Author Archives for Herb Weiss

Concerts Support Health Care Initiative for R.I. Musicians

Published in Pawtucket Times, November 8, 2013

When Bruce McCrae (a.k.a. Rudy Cheeks), a member of legendary Rhode Island musical bands the “Fabulous Motels,” “The Young Adults” and “The Jackiebeat Orchestra,” left his full-time job in 2011, the sixty-one year old had the freedom to pursue his dream of creating a television series about Rhode Island’s music scene. But, the long-time musician, a highly regarded columnist who writes the Phillipe & Jorge’s Cool Cool World with sidekick Chip Young for the Providence Phoenix, left his employment with no health care coverage in place.

Throughout his career, Cheeks had health care insurance when he was employed by radio stations or at Insight, a nonprofit serving blind and visually impaired Rhode Islanders. Today, at age 63, Cheeks, who is Executive Producer and host for the TV show “Meet Me at the Met,” is among hundreds of Ocean State musicians who do not have health insurance (unless they are the lucky few provided coverage through a spouse’s coverage.)

Cheeks clearly understands the value of health insurance coverage. Three years ago, high blood pressure would put him in the intensive care unit at Rhode Island Hospital. Luckily he had health insurance at that time. But today, with no health insurance coverage he is forced to forgo medical treatment from a primary care physician even if he is sick.

Bringing Health Care to Musicians

In 2011, Cheeks and a group of local musicians banded together to found the Rhode Island Music Hall of Fame (RIMHOF). Although the Pawtucket-based nonprofit is primarily dedicated to celebrating and honoring the legacy of Rhode Island musicians, educators and industry professionals, who have made significant contributions to both the local and national music scene, the Organization also decided to turn its attention to bringing health care and wellness options to those in the music scene, says Cheeks.

According to Cheeks, RIMHOF’s Tune In & Tune Up initiative came about because its Board members, along with many of the state’s musicians, were fed up with the lack of affordable health care options for those in the music community.

The Tune In & Tune Up (TI&TU) Rhode Island Musicians Health Awareness Initiative has already partnered with medical professionals such as Dr. Stephanie Hansen, psychologist, and Dr. Mark Andreozzi, ENT, who both serve on the advisory committee. They also support Dr. Zaheer A. Shah’s Access Basic Care (ABC) initiative and have already enrolled nine R.I. musicians in Shah’s membership health care program, some who had not had an annual physical for decades.

The ABC initiative waives a $15 charge for health visits when the patient presents their TI&TU membership card. RIMHOF is also looking into other well-run, inexpensive and effective health care programs to suggest to members, adds Cheeks.

As part of TI&TU, members will be eligible for discounts at area health and wellness retail locations and will receive free admission to a planned series of health-related forums geared specifically to musicians. Additionally, a web site focusing on the music community will be developed directing them to area health and wellness options and trying to make the topic of health care more understandable so they don’t just “tune out.”

To date, Cheeks and 100 people in the music industry have been issued TI&TU membership cards. RIMHOF anticipates another 200 to be signed up for and available by the Unity Concerts weekend.

In addition, TI&TU’s planned bi-monthly series of conversations/ workshops will focus on topics aimed at the music community, everything from carpal tunnel problems, to stage anxiety, to vocal health and more. The first of the series will feature Megan Hall, the Outreach and Education Lead at HealthsourceRI.

A Call for Action

According to a RIMHOF press release, during the nonprofit’s first induction ceremony in 2012, Hall of Fame inductee Ken Lyon mentioned from the stage that many musicians in the Ocean State do not have adequate health care and that it was an issue that concerned him greatly. He challenged the Hall of Fame to look into this important issue and that is exactly what happened as board member Don “D.C.” Culp started constructing what would eventually turn in to a grassroots movement spearheaded by several Hall of Fame board members.

Culp explains “I first brought up the idea of joining together some type of affordable health care with a health awareness information center. The idea was met with great enthusiasm but also a realization of the greatest obstacle to overcome – existing programs with very high monthly fees and/or high co-pays which make them far from affordable for most musicians.”

