State Lawmakers to Tackle High Prescription Drug Costs

Published in the Woonsocket Call on February 16, 2020

The Washington, DC-based AARP began its call for reducing prescription drug prices nationally in the late spring of 2019. At the same time, state legislatures around the country began taking up legislation. However, in Rhode Island, where the legislature meets only once a year, from January to June, it was too late to introduce bill in last year’s session.

AARP’s Elaine Ryan, VP of State Advocacy and Strategy reports: “We’re seeing an unprecedented number of states tackling the problem of high prescription drug prices. About 45 states expect to engage on prescription drug legislation or regulations this year. Right now, AARP is actively engaged in legislation in 25 states to address rising prescription drug prices. A variety of bills are moving through state legislatures, including bills on cost-sharing caps on insulin, price transparency, importation, price gouging, and affordability boards.”

Now, AARP Rhode Island is gearing up its lobbying efforts on Smith Hill this legislative session to put the brakes on rising prescription drug costs.

High Prescription Costs Top AARP Rhode Island’s Issues

State Director Kathleen Connell, of AARP Rhode Island, led the charge against skyrocketing drug costs by taking the group’s “Stop Rx Greed: Cut Drug Prices Now” campaign to four Rhode Island communities. At its AARP RI Community Conversations kickoff event in Warwick on Oct. 15, she called on Congress and the Rhode Island General Assembly to make prescription drugs more affordable a legislative priority. “We pay not only at the pharmacy counter, but through higher insurance premiums, and through the higher taxes we need to pay to fund programs like Medicare and Medicaid. Older Americans are hit especially hard. Medicare Part D enrollees take an average of 4 to 5 prescriptions per month, and their average annual income is around $26,000. One in three Americans has not taken a medication as prescribed because of the cost,” she said.

Connell reported that a recent AARP Rhode Island’s survey revealed that 79 percent of the member respondents called for lowering the price of prescription drugs, considering it the organization’s top priority.

During these events, using state-by-state specific data released last summer by AARP researchers, Connell was able to use Rhode Island data to document an increase in drug costs for seniors, identifying these drugs, the number of Rhode Islanders who need them and how much costs have risen.

Rhode Island’s state specific data revealed that the average annual cost of brand name prescription drug treatment increased 58 percent between 2012 and 2017, while the annual income for Rhode Island increased only 5.6 percent. Prescription drugs don’t work if patients can’t afford them, says the aging advocacy group, says Connell.

AARP Rhode Island also held Community Conversations in North Providence (Oct. 29), East Providence (Nov. 21) and Newport (Dec. 5). About 80 people attended these events, including in the legislative districts in those communities, along with Senate President Dominick J. Ruggerio (D-District 4, North Providence, Providence) and House Majority Leader Joseph Shekarchi (D-District 23, Warwick).

AARP Rhode Island Calls for Lower Prescription Drug Costs

On Feb. 5, over 120 people, including state lawmakers, Secretary of State Nellie M. Gorbea, and AARP Rhode Island staff and members, gathered in the State Room to attend the AARP Rhode Island Annual Reception. The event would become the backdrop to announce the Rhode Island Senate’s legislative agenda to tackle increasing prescription drug costs, the unveiling of package of eight bills supported by AARP Rhode Island.

At the event, Connell said: “This is an issue we are pounding on and I think you are going to see progress this year on this stellar important issue – Stop Rx Greed. I don’t need to go through the list of hardships suffered as these prices escalate way beyond reason. And we know this can’t continue the way it is. It’s probably not going to be a silver bullet that will solves this, but a lot of lot more work of the kind you have seen to make this iceberg move.”

Senate President Ruggerio along with 14 Senators from his chamber came to announce their support of the AARP sponsored legislation that would provide a pathway to import less-costly drugs from Canada, increase more market transparency, raise senior’s awareness around price changes and limit patients’ share of the costs.

House Majority Leader Shekarchi, came to the legislative reception with 20 House lawmakers, to share their concern about the lack of affordability of prescription. Shekarchi personally knows about high drug costs. “I am a Type II Diabetic and I have a lot of prescriptions. I feel the pain because I pay $30 a pill with the copay. I know what it costs and it is ridiculous,” he says.

“Patients deserve to know what drugs will cost, how they can pay for them in a fair and reasonable way, and how they can take advantage of any or all opportunities to save on those costs,” said Shekarchi, stressing that “people living on fixed incomes should not have to skimp between doing what is essential in buying prescription drugs, or food or housing.”

Shekarchi noted that he has already put in legislation with House colleagues, calling for Rhode Island’s insurers to completely cover the cost of copays for epinephrine injectors, or EpiPens. The bill would help reduce the high cost of the injectors, which has prevented some people with allergies from obtaining the life-saving device. The Warwick lawmaker also cosponsored a bill to create a prescription drug affordability board to protect Rhode Islanders from the high costs of prescription drug products.

Shekarchi concluded, by announcing that House lawmakers will shortly join the Senate in introducing AARP’s package of legislation (from five up to eight bills).

In a statement announcing the introduction of Senate bills to lower prescription drug costs, Ruggerio said: “Rhode Island’s population is one of the oldest in the nation, and the high prices consumers pay for prescriptions have a significant impact on us. Most older Rhode Islanders have limited means, and the high costs mean many people are cutting back on essentials of living or taking less than their prescribed amount of expensive drugs. The pharmaceutical industry is not going to address this on its own, so it’s up to the state and federal governments to take action.”

