House Committee Moves to Rein in Skyrocketing Prescription Drug Costs

Published in the Woonsocket Call on December 1, 2019

On Nov. 18, House Antitrust Subcommittee Chair David N. Cicilline (D-RI) and Judiciary Committee Chairman Jerrold Nadler (D-RI) introduced The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 (H.R. 5133) to put the brakes on skyrocketing prescription drug costs. The bill attacked increasing costs by prohibiting pharmaceutical companies from engaging in anticompetitive “product hopping.”

Two days later, the Committee unanimously passed the bipartisan bill to drive down the rising costs of prescription drugs. Now H.R. 5133 goes to the House floor for a vote.

“Big pharmaceutical companies have done everything they can to increase their profits regardless of who it affects. Their CEOs make millions in bonuses ever year while hardworking folks are forced to ration their medicine just so they can put food on the table for their kids,” said Cicilline, in a released statement announcing the introduction of the bill.

Since becoming Chair of the House Antitrust Subcommittee, Cicilline has sought to take on the anticompetitive behavior in the health care and pharmaceutical sectors. “This is wrong, and it needs to stop. This bill, along with the suite of legislation to lower health care costs the House has passed already this year, will put an end to anticompetitive behavior that is driving prices up while pushing the middle class further and further down,” says Cicilline in pushing for the bill’s passage.

“This bill builds on the Committee’s strong record of bipartisan legislation to confront one of the leading drivers of high prescription drug costs—efforts by drug companies to keep generic drugs off the market so that they can preserve their monopoly profits,” adds Chairman Nadler when H.R. 5133 was thrown into the legislative hopper. “The outrageous behavior of product hopping puts profits before patients and thwarts the competition that is essential to lowering prescription drug prices,” he charges. Nadler says that H.R. 5133 would “encourage drug companies to focus on delivering meaningful innovation for sick patients rather than delivering profits to their bottom line.”

Fixing the Problem

According to Cicilline and Nadler, pharmaceutical companies use a wide array of tactics when their patent on a drug is near expiration to switch patients to another version of the drug that they have the exclusive right to sell. Called “product hopping,” this anticompetitive practice extends the manufacturer’s ability to charge monopoly prices by blocking the patient’s ability to switch to a cheaper, generic alternative. Product hopping benefits the manufacturer’s bottom line at the expense of patients who are stuck paying higher prices often for many years at a time, they say.

The two Congressmen say that there is another roadblock to lowering prescription drug costs. Although antitrust agencies have made an effort to curb product hopping, the Federal Trade Commission (FTC) still faces a number of hurdles under existing law when trying to hold companies accountable for this anticompetitive conduct. The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 strengthens the FTC’s ability to bring and win cases against pharmaceutical companies that engage in all forms of product hopping.

A similar version of H.R. 5133 was considered in the Senate and it would save taxpayers an estimated $500 million according to the nonpartisan Congressional Budget Office.

A week earlier, before H.R. 5133 was passed by the and Judiciary Committee, a new report was released by AARP Public Policy Institute (PPI), giving data to Congress to enact legislation to lowering prescription drug costs. The report findings indicate that brand-name drug prices rose more than twice as fast as inflation in 2018.

According to the AARP PPI report, retail prices for 267 brand-name drugs commonly used by older adults surged by an average of 5.8 percent in 2018, more than twice the general inflation rate of 2.4 percent. The annual average cost of therapy for one brand-name drug ballooned to more than $7,200 in 2018, up from nearly $1,900 in 2006.

“There seems to be no end to these relentless brand-name drug price increases,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP, in a Nov. 13 statement announcing the release of the report. “To put this into perspective: If gasoline prices had grown at the same rate as these widely-used brand-name drugs over the past 12 years, gas would cost $8.34 per gallon at the pump today. Imagine how outraged Americans would be if they were forced to pay those kinds of prices,” says Whitman.

Brand-name drug price increases have consistently and substantially exceeded the general inflation rate of other consumer goods for over a decade, notes the AARP PPI data.

If brand-name drug retail price changes had been limited to the general inflation rate between 2006 and 2018, the average annual cost of therapy for one brand-name drug would be a whopping $5,000 lower today ($2,178 vs. $7,202). The report’s findings note that the average senior takes 4 to 5 medications each month, and the current cost of therapy translates into an annual cost of more than $32,000, almost 25 percent higher than the median annual income of $26,200 for a Medicare beneficiary.

“While some people will undoubtedly see a slower rate of price increases as a sign of improvement, the reality is that there is absolutely nothing to stop drug companies from reverting back to double-digit percentage price increases every year,” said Leigh Purvis, Director of Health Services Research, AARP Public Policy Institute, and co-author of the report. “Americans will remain at the mercy of drug manufacturers’ pricing behavior until Congress takes major legislative action,” adds Purvis.

With over 340 days before the upcoming 2020 Presidential and Congressional elections, Senate Democrats say that more than 250 House-passed bills are “buried in Senate Majority Leader Mitch McConnell’s (R-Ky) legislative graveyard.” The Senate’s top Republican}, referred to as the “Grim Reaper,” has blocked consideration on these bills (including prescription drug pricing bills) effectively killing them. As the election day gets closer this number is expected to increase.

