Monthly Archives for October 2023

Will Magaziner fulfill call to reestablish House Aging Committee? 

Published in RINewsToday on October 9, 2023

With Congressman David Cicilline retiring from Congress, no House lawmaker has yet stepped up to reintroduce, H.R. 583,  the Rhode Island lawmaker’s resolution to reestablish the House Select Committee on Aging (HSCoA).  Without receiving a vote in the House Rules Committee at the end of the 117th Congress, the resolution was considered “dead.” On his way out Cicilline was not successful in passing the legislative baton and finding a new original sponsor. 

The resolution to approve the initial HSCoA was passed on October 8, 1974, by a large margin (299–44) in the House. Its legislative duties expired in 1992 during the 103rd Congress, as the House leadership was under pressure to reduce its internal costs to save $1.5 million and to streamline the legislative process. 

On May 26, 2016, Cicilline began his legislative efforts to bring back the HSCoA.  The simple resolution, consisting of 245 words, would authorize the Select Committee to study the use of all practicable means and methods of encouraging the development of public and private programs and policies which will assist seniors in taking a full part in national life and which will encourage the utilization of the knowledge, skills, special aptitudes, and abilities of seniors to contribute to a better quality of life for all Americans.

HSCoA would not craft legislative proposals, but hold investigative hearings to put the Congressional spotlight on aging issues. Its purpose was to push for legislation and other legislative actions, working closely with standing committees, through regular committee channels. 

According to the Congressional Research Service, it would be relatively simple to create a select committee by approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other issues that need to be address.  Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill. 

Once introduced, the resolution would be referred to the House Rules Committee for consideration.  If passed, it would be scheduled for a floor vote.  If passed, no Senate action or Presidential signature would be required.

The fourth time’s not the charm

Over eight years (during four Congressional Sessions), Cicilline was unsuccessful in getting the support of either the Republican or Democratic House Speakers to pass his resolution. During the 114th Congress Cicilline began his legislative push to bring back the HSCoA by introducing H. Res. 758.  Twenty-eight Democratic lawmakers out of 435 House members (with no Republican supporting) became cosponsors. But it caught the eye of the co-chairs of the Seniors Task Force (later renamed the House Democratic Caucus Task Force on Aging & Families), Congresswomen Doris Matsui (D-CA) and Jan Schakowsky (D-IL). The lawmakers became cosponsors of this resolution.

Correspondence penned by Cicilline to House Speaker Paul Ryan (R-WI) requesting support of H.R. 758 went unanswered.   Without the blessings of the GOP House Speaker, the resolution was not considered in the House Rules Committee and no floor vote scheduled.  

Two years later, with Ryan’s GOP caucus still retaining the control of the House during the 115th Congress, Cicilline’s H. Res. 160 would again not gain legislative traction. At that time only 27 Democratic lawmakers stepped forward to become cosponsors, just like the previous Congressional session, with the resolution not attracting one single GOP lawmaker as a cosponsor.    

For the third time, during the 116th Congress, Cicilline would  introduce H. Res. 821 to resurrect the HSCoA. Even with House Speaker Nancy Pelosi controlling the lower chamber’s legislative agenda, the resolution would not get Rules Committee consideration, again blocking it from reaching the floor for a vote.

Even with House Speaker Pelosi retaining the gavel again during the 117th Congress, Cicilline could not push H. Res 583 to the legislative goal line.  Like Cicilline’s other three attempts, the resolution was referred to the House Committee on Rules for mark-up and vote. Without Pelosi’s blessings and support for passage, like previous attempts, the  resolution died at the end of the Congressional session.   

Cicilline’s efforts drew the support and attention of Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare, who was former Staff Director of the Senate Special Committee on Aging, the Leadership Council of Aging Organizations (representing 66 national aging groups), along with President Nancy Altman of Social Security Works, and Chair of Strengthen Social Security Coalition.   

Robert Weiner, former chief of staff of the HSCoA, Tom Spulak, former staff director and General Counsel of the House Rules Committee, and Vin Marzullo, a well-known aging advocate in Rhode Island, were strong advocates for the resolution’s passage.