Tackling the High Cost of Prescription Drugs

After AARP Rhode Island’s Annual Legislative Reception, the following legislative proposals were thrown into the legislative hopper that day and companion measures have now been introduced in the House.

Senate legislative proposals included:

A bill limiting changes to a health plan’s drug formulary — its list of covered drugs — to protect consumers. Sponsored by Sen. Elizabeth A. Crowley (D-District 16, Central Falls, Pawtucket), this legislation (S 2324) would generally limit plans to modifying formularies at renewal time with 60 days’ notice and require that modification be identical among all substantially identical benefit plans.

Legislation (S 2319) sponsored by Senate Majority Leader Michael J. McCaffrey (D-District 29, Warwick) to cap out-of-pocket expenses for prescription drugs at the federal limits for high-deductible health plans, currently $1,400 for individual plans and $2,800 for family plans.

A bill (S 2317) sponsored by Senate Majority Whip Maryellen Goodwin (D-District 1, Providence) to prohibit cost sharing for patients 45 or older for colorectal screening examinations, laboratory tests and colonoscopies covered by health insurance policies or plans.

Legislation (S 2322) sponsored by Sen. Melissa A. Murray (D-District 24, Woonsocket, North Smithfield) to limit the copay for prescription insulin to $50 for a 30-day supply for health plans that provide coverage for insulin.

A bill sponsored by Sen. Walter S. Felag Jr. (D-District 10, Warren, Bristol, Tiverton) requiring pharmacists to advise patients about less-expensive generic alternatives to their prescriptions or when it would cost them less to pay for their drugs outright instead of using their insurance. The bill (S 2323) would also bar pharmacy benefits managers from imposing gag orders on pharmacists that prevent them from making such disclosures.

A prescription drug transparency act (S 2318), sponsored by Senate President Ruggerio. This bill would requires pharmaceutical drug manufacturers to provide wholesale drug acquisition cost information to the Department of Health and pharmacy benefit managers to provide information related to drug prices, rebates, fees and drug sales to the health insurance commissioner annually. Such transparency would help payers determine whether high prescription costs are justified.

A bill (S 2321) sponsored by Sen. Louis P. DiPalma (D-District 12, Middletown, Little Compton, Tiverton, Newport) to create a state-administered program to import wholesale prescription drugs from Canada, which has drug safety regulations similar to those of the United States. Such programs are allowed under federal law, with approval from the U.S. Food and Drug Administration.

Legislation (S 2320) sponsored by Sen. Cynthia A. Coyne (D-District 32, Barrington, Bristol, East Providence) to create a prescription drug affordability board tasked with investigating and comprehensively evaluating drug prices for Rhode Islanders and possible ways to reduce them to make them more affordable.

As the 2020 Presidential election looms, Congress and state law makers are very aware that lowering skyrocketing prescription drug costs is a top priority for their older constituents. With more than 250 bills passed by the Democrats in the House (some of these bills would lower prescription drug costs) sitting in Senate Majority Leader Mitch McConnell’s “legislative graveyard,” the Rhode Island General Assembly must take the lead to legislatively fix the problem.

Connell anticipates that there might be more than 15 drug bills in the House and Senate, 10 submitted by AARP. Rhode Island lawmakers must seriously consider these legislative proposals and join the 26 states that have already passed new laws aimed at lowering prices for prescription medications.

AARP Says Age Discrimination Robs $850 Billion from Nation’s Economy

Published in the Woonsocket Call on February 9, 2020

In 1985, my 71-year old father was ready to leave his job, looking for greener pastures. After working for Dallas, Texas-based Colbert-Volks for over 33 years as Vice President, General Merchandise Manager, he knew it was time for a job change.

After telling me of his desire to find a new employment, I told my father that he would bring over three decades of experience in the retail sector to a new company along with a vast network he had accumulated. I remember saying “You would be a great catch.” His curt response: “Nobody will hire me at my age.”

Thirty-five years after this conversation, AARP releases a report charging that age discrimination is still running rampant in America’s workplaces and it even negatively impacts the nation’s economy, too.

Last month, AARP and the Economist Intelligence Unit released a report, The Economic Impact of Age Discrimination, reporting that the age 50 and over population contributed 40 percent of the U.S. Gross Domestic Product (GDP) in 2018, creating 88.6 million jobs and generating $5.7 trillion in wages and salaries through jobs held directly or indirectly.

But older workers would have contributed a massive $850 billion more in 2018 to the GDP if they could have remained in or re-entered the labor force, switched jobs or been promoted internally, notes the AARP study.

AARP’s new study shows that the elimination of that bias in 2018 would have increased the contribution of the 50-plus cohort to the GDP from $8.3 trillion to $9.2 trillion. It also projects that the potential contribution of the older population could increase by $3.9 trillion in a no-age bias economy, which would mean a total contribution of $32.1 trillion to GDP in 2050.

“This important report shows the cost to the entire economy of discriminating against older workers,” said Debra Whitman, AARP’s Executive vice president and Chief Public Policy Officer in a Jan. 30, 2020 statement announcing the release of the 22-page report. “The economy in 2018 could have been 4 percent larger if workers did not face barriers to working longer,” says Whitman.

“Studies have shown that older workers are highly engaged, with low turnover, and often serve an important role as mentors,” Whitman added. “Their expertise helps businesses and pays big dividends for the economy as a whole. Employers who embrace age diversity will be at an advantage,” she says.

