Tracking legislation of interest to seniors as RI General Assembly wraps up – Herb Weiss

Published in RINewsToday on June 28, 2021

 In the waning days of the 2021 legislative session, RI House lawmakers approved a $13.1 billion state budget for the 2022 fiscal year (by a party-line vote of 64 Democrats to 10 Republicans) that boosts key supports for vulnerable Rhode Islanders — particularly affordable housing and social services— without imposing any broad-based tax increases.

The budget plan also fully funds K-12 education, boosts support for higher education, restores funding to Eleanor Slater Hospital and funds a first-of-its-kind statewide program for police body cameras.  

Additionally, the budget codifies the state’s existing Livable Home Grant Program to provide subsidies (up to 50%) for certain disability and accessibility home modifications, which will enable older people to remain in their homes. The budget includes $500,000 for the Livable Home Grant Program.

At press time, the state budget moves to the Senate for consideration. Once passed by the upper Chamber and signed into law by Gov. Dan McKee, the budget covers the new fiscal year, beginning July 1.

In the Waning Days…

According to Larry Berman, the House’s Communication Director, 1,470 bills were introduced in the House and 978 in the Senate. According to the RI General Assembly’s bill tracker, less than 30 are identified as directly related to seniors.

Here is a sampling of these bills:

The Nursing Home Staffing and Quality Care Act, sponsored by Senate Majority Whip Maryellen Goodwin (D- District 1, Providence) and Rep. Scott A. Slater (D-District 10, Providence), sets minimum staffing levels for Rhode Island nursing homes and was signed into law by Gov. McKee, two days after General Assembly passage. The legislation (S 0002A, H 5012Aaa) will establish a minimum standard of 3.58 hours of resident care per day, initially, and 3.81 hours of resident care per day beginning January 1, 2023. The bill also provides funding to raise wages for direct care staff to help recruit and retain a stable and qualified workforce.

With final votes in both chambers, the General Assembly approved The Elder Adult Financial Act sponsored by Sen. Cynthia A. Coyne (D-District 32, Barrington, Bristol and East Providence) and Rep. Joseph J. Solomon, Jr. (D-District 22, Warwick). The legislation requires financial institutions to report suspected financial exploitation of seniors to the Office of Healthy Aging and authorizing them to temporarily hold transactions they suspect as such. The legislation will be sent to the governor for signature. The legislation (S 0264A, H 5642A) would require financial institutions to train employees to recognize indicators of elderly financial exploitation, and on their obligation to properly report it and place a hold on suspicious transactions. The legislation was the result of recommendations made by the Special Task Force to Study Elderly Abuse and Financial Exploitation, a group led by Sen. Coyne that met in 2018 and 2019 to explore the facets of elder abuse and make policy recommendations to address them.

Rep. Gregg Amore (D-District 65, East Providence) and Sen. Valarie J. Lawson’s (D-District 14, East Providence) legislation, The Uniform Control Substance Act, would exclude chronic intractable pain from the definition of “acute pain management” for the purposes of prescribing opioid medication has been signed into law by Gov. McKee. The legislation (H 5247A, S 0384A) calls for new guidelines for treatment of chronic intractable pain based upon the consideration of the individualized needs of patients suffering from it. The legislation acknowledges that every patient and their needs are different, especially those suffering from chronic pain. Chronic intractable pain is defined as pain that is excruciating constant, incurable, and of such severity that it dominates virtually every constant, moment. It also produces mental and physical debilitation and may produce a desire to suicide for the sole purpose of stopping the pain.

The House passed legislation sponsored by Rep. June S. Speakman (D-District 68, Warren, Bristol) to allow visitation for nursing home residents by a designated family member or caregiver during a state of emergency. Under the Rights of Nursing Home Patients legislation, an essential caregiver would be an individual—whether a family member or friend of a resident of a nursing home or long-term care facility – who is designated to provide physical or emotional support to the resident during a declaration of disaster emergency. The legislation (H 5543aa) would require the Department of Health to create rules and regulations providing for the designation of essential caregivers to provide in-person physical or emotional support to a resident of a nursing home or long-term care facility during the period of 15 days after a declaration of disaster emergency and until 60 days after the termination of the declaration. The bill would require DOH to develop rules and regulations on designating an essential caregiver and the criteria to qualify. Those rules would include health and safety regulations as well as requirements allowing an essential caregiver to have regular and sustained in-person visitation and physical access to a resident of the nursing home or long-term care facility. The bill now goes to the Senate, which on June 1st passed companion legislation (S 0006A) sponsored by introduced by Sen. Frank S. Lombardi (D-District 26, Cranston).

