House Study Commission could create first state plan on aging in Rhode Island

Published in RINewsToday on March 20, 2023

With oversight of the state’s aging programs and services scattered among state agencies charged with overseeing a fragmented long-term care (LTC) system, House Deputy Majority Leader Lauren Carson (D-District 75, Newport) tossed H 5224 into the legislative hopper. The bill calls for the creation of a Special Legislative Commission (to be referred to as House Study Commission), with 14 members, to study and provide recommendations to coordinate the state’s program and services provided to older residents.  The commission, charged with taking a comprehensive look at the funding, coordination and delivery of state agency programs and services to older Rhode Islanders, would be required to report its findings and recommendations to the House no later than Feb. 7, 2024, and it would expire on May 7, 2024.

According to House Communications Director Larry Berman, “Legislation to create commissions are requested when issues need greater study than just one hearing. Commissions usually consist of House members, along with experts in the field, who will meet on multiple occasions and then develop recommendations to the House.”

The Nuts and Bolts

The House Study Commission’s legislative charge would include making a comprehensive study of key statistics that includes compiling demographic and financial statistics, and health status of older Rhode Islanders, and taking a look at their strengths and vulnerabilities to enable them to stay in the community. It would assess federal, state and local programs available, examining duplication of services, and provide recommendations as to how to eliminate red tape and better coordinate services among state agencies to improve the delivery of programs and services.

Its final report would also review and provide recommendations for the funding of services through State, Federal, and private grants, and provide recommendations for more efficient distribution and use of these dollars. It would also include making recommendations for the creation of a portal to provide and coordinate aging programs and services in the areas of employment, education, independent living, accessibility, and advocacy, as well as local older adult centers and services. 

Also, recommendations would be provided on mental health, transportation, food access, and health care. The commission would also explore and provide recommendations for additional regionalization of services.

Aging Organizations and Advocates push for passage

Last week, the primary sponsor of H 5224, and supporters, testified before the House Health and Human Services (HHS) Committee to give their thoughts about the creation of a House Study Commission and its positive impact on the delivery of programs and services to older Rhode Islanders.

Carson, the primary sponsor, opened up the hearing on the legislation telling lawmakers that many programs for older Rhode Islanders fall in different places around the state. “Even professionals are having problems navigating the system, never mind family, friends and parents,” she says, referencing a conversation she had with a Director of a Newport-based Senior Center, discussing the challenges during the COVID pandemic to navigate the system at state-level, providing services to her older clients.

“If we look back over the last 20 years, we used to have a cabinet-level position on Aging, then we had a Division on Aging, and  now we have an Office on Aging,” says Carson, noting that we have an increasing amount of older people in Rhode Island. She called for lawmakers to return the Office of Healthy Aging at a cabinet-level.

By creating a House Study Commission, lawmakers can look in an organizational way at how programs are being offered to seniors,” says Carson.  

According to George Neubauer, Chair of the Senior Agenda Coalition of Rhode Island (SACRI), an advocacy coalition representing 21 organizations, told lawmakers that SACRI had called for candidates at its Gubernatorial forum held last August to create a Rhode Island Strategic Plan on Aging. This plan would help the state look at its infrastructure and coordination of services for its rapidly growing older population, he said. At this time Rhode Island has no such plan, he said. 

In his testimony, Neubauer stated: “While the purpose of this proposed House Study Commission does not specifically call for development of a state Strategic Plan on Aging, it does call for a comprehensive look at our older population. “It would be charged with providing recommendations of collaboration, coordination within agencies, funding of services, and recommendations in areas of importance to older adults’ needs and quality of life, he added.

 “A number of states have developed what are sometimes referred to as Master Plans on Aging (including California, Massachusetts and New York). A Master Plan could be a roadmap to help the state transform its infrastructure and coordinate services for its older persons.  The findings and recommendations of this study Commission could lead to development of such a plan for Rhode Island,” says Maureen Maigret, former Director of the Rhode Island Department of Elderly Affairs (now the Office of Healthy Aging) and Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council.