House Moves to Combat Age Discrimination

The groundbreaking AARP report comes on the heels of the House of Representative’s recent passage of HR 2030, “Protecting Older Workers Against Discrimination Act,” to combat age discrimination.

The House chamber’s action comes as older workers play an increasingly important role in the workforce. Estimates are that by 2024, 41 million people ages 55 and older will be in the labor force, nearly an 8 percent increase from the current number. In addition, next year the oldest millennials will start turning 40 and then will be covered by the Age Discrimination in Employment Act (ADEA).

The legislation, passing with bipartisan vote of 261-155, restores anti-discrimination protections under the ADEA that were weakened by the Supreme Court’s 2009 decision in Gross v. FBL Financial Services, Inc. The decision changed the burden of proof for workers to be the sole motivating factor for the employer’s adverse action, making it much harder for workers to prove age discrimination.

In the Senate, the bipartisan companion legislation (S.485) is sponsored by Senators Chuck Grassley (R-Iowa) and Bob Casey (D-PA).

“The House vote sends a strong bipartisan message that age bias has to be treated as seriously as other forms of workplace discrimination,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer. “Age discrimination is widespread, but it frequently goes unreported and unaddressed,” charges LeMond.

Thoughts on Age Discrimination

AARP’s new report includes survey findings gleaned from a study conducted last July and August, interviewing 5,000 people age 50-plus to identify how they have experienced age discrimination at work or while looking for work.

The researchers analyzed: involuntary retirement due to age bias; 50-plus workers involuntarily in part-time jobs; missed opportunities for wage growth; lost earnings following involuntary job separation; longer periods of unemployment compared to younger workers; and people age 50 and older who dropped out of the labor force, but want to continue working.

The study’s findings indicate that the age 50 and over labor force has grown by 80 percent since 1998, about 40 percent of workers age 65 over intend to continue working into their 70s. While 80 percent of employer’s support employees working into their later years, nearly two-thirds of older workers say they have experienced or seen age discrimination in the workplace.

As to gender, the study’s findings note that men who retire between ages 50 and 64 are most likely to feel that they are being forced into retirement because of their age. Older women bear the double burden of age and gender discriminate, say the researchers. Those age 50-64, especially women, experience longer unemployment than other groups

The study also found that lower-income workers are more likely to feel trapped in their present role as a result of age discrimination.

AARP’s report warns that “in order to benefit from age ‘inclusion,’ employers need not only to recognize age bias, but actually “actively” stop it; they need to “bust myths” about older workers, be it that they cost too much or are not tech-savvy; they need to recognize the value that experienced workers bring to the workplace, like their dependability and ability to problem-solve and remain calm under pressure, and they must build and support a multigenerational workforce.”

Final Thoughts

We have worked for years to raise awareness of valuing people in the workforce, regardless of age,” said AARP Rhode Island State Director Kathleen Connell. “This isn’t AARP rhetoric. Data repeatedly proves that age discrimination is not only is unfair to older workers, but something that also has a negative impact on the economy.

“Employers should take advantage of the best talent available without dismissing equally capable employees at a certain age or by choosing not to hire new workers simply because of their age,” Connell added. “Companies with a diverse cultural often laud that as a business asset. That philosophy should not exclude older workers. They can bring experience and wisdom into the mix and should be judged only on their performance.”

For information on AARP workforce-related resources, go to http://www.aarp.employers.

For a copy of AARP’s report, go to http://www.aarp.org/content/dam/aarp/research/surveys_statistics/econ/2020/impact-of-age-discrimination.doi.10.26419-2Fint.00042.003.pdf.

2020 Census Data Impacts Federal Funding Allocated to Aging Programs and Services

Published in the Woonsocket Call on January 19, 2020

By April 1, every home across the nation will receive an invitation from the U.S. Census Bureau, a nonpartisan government agency, to participate in the 2020 Census. Once this invitation arrives, it’s important for you to immediately answer the short questionnaire by either going on-line, phone, or by mail. When you respond to the census, you’ll tell the Census Bureau where you live as of April 1, 2020.

The U.S. Constitution: Article 1, Section 2, mandates that the country conduct a count of its population once every 10 years. The 2020 Census will mark the 24th time that the country has counted its population since 1790

The population statistics generated by the upcoming 2020 Census will be used to distribute over $700 billion annually in federal funds back to tribal, state and local governments. The collected census data also determines the number of seats each state has in the U.S. House of Representatives, provides insight to governments, business and community planning groups for planning purposes, and finally defines congressional and state legislative districts, school districts and voting precincts

2020 Census Statistics and the Graying of America

According to a blog story published on Dec. 10, 2019, by American Counts (AC) Staff, the upcoming 2020 Census will provide the federal government with the latest count of the baby boom generation, now estimated at about 73 million. The boomer generation born after World War II, from 1946 to 1964, will turn 74 next year. When the 2010 census was taken, the oldest had not even turned 65.

Baby Boomers are also projected to outnumber children under age 18 for the first time in U.S. history by 2034, according to Census Bureau projections. With an increasing need for caregiver and health services and less family caregiver support, the boomers will be forced to depend on federally-funded support services, their allocation depending on policy decisions based on census data.

“Data from the 2020 Census will show the impact of the baby boomers on America’s population age structure,” said Wan He, who has for over 21 years overseen the Aging Research Programs for the Population Division of the U.S. Census Bureau.