As part of its ongoing efforts of addressing the cost of prescription drugs, the RI Senate passed legislation that requires pharmaceutical companies to disclose drug pricing information and legislation would prohibit an annual or lifetime dollar limit on drug benefits. The first legislative proposal (S 0494A), which was introduced by Senate President Dominick J. Ruggerio (D-District 4, North Providence, Providence) would require the pharmaceutical manufacturers disclose to the Office of the Health Insurance Commissioner the wholesale acquisition costs of drugs if this cost is at least $100 for a 30-day supply. It would also require the disclosure of pharmacy benefit management information to include rebates, price protection payments and other payments that are saved by the pharmacy, health plan issuer or enrollees at the point of the drug. The second one, (S 0381A), which was introduced by Senate Majority Leader Michael J. McCaffrey (D-District 29, Warwick), would require that health plans that provide prescription drug coverage not include an annual or lifetime dollar limit on drug benefits. It would also cap out-of-pocket expenses that some consumers would be required to pay for prescription drugs.  The measures now move to the House for consideration.

The Senate also approved legislation sponsored by Sen. Melissa A. Murray (D-District 27, Woonsocket, North Smithfield) limiting insured patients’ copays for insulin used to treat diabetes to $40 for a 30-day supply. The legislation (S 0170A), which is part of the Senate’s prescription drug affordability legislative package, would apply to all insurance plans that cover insulin. Under the legislation, insurers would be required to cap the total amount that any covered person is required to pay for covered insulin at $40 for a 30-day supply, regardless of the amount or type of insulin prescribed. It also forbids that coverage from being submit to any deductible. The bill does allow insurers to charge less if they choose. The cost of insulin has risen sharply over the years, and the cost is much higher in the United States than in other countries.  Millions of Americans depend on insulin for the management of diabetes. The legislation goes to the lower chamber, where House Speaker Pro Tempore Brian Patrick Kennedy (D-District. 38, Hopkinton, Westerly) is sponsoring a companion bill (H 5196A).

Finally, the passed legislation sponsored by Sen. Valarie J. Larson (D-District 14, East Providence) would increase temporary caregiver benefits for Rhode Islanders. The bill (S 0688) increases temporary caregiver benefits to six weeks in a benefit year starting Jan. 1, 2022, and would increase temporary caregiver benefits to eight weeks in a benefit year beginning Jan. 1, 2023.Rhode Island was the third state in the nation to pass a paid family leave programs when it enacted the Temporary Caregiver Insurance program in 2013.  It provides up to four weeks of partial (about 60%) wage replacement for workers who need to take time from their jobs to care for a serious ill family member or to bond with a newborn, adopted or foster child.  The worker’s job and seniority are protected while the worker is on leave.An amended companion measure (H 6090A), sponsored by House Majority Whip Katherine S. Kazarian (D-District 63, East Providence) passes the House and now heads to the Senate for consideration.

Deputy House Republican Minority Leader, George Nardone (R-Dist. 28, Coventry, Rep. Michael Chippendale (R-Dist. 40, Coventry, Foster, and Glocester and Rep. Raymond A. Hull (R-District 6, Providence) submitted H 5547 to ensure proper, safe, and personal contact with loved ones in congregate care facilities.  The legislation addresses the COVID-19 mandates that denied access to individuals in hospitals, group homes, nursing homes, assisted living facilities and Veterans homes. The purpose of this legislation is to entitle all residents of healthcare facilities and group homes the opportunity to designate a support person for regular, in-person visits. The policy is designed to balance disease transmission protocols with the benefits of having a loved one present during a lockdown. The House Health & Human Services Committee recommended the legislation be held for further study.

Senate Minority Whip Jessica de la Cruz (R-Dist. 23, Burrillville, Glocester, North Smithfield, introduced S 644 to provide medical assistance coverage for medical services provided qualifying eligible recipients for community-based care. The Senate Health & Human Services Committee has also recommended the legislation be held for further study.

Thoughts from the Sidelines at AARP

AARP Rhode Island says they “…are thrilled that the Livable Home Modification Grant Program, which provides matching funds for needed construction to ensure that Rhode Islanders with disabilities can remain safely and comfortably at home, was included in the FY22 budget,” said AARP Rhode Island State Director Catherine Taylor. “That was the highlight of the budget for us. Codifying this program has been a major priority.