President Trump and Republican lawmakers are loudly chanting that the Democrats are “getting nothing done in Congress.” This is just fake “political” news. Major reforms that would prop up Social Security, Medicare, and lower Prescription Drug prices get the legislative kibosh in the GOP-controlled Senate. It is now time to put these bills to an up or down vote in the upper chamber. The voters will send a message to Congress next November if they agree with the results. It’s time for McConnell to put down his reaper

For details, of AARP report, go to http://www.aarp.org/rxpricewatch.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Reauthorization of AOA Now in the Senate’s Hand

Published in Woonsocket Call on November 10, 2019

Last month, after a 40-minute debate, the House moved to pass H.R. 4334, The Dignity in Aging Act of 2019, a bipartisan reauthorization of the Older Americans Act (OAA) that provides funding for a wide range of popular local and state programs. These programs make sure seniors have access to food thru Meals on Wheels, transportation, part-time job opportunities to support financial security and to combat social isolation and other basic services they need to live independently and with dignity.

Introduced on Sept. 16 by Rep. Suzanne Bonamici (D-OR), who chairs the House Education and Labor Committee’s Subcommittee on Civil Rights and Human Services which has jurisdiction of AOA, and 25 cosponsors (eleven Democrats and fourteen Republicans, the House Committee on Education and Labor reported out a marked-up 68 page bill on Oct. 28, and a motion to suspend the rules and pass the bill as amended was agreed to by a voice vote on the House floor that day. The bipartisan bill would reauthorize $12.5 billion through 2024 for AOA programs assisting seniors.

Although the Houses passes a bill to reauthorize the OAA, the Act expired at the end of the fiscal year on Sept. 30. With bipartisan support it is expected that the reauthorization will move through both chambers as quickly as possible. Until then, OAA programs will continue to operate, and funding will flow either through enactment of continuing resolutions (CRs) or final FY appropriations legislation.

The Nuts and Bolts

Specifically, the House passed AOA reauthorization bill establishes a National Research, Demonstration, and Evaluation Center for the Aging Network in the Office of the Assistant Secretary of HHS. It would create an initiative to coordinate federal resources to promote the independence and safety of adults living at home as they age. The legislation would also provide tailored support to family caregivers who play a vital role in helping again Americans maintain their independence. It also puts a stronger focus on addressing social isolation among seniors by empowering local organizations to test local solutions.

On the day of the floor vote, over 70 aging and health care groups including AARP, Meals on Wheels, the Medicare Rights Center, and National Association of Area Agencies on Aging, wrote to House Speaker Nancy Pelosi and Ranking Member Bobby Scott, urging the House to swiftly advance H.R. 4334 to reauthorize the AOA because the current reauthorization of the Act expired September 30, 2019.

The OAA, initially passed in 1965 with Medicare, Medicaid, along with landmark civil rights laws, as part of President Lyndon B. Johnson’s Great Society initiative. OAA currently serves roughly 11 million older Americans, including 3 million older Americans who regularly rely on this federal program to meet their basic needs. The law provides funding to each state based on its share of the nation’s older adults.

The population of Americans age 60 and over has grown more than 60 percent since 2001, but OAA funding has only grown by roughly 20 percent. In 2010, OAA funding was $42.95 per senior in today’s dollars. Today it is $27.25 per senior. According to the Government Accountability Accounting Office, as a result, 83 percent of low-income older Americans who experience food insecurity do not receive any meal services through OAA. The same report found that two-thirds of older Americans who struggle with daily activities received limited or no homebased care services.

Most important, The Dignity in Aging Act includes an inflation-adjusted 7 percent increase in funding for OAA programs in the first year, followed by a 6 percent increase in each of the four years that follow. This results in more than a 35 percent total increase in program funding over the five-year reauthorization period, boosting OAA funding above its historical high watermark in FY2010.

Calls for AOA Reauthorization

“Aging Americans have supported our communities throughout their lives – now it is our turn to care for them,” said Bonamici. “I’m proud that the House passed my bipartisan Dignity in Aging Act, which will provide seniors and their caregivers with desperately needed resources and expanded services,” says the lawmaker who was first elected to Congress in 2012.

“I have heard and read too many stories about seniors rationing medication or saving portions of their meals so that they can stretch their resources just a bit further into the week,” Bonamici said on the House floor. “… This bill provides a rare bipartisan opportunity to help millions of older Americans across the country spend less of their limited income on costly care and, just as importantly, to empower every individual to age with dignity.”

I look forward to working with my colleagues in the Senate so this legislation can swiftly be signed into law,” says Bonamici, who also played a key role in the last reauthorization of OAA in 2016.

After passage of H.R. 4334, Rep. David N. Cicilline (D-RI) said, “After a lifetime of working hard and playing by the rules, Rhode Island seniors should never have to worry about making ends meet. I was proud to support the bipartisan Dignity in Aging Act to help ensure all seniors can retire with dignity and economic security. The Senate should take this bill up without delay.”

According to Cicilline, “In FY18, Rhode Island received $7,013,999 through the Older Americans Act. These funds are used to provide Meals and Nutrition Services, Supportive Services and Preventive Health, and the National Family Caregiver Support Program. This reauthorization will mean that older Rhode Islanders will continue to receive these services,” says the Rhode Island Congressman who serves as co-chair of the House Democratic Policy and Communications Committee

The Washington, D.C.-based AARP also applauded the passage of H.R. 4334. In a statement, AARP Senior vice president Bill Sweeney said, “The Dignity in Aging Act addresses AARP’s family caregiving priorities, including further strengthening support for family caregivers, extending the RAISE Family Caregivers Act, and providing increased funding levels for OAA programs. OAA programs provide services like home-delivered meals, transportation, medical appointments, protection from elder abuse, and job training.”