AC’s blog article, part of a Census Bureau series detailing the important community benefits that come from responding to the 2020 Census questionnaire, stresses that exact count of American’s age 65 and over is important for tribal, local, state and federal lawmakers to determine how they will spend billions of dollars annually in federal funds on critical aging programs and services for the next 10 years.

While everyone uses roads, hospitals and emergency services some state and federal programs specifically target older Americans – the 2020 Census statistics will be used to distribute funding to senior centers, adult day care facilities, nutrition programs including meals on wheels, and the Supplemental Nutrition Assistance Program, job-training programs, elder abuse programs, Medicare Part B health insurance and Medicaid, the health insurance program for low-income people including those age 65 and older.

“The census is really important to us in the aging community,” said John Haaga, of the National Institute on Aging in Washington, D.C. in the AC’s blog article. “It’s our only way to figure out how things are different across the country, what areas are aging faster, where elderly disabled people live, or where older people are concentrated, like Appalachia or West Virginia, because young people are leaving for the cities,” says Haag, noting that “Older people are remaining behind there.”

Haaga noted, “Other states, such as Florida, have large older populations because people are moving there to retire.”

“You can start to look at specifics like how many older people are living alone who are more than 10 miles from an adult day care centers,” says Haaga. “You can answer questions of access and how to improve it,” he adds, noting that census statistics helps lawmakers or business people decide where to open health clinics or senior citizen centers, among other services.

Calls for Action: Fill Out that Census Questionnaire

AARP has three main goals, according to State Director Kathleen Connell. “First,” she said, “to ensure a fair and accurate census count by educating our​ members and older adults about the census outreach efforts. Second, to provide tips and resources to encourage safe participation while protecting themselves from bad actors and census related fraud during this time. And third, to help people age 50 and over gain employment as census enumerators.”

“AARP has long been involved in informing people about the census, including the fact that the headcount is labor intensive – to the tune of 400,000 temporary staff. In the past, retired adults have made up a good portion of those who work in the decennial count of Americans, often as enumerators who go door-to-door in neighborhoods. In many communities, the Bureau will be looking for bilingual applicants.”

To be sure, Connell adds, the loss of a Congressional seat would have an impact on Medicare funding and other services that support Rhode Island’s age 50 and over population. “If a subset of people doesn’t participate in the census, the area in which they live will be represented as having fewer residents than it actually does; the costs to states and communities could be large, consequential and long-lasting. A census that is as complete and accurate as it can be – and doesn’t undercount the number of residents in a given area – is a vital resource for everyone,” she said.

Connell sits on the RI Complete Count committee and the AARP State Office is using its email list and social media in a series of reminders and encouragement to participate in the census. AARP also is reaching out to members who might consider becoming census workers.

Adds Jennifer Baier, AARP Senior Advisor, Census lead: “Many federally funded programs rely on census data to distribute billions of dollars to states and localities across the country. According to the George Washington Institute of Public Policy, Rhode Island receives about $3.8 billion per year based on Census data. That includes funds for schools, roads and hospitals and also programs that aid older Americans, such as Medical Assistance Program (Medicaid) Medicare Part B, Special Programs for the Aging, Meals on Wheels, Heart Disease Prevention Programs and more.”

“The 2020 Census is just nine questions long, and takes about 10 minutes to fill out – those ten minutes impact millions of dollars of federal funding in every state and communities across the country,” says Baier.

Kidnapping Scam” Hits the Ocean State

Published in the Woonsocket Call on October 6, 2019

Last Monday, local media picked up a warning issued on the Pawtucket Police Department ‘s Face Book page that called on residents to watch out for the “kidnapping scam” that has recently resurfaced.

According to a Pawtucket Police spokesperson, a Pawtucket family was targeted with the “kidnapping hoax” scam, this incident triggering the social media warning on Sept. 30, with the case being referred to the Rhode Island State Police.

The Alexandria, Virginia-based International Association of Chiefs of Police’s Law Enforcement Cyber Center (LECC), say the scammers “use fear and threats over the phone to manipulate people into wiring them money. First noted by the FBI in the Southwest border states, it has now spread throughout the country.

LECC warns that the scammers are using “increasingly sophisticated tactics” — extensive online reconnaissance utilizing social media and other digital information — to convince victims that a loved one is being held hostage.

Here’s how the “kidnapping hoax” works.

This extortion scam typically begins with a phone call, usually coming from an outside area code and sometimes from Puerto Rico with area codes (787), (939) and (856), saying your family member is being held captive. The caller may allege your son or daughter has been kidnapped and you may hear screaming in the background. Callers will typically provide the victim with specific instructions to ensure a safe return of the family member. Callers go to great lengths to keep you on the phone line until money is wired. Ransom money is only accepted via wire transfer services. The caller may claim not to have received the money and may even demand additional payments.

Advice on Keeping Out of Harm’s Way

The Pawtucket Police’s Face Book posting gives a simple tip on how you can protect yourself from this scam. Just hang up.

Or you can attempt to contact the alleged victim, either by phone, text or other social media, and request that they call you back from their cell phone. Do not disclose your family member’s name or identifying information. Also, avoid sharing information on digital profiles about yourself or your family.

The police also suggest that when responding to the scammer, request to speak to your family member, asking “How do I know my loved one is OK?” Always ask questions only the alleged kidnap victim would know the answers to.

The police warn people to not agree to pay ransom, by wire or in person. The kidnappers often have you go to multiple banks and multiple locations and have you wait for further instructions. Delivering money in person can be dangerous.

If you suspect a real kidnapping is taking place or you believe a ransom demand is a scheme, always contact your local or nearest law enforcement agency immediately, urge the police.