It’s a no-brainer not to bring back HSCoA

Weiner, the President of Robert Weiner Associates News, who was a close friend and confidant of Claude Pepper, clearly knew the importance Cicilline’s efforts to bring back the HSCoA and its impact on the quality of life of America’s seniors.  Weiner, who served as Staff Director for the Subcommittee on Health and Long-term care from 1975 to 1977 and Chief of Staff of the full Aging Committee, from 1976 to 1980, remembered how the late Congressman Claude Pepper used the Select Committee as a force to push Congress to tackle aging issues.

“Bringing it back would be immeasurably helpful regardless of which party has the White House or controls Congress in assuring the best health care programs for seniors,” says Weiner. 

Weiner says that the HSCoA successfully prodded Congress to abolish forced retirement, investigate nursing home abuses, monitor breast cancer screening for older women, improve elderly housing, and bring more attention to elder abuse by publishing a number of reports, including “Elder Abuse: An Examination of a Hidden Problem and Elder Abuse: A National Disgrace,” and “Elder Abuse: A Decade of Shame and Inaction.” The Committee’s work would also lead to increased home care benefits for the aging and establishing research and care centers for Alzheimer’s Disease, he said.

“One of the best-known aging accomplishments of Claude Pepper was to end mandatory retirement by amending the Age Discrimination in Employment Act,” adds Weiner, noting that with HSCoA support the bill passed 359 to 2 in the House and 89 to 10 in the Senate, with President Jimmy Carter signing the bill into law despite strong opposition of the Business Roundtable and big labor.

Weiner noted that among the HSCoA’s other legislative achievements was supporting the passage of legislation creating standards for supplemental insurance and holding hearings to expose cancer insurance duplication. “Witnesses were literally forced to wear paper bags over their heads to avoid harassment by the insurance companies. That legislation became law,” he said.

According to Weiner, “Republican lawmakers just didn’t want to support Cicilline’s resolution to reauthorize the HSCoA,” says Weiner, despite the fact that Congressman John Heinz  (R-Pa.), later a renowned Senator, was an original prime sponsor of the House resolution that would initially establish the select committee. 

Seniors are now the most powerful voting block who would see the need, like Heinz, for a HSCoA, especially to protect Social Security, Medicare and other federal aging programs, says Weiner.  Republican House lawmakers are threatening to cut Social Security benefits and raise the full-time retirement age, he warns, calling their actions “reforms.” “But the program is actually solvent, with trillions in surplus beneficiaries paid for as the Pepper-Reagan original deal provided,” he notes. 

If HSCoA resolution is passed during the 118th Congress, the Republicans would control its legislative agenda.  Historically, the House select committee allowed open, bipartisan debate from different ideological perspectives to promote bipartisan consensus that, in turn, would facilitate the critical policy work of the standing committees.

Passing the torch

Who will ultimately pick up the legislative baton from Cicilline to become Rhode Island’s fiery aging advocate.  Will it be Congressman Seth Magaziner, or the newly elected Congressman from Rhode Island’s Congressional District 1 to step to the plate?

Why shouldn’t Magaziner or Cicilline’s replacement follow in the footsteps of former Rhode Island Congressman John E. Fogarty (dec.) and be the original sponsor of legislation that will have a major impact on national aging policy.  The lawmaker would become a hero to America’s seniors.  The White House Conference on Aging was the result of legislation successfully sponsored by Fogarty, and led to the enactment of his bill to establish an Administration of Aging in the Department of Health, Education and Welfare.  He was the original sponsor of legislation that established the Older Americans Act of 1965.

But even if a Rhode Island Congressman makes a decision to become the original sponsor to Cicilline’s resolution that reestablishes the HSCoA, passing this resolution in a GOP-controlled House will require support from that caucus. 

Congressmen Brian Fitzpatrick (R-PA) and Josh Gottheimer (D-NJ), co-chairs of the “Problem Solvers Caucus,” consisting of essentially an equal number of 63 Republican and Democratic lawmakers, may well be the way to finally pass a resolution to reestablish the HSCoA. 