Sweeney says, “an estimated 40 million family caregivers provide a staggering $470 billion annually in unpaid care to their loved ones—ranging from bathing and dressing to paying bills and transportation and assisting with complex medical/nursing tasks. By supporting family caregivers, we can help people live independently in their own homes, helping to delay or prevent more costly nursing home care and unnecessary hospitalizations.”
Sweeney urges Congress to reauthorize OAA by the end of the year to help ensure the sustainability of OAA programs.”

A Final Note

Now the action of reauthorizing AOA moves to the Senate where a bill has not been formally introduced. But Senators Susan Collins (R-ME) and Bob Casey (D-PA) the chairman and ranking member of the Senate Special Committee on Aging are working on a reauthorization bill, says Richard Luchette, Communications Director for Rep. David N. Cicilline. With Senate Majority Leader Mitch McConnell (R-Kentucky) systematically blocking Senate voting on House passed legislation, Luchette urges the McConnell to take up the House bill so that seniors will be provided the services they rely on.

Seniors Can Expect Small Increase in Their 2020 Social Security COLA

Published in the Woonsocket Call on Oct. 27, 2019

The Social Security Administration (SSA) announces Oct. 10 that Social Security and Supplemental Security Income (SSI) benefits for nearly 69 million Americans will increase 1.6 percent in 2020 (Some recipients receive both Social Security and SSI benefits).

Social Security and SSI recipients will be notified about their new benefit amount by mail in early December. This COLA notice can also be viewed online through their my Social Security account. People may create or access their my Social Security account online at http://www.socialsecurity.gov/myaccount.

According to SSA, the 1.6 percent COLA increase will begin with benefits payable to more than 63 million Social Security beneficiaries in January 2020. Increased payments to more than 8 million SSI beneficiaries will begin December 31, 2019. The Social Security Act ties the annual COLA to the increase in the Consumer Price Index as calculated by the Department of Labor’s Bureau of Labor Statistics.

The maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase from $132,900 to $137,700, says SSA.

The earnings limit for workers who are younger than “full” retirement age (age 66 for people born in 1943 through 1954) will increase to $18,240. SSA will deduct $1 from benefits for each $2 earned over $18,240.

The earnings limit for people turning age 66 in 2020 will increase to $48,600. SSA will deduct $1 from benefits for each $3 earned over $48,600 until the month the worker turns age 66.)

There is no limit on earnings for workers who are “full” retirement age or older for the entire year.

COLA Not Keeping Up with Rising Cost of Living

Over the years, Social Security’s COLA has not provided financial protection against rising costs, charge aging advocacy groups.

Social Security checks in 2019 are as much as 18 percent lower due to the impact of extremely low COLAs over the past 10 years, says an analysis recently released by the Arlington, Virginia-based The Senior Citizens League (TSCL). TSCL’s Social Security policy analyst, Mary Johnson authored this analysis.

Johnson’s analysis noted that from 2000 to 2010, COLAs routinely averaged 3 percent
annually. People who have been receiving Social Security checks since 2019, have only seen a COLA higher than 2,8 percent one time (in 2012), she said, noting that Social Security benefits have lost 33 percent of buying power since 2000.

Johnson’s findings reported that in 2010, 2011, and 2016 there was no COLA payable at all and, in 2017, the COLA was just 0.03 percent. However, in 2018, the COLA was 2 percent, but rising Part B premiums consumed the entire increase for roughly half of all beneficiaries.

Calls for Strengthening the COLA

According to the National Committee to Preserve Social Security and Medicare (NCPSSM), the upcoming COLA change will give a whopping $24 per month increase for the average beneficiary. With Medicare Part B premiums expected to rise around $8 next year, the net cost-of-living adjustment for most seniors will be only $16 per month. The new COLA brings the average monthly retirement benefit up to $1,503 — it’s just a $288 yearly raise for seniors living on fixed incomes.

NCPSSM notes that roughly half of America’s seniors rely on Social Security for at least 50 percent of their income, and 1 in 4 depending on the program for at least 90 percent of their income, the 2020 COLA increase does not go very far in helping these recipients pay their bills. A $16 per month probably won’t cover typical expenses, such as the cost of a single prescription copay, a month’s medical supplies, or transportation to a doctor’s appointment, adds the Washington, DC- advocacy group whose goal is to protect Social Security and Medicare.

“It’s ironic that as billionaires and big corporations continue to profit from the $1.5 trillion in Trump/GOP tax cuts, America’s seniors are to get by with a meager $24 monthly raise,” says Max Richtman in a statement after SSA announced the 2020 COLA increase. NCPSSM’s President and CEO. “The negligible 2020 COLA illustrates why seniors need a more accurate formula for calculating the impact of inflation on their Social Security benefits. For years, we have urged the government to adopt the CPI-E (Consumer Price Index for the Elderly), which reflects the spending priorities of seniors, including health care, as opposed to the current formula based on younger urban wage earners’ expenses,” says Richtman.