Rhode Island Attorney General Peter Neronha notes that the “kidnapping scam” is just a newer version of the Grandparent or Bail scam. “Most scams continue to evolve as more people start to recognize them,” he says. “All of these scams use fear to quickly manipulate people into sending their money away,” he says.

Neronha also gives advise as to how to protect yourself from becoming a victim of a scam. He says beware of scammers seeming to be legitimate organizations, agencies or companies such as the IRS, a utility company, bank or credit card, among others. If it doesn’t seem right, it probably isn’t. Don’t answer unrecognized calls or e-mails. Keep in mind that scammers can also make their number appear to be one that you may know or recognize. Finally, never give out solicited personal information.

AARP Continues its Fight Against Cybercrime.

“AARP has been fighting fraud and cybercrime for some time with education and resources – most notably the free AARP Fraud Watch Network,” says AARP Rhode Island State Director Kathleen Connell. “You can join and get email alerts and updates by registering at http://www.aarp.org/fraudwatchnetwork.
“Fraud Watch – free to both members and non-members – keeps people abreast of latest dangers, such as the nasty virtual kidnapping scam we first reported on in 2016. Some of these crimes never go away, they just get re-invented in subtle ways,” she added. “Once you’ve heard about a scam, you become far less vulnerable.

“During October’s National Cyber Security Month, AARP is getting the word out on three keys to staying safe online: Own it, secure it, and Protect it. The ‘it’ is your digital profile – the personal things about yourself that you put online. Living in the digital age means putting a lot of personal information online such as your home address, where you work, family members, and much more.

“Keeping that information safe requires a bit of work. First, you need to own it by understanding what you’re putting out there (such as what you’re posting on social media). Next, you have to secure it with strong passwords or using a password manager and enabling two-step authentication where available. Lastly, you need to protect it by staying current with the latest security updates on your devices and using Public Wi-Fi safely,” Connell said.

Another site Connell recommends is staysafeonline.org.

Putting the Brakes on Skyrocketing Prescription Drug Costs

Published in the Woonsocket Call on August 25, 2019

A few days ago, AARP Rhode Island released new state specific data detailing the impact of high prescription drug prices for Ocean State residents, specifically those living with cancer, prediabetes or diabetes, and heart disease. The Washington-based AARP unveiled the infographic at the National Academy for State Health Policy (NASHP) annual conference as part of AARP’s nationwide Stop Rx Greed campaign to lower drug prices for all Americans.

“While prescription drug prices continue skyrocketing, Americans are being forced to choose between filling life-saving medications or paying rent and buying food,” said AARP State Director Kathleen Connell in an August 21 statement announcing the release of the drug cost data. “So far in 2019, 29 states have passed 46 new laws to rein in drug prices. It’s critical that state and federal lawmakers continue this momentum to stop Rx greed.” says Connell.

Across the nation, 28 percent of consumers ages 19 to 64, say they are being forced to choose between filling costly life-saving prescriptions and paying their rent, buying food and affording other critical essentials, according to AARP research. In 2016, 25 percent of Rhode Islanders stopped taking a prescription drug prescribed by their health care provider due to cost.

The AARP Rhode Island-specific Infographic zeros in on three commonly used prescriptions to treat cancer, diabetes and heart disease to detail the spiraling increases in drug costs.

Between 2012 and 2017, the retail price of Revlimid, used to treat cancer, increased from $147,413 per year to $247,496 per year. In Rhode Island, 112,403 people are living with cancer.

Lantus, a form of insulin used to treat diabetes, increased from $2,907 per year to $4,702 per year. There are 82,318 people with diabetes in Rhode Island.

Finally, Aggrenox, a heart disease medication, increased from $3,030 per year to $5,930 per year. In Rhode Island, 31, 756 people have heart disease.

Specialty Drug Prices Continue 12-Year Surge

The AARP-state specific infographic released this month follows on the heels of an earlier AARP Public Policy Institute report released in June, reporting that the prices of widely used specialty prescription drugs grew more than three times faster than general inflation in 2017.

The researchers found that the average annual price for a single specialty drug used on a chronic basis is now nearly $79,000, compared to $27,824 in 2006.

Specialty drugs often require special administration and handling and are used to treat conditions that often affect older populations, including cancer, rheumatoid arthritis, and multiple sclerosis.

According to the findings of the AARP report, the average annual cost for a single specialty drug was almost $20,000 more than the median U.S. household income ($60,336), more than three times the median income for beneficiaries ($26,200, and over four-and-a-half times higher than the average Social Security retirement benefit ($26,200).

The report also found that the average annual p rice for one specialty medication would have been $29,843 in 2017 – almost $50,000 lower – if the retail price changes for these products had been limited to general inflation between 2006 and 2017.

“Prescription drugs are not affordable when their prices exceed the patient’s entire income,” said Debra Whitman, AARP’s Executive Vice President and Chief Public Policy Officer. Unfortunately, drug prices seem to be in a never-ending race to the top, leaving more and more people unable to afford the medications they need,” she says.

The researchers also noted that revlimid, used to treat cancer, had the highest annual price surge of the 30 top selling specialty drugs at 21.4 percent, going from $203,928 in 2016 to $247,497 in 2017. Revatio, a pulmonary hypertension medication, had the single highest retail price increase (48 percent) among the 97 most widely used specialty drugs.

