Category Archives for Rhode Island General Assembly

Complete Streets Legislation Stalled in House Committee

Published May 19. 2012, Pawtucket Times

            A properly designed road system helpsolder Rhode Islanders to successfully “age in place” and stay safely and comfortably in their homes for as long as they choose. But the benefits of so-called Complete Streets design benefits people regardless of age, abilities or mode of transportation.  AARP Rhode Island has joined a broad-based coalition of 17 aging, health and transportation groups and smart growth advocates to push state policy makers into making the Ocean State’s streets, highways and byways more accessible and safer for all users. Out of 2,111 legislative proposals submitted this year for consideration by the Rhode Island General Assembly, H 7352 and S 2131, its companion measure in the Senate, would accomplish this lofty goal.

          Coalition members fear that their efforts to make sure that the state’s transportation infrastructure becomes more user friendly for all ages and abilities is in jeopardy with the House Committee on Municipal Government which has held H 7352 for further study.  While the Senate passed the companion measure (for the second year in a row) last month, this House Committee might just kill the legislation unless it can be resuscitated. 

The Details of H 7352

            The legislationwould require that whenever the state is building or modifying a road, planners and designers must consider Complete Streets design concepts – that is, considering safe travel by all users, current and projected, particularly pedestrians and bicyclists of all ages and mobility capabilities.  Features of Complete Streetsdesign include sidewalks, paved shoulders suitable for use by bicyclists, lane striping, bicycle lanes, “share the road” signage, “road diets” (narrower lanes to discourage speeding and leave room  for pedestrians and bicyclists), roundabouts, crosswalks, pedestrian control signalization, bus pull-outs, curb cuts, raised crosswalks and ramps and traffic-calming measures.

            Meanwhile, this legislation allows common-sense exceptions, such as on interstate highways, where pedestrians and bicyclists are prohibited, and on projects where the space is too limited or costs would be disproportionate to the use such features would likely get.

            Furthermore, this legislation also requires the State’s Department of Transportation to issue a report within two years detailing what it has done to comply with the law, how it has changed its guidelines on such features as lane width, design speed and more, and what best practices the agency has employed.  It would also be required to include information on exceptions made, and why they were made.

            In a press release touting the passage of S 2131, bill sponsor, Senator Louis P. DiPalma, noted that the legislation’s goal is to plan streets that encourage people to use healthy, greener, transportation modes whenever possible, contributing in their own health as well as the wellbeing of the environment.

            “Cars shouldn’t be the only consideration when public roads are being built.  The health and environmental benefits of walking, bicycling and other active modes of transportation are well know, and we should be building our roads in ways that are safe for those activities and encourage people to choose them,” said Senator DiPalma.

Pushing for Safer Roads, Highways and Byways

            In her testimony before the House Committee on Municipal Government, AARP State Director Kathleen Connellsaid the goal of H 7352 is to direct the Department of Transportation  to plan with all users in mind.  “Making it easier for older people to get around is an obvious reason we’re involved, but Complete Streets design promotes public safety, helps revive our towns and cities and increases property value,” she said.

            Molly Clark, Manager, Health Promotion and Public Advocacy for the American Lung Association, also testifying to support H 7352, predicted that Complete Streets design that would promote walking and bicycling and this would ultimately improve the health of Rhode Islanders.

             Also attending the Committee Hearing, Co-Chair John Flaherty, of the Coalition for Transportation Choices, advocated for 21st century transportation system “that’s good for the economy, good for the environment and that provides clean, healthy and affordable transportation choices for all Rhode Islanders.”

            There is no fiscal note estimating the true costs of H 7352 due to the multitude of factors that must be considered.  However, bill supporters believe that this legislative proposal does not necessarily add costs to the road construction project.

            Addressing concerns about the legislative proposals “possible” fiscal impact on the State’s budget, Senator DiPalma notes that H 7352 has been crafted in such a way to reduce the fears of fellow lawmakers that there could be initial and future costs if the legislation is enacted.  Provisions would protect the state’s coffers by requiring common sense exceptions to take effect if a road construction design project incurs a cost that is disproportional to its benefits, he says.

It’s All About the Economy

            Doing it right the first time makes economic sense,” says AARP Associate Director for Advocacy Deanna Casey.

             Enacting H 7352 is just good economic policy, adds Scott Wolf, Executive Director of Grow Smart Rhode Island.  According to Wolf, “forRhode Islandto thrive economically it needs to attract and retain talented young people. These people, research shows, are looking for places that are vibrant, user friendly and possess an abundant natural and architectural beauty.” 

            Wolf stated “Rhode Island has many of these ingredients but we need to be much more user friendly with regard to transit, walk ability and bike ability to maximize our appeal to this new segment of workers. He added, “Adopting an aggressive complete street strategy that requires all roads built to accommodate bikes, pedestrians, and mass transit as well as autos could do a lot to increase our appeal to this critical cadre of mobile young talented workers.”   

             In these tough economic times usually a price tag on a legislative proposal is just enough for General Assembly leadership to doom a legislative proposal’s passage by not taking action on it.  Just refer it for further study.  Complete Street supporters are puzzled by the inaction in the House panel because of the protections built into the measure to rein in initial or future costs of a project.  At press time, the City of Pawtucket along with eight other cities and towns, have already passed resolutions supporting the Complete Street legislation being considered by the Rhode Island General Assembly and another eight communities are also considering supporting this legislation by enacting  resolutions.  Most important, the State’s Department of Transportation is not even blocking passage but endorsing it.

           According to the National Complete Streets Coalition, in 2011 alone “over 140 jurisdictions adopted a policy, up from 80 that committed to Complete Streets in 2010. In total, 352 regional and local jurisdictions, 26 states, the Commonwealth of Puerto Rico, and the District of Columbia have adopted policies or have made written commitment to do so.”

           Elections are looming and House and Senate leadership are looking to adjourn in early June.  The Rhode Island General Assembly must move quickly in the waning days of the 2012 legislative session to join 26 states that get it.  House leadership must do the right thing to make streets, highways and byways more accessible and safer for all Rhode Islanders, regardless of age, abilities or modes of transportation.   That is to pass H 7352.    

             Herb Weiss is a Pawtucket-based writer covering aging and health care issues.  His Commentaries are published in two Rhode Island Daily’s The Pawtucket Times and Woonsocket Call.

Fogarty, Senior Advocates to Rally for Increased Funds for State’s Co-Pay Program

Published in Pawtucket Times on March 22, 2004

Research is just beginning to show what Rhode Island aging advocates already know – that more assistance is required for helping the disabled and seniors to reside independently in their homes in the community.

According to researchers at the Disability Statistics Center at the University of California at San Francisco, about 3.3 million community-residing adults who require assistance with two or more activities of daily living (ADLs) need help from another person.

Of these, almost one million people need increased care, more than they are receiving – particularly those who live alone.

ADLs include bathing, dressing, getting into or out of bed or a chair, toileting, eating and other activities that are required to maintain their homes, such as shopping and preparing meals.

This study, published in the March issue of The Journal of Gerontology: Social Sciences, is considered to be the first to estimate the level of care required to help people.

“Individuals who need personal assistance with two or more of the five basic ADLs [mentioned above] and whose needs are unmet, have a shortfall of 16.6 hours of help per week,” said lead author Dr. Mitchell P. LaPlante.  Joining him on the project were Drs. H. Stephen Kaye, Taewoon Kang, and Charlene Harrington, in a written statement.

Among adults whose assistance needs are not fully met, people living alone fare worse than those who live with others, the researchers said. The study found those living by themselves receive only 56 percent of the help they need, while those living with family members or friends receive 80 percent of the hours of help, they need.

The research findings indicate that having unmet needs is linked with numerous adverse consequences, including discomfort, weight loss, dehydration, falls, burns and dissatisfaction with the help they do receive.  This puts these people at risk of being forced to leave their homes and move into costly nursing facilities.

Additionally, the University of California at San Francisco study also reported that unmet needs among people living alone are more an issue for the elderly, since two-thirds of those living alone and needing more help are age 65 or older.

This research study, probably the first of may to come that estimates the assistance required by the nation’s disabled and elderly, should be delivered to the doorstep of Gov. Donald Carcieri and every state lawmaker.

Even with the graying of the Ocean State’s population, the governor and the Rhode Island General Assembly are moving too slow to adequately fund less costly community-based care programs.

