Casey Calls on Federal Agencies to Enhance Web Access for People with Disabilities, Seniors

Published in RINewsToday on February 27, 2023

After Sen. Bob Casey (D-PA) introduced on March 20, 2020, the bipartisan Department of Veterans Affairs Website Accessibility Act with Sen. Jerry Moran (R-KS) and Rep. Elaine Luria (D-VA), the legislative proposal passed both chambers to ultimately be signed into law nine months later by President Donald Trump. The new law directed the U.S. Department of Veteran Affairs (VA) to report to Congress regarding the he accessibility of VA websites to people with disabilities.

Casey calls for better website technology 

On Dec. 20, 2022, Casey released Unlocking the Virtual Front Door, a 72-page report detailing the findings of an 11-month investigation that found widespread failure across the federal government to ensure that website technology is accessible for people with disabilities, seniors, and veterans. The investigators identified the absence of U.S. Department of Justice (DOJ) reporting as a contributing factor to widespread accessibility gaps at the numerous federal departments and agencies.

On June 30, 2022, Casey led a bipartisan group of Senators respondence led by Casey in sending correspondence to DOJ Attorney General Merrick Garland demanding answers from the agency on its lack of website accessibility for people with disabilities. 

Earlier that month, Casey also had sent correspondence to VA Secretary Denis McDonough urging the agency to improve VA website accessibility for disabled veterans.

Casey also released a report from the VA from the VA which found that only 10 percent of VA websites are fully accessible for people with disabilities, as required by law, posing barriers to deaf, blind and paralyzed veterans as well as tens of thousands of veterans with other disabilities. 

On July 28, 2022, Casey’s Senate Aging Committee held a hearing that further investigated the issue the issue of federal website accessibility.

With Casey’s ongoing pressure, ultimately DOJ would finally release a report last week  for the first time in a decade.  

Reaction’s to DOJ’s website data release

Casey, Chair of the Senate Special Committee on Aging, quickly reacted to the release of DOJ data in a Feb. 22, 2023, press release, noting that the agency was required by Section 508 of the Rehabilitation Act to provide a report to Congress and the President every two years on federal technology accessibility. “Despite this mandate, the latest report was from 2012, leaving taxpayers in the dark for over a decade about the accessibility of government technology, including websites, for people with disabilities,” said the press release.

While new data confirmed the findings of Casey’s recent investigation that exposed widespread accessibility barriers to federal technology, the press release criticized the data as “insufficient and incomplete,” calling on DOJ and the entire federal government to prioritize technology and web accessibility and transparency.

Section 508 of the Rehabilitation Act requires the federal government to make all its website information technology accessible to people with disabilities. Unfortunately, because of ongoing barriers to federal website and technology access, Casey charges that many people with disabilities—including seniors and veterans—are being barred from accessing key government resources, facing barriers to accessing information about COVID-19, filing claims and accessing health care, using VA kiosks, and more.

Casey’s repeated calls for data for transparency confirmed by his investigation that revealed that people with disabilities are being locked out of government services and are not given a level playing field in federal workplaces due to inaccessible technology. ”Unfortunately, after a decade of keeping the public in the dark, DOJ has not provided Americans with disabilities insight into what progress has been made over that time period—which will make it harder for the federal government to remedy these issues and ultimately improve web and technology accessibility,” says the Pennsylvania Senator. “It is clear that the federal government has a lot more work to do to make technology accessibility and transparency a priority and fulfill our promise to Americans with disabilities, older adults, and veterans,” he said.

Casey urged the DOJ to improve transparency around Section 508 compliance by returning to their mandated biennial reporting and ensuring their reports are modeled more closely after the agency’s 2012 web report  instead of an abridged data set that DOJ released last week 

Taking a closer look 

DOJ’s recently released report, based on data from Feb. 2021 through August 2022, compiled in partnership with the General Services Administration, found that one in 10 public-facing websites at major federal departments and agencies are not fully accessible for people with disabilities. In addition, three in five internal websites at major federal departments and agencies are not fully accessible to people with disabilities.

According to the data, the Department of Agriculture, Department of Labor, Department of State, and VA reported that 50 percent or less of the public-facing websites that were tested comply with federal accessibility requirements.

The DOJ data noted that some departments and federal agencies did not report conducting any accessibility testing of internal websites. It not clear what steps departments and agencies are taking to test other types of technology covered by Section 508 of the Rehabilitation Act. 

DOJ data indicated that key government agencies, including DOJ itself, as well as the Department of Agriculture, the Department of Defense, and the Environmental Protection Agency did not have adequate “resources committed and/or staff trained to implement policies, processes, and procedures.” These shortfalls in staffing were reflected in data regarding the low number of federal and contract employees directly supporting Section 508 programs in many agencies. 