“Another important win was enactment of the Elder Adult Financial Exploitation Prevention Act. This law is an important new tool to fight for the one-in-five older Rhode Islanders who is a victim of financial exploitation, with an average loss of $120,000. AARP-RI wrote to Governor McKee urging him to sign this critical legislation and they are delighted that he has done so.  This will be a game-changer in the effort to protect the life savings of older Rhode Islanders.

“Now we have our eye on the number of prescription drug bills that we’ve been working hard on, and we’re hopeful they will see passage before the end of the session. At this time, there are four Senate-approved Rx bills that need action in the House, and we are eagerly awaiting House passage of Rep. Brian Patrick Kennedy’s insulin cap bill.

The Legislative session is expected to end by the end of next week. Stay tuned to see what legislative proposals ultimately make it to the Governor’s desk for signature.

UPDATE:

‘According to Maureen Maigret, Vice Chair of Rhode Island’s Long-Term Care Coordinating Council, a former state representative and Director of Rhode Island’s Elderly Affairs, one of the biggest wins for older adults in the budget — the expansion of the Office of Healthy Aging @Home Cost Share program to increase income eligibility from 200% of the federal poverty level to 250% and to include persons under age 65 with Alzheimer’s/dementia. “Over $2Mil in all funds was added to the budget to do this. It was promoted by legislation sponsored by Sen. Walter Felag and Rep. Joseph Solomon. An estimated 500 persons will get subsidized home care and/or adult day services with this expansion. It was a priority of the Aging in Community Subcommittee for several years,” she says. 

Maigret also notes that the budget also includes Medicaid rate increases for a number of home and community care providers designed to increase access to these options for persons needing care. “These include assisted living, adult day services, shared living and home care. Importantly, with the cost of so many basic services such as rent and food increasing it raises the amount of money a person on home care can keep to pay for living expenses before they must pay a share of the cost of the services,”

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The Slater Mill Field Trip: Following the Foot Steps of Samuel Slater

Published June 17, 2021 in Pawtucket Time’s Special Supplement, 100 Years/Old Slater Mill Association

In Pawtucket’s downtown, you will find historic Slater Mill, consisting of the Slater and Wilkinson Mill and the Sylvanus Brown House, sitting on five acres of land on both sides of the Blackstone river, a mill that celebrates America’s Industrial Revolution, to generations of visiting students.

Pawtucket resident Patricia S. Zacks fondly recalls her field trip to Slater Mill almost 60 years ago. “We were escorted single file by all the machines.  Some were even operational, she said.

Looking back, the former student from Curtis Elementary School says, “it was a rite of passage for every elementary student to pass thru the old mills doors,” says Zacks. “We went home with a little piece of cotton. It was a very special day for me,” she says.”

Like Zacks found out, the Slater Mill Field Trip is as iconic as many other Rhode Island institutions. Many Rhode Islanders between the ages of 10 and 75 have experienced this “rite of passage” of sorts for elementary school students in the state, particularly 4th graders.

As Authentic As You Can Get

“Slater Mill is authentic as you can get, it’s not recreated like many historical sites scattered throughout the nation,” says President Robert Bllington, of the Blackstone Valley Tourism Council. “When visiting, the young students walk on 200-year-old floors, he says, actually walking on the fir wooden planks that Samuel Slater, the Father of the American Revolution” once walked on.

“It’s hard to find a museum that makes things right in front of your eyes.  Slater Mill is that place for the young students,” he notes.

Although, Older Slater Mill Association’s (OSMA) Bylaws recognized the museum’s important role in educating children to future careers in the textile industry, things didn’t happen immediately.  In 1921, the non-profit was founded, saving the historic mill. Efforts to restore the mill began in 1923, restoring the mill to its 1835 appearance.  During a 1961 Annual Meeting, OSMA President Norm MacColl recalled the mill for “nearly 30 years stood as a shell, seldom used and sparely visited.”  He suggested that there was not an education program nor much student visitation prior to this.


Student visitations began in the mid-1950s, when East Avenue School in Pawtucket and schools as far away as South Orange, New Jersey, New York City, came to the City to visit the mill.  Admission fees for the visiting students were kept affordable by the OSMA, with adults being charged 50 cents and 25 cents for children. 

In 1962, a new record was set as 28,648 visitors came to Slater Mill, half being students. By 1974, inflation and the energy crisis had an impact on student visits to the mill.  During this year, OSMA hired Cynthia Dougherty to be its first dedicated school services staffer, a position that would grew to a full-time Curator of Education.  OSM’s education staff “Museum on Wheels” program to bring Slater Mill’s history to the schools.