“Unfortunately,” RIMHOF chair Robert Billington says, “most in the music community make the hard decision to live without proper preventive health care, skipping routine annual exams and turning down medical services because they can’t afford them or are unwilling to pay their insurance’s high deductibles if they even have insurance. In effect, people are denying themselves basic primary care.”

Fellow RIMHOF board member and Tune In & Tune Up cofounder Russell Gusetti, who plays in Pendragon, one of Rhode Island’s most prominent Celtic band, adds, “It can be scary being a musician. Because we are independent contractors, we usually have no health insurance unless we are lucky enough to have a spouse who does. Because we don’t work for just one company, musicians have no benefits nor do we make much to begin with.”

Gusetti notes, “Too many of us have seen friends who are musicians go without health care of any kind, simply because they felt they could not afford it. So year after year, we end up holding benefit concerts for fellow musicians who have suffered major health events. And with musicians, if you are sick, you don’t play. And if you don’t play, you can’t earn a living let alone pay for health care visits or procedures. It made us want to do something to let the music community know that there ARE options out there for affordable health care and that prevention really IS the best medicine.”

Culp adds, “And we want to be clear – we are trying to reach the entire music community so that includes music professionals such as sound techs, studio engineers, roadies and more, as well as their spouses. We also want to stress that there is no paid staff or financial gain for RIMHOF or Tune In & Tune Up committee members. Our sole interest is helping our fellow musicians… it is straight from the heart.”

Gusetti concludes, “Instead of only reacting after a health problem becomes serious we hope we can, in some small way, inspire the music community to be proactive about their health so they can prevent or address some health problems before they get even worse. And if we become a model for the dance, visual arts and acting community, we would be thrilled as we all face similar situations and as parts of the creative community, we are all in this together.”

RIMHOF organizers say that the upcoming Unity Concerts idea builds off the March, 2013 CD release concerts held at The Ocean Mist by 2012 Hall of Fame inductees Roomful of Blues who chose to donate the proceeds of one of those concerts to the Tune In & Tune Up initiative which was just then getting off the ground. Ocean Mist owner Kevin Finnegan was so inspired by the idea that he suggested trying an even bigger benefit event with more bands later in the year.

The Unity Concerts Benefits Musicians

So, this weekend, RIMHOF, in partnership with The Wakefield-based Ocean Mist (895 Matunuck Beach Rd) will hold The Unity Concerts, with ALL proceeds benefiting the TI&TU Rhode Island Musicians Health Awareness Program, tomorrow, November 9, from 6 p.m. to 1 a.m., and Sunday, November 10, from 2 p.m. to 11:30 p.m.

Participating bands, who are all donating their performances, represent an unprecedented array of R.I. talent teamed with the generous donation of the venue as well as concert support by The Ocean Mist. The weekend features four inductees to the R.I. Music Hall of Fame on the same stage for the first time – John Cafferty and the Beaver Brown Band, Roomful of Blues, Ken Lyon, and Steve Smith & the Nakeds. In addition, participating bands include every musician member of the R.I. Music Hall of Fame board as well as two up-and-coming bands – Kim Petrarca and The Brian McKenzie Band – to further the Hall’s mission of also spotlighting new musical talent in the Ocean State while celebrating Rhode Island’s past and present music scene.

On Saturday, the lineup in order of appearance is: Adrienne West and the Tabers, Rossoni, The Brian McKenzie Band, John Cafferty and the Beaver Brown Band, The 100 Watt Suns, and The Rudy Cheeks Band.

Sunday’s lineup in order of appearance features: Kim Petrarca, Ken Lyon, The Zimmermen, Longshot VooDoo, Becky Chace, Mark Cutler, Pendragon, Roomful of Blues, Steve Smith & the Nakeds, and James Montgomery.

Cheeks gives credit to RIMHOF for getting the ball rolling on putting together an initiative to bring health care to Rhode Island musicians who are not covered. “You need a large organization [and vision] to take it on. I am glad they saw a problem and moved quickly to address it,” he says.