If the CPI-E were adopted, beneficiaries would see a 6 percent overall increase in benefits over 20 years compared to the current formula used, which yielded a zero cost-of-living adjustment three times during the past decade — and a mere 0.3 percent in 2017, says Richtman, noting that health care costs have increased about 6 percent in 2019 alone.

“The prices of the most commonly prescribed drugs for seniors on Medicare rose ten times the rate of inflation from 2013-2018. The cost of senior living facilities is growing at 3 percent annually – which adds up quickly over time,” adds Richtman.

Adds Webster Phillips, NCPSSM’s Senior Legislative Representative, “COLAs are out of sync with seniors’ actual expenses. Retirees have been living on very tight cost-of-living adjustments for a number of years now, which forces them to make hard decisions about their monthly budgets.”

In a statement, AARP chief executive officer Jo Ann Jenkins said, “Social Security’s annual COLA amount typically does not keep pace with all the increases in living expenses that most seniors face, including the costs of housing, food, transportation and, especially, health care and prescription drugs. AARP’s recent Rx Price Watch report found that retail drug prices increased by twice the rate of inflation during 2017, and have exceeded the inflation rate for at least 12 consecutive years,” she says.

“AARP will continue our advocacy for bipartisan solutions to help ensure the long-term solvency of the Social Security program, as well as adequate benefits for recipients. We will also continue to fight for lower health care and prescription drug costs, which are eating up a growing share of Social Security benefits,” adds Jenkins.

TSCL’s Mary Johnson says that her group calls on Congress to require a minimum COLA of no less than 3 percent every year, even in years when inflation falls below that amount. “Strengthening the COLA,” she says, “would help slow the drain of retirement savings and help keep older Americans out of poverty.”

For information about Social Security benefits and claiming strategies, those approaching retirement age may visit AARP’s Social Security Resource Center, at https://www.aarp.org/retirement/social-security/.

Caregivers Find it Difficult to Shop at Retail Stores

Published in the Woonsocket Call on September 22, 2019

Survey findings from a recently released national study, by the Washington, DC-based AARP and NORC at the University of Chicago, will send a strong message to America’s businesses.

With the graying of America, retail stores must change the way they do business in order to attract customers who provide unpaid family caregiving to their loved ones.

The study, “Family Caregiver Retail Preferences and Challenges,” and its survey findings were presented at the AARP Executive Summit, The Price of Caring, on September 10 in Washington, D.C. The summit’s mission was to highlight public- and private-sector solutions to support Americans who care for an older or ill loved one.

In-store Shopping is a Struggle

While juggling a multitude of caregiving tasks, caregivers say a lack of accommodations for their frail family members is a problem for shopping at retail stores. The study’s findings reveal that in-store shopping is a struggle for one-third of the nation’s 40 million unpaid family caregivers. Many leave their loved ones at home or choose to shop online, despite strongly preferring the in-store experience.

A whopping 93 percent of caregivers surveyed say they shop for the person they care for. Among these caregivers, most report shopping monthly for groceries (87 percent), basic household items (65 percent), toiletries (61 percent), prescription drugs (58 percent) and other health products (52 percent for persons they regularly care for.

“Americans who take care of loved ones are often strapped for time, and many face logistical challenges doing something as simple as going to the grocery store,” said Nancy LeaMond, AARP executive vice president and chief advocacy & engagement officer, in a September 10th statement announcing the study’s findings. “Retailers can score big with caregivers if they make it easier for them to bring their loved ones along when they shop,” says LeaMond.

The AARP survey findings detail simple but important changes retailers should consider to enhance the shopping experience of caregivers. Businesses can provide dedicated parking spots and ample comfortable reserved seating for older shoppers to rest, wider aisles that easily accommodate both wheelchairs and shopping carts, longer store hours, and train their staff to specifically work with caregivers.

The Pros and Cons of In-Store and On-Line Shopping

The survey findings in the 26-page study reveal that 82 percent of the caregiver respondents prefer to shop in-store because of the ability to touch the products and they don’t have to wait for a product’s delivery or pay for shipping charges. But 84 percent say they shop online for ease and convenience, despite preferring an in-store experience. Forty three percent of the respondents say a major reason they leave their loved one at home when shopping is because the store environment is too difficult for the recipients of their care.

More than 56 percent of the caregiver respondents say that when shopping on behalf of their loved ones they spend at least $50 per month. Forty one percent note they spend more than $250 or more a month when shopping for a loved one.

Businesses Must Listen to the Shopping Needs of Caregivers

We listen to a lot of caregivers and it seems clear that, regardless of the challenge, the help they want most is for somehow to find a convenient, time-efficient and accommodating means of getting what they need, when they need it,” said Rhode Island AARP State Director Kathleen Connell. “In retailing, convenience is a huge competitive advantage these days. But there are aspects of convenience that – for caregivers – go beyond finding what you need on Amazon and having it delivered the next day or two,” says Connell.

“Some caregiver needs are in the ASAP category and they head for brick and mortar retail establishments. Shopping for food and clothes, picking up a prescription or medical supplies, even simple things such as picking up dry cleaning feel like ‘emergencies’ because time is so. Imagine this in the context of being with someone in a walker or wheelchair,” notes Connell.

Connell urges retailers to take this report to heart. “There is an incredible amount of goodwill to be earned if you think about caregivers, as well as those in their care, and give them the consideration that makes their tasks a little easier.”

