Monthly Archives for March 2004

Better Business Bureau Resource Book Offers Seniors Valuable Tips

Published in Pawtucket Times on March 29, 2004

Everyone has probably heard the old adage…If you don’t pay for it, you won’t appreciate it.”

Maybe this is true in some situations, but this is not the case should you pick up a “free” issue of the Rhode Island Senior Citizens Edition 2004, published by the Better Business Bureau Book (BBB) series.

The 53-page resource book is free and available at local grocery stores and retail sites throughout the state. It was written to address special needs of seniors by using reliable information.

Seniors and caregivers can become savvy shoppers by simply skimming through this annually updated publication when they seek out products and services.

Do you need to modify your home to adapt it to promote greater independence or to prevent falls?  BBB’s 2004 senior edition gives you sound advice when you begin your home fixups.

When shopping around, make sure the contractor you will use is both licensed and bonded.  Always get a written down payment and only make it a small down payment.

Your final payment should be made when the contractor completes the project to your satisfaction. Always contract Rhode Island’s Better Business Bureau (785-1212) for a reference.

While many may consider BBB’s useful recommendations as common-sense advice, sadly some seniors don’t follow the advice and become victims to unscrupulous contractors.

BBB’s 2004 senior edition is jam-packed with useful information, from outlining senior housing choices to tips on choosing a nursing home, medical insurance and long-term care insurance, eye care and dental prosthetics.

Do you need help with managing your assets or spending within your means?  Are you seeking a lawyer to write your will , creating a trust, durable power of attorney or advance directives?  Have you considered pre-planning your funeral. Yes. BBB’s senior 2004 edition gives timely suggestions on hiring financial planners, lawyers, or even choosing a funeral home.

About 30 percent of the nation’s seniors and 50 percent of those over 85 suffer from hearing impairment. Buying a hearing aid can be a frustrating, intimidating experience for many seniors.  BBB’s 2004 senior edition walks seniors through the process of purchasing a hearing aid.

The publication gives an easy-to-understand explanation of the types of hearing losses and where to turn to for treatment – an otologist, audiologist or a hearing aid retailor. Seniors can turn to page 27 to learn the  specifics about hearing aid products, what to expect during the hearing examination, what to look for in contracts and warranties and service and repair issues.

BBB’s 2004 senior edition warns that Rhode Island is now considered a “target state” for scams because of the state’s high percentage of seniors – 16 percent of the Ocean State’s population is over age 55. The resource book warns about seniors about Canadian telemarketing scams, thieves posing as utility workers or inspectors or Nigerian “fund transfer” scams and how to avoid them.

Finally, seniors are taught how to successfully complain via writing effective complaint letters.  Effective complaining begins by sending a letter addressed to the person in charge of the company, not the consumer protection agency. Always allow the company an opportunity to fix the problem.

When corresponding be courteous, describe the problem clearly and be reasonable when requesting your solution, and enclose “copies” of all appropriate documents. Most importantly, always give the company a reasonable amount of time to respond to your complaint. These are not bad suggestions for seniors or caregivers to follow when attempting to resolve a consumer issue.

In his forward to BBB’s 2004 senior edition, A. Michael Marino, BBB’s president, calls on the reader to keep this handy resource book in a very convenient location for easy reference.  You’ll be able to truly appreciate the sound advice and information this free BBB publication offers, despite the old adage about appreciating only the things we pay for.

Call 785-1212 for a copy of BBB’s senior edition, for pickup locations or for detailed information on how seniors can access BBB services.

Fogarty, Senior Advocates to Rally for Increased Funds for State’s Co-Pay Program

Published in Pawtucket Times on March 22, 2004

Research is just beginning to show what Rhode Island aging advocates already know – that more assistance is required for helping the disabled and seniors to reside independently in their homes in the community.

According to researchers at the Disability Statistics Center at the University of California at San Francisco, about 3.3 million community-residing adults who require assistance with two or more activities of daily living (ADLs) need help from another person.

Of these, almost one million people need increased care, more than they are receiving – particularly those who live alone.

ADLs include bathing, dressing, getting into or out of bed or a chair, toileting, eating and other activities that are required to maintain their homes, such as shopping and preparing meals.

This study, published in the March issue of The Journal of Gerontology: Social Sciences, is considered to be the first to estimate the level of care required to help people.

“Individuals who need personal assistance with two or more of the five basic ADLs [mentioned above] and whose needs are unmet, have a shortfall of 16.6 hours of help per week,” said lead author Dr. Mitchell P. LaPlante.  Joining him on the project were Drs. H. Stephen Kaye, Taewoon Kang, and Charlene Harrington, in a written statement.

Among adults whose assistance needs are not fully met, people living alone fare worse than those who live with others, the researchers said. The study found those living by themselves receive only 56 percent of the help they need, while those living with family members or friends receive 80 percent of the hours of help, they need.