It is now time for the creation of the House Study Commission, says Vincent Marzullo, who served 31 years as a career federal civil rights and social justice administrator at the National Service Agency, and a well-known aging advocate. “For the first time in recorded history, there are more people over the age of 64 in the world, than children under five. In Rhode Island, over 31 percent of residents are age 55 or older, and by 2030 one-quarter of our population will be over 65,” he says.

“Don’t we now have an obligation to ensure better healthcare, safety, housing, livability, caregiving, etc. for this aging community?” asked Marzullo, noting that during the pandemic more than 90% of the deaths were individuals over 60 —- and 53% of overall deaths were congregate care residents.

“With the lessons learned over the past two years and the devastating impact of COVID on our older adults, it’s critical that we reexamine our aging infrastructure, the needs for services, and the local service capabilities to this growing population, adds Marzullo, calling for “a serious, adult conversation that is long overdue to take place with the aging community, service providers and lawmakers about designing our plan for a more ‘Age-Friendly’ RI, which supports local senior centers as the local hub for the delivery of services.”

Deborah Burton, Executive Director of RI Elder Info, said that enacting H 5224 is “an essential step” towards improving the lives of older Rhode Islanders. “By studying our current services and initiatives, identifying future needs, and identifying potential areas for improvement, we can ensure that all older adults in our state have access to the resources they need to achieve wellbeing and maintaining maximum independence in ways that value, empower and engage them,” she said.

Carmela Greer, Executive Director of Edward King House Senior Center, gave her views as to why it is important to establish a House Aging Commission authorized by H 5224. “This opportunity to document who does what, when, for whom, with what dollars is a common-sense approach to building a comprehensive cost-effective way to care for the other of our most vulnerable populations second only to children,” she said.

According to Greer, who also serves as Policy Committee Lead for the RI Senior Center Directors Association, once this policy road map is designed, “smart decisions can be made to establish where the money can be saved, where duplication can be eliminated, and where existing funding can be re-directed, where duplication can be eliminated, and where existing funding can be re-directed to serve all parties involved.”

In concluding her testimony, Greer said: “We don’t want to re-invent the wheel.  We want to fix the one we have.”

Where House Leadership Stands…

House Minority Leader Michael L. Chippendale (R-District 40, Coventry, Foster, Glocester), goes on the record supporting Carson’s call to create a special legislative commission to study aging policy in the state. “House Republicans recognize the fact that RI is aging and how important it is to coordinate our services to cut duplicity and inefficiencies. A study commission establishes a deep dive public discussion into an understanding of our statewide need, and lessens the possibility of bureaucratic, unintended consequences, which can occur in the submission of haphazard bills,” he says, noting that “Republicans also believe that this is an area, where if the topics are properly vetted, the state can cut costs and bring efficiency to our core government senior services.”

“I support the concept of this commission and I am certainly open to it, but I need to discuss it further with the sponsor, Representative Lauren Carson, before recommending further action. I look forward to speaking with her in the coming weeks of the legislative session,” says House Speaker K. Joseph Shekarchi (D-District 23, Warwick).

Shekarchi and his leadership team will evaluate all legislative resolutions creating House Study Commissions introduced this legislative session to determine which one(s) will be allowed to proceed for a committee, and ultimately, floor vote.  At press time, there is no fiscal note. Creating House Study Commissions must have adequate resources and staffing for their operations. 

With H 5224 having bipartisan support, aging organizations hope that Speaker Shekarchi sees the importance of allowing a committee and floor vote on this resolution.  Democratic and Republican lawmakers must lobby the House Speaker for his endorsement to support passage of this very important commission. Every Rhode Islander will ultimately need to access comprehensive aging programs and services in their later years.

House debate on Carson’s Health Study Commission may well create the political will down the road after it releases its report leading to the creation of Rhode Island’s first Strategic Plan on Aging.

H 5224 cosponsors are Representatives Samuel A. Azzinaro (D-District 37, Westerly), Thomas E. Noret (D-District 25, West Warwick), Susan R. Donovan (D-District 69, Bristol, Portsmouth), House Majority Whip Katherine S. Kazarian (D-District, East Providence), Karen Alzate (D-District 60, Central Falls, Pawtucket), Jason Knight (D-District 67, Barrington, Warren),  and Kathleen Fogarty (D-District 35, South Kingston.