Tying into Educational Curriculum 

By May 2003, Slater mill staff were dressed in simple ‘period’ costumes, which were upgraded a few years later, says Rosemary Danforth, former Outreach Program Presenter, and an on-site Interpreter who joined the OSMA staff in 2002. “That became a selling point for some of the teachers,” she remembers.

OSMA staff worked closely with visiting teachers, coordinating the onsite experience with their curriculum, says Danforth, with staff fitting the tour to the specific educational level of the visiting students.  

Over the years, the number of students would fluctuate, being tied to gas shortages and the economy.  Just a few years ago state education policy advising that families should not be approached to support the cost of field trips due to potential inequities would reduce the number of student visits.

Funding to support the OSMA’s operations and programs would come from the City of Pawtucket, state and federal grants, civic groups including the Rotary Club of Pawtucket and from local businesses.  These contributions led to the first free field trip offerings for RI public schools.

Before the pandemic, Lori Urso, Executive Director of Slater Mill, recalls that “we typically had 7000 – 8000 students per year, counting those who came to the site, and those who’s schools our staff visited. Some years it even reached 10,000.  

Looking Forward

Today, visiting students don’t walk past metal railings to keep them from touching the machine exhibits.  The philosophy of hands-on experience is built into the ___ hour tour. For instance, a child is allowed to turn a small metal wheel.  An attached leather strap from its rim is connected to a smaller gear operating a drill press that ultimately drills a hole in a wooden spool.  

According to Urso, the Field Trip has evolved to a more STEAM-based, and place-based objective. In response to educator feedback asking for more hands-on activities at the museum, a fiber art studio component was introduced, with a participating artist, to compliment the science and tech aspects. It was a highly-praised program that unfortunately came to a halt with the onset of the COVID Pandemic, closure of schools, and elimination of field trip programs.”

“The timing of the return of the Slater Mill Field Trip remains unclear at the moment,” says Urso. “The National Park Service is eager to welcome students back to the mill in the future, but much of this depends on the policies of the individual school districts, and priorities for student and teacher safety,” she says.

Seniors would benefit in President Biden’s $6 trillion budget

Published in RINewsToday on June 14, 2021

On May 28, with the release of a $6 trillion budget for fiscal year (FY) 2022, President Joe Biden outlined his values and vision as to how he proposes to revive the nation’s sputtering economic engine as it emerges from the devastating impact of the COVID-19 pandemic. The 72-page budget document, “Budget of the United States,” (with more than a 1,400-page appendix) details his spending priorities that begin next Oct. 1. Biden’s generous budget depends on increasing taxes on America’s corporations (from 21 to 28 percent) and high earners, who received significant tax breaks from the President Trump/GOP tax cuts of 2017.

With the FY 2022 Budget pushing federal debt to the highest levels since World War 1I, Republican lawmakers quickly called the proposal “dead on arrival” in Congress.  However, Cecilia Rouse, chair of President Biden’s Council of Economic Advisors says the Biden Administration is willing to live with a budget deficit to invest in the economy now, especially with low interest rates to borrow; deficits can be reduced later. 

President Biden’s new spending under the just released proposed FY 2022 budget, recognizing his Administration’s priorities, reflects the major proposals already outlined under the administration’s $2.3 trillion American Jobs Plan and $1.8 trillion American Families Plan. Provisions in these two proposals would overhaul the nation’s aging infrastructure and invest in education, childcare, paid family and medical leave, fight climate change. 

President Biden’s spending plan also recognizes priorities outlined in the American Rescue Plan passed earlier this year as well as the Administration’s “skinny” discretionary budget request released in April. Most importantly, it reflects a commitment from the president to safeguard Medicare, Medicaid and Social Security.

Loving It or Hating It Depends on Where You Sit

In remarks delivered Thursday in Cleveland, President Biden made the case for his budget request and what he describes as an investment in the country’s future. “Now is the time to build [on] the foundation that we’ve laid to make bold investments in our families and our communities and our nation,” he said. “We know from history that these kinds of investments raise both the floor and the ceiling over the economy for everybody.”

In the FY 2020 Budget proposal’s “Message from the President”, Biden says, “The Budget invests directly in the American People and will strengthen the nation’s economy and improve our long run fiscal health. It reforms our broken tax code to reward work instead of wealth while fully paying for the American Jobs and American Family Plans over a 15- year period. It will help us build a recovery that is broad-based, inclusive, sustained, and strong,”

Of course, response to Biden’s Spending plan depends on which side of the aisle you are sitting.