The research findings indicate that having unmet needs is linked with numerous adverse consequences, including discomfort, weight loss, dehydration, falls, burns and dissatisfaction with the help they do receive.  This puts these people at risk of being forced to leave their homes and move into costly nursing facilities.

Additionally, the University of California at San Francisco study also reported that unmet needs among people living alone are more an issue for the elderly, since two-thirds of those living alone and needing more help are age 65 or older.

This research study, probably the first of may to come that estimates the assistance required by the nation’s disabled and elderly, should be delivered to the doorstep of Gov. Donald Carcieri and every state lawmaker.

Even with the graying of the Ocean State’s population, the governor and the Rhode Island General Assembly are moving too slow to adequately fund less costly community-based care programs.

Carcieri has given an additional $ 200,000 in funding to the Department of Elderly Affairs (DEA) co-pay program in his recently released proposed 2005 budget.

While appreciative for this increase in funding in the showdown of the state’s huge budget deficit, senior advocates say this is not enough to keep people off the waiting list for this worthy program.

DEA’s co-pay program keeps 1,500-plus low-income frail seniors who do not qualify for the state’s Medicaid program but who require ongoing services to remain in the community in their homes by providing a little bit of funding for certified nursing assistants (for assisting with bathing, meals, shopping, laundry, and light housekeeping). And DEA’s co-pay program also provides subsidies for adult day care.

Last October, a DEA freeze on new admissions to the co-pay program left 200 frail seniors on a waiting list for home and community-based care, said senior advocates.

According to the state’s Long-Term Care coordinating Council (LTCCC), the typical person in DEA’s co-pay program is between ages 65 and 104, with the average age being 84. Most are women and more than half live alone. Without the state’s co-pay, these seniors will have to pay the entire fee for their care –    which they cannot afford – or enter a nursing home, or go without the help they need to do simple things such as bathing, shampooing and dressing.

Susan Sweet, a consumer advocate  who sits on the LTCCC, expressed concern that a DEA freeze – putting the copayment program on hold – for those on the waiting lists still exists this fiscal year.

“These people have been waiting a long time to get the home care or adult day care services that they need. I am afraid that waiting longer will result in many of them entering nursing facilities prematurely,” said Sweet.

Sweet noted Carcieri’s proposed 2005 allocates an additional $ 200,000 in funding for next year’s DEA’s co-pay program.

“It will take more funding than that to take care of the frail seniors still left on a waiting list,” Sweet charged, noting that DEA Director Adelita S. Orefice, did say another $ 250,000 would be needed in FY 2005 to meet DEA’s co-pay program demand.

Lt. Gov. Charles J. Fogarty, who is chairman of the LTCCC, will join senior advocates today at 11:00 a.m. at the Statehouse, calling for the state to reopen admission to a state-funded co-pay program that helps limited-income seniors pay for home and community-based care.

The press conference is expected to draw several family caregivers and representatives of AARP-RI, Choices Coalition, Respite Services, R.I. Adult Day Care Services Association, Alzheimer’s Association of R.I., R.I meals on Wheels, R.I Partnership for Home Care, R.I. Senior Center Directors Association, Senior Agenda Consortium and the Silver-Haired Legislature.

“Freezing the DEA co-pay program is a fiscal folly,” Fogerty said in a written statement obtained by All About Seniors that will be released at today’s rally.

“It is shortsighted from both a financial and a human perspective. It is not as if this freeze will result in overall cost savings,” said the Lt. governor.

Fogarty said this freeze was ordered to avoid having the DEA spend more than what was budgeted for the program in the current fiscal year – an amount that was less than what was spent on the program in FY 2003.

At this rally Fogarty will call for the state to provide adequate funding in the FY 2005 budget for DEA’s co-payment program to address the unmet need.

“To the contrary,” Fogarty said, “it may wind up costing taxpayers much more, because these seniors are still going to need care and they’re going to get by being forced into nursing homes where the taxpayers will pay tens of thousands more than we would have paid for the co-pay program.”

According to Fogarty, in FY 2003, the state supported 1,457 seniors in the program, spending $ 3,650,117, or $ 2,505 per senior. That’s less than 1 percent of all long-term care spending. Contrast this, he said, in is written statement, with the annual cost per nursing home resident – between $ 32,000 and $ 53,700 (this figure excludes the average 20 percent patient contribution to care and includes state and federal dollars).

Fogarty said, “It boggles the mind that in tight budget times, we would opt for the more expensive solution – especially in light of the fact that the less costly option of keeping seniors in their homes is the most humane option.”

As mentioned in a previous column, there is also a freeze and waiting list for the state’s respite program, which provides assistance to family caregivers. This freeze continues and no additional funding has been allocated for this program in Carcieri’s proposed 2005 budget.