Admission to the Unity Concerts is only $20.00 per day or $35.00 for a weekend ticket. Etix can be purchased at http://www.oceanmist.net or tickets can be purchased at the door. For a special room rate for the Unity Concerts call the Hampton Inn South Kingstown at 401/788-3500.

Herb Weiss, LRI ’12, is a Pawtucket-based freelance writer covering aging, health care and medical issues. Weiss is a board member of the Rhode Island Music Hall of Fame. He can be reached at hweissri@aol.com.

RI’s State Alzheimer’s Plan Won’t Sit on Dusty Shelf

Published in Pawtucket Times on November 1, 2013

Seeing a huge rise in Alzheimer’s Disease over the last two years, federal and state officials are gearing up to strategize a battle to fight the impending epidemic.

According to the Rhode Island Chapter of the Alzheimer’s Association, in 2013 an estimated 5 million Americans age 65 and older have Alzheimer’s disease. Unless more effective ways are identified and implemented to prevent or treat this devastating cognitive disorder, the prevalence may well triple, skyrocketing to almost 16 million people.

Furthermore, national health care costs are spiraling out of control, says the nonprofit group’s Facts Sheet. By 2050, it’s estimated that the total cost of care nation-wide for persons with Alzheimer’s disease is expected to reach more than $1 trillion dollars (in today’s dollars), up from $172 billion in 2010.

Meanwhile, with 24,000 Rhode Islanders afflicted with Alzheimer’s Disease, every Rhode Islander is personally touched, either caring for a family member with the cognitive disorder or knowing someone who is a caregiver or patient.

In February 2012, the U.S. Department of Health and Human Services released its draft National Plan, detailing goals to prevent or treat the devastating disease by 2025. Almost six months later, in May 2012, the Rhode Island General Assembly passed a joint resolution (The same month that the final National Plan was released.), signed by Governor Lincoln Chafee, directing the state’s Long Term Care Coordinating Council to lead an effort to create a state-wide strategy to react to Rhode Island’s growing Alzheimer’s population. Almost one year later, a 122 page document, the Rhode Island State Plan for Alzheimer’s Disease Disorders, was released to address the growing incidence in the Ocean State.

In July 2013, with the graying of the nation’s population and a skyrocketing incident rate of persons afflicted with Alzheimer’s disease, the Chicago-based Alzheimer’s Association and the U.S. Centers for Disease Control (CDC) and Prevention released a 56 page report that called for public health officials to quickly act to stem the growing Alzheimer’s crisis. .

Battle Plan Against Alzheimer’s Disease

The State’s Plan to battle Alzheimer’s Disease is the culmination of a yearlong effort co-chaired by Lt. Governor Elizabeth Roberts and Division of Elderly Affairs Director Catherine Taylor, in partnership with the state chapter of the Alzheimer’s Association.

Much of the research and writing was conducted by six subgroups (Caregivers, Access, Legal, Workforce, Long-Term Care, and Care Delivery & Research) formed to identify and tackle the many challenges that Alzheimer’s disease poses to individuals, their families and to the health care delivery system. .

At their meetings, the subgroups drew upon the expertise of staff at the Geriatric Education Center at the University of Rhode Island, the Brown University Center for Gerontology and Health Care Research, the Brown Brain Bank, and the Norman Price Neurosciences Institute and the Alzheimer’s Prevention Registry

Public input was crucial in the development of the State Plan. Eight listening sessions were held across the Ocean State, two of them held with Spanish translators, at public libraries and local YMCAs, to get the opinions of those with the cognitive disorder, caregivers, and health care professionals. The probate judges association, law enforcement and other groups with unique perspectives on Alzheimer’s Disease were invited to listening sessions, too. Finally, the draft plan was made available for a ten-day public comment as part of the extensive outreach process.

