Author Archives for Herb Weiss

Mable Anderson was a True Advocate for Rhode Island’s Senior Population

Published in the Pawtucket Times on May 5, 2003

During her 7 years, Mabel Anderson wore many hats – teacher, dedicated wife to George, loving mother to her children Jon and Jane, state representative and writer of children’s books.

Mabel played a key role representing Pawtucket’s District 77. Once she was elected to the Rhode Island General Assembly, she would eventually be re-elected nine more times. She rose through the Democratic leadership ranks and ultimately would for 10 years as speaker pro-tem, sometimes presiding over  House legislative sessions.

As a state representative, Mabel used her growing power and influence to advocate for the needs of Ocean State seniors.

Her efforts led to the passage of legislation that would add a grandfather clause to drug-coverage provisions of insurance plans. Under the newly enacted law, any physician authorized by the Department of  Health to prescribe medicine would be allowed to prescribe medication previously on, or not on, the insurer’s formulary if it was deemed “medically necessary.”

To many, Mable was a tireless worker on behalf of Pawtucket’s elderly population. Joan Crawley, director of Pawtucket’s Leon Mathieu Senior Center, said Mabel possessed a rare quality for a politician.

“She wasn’t swayed by popular opinion and she never stopped to see which way the wind was blowing,” she said.

Mabel always voted her conscience, always striving to represent seniors in her legislative district, Crawley noted.

According to Crawley, her advocacy on behalf of senior transportation was relentless. “She called me late last Thursday afternoon when she heard the hospital’s contract to provide transportation for the RIDE program was in jeopardy. Even though she was no longer a lawmaker, Mabel told me she was willing to champion this cause.”

Crawley said she had called her to discuss the transportation issue on Friday at noon, just a few hours before her untimely death.

George Anderson, Mabel’s husband of more than 40 years, recalled his wife’s constituency work.

“Mabel worked hard to represent older constituents who were being ignored by the state’s bureaucracy,” he said.

Anderson remembered when Mabel was first elected and was relatively unrecognized. She would stand in line behind an older constituent. IF the person was not assisted, she would simply introduce herself as a state representative and any problems would be worked out, he said.

Often times, a quick trip to the grocery store turned into several hours. Anderson said, as constituents would come up to her along every aisle just to say “hello,” catch up or discuss problems.

And Mabel never forgot those close to her who needed assistance, Anderson said. When she went to Memorial Hospital to participate in a program to help her cope with arthritis, she asked her husband for a check. The amount just happened to cover the enrollment fee of two persons not one, he said, allowing a friend who was on a fixed income to participate.

Audrey Salvas, 67, a long-time Pawtucket resident knew who to call when she had problems.

“When we needed to find out something, all we had to do was call Mabel,” said Salvas.

Mabel quickly straightened out a drug problem in the Beverage Hill area, noted Salvas. She pushed to erect a fence around the Prospect Heights project, which ultimately reduced drug trafficking and noise.

Mary Francis Campbell, 89, a former educator and President of the Pawtucket Senior Citizens Council (PSCC), added that Mabel aways backed PSCC’s legislative proposals. “The Pawtucket lawmaker worked closely with PSCC in its 15 years of existence,” she said.

With a strong determination to remain independent, Mabel ultimately overcame a stroke she suffered in 1992 that temporary left her impaired  on her right side. Her love for public service gave her the needed energy to stay actively involved long past retirement, fighting for senior issues, the underdogs and for her beloved City of Pawtucket. It also enabled her to reach out the younger generations to develop new skills to learn.

Using the same veracity and gusto she used for all her other interests she held close to her heart; Mabel was not afraid to experience new things. With a passion for living, this former state representative was ready to enjoy and pursue new interests, such as learning how to use a computer to recalling her younger days on the family farm and turning these stories into children’s book.

Internet will soon be good source for information on nursing homes

Published in The Pawtucket Times, May 2003

A growing number of Americans are doing their shopping for products and services, via the Internet.  But if the federal government has its way consumers in five states will rely on Medicare and Medicaid programs and their family members, will be able to cruise the world wide web to find the best nursing facilities to meet their specific needs.

Rhode Island is among five states chosen by the Centers for Medicare and Medicaid Services (CMS) for a pilot project that will identify collect, and publish nursing home quality information on the Internet for easy access and comparison of facilities.

