New Legislative Commission to work on improving programs, services to seniors

Published in RINewsToday on June 19, 2023

During May, designated as Older Americans Month, the Rhode Island House of Representatives approved H 5224-SUB A, sponsored by House Deputy Majority Leader Lauren H. Carson (D-District 75, Newport), creating a legislative commission to study the services and programs for 240,000 older adults in Rhode Island – and to make recommendations for ways to improve and coordinate them. The number of seniors is expected to skyrocket to almost 265,000 by 2040, constituting an increase of nearly 75% since 2010.

On May 11, 2023, over three months since the resolution was dropped in the legislative hopper, it passed by a whopping bipartisan vote of 69 to 0 (with 6 members absent). There was no opposition to H 5224- SUB A from any organization. It seems that any House lawmaker or organization opposing this resolution would also oppose “motherhood and apple pie.”

With a number of House GOP concerns addressed in the state’s $14 billion budget, House Minority Leader Michael Chippendale directed his caucus to support passage. The House Republican Caucus also unanimously voted for H5224 – SUB A, and fully supported the mission of a legislative commission which is charged with collecting and analyzing the current state of affairs in regard to Rhode Island’s growing senior population.

Carson’s resolution calls for “a collaborative study of Rhode Island’s current services, and recommendations for potential initiatives that would help residents, agencies, providers, and the government to better assist the growing population of older adults in our state achieve well-being and maximum independence in ways that value, empower and engage them,” adding that such an effort is essential to the state’s future resilience and prosperity.

According to House Communications Director Larry Berman, 21 House legislative Commissions will be operational when Carson’s legislative commission becomes operational. The House Policy Office will staff the Commission. The number of meetings (open to the public) has not yet been determined. The meeting agenda will be determined by its Chair, with input provided by the 16 Commission members, House lawmakers, members of the public, and aging advocates.

Because H 5224 – SUB A only creates a House legislative commission, there is no need for a companion measure to be introduced in the Senate,” says Berman who notes that this Commission will begin in the Fall of 2023. It is charged to report its findings and recommendations to the House of Representatives no later than May 7, 2024. The Commission would then expire on August 7, 2024.

Providing a Road Map to Fix Systemic Policy Flaws

“This commission will provide valuable information to the House next year to provide a roadmap for providing service and programs for older Rhode Islanders, including funding options that will be strongly considered,” stated House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick), after passage of the special legislative committee.

“We have had excellent results with other commissions that have studied housing and shoreline access that have led to legislation that the General Assembly has adopted. Representative Carson is an extremely thoughtful and dedicated legislator who will work hard with commission members to develop great plans for the future,” says Shekarchi.

“Rhode Island should invest much more than we do in services that enable people to age in place and safely remain in their communities. Those services are far more cost-efficient overall, and encourage an active, more fulfilling lifestyle for people as they age. Considering that nearly a quarter of our population is over 60, and Baby Boomers will continue to swell those ranks, now is the time,” said Carson. “This commission will take a look at the services we have, how we could improve and better coordinate them and offer them to more individuals, where the gaps and needs are, and what we need to do to better enable our population, as we grow older, to safely remain in the community and lead full lives,” she says.

The 16-member commission, all appointed by the House Speaker, will include three members of the House of Representatives, two Rhode Island residents over the age of 65, three directors from the Rhode Island Senior Center Director’s Association, a community action program director from the Rhode Island Association of Community Action Agencies, a member of the Long-Term Care Coordinating Council, and a member of a Rhode Island organization representing adults with disabilities.

In addition, the directors of the Office of Healthy Aging, the Department of Health, AARP Rhode Island, Age-Friendly RI and the Senior Agenda Coalition of RI or their designees will participate.

H 5224 – SUB A instructs the commission to study key statistics about services for older adults in Rhode Island, examining strengths, vulnerabilities, and demographic and financial statistics; assess the current state, federal and local services currently available, as well as any duplication of services; recommend ways to coordinate services within agencies and focus on better service delivery, including housing options and various living arrangements, health status and health care resources; provide recommendations for the creation of a portal to coordinate aging services in employment, education, independent living, accessibility and advocacy, as well as local older adult centers and services; provide recommendations on mental health, transportation, food access, and health care; provide recommendations for the funding of services through state, federal and private grants and for more efficient distribution and use of these dollars; and explore more regionalization of services.