The narrative in each section, nicely pulled together by Lindsay McAllister, the Lt. Governor’s Director of Health Policy, reflected many of the concerns and challenges identified by many presentations and discussions in each of the subgroup meetings over several months. The State Plan details 30 pages of recommendations outlining solutions and specific steps to be taken for preventing and caring for persons with Alzheimer’s Disease for six identified areas.

A Sampling of Recommendations

The plan encourages the development of social media networks as resources for caregivers, also calling on utilizing existing caregiver newsletters to detail more information about the Ocean State’s specific programs and services. It also calls for better training and education opportunities (for young children) to help them understand the devastating disorder and the creation of a two-week certification program, offered by local colleges and universities with input from the state’s Alzheimer’s Association.

In addition, the plan recommends the timely dissemination of research findings and best practices in nursing facilities, dementia care units, and home care to providers and families. Meanwhile, recommendations note the need to standardize dementia training and educational programs as well as the certification of facilities that offer dementia-specific care so that individuals and families impacted by Alzheimer’s Disease can rely upon high quality “dementia capable” care that they can find more easily.

The plan pushes for all Employee Assistance Programs (EAPs) to receive information about referral resources for employees requiring more intensive or long-term mental health services. EAP’s might also provide educational and informational resources on caregiver support for families dealing with Alzheimer’s disease.

Another key recommendation is the development of an internet resource referred to as the Rhode Island Alzheimer’s Disease (RIAD) Web Site. The site would enable better coordination among researchers and clinicians and assist them in recruiting participants for clinical trials and research studies. It would also provide consistent centralized support to individuals living with Alzheimer’s and their families by making practical care giving information readily and easily available.

“AARP has a long history of supporting Alzheimer’s patients and their families,” said AARP Rhode Island Advocacy Director Deanna Casey. “We applaud the effort in Rhode Island and Lt. Gov. Roberts’ efforts on behalf of those who suffer from the disease,” she says.

Casey says “far too many of our nonprofit’s 130,000 Rhode Island members are painfully familiar with Alzheimer’s, and the work of the many stakeholders in this effort is further indication of the great need to recognize our collective responsibility to help families through what is a most challenging journey.”

“Rhode Island has a tremendous opportunity to be a national leader in response to this disease,” she believes.

Briefing by Key Supporters

Two days ago, the full Alzheimer’s Work group kicked off the implementation phase of the Rhode Island State Plan on Alzheimer’s Disease & Related Disorders, discussing how to move forward with the goal of getting the recommendations up and running.

In Room 116 at the State House, Lt. Governor Elizabeth Roberts and Director Catherine Taylor of the Division of Elderly Affairs were clearly pleased to see their year-long initiative moving into its implementation phase to assist the State to handle a growing number of persons with Alzheimer’s Disease.

On the heels of a nationally released plan to address the Alzheimer’s epidemic, Taylor tells me that it was “great timing” for the Rhode Island General Assembly to enact a joint resolution to create a state plan to “respond to Rhode Island’s specific needs and gaps of service.” She credits the Rhode Island Chapter of the Alzheimer’s Association with the getting the ball rolling on this major health care policy initiative.

According to Lt. Governor Roberts, public sessions where care givers and people with Alzheimer’s Disease told their personal stories allowed the Subgroups to understand the personal impact of the devastating disease on both the afflicted and caregivers. For instance, the listening sessions made it very clear that the specific care needs of middle age adults with early onset Alzheimer’s Disease is quite different from those who are decades older, she said. Taylor agreed, citing adult day care eligibility requirements which keep those under age 60 from participating in this program, one that provides respite care to caregivers.

Lt. Governor Roberts states “younger people can not relate to programs that are developed for older people.” The patient must become the center of treatment rather than the treatment geared to age, she says.

Both Lt. Governor Roberts and Taylor do not want to see the State Plan sit on a dusty shelf, noting that it now becomes important to implement the written plan’s recommendations. “Let’s get the ball rolling now,” says Taylor.