Weiner, who would later become a senior staffer to both the Clinton and Bush White Houses and now is a national columnist and winner of the National Press Club President’s Award for recruiting young journalists, agrees that it is now time to bring the Problem Solvers Caucus to the forefront to endorse and together have a bipartisan House support push for reestablishing the HSCoA.  “The Aging Committee has always been bipartisan, with leaders including not only Pepper and Ed Roybal as chairs, but supportive ranking minority members including then House members — later Senators — Chuck Grassley, Bill Cohen, and John Heinz.

Passages – Life and Times of Morris Nathanson

Published in RINews Today on October 7, 2023

Painter, Illustrator and Restaurant/Hospitality Designer Morris Nathanson’s artist studio is just a stone’s throw away from his childhood home on Japonica Street in Pawtucket, Rhode Island. Growing up poor during the depression in his Pleasant View neighborhood, settled by Armenian and Syrian immigrants who worked in the surrounding mills, he would see his home and surrounding properties demolished to make way for Interstate 95. This made him skeptical of the policy of Eminent Domain, as it left his family and neighborhood languishing for years in expected dread of demolition, years before it was to occur, destroying the spirit of his neighborhood. It was this singular policy that encouraged his work in historic preservation.

Morris, raised in a Jewish household, was a lifelong adult member of Temple Beth El on Providence’s East Side.  He practiced his faith throughout his life including the orthodox values taught to him by his mother. 

Morris, a spitting image of Mark Twain, or maybe even Albert Einstein, because of his distinctive head of hair, always wore colorful bow ties, considered by many to be his trademark look. He was a man who made a definitive impact on the international art and design scene. In the City of Pawtucket, he was the force that initiated the City’s art scene by bringing the strategy of adaptive reuse of underutilized and vacant mills to city officials, a concept he learned from his years of working in New York City as a restaurant designer and watching the development and transformation of the industrial mill buildings in SOHO.

My friend, Morris, passed away peacefully at the ripe old age of 95 in September, one year ago.

Over two decades, this writer would visit Morris on Saturday afternoons sitting in his living room drinking cups of freshly brewed coffee. The cozy room is surrounded by large bookcases jam packed with literary classics, architectural, art and design books, and walls filled with artwork he created throughout the years, and of course the piles of newspapers, specifically the New York Times, Boston Globe and Providence Journal, that he read daily.  We would talk about Pawtucket, world events, and he would reminiscence about his amazing life’s journey from his childhood in Pawtucket, to the international world he lived in later in his life.

The War Years

Morris was motivated to enlist in the military service because of the Nazi’s policy of exterminating all Jews. His family was aware that they lost many of their relatives in Europe as they were transported to the concentration camps where they perished.  

Walking into the Pawtucket post office on Montgomery Street, registering for the draft at age 17, with the required parental approval to enlist in the Navy, he, like many young boys, left Pawtucket East to fight in World War II.

This memory never faded from his mind.

After his basic training at Sampson Naval Base in upstate New York, half of his class of Navy recruits were assigned to the U.S.S. Catamount (LSD 17) and the other half were sent to the U.S.S. Indianapolis. The U.S.S. Indianapolis was a Portland-class heavy cruiser which was charged with a top-secret mission – to deliver the uranium and other components for “Little Boy,” the first nuclear weapon to be used in combat, to Tinian Naval Base.  The bomb would be dropped on Hiroshima the following week.  After the ship’s departure to the Philippines for training duty, it was sunk by a Japanese submarine. Sinking in just 12 minutes.  Out of the 1,195 crewmen onboard, only 316 survived.  The survivors faced injuries, dehydration, and shark attacks. It was the luck of the draw for Morris to be assigned to serve on U.S.S. Catamount, and not the U.S.S. Indianapolis.

Morris remembered the U.S.S. Catamount among hundreds of naval ships in Tokyo Bay, carrying special equipment to be used during the occupation of Japan. His ship would ultimately not have to participate in the all-out ground invasion of Japan because of the dropping of the atomic bombs on Hiroshima and Nagasaki.  His ship was one of 260 vessels of the Allied navies present in Tokyo Bay when Japanese officials on the U.S.S. Missouri signed the declaration of surrender on Sept. 2, 1945.

