When the dust settles. Looking back at 2024’s legislative days

Published in RINewsToday on June 24, 2024

Over a week ago, after being in session for 49 legislative days (opening day was Jan. 2, 2024), the Rhode Island General Assembly held its final session at 4pm on June 13, 2024, and ended at about 1:30am on June 14, 2024. During this year’s legislative session 1,167 bills and resolutions were introduced in the Senate, and 1,369 in the House. This total does not include Resolutions, which were  congratulatory in nature or noted prominent Rhode Island residents who have passed away.

With the dust settling at the end of this year’s session, there were 249 bills that passed both the House and Senate, and that are now sitting on Gov. Dan McKee’s desk for his signature to enact, or to pass without signature, or to be rejected.

“This was an outstanding legislative year for Rhode Island’s seniors,” observes House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick). “In addition to all the investments for seniors made in the state budget that has been signed by Governor McKee, there were excellent bills that will be of great benefit to our aging population, he says. 

Attacking the housing crisis head on

In a joint statement, the House Speaker and Senate President Dominick Ruggerio said, “It is critical to attack our housing crisis from many different angles. Allowing ADUs in other states has been proven to make a significant impact by immediately increasing available housing supply.  We are confident that ADUs will be beneficial for the many Rhode Islanders who need flexibility in housing options, particularly seniors wishing to age in place in their communities,” they say.

Shekarchi points out the enactment of ADU legislation sponsored by House Commission on Housing Affordability Chairwoman June S. Speakman (D-Dist. 68, Warren Bristol) and Sen. Victoria Gu (D-Dist. 38, Westerly, Charlestown, South Kingston) that would boost the development of accessory dwelling units (ADUs), which are also known as in-law apartments. The House Speaker is the House bill’s top co-sponsor.

“I have heard from so many seniors who would like to downsize and continue to live independently, but would enjoy the extra assurance of living on the property of their children,” he noted, thanking AARP Rhode Island and housing advocates, including Rhode Island Housing, Grow Smart RI and Housing Network RI, who pushed this “significant legislation” across the finish line. 

The bills (2024-H 7062A2024-S 2998A) would provide homeowners statewide the right to develop a single ADU on an owner-occupied property or within the existing footprint of their structures or on any lot larger than 20,000 square feet, provided that the ADU’s design satisfies building code, size limits and infrastructure requirements.

The purpose of the bill is to encourage the development of rental units that are likely to be more affordable than many other apartments, and also to provide opportunities for homeowners with extra space to generate income that helps them maintain ownership of that property.

To ensure that the bill achieves its goal of housing Rhode Islanders, the legislation prohibits ADUs constructed under this provision from being used as short-term rentals, and streamlines the permitting process.

In the HEALTH arena

According to Senate President Dominick J. Ruggerio, several legislative proposals in the Senate’s health care package passed the General Assembly.

“Few issues are as important as health care, and right now, our health care system is in critical condition. Health care absolutely must be accessible and affordable for all Rhode Islanders,” says Ruggerio, noting that for too many people in the Ocean State is too expensive or too difficult to get. “And we know that many health care providers are feeling enormous strain due to many factors,” he adds.

“Like providers and consumers, our community hospitals, including Fatima in my district, are facing difficult circumstances,” said the Senate President, who recognized his Senate colleagues in the development of this package of legislation.

“As we celebrate our victories in the 2024 session, we are committed to continuing our work on this issue and accomplishing all the objectives of the HEALTH initiative. “

According to Ruggerio, several legislative proposals in the Senate leadership’s HEALTH (Holistic Enhancement and Access Legislation for Total Health) initiative include legislative proposals to join five interstate licensing compacts to make it easier for Rhode Islanders to access the care they need and budget provisions to use $1 million of general revenue to purchase debts of struggling Rhode Islanders and incentivize providers to enter primary care fields.

Advocates on aging give their recap of the 2024 Legislative Session

“The Senior Agenda Coalition of RI supported several housing-related bills (that did not pass) that would benefit older adults including those sponsored by Rep. Meghan Cotter (D-Dist. 39, Exeter, Richmond, and Hopkinton)  and Sen. Linda Ujifusa (D-Dist. 11, Portsmouth, Bristol) to increase the income cap for the Property Tax Relief program to $50,000 and the credit or refund to $850 to help offset the costof property taxes and rents for older adults and persons with disabilities,” says Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of RI (SACRI), noting the Coalition plan to continue to advocate for them next year.

Maigret warned that with a growing older population the need for more accessible housing will increase and the Coalition supported and will continue to support bills to create greater accessibility in new housing.  