The other states are Colorado, Maryland, Ohio and Washington.  Eventually, this federally-funded initiative will be expanded nationwide.

People covered by Medicare and Medicaid have the power to choose the best care to meet their individual needs, but they have to have more reliable information to choose quality care, HHS Secretary Tommy G. Thompson, who oversees the Medicare and Medicaid programs. “Our efforts will help beneficiaries all across the country to compare the performance of their local nursing homes, and will provide the recognition that high-quality nursing homes deserve”.

In April 2002, the newly compiled performance information becomes available online at www.medicare.gov and will also be disseminated through Rhode Island Quality Partners, an agency contracted by the federal government to oversee the quality of health services provided to Rhode Island Medicare beneficiaries.

So what information can consumers find when shopping for the right nursing facility on the world wide web?

Currently, the CMS’s website provides nursing facility-specific information compiled from state annual surveys.

As a result of this five state pilot project, consumers will be able to see data culled from the Minimum Data Set (MDS), a standardized medical collection form that every nursing home is required to complete on every patient upon admission and on a regular schedule thereafter.

For those seeking a long-term placement, CMS will bring together comparative state-wide information that indicates quality care is being provided.  When shopping you will be able to find out how many residents are being physically restrained, how many have pressure sores, how many are taking anti-psychotic drugs without a psychiatric diagnosis, how many have lost weight, how many have acquired an infection, and finally how many residents can no longer take care of themselves.

For those seeking short-term stays after hospitalization, CMS will provide state-wide MDS data compiled from nursing facilities that can tell you how many residents are in pain, how many residents fail to recover from delirium, along with how many are re-hospitalized and improvement in walking.

Dr. David R. Gifford, principal clinical coordinator with Rhode Island Quality Partners, told All About Seniors that CMS chose Rhode Island for the pilot project because of the state’s interest in public reporting of consumer information.  He noted that CMS was aware of Lt. Gov. Charles Fogerty’s legislation, recently enacted that now requires reporting of nursing facility quality information.

“We’re very pleased to be involved in the pilot project because it allows us to help shape the national data dissemination effort,” Gifford adds.

How will consumers not computer savvy gain access CMS’s new quality measures?

Dr. Gifford notes that each state participating in the pilot project must develop other avenues for non-computer users to tap into the MDS data compiled on its website.

Roberta Hawkins, Executive Director of the Alliance for Better Long Term Care and the state’s ombudsman, applauds the new federal effort to help consumers in choosing nursing facilities.

However, Hawkins is concerned that the MDS does not always provide “insight into the personality of a nursing facility.”

“MDS won’t tell you if a facility’s staff are compassionate to residents.”  she says.  Additionally, the newly compiled CMSA information will not provide you with specifics about how some facilities specialize in taking care of ethnic populations.”  she added, specifically, if staff speak a foreign language, sever ethnic cuisine, or plan culturally-related activity programming.

Additionally, Hawkins notes that while CMS’s website may tell you how many persons have bed sores, a higher incidence of bed sores may only reflect that a newly admitted resident came to the facility with bed sores or that a facility specializes in taking care of that medical condition.

At best, internet information can only provide a snapshot of care being provided by facility staff, warns Hawkins.  “Today’s best nursing homes may become next weeks providers of poor care,” she adds, when key staff in leadership positions leave the facility.

Take advantage of CMS’s website to cull nursing facility specific information compiled from state annual surveys.

When in doubt, call the Alliance for Better Long-Term Care at 785-3340.

Fix the Nursing Facility Problem Once and For All

Published in Pawtucket Times on April 28, 2003

Forty-years ago, the Senate Aging Committee hearings put the spotlight on the poor care provided in the nation’s nursing facilities.

This month, the April 2003 special issue of “the Gerontologist” sends the troubling message that nationwide improvement in nursing facility care is not likely.

Despite substantial regulatory oversight, Joshua Wiener, of the Urban Institute said “quality of care in nursing homes remains problematic. Quality of care in nursing facilities remains a problem for which there are not simple solutions.”

Before this national crisis can e directly confronted, increased staffing and raising the wages of nursing facility workers appear to be necessary preconditions for improving care quality and should receive high priority, said Weiner. (Rhode Island nursing facility providers hold similar beliefs and have called on Gov. Don Carcieri and state lawmakers to provide the necessary funding to raise facility worker’s wages.