With Japan’s surrender, the members of Morris’ crew were sent on shore to rout out any Japanese soldiers hiding in caves.  A terrifying moment for Morris occurred in the caves, not from meeting enemy soldiers, but realizing he was lost and he couldn’t read the signage written in Japanese. Fortunately, fate smiled on Morris and brought him out to safety. 

On a light note, during his Naval service Morris was recognized by his crewmates for his artistic talent.  He was always selected to do any assignments involving illustrations.  His favorite project was designing Mother’s Day cards for his shipmates.

Fighting Antisemitism and Civil Rights for All

Experience aboard the U.S.S. Catamount gave this young medic his first awareness of systemic racism.  Witnessing first hand man’s biases and prejudices motivated him throughout seventy-five years of his long life to fight for the equal rights of all.  Morris’s civil rights activism solidified his belief that human rights are essential to life and recognized that they must be consistently fought for.  Which he did.

Morris participated in the Freedom Rides of 1961, Dr. Martin Luther King’s campaigns in Selma and Birmingham, Alabama, and the March on Washington for Jobs and Freedom.  For anyone not familiar with the dangers and complexities of these marches – these courageous civil rights activists were subjected to threats, beatings, mass arrests, bombings and even murder.  Our criminal justice system in the 60s more often than not, turned a blind eye to the plight of those protesting against these injustices.

When Morris was discharged in 1945, like so many servicemen, he took advantage of the GI Bill, enrolling at Curry College in downtown Boston.  During his second year, with his best friend, Donnie Shear, they began to seek out Colleges, “anywhere warm” he would say.  They ultimately transferred to University of Miami.

At the University of Miami, he earned a Bachelor of Arts (BA) in Theatre and Fine Arts.  He was a member of Alpha Epsilon Pi, a Jewish fraternity on campus.  He later went on to the New School for Social Research in New York City to study Theatre.  At that time, he wanted to become a playwright and director for the New York stage but fate would bring him back to Rhode Island with a call from his mother asking him to return to help her provide for his younger siblings.

Finding a Niche in the Design Sector

Ultimately, the young college graduate took his first job as a social worker in Providence.  Morris worked for two years in the Charles Street neighborhood assisting struggling Italian families and although his supervisor offered to send him to graduate school in Boston to get a Bachelor of Social Work degree, he instead decided to follow his dreams and passion (suggested by his high school teachers) to become an artist.

Rhode Island would be pivotal to Morris by guiding him into his new profession.  His first design job, sort of like a one degree of separation, began when his brother Abe decided not to accept a job offered by the Providence-based Paramount Restaurant Supply Co.  When Morris heard this news, he went and applied for the job the next day and got it. This job officially propelled him into the restaurant design sector, working with the best, David Friedman, owner of Paramount Restaurant Supply Co.

Friedman had one of the largest design shops on the East Coast. The company designed case goods for numerous department stores in New York City, which had luncheonettes and restaurants.  Interesting enough, Morris’ first designs were drawn on paper napkins in front of his new clients.  However, that was very short lived as Morris immediately undertook developing a serious design department.

At age 24, Morris, head of the design team at Paramount, developed and designed the first franchise in American history, Dunkin Donuts. While working with Friedman he also designed restaurants in the pavilions of the 1964 World’s Fair in Flushing Meadows, New York.

When Morris left Paramount Restaurant Supply Co, he retained his relationship with Friedman which became a lifelong friendship. His artistic flair and design talents were brought out in his new company, Morris Nathanson Design, ultimately attracting clients throughout  Rhode Island, the U.S., and later, internationally.   

His most notable design projects locally include Hemenway’s, Ruth Chris Steak House, 22 Bowen, restaurants and bars for the Inn at Castle Hill, Capital Grill, Pizzeria Uno, Joe’s American Bar & Grill, Mills Tavern, Waterman Grill, Red Stripe and for those who still remember, the beloved Ming Garden and McGarry’s Restaurant in downtown Providence.  He also had clients in the legal, medical and retail sectors.