Towards the Creation of a Strategic State Plan on Aging

“The newly established legislative commission to study the services and programs for our rapidly growing older population can become the launching pad for the state to move forward to create a multi-sector Strategic State Plan on Aging to coordinate Rhode Island’s programs and services for older Rhode Islanders, says Maureen Maigret chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council who also serves as a policy consultant and board member of the Senior Agenda Coalition of RI. She notes that 10 states have already developed this “master plan” and she hopes Rhode Island will also join their ranks.

At the Senior Agenda Coalition of RI’s August 2022 Gubernatorial Forum, she warned that the state’s aging and long-term services were fragmented, spread across a number of state agencies, charging that these agencies often lacked stable leadership and a coherent and overarching vision. Creating a Strategic Plan on Aging builds on work being done now by the Office of Healthy Aging and Subcommittees of the Long Term Care Coordinating Council, and would be a fix for this,” says Maigret.

According to Maigret, at the August Forum Gov. Dan McKee stated he would issue an Executive Order for initiating a Master Plan on Aging, but that has not happened. Aging advocates are still waiting for this to happen.

“We look forward to joining with older-adult focused direct service, advocacy, non-profit, and state colleagues, and older adults themselves, to discuss how Rhode Islanders want to age and what we can build collectively to make that possible, says Director Maria Cimini, of the state’s Office of Health Aging (OHA).

“At the OHA we are thrilled there is interest and a commitment of time and resources to understand and plan for our state’s aging population, from where we sit, this opportunity will equip us to advocate for policies that empower and uplift our senior population, fostering dignity, purpose, and respect for all older adults,” adds Cimini.

Don’t Forget the Rhode Island’s Poor and Minority Elders

Susan Sweet, long-time advocate for poor and disadvantaged elders and the founder of The R. I. Minority Elder Task Force which provides limited financial assistance to low-income seniors in crisis reports: “We are seeing a large uptick in elders in crisis situations lacking basic needs such as food, utilities, housing, and personal items. Minority group members, immigrants, retirees as well as general population seniors are suffering more intensely since Covid, inflation, and lack of affordable housing matters have exacerbated the existing poverty among elders. In particular, homelessness among elders is at a peak we have not seen before.”

Sweet is hopeful that this new Legislative Commission will consider and react to the particularly difficult situations that confront the poor and minority elder populations. “I have seen many plans for services to elders that either ignore or do not implement agenda items addressing these populations and I hope that this commission will prioritize the severe privations that they face on a daily basis,” she says.

“With the lessons learned over the past 2 years and the devastating impact of COVID on our older adults, it’s critical that we reexamine our aging infrastructure, the needs for services, and the local service capabilities to this growing population,” Vin Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service agency.

“A serious, adult conversation is long overdue with the aging community, service providers and lawmakers about designing our plan for a more “Age-Friendly” RI, – which supports local senior centers as the local hub for the delivery of services,” suggests Marzullo.

The nursing home industry supports the mission of the newly enacted legislation committee. “Included in their charge is to, among other things, provide recommendations regarding available health care services. Rhode Island’s nursing facilities play a vital role in health care for our older adults – providing care and services to over 18,500 seniors each year. Many of these individuals are provided with short-term skilled nursing, physical, occupational and/or speech therapy following a hospitalization – enabling them to safely transition from the acute hospital level of care back home with continued services,” says John E. Gage, President and CEO of the Rhode Island Health Care Association.

“Of course, every Rhode Islander wants to remain independent, healthy and in their home for as long as possible. When this is no longer viable, however, our state needs a strong spectrum of care, including home care, assisted living residences and skilled nursing facilities to support them as their care needs change. Workforce is perhaps the most daunting challenge facing these health care providers, and this will need to be a focus for years to come,” notes Gage.

H 5224 A cosponsors are Representatives Samuel A. Azzinaro (D-District 37, Westerly), Thomas E. Noret (D-District 25, West Warwick), Susan R. Donovan (D-District 69, Bristol, Portsmouth), House Majority Whip Katherine S. Kazarian (D-District, East Providence), Karen Alzate (D-District 60, Central Falls, Pawtucket), Jason Knight (D-District 67, Barrington, Warren), and Kathleen Fogarty (D-District 35, South Kingston.