“Specialty drugs account for the majority of the prescription drugs that were approved by the FDA in recent years,” said Leigh Purvis, Director of Research at AARP Policy Institute. “Given the remarkably high prices associated with such products, it is imperative that policymakers finally enact meaningful changes that target drug manufacturers’ pricing behavior,” she said.

Putting the Brakes to Skyrocketing Drug Costs

Last March, AARP launched its ‘Stop Rx Greed Campaign’ to find Federal and State solutions to slash skyrocketing drug prices. The goal of AARP’s sustained campaign is to help drive down drug prices for all Americans by advocating for a variety of legislative, executive, and regulatory actions at both the federal and state level.

“Americans are paying the highest prescription drug prices in the world,” said Executive Vice President and Chief Advocacy & Engagement Officer Nancy LeaMond, in a statement kicking off this advocacy initiative. “It’s time for pharmaceutical companies to stop deflecting blame and acknowledge that the root cause is the price they set for their products,” she says.

The Stop Rx Greed campaign will include national television, radio and digital ads, editorial content, emails to members, social media posts, ongoing advocacy and grassroots activity in D.C. and the states, and a petition calling on Congress and the Administration to take action now.

As part of the campaign, AARP is actively supporting a number of policy solutions at the national and state level to help lower drug prices. The aging advocacy group supports allowing Medicare to negotiate for lower prescription drug prices and states to negotiate lower prices with drug companies. AARP also calls for giving state Attorneys General authority to crack down on outrageous price increases and clamping down on pay-for-delay and other loopholes that keep
lower cost generic drugs off the market. Finally, AARP endorses capping prescription drug out-of-pocket costs and preserving state pharmacy assistance programs.

Congress is now considering legislation to put the brakes on rising pharmaceutical calls. As the 2020 election approaches the GOP-controlled Senate must work across the aisle with Senate Democrats to craft and pass bipartisan legislation to lower drug costs. It’s time for Senate Majority Leader Mitch McConnell, who vows to block any Democratic priories coming out of the Democratic-controlled Houses to the Senate, to put Senate companion bills on the floor for a vote. It’s time for the Kentucky Senator to put the needs of older Americans first, rather than political wins.

For more details about AARP’s Stop Rx Greed initiative, go to http://www.aarp.org/politics-society/advocacy/prescription-drugs/.

McKee to Unveil Updated State Alzheimer’s Plan

Published in Woonsocket Call on February 10, 2019

Seven months ago with the hiring of Michael Splaine and Kate Gordon of Splaine Consulting, a nationally recognized health policy firm that has provided content matter expertise to over two dozen state Alzheimer’s plans, Lt. Governor Daniel J. McKee, who serves as chair of the state’s Long-Term Care Coordinating Council, rolled up his sleeves to begin his legislative charge to update the 2013 state Alzheimer’s plan.

The hiring of the Columbia, Maryland-based consultants was made possible by two grants totaling $30,000 given by the Tufts Health Plan Foundation and Rhode Island Foundation. When announcing the successful fundraising effort to raise those monies, McKee observed, “Each day, we make great strides in expanding clinical trials and innovating treatments. Over the last few years alone, the local landscape of prevention and treatment has changed dramatically and positively.”

“The updated plan will be an invaluable tool for local leaders, researchers, physicians, advocates and families as we work together to build the momentum in the fight against Alzheimer’s,” says McKee, noting that it is one of the most challenging public health issues facing Rhode Island today. “With the number of affected Rhode Islanders projected to rise to 27,000 by 2025, elected leaders, advocates, caregivers, clinicians and researchers must come together to take unified, targeted action,” he says.

The compilation of the plan is the result of collaboration between McKee, the Alzheimer’s Association Rhode Island Chapter and the state’s Division of Elderly Affairs (DEA). In 2012, the General Assembly directed the Long-Term Care Coordinating Council to serve as the organizational umbrella for a work group that would oversee the development of the plan. In 2013, the state’s five-year Alzheimer’s plan was published. Last year, efforts to update it began.

Last July under the leadership of McKee, Splaine and Gordon worked closely with the Alzheimer’s Association Rhode Island Chapter, DEA, researchers, advocates, clinicians and caregivers sitting on the Lieutenant Governor’s Executive Board on Alzheimer’s,to develop a community-focused strategy for the 2019 State Plan on Alzheimer’s disease and Related Disorders. Over a six-week period, that group held 23 town hall meetings, conducted 45 expert interviews and surveyed (in both England and Spanish) more than Rhode Islanders impacted by Alzheimer’s.

The Official Release…

On Feb. 26 at a press conference in the State Library at 3:30 p.m., McKee will join Sen. Cynthia A. Coyne (D-Barrington) to officially unveil the plan, Rhode Island’s official roadmap to combat the growing Alzheimer’s epidemic. Coyne will announce the introduction of a Senate resolution on behalf of McKee to officially adopt the plan. (House staff are still reviewing the updated plan. There is no House sponsor at this time)

Coyne’s resolution follows her introduction of legislation to create a Rhode Island program to address Alzheimer’s disease within the Department of Health (DOH). The bill would also create an advisory panel to review and make recommendations to improve the state policies, research and care.