Well-known clients outside the Ocean State included Nathan’s Famous, B.B. King Blues Club, Carmine’s, Docks, Rue 57, Oceana, Virgil’s and Angelo and Maxie’s in Manhattan and the Hyde Park, New York-based Eveready Diner featured on the Food Network’s “Diners, Drive-in and Dives” television series.  Another accolade for the Eveready Diner is the 1995 visit of President Clinton and Russian President Boris Yeltsin to the diner for a meal during their summit held at the summer cottage of Franklin Delano Roosevelt, whose property is across the street from the diner. 

Morris was also instrumental in the ongoing development of Johnson & Wales University.  School leaders asked him to visit the renowned chef, Louis Szathmary, owner of The Bakery, in Chicago and a New York Times best-selling cookbook author, “The Chefs Secret Cookbook,” to review his extensive culinary collection which filled two Brownstones in Chicago.  Morris persuaded Szathmary to donate his entire collection of culinary memorabilia  to Johnson & Wales University and convinced the University to build a museum to house thousands of the historic artifacts that he so graciously donated.

An Early Advocate for Mill Adaptive Reuse

Morris did not forget or leave his old Pawtucket neighborhood.  With his offices in Providence, he would later return to his roots in the blue-collar community of Pawtucket and purchase the decaying Rhode Island Cardboard Manufacturing complex, now known as Blackstone Studios, just across the street from his former high school, East High, now Tolman High. 

Morris’s historic mill sits by Pawtucket’s Veterans Memorial Amphitheatre, an outdoor music venue he designed at Roosevelt and Exchange Street. Then the Exchange Street Bridge was later renamed the Morris Nathanson Bridge in his honor in 2010.

Over the years, Morris and his wife Phyllis renovated the former manufacturing mill building (ultimately located in Pawtucket’s 307-acre Arts and Entertainment District) to become the new headquarters of Morris Nathanson Design and also created artist studios and lofts, gathering a community of artists to live and work.  These artists and craft persons, residing in his mill, would become independent contractors of his design firm and would be hired to work with his company on many restaurant design projects. His clients loved this concept because it made it easy to manage all their design needs in one building. 

With the experiences learned in redeveloping their mill, Morris and his wife, Phyllis, took on developing the former Lebanon Knitting Mill and Vesta Underwear which sat on the banks of the Blackstone River.  The project is now known as Riverfront Lofts which houses 59 live-work condominiums for artists.  The success of this project was unrivaled in the state.

The Nathansons were leaders encouraging other artists to rehabilitate vacant buildings throughout Pawtucket and statewide. As an early advocate for mill adaptive reuse, Morris was in the forefront of developing Pawtucket as a highly visible and respected arts and entertainment center.  He led the efforts in the blue-collar community to change to zoning ordinances (locally and statewide) to assist developers to rehab vacant and underutilized mills to allow live-work spaces.

While residing in Rhode Island, Morris has lived his life on the international stage as a designer of award-winning restaurants, concert spaces, and hospitality venues. He was widely recognized as the father of modern restaurant and hospitality design.

A Prolific Fine Artist Who Made a Difference  

A lifetime member of the Providence Art Club, Morris was a highly respected and prolific fine artist, with numerous exhibitions in Providence and New York. The Pawtucket native’s paintings, prints, wood sculptures, and drawings reflect nearly a century of work, and trace his truly extraordinary and vibrant life through bold colors and iconography that pulled from personal history.

Mr. Nathanson was a founding board member of Trinity Repertory Company. One of Trinity Rep’s earliest set designers, he was also in charge of its relocation to the Emery’s Majestic Theater (now the Lederer Theater Center), which has been the theater’s home for over 50 years.   

Among his many activities in Rhode Island, Morris served as a member of the Providence Historic Commission and the Pawtucket Armory Association, he played a critical role in securing the historic armory from the State of Rhode Island and oversaw the design and build of the Sandra Feinstein Gamm Theatre and the creation the Jacqueline Walsh School for the Arts. He also offered his time and expertise to the City of Pawtucket’s Riverfront Commission, the Pawtucket 2020 Committee, the Pawtucket Foundation, and the Pawtucket Arts Collaborative.

Morris also found time to design and teach courses at the Rhode Island School of Design, and served as a design consultant to Providence Mayor Joseph Paolino Jr.  He also served as a commissioner under the direction of Antoinette Downing on the Providence Historic Commission.