The AARP survey was conducted by NORC at the University of Chicago and is based on a nationally representative survey of 1,127 Americans who provide unpaid care for an adult age 18 or older. The survey was funded by AARP and used AmeriSpeak®, the probability-based panel of NORC at the University of Chicago. Interviews were conducted between Aug. 1-19, 2019, online and using landlines and cell phones. The overall margin of sampling error is +/- 4.1 percentage points at the 95% confidence level, including the design effect. The margin of sampling error may be higher for subgroups.

To read the full report, visit: http://www.aarp.org/caregivershopping.

For more details about AARP’s Caregiver Shopping study, contact Laura Skufca, AARP Research, Lskufca@aarp.org.

Study Calls for Action on Creating Senior Housing for Middle-Income Seniors

Published in the Woonsocket Call on August 18, 2019

A recently released report sends a stark warning to federal and state policy makers and to the private senior housing sector. The report forewarns that in the coming years, a large number of middle-income seniors, who need assisted living with supportive services, will be priced out of this level of care.

Seniors housing in the United States is paid out of pocket by seniors with sufficient assets. A relatively small percentage of Americans have long-term care insurance policies to defray the costs. For seniors with the lowest incomes, Medicaid covers housing only in the skilled nursing setting, but increasingly also covers long-term services and supports in home and community-based settings. Programs such as low-income housing tax credits have helped finance housing for economically-disadvantaged seniors.

The researchers call on the government and the senior housing sector to step up and to assist the projected 14.4 million middle-income people over age 75, many with multiple chronic conditions, who won’t be able to afford pricey senior housing.

According to this first-of-its-kind study that appears in the April 24 2019 edition of Health Affairs, 54 percent of middle-income older Americans will not be able to meet yearly costs of $60,000 for assisted living rent and other out-of-pocket medical costs a decade from now, even if they generated equity by selling their home and committing all of their annual financial resources. The figure skyrockets, to 81 percent, if middle-income seniors in 2019 were to keep the assets they built in their home but commit the reset of their annual financial resources to cover costs associated with seniors housing and care.

Accompanying the senior housing study are two perspective pieces in Health Affairs on how society can adapt to aging and supporting aging in communities.

The study, “The Forgotten Middle: Many Middle-Income Seniors Will Have Insufficient Resources For Housing And Health Care, was conducted by researchers at NORC at the University of Chicago, with funding provided by the National Investment Center for Seniors Housing & Care (NIC), with additional support from AARP, the AARP Foundation, the John A. Hartford Foundation, and The SCAN Foundation.

Learning About the Needs of the Emerging ‘Middle Market’

“We still have a lot to learn about what the emerging ‘middle market’ wants from housing and personal care, but we know they don’t want to be forced to spend down into poverty, and we know that America cannot currently meet their needs,” said Bob Kramer, NIC’s founder and strategic adviser in a April 24, 2019, statement. “The future requires developing affordable housing and care options for middle-income seniors. This is a wake-up call to policymakers, real estate operators and investors,” he adds.

The report notes that significant financial challenges are expected to coincide with many middle-income seniors seeking seniors housing and care properties due to deteriorating health and other factors, such as whether a family member can serve as a caregiver. The study projects that by 2029, 60 percent of U.S. middle-income seniors over age 75 will have mobility limitations (8.7 million people), 67 percent will have three or more chronic conditions (9.6 million people), and 8 percent will have cognitive impairment (1.2 million people). For middle-income seniors age 85 and older, the prevalence of cognitive impairment nearly doubles.

The researchers say that this ‘middle market’ for seniors housing and care in 2029 will be more racially diverse, have higher educational attainment and income, and smaller families to recruit as unpaid caregivers than today’s seniors. Over the next 10 years, growth in the number of women will outpace men, with women comprising 58 percent of seniors 75 years old or older in 2029, compared to 56 percent in 2014, they say.

Bringing the Public and Private Sector Together

“In only a decade, the number of middle-income seniors will double, and most will not have the savings needed to meet their housing and personal care needs,” said Caroline Pearson, senior vice president at NORC at the University of Chicago and one of the study’s lead authors.

“Policymakers and the seniors housing community have a tremendous opportunity to develop solutions that benefit millions of middle-income people for years to come,” says Pearson.

Researchers say there is an opportunity for policymakers and the seniors housing and care sector to create an entirely new housing and care market for an emerging cohort of middle-income seniors not eligible for Medicaid and not able to pay for housing out of pocket in 2029.

The study’s analysis suggests that creating a new ‘middle market’ for seniors housing and care services will require innovations from the public and private sectors. Researchers say the private sectors can offer more basic housing products, better leverage technology, subsidize ‘middle-market’ residents with higher-paying residents, more robustly engage unpaid caregivers, and develop innovative real estate financing models, among other options.

As to the public sector, the researchers call on government to create incentives to build a robust new market for middle-income seniors by offering tax incentives targeted to the ‘middle market,’ expanding subsidy and voucher programs, expanding Medicare coverage of nonmedical services and supports, creating a Medicare benefit to cover long-term care, and broadening Medicaid’s coverage of home and community-based services.

“This research sets the stage for needed discussions about how the nation will care for seniors who don’t qualify for Medicaid but won’t be able to afford seniors housing,” said Brian Jurutka, NIC’s president and chief executive officer. “This discussion needs to include investors, care providers, policymakers, and developers working together to create a viable middle market for seniors housing and care,” he says.