Maigret stated that SACRI will also continue to support legislation to create a caregiver tax credit as provided for in 2024 legislation sponsored this year by Rep. Susan Donovan and Sen. Linda Ujifusa. “Our caregivers are valued and deserve our support. A caregiver tax credit will help the many R.I. family caregivers who provide thousands of hours of care for spouses and parents often spending thousands of dollars of their own money to give their loved ones a better, more comfortable life,” she says.

She noted that SACRI also plans to build on its efforts to further expand the Medicare Savings Program to help more lower-income persons on Medicare afford needed healthcare by covering required co-pays and deductibles and to continue its work to promote quality long term care through support for staffing standards, worker training programs and Medicaid enhanced reimbursement for private rooms to help with infection control issues that became so apparent during the Covid pandemic.

SACRI will also push next legislative session to enact legislation to establish a formula for state funding to support local senior centers and programs based on a community’s population of those 65 years and over.  

Raise the Bar on Resident Care and other advocates successfully pushed the passage of H 7733 and S 2621 legislation sponsored by Rep. Scott Slater (D-Dist. 10, Providence) and Sen. Bridget Valverde (D-Dist. 35, (East Greenwich, North Kingstown, South Kingstown) that would establish the Nursing Home Work Standards Board (NWSB). According to Raise the Bar, NWSB will help stabilize the nursing home system by establishing training standards, promoting caregiver rights, depoliticizing funding allocations and implementing financial oversight of nursing homes.  A 13-member board (including frontline staff, nursing home management representatives, state government and community organizations will work with Medicaid to ensure comprehensive and informed decision-making.

“In 2023, Minnesota passed its own Nursing Home Workforce Standards Board and just voted to raise wages for caregivers to over $23 an hour in 2027 while guaranteeing 11 paid holidays. Here in Rhode Island, the Workforce Standards Board is a critical step toward transforming nursing home jobs into sustainable careers that can support a family and provide quality resident care. Now we need Governor McKee to show his support and sign this bill into law,” said Jesse Martin, Executive Vice President of SEIU 1199 New England, member of Raise the Bar on Resident Care.

Raise the Bar also advocated for the passage of the Financial Transparency Act (S 2604 | H 8204) but ultimately pulled the bill in order to re-adjust some of its language. This legislative proposal, S 2604, sponsored by Sen. Dawn Euer (D-Dist.13, Newport, Jamestown) and its companion measure, H 8204, sponsored by Rep. Matthew Dawson (D-Dist.65, East Providence) would require nursing homes to provide annual, audited financial statements that include detailed income, expenses, and cash flow, alongside transparent ownership information to prevent for-profit owners from misusing Medicaid and Medicare dollars. “We look forward to advocating for its passage in next year’s legislative session to ensure all for-profit nursing homeowners are held accountable to investing public dollars appropriately in direct care,” continued Jesse Martin. 

Advocates for Better Care in Rhode Island, a grassroots community organization founded to advocate for the rights and interests of residents of long-term care facilities in RI, celebrates the passage of S. 2263. The Long-Term Care Residents Rights Camera Bill, notes Director Kathleen Gerard. 

“The legislation gives residents of nursing homes and assisted living facilities and their legal representatives the right to install a monitoring device in their room provided all residents in the room consent. The consent can be withdrawn at any time, and a variety of safeguards exist to protect resident privacy,” says Gerard.

The legislation, S 2263 A, sponsored by Sen. Dawn Euer (D-Dist. 13, Newport, Jamestown, who chairs the Senate Committee on Judiciary and H 7969 A, sponsored by Deputy Majority Leader Jason Knight (D-Dist. 67, Barrington and Warren) has been signed by the governor and will take effect Jan. 1, 2025.  

According to Gerard, the legislation was first introduced in this form in 2021, but the care staffing crisis and massive 138% increase in serious deficiencies cited in RI long-term care facilities since 2022 made it even more urgent to finally pass it this year.

“Speaker Shekarchi worked tirelessly to reach a compromise that was acceptable to the various parties supporting and opposing the bill, and long-term care residents will consequently soon be able to have their care and condition monitored remotely by loved ones and care-partners, resulting in more peace of mind for everyone,” she says. 

“A legislative proposal we backed this year and that we hope to see enacted next year was introduced by the Rhode Island Department of Health.  The legislation, (S 2818 sponsored by Sen. Joshua Miller (D-Dist. 28, Cranston, Providence and H. 7819 sponsored by Rep. June S. Speakman), would improve financial transparency in nursing home ownership and prevent the rapid extraction of equity from facilities that we see with many private equity firms, real estate investment trusts, and investor groups,” says Gerard.

Next legislative session, Gerard says Advocates for Better Care in Rhode Island will also continue to advocate for legislation requiring assisted living facilities to support family councils.   This requirement already applies to nursing homes, she notes.