Morris is the recipient of numerous personal awards and recognitions, including honorary doctorates from Johnson & Wales University and Rhode Island College. Morris has been inducted into the Pawtucket Hall of Fame, and been awarded the Pawtucket Foundation Heritage Award, the Arts and Business Council of Rhode Island’s Small Business Award, and the Pell Award from the Trinity Repertory Company for his life-time contribution to the arts. He was awarded the Paul Harris Award, Rotary’s highest honor by the Pawtucket Rotary Club.  

Morris has also been designated as a ‘Thought Leader’ by the American Society of Interior Designers, considered to be the best in the design community. 

Upon his retirement in 2008, Morris was asked by Boston University Culinary School to donate over 400 hand-drawn renderings of restaurants, hotel and resort projects, to become part of the new “Morris Nathanson Design Collection” at the Howard Gotlieb Archival Research Center.  Boston University recognized Morris’s lifelong work by calling him “the pioneer” of modern restaurant design. 

The Howard Gotlieb Archival Research Center also houses Martin Luther King’s letters, papers and archives, a fitting tribute to Morris’ years as a civil rights advocate.

With the international acclaim and recognition that Morris has received in his 95 years of living, Morris always would tell you where he comes from Pawtucket, a man who never forgot his roots.

Morris never consider himself retired; he just had a job as a full time artist.  

Morris is survived by his loving and devoted wife, Phyllis Van Orden Nathanson, and their son, John David Nathanson, and Josh Nathanson and Kim Nathanson Arsenault, from his marriage to Roxie Sgouros, along with four grandchildren, Emma, Sarah, Lily, Adrian and his sister Rachel Schuchman.

Morris’ legacy as an artist and designer lives on in his three children.  Josh and Kim are both involved in restaurant and hospitality design while John David is a following his love and passion creating animation films at DreamWorks in California.

Supporting Young Artists

Morris says that he knew that he would become an artist at the tender age of six years old, remembering that he would draw on the walls.  As he got older, he continued to sharpen his drawing skills. An elementary school teacher identified him as having artistic abilities and faculty at Tolman High School encouraged him to follow his passion for the arts.

To recognize the encouragement that Morris received throughout his schooling, Morris’s family has created “The Morris Nathanson Tribute Fund,” a scholarship supporting Rhode Island students aged K-12 to participate in Saturday youth classes at the Rhode Island School of Design (RISD) which he himself attended as a young boy.  The family hopes that the Rhode Island community will give generously to the “Morris Nathanson Tribute Fund” at RISD so that poor children with artistic talent may have the same opportunity to explore and cultivate these talents as he once did. 

Donations can be mailed to:  Morris Nathanson Scholarship Fund, Rhode Island School of Design, Office of Institutional Advancement, 20 Washington Place, Providence, RI 02903. 

By Herb Weiss and Phyllis Van Orden Nathanson

Herb Weiss, LRI -12, is a Pawtucket-based writer who has covered aging, health care and medical issues for over 43 years.  To purchase his books, Taking Charge: Collected Stories on Aging Boldly and a sequel, compiling weekly published articles, go to herbweiss.com.

Phyllis Van Orden Nathanson, wife of Morris Nathanson, continues her work as an arts advocate.

AARP report: States’ care for seniors “painfully inadquate”. Major gaps in RI

Published in RINewsToday on October 2, 2023

Last week, the Washington, DC-based AARP released its latest Long-Term Services and Supports (LTSS) Scorecard, calling care provided to seniors and persons with disabilities during the last three years after the COVID-19 pandemic “painfully inadequate.”  This nine-page report detailed state specific data, finds major gaps in providing care in every state, including Rhode Island, especially in these categories:  “Housing for Older Adults”, “Home Care Costs” and “Home Health Aide Supply”. 

The LTSS Scorecard, consisting of 50 indicators, focused on: affordability and access; choice of setting and provider; safety and quality; support for family caregivers; and community integration, using data from a variety of publicly available sources, such as the Centers for Medicare and Medicaid Services, American Community Survey, and Bureau of Labor Statistics.