To show your support for H 5224, contact your House Representative.  Go to https://www.rilegislature.gov/representatives/default.aspx. You can also contact House Speaker Shekarchi by calling (401) 222-2447.  Or email, rep-shekarchi@rilegislature.gov.

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AARP Report: Unpaid Caregiving Valued at $ 600 Billion

Published in RINewsToday on March 13, 2023

Family caregivers put in over $36 Billion hours in unpaid care taking care of loved ones, a responsibility that takes a heavy toll on them financially, physically, emotionally, and mentally.

But now, a new AARP report reveals that the family caregiver unpaid work is estimated to be valued at more than $600 Billion. This is a $130 Billion increase in unpaid contributions from family caregivers since the last report in the series was released in 2019. The economic impact of $600 Billion is more than all out-of-pocket spending on health care in the U.S. in 2021, notes the AARP report.

The 32-page 2023 update, Valuing the Invaluable, highlights trends in family caregiving, explores the growing scope and complexity of family caregiving, and discusses actions needed to be taken to address the financial, social, and emotional challenges of caring for parents, spouses, and other loved ones. 

AARP continues to put the spotlight on this important aging policy issue as the graying of the nation’s population continues. According to the group, by 2034, adults aged 65 and older will outnumber children under the age of 18 for the first time ever.

The share of available family caregivers is projected to continue shrinking, relative to the number of older adults who will potentially require long-term care. In addition, family caregivers will continue to face the dual demands of employment and caregiving responsibilities, which often includes bringing up children while taking caring of older parents simultaneously.

“Family caregivers are the backbone of long-term care in this country,” said Susan Reinhard, senior vice president, AARP Public Policy Institute, and a lead author of the report. In a March 8, 2023 statement announcing its release, Reinhard said, “The care they provide is invaluable to those receiving it. But this is not just a family issue: it impacts communities, employers, and our health and long-term care systems. We must treat family caregivers as the valuable resource that they are by providing them the support they need to care for loved ones while also caring for themselves.”

AARP, the nation’s largest aging advocacy group representing over 38 million members, says it plans to push this year to turn the National Strategy to Support Family Caregivers into action that provides meaningful, tangible outcomes and support for family caregivers. The National Strategy, delivered to Congress last September, stemmed from the RAISE Family Caregivers Act, which was championed by AARP. The National Strategy highlights nearly 350 actions that the federal government will take and more than 150 that can be adopted by stakeholders and other levels of government to give family caregivers the necessary help they need.

Taking a Closer Look at Home

AARP’s latest report in the Valuing the Invaluable series also provides us data for the Ocean State as to the value of unpaid caregiving provided here. The unpaid care provided by the 121,000 Rhode Island caregivers is valued at $2.1 Billion. This amount was calculated at an $18.95 hourly value to the estimated 113 million hours of unpaid care that family caregivers provided in 2021 – a $300 million increase in unpaid contributions since the last report was released in 2019.

“Family caregivers play a vital role in Rhode Island’s health care system, whether they care for someone at home, coordinate home health care, or help care for someone who lives in a nursing home,” said Catherine Taylor, AARP Rhode Island State Director. “We want to make sure all family caregivers have the financial, emotional and social support they need, because the care they provide is invaluable both to those receiving it and to their community,” she says.

At the Rhode Island State Capitol, AARP Rhode Island says it will continue its fight for assisting family caregivers and the loved ones they care for. During the 2021 Rhode Island General Assembly Session, AARP Rhode Island, along with other aging advocacy groups, successfully lobbied to enhance the Temporary Caregiver Insurance program by increasing the number of weeks a worker can take annually to care for a loved one from 4 to 6 weeks.

During the current legislation session, AARP Rhode Island calls for state lawmakers to support family caregivers who work because caring for a loved one shouldn’t mean losing pay—or even their job. House Bill 5781/Senate Bill 139 will increase the number of weeks that one can take annually to 12. These bills would also expand the definition of family in Rhode Island’s existing paid family leave law to include siblings, grandchildren and other care recipients to fit the reality of Rhode Island’s diverse and multigenerational families.