Adds, Lisa Marsh Ryerson, President of AARP’s Foundation, “All seniors want to live in affordable, safe and supportive housing, and more than 19 million older adults are unable to do so. We must act now to implement innovative solutions – including robust aging-in-community efforts – to accommodate what is sure to be an increasing demand for housing that meets the needs of older adults.”

Is Rhode Island prepared to meet the senior housing needs of the state’s middle-income seniors in 2029? If not, the state’s federal delegation, lawmakers, state policy makers and the senior housing industry must begin to chip away at this looming policy issue.

To view the study, go to http://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05233.

Bills Passed to Assist Rhode Island’s Seniors, Disabled

Printed in the Woonsocket Call on July 7, 2019

With the dust settling after the adjournment of the Rhode Island General Assembly’s 2019 legislative session on June 30, 2019, Rhode Island Governor Gina Raimondo halfheartedly signed the state’s 2020 fiscal year $9.9 billion budget into law.

The newly enacted budget closes a $100 million budget gap while avoiding new taxes for businesses, fully funding the state’s education aid formula, continuing to phase-out the car-tax, maintaining fiscal support for municipalities. And, State lawmakers did not forget older Rhode Islanders and disabled persons, putting tax dollars into programs assisting them.

Included in the state budget signed by Raimondo is $499,397 to fund the Rhode Island Livable Home Modification Grant Act that was introduced by Rep. Joseph M. McNamara, D-Warwick, Cranston and Sen. Walter S. Felag Jr., D -Bristol, Tiverton, Warren.

The grant allows eligible homeowners and renters to retrofit their residence to nationally recognized accessibility standards and receive 50 percent of the total sum spent, up to $5,000, to retrofit their existing residence.

The intent of this state program is to assist older Rhode Islanders and disabled persons to stay safely in their homes longer rather than being admitted to costly nursing homes, which costs taxpayers millions of dollars each year in Medicaid costs. With the graying of state’s population, there is a need for housing that is safe and adapted to the needs of their older occupants. (The Livable Home Modification Grant Application and Post-Retrofit Claim form can be found at http://www.gcd.ri.gov.)

Meanwhile, aging advocates gave the thumbs-up to Rhode Island lawmakers who eliminated a sunset provision in the state budget for a program that provides fare-free bus passes to low-income seniors and elderly Rhode Islanders, making this program permanent.

Awaiting the Governor’s Signature

The General Assembly passed legislation (S 0691A, H 6219), introduced by Senator Frank S. Lombardi, D-Cranston and Rep. Evan P. Shanley, D-Warwick, that would help caregivers to build onto their houses to provide space for relatives. The measure now moves to the governor’s office for consideration.

The passed legislation expands the definition of “family member” for purposes of zoning ordinances to include child, parent, spouse, mother-in-law, father-in-law, grandparents, grandchildren, domestic partner, sibling, care recipient or member of the household.

Under the legislation, the appearance of the home would remain that of a single-family residence with an internal means of egress between the home and the accessory family dwelling unit. If possible, no additional exterior entrances would be added. Where additional entrance is required, placement would generally be in the rear or side of the structure.

This legislative session, State lawmakers also approved legislation sponsored by Sen. Adam J. Satchell D- West Warwick and Rep. Robert E. Craven, D- North Kingstown, to establish a formal process recognizing “supported decision making,” a structure of support for disabled or aging individuals.

The legislation, which now heads to the governor’s desk, establishes a system of personal support that is less restrictive than guardianship to help individuals maintain independence while receiving assistance in making and communicating important life decisions. It is aimed at providing an alternative with more self-determination for individuals who are aging or who have developmental or intellectual disabilities.

Under the bill (2019-S 0031A, 2019- H5909), Rhode Islanders would be able to designate another person, or a team of people, as a supporter who would help them gather and weigh information, options, responsibilities and consequences of their life decisions about their personal affairs, support services, medical or psychological treatment, education and more. The supporter would also help the individual communicate the person’s wishes to those who need to know.

The legislation creates a legal form that establishes the agreement between individuals and their supporters, and designates the types of decisions with which the supporter is authorized to help. The bill establishes that decisions made with support under such an agreement are legally valid, and allows supporters to assist with the accessing of an individual’s confidential health and educational records.

It also requires that any other person who is aware that an individual is being abused, neglected or exploited by their supporter is obligated to report that abuse to the proper authorities.

Protecting Rhode Island’s Seniors and Disabled from Financial Exploitation

Sen. Valarie J. Lawson, D-East Providence and Rep. Joe Serodio’s D-East Providence, legislation (2019-0433A, 2019-H 6091A), “Senior Savings Protection Act,” was passed by the General Assembly and now heads to the Governor’s desk for signature.

The act would require certain individuals to report the occurrence or suspected occurrence of financial exploitation of persons who are age 60 and over or those with a disability between the ages of 18 and 59 years old.

According to the legislation, if a qualified individual, a person associated with a broker-dealer who serves in a supervisory, compliance or legal capacity, believes that financial exploitation is taking place, or being attempted, the individual must notify Rhode Island’s Department of Business Regulation and Division of Elderly Affairs, and law enforcement. The individual may also alert immediate family members, legal guardians, conservators, or agents under a power of attorney of the person possibly being financially exploited.

The legislation also calls for the Department of business Regulation and the Division of Elderly Affairs to develop websites that include training resources to assist in the prevention and detection of financial exploitation against Rhode Island’s seniors and disabled.