DOJ also found that “agency maturity remains largely unchanged from prior reporting,” raising concerns that, despite over a decade of technological evolution, many federal government agencies have not made efforts to improve and better integrate Section 508 compliance and ensure the federal government’s resources are available for people with disabilities, including taxpayers and federal workers.

Finally, Casey observed that DOJ’s recommendations underscore many of the recommendations he made in his report, which called for enhanced oversight and transparency from DOJ regarding Section 508 compliance as well as better integration of accessibility into everyday oversight efforts at every federal agency.

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“Secure Choice” will help saving for retirement

Published in RINewsToday on February 20, 2023

Most Rhode Islanders save for retirement through an employer-based plan such as a pension or 401(k). But 172,000 Rhode Island workers (roughly 40 percent of the state’s workforce) do not have access to this crucial savings tool. At a Feb. 14, 2023 press conference held at the State Library, Sen. Meghan E. Kallman (D-Pawtucket, Providence) and Rep. Evan Shanley (D-Warwick, East Greenwich) were joined by General Treasurer James A. Diossa, and advocates calling for a policy fix by enacting a program called “Secure Choice.” These advocates were invited to publicly give their support: Catherine Taylor, State Director of AARP Rhode Island, the Rhode Island Black Business Association, Progreso Latino and the Hispanic Chamber of Commerce.

During early February, S 0089 and H 5417 were introduced by Sen. Meghan Kallman (D-Pawtucket, Providence) and Rep. Shanley (D-Warwick, East Greenwich) to allow employees to take their savings with them when they change jobs.  The Senate and House proposals were referred to the Senate Finance and House Committees in their respective chambers. 

At press time, Kallman withdrew S 0089 to redraft it to match the House version.  It will be reintroduced after Feb. 28 when the Rhode Island lawmakers come back from recess. At this time, the General Assembly’s House and Senate GOP caucus have no position on these legislative proposals.  

“It’s in everyone’s interest to help workers save for retirement,” said Kallman, the press conference announcing the introduction of the Secure Choice legislative proposals. “The evidence is really clear: giving workers access to pre-tax payroll deductions is the best way to encourage retirement savings. And having those savings is a big part of being able to live a comfortable and healthy retirement, which is what we want for everyone in our community,” she said.

“When I talk to small businesses in my community, they really care about their staff and want their workers to be able to save for retirement,” said Shanley, primary sponsor of the House companion measure. “But small business owners can’t be experts in everything and often don’t know where to start with offering retirement savings. This bill gives them a way to support their workers and gives workers a chance to save,” he says.

“Too many employees across the state are working day and night without the assurance of a solid financial future,” said Treasurer Diossa. “By providing workers with an optional retirement plan, the Secure Choice Act is a prime example of how government can improve the lives of workers. We must fulfill the fundamental promise that a lifetime of hard work will be met with a retirement of dignity and security.”

 Taking a Look at the Nuts and Bolts

“Most Rhode Island workers hope to retire someday,” said Catherine Taylor, State Director of AARP RI in supporting the passage of the Secure Choice legislative proposals that tie nicely into AARP’s mission to “empower people to choose how we live as we age.”  

According to Taylor, Secure Choice provides a “simple and easy way to save to the over 172,000 private sector employees in Rhode Island who currently do not have access to a way to save through their work.” That is about 40 percent of Rhode Island’s private sector workers, she says, noting that this percentage includes workers at all levels of earnings, education, and backgrounds.

“All of them would benefit from the ability to use payroll deduction to save for retirement. People are 15 times more likely to save if it can be done out of their regular paycheck. 20 times more likely if this can be done automatically,” she added, stressing that this program would be easy for employees of Rhode Island’s small businesses to participate in. It’s also free for employers.

At last Tuesday’s press conference, Taylor noted that AARP’s mission is to “empower people to choose how we live as we age.”  

“Saving for retirement is critical because those savings mean financial resilience and empowerment for older Rhode Islanders. Many older Rhode Islanders who did not save for retirement are living solely off Social Security and have few options as to where and how they age. For older Rhode Islanders to thrive it is important to have access to a simple and easy way to save for retirement during our working years,” says Taylor.

Taylor states that passage of Secure Choice will give all workers the chance to begin saving for their retirement, giving them a way to retire with more security. 

By the numbers…

In May 2022 AARP Rhode Island surveyed 502 small Rhode Island businesses and the results showed that 72 percent of these small business owners were supportive of a privately managed, ready-to-go retirement savings option that would help them offer employees a way to save for retirement. The study, released on July 2022, found that 81 percent –  https://www.aarp.org/research/topics/economics/info-2022/rhode-island-retirement-savings-small-business-owners.html – of the respondents agreed that the lawmakers should pass a bill to make it easier for small business owners to access a retirement savings option for their employees and themselves.