“Too often our unpaid caregivers are not acknowledged. We need to show the many thousands of unpaid caregivers in Rhode Island we value their contributions with sound policies, programs and laws that support them,” says Maureen Maigret, Policy Advisor for Senior Agenda Coalition of RI.

Maigret also calls for expanding the state Temporary Caregiver Insurance law from six to twelve weeks as most states that have such programs allow, and for including siblings, grandchildren and care recipients – important steps in making Rhode Island a more family-friendly state. “I have personally been a caregiver for a number of family members and know how challenging it can be to navigate our long-term care system,” Maigret says.

“Another important step to support our caregivers is to provide state funding to strengthen The POINT, the state Aging and Disability Resource Center, so that caregivers have a single place they can go to get timely, reliable information and person-centered counseling about the services, supports and benefits available to them as caregivers,” says Maigret. “Too often caregivers are not aware of programs such as subsidized respite and adult day or benefits available to care recipients. That is why the Senior Agenda Coalition of RI is asking the legislature to add $.5 Million to the state budget as The POINT currently receives no state funds and relies entirely on insufficient federal dollars,” she adds.

“It is also important that caregivers be viewed as part of a person’s healthcare team. Healthcare providers, especially those in primary care, need to ask patients if they are getting care from a family member or if they themselves are a caregiver,” says Maigret, noting that this action will provide an opportunity for providers to offer information and guidance about available services and supports.

Resources for Caregivers

“We know that everyone’s path to aging is different and it’s our paid and unpaid caregivers that provide critical supports to our loved ones,” said Office of Healthy Aging Director Maria Cimini. “At the Office of Healthy Aging, we are committed to supporting our caregivers in a variety of ways encouraging self-care through respite programs, informational workshops, and our senior companion volunteer program,” says Cimini.  She suggests that family caregivers go to https://oha.ri.gov/resources/oha-resource-center to download OHA’s 2023 Pocket Manual, detailing resources available programs and services that the state agency provides to family caregivers.

Dementia and Alzheimer’s care

“Dementia caregiving is challenging emotionally, physically, and financially. The care that family members provide is priceless, really. We want people to know they are not alone and that the Alzheimer’s Association, Rhode Island chapter has both in person/virtual support groups and community based educational programs for people who are caring for a person living with a diagnosis of Alzheimer’s disease or a related dementia throughout the state,” says Donna McGowan, Executive Director, Alzheimer’s Association Rhode Island Chapter, noting that there are 24 thousand people living with Alzheimer’s in Rhode Island and 39,000 caregivers, many unpaid family members.

“The Alzheimer’s Association believes that understanding how the diagnosis will affect the entire family is truly important to know what resources the family may/will need and how to pay for care must be considered starting right from when a diagnosis is made,” says McGowan.

McGowan says that the Alzheimer’s Association’s  24/7 Helpline clinicians guide callers to financial assistance programs that may help pay for respite or a needed break. For details, go to https://www.alz.org/ri

Chris Gadbois, DNP, RN, PHNA-BC, PMH-BC, Chief Executive Officer of the East Providence-based CareLink, says AARP’s report highlights the critical need for support for caregivers in Rhode Island. “At CareLink, we see firsthand the impact on the health and well-being of caregivers and are working hard to provide programs to provide resources. Our Administration on Community Living grant funded program to support individuals with dementia and their care partners is just one example of services that can help people to remain safely in their homes,” she says. 

The program, delivered by a trained Occupational Therapist, during five ninety-minute home visits, includes techniques to reduce challenging behaviors, promote functioning, improve caregiver communication, home environment safety, and tips focused on caregiver self-care, including problem solving and teaching stress management techniques. For more details, go to https://carelinkri.org/member-services/therapeutic-services-for-dementia/.

AARP provides a comprehensive listing of resources and information on family caregiving.  Go to aarp.org/caregiving.

For a 2023 copy of Valuing the Invaluable, go to https://www.aarp.org/content/dam/aarp/ppi/2023/3/valuing-the-invaluable-2023-update.doi.10.26419-2Fppi.00082.006.pdf.