“We’ve Only Just Begun, says Sandra Paquette, representing Advocates for COLA Restoration and Pension Reform, a non-profit representing 4,700 retirees. “Our group numbers continue to increase, along with our determination and commitment, to fight for the justice which was so unnecessarily and ruthlessly taken away,” she says. .

According to Paquette, there were legislative proposals pertaining to current and future state and teaching retirees, which did not reach the floor of the House or Senate. One legislative proposal applied to those active employees whose retirement is based upon an arbitrary “rule of 95”. This translates into a calculation where the years of service and the age of those wishing to retire must add up to 95. The law would have changed this total to 90. Another one for which we strongly advocated, and for which we provided thousands of letters, verbal testimony and volunteer lobbying sessions was Pat Serpa’s (D-Dist. 27, West Warwick, Coventry and Warwick), H-8193, would have restored a compounded Cost of Living Adjustment (COLA) to all current and future retirees, and would have been enacted as of July of this year.

“Our goals for next year will remain— to advocate through testimony, letters, media and lobbying–for the passage of the two bills which will provide the now essential support to the victims of the 2011 Rhode Island Retirement Security Act,” says Paquette.

And here are specifics about other bills that impact seniors:

RI’s State Alzheimer’s Plan Won’t Sit on Dusty Shelf

Published in Pawtucket Times on November 1, 2013

Seeing a huge rise in Alzheimer’s Disease over the last two years, federal and state officials are gearing up to strategize a battle to fight the impending epidemic.

According to the Rhode Island Chapter of the Alzheimer’s Association, in 2013 an estimated 5 million Americans age 65 and older have Alzheimer’s disease. Unless more effective ways are identified and implemented to prevent or treat this devastating cognitive disorder, the prevalence may well triple, skyrocketing to almost 16 million people.

Furthermore, national health care costs are spiraling out of control, says the nonprofit group’s Facts Sheet. By 2050, it’s estimated that the total cost of care nation-wide for persons with Alzheimer’s disease is expected to reach more than $1 trillion dollars (in today’s dollars), up from $172 billion in 2010.

Meanwhile, with 24,000 Rhode Islanders afflicted with Alzheimer’s Disease, every Rhode Islander is personally touched, either caring for a family member with the cognitive disorder or knowing someone who is a caregiver or patient.

In February 2012, the U.S. Department of Health and Human Services released its draft National Plan, detailing goals to prevent or treat the devastating disease by 2025. Almost six months later, in May 2012, the Rhode Island General Assembly passed a joint resolution (The same month that the final National Plan was released.), signed by Governor Lincoln Chafee, directing the state’s Long Term Care Coordinating Council to lead an effort to create a state-wide strategy to react to Rhode Island’s growing Alzheimer’s population. Almost one year later, a 122 page document, the Rhode Island State Plan for Alzheimer’s Disease Disorders, was released to address the growing incidence in the Ocean State.

In July 2013, with the graying of the nation’s population and a skyrocketing incident rate of persons afflicted with Alzheimer’s disease, the Chicago-based Alzheimer’s Association and the U.S. Centers for Disease Control (CDC) and Prevention released a 56 page report that called for public health officials to quickly act to stem the growing Alzheimer’s crisis. .

Battle Plan Against Alzheimer’s Disease

The State’s Plan to battle Alzheimer’s Disease is the culmination of a yearlong effort co-chaired by Lt. Governor Elizabeth Roberts and Division of Elderly Affairs Director Catherine Taylor, in partnership with the state chapter of the Alzheimer’s Association.

Much of the research and writing was conducted by six subgroups (Caregivers, Access, Legal, Workforce, Long-Term Care, and Care Delivery & Research) formed to identify and tackle the many challenges that Alzheimer’s disease poses to individuals, their families and to the health care delivery system. .

At their meetings, the subgroups drew upon the expertise of staff at the Geriatric Education Center at the University of Rhode Island, the Brown University Center for Gerontology and Health Care Research, the Brown Brain Bank, and the Norman Price Neurosciences Institute and the Alzheimer’s Prevention Registry

Public input was crucial in the development of the State Plan. Eight listening sessions were held across the Ocean State, two of them held with Spanish translators, at public libraries and local YMCAs, to get the opinions of those with the cognitive disorder, caregivers, and health care professionals. The probate judges association, law enforcement and other groups with unique perspectives on Alzheimer’s Disease were invited to listening sessions, too. Finally, the draft plan was made available for a ten-day public comment as part of the extensive outreach process.