A copy of H 5224 A may be accessed here: http://webserver.rilegislature.gov/BillText/BillText23/HouseText23/H5224A.pdf.

The House Floor vote (5/11/23) – 48 minute 48 second mark may be accessed here: https://ritv.devosvideo.com/show?video=d12583542bad&apg=84a99049.

The Health & Human Services Committee heard this resolution on March 15, 2023. See the 1hour and 50-minute hearing by going to https://ritv.devosvideo.com/show?video=e3ea82fcb949&apg=6aae3d42)

Herb Weiss, LRI -12, is a Pawtucket-based writer who has covered aging, health care and medical issues for over 43 years. To purchase his books, Taking Charge: Collected Stories on Aging Boldly and a sequel, compiling weekly published articles, go to herbweiss.com.

A Call for Supporting the Nation’s Caregivers

Published in RINewsToday on June 12, 2023

Just 519 days until the 2024 Presidential Election (Nov. 5, 2024), older voters call on Congress to provide more support for the nation’s family caregivers, according to a new AARP Family Caregiving study, released on May 5, 2023, conducted by the bipartisan polling team of Fabrizio Ward and Impact Research.

Former First Lady, Rosalynn Carter, observed that “there are only four kinds of people in the world. Those who have been caregivers. Those who are currently caregivers. Those who will be caregivers, and those who will need a caregiver.” The results of AARP’s survey of U.S. registered voters, compiled in the 26-page report, U.S. Voters’ Views on Support for Family Caregivers, gives weight to the truth behind Carter’s quote as one-third of the voters in this study were caregivers in the past, one-fifth are currently caregivers, and half expect to be a caregiver in the future.

Caregivers Call for Government Support

According to AARP, this is especially true for those age 50 and older: over two-thirds of voters, and 75% of voters 50+, say it is very important for Congress to help seniors live in their own homes. More than half (57%) say the same for supporting unpaid family caregivers, notes the poll’s findings.

An overwhelming majority of voters, 78%, are either a current, past, or future family caregiver. Over 70% of voters across the political spectrum say they would be more likely to support a candidate who backed proposals to support family caregivers, such as a tax credit, paid family leave, and more support and respite services.

“Family caregivers are the backbone of a broken long-term care system, providing $600 billion in unpaid labor each year and saving taxpayers billions,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy and Engagement Officer in a statement announcing the release of the poll findings. “It is long past time for lawmakers to enact commonsense solutions that support family caregivers and help older Americans live independently in their homes, where they want to be,” she says.

The poll’s findings indicate that legislative caregiving proposals are strongly supported across party lines: 89% of Democrats and 72% of Republicans support expanding services to help seniors live at home in the community rather than in a nursing home. Requiring minimum staffing standards in nursing homes so residents receive quality care is supported by 8 of Democrats and 74% of Republicans polled in this survey.

The researchers say that black voters, women, Democrats, and Latinos are especially likely to see long-term care and support for caregivers as key issues to be addressed by Congress. Among those groups, 77% of women, 82% of Black voters, 71% of Latinos and 77% of Democrats say expanding services to help seniors live independently in their own homes instead of a nursing home is very or extremely important.

Most caregivers feel stressed emotionally, stretched thin in both time (18%) and money (18%), and overwhelmed; 40% of all family caregivers say they spend over 20 hours a week on caregiving, with almost half (48%) of women caregivers spending over 20 hours a week.

“Anxiety over caregiving is not limited to those currently providing care,” says AARP, noting that more than two-thirds of voters express concerns about whether they will be able to get the care they need as they grow older or live independently.

“The data is clear: regardless of your political stripes, people adamantly want to age at home rather than a nursing home,” said Tony Fabrizio, partner in Fabrizio Ward, noting “It’s why support for helping caregivers is so politically important.”

“Family caregivers are stressed emotionally and financially, and proposals to help them are overwhelmingly popular and key to helping older Americans remain in their homes,” said John Anzalone, founder of Impact Research. “This may be the sleeper issue of the 2024 elections with a voting group that makes up one in five Americans,” he says.