Resources and information on family caregiving are available at aarp.org/caregiving.

Dueling Social Security Proposals Heard by Senate Finance Committee

Published in RINewsToday on March 6, 2023

Almost eight years ago, Rhode Island lawmakers reduced the tax burden on older Rhode Islanders by tweaking the state’s tax on Social Security in the fiscal year 2016 budget. The exemption to Social Security taxation as it currently stands in statute was put in place in 2015, as part of the FY 2016 budget.

According to Greg Pare, Rhode Island’s Senate Director of Communications, the Assembly expanded a budget proposal by then Governor Gina Raimondo to make Social Security benefits exempt from state taxes for many. “The original proposal would have made them exempt for single filers with federal adjusted gross incomes of up to $50,000 and joint filers up to $60,000,” noted Pare, but lawmakers raised the limit to $80,000 for single and $100,000 for joint filers.

During this current legislative session – 2023 – there are two legislative proposals that, if passed, would decrease the state taxes on Social Security income for up to 175,840 retirees.

Helping Social Security retirees

During the current legislative session, Senator Elaine Morgan (R-Dist. 34, Charleston, Exeter, Hopkinton, Richmond, West Greenwich) introduced SB 84 to completely eliminate the state tax on Social Security income in Rhode Island. The bipartisan legislative proposal specifies for tax years beginning on or after January 1, 2024, an individual may subtract from federal adjusted gross income all Social Security income.

Morgan’s SB 84 has attracted the support of GOP Senate colleagues, along with Democratic Senators on the other side of the aisle.  The senior-friendly, bipartisan legislative proposal sponsors are: Sens. Anthony Phillip Deluca (R-Dist. 29, Warwick), Minority Leader Jessica de la Cruz (R-Dist. 23, Burrillville, Glocester, North Smithfield), Gordon Rogers (R-Dist. 21, Coventry, Foster, Scituate, West Greenwich), Thomas Paolino (R-Dist. 17, Lincoln, North Providence, North Smithfield), Leonidas P. Raptakis (D-Dist. 33, Coventry, West Greenwich), John Burke (D-Dist. 9, West Warwick), Mark  McKenny (D-Dist. 30, Warwick), Frank  Lombardi (D-Dist. 26, Cranston) and Frank Ciccone, III (D- Dist. 7, Providence, Johnston).

“Eliminating state income tax on Social Security benefits will be akin to giving Rhode Island retirees a raise. We must make Rhode Island a better place for retirees and not taxing Social Security income is a large step in that direction. It will help stem the flow of retirees leaving Rhode Island and taking their spending power with them.” says Morgan who made an argument in support of the legislation at the Senate Finance Committee last week, when it was scheduled for consideration, and held for further study.  A fiscal note has been requested, but has not been released.

Time to give older Rhode Islanders tax relief

“Eliminating the tax on Social Security benefits at the state level for seniors who have worked for decades, paying taxes on their hard-earned income, and contributing to Social Security with post-tax dollars, would boost the retirement income for much of Rhode Island’s vulnerable elderly population,” reasoned Morgan. “Social Security is part of the social safety net. It was never meant to fill state coffers; it was meant to carry people throughout their retirement years. It’s time to give our growing older population some tax relief by eliminating the income threshold, beginning with the 2024 tax year,” she said, noting that her legislation will help ensure that even more middle-class retirees and their families can keep more of their hard-earned benefits.

Sen. Walter Felag’s (D-Dist. 10, Bristol, Tiverton, Warren) legislative proposal, SB 246, cosponsored by Sens. Lou DiPalma (D-Dist. 12,  Little Compton, Middletown, Newport, Tiverton), Frank Lombardi (D-Dist. 26, Cranston), V. Susan Sosnowski, (D-Dist. 37, South Kingston) and Frank Ciccone, III (D-Dist. 7, Providence, Johnston), was also heard at the Senate Finance Committee, along with Morgan’s Social Security legislation.  This legislative proposal would not eliminate the state’s Social Security tax but increase income thresholds to $110,000 for single, and $140,000 for joint, filers. Like Morgan’s legislative proposal, the Committee recommended that Felag’s measure be held for further study. No fiscal note has been released yet on this legislative proposal.