House Speaker Nancy Pelosi (D-CA) released a statement strongly endorsing Biden’s fiscal blueprint. “Congressional Democrats look forward to working with the Biden-Harris Administration to enact this visionary budget, which will pave the path to opportunity and prosperity for our nation. The Biden Budget is a budget for the people,” she said.

On the other hand, Senate Minority Leader Mitch McConnell strongly opposing Biden’s Budget proposal. “Americans are already hurting from far-left economics that ignores reality,” said McConnell, in a statement. “The Administration’s counterproductive ‘COVID relief bill’ has slowed rehiring. Families are facing painful inflation, just as experts warned the Democrats’ plans might cause. And the Administration wants to triple down on the same mistakes?” said the six-term Republican Kentucky Senator.

With the Democrats holding the slim majorities in the House and Senate and controlling the White House, Biden’s FY 2022 Budget proposal will have more weight than if the Republicans were in the majority, says Dan Adcock, Government Relations and Policy Director at the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM).

According to Adcock, Biden’s funding numbers will change as his FY 2022 budget proposal goes through the appropriation process in the upcoming months. With its release, Congress can now begin negotiating funding levels and spending bills. Competition for a finite amount of funding will ultimately result in funding level ultimately allotted to programs and agencies by each of the 12 appropriations under their jurisdiction. Funding for most programs important to older Americans is under the jurisdiction of the Subcommittee on Labor, Health and Human Services and Education.

“With 10,000 Baby Boomers turning 65 every day – and the number of seniors projected to double by 2050 – it’s clear that President Biden understands the need to safeguard the older Americans he calls ‘pillars of every community – now and into the future.” Says Max Richtman, NCPSSM’s President and CEO.

Slashing Drug Costs to Pay for Expanding Medicare Coverage

Richtman says that Biden’s fiscal blueprint calls on Congress to allow Medicare to negotiate prices for certain high-cost, life-saving drugs that many seniors currently cannot afford and to require manufacturers to pay rebates when drug prices rise faster than inflation. These reforms could yield over half a trillion in federal savings over 10 years, which could help pay for coverage expansions and improvements, including access to dental, hearing, and vision coverage in Medicare,” he notes. Today, traditional Medicare does not cover routine care like dental checkups or hearing aids.

According to Richtman, President Biden’s budget also includes more than $400 billion in new spending over ten years to expand Home and Community-based Services (HCBS) for low-income seniors and people with disabilities who prefer to receive skilled care in the comfort of their homes and communities, even moreso after the devastation COVID wrought on nursing homes.  

In states that have not taken advantage of Affordable Care Act (ACA) opportunities to expand Medicaid, the budget proposes providing premium-free, Medicaid-like coverage through a federal public option, along with incentives for states to maintain their existing expansions. 

Biden’s FY 2022 budget also urges Congress to improve customer service for Social Security beneficiaries to prescription drug pricing reform to expanded HCBS, adds Richtman.  It also proposes a $1.3 billion (or 9.7%) funding increase for the Social Security Administration.  The increase seeks to improve customer service, including services at SSA’s field offices, state disability determination services, and teleservice centers.

 The Older Americans Act (OAA) provides funding for a wide range of home and community-based services, such as meals-on-wheels and other nutrition programs, in-home services, transportation, legal services, elder abuse prevention and caregivers’ support. These programs help seniors stay as independent as possible in their homes and communities. 

For details about Biden’s FY 2022 Budget proposal and OAA funding levels, made available from the Washington, DC-based National Association of Area Agencies on Aging, go to: https://www.n4a.org//Files/FY22%20PresBudget%20and%20historical%20Labor-HHS%20Appropriations%20Chart.pdf

 Stay Tuned 

The House continues its work on hammering out appropriation bills through subcommittees in June and in the full House in July.  The Senate’s work is expected to begin in mid-Summer and to continue well into September. If the appropriate bills are not passed and signed into law by Oct. 1, Congress will need to pass a continuing resolution to fund the federal government into the first months of FY 2022.

Like most Budget proposals, especially in a partisan Congress, Biden’s spending plan will need to be rewritten to win support from lawmakers on both sides of the aisle. However, it will serve as a roadmap for a Democratic controlled Congress in crafting 12 appropriation spending bills. Partisan bickering during the appropriations process may well force passage of a continuing resolution before Oct. 1 to block a government shutdown.