“Secure Choice is all about choice and control. It is voluntary for employees: how much you save, if at all, is entirely up to you, as are the investments you choose. Employers need only pass on information from the program and add a payroll deduction option, says AARP’s Taylor, stressing that they can open an alternative plan of their choosing at any time.

Taylor notes that Sixteen states have enacted similar programs. Eight of those programs are open for business and have over 634,000 funded accounts and $662 million in assets under management as of December. Over 30 states recently acted to study program options or consider legislation., she said.

Legislative proposals to create a Secure Choice program were introduced in 2019, 2020, 2021 and 2022.  During this legislative session, now is the time for lawmakers to push the legislative proposal to the goal line for passage. 

Taylor sees a positive impact on the state’s budget if the Secure Choice is passed and signed into law by Rhode Island Governor Dan McKee.  “When more people save for retirement, it decreases reliance on public assistance, having an enormously positive effect on the state’s balance sheet,” she said stressing that it’s sound fiscal policy for state. AARP Rhode Island will be releasing a fiscal impact analysis on Feb. 28, that is being prepared by The Pew Charitable Trusts.  Stay tuned.  

A broad coalition of aging advocacy groups from across the state support Secure Choice, including AARP Rhode Island, the Latino Policy Institute, SEIU, Progreso Latino, Working Families Party, Hispanic Chamber of Commerce Economic Policy Institute, and the Rhode Island Black Business Association.

To watch the Secure Choice Press Conference, held on Feb. 14, 2023, go to

https://ritv.devosvideo.com/show?video=037dd6f1f3d8&apg=7e98c085

To read Aug. 2022 Fact Sheet: Rhode Island detailing the benefits of enacting enabling Rhode Islanders to save for their retirement, go to

Click to access rhode-island.doi.10.26419-2Fppi.00164.041.pdf

To read AARP Director Catherine Taylor’s Op Ed, “We Need Secure Choice”, go to  

https://states.aarp.org/rhode-island/we-need-risavers

Nursing home workforce crisis deepens with minimum staffing standards

Published in RINewsToday on February 13, 2023

“The long-term care industry is enduring the worst workforce crisis in its history, in Rhode Island, and across the country. Although providers are committed to recruiting and retaining staff to provide quality care for residents, despite our best efforts, many nursing homes have fallen short of the staffing ratio set by the RI Department of Health,” notes James Nyberg, Executive Director of the East Providence-based Leading Age Rhode Island (LARI), representing nonprofit providers of aging services.

“We are extremely  concerned about the impending fines that will be imposed on nursing homes here in Rhode Island as a result of our state’s existing nursing home minimum staffing ratio statute,” said Nyberg. Because of staffing ratio mandates, “the industry would have faced fines of over $11 million, in just one sample quarter (April – June 2022), since over 70% of nursing homes are not in compliance,” he said.  

“While April-June was a sample, the fines go into effect for July-September and we will receive a similar notice in just a few weeks, with only 10 days to pay the fine,” says Nyberg, stressing that these fines will only increase going forward if nursing homes are unable to meet the minimum staffing ratio.

Nyberg calls on the Rhode Island General Assembly to rescue Rhode Island’s nursing homes and provide relief from these penalties by delaying them and exploring an alternative approach to support the efforts of nursing homes to meet the ratio.  He warns that the current fine-based approach is excessive and counterproductive and will lead to reduced access to care and threaten the survival of the state’s nursing homes.

Nyberg points out that the current workforce shortages are already preventing nursing homes from filling open positions, limiting new admissions, and forcing organization closures (five nursing homes have already closed since the COVID pandemic began).  These challenges are also resulting in backlogs at hospitals, which are unable to discharge patients due to reduced capacity in nursing homes.  

“We are working with numerous stakeholders on various initiatives to develop a pipeline of workers, but the simple fact is that it will take time.  In addition, as you know, the industry has faced years of underfunding from Medicaid, which pays for the majority of nursing home care.  This has made recruiting and retaining workers more difficult than ever,” says Nyberg. 

John Gage, President of the Rhode Island Health Care Association (RIHCA) agrees with Nyberg’s assessment of the nursing home workforce.  “Nursing homes across the nation are facing an historic labor shortage as the direct result of chronic Medicaid underfunding and the devastating impact of the Covid-19 pandemic on the workforce, he says, noting that the state’s nursing home workforce is down 20% since the start of the pandemic, with 2,000 workers lost from Jan. 2020 to June 2022.  Nationwide, the nursing home workforce is down 210,000 workers.

According to Gage, Rhode Island’s staffing mandate, while well-intentioned, will siphon tens of millions of dollars from resident care. In the first year of full implementation of the state’s minimum staffing mandate, RIHCA estimates that facilities will be fined upwards of $60 million. “These fines will imperil care, not bolster it,” he warns.  