Many benefits of accessing the data

According to AARP, this Scorecard can be a roadmap for improving the LTSS systems and the lives of those who rely on assistance.  Many others will benefit by reviewing this data, too. Federal, state, and local policy makers can identify priorities and ensure resources are allocated equitably. Aging advocates can glean public data and hold government officials accountable. Family caregivers can identify needed resources and become actively involved in policy discussions and advocacy. Seniors relying on long-term care programs and services can learn to inspire culture change and demand available tools. Finally, employers can improve workplace policies and practices to assist caregivers and healthcare groups so they can explore public-private partnerships and alliances. 

Like the findings reported in AARP’s LTSS Scorecard in 2020, Rhode Island ranked 12th in the country in 2023, but this year’s Scorecard reveals that the state has made some progress in improving care options for older Rhode Islanders, specifically the enrollment in the Program of All-Inclusive Care for the Elderly (PACE), as well as the availability of Adult Day Services.

“The pandemic reinforced the need to strengthen long-term care for countless loved ones across the country, including here in Rhode Island,” said AARP Rhode Island State Director Catherine Taylor in a Sept. 28th statement announcing the release of the 2023 LTSS Scorecard. 

“AARP’s Scorecard shows that there are many roads to meet the needs of all Rhode Islanders who deserve the very best care, including the 121,000 family caregivers in our state. The overwhelming majority — 87% — of Rhode Islanders age 45+ would prefer to receive care for themselves or loved ones at home with caregiver assistance. Yet, our low rankings in Housing for Older Adults (51st), Home Care Costs (43rd) and Home Health Aide Supply (41st) underscore how difficult it is for them to age the way they choose. It’s time to accelerate our efforts, for the sake of saving more lives,” she says.  

RI is dead last in housing

“In particular, Rhode Island’s dismal ranking for Housing for Older Adults – dead last – points to the urgent need to increase the supply of affordable, accessible housing. We can do that by passing legislation early in 2024 to strengthen homeowners’ ability to build an accessory dwelling unit (ADU) to allow them to age in place, support a family member, or house a caregiver,” Taylor said.

A national snapshot of the LTSS Scorecard’s 2023 Data

According to Scorecard, 12 states, including Rhode Island, have enacted paid family leave laws and 18 states have paid sick day laws, which can be used to assist caregivers. AARP’s latest Scorecard also reported that only 6 states provide a tax credit for family caregivers’ out-of-pocket expenses. Rhode Island does not provide a tax credit – nor is it among the 7 states that have statewide laws protecting caregivers from discrimination in the workplace that ensure they are not unfairly treated due to caregiving duties outside of work.

Meanwhile, it was reported that dozens of states experienced declines in the number of care choices that help support family caregivers. For instance, 16 states, including Rhode Island, had declines of 10% or more in access to home health aides since 2019. 

Regarding Home and Community-Based Services (HCBS), the LTSS Scorecard reported that 11 states, including Rhode Island, had state policies that improve presumptive eligibility for Medicaid HCBS at the time of data collection, making it possible for people to go home to receive care after being in the hospital – rather than having to be admitted to a nursing home while their eligibility for Medicaid payments is being determined.

The research indicated that many states also have large numbers of people with low care needs living in nursing homes, indicating a lack of HCBS access and services. More than 20% of nursing home residents in Rhode Island have low needs – compared to 9% nationally.

Data confirms Major Workforce Crisis in nursing facilities across US

As to nursing homes and institutional care, the AARP’s 2023 Scorecard confirmed that a  major workforce crisis exists in facilities across the country. Across all states, wages for direct care workers are lower than wages for comparable occupations, with shortfalls ranging from $1.56 to $5.03 per hour. In Rhode Island, wages are $1.79 lower than other entry level jobs.   

Nationally, more than 50% of nursing staff in nursing facilities leave their job within a year (53.9% turnover rate). However, in Rhode Island, the rate is slightly better than the average, at 49.3% – with Montana, Vermont, and New Mexico experiencing the highest averages in staffing turnover.  