While many of the State Plan’s recommendations may take time to implement, some are easy to implement like a Spanish language support group, says the Lt. Governor. Taylor states that RI has already requested a modification to the Medicaid waiver to expand Adult Day Health Center eligibility to individuals younger than 60 who have a diagnosis of Alzheimer’s.

Senior Police and Fire Advocates need to be trained in every Rhode Island community about Alzheimer’s Disease and resources available for caregivers, states Taylor. “These individuals know those who need programs and services in the community,” she notes, adding that an information conference is scheduled this week to train these individuals.

Lt. Governor Roberts believes that the State plan is a “living document” and it will be around as long as there is one person with Alzheimer’s Disease.”

To review the State plan go to http://www.ltgov.state.ri.us/alz/State%20Plan%20for%20ADRD%202013.pdf.

Herb Weiss, LRI’12, is a writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Meals on Wheels Should Be Expanded

 Published in Pawtucket Times, October 25, 2013

            A warm, nutritious meal combined with social interaction can go a long way to putting the brakes to a state’s spiraling Medicaid costs.  According to new study findings detailed in this months issue of Health Affairs by Brown University public health researchers, expanding programs like Meals on Wheels, would save 26 of 48 states money in their Medicaid programs, just by allowing a person to stay in their own homes. 

            Kali Thomas, Assistant Professor of Research in the Brown University School of Public Health, says that if every U.S. state in the lower 48 expanded the number of seniors receiving meals by just 1 percent, 1,722 more Medicaid recipients avoid living in a nursing facility and most states would experience a net annual savings from implementing the expansion.

Put the Brakes to Medicaid Costs

            According to the study’s findings, Medicaid cost savings would be different in every state.  For instance, Pennsylvania would see the greatest net savings – $5.7 million – as Medicaid costs for nursing facility care decrease more than costs rose for delivering the additional meals.  Meanwhile, Florida would see a net cost of nearly $11.5 million instead. Overall, 26 states would stand to see a net savings according to the Brown University Public Health analysis, while 22 would end up spending more.

            Every state would enable more seniors, who could live independently except for meals, to remain in their homes regardless of whether they are on Medicaid.

            Thomas, the study’s lead author, believes the study’s findings can provide guidance for state lawmakers and state policymakers as they hammer out budget funding for home-delivered meals programs, which are conducted under the Older Americans Act.

            “We wanted to provide a roadmap for people,” Thomas said.

             To calculate Medicaid savings, Thomas and co-author Vincent Mor, Brown’s Florence Pirce Grant Professor of Community Health, examined data, including how many seniors in each state receive home-delivered meals and how much it costs each state to provide those meals. She and Mor also took a look at nursing facility and Medicaid data to estimate the number of seniors that Medicaid maintains in nursing facilities who are “low-care,” meaning they may have the functional capabilities to live at home. Finally they looked at the per diem Medicaid pays in each state for seniors to live in nursing facilities.

 Keeping Seniors at Home

             The study findings allowed them to estimate the incremental cost of providing meals to 1 percent more seniors in each state, the number of additional seniors on Medicaid who would no longer need to live in nursing facilities, and how much less Medicaid would have to pick up for the higher level of care in each state.

            The researchers found that the 1 percent expansion nationwide would bring meals to 392,594 more seniors at a cost of more than $117 million. Because 1,722 seniors would no longer have to live in costly nursing facilities paid for by Medicaid, total program savings would total $109 million.

            The reason why the study’s findings indicate that additional food delivery costs outstrip Medicaid savings nationwide, even though most states would save money on a net basis, is that in some very large states with relatively few low-care seniors or relatively low Medicaid per diems, food costs outweighed the resulting Medicaid savings on a relatively large scale.

            “In states like California and Florida where a 1-percent increase in the 65-plus population is a lot of people, it will cost those states a lot more to feed them,” Thomas said.

            But, as she and Mor wrote in Health Affairs, “Our analyses suggest that 26 states with high Medicaid nursing home per diem reimbursement rates, a large proportion of low-care [nursing home residents on Medicaid], and a relatively small population of older adults, could save money.”