Caregivers Need Assistance

For many caregivers, providing care to their loved ones takes a big chunk out of their yearly finances, and time that they must give to providing the caregiving. According the AARP’s report, four in ten family caregivers report spending over 20 hours a week on their caregiving responsibilities, while roughly six in ten incur $1,000 or more in annual out-of-pocket expenses on items such as medical supplies and equipment, transportation, or home modification. Emotional stress, having to miss important events, and needing to balance their work, family, and caregiving responsibilities are impact the majority of family caregivers.

When asked what they would like Congress or their state government to do, family caregivers say they would like increased access to healthcare and financial support. Seven in ten voters ages 18 and older say they would be more likely to support a political candidate who backed legislative proposals to support family caregivers, such as paid family leave; a tax credit of up to $5,000; and expanded access to support and respite services. These policies would allow family caregivers an opportunity to take a break from caregiving, helping to prevent their burnout and allowing them to continue providing caring for their loved ones.

According to the polls findings, most voters ages 18 and older express concern about whether or not they will be able to get the care they need when they grow older. Roughly two-thirds says they are concerned they won’t have enough money to pay for the care they need, or they won’t be able to live independently at home, while six in ten are worried that they will need to live in a nursing home providing poor care.

The Support for Family Caregiving study was conducted by the bipartisan polling team of Fabrizio Ward and Impact Research for AARP. The poll used a sample of U.S. voters age 18 and older (with oversamples of voters age 50 and over, black voters, Hispanic voters, Asian and Pacific voters and family caregivers) using a combination of phone and text to web sampling. A total of 1,425 completed 20-minute in length interviews, were conducted in English from April 4-10, 2023.

The margin of error for the 1,425 adults’ sample is +/- 3.4% at the 95% level of confidence. For the oversampled groups, the margins of error are: +/- 3.4% for voters 50+, +/- 6.9% for Black and Latino voters, +/- 8.9% for AAPI voters, and +/- 4.9% for voters 50+.

To see poll findings, go to https://www.aarp.org/content/dam/aarp/research/surveys_statistics/ltc/2023/voters-views-caregiving-support-report.doi.10.26419-2Fres.00616.001.pdf.

For more details, contact Teresa Keenan, AARP’s Director, Consumer Insights, Health and Health Security, at TKeenan@AARP.org.

Path to an “age-friendlier” budget

Published in RINewsToday on June 5, 2023

After a 47:10 minute meeting on Friday night, the House Finance Committee approved a $14 billion budget for the 2024 fiscal year that commits funding toward addressing the housing crisis (top priority), supports business development and makes education funding more equitable while limiting the use of one-time revenue to one-time expenditures.

The passed budget reflects the May revenue estimate that was $61.2 million lower than projected last November.

On June 2, 2023, the budget passed on a partisan vote of 13-3, sending the budget bill (2023-H 5200A) to the full House of Representatives, which is slated to take it up June 9 at 2:30 p.m. Changes could be made.

Hammering Out a Compromised Budget

At a news conference held on Friday at 3:30 p.m. before the vote, House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick) compared the politics of hammering out the state budget proposal to Democratic and GOP leadership making a deal to avoid a national default earlier this week. “Nobody, including me and everyone else here, got everything they wanted,” he said, noting that the state budget required “compromise.”

“Our goal with this budget is to support Rhode Islanders’ needs while responsibly preparing for our future. Our top priority, of course, is addressing our housing crisis, and we have worked hard, in collaboration with Governor McKee and our colleagues in the Senate, to identify the most effective ways we can direct the funding we have toward solutions that will help create more affordable housing access. This budget also strengthens our efforts to provide educational opportunities in K-12 and higher education and supports businesses, working Rhode Islanders, retirees and those struggling to meet their families’ basic needs,” said Shekarchi, in a statement announcing the House Finance Committee’s passage of the budget.

“At the same time, we are being realistic. Given the end of the federal funding related to the pandemic, we need to plan not only for next year, but for the following years, when we are not going to have the level of revenue we’ve been fortunate enough to have for the past few years. We are spending our remaining federal COVID funding and our available revenue on one-time investments rather than creating long-term commitments that we can’t sustain,” he said.

Adds Marvin L. Abney (D-Dist. 73, Newport, Middletown), chairman of the House Finance Committee: “This budget was carefully crafted so that our residents, particularly our most vulnerable, retain the supports and assistance that they and their families need, so that our businesses have the ability and opportunity to grow, and so that Rhode Island is situated to withstand a very possible financial downtown that will affect both our state and national economies. Responsible, compassionate and thoughtful decisions were made to create a budget that will benefit all Rhode Islanders and this budget positions the state to be as competitive as possible into the future.”