Once the Rhode Island General Assembly approves the plan, the Long-Term Care Coordinating Council’s executive board will seek legislative and regulatory changes to carry out its bold set of recommendations for improving supports to those afflicted by Alzheimer’s and other dementias. More than 30 recommendations are detailed in the 35-page plan, which calls for the implementation of three main recommendations.
In order to keep the plan from sitting on a dusty bureaucrat’s bookshelf, the first recommendation calls for the creation of one director-level position within DOH to assist in the coordination of its recommendations. The second urges promoting Alzheimer’s disease and related dementia research opportunities of all types, including federal opportunities to a broad group of Ocean State researchers. Finally, the third calls for the inclusion of brain health in existing publicly-funded promotion and chronic disease management activities.
Many of the recommendation can be easily implemented without additional state funding or legislative approval, says McKee. But, for those that may require state funding, he plans to make it a priority to lobby for those monies.

Taking a Close Look

Maureen Maigret, co-chair, state’s Long-Term Care Coordinating Council, says, “It is terrific to have the plan update completed as it provides direction to our state government leaders and other persons in key positions to proceed with implementation of the recommendations, which can have such far-reaching impacts on the many thousands of individuals with neuro-cognitive conditions and their dedicated caregivers, both those who are unpaid and those in the paid work force.”

Maigret notes that the updated plan’s recommendations also call for assisting family caregivers who provide the vast majority of care for persons with Alzheimer’s and related dementias, expanding subsidies for home and community care services offered by the state’s Division of Elderly Affairs, and making family caregiver support services part of the Medicaid program.

According to Maigret, one issue not mentioned in the updated plan is the need for increasing state funding for the DEA’s respite care program, which has a waiting list. “This is an important program that gives caregivers small subsidies to purchase ‘care breaks.’ Our Aging in Community Subcommittee and the AARP and Senior Agenda Coalition will all be advocating to restore state funds to this program (in the upcoming legislative session),” she says.

“The Alzheimer’s State Plan is a thorough blueprint to address the growing Alzheimer’s crisis by creating an infrastructure and accountability that will help build dementia-capable programs,” said AARP Rhode Island State Director Kathleen Connell. “We applaud the work that has gone into the report and the continuing efforts to address Rhode Island’s growing needs. We are especially encouraged to see that the plan supports community education about caregiver health and caregiver rights under the CARE Act, which is legislation that AARP championed in the General Assembly. AARP also encourages and supports age-friendly communities, which includes dementia-friendly awareness and resources so that people of all abilities can thrive as they age.”

Sen. Coyne added, “Alzheimer’s impacts tens of thousands of Rhode Islanders, and we need a coordinated strategy to improve education among the public and training for providers, and to promote research opportunities. This plan provides a strategic framework for moving forward to bring positive policy change where it is needed.”

See you at the press conference.

For details about the press conference and the Alzheimer’s State Plan, contact Andrea Palagi, Communications Director, Office of Lt. governor Daniel J. Mckee at
Andrea.Palagi@ltgov.ri.gov.

Funding for Seniors in Raimondo’s FY 2020 Budget Blueprint

Published in the Woonsocket Call on January 27, 2019

By Herb Weiss

Almost two weeks ago, Democratic Governor Gina Raimondo formerly unveiled her $9.9 billion budget proposal to the Rhode Island General Assembly. The House and Senate Finance Committees then begin the task of holding hearings on budget plan, getting feedback from the administration and the public. Once the revised estimates of tax revenue and social-services spending is available in May, negotiations seriously begin between Raimondo, the House Speaker and Senate President to craft the House’s budget proposal. Lawmakers will hammer out and pass a final state budget for the fiscal year that begins July 1.

Local media coverage of Raimondo’s ambitious spending initiatives zeroed in on her call for expanding free tuition to Rhode Island College and adding some public pre-kindergarten, increasing minimum wage from $ 10.50 to $ 11.10 per hour, allowing mobile sports betting and legalizing recreational marijuana.

But, Raimondo’s budget proposal gives state lawmakers a road map for what programs and services are needed for a state with a graying population.

According to Meghan Connelly, DEA’s Spokesperson, a nearly 60 percent increase in the State’s population of residents aged 65 and older from the years 2016 to 2040 highlights the need for continued investments in programs servicing Rhode Island’s older adults and their family caregivers.

Connelly says Raimondo’s budget proposal, released on January 17, elevates Elderly Affairs from a division under the Department of Human Services to an Office within the Executive Office of Health and Human Services. The governor shifts financing for the office and 31.0 FTE positions to EOHHS to accomplish this recommended action.

“The projected increase in the state’s senior population – from 174,000 in 2016 to 265,000 by 2040 – coupled with the proven impact of community-based supports and services, highlights the need for continuing to invest in helping our seniors remain home, connected to their families and networks. Support of aging-related health-promotion initiatives are essential to maintain a high quality of life for Rhode Island seniors while minimizing aging-related healthcare costs,” says Connelly

“We are focused on making it easier for older adults to live independent, fulfilling lives for as long as possible,” said Michelle Szylin, Acting Director of the Division of Elderly Affairs. “The Co-Pay expansion [in the governor’s proposed budget] enables additional older adults to age-in-place, remaining safely in their homes and engaging in their communities.”

The Co-Pay expansion enables additional older adults to age-in-place, remaining safely in their homes and engaging in their communities. The governor’s proposal to expand the state’s Co-Pay program [by $ 550,000] will allow more seniors to reside in their communities, staying connected to their family and network of friends and neighbors.

Providing access to the Co-Pay program to individuals earning up to 250% of the Federal Poverty Level will allow more seniors to age-in-place with a better quality of life and delay nursing home admission. The DEA Co-Pay program was established in 1986 as an option for elders who would otherwise be ineligible for subsidized home and community care assistance because they did not qualify for the Rhode Island Medical Assistance program.

