RI Seniors, aging advocates call for an “age friendly” budget

Published in RINewsToday on March 27, 2023

Over two months ago, Gov. Dan McKee unveiled a sweeping $13.7 billion budget for the upcoming fiscal year.  After its release, the Senior Agenda Coalition of RI (SACRI), representing 21 organizations, called this budget “unfriendly to seniors,” charging that it “short-changed” seniors.  In an e-blast that was sent to 1,800 seniors and aging advocates SACRI urged them to contact their lawmakers asking that they put more funding into the delivery of aging programs and services.  

As the House Finance Committee continues to hold hearings on bills that might ultimately be rolled into the upcoming FY 2024 Budget, last week the SACRI brought 220 seniors, aging advocates and professionals in the aging network to the Warwick Crown Plaza to personally urge House Speaker Joe Shekarchi (D-Warwick) and Senate President Dominick Ruggerio (D-Providence, North Providence to hammer out an “age-friendly” budget.

SACRI Board Chair George Neubauer began this year’s Legislative Leaders Forum by quoting President Joe Biden’s call to Congressional lawmakers at the annual State of the Union Address to maintain Medicare and Medicaid. The President urged lawmakers to “stand up for seniors”.  Setting the stage for why this event was organized, Neubauer told the packed room: “Today, we are here to speak up for ourselves.”

Painting a Portrait of Rhode Island Seniors

“Effective advocacy includes good data and good stories,” said Maureen Maigret, a SACRI Board member and policy advisor for the group setting the stage for the speakers. She presented demographic data on the state’s graying population, discussed the increased needs of state’s aging programs and services to keep people at home, and detailed SACRI’s budget policy fixes.

“We speak up for 200,000 seniors and our numbers are growing,” says Maigret, also a former State  Representative and Director of the RI Department of Elderly Affairs. By 2030, 1 in 5 Rhode Islanders will be aged 65 and over,” she says.

While many think that seniors are a drain on the economy, they are not. According to Maigret, $3 billion dollars in Social Security benefits are pumped into the state’s economy. Twenty percent of seniors are still working and paying taxes and employers are very aware that seniors have extensive job experience skills and are usually very reliable employees.

“Additionally, seniors are part of an invisible workforce of unpaid caregivers who take care of family members and friends, also,” says Maigret, noting that AARP Rhode Island recently released a study reporting that there are 121,000 unpaid caregivers, with the value of their unpaid care estimated to be $2.1 billion dollars (just under $19 per hour).

“Seniors also contribute thousands of hours of volunteer work to their local communities, lending a helpful hand to senior centers, friendly visitor programs, Meals on Wheels, and to the Village Common of RI at four Village communities and multiple other agencies,” adds Maigret.  

“An overwhelming 70% of Rhode Island seniors want to age in place and remain in their communities,” says Maigret, noting that “after age 65, 3 out of 5 of these individuals will need some support to stay in their homes.”

SACRI survey on areas of concern for seniors

With Rhode Island’s top House and Senate leadership listening, Maigret touched on the findings of a SACRI survey that identified an array of concerns expressed by their older constituents.  Health and care issues came up on the top of this list, followed by isolation and loneliness, lack of knowledge of community support services, the need for transportation, loss of mobility, high housing costs, and lack of income.

The survey findings indicate that needed information is not reaching older adults to navigate the long term care system, says Maigret. Forty percent do not know about programs and services offered by Rhode Island’s Office of Healthy Aging (OHA) and The Point, the state’s aging and disability resource center.  She noted that the Governor’s FY 2024 budget didn’t allocate any state dollars to operate The Point, whose mission is to direct seniors to needed programs and services.

“Even with Social Security, a large number of seniors have low incomes,” says Maigret, with 50% of older households living on less than $50,000 a year, another 27% living on less than $25,000. “The cost of long-term care is staggering and unaffordable with semi-private rooms in nursing facilities going for $94,900 a year,” she pointed out. “Assisted living facilities is out of reach for many, too, costing about $54,000 a year. Bringing a home care aide 40 hours per week into a person’s home costs a whopping $56,160,” she adds.

Maigret urged Shekarchi and Ruggerio to reallocate more state dollars to home care services.  While other states, on average, spend 45% of Medicaid long-term care dollars on home care, Rhode Island only spends 22% with hundreds of seniors having to wait over 3 months to get home care services.

Maigret says that SACRI supports a legislative agenda that calls on the Rhode Island General Assembly to craft a “Better Budget for Better Care,” which will result in a permanent investment to improve the care provided to seniors.  SACRI also urges that lawmakers raise direct workers pay to $20 per hour to attract workers into home care agencies and nursing facilities. To assist seniors to access needed programs and services, $500,000 must be allocated into the House budget to better market available information and referral services offered by The Point.  

“Meanwhile, SACRI also is pushing to add five new positions at the OHA, with two being assigned to its Adult Protective Services Unit to increase increased caseloads,” says Maigret.  By allocating funding to help more lower income Medicare beneficiaries pay their Medicare Part B premiums, seniors will have more money to pay their bills.     

Telling Powerful Stories

SACRI pulled together a few “real life” stories to illustrate why Rhode Island lawmakers must craft an “Age Friendly” FY 2024 Budget.

Jeanne Gattegno, working in the elder abuse sector, shared her thoughts as to why OHA’s Adult Protective Service Unit (APSU) is underfunded.  “Elder abuse is a crime and anyone suspecting abuse must report it.  When its reported it must be investigated by the APSU,” she says.

According to Gattegno, in 2021, there were over 6,200 calls to OHA, over 1,400 calls were elder abuse complaints, and 2,800 were investigated as self-neglect. “There are five workers in the APSU. Just do the math. It’s an incredibly difficult job and it’s life and death and there are not enough people to help,” warns Gattegno.

Allyson Manning, an overworked Registered Nurse at a local nursing facility, highlighted her typical day working with two Certified Nursing Assistants to take care of 26 residents.  Due to low wages, the facility can’t fill the third CNA position to assist the other two CNAs on the shift. 

Serving as Team Leader, Manning says that there is not enough time to take care of her 26 residents.  During this shift her chief responsibility is to pass medications, perform treatments and assessments.  She often finds that her primary functions as an RN are late or difficult to carry out, due to the need to assist the CNAs with their tasks of toileting, washing, dressing and feeding residents.

“We are not attracting the people we need to these [CNA] positions.  They are low paid jobs, but it is really rewarding work but it is hard work., she says.  When hired, CNA’s are not staying long, turnover is high says Manning. While initially working full-time, she now only works two days a week.  

Giving Their Thoughts…

RI Speaker of the House, Joe Shekarchi remarked that he clearly understood the very powerful stories shared by Gattegno, