Category Archives for Rhode Island General Assembly

State Lawmakers Ok Many Senior Initiatives  

Published in Pawtucket Times on July 7, 2003

 As this year’s legislative session came to an end, even the widely publicized tight state budget did not keep aging advocates from seeing some of their legislative proposals get passed by the House and Senate.

With the passage of companion legislative proposals (H 5841/ S 876), the state’s long-term care ombudsman law will be revised to reflect federal law, expanding the scope and authority of the state’s ombudsman program.

The new statute changes will require the state ombudsman to represent the interests of nursing facility residents or clients of service providers before governmental agencies.

The state ombudsman will also be charged with seeking administrative, legal and other remedies to protect the health, safety, welfare and rights of Ocean State seniors.

Another legislative proposal also got the thumbs-up from lawmakers. With the passing of companion proposals  H 5418/ S 506, new state funds totaling $ 300,000 will pay for nursing facility care of legal immigrant Rhode Island seniors who ae not eligible for Medicaid.

Meanwhile, the Rhode Island General Assembly provided that it sees the value in preventative medicine and how it can ultimately save health care dollars.

The Ocean State Adult Immunization Coalition requested $ 103,000 in new state funding to expand the coalition’s efforts to get the world out about the importance of seniors getting influenza and pneumococcal vaccinations.  While not receiving the whole loaf, lawmakers gave a half loaf instead – about $ 50,000.

With state dollars now allocated up front, large savings will be realized down the road. The cost of a flu shot is $ 15 and a pneumonia shot is $ 30.

If a senior is hospitalized, the average length of stay for an older person with influenza is five days, costing $ 12,000.  That’s a huge savings.

Lawmakers also passed legislation to make pharmaceutical drugs more affordable to Rhode Island seniors.

With the passing of companion proposals H 5237/S 374, persons eligible to participate in the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE) who also have prescription drug coverage through a health plan, will now be allowed to use RIPAE to pay for an individual prescription drug once they reach the maximum level of coverage for that drug.

Also, companion measures H 5239/ S378 passed, expanding RIPAE to allow persons age 55 to 61 on Social Security Disability Insurance to receive a 15 percent RIPAE co-payment in addition to their RIPAE drug discount rate.

As previously reported in All About Seniors, an 18-month study of .B.D.O. Seidman, a consulting firm hired by the state Department of Human Services, found that Rhode Island was underpaying its nursing facilities in excess of $ 30 million annually.

It seems that the General Assembly agreed with that report’s assessment and made a partial allocation of new Medicaid dollars to overhaul the state’s ailing Medicaid system.

With the passage of the state’s budget, nursing facilities will receive a total of $ 18.8 million in state and federal dollars – a three-year phase in will bring the total federal and state dollars to $30 million.

On the other hand, some aging agenda items went down in flames.

Aging advocates called on Gov. Don Carcieri and state lawmakers to allocate taxpayer dollars in the FY 2004 budget to allow more low-and moderate-income persons to choose Medicaid waiver-funded assisted living.

Although the federal government has already approved an additional 180 units in the state’s Medicaid assisted living waiver program, state funding of this initiative is required.

No funding in this year’s budget ensures that low-and- moderate income seniors will continue to be denied an option of choosing a less restrictive level of care, an option that higher income seniors have.

Additionally, lawmakers chose not to pass companion proposals (H 5478/ S 299) which would have allowed Rhode Island residents to buy prescription drugs from Canadian pharmacies, where they are routine cheaper.

Finally, in the aftermath of the tragic Station nightclub fire, the General Assembly and governor moved quickly to tighten regulations and to hire additional staffing at the Fire Marshal’s office to protect the patrons of bars and restaurants from fire.  However, beefing up the state Department of Health’s regulatory oversight of the Ocean State’s assisted living facilities, where 3,700 plus seniors reside, did not receive one dime in funding in the FY 2004 budget.

An assisted-living provider group, aging advocates, the Long-Term Coordinating Council, the state ombudsman and officials at the state Department of Health, have all called for new state dollars to fill one full-time surveyor position ( a nurse) to ensure that assisted living residences across Rhode Island are inspected on a timelier basis.

Last year, state lawmakers passed legislation to protect frail Rhode Island seniors who receive assisted-living services.

As this legislative session ends, the governor and General Assembly have failed to allocate the necessary funding in the FY 2004 state budget to fully implement state law that would result in the inspection of the state’s 72 assisted-living facilities and 155 assisted-living beds in nursing facilities in a timely manner.

According to the state’s Department of Health, another seven assisted-living projects are expected to be up and running over the next 18 months.

The ball now moves to Carcieri’s court to either use contingency funds in his office budget or to take administrative action to hire more assisted-living inspectors.

While it has been reported that the governor is amenable to using funds flushed out by his “fiscal fitness program” to pay for a new surveyor position, the time to act is now, rather than later.

Acting now to fix this policy glitch is sound public policy.  I am sure that Rhode Island seniors and taxpayers will agree.

Statehouse Rally Calls for Passage of Nursing Home Payment Reforms

Published in Pawtucket Times on June 9, 2003

In the final days of this year’s legislative session, the Coalition to Ensure Funding for Quality Long-Term Care rallied its troops at the Statehouse rotunda to push for the passage of two legislative proposals that would fix an ailing Medicaid reimbursement system.

The goal of last Wednesday’s rally was to keep the Coalition’s two legislative proposals on the radar map of the Rhode Island General Assembly, which has been bogged down with a multitude of heated legislative issues – separation of powers , fire code changes, smoking bans in restaurants to name a few.

Even with an expected $ 225 million budget deficit for fiscal year 2004, the long-term care advocates, including provider groups, consumer advocates, state policy makers and legislators, urged lawmakers to pay a fair Medicaid rate for nursing facilities, required by state and federal law to provide quality of care to 9,000-plus vulnerable Rhode Island seniors who need intensive, 24-hour-a-day care.

Rally supporters gave a thumbs-up to two legislative proposals ( H 5803/ S 0899). The companion bills, if enacted would revise the state’s Principles of address the inadequate funding of the state’s nursing facilities.

The two legislative proposals, still in the House and Senate Financial Committee, reflected the findings of an 18-month study of B.D.O. Seidman, a consulting firm hired by the state Department of Human Resources to re view and recommend fixes to the state’s flawed reimbursement system.

A major finding of this state-financed study found that the state was underpaying facilities in excess of $ 29 million annually.

These bills call for an additional $ 14 million to state funding for Medicaid reimbursement to nursing facilities. With the infusion of state dollars, the federal government would then kick in $ 16 million for a total increase of $ 30 million.

Eighty percent of the state’s nursing facility residents rely on the Medicaid program to pay for their care, John Gage, administrator of the Coventry-based Riverview Health Care Community and a Coalition member, told those who intended the rally.

Many facilities are left struggling to remain open because Medicaid does not pay for the actual cost of care, he said, noting a number of Ocean State nursing facilities have already filed for bankruptcy of receivership, and some are even closing their doors.

An inadequate reimbursement rate continues to fuel Rhode Island’s critical nursing shortage, too, said Gage. Due to the current  reimbursement system, facilities are hard-pressed to come up with the necessary funds for increases in salaries and benefits to retain nursing staff.

Lt. Gov. Charles Fogarty, who chairs the state’s Long-Term Care Coordinating Council, warned the crowd that Rhode Island’s nursing home industry “is on verge of a meltdown.”

He- along with Sen. Stephen D. Alves (D-West Warwick) and Rep. Steven M. Costantino (D-Providence), sponsors of the Coalition’s nursing home payment reform bills – urged Gov. Donald Carcieri and House and Senate leaders to include funding in the fiscal year 2004 budget to begin the steps needed for Medicaid reform.

Throughout the afternoon rally, until 6:00 p.ml, the Coalition gathered hundreds of signatures to support efforts to increased Medicaid reimbursement to nursing facilities.

Meanwhile, posters strategy placed outside the House and Senate chambers illustrated the rally supporters point that the state is not paying enough for care  of family members in nursing facilities.

At one poster site, piles of dirt were placed on a 6-foot table.  A  poster said: “Did you know this mulch topsoil costs more than $ 5.63 – that’s more than the Medicaid system’s pay for an hour’s worth of nursing facility care for your loved one.  Isn’t your grandmother’s care worth more than the cost of a pile of dirt.”

In a previous All About Seniors column, this writer called for lawmakers to fix the state’s flawed Medicaid reimbursement system once and for all.

The legislative session will soon be ending, and immediate action must be taken now by lawmakers to pass the Coalition’s two legislative proposal, with Gov. Carcieri hopefully signing the bills into laws.

State policy makers must no longer use a Band-Aid approach to fix  broken Medicaid payment system, especially with the graying of the Ocean State’s population. A growing number of Rhode Islanders will soon require this level of intensive care.

It’s time for lawmakers to ratchet up the Medicaid rates to pay for actual costs of care, allowing facilities to deliver quality services.

Lawmakers to Consider Funding for Vaccine Immunizations for Seniors

Published in Pawtucket Times on May 12, 2003

Even with a state budget deficit looming, sometimes putting a little money into a statewide initiative can ultimately save big dollars.  It’s just the right thing to do.

For the second year, the Ocean State Adult Immunization Coalition (OSAIC) has 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 is quite simple: “Avoid a Hospital Stay: Get Your Flu Shot Now!”

According to OSAIC, pneumonia and influenza deaths together are considered the six-leading cause of death in the nation.

Since 1999, there have been 300 deaths and 6,800 hospitalizations that were attributed to influenza and pneumococcal disease in the Ocean State.

OSAIC said vaccinations are a cost-effective way to prevent these unnecessary hospitalizations and deaths.

OSAIC, a coalition of 40 agencies, including hospitals, nursing facilities, vaccine manufacturers, medical societies, managed care groups, the Rhode Island Department of Health, Rhode Island Quality Partners, the Visiting Nurses Association, and Blue Cross Blue Shield of Rhode Island, call on Gov. Don Carcieri and lawmakers to see the big picture – preventative medicine care can ultimately save tax dollars.

Anne Marie Beadsworth, OSAIC’s chair, said the cost of a flu shot is $ 15 and a pneumonia shot is $ 30.

On the other hand, she added that the average length of stay for an older person with influenza is five days, costing $ 12,000.

Since OSAIC was established in 1997, Beadsworth has seen a steady progress in the coalition’s efforts to get more older Rhode Islanders immunized to prevent the influenza and pneumonia.

“The immunization coverage rates for those age 65 and over has increased by eight precent (from 67 percent to 75 percent) for influenza vaccine and 24 percent (from 43 percent to 67 percent) for pneumococcal vaccine,” she noted.

Beadsworth said OSAIC is working to reach the Healthy People 2010 goal of a 90 percent immunization rate for influenza and pneumococcal  for people age 65 and over.

“Through promotional efforts in five languages in 2002, more than 350 flu clinics were conducted throughout Rhode Island with the guarantee that any person age 65 and older, regardless of insurance status, could get a flu shot without any out-of-pocket expenses,” she said.

Furthermore, OSAIC’s gains have propelled the Rhode Island-based initiative into top 10 standings in the United States, says Beadsworth.

“We rank number seven for both flu and pneumococcal vaccination rates,” she added.

Beadsworth said that during last year’s legislative session, OSAIC’s efforts for the state funding fizzled because of state funding fizzled because of state budget cuts. The coalition was just not effective in getting its message out to lawmakers, she added.

During this year’s legislative session, OSAIC is pushing for $ 103,169 in new funding in Fiscal Year 2003-2004 to expand the coalition’s educational outreach efforts and to hire a part-time staffer to oversee its ongoing programs to improve the state’s immunization rates.

Currently, OSAIC is a volunteer-driven organization with its $ 50,000 working budget coming from member organizations and from the community.

It seems things may be different this year at the Rhode Island General Assembly. Support among lawmakers is growing for OSAIC’s ongoing preventative medicine initiatives.

“Quite a few advocates are coming to the Senate asking for funding,” said Sen. Stephen D. Alves (D-West Warwick), who said there is now growing support for OSAIC’s funding request.

Alves, who serves as chair in the Senate Finance Committee, told All About Seniors the funding request will be brought up during the chamber’s budget debates.

“Everyday, we talk about preventative medicine – funding this program is a step in the right direction,” said Alves.

Rep. Steven M. Costantino (D-Providence), who sits on the House Finance Committee, told me he sees the value of OSAIC’s efforts, too, and plans to call for funding OSAIC’s initiative during House budget deliberations.

Health Director Patricia A. Nolan also sees the positive benefits of OSAIC’s prevention campaign.

“Adults need their shots, too – especially people aged 50 and older or people with chronic health conditions. Vaccinations are one of the easiest and most effective ways to stay healthy,” she says.

As state revenue estimators meet to determine the breath and scope of the state’s budget deficit, Gov. Carcieri’s staff continue their ‘Big Audit” to identify ways to save taxpayer dollars.

When the dust settles, even with a projected budget deficit, it may be time for the governor and the General Assembly to view preventative medicine as a worthy cost containment approach for reining in skyrocketing health care costs. Even though state dollars have to be allocated up front, large savings might be realized down the road.

As the state’s final budget is being crated, we must not be “penny wise but pound foolish” when determining what bills live or die in the 2004 legislation hopper. Taxpayers will ultimately lose if this happens.