Recognizing the importance of the state’s Elderly Transportation Program to keep older Rhode Islander’s independent, Raimondo’s budget proposal calls for additional funding of $1.8 million from general funds to support the State’s elderly transportation program. This program provides non-emergency transportation benefits to Rhode Islanders age 60 and over who do not have access to any means of transportation. The program provides transportation to and from medical appointments, adult day care, meal sites, dialysis/cancer treatment and the Insight Program.

Raimondo’s proposed budget also increases Health Facilities regulation staffing to increase the number of inspections to state-licensed health care facilities. The governor recommends a $327,383 increase in restricted receipt funds for 3.0 FTE positions. These positions will bolster existing staffing to increase the number of inspections to state-licensed healthcare facilities.

The Governor’s proposed FY 2020 budget also through the Rhode Island Public Transit Authority continues to subsidize the transit of elderly and disabled Rhode Islanders through the Rhode Island Public Transit Authority.

Raimondo’s proposed budget also continues the support for the Independent Provider model P model with almost $200,000 in general revenue funds budgeted (about $770,000 all funds) to cover implementation costs. The goal of this model is to increase workforce capacity and create a new option for delivery of direct support services for both seniors and people with developmental disabilities.

Finally, the governor’s FY 2020 budget also allocates funding to an array of programs and services for seniors. Here’s a sampling: $800,000 to support the state’s senior centers through a grant process (the amount was doubled last year); $ 530,000 to support Meals on Wheels; $ 85,000 to implement security measures in elderly housing complexes; $ 169,000 for the long-term care ombudsman through the Alliance for Better Long Term Care, which advocates on behalf of residents of nursing homes, assisted living residences and certain other facilities, as well as recipients of home care services; and $ 500,000 funds the state’s Home Modifications program at Governor’s Commission on Disabilities.

Nursing Facility Provides Take a Hit

Raimondo’s proposed budget plan seeks to freeze the state’s Medicaid payment rates to hospitals, slashing funding by an estimated $15 million overall for the year, and to limit the rate increase for nursing homes to 1%, costing them nursing home providers about $4 million.
“We are beginning the budget process with a 1 percent increase in the COLA (Cost of Living Adjustment), says Scott Fraser, President and CEO of Rhode Island Health Care Association (RIHCA), warning that “this is not enough.”

“Since 2012, nursing facility costs have risen 21.6 percent while Medicaid payment rates have only gone up by 9.6 percent, adds Fraser, noting that by statute, rates are supposed to be adjusted annually for inflation. “We will be advocating for additional funding for nursing facilities throughout the remainder of the budget process,” he warns.

Jim Nyberg, Director LeadingAge RI, an organization representing not-for-profit providers of aging services, joins with RIHCA in calling on Rhode Island lawmakers to restore the full inflation adjustment. “Ongoing increases in minimum wage (up 42 percent since 2012) make it harder for publicly funded providers to compete for skilled workers,” says Nyberg, noting that most of his nonprofit nursing homes have 60 percent to 70 percent of their residents on Medicaid. “A rate increase is needed help nursing homes recruit and retain the direct care workers that are so critical to providing quality care,” he says.

“Since 2016, our nursing homes and consumers have been severely disrupted by UHIP, financially and operationally. The ongoing problems with Medicaid application approvals and payments has resulted in significant increases in staff workload just to maintain operations, let alone the impact on cash flow and financial stability, adds Nybrg.

Nyberg’s group is also advocating to expand the CoPay program for individuals under the age of 65 with dementia. “This has been proposed in the past but not included in this budget. We think that such an expansion will help this at-risk population for whom no publicly-funded programs and services currently exist,” he says.

Lawmakers, AARP Rhode Island Gives Comments

AARP Rhode Island is encouraged to see that the Governor placed an increase in the State Budget for the Department of Elderly Affairs home healthcare Co-Pay program,” said AARP Rhode Island Advocacy Director John DiTomasso. “By increasing the income eligibility from 200% of the poverty level to 250%, more older Rhode Islanders will be able to obtain home care services at reduced hourly rates,” he added. “This will help large numbers of people to extend the time they can age in place in their home and in their community rather than in more costly state-paid long-term care facilities,” says DiTomasso.

Senate President Dominick J. Ruggerio says, “Upon a first look at the budget, I am very pleased that some of the Senate’s top priorities are incorporated. The Governor had to close a significant deficit, and difficult choices had to be made. However, the budget is a statement of priorities, and initiatives like the no-fare bus pass program for low-income seniors and disabled Rhode Islanders are a priority for us in the Senate. I am very pleased to see this program funded in the budget, along with many other services for seniors, and I look forward to deeper analysis of all aspects of the budget in the months ahead.”

AddsD House Speaker Nicholas Mattiello, “The House Finance Committee will soon begin holding public hearings and reviewing every aspect of the Governor’s budget proposal. We will make certain that the level of care and services to older adults will be maintained and hopefully enhanced. We are facing significant budget challenges this year, but we will always keep the needs of our seniors at the forefront of the discussions.”

Older Rhode Islanders and aging groups must continue to push the House to at a minimal maintain the governor’s senior agenda. Hopefully, as Mattiello said, senior programs and services can be enhanced.

For a Senate Fiscal Analysis of Raimondo’s FY 2020 budget, go to http://www.rilegislature.gov/sfiscal/Budget%20Analyses/FY2020%20SFO%20Governor’s%20Budget%20-%20First%20Look.pdf.