Combating Alzheimer’s Disease

With the number of persons with Alzheimer’s Disease expected to increase in the coming years, the General Assembly approved bills to better support Rhode Islanders affected by debilitating mental disorder and to protect against elder abuse. There are an estimated 23,000 Rhode Islanders age 65 and older living with Alzheimer’s disease. In just six years, the number is expected to increase to 27,000.

The Rhode Island General Assembly approved legislation (S 20223, 2019-H 5178) sponsored Sen. Cynthia A.Coyne, D-Barrington, Bristol, East Providence, and House Majority Leader K. Joseph Shekarchi, D-Warwick, to establish a program within the Department of Health dedicated to Alzheimer’s disease, and create a 13-member advisory council that would provide policy recommendations, evaluate state-funded efforts for care and research and provide guidance to state officials on advancements in treatment, prevention and diagnosis. The bill is based on legislation signed into law last year in Massachusetts.

The legislation requires the Department of Health to assess all state programs related to Alzheimer’s, and maintain and annually update the state’s plan for Alzheimer’s disease. It would also require the Department of Health to establish an Alzheimer’s disease assessment protocol specifically focused on recognizing the signs and symptoms of cognitive impairments, and appropriate resource information for effective medical screening, investigation and service planning. The legislation would also require caseworkers working with the Department of Elderly Affairs to become familiar with those protocols. Additionally, the legislation would require a one-time, hourlong training on diagnosis, treatment and care of patients with cognitive impairments for all physicians and nurses licensed in the state.

Most importantly, adoption of the legislation would enable Rhode Island to qualify for federal funding that is available to help states with their efforts to support those with Alzheimer’s disease.

Also gaining final Rhode Island General Assembly approval was legislation (2019-S 0302A, 2019-H 5141) sponsored by Sen. Coyne and Rep. Joseph M. McNamara, D-Warwick, Cranston, to allow the spouses or partners of patients residing in Alzheimer’s or dementia special care unit or program to live with them, even if they do not meet the requirements as patients-themselves.

Finally, Sen. Coyne, who lead the Senate’s Special Task Force to Study Elderly Abuse and Financial Exploitation, successfully spearheaded an effort this session to pass legislative proposals to beef up the state’s efforts to combat elder abuse, that is growing and vastly under reported. For details, go to herbweiss.wordpress.com, to access the June 30 commentary, “Senate Task Force Calls for Action to Combat State’s Growing Elder Abuse.”

Some Tips to College Seniors

Published in t he Woonsocket Call on June 2, 2019

Throughout May and June, robed college graduates at Rhode Island’s 11 Colleges and Universities listened to commencement speeches delivered by well-known lawmakers, judges, television personalities, actors, and chief executive officers of businesses. These included: former congressman Patrick J. Kennedy at University of Rhode Island; Bryan Stevenson, a widely acclaimed public interest lawyer, at Rhode Island School of Design; and actor and director John Krasinski, at Brown University. Many of the orators advised the young adults on how to create a more rewarding personal and professional life in their later years.

Members of the Association of Rhode Island Authors (ARIA), from their life experiences, also have insightful tips on aging gracefully in a very challenging and constantly changing world to give to the Class of 2019, and some of what the authors would have said if they had been invited to speak follows.

Co-authors Victoria Corliss, (a resident of Cumberland) and Leigh Brown, (from Warwick) have written three books. The newest book, “The Pendulum’s Truth,” published in 2018, is a story of Ava Dell, a protagonist with a twist. Like many people, Ava firmly believes that everything happens for a reason; but unlike her friends and family, she also believes she knows why they happen. She happily shares her intuitive insights with the people she loves providing them guidance and affirmations until the day her awareness fails her. When tragedy results, Ava suddenly finds herself in a moral and emotional dilemma. For Details, go to http://www.browncorlissbooks.com.

Commencement Tips: “Sometimes, when you think things are falling apart, they’re really just falling into place. So, in times of chaos, of which there will be many, take a deep breath, a step back and be still; it will help you to see the sense of things. One more piece of advice: ‘It’s not what happens to you that matters most, but how you react to it.’ Taking things in stride is a skill that keeps on giving.”

Dana Gambardella, 42, a Reading Specialist, resides in North Providence. She has written two children’s books, “Mama Bear’s Magic” and Grandma’s House,” published in 2018. In “Mama Bear’s Magic, Tiny Bear realizes that bath time is “bear” fun! This humorous, truth-telling tale illustrates how Mama Bear embraces Tiny Bear’s process so he can overcome his apprehension for the bath and discover that bathing is enjoyable. With brother Bear’s modeling and Mama Bear’s clever approach, it’s like magic! Savor the sounds, tastes, smells and feelings that come alive only at “Grandma’s House.” The illustrations in this book replicate the author’s grandmother’s house that still stands in Providence, Rhode Island. Vivid memories come alive through the light, impressionistic watercolor techniques on each page that evoke feelings of nostalgia for readers of all ages. For details, go to http://www.literacychefpublishing.com.
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Commencement Tips: “Always savor your own story. It’s made up of the best ingredients. My two passions, literacy and culinary arts, have nurtured my story since graduating college. Being a reading specialist educating the highest priority reader is not that different from being a chef enthusiast. Experts in both areas must combine the right ingredients and practices to create a successful recipe that reaches many individual learners and palettes. Embrace Literacy. Live to Learn. Love Your Process.”