The narrative in each section, nicely pulled together by Lindsay McAllister, the Lt. Governor’s Director of Health Policy, reflected many of the concerns and challenges identified by many presentations and discussions in each of the subgroup meetings over several months. The State Plan details 30 pages of recommendations outlining solutions and specific steps to be taken for preventing and caring for persons with Alzheimer’s Disease for six identified areas.

A Sampling of Recommendations

The plan encourages the development of social media networks as resources for caregivers, also calling on utilizing existing caregiver newsletters to detail more information about the Ocean State’s specific programs and services. It also calls for better training and education opportunities (for young children) to help them understand the devastating disorder and the creation of a two-week certification program, offered by local colleges and universities with input from the state’s Alzheimer’s Association.

In addition, the plan recommends the timely dissemination of research findings and best practices in nursing facilities, dementia care units, and home care to providers and families. Meanwhile, recommendations note the need to standardize dementia training and educational programs as well as the certification of facilities that offer dementia-specific care so that individuals and families impacted by Alzheimer’s Disease can rely upon high quality “dementia capable” care that they can find more easily.

The plan pushes for all Employee Assistance Programs (EAPs) to receive information about referral resources for employees requiring more intensive or long-term mental health services. EAP’s might also provide educational and informational resources on caregiver support for families dealing with Alzheimer’s disease.

Another key recommendation is the development of an internet resource referred to as the Rhode Island Alzheimer’s Disease (RIAD) Web Site. The site would enable better coordination among researchers and clinicians and assist them in recruiting participants for clinical trials and research studies. It would also provide consistent centralized support to individuals living with Alzheimer’s and their families by making practical care giving information readily and easily available.

“AARP has a long history of supporting Alzheimer’s patients and their families,” said AARP Rhode Island Advocacy Director Deanna Casey. “We applaud the effort in Rhode Island and Lt. Gov. Roberts’ efforts on behalf of those who suffer from the disease,” she says.

Casey says “far too many of our nonprofit’s 130,000 Rhode Island members are painfully familiar with Alzheimer’s, and the work of the many stakeholders in this effort is further indication of the great need to recognize our collective responsibility to help families through what is a most challenging journey.”

“Rhode Island has a tremendous opportunity to be a national leader in response to this disease,” she believes.

Briefing by Key Supporters

Two days ago, the full Alzheimer’s Work group kicked off the implementation phase of the Rhode Island State Plan on Alzheimer’s Disease & Related Disorders, discussing how to move forward with the goal of getting the recommendations up and running.

In Room 116 at the State House, Lt. Governor Elizabeth Roberts and Director Catherine Taylor of the Division of Elderly Affairs were clearly pleased to see their year-long initiative moving into its implementation phase to assist the State to handle a growing number of persons with Alzheimer’s Disease.

On the heels of a nationally released plan to address the Alzheimer’s epidemic, Taylor tells me that it was “great timing” for the Rhode Island General Assembly to enact a joint resolution to create a state plan to “respond to Rhode Island’s specific needs and gaps of service.” She credits the Rhode Island Chapter of the Alzheimer’s Association with the getting the ball rolling on this major health care policy initiative.

According to Lt. Governor Roberts, public sessions where care givers and people with Alzheimer’s Disease told their personal stories allowed the Subgroups to understand the personal impact of the devastating disease on both the afflicted and caregivers. For instance, the listening sessions made it very clear that the specific care needs of middle age adults with early onset Alzheimer’s Disease is quite different from those who are decades older, she said. Taylor agreed, citing adult day care eligibility requirements which keep those under age 60 from participating in this program, one that provides respite care to caregivers.

Lt. Governor Roberts states “younger people can not relate to programs that are developed for older people.” The patient must become the center of treatment rather than the treatment geared to age, she says.

Both Lt. Governor Roberts and Taylor do not want to see the State Plan sit on a dusty shelf, noting that it now becomes important to implement the written plan’s recommendations. “Let’s get the ball rolling now,” says Taylor.

While many of the State Plan’s recommendations may take time to implement, some are easy to implement like a Spanish language support group, says the Lt. Governor. Taylor states that RI has already requested a modification to the Medicaid waiver to expand Adult Day Health Center eligibility to individuals younger than 60 who have a diagnosis of Alzheimer’s.

Senior Police and Fire Advocates need to be trained in every Rhode Island community about Alzheimer’s Disease and resources available for caregivers, states Taylor. “These individuals know those who need programs and services in the community,” she notes, adding that an information conference is scheduled this week to train these individuals.

Lt. Governor Roberts believes that the State plan is a “living document” and it will be around as long as there is one person with Alzheimer’s Disease.”

To review the State plan go to http://www.ltgov.state.ri.us/alz/State%20Plan%20for%20ADRD%202013.pdf.

Herb Weiss, LRI’12, is a writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.