Taking a Look at Aging Programs and Services

“I am extremely pleased the budget passed by the House Finance Committee contains important funding that will benefit seniors as well as older adults with disabilities,” says Maureen Maigret, chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council and policy consultant and board member of the Senior Agenda Coalition of RI. “The Office of Healthy Aging (OHA) will receive an additional $250,000 in general revenue for the Aging and Disability Resource Center (ADRC). The ADRC provides counseling about services and benefits and assistance with the application process. Advocating to strengthen the ADRC (called the POINT) was a high priority for the Senior Agenda Coalition of RI and the Aging in Community Subcommittee of the Long Term Care Coordinating Council,” says Maigret.

According to Maigret, this is the first time that ADRC will receive state funds. To date, it has operated with limited federal dollars and too many persons are not aware of the program. The state funding can be matched by federal Medicaid funds. “ADRC services are critically important for older adults, persons with disabilities and family caregivers, as they attempt to find appropriate services and navigate a sometimes-fragmented system of care, says Maigret.

Maigret says that the budget also adds funds to support two new staff positions for OHA’s protective services unit to deal with increasing reports of elder abuse and exploitation. OHA’s Adult Protective Services received over 6,000 calls last year. The additional funding for these positions will ensure that reports are investigated in a timely manner and protect older adults at risk of abuse and neglect.

Other notable additions to the budget include an increase in the Personal Needs Allowance (PNA) for nursing home residents on Medicaid to $75/month (from $50.) This amount had not been adjusted since 1999, says Maigret noting that the additional funding will help thousands of nursing home residents pay for such items as haircuts, clothing and, telephone service.

“The House Finance Committee also added $250,000 to increase funding for the Livable Home Modification grant program to $0.8 million,” says Maigret, noting that the program helps pay for costs of support home modifications and accessibility enhancements to allow individuals to remain in community settings. And of course, the funds dedicated to addressing housing affordability although not specific to the older population will benefit them,” adds Maigret. “Overall, these budget additions and the additional funds for community senior services and Meals on Wheels proposed by the Governor demonstrate a continued commitment on the part of our state leaders to address the needs of our growing older population,” she says.

The budget didn’t reinstate the retiree Cost of Living Adjustments (COLAs) eliminated in 2011. “Once again, retired state workers, teachers, and municipal retirees who are part of the state retirement system have been shown how little they are valued by state legislators”, comments Susan Sweet, a former state associate director of elderly affairs and an advocate for low-income elders. “Although there were many bills in to restore the COLA or at least provide a token payment to these retirees, it appears that no funds at all are being directed towards that purpose. This is a great disappointment to so many folks who faithfully performed their duties and were stripped of their promised pensions. No wonder that teachers and government workers are reluctant to spend their career lives in the public sector” she states.

Is Proposed House Budget “Age Friendly” ?

Maigret believes that the state has taken some positive steps toward becoming “age friendly” especially if we think of age-friendly with an intergenerational lens. Items that address children and youth such as expanded tuition assistance of Rhode Island colleges are important. “However, we still have a long way to go in many of the domains for age friendliness,” she notes, “especially in the area of economic security for older adults as many live with income less than $25,000 relying mostly on fixed incomes.”

Maigret calls on the Rhode Island General Assembly to fund mini-grants to communities to incentivize them to “look at their comprehensive plans with age-friendly lens.”

Here is the link to the bill to establish the budget:

Click to access H5200A.pdf

Here is the link to the entire budget and every article (as well as how it compares to the budget as submitted by the Governor in January): https://www.rilegislature.gov/Budget/SitePages/FY24.aspx.

Here is a link to a press release which contains a summary of the highlights of the budget:

https://www.rilegislature.gov/pressrelease/_layouts/15/ril.pressrelease.inputform/DisplayForm.aspx?List=c8baae31-3c10-431c-8dcd-9dbbe21ce3e9&ID=373660.

To watch the House Finance Committee meeting, go to https://ritv.devosvideo.com/show?video=defebab838c1&apg=52ab780b.