Carcieri has given an additional $ 200,000 in funding to the Department of Elderly Affairs (DEA) co-pay program in his recently released proposed 2005 budget.

While appreciative for this increase in funding in the showdown of the state’s huge budget deficit, senior advocates say this is not enough to keep people off the waiting list for this worthy program.

DEA’s co-pay program keeps 1,500-plus low-income frail seniors who do not qualify for the state’s Medicaid program but who require ongoing services to remain in the community in their homes by providing a little bit of funding for certified nursing assistants (for assisting with bathing, meals, shopping, laundry, and light housekeeping). And DEA’s co-pay program also provides subsidies for adult day care.

Last October, a DEA freeze on new admissions to the co-pay program left 200 frail seniors on a waiting list for home and community-based care, said senior advocates.

According to the state’s Long-Term Care coordinating Council (LTCCC), the typical person in DEA’s co-pay program is between ages 65 and 104, with the average age being 84. Most are women and more than half live alone. Without the state’s co-pay, these seniors will have to pay the entire fee for their care –    which they cannot afford – or enter a nursing home, or go without the help they need to do simple things such as bathing, shampooing and dressing.

Susan Sweet, a consumer advocate  who sits on the LTCCC, expressed concern that a DEA freeze – putting the copayment program on hold – for those on the waiting lists still exists this fiscal year.

“These people have been waiting a long time to get the home care or adult day care services that they need. I am afraid that waiting longer will result in many of them entering nursing facilities prematurely,” said Sweet.

Sweet noted Carcieri’s proposed 2005 allocates an additional $ 200,000 in funding for next year’s DEA’s co-pay program.

“It will take more funding than that to take care of the frail seniors still left on a waiting list,” Sweet charged, noting that DEA Director Adelita S. Orefice, did say another $ 250,000 would be needed in FY 2005 to meet DEA’s co-pay program demand.

Lt. Gov. Charles J. Fogarty, who is chairman of the LTCCC, will join senior advocates today at 11:00 a.m. at the Statehouse, calling for the state to reopen admission to a state-funded co-pay program that helps limited-income seniors pay for home and community-based care.

The press conference is expected to draw several family caregivers and representatives of AARP-RI, Choices Coalition, Respite Services, R.I. Adult Day Care Services Association, Alzheimer’s Association of R.I., R.I meals on Wheels, R.I Partnership for Home Care, R.I. Senior Center Directors Association, Senior Agenda Consortium and the Silver-Haired Legislature.

“Freezing the DEA co-pay program is a fiscal folly,” Fogerty said in a written statement obtained by All About Seniors that will be released at today’s rally.

“It is shortsighted from both a financial and a human perspective. It is not as if this freeze will result in overall cost savings,” said the Lt. governor.

Fogarty said this freeze was ordered to avoid having the DEA spend more than what was budgeted for the program in the current fiscal year – an amount that was less than what was spent on the program in FY 2003.

At this rally Fogarty will call for the state to provide adequate funding in the FY 2005 budget for DEA’s co-payment program to address the unmet need.

“To the contrary,” Fogarty said, “it may wind up costing taxpayers much more, because these seniors are still going to need care and they’re going to get by being forced into nursing homes where the taxpayers will pay tens of thousands more than we would have paid for the co-pay program.”

According to Fogarty, in FY 2003, the state supported 1,457 seniors in the program, spending $ 3,650,117, or $ 2,505 per senior. That’s less than 1 percent of all long-term care spending. Contrast this, he said, in is written statement, with the annual cost per nursing home resident – between $ 32,000 and $ 53,700 (this figure excludes the average 20 percent patient contribution to care and includes state and federal dollars).

Fogarty said, “It boggles the mind that in tight budget times, we would opt for the more expensive solution – especially in light of the fact that the less costly option of keeping seniors in their homes is the most humane option.”

As mentioned in a previous column, there is also a freeze and waiting list for the state’s respite program, which provides assistance to family caregivers. This freeze continues and no additional funding has been allocated for this program in Carcieri’s proposed 2005 budget.

Carcieri and state  lawmakers must not continue to put patches on the state’s old dilapidated long-term care deliver system. As I previously mentioned, now is the time to tackle the thorny issues of long-term care and its rising costs.