With the cost of goods and necessary services increasing, Felag says that it was  crucial to help Social Security beneficiaries by throwing SB 248 into the legislative hopper. “By raising the tax exemption level, we can lessen the financial stress that many retirees on Social Security feel on a daily basis, keeping more of their hard-earned money in their pockets and bank accounts,” he says.

Sen. DiPalma, who serves as Chairman of the Senate Finance Committee, reported that a couple of proposals have been submitted and heard in the Senate Finance Committee.  “Both sponsors and witnesses made the case for why we need to continue to assist our seniors, especially during these inflationary and soon to be “slow-cessionary” periods. These proposals must and will be evaluated in the context of the overall budgetary review process, which is currently ongoing,” he says.

When asked if she ever considered becoming a cosponsor of Felag’s legislative proposal, Minority Leader Jessica de la Cruz stated, “I would have loved to, but I was unaware of his bill.”

“It’s not too late to bring Democratic and Republican Senators together to hammer out a compromise legislative proposal,” says de la Cruz, noting she will be discussing this possibility with Senate President Dominick Ruggerio (D-Dist.4, North Providence, Providence). 

Although I do not see eye to eye with my Democratic colleagues 100% of the time, we find common ground on many other issues,” says de la Cruz. ” I believe there would be bipartisan support for crafting a compromise piece of legislation if it ensured tax relief to retirees on Social Security.

Calls for passage of Social Security proposals

AARP State Director Catherine Taylor, representing over 128,000 members in Rhode Island, called for passage of SB 84 and SB 246. “They would protect the Social Security benefits of older Rhode Islanders,” helping them keep the benefits they have earned over a lifetime of hard work,” she said.

“Assuring that our members are financially secure in retirement is a key component of our advocacy,” stated Taylor, noting that Rhode Island is one of only 11 states that still tax hard-earned Social Security benefits. “State taxes on Social Security benefits in Rhode Island undermines the purpose of Social Security, which was designed to lift seniors out of poverty- not to fund state government,” she says.

“Now, when so many Americans are struggling to afford health care and other basic needs, the promise of Social Security is even more important,” adds Taylor.  

“Whether it is raising the income threshold under existing law, or a complete exemption of Social Security benefits from taxation, like 30 other states around the country, AARP supports all efforts to keep hard-earned money in the pockets of older Rhode Islanders,” Taylor told Senate Finance Committee members.

A Call to Action

According to the Healthy Aging 2020 report, Rhode Island’s older population is growing dramatically. Today, more than 240,000 Rhode Island residents are age 60 or older -  that’s 23% of the population. By 2040 that figure is expected to rise to almost 265,000.  In addition, the state has one of the highest proportions of adults aged 85 and older, of any state in the nation, ranking first in New England.

With the expected graying of the Ocean State’s population, now is the time for Rhode Island lawmakers to reduce the financial stress of Rhode Islanders who struggle to pay their bills and want to remain independent at home in the community.   

Although both Social Security legislative proposals have been held for further study, don’t get concerned, says Pare, the Senate’s Communication Director. “It is common to hold bills for further study on a first hearing, and that is almost always the case for bills with a fiscal impact, which would have to be incorporated into the budget bill when it is considered later in the legislative session,” he says. 

“There is an obvious bi-partisan appetite to provide tax relief to our growing aging population who have been greatly impacted during this pandemic. This is a significant opportunity for Senate Finance Chair Lou DiPalma to craft a compromise bill that will advance Rhode Island as an “age-friendly” state, says  Vincent Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service Agency.  Now is the time for both sides of the aisle to come together for a needed public action,” he says.

For details about 9 States With No State Income Tax, go to https://www.aarp.org/money/taxes/info-2020/states-without-an-income-tax.html

For details about 4 States That May Cut Taxes on Social Security Income, go to https://www.aarp.org/retirement/social-security/info-2023/cut-taxes-social-security-benefits.html