Gledé Browne Kabongo, 45, author and marketing consultant, living in North Attleboro, Massachusetts. She has written four novels, the latest, the award-winning “Autumn of Fear,” published in 2018. In her tome, College student Abbie Cooper’s dream of becoming a surgeon is shattered when she wakes up in the hospital after a violent assault with no memory of the attack. To uncover the truth of what happened that night, Abbie must confront a stunning web of lies that stretch back decades, and a vicious predator who is willing to kill to protect his secret. For details, go to http://www.gledekabongo.com.

Commencement Tips: “If you live for the approval of others, you will die by their criticism. So, take your time and figure out who you are and what you want in life. It’s OK if it takes a while, the journey is as important as the destination. You will have many failures and make many mistakes. Don’t hide from them. It’s part of the journey. Be kind to yourself and others. Kindness is powerful and can change the world.”

Sheryl Lynn Kimball, 51, a resident of North Smithfield and owner of Kimball Property Maintenance. In 2019, she published “The Witches’ Antidote: Abigail’s.” In this book, when best friends Evan and Valarie hear that a tiny island on the Blackstone River is haunted, they have to see it for themselves. Once there, they discover an enchanted book instructing them how to put Salem Witch Trials victim Abigail Carver to rest. The teens will have to draw on all their strength if they are to survive the night and bring peace to a tortured soul. For details, go to http://www.Amazon.com.

Commencement Tips: “Follow your dreams. Many things will come along to throw you off your intended path. You’ll tell yourself you’re only taking a short detour but suddenly you’ve become just another hamster on the wheel. Understand that a few tiny steps in the direction of your heart are so much more valuable than any strides you make that go against your grain.”

Richard T. Rook, 71, a lawyer from Wrentham, Massachusetts. The basic plot of his book, “Tiernan’s Wake,” is a real-life historical mystery. An unlikely team apply their different skills to locate the only identifiable portrait, and maybe the missing treasure, of the iconic 16th-century Irish Pirate Queen (and political operative) Grace O’Malley. But it’s also a story of damaged adults confronting their mortality and looking for the “missing portraits” of themselves. Sometimes the important messages are delivered by ancestral spirits, if we’re smart enough to listen. For details, go to http://www.richardrook.com.

Commencement Tips: “Advice: Congratulations! You’ve accomplished a great deal, but not enough. Savor it, then start thinking about your obituary. By that I mean your legacy, how you want to be remembered. If you’re not careful, life will eat your dreams one small bite at a time, and you won’t even notice. I put off writing for 50 years, one day at a time. Be smarter. Draft your legacy now, then go make it happen.”

Angelina Singer, 22, an entrepreneur and crochet artist, lives in Boson, Massachusetts. She is author of “The Sorting” (Book 1 of the Upperworld Series), published in 2017. When asked to describe her book, Singer says: “Who decides where we are born and who we love? Luna is an immortal entity in the Upperworld learning how to assign human souls to bodies. Everything goes well until Luna’s friend makes a major mistake and Luna is sent to Earth after covering for her. For details, go to angelinasingerauthor.wordpress.com.

Commencement Tip: “Life is a lot like writing a book. Even if you haven’t formally published anything in the literal sense (or even want to), everyone has the power to write their own life story. This is both equal parts exciting and scary, but that’s why I write – to make sense of everything I can’t understand or even to get a second chance at something I’d like to redo.”

Dana Vacca, a college instructor, residing in Narragansett. Her historical fiction tome, “A Civil War Slave Escapes by Sea,” was published in 2018. When asked to describe this book, she says: “A storm at sea, a voyage aboard a whaling ship, the battlefields of Virginia, the Great Dismal Swamp, perilous escapes, a forbidden romance, – change the life of a run-away slave, forever. This epic journey to freedom in the midst of the Civil War is an unforgettable story of strength, determination and love. Historically accurate, action-packed adventure.” For details, go to http://www.amazon.com.

Commencement Tips: “You have come of age with purpose, with desires, with resolve and probably, also with fears. Do not be ashamed of those fears. Do not merely react to them letting them dictate your journey or paralyze you into stasis. But, do not expect to find a magic potion to make them disappear. Instead, dominate fear; – take up the reins and steer your life, in spite of it. The face of fear may change with age, but it will always be your traveling companion. If you keep your eyes on what is honest, what is just and forge ahead, you can be its master.”

Mary Catherine Volk, over age 55, is a life coach residing in Narragansett. In her book, “Believe in Forever: How to Recognize Signs from Departed Loved Ones,” published in 2015, she details firsthand experiences of people being contacted by their deceased family members and friends. She says that the humorous and heartwarming stories will give you chills as they touch your heart; teaching you to trust your own intuition. It was not just your imagination or an odd coincidence. Our loved ones are near shortly after passing to help us with our grief and to let us know their consciousness and love for us is eternal. For details, go to http://www.marycatherinevolk.com.

Commencement Tips: “What did you enjoy playing as a child in the third or fourth grade? What gave you Joy? Your answer holds a valuable key to your unique gift. Embrace your uniqueness! Follow your dreams, you will have support along the way, it’s all part of the journey to discover you and your special gifts. Don’t be afraid to share your gift with the world. Humanity needs you!”

For more information about the ARIA go to http://www.riauthors.org.