollars. This group excludes the super-wealthy. Each individual’s wealth at age 65 was compared with their wealth just before they died to calculate the percentage of affluent people who exhausted their financial resources and the likelihood that would occur among different groups.
To calculate how many people were likely to need long-term care, how many people needing long-term care services were receiving them, and who was providing care to people receiving help, we looked at people ages 65 and older of all wealth levels in the 2020-21 survey, the most recent.
The U.S. Health and Retirement Study is conducted by the University of Michigan, and funded by the National Institute on Aging and the Social Security Administration.
The analysis was conducted by Albert Sun, a graphics editor for the Times, and Holly K. Hacker, a data editor for KFF Health News, part of the organization formerly known as the Kaiser Family Foundation.
Bankruptcy at an Illinois retirement community has financial impact on residents and families too
Robert McCoppin, Chicago Tribune – November 15, 2023
Stacey Wescott/Chicago Tribune/TNS
At age 88, World War II veteran Robert Kroll moved to Friendship Village of Schaumburg, Illinois, a retirement community where he would be taken care of until death, and so his children would get their inheritance after he died.
He paid an entrance fee of $124,000, plus about $2,400 a month, to guarantee that he would always get housing and medical care even if he ran out of money, with the understanding that his family would get 90% of his remaining entrance fee after expenses upon his passing.
Kroll died in 2019, but his family still hasn’t gotten their money back. In June, Friendship Village, citing problems caused by the COVID pandemic, filed for Chapter 11 bankruptcy, in which officials say operations will continue as usual, but with some debts unpaid. A company has bid $115 million to buy the facility, but the bankruptcy proposal includes only $2 million to pay back families of former residents — about 10% of what is owed.
“Our family has been waiting for four years with no resolution,” Kroll’s daughter, Michelle Barnes, told the Tribune. “I wanted to share our story to help inform the public and put pressure on our politicians to change the laws in Illinois that will protect seniors from this type of deception in the future.”
Her dispute is over Friendship Village’s policy of only paying back entry fees upon the resale of a resident’s unit. The facility — the largest not-for-profit retirement community in Illinois, with 815 units — didn’t resell Kroll’s one-bedroom unit, so hadn’t paid his family back.
Now that Friendship Village has entered bankruptcy, families of former residents are unlikely to ever receive full repayment, which Barnes and other families see as a betrayal of what they were promised.
Friendship Village officials say the contracts were clear about the arrangement, which had worked well for decades since the retirement community opened in 1977.
“We never expected this to happen,” CEO Mike Flynn said.
Friendship Village provides a full continuum of care from independent living to assisted living and skilled nursing residences. It has a three out of five star overall rating from Medicare.gov, and residents and others the Tribune interviewed spoke highly of the staff and facilities there.
But in 2020, COVID was particularly deadly for older victims, and prompted Illinois Gov. J.B. Pritzker to close general access to nursing facilities. That prevented Friendship Village from showing its units to new customers, and prevented the sale of what normally was a turnover of some 100 units a year. Some expenses increased while demand for nursing homes dropped.
The owner of Friendship Village, Evangelical Retirement Homes of Greater Chicago, estimated allowed claims by bondholders total almost $132 million, for current residents $78 million, and for former residents $20 million. But the bond debt is secured, meaning its repayment is backed by the collateral of the property itself.
The facility has more than 200 creditors, including dozens of residents and family members, many owed hundreds of thousands of dollars.
Because Friendship Village is deemed a not-for-profit business, it does not pay property taxes. It did pay $23 million in employee compensation in 2022, including $406,000 to its prior CEO, Stephen Yencheck. Bankruptcy attorney Bruce Dopke reported he’s been paid $350,000 for legal services, and would be paid for any additional costs. Before bankruptcy, the company had a prospective buyer, but the deal fell through.
The amount available to repay debtors depends on the amount offered by a buyer in auction. The highest bid was recently reported at $115 million by Encore Healthcare Services of New York.
“It would have been nice if somebody stepped up and honored the entrance fee refund,” Flynn said. “That didn’t happen, but at least they’re getting something.”
Besides former residents like Kroll, current residents are also worried about their investment.
Ed and Toby Gordon, age 88 and 87, respectively, moved into Friendship Village in January, in part to be close to their daughter, Michelle Miller, and because they knew they would need more care. They paid more than $300,000 as an entrance fee, Miller said. Under the bankruptcy proposal, residents who die or leave would be repaid over about 16 years.
Miller is upset that her parents did not know about the facility’s dire financial situation.
“My parents should have known how bad those numbers were,” she said, “because they could have been renters instead.”
Residents are concerned that they won’t get the continuing care they expected and won’t get the refunds they were guaranteed. “A lot of people are just scared and don’t know what’s going to happen to them,” she said.
Friendship Village issued a statement reassuring residents that they will be taken care of.
Within the new ownership contract, the statement read, “there are provisions to take care of the current residents who entered the community under an entrance fee agreement for the rest of their lives, regardless of the level of care needed. There is also a benevolent fund that has been doubled by the new owner for those who run out of money through no fault of their own.”
In response to complaints even before the bankruptcy, state Rep. Michelle Mussman, a Democrat whose northwest suburban district includes Friendship Village, introduced a bill that would require repayment of entrance fees in order of those who leave, rather than upon resale of each individual’s unit.
But after getting pushback from the industry, Mussman is taking a step back and talking to stakeholders. Chronological repayment may not be as fair to residents who paid for more desirable units that sell faster, and may impair the ability to care for residents still living there, Mussman said.
“It’s not perfect,” she said. “We’ve not been able to find the right combination that would work.”
