Category Archives for Healthcare

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.