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 new national survey says one in five Americans 50 and older has nothing in savings for retirement.

Wisconsin workers young and old are being urged to take action now, to avoid added financial stress in their later years.

The survey results were issued by AARP this month.

Just affording basic expenses right now is a concern for many. But AARP Wisconsin's Communications Director Jim Flaherty said you don't want to be caught off guard when retirement nears.

He acknowledged that it can be hard for younger adults to plan that far ahead, when they're juggling expenses like student loan debt - or for older individuals managing costly medications, and higher grocery bills.

"A lot of times, because they're just trying to get by and they do have to live paycheck-to-paycheck," said Flaherty. "But this is one way to say, 'Hey, if you can live with a little less from your paycheck every week, that will sure grow.'"

Researchers note that 57 million Americans don't have access to a retirement plan through their work.

Wisconsin has not yet joined the list of states that have created state-operated retirement accounts, where employers and their workers can contribute money each pay period.

Supporters hope the issue is revisited next legislative session.

Flaherty said a combination of individuals being proactive and policymakers easing household budget pressure can hopefully put more people on a path toward a healthy retirement.

He said making progress can deter them from looking elsewhere to spend their golden years.

"Let's have an infrastructure that makes drugs affordable, that makes healthcare affordable, that makes retirement savings something that's part of their plan," said Flaherty. "And that'll keep Wisconsinites here."

And groups like AARP have encouraged Congress to address long-term stability concerns for Social Security, so that younger workers can anticipate full benefits.

Some Republican lawmakers have floated cuts, but senior advocates contend any solutions to make the program stronger should not be tied to deficit talks.

Oregon is working to address the state's digital divide with hundreds of millions of dollars in funding.

Infrastructure presents the largest challenges for connecting people in Oregon to high-speed broadband internet.

Nick Batz, director of the Oregon Broadband Office, said there are more than 170,000 residencies in the state with no or slow internet access.

"Our goal through the broadband office and with all our stakeholders throughout Oregon is to provide access to all 112,000 unserved locations and as many of the 60,000 underserved locations as we can," Batz explained.

The state has received federal funding from a variety of sources, including nearly $690 million from the Broadband Equity, Access and Deployment program, and more than $150 million from the Capital Projects Fund approved in the American Rescue Plan Act from 2021.

Oregon's Digital Equity Plan has also been approved and along with it, nearly $10 million in funding.

Bandana Shrestha, state director of AARP Oregon, said there was a time when high-speed broadband internet was considered a luxury.

"Now, it's such a big necessity for everyone, including for older adults," Shrestha pointed out. "Because we know that if you don't have connectivity, you're not going to be able to see your doctor when you want to. Telemedicine is not going to be possible."

Batz added his office is working to ensure every Oregonian can get on the internet.

"It is an interesting challenge," Batz observed. "Nothing has been done like this in Oregon's history of trying to get internet access to everybody. So, it's going to be quite the challenge and it's absolutely going to require participation from everybody to make this happen."

Nursing homes across South Dakota will soon receive a boost in support, as part of the most recent legislative session.

Facilities caring for Medicaid recipients are reimbursed by the state for some of the cost. Reimbursement rates have been calculated based on patient needs, occupancy and funds available in the state budget. Last year, the South Dakota Legislature increased the rate from about 75% to 100%.

House Bill 1167 now allows the Medicaid reimbursement rate to be adjusted annually, to keep up with inflation and other changes.

Erik Nelson, advocacy director for AARP South Dakota, is glad lawmakers are giving nursing homes attention.

"We have seen a number of nursing homes close in recent years," Nelson pointed out. "Financial considerations were a factor in that, along with workforce and some other issues."

Since 2019, 15 nursing homes have closed across the state, with six of the remaining 98 on a federal list of facilities not meeting basic standards of care. In addition to a lack of funding, the average staff turnover rate is 54%.

State lawmakers also approved the use of $5 million in American Rescue Plan Act funding toward expanding telehealth services in facilities including nursing homes, allowing patients to receive some health care services remotely.

Nelson noted telehealth is one way to supply needed support.

"For not only the residents, but the family caregivers that are supporting their loved ones in the nursing homes," Nelson emphasized. "And of course, the staff of the nursing home that's in the community."

Census data show South Dakota's population is aging and by 2030, one-fifth of residents will be older than 65.