Staffing disparities are also a significant challenge, say researchers, noting that residents of nursing facilities with high admissions of Black residents receive almost 200 fewer hours of care per year compared to residents of facilities with high admissions of white residents. 

According to the LTSS Scorecard, only 22% of nursing facility residents live in a facility with a 5-star rating in the US – with less than the national average, about 20.2%, of Rhode Island residents living in a 5-star facility. Gaps in workforce and equity result in persistent problems in care, say the researchers. One measure, pressure sores, can be life-threatening as they can lead to bone or joint infections, cancer, and sepsis. In this measure, 10% of facility residents nationwide experienced a pressure sore.

Finally, this year’s Scorecard announced that there is progress being made to create innovative and effective alternatives to traditional nursing facility models. Specifically, the researchers say that 10 states, including Rhode Island, made strides in nursing home innovations, such as by utilizing Green House® Nursing Home availability and policies, which includes small facilities, private rooms, and other best practices.

AARP’s 2023 LTSS Scorecard identified recommendations that can fix the nation’s delivery of long-term care programs and services to enable seniors to age in place in their communities. It called for increasing support to the nation’s 48 million family caregivers, “who are the backbone of the long-term care system, providing over $600 billion in unpaid care, such as with paid leave, tax credits, and other mechanisms to address health and financial needs.”

AARP Rhode Island continues to call on the Rhode Island General Assembly to support the state’s 121,000 family caregivers by advocating for enhancements to the state’s Temporary Caregivers Insurance program.

Recommendations on enhancing Long-Term Services and Supports

The Scorecard’s recommendations also called for investing in states’ Home and Community-based Care Infrastructure, by increasing support and training for home health aides and home visits, supporting the ability to access and use medical devices and equipment, and updating key Medicaid regulations and payment models.  

To tackle the workforce crisis, a recommendation suggests that it is crucial to support both nursing facility and in-home workforce by improving recruitment and training, increasing pay, and expanding the ability of trained nurses, aides, community health workers and other paraprofessionals to take on some aspects of care. States can choose to enact and enforce staffing and related care standards.

A recommendation also calls on States to expand the use of innovative, effective models for nursing homes can improve both quality of care and quality of life, such as with smaller facilities and private rooms and to address inequities by investing to close the staggering gaps in access to quality care and facilities and staffing shortages.

(Editor’s Note:  During the pandemic, then Governor Gina Raimondo allocated $5 million towards 2 changes in nursing homes – making all rooms private and providing non-shared, private bathrooms – for all residents – efforts to follow up on this effort have not resulted in what happened to that initiative according to the RI Department of Health).

Another recommendation urges states to create multisector plans for aging and building of coalitions and age-friendly health systems, to help seniors to age in place at home by having affordable and accessible housing and transportation, improved community design, and comprehensive emergency preparedness plans.

Researchers also suggested the advancing innovation in cities, counties, and states by supporting comprehensive state- and community-wide aging plans and piloting new approaches and programs, like Green House® Nursing Homes and presumptive eligibility, that can then be scaled.

Finally, Climate Change is increasing national disasters, and the LTSS Scorecard recommends that every state have a sound emergency preparedness plan to support nursing home residents, in particular, in times of crisis – including natural disaster.

“AARP’s LTSS Scorecard shows some progress and innovation, but there’s still a long way to go before we have systems that allow people to age well, and independently, for as long as possible and support the nation’s 48 million family caregivers. It’s also clear some emerging issues deserve more attention – from whether nursing homes are prepared to confront natural disasters, to whether they have plans in place to maintain and grow their workforces,” says Susan Reinhard, Senior Vice President, AARP Public Policy Institute.

The LTSS Scorecard is a charitable project made possible by a grant from AARP Foundation, with support from The SCAN Foundation, The Commonwealth Fund, and The John A. Hartford Foundation, and has been updated every three years since 2011.

To view the full Scorecard and state-by-state information visit https://ltsschoices.aarp.org/ 

To view the Scorecard for specifically Rhode Island, go to:  https://ltsschoices.aarp.org/scorecard-report/2023/states/rhode-island.

To view Previous Scorecards (2011, 2014, 2017 and 2020) go to https://ltsschoices.aarp.org/scorecard-report/report-archive/