The article’s written by 14 prominent policy experts in this special issue – “The Challenges in Nursing Home Care” – address central concerns in nursing facility care and help provide answers to questions, such as how these facilities can be financed and how care can be delivered.

The articles in this issue are the result of a conference held at Florida State University that was sponsored in part by the National Institute on Aging.

Dr. Quadagno and Dr. Stahl, guest editors of this special issue, believe a major challenge at both the national and state levels concerns the effective recruitment, training and retention of certified nursing aides.  Nursing aides, they pointed out provide about 60 percent of total nursing hours to residents (Again, this observation has been delivered to lawmakers at numerous legislative hearings on Smith Hill).

Many experts who wrote articles in this special issue contend the overall quality of nursing facility care in America still remains poor.  There are serious ongoing quality problems.

And like the rest of the nation, Rhode Island’s facilities are having problems recruiting and retaining certified nursing aids and providing higher wages to them as they receive inadequate Medicaid reimbursement.

What can be done about it?

Simply put, improving the quality of care in Rhode Island nursing facilities is directly linked to getting adequate Medicaid funding. The state must pay a fair rate when facilities are required  to provide quality care to 10,000-plus vulnerable Ocean State seniors who require intensive 24-hour-a-day care.

“The Principes of Reimbursement for nursing facilities are grossly underfunded,” charged Hugh Hall, president of the Rhode Island Health Care Association (RIHCA), a state-wide trade group representing nursing facility providers.

Hall, who is the administrator of the Cherry Hill Manor Nursing & rehabilitation Center in Johnston, estimated only two percent of the state’s nursing facilities are receiving adequate Medicaid reimbursement to cover their true costs of care.

Hall said that unless reimbursement is addressed swiftly, the quality of care delivered by facilities will begin to suffer the effects of the continued lack of attention of state policy makers.

“There is always another need for state tax dollars to be spent elsewhere,” Hall said, recognizing the growing number of special interest groups, who approach the General Assembly each year.

“Hopefully, it will be spent on where it is needed most, on the state’s frailest citizens,” he said, noting that “if the state does not spend it on them, who will?”

According to Alfred Santos, RIHCA’s executive director, the General Assembly is considering legislation (H 5803/S 0901) that would revise the state’s Principles of Reimbursement. Passage would begin to address the inadequate funding of the state’s nursing facilities, he said.

The legislative proposals, referred to the House and Senate Finance Committees, reflect the findings of an 18-month study of B.D.O Seidman, a consulting firm hired by the Department of Human Services to review and recommend fixest to the state’s flawed reimbursement system. Santos said one of the findings of this study was the state was underpaying facilities in excess of $ 30 million annually.

It’s time to fix the state’s flawed Medicaid reimbursement system once and for all. A Band-aid solution is not the appropriate approach considering the growing number of Ocean State seniors who will require higher levels of intensive care.

At an AARP  debate in gubernatorial candidates last September, this writer asked Carcieri if he would budget $ 15 million to overhaul the existing Medicaid payment system. The additional funding would greatly improve the quality of care and services provided to 10,000-plus nursing facility residents.

With this additional $ 15 million in state funding, the federal government would pick up another $ 15 million for a total of $ 30 million. This funding would allow Rhode Island facilities to provide quality care.

Candidate Carcieri acknowledged it would be difficult to find $ 15 million to fix the system because of the state’s looming budget deficit.

But there may be a light at the end of the tunnel. When the dust settles on the governor’s “Big Audit,” state funds may be identified and targeted toward ratcheting up the state’s inadequate reimbursement rate.

Combine these newly discovered funds with new tx revenues generated from the Lincoln greyhound track and you might just have the $15 million in state funds required to bring in millions of federal dollars.

For those Rhode Island seniors who are currently in nursing facilities, and for their children and grandchildren who may unfortunately require that intensive level of care, lawmakers must fix the payment problem once and for all.

Hopefully, Carcieri, along with the General Assembly, will not allow the B.D.O. Seidman report’s recommendations on fixing the state’s Medicaid payment system to sit on the dusty shelf in the Department of Human Services.

If that happens, what a waste of taxpayer money.