Angela Schnepf, president and CEO of LeadingAge Illinois, which represents the senior care industry, said entrance fees are like an insurance policy. The community takes on the risk of caring for residents even if they run out of money, while residents carry the risk of not getting their fee back until their units sell.
She said some residents see the queue system as paying other residents when their own unit sells.
“If their neighbor gets their refund sooner just because they put their unit up for sale sooner, they find this very unfair,” Schnepf said.
If retirement communities were forced to pay back before selling units, she said, it might put them at financial risk.
But under the current arrangement, current and former residents are at risk because of the bankruptcy. A creditors’ committee continues to investigate the management of funds in the case.
The next court hearing to consider the bankruptcy terms is set for Nov. 22 in federal court in Chicago. The proposed repayment plan is subject to a vote by creditors and is scheduled to be ruled on Jan. 17 by U.S. Judge Timothy Barnes.
More broadly, the problems facing Friendship Village also face Life Plan or Continuing Care Retirement Communities in general.
Several such not-for-proft communities nationwide have fallen into financial distress recently and been acquired by for-profit companies, said Dan Hermann, president and CEO of Ziegler, which has provided financing to senior living businesses, including Friendship Village.
The for-profit companies can offer efficiencies by providing their own ancillary services such as pharmacy and tech work, and tighter staffing.
An underlying problem, Hermann said, is that Illinois for years has had low reimbursement rates for Medicaid residents, which make up a significant portion of some retirement communities like Friendship Village.
Sir David Attenborough makes bold statement about the future of humanity: ‘This needs to be shared as much as possible’
Erin Feiger – November 15, 2023
The voice of “Planet Earth” has spoken, and it brings a dire warning and a plea.
Sir David Attenborough, British biologist, natural historian, and narrator of the beloved television series “Planet Earth,” among many other things, spoke about the state of the planet.
The video was shared to X, formerly known as Twitter, and is just over a minute long, yet carries a warning spanning millions of years.
“‘Please make no mistake. Climate change is the biggest threat to global security that modern humans have ever faced.’ Sir David Attenborough,” reads the caption above the video.
"Please make no mistake. Climate change is the biggest threat to global security that modern humans have ever faced." Sir David Attenborough.
The Attenborough quote — which is spoken at the end of the video — is then followed by words from the poster: “No time to wait. #ActOnClimate.”
As for the video itself, Attenborough explains that due to increased warming, “Our atmosphere now contains concentrations of carbon dioxide that have not been equaled for millions of years.”
He continues to say that we are close to reaching tipping points that, once passed, will send global temperatures spiraling.
“If we continue on our current path,” he warns, “We will face the collapse of everything that gives us our security. Food production, access to fresh water, habitable ambient temperatures, and ocean food chains, and if the natural world can no longer support the most basic of our needs, then much of the rest of civilization will quickly break down.”
His warning is not unfounded either, as there are more and more examples of ocean food chains at risk, dangerous extreme temperatures, decreasing water access, and loss of essential ecosystems like glaciers.
While the video and the warning came with the usual level of naysaying and denial, many viewers seemed to hear the message loud and clear.
“The feeling of shouting into a void,” lamented one viewer. “He’s absolutely correct, but no one is listening.”
“This needs to be shared as much as possible,” said another. “Humanity has to realize, we are all in trouble…earth is home to all of us.”
One of the cows reportedly suffered as many as 10,000 tick bites.
Asian longhorned ticks (ALTs) have been spreading across the Eastern and Midwestern U.S. since at least 2017, according to the Center for Disease Prevention (CDC), and the pests’ numbers are now on the rise in Ohio—a recent study from the Ohio State University reveals. According to the study’s authors, 9,287 invasive ticks were removed from a farm in eastern Ohio in the summer of 2021 after three cattle were reported dead from tick bites by the landowner.
During the study—lead-authored by Ohio State Assistant Professor of Veterinary Preventive Medicine Risa Pesapane—scientists continued to monitor the invasive tick population after most of the pests were killed off with pesticides. They found that the Asian longhorn ticks returned to the pasture and continued to spread in June 2022, despite the tick control efforts undertaken in 2021.
“You cannot spray your way out of an Asian longhorned tick infestation,” Pesapane said in a Nov. 3 news release. “They are going to spread to pretty much every part of Ohio and they are going to be a long-term management problem. There is no getting rid of them.”
Pesapane said that the cattle killed during the 2021 ALT infestation in eastern Ohio sustained thousands of tick bites. “One of those was a healthy male bull, about 5 years old,” she said in the press release. “Enormous. To have been taken down by exsanguination by ticks, you can imagine that was tens of thousands of ticks on one animal.” The term “exsanguination” refers to the action of draining a person, animal, or organ of the blood needed to sustain life.
On its website, the CDC says that ALTs, native to east Asia, have spread to 19 U.S. states since they were first reported in New Jersey in 2017. The list includes Arkansas, Connecticut, Delaware, Georgia, Indiana, Kentucky, Maryland, Massachusetts, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, and West Virginia.
According to Pesapane, the invasive tick’s rapid spread lies in its ability to reproduce asexually, without mating. “There are no other ticks in North America that do that. So they can just march on, with exponential growth, without any limitation of having to find a mate,” Pesapane said. “Where the habitat is ideal, and anecdotally it seems that un-mowed pastures are an ideal location, there’s little stopping them from generating these huge numbers.”
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The CDC is urging anyone who finds an Asian longhorn tick on a person, pet, or on livestock, to remove the pest as quickly as possible. “Save the tick in rubbing alcohol in a jar or a ziplock bag,” the agency advises, “then contact your health department about steps you can take to prevent tick bites and tickborne diseases.