Without legislative action, Rhode Island nursing homes will be fined an estimated $11 million on or about February 28, 2023, because of their inability to attract workers to meet the mandate from July 1, 2022, through September 30, 2022, Gage charges. “There are simply not enough available workers to fill the open staff positions, and resources are scarce.  Nursing homes will be devastated by these fines.  Facilities will reduce admissions, backing up hospital referrals and clogging hospital beds.  More nursing facilities will close – five have already closed since the beginning of the pandemic,” he predicts.  

Gage asks, “Who will care for Rhode Island’s frailest elders?” To recreate a minimum staffing mandate in nursing homes on the federal level would be a huge mistake, especially given the historic workforce crisis here in Rhode Island and nationwide,” he says.  

Gage’s comments echo concerns expressed by another group of US Senators in Jan. 20 correspondence (https://www.tester.senate.gov/wp-content/uploads/1-20-23-Nursing-Home-Staffing-Mandate-Letter-FINAL.pdf) sent to CMS by Senators John Bourasso, Jon Tester, and eleven other US Senators.  They caution the agency that a one-size fits all mandate would undermine access to care for patients, and they encouraged CMS to work with Congress on tailored solutions that address the workforce challenges facing nursing facilities.

At the federal level

Just days ago, U.S. Senators Bob Casey (D-PA), Chairman of the Senate Committee on Aging, and Ron Wyden (D-OR), Chairman of the Senate Finance Committee, called on the Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to encourage the federal agency to establish minimum staffing standards in nursing homes to ensure high-quality care for nursing home residents. In Feb. 10 correspondence, Casey and Wyden, along with Senators Sherrod Brown (D-OH), Kirsten Gillibrand (D-NY), Richard Blumenthal (D-CT), Cory Booker (D-NJ), and Elizabeth Warren (D-MA) urged CMS to advance the agency’s ongoing study to determine adequate staffing requirements in nursing homes.

“We appreciate the work that CMS has undertaken to promote safety and quality in nursing homes and applaud the Biden-Harris Administration’s commitment to protecting our nation’s seniors,” said the senators in Feb. 10 correspondence, urging CMS to “bring this work to completion.” 

“In our view, that means continuing the agency’s ongoing study to determine the level of staffing that is necessary to ensure safe and high-quality care for nursing home residents, developing an evidence-based and actionable proposal for mandatory minimum staffing levels, and a robust and transparent process—including direct stakeholder engagement— that will allow for further discussion and fine-tuning of requirements before the proposal is finalized,” wrote the senators.

The senators noted that studies have shown a correlation between inadequate staffing levels and lower quality of care. More recent studies have demonstrated that higher nurse staffing ratios mitigated the effect of COVID-19 outbreaks in nursing homes and resulted in fewer deaths. A recent Department of Health and Human Services Office of Inspector General report examining the high level of COVID-19 infections in nursing homes also pointed to the need for the establishment of minimum staffing requirements.  

In the correspondence, the senators cite the Social Security Act, which requires skilled nursing facilities to “provide 24-hour licensed nursing service which is sufficient to meet nursing needs of its residents,” including the services of a registered nurse at least 8 consecutive hours per day, 7 days a week. The letter commends CMS for working to update this vague standard that has led to substantial variation in staffing levels and quality of patient care across facilities.

“Achieving the shared goal of ensuring quality care in nursing homes nationwide is a complex undertaking, says LeadingAge’s Ruth Katz, senior vice president, policy. LeadingAge is an association of nonprofit providers of aging services, including nursing homes.

“As our Get Real on Ratios proposal highlights, a number of conditions must be met in advance of any mandate implementation,” suggests Katz. “The senators correspondence to CMS is a promising development; it covers many of the same points as our Get Real on Ratios proposal – a recognition of the critical need for adequate reimbursement; that one size does not fit all, and that workforce shortages will need to be addressed with additional support. Without addressing these, staffing mandates are impossible. We look forward to continuing our discussions with Congressional leaders on this critical issue so that older adults and families can access much-needed care and services,” she says.

“The Senior Agenda Coalition of RI fully supports the need to develop national staffing standards to ensure quality care is provided to nursing home residents across our nation. It is important to note that Rhode Island has been a leader in this area. For many years our state has required 24/7 RN coverage in nursing homes and in 2021 the legislature passed the Nursing Home Staffing and Quality Care Act that includes staffing standards,” says Maureen Maigret, Policy Advisor to Senior Agenda Coalition of RI. “Now we must work to address workforce shortage issues and ensure that adequate government resources are provided especially through Medicaid payments so the standards can be met, and our critical direct care workers receive competitive living wages in order to keep them working in long term care,” she adds.

As the House Leadership hammers out the FY 2024 budget, it is crucial that adequate Medicaid funding is allocated to allow nursing homes to attract the necessary staff to meet the state’s minimum nursing standards that it codified into law. We must address this policy problem now rather than just kick the can down the road.