Rhode Island must move to create a long-term care delivery system that will adequately provide funding for keeping seniors independent in the comfort of their homes while adequately providing reimbursement to nursing facilities that take care of sicker patients.

Seniors can support Fogarty’s call for adequate state funding for DEA’s co-pay program by attending the rally scheduled today at 11:00 p.m.at the Statehouse.

Meanwhile a DEA budget hearing will be held before the House Finance Committee later in the afternoon, at 1:00 p.m. in Room 35 of the Statehouse.

Seniors can attend this hearing to give their support for increased state funding for community-based care long-term programs. Testimony taken from the public will be televised on the state’s access cable channel.

Expanding Vaccinations Initiative Will Save State Money

Published in Pawtucket Times on January 5, 2004

During last year’s legislative session, the Ocean State Adult Immunization Coalition (OSAIC) approached the Rhode Island General Assembly for funding to promote the group’s efforts to get the word out about the importance of Rhode Island seniors getting influenza and pneumococcal vaccinations.

OSAIC’s message was quite simple – “Avoid a Hospital Stay: Get Your Flu Shot Now!”

The Providence-based nonprofit, a coalition of 40 agencies including hospitals, nursing facilities, vaccine manufacturers, medical societies, managed care groups, the R.I. Department of Health, the R.I. Health Care Association, and Blue Cross Blue Shield of R.I., call vaccinations a cost-effective way to prevent these unnecessary hospitalizations and deaths.

According OSAIC, pneumonia and influenza deaths together are considered the  sixth-leading cause of death in the nation. Since 1999, when this initiative began, there have been more than 300 deaths and 6,800 hospitalizations that were attributed to influenza and pneumococcal diseases in the Ocean State.

OSAIC stated that the cost of a flu shot is $ 15 and a pneumonia shot is $ 30.

On the other hand, the average length of stay for an older person with influenza is five days, costing $ 12,000. Treatment in a hospital for pneumonia lasts six days and costs $ 12,000l

At the conclusion of last year’s General Assembly session, lawmakers allocated $ 50,000 to OSAIC to push its many immunization initiatives. Charles Harris, owner of Harris Health Centers and an OSAIC executive board member, noted last year’s funding enabled his group to work closely with providers to create a system to identify vaccine recipients.

“We also were able to assist the state’s Health Department to expand the statewide vaccine record system,” he said.

OSAIC also worked with managed care providers to assist them in informing their beneficiaries through newsletters and reminders about the many benefits of flue and pneumonia vaccinates,” Harris added.

Furthermore, Harris said OSAIC reached out to the state’s media outlets to educate Ocean State seniors as to the importance of vaccine shots and the locations where they could get those shots. Meanwhile, an outreach program, utilizing both providers and pharmacists, also encouraged older Rhode Islanders to get their shots.

To get the  facts out, OSAIC senior volunteers even managed the nonprofit’s group’s flue hot line.

“Last year’s funding appropriation has even allowed us to begin our work this spring to urge seniors to get their pneumonia vaccines,” Harris noted.

“It also enabled OSAIC to bring its message into the state’s nursing facilities. Most nursing facility residents or staff who requested a shot got one, even with the flue vaccine shortage,” he said.

OSAIC is now posed to ratchet up its efforts to protect more of the state’s seniors. Look for the nonprofit group to push for making vaccinations a standard of care, Harris told All About Seniors.

“Rhode Island’s age 65 and over uninsured should receive these inoculations either free or at a nominal cost,” Harris said.

Senate Finance Committee Chair Stephen D. Alves, and Rep. Stephen M. Constantino (D-Providence), who serves as vice chair of the House Finance Committee, were key in getting OSAIC’s $ 50,000 funding allocation last year.

When the 2004 legislative session kicks off this columnist hopes that Sen. Alves and Rep. Costantino will again bring their passion for this preventative care issue to their respective committees and to the House and Senate floors during budget debates.

Even with a huge budget deficient looming, Gov. Don Carcieri and state lawmakers must see that preventative medicine is a worthy cost containment approach for reining in skyrocketing health care costs. Even with state dollars allocated up front, the savings will be ultimately realized down the road.

If Gov. Carcieri and state lawmakers choose to act “penny-wise” but pound-foolish” Rhode Islanders taxpayers will ultimately become the losers in the upcoming legislative session.