            Thomas said states projected to lose money can opt to focus their efforts in ways that are more precise than an across-the-board expansion.

            “We’re not proposing that all states simply increase the proportion of age 65 plus receiving meals by 1 percent,” she said. “But if they were to target these vulnerable people who are at risk for nursing home placement they would likely see more savings. This is a program that has the potential to save states a lot of money if it’s done correctly.”

            Policymakers should consider not only the fiscal implications of providing home-delivered meals, which the study quantifies, but also the impact on individual seniors, said Thomas, who has seen the benefits anecdotally as a Meals on Wheels volunteer in both Florida and Rhode Island.

            Thomas’s research, detailed in this month’s issue of Health Affairs, which was completed last December, is featured in AARP Rhode Island’s award-winning documentary Hungry in the West End. Creator and director John Martin of the AARP

             Rhode Island state office screened the documentary in August at the Meals on Wheels Association of America National Conference in Boston. You can watch Hungry in the West End online at www.aarp.org/hungry.

             Although the quality of life argument is easy to see, other researchers, like Thomas, are closely looking at how the Meals on Wheels program can lower Medicaid costs.

             Based on a study by the Washington, D.C. based Center for Effective Government released in April 2013, every dollar invested in Meals on Wheels today could save taxpayers up to $50 in Medicaid costs down the road.

 Other Benefits of Meals on Wheels  

             Ellie Hollander, President and CEO of the Meals on Wheels Association of America, observes that both Brown University and the Center for Effective Government studies specifically focused on Medicaid savings attributable to nursing homes, but do not take into consideration significant savings that would be realized through reduced Medicare costs as well, through fewer visits to physicians and the emergency room and less hospitalization or reduced readmissions.

             Hollander says, “We have long known that the value of Meals on Wheels goes beyond the social and moral imperative of helping to address the epidemic of senior hunger in America.  “The friendly visit and a safety check are a lifeline enabling seniors to live more independently and healthy in their own homes, which in turn avoids far more costly health care alternatives often paid through Medicare and Medicaid,” she says.

             “The Brown University research proves what our work has long suggested to us: the Home Delivered Meals Program not only makes a positive impact for the senior, it is a good investment for the state as well,” says Executive Director Heather Amaral, Meals on Wheels of RI.

            Another study is in the works to support Thomas’ efforts to closely look at the impact of nutritious home delivered meals.  According to Hollander, a $350,000 grant from the AARP Foundation and the Meals on Wheels Association announced on Oct. 6 will enable Thomas to begin her randomized controlled trial of 600 seniors representing a cross-section of rural, urban, low income and minority populations across the country and a majority of the grant will be used to feed these seniors.            

            In this upcoming study, 200 seniors will receive meals daily, 200 more will receive a delivery of frozen meals once a week and then another 200 will continue on the waiting list as before as a control group. The study will compare quality of life, isolation, and health care utilization among individuals before and after they begin receiving meals and across the three groups.

             Holland says, “Through our generous grant from AARP Foundation, and with Dr. Thomas and Brown University’s help, we will seek to monetize the value add of the “more than a meal” component of Meals on Wheels.”

A Call for Support

            On AARP.org, Kathleen S. Connell, Rhode Island AARP State Director, calls on state lawmakers to take a very hard look at how they fund the state’s Meals on Wheels program.  Connell urges Congress not to put the Meals on Wheels program on the budgetary chopping block as a way to chop the huge federal budget deficit.

            Connell says that “Leaders need to be reminded that Meals on Wheels recipients aren’t unemployed workers waiting to return to jobs that will accompany an economic recovery. They are older retirees living on limited fixed incomes. With the cost of prescription medicines, healthcare and utilities going up, they sometimes can’t afford to eat. Many commonly sacrifice on food because of money worries – real or feared.”

            Connell notes, “Meals on Wheels is a big deal [to seniors]. No one should take it for granted.”

            Herb Weiss, LRI ’12, is a writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.