Carcieri and state  lawmakers must not continue to put patches on the state’s old dilapidated long-term care deliver system. As I previously mentioned, now is the time to tackle the thorny issues of long-term care and its rising costs.

Rhode Island must move to create a long-term care delivery system that will adequately provide funding for keeping seniors independent in the comfort of their homes while adequately providing reimbursement to nursing facilities that take care of sicker patients.

Seniors can support Fogarty’s call for adequate state funding for DEA’s co-pay program by attending the rally scheduled today at 11:00 p.m.at the Statehouse.

Meanwhile a DEA budget hearing will be held before the House Finance Committee later in the afternoon, at 1:00 p.m. in Room 35 of the Statehouse.

Seniors can attend this hearing to give their support for increased state funding for community-based care long-term programs. Testimony taken from the public will be televised on the state’s access cable channel.

Drug Company CEOs Receive Plea  for Lower Drug Costs

Published in Pawtucket Times on March 15, 2004

Seniors can only hope the pen is mightier than the sword as senior advocates send correspondence to CEOs of major drug companies, urging them to take more responsibility in putting the brakes on skyrocketing pharmaceutical drug costs.

Last Monday, AARP CEO William D. Novelli drafted a letter challenging 16 CEOs of major drug companies to lower the nation’s spiraling drug costs.

AARP’s CEO charged in this correspondence -which has been obtained by All About Seniors – that even with last year’s newly enacted Medicare prescription drug law, high drug prices are still a very serious issue for the nation’s seniors.

“Too many people cannot afford the drugs they need,” Novellis said, resulting in a “very substantial non-compliance with physicians’ recommendations.

Also contributing to higher drug prices, said AARP’s top official, is that seniors do not use geriatrics despite their “comparable effectiveness and lower cost.”

Novelli called on each drug company CEO to limit their company’s price increases to no greater than the level of inflation for current drug products. Additionally, he requested they stop price increases of new drugs, asking them to use their influence to stop drug mark-ups throughout the drug distribution chain.

Novelli urged the drug company CEOs to support drug-importation legislation, subject to proper FDA oversight to ensure safety of the imported medications. (Currently there is legislation being considered by Rhode Island lawmakers to allow drug importation from Canada).

Furthermore, Novelli asked CEOs for their drug companies’ strong endorsement of federal and state funding “to support clinically based, comparative effectiveness research that will permit objective, scientific comparisons of specific drugs in the same therapeutic class.”

Novell even urged the CEOs not to oppose any federal legislation introduced that would provide the Secretary of Health and Human Services with appropriate negotiating authority in the event the competitive private purchasing system does not produce the anticipated cost savings for the Medicare program.

The Republican-crafted Medicare law does not allow the federal government to negotiate for lower drug prices – a move that’s been opposed by the Democrats.

To put the brakes on rising out-of-pocket costs for seniors, Novelli also asked the CEOs to support a disclosure of pricing information by pharmaceutical benefits managers to their payer clients. This would assure that those enrolled in the Medicare program will receive full advantage of negotiated discounts and rebates.

Better displays of drug information regarding the risks, side effects and proven effectiveness of their consumer advertising is needed, Novelli told the CEOs. He also called for generics to be quickly moved into the marketplace when the patent has expired for brand name drugs.

In his correspondence, Novelli called on the CEOs to follow the ethics guidelines of the American Medical Association when it comes to giving gifts to physicians and sponsorships of educational meetings.

Last month, Lt. Gov. Charles J. Fogarty, chairman of the state’s Long-Term Care Coordinating Council, in Feb. 19 correspondence, called on Alan F. Holmer, president and CEO of PhRMA, to join the lead of drug manufacturer Merck in providing medication at no cost to low-income Medicare beneficiaries who participate in the new federal Medicare prescription drug discount card program.

Low-income seniors would be eligible for the Merck benefit once they use up their $ 600 federal allotment on their cards. Fogarty said in his written statement.

The Medicare drug discount cards are an interim measure put in place by the federal government until 2006, when newly passed Medicare changes will take affect, said Fogarty. The lieutenant governor, along with many of the state’s senior advocacy groups and the state’s Congressional delegation, have given their thumbs-down to the Republican-backed enacted Medicare revisions and have urged Congress to scrap the law and “to back to the drawing table.”

By accepting his invitation to help lower the cost of pharmaceutical rugs, Fogarty believes, “This will give the industry the opportunity to partner with the government and make a significant difference for those in need.”

The seniors’ battle to slash the out-of-pocket costs of pharmaceuticals must take place both on Capitol Hill, inside the Washington, D.C. Beltway, and at the Rhode Island Statehouse in Providence.  Novelli and Fogarty are now taking the fight to the boardrooms of major drug manufacturers across the nation.

Seniors may well hope that the pen is indeed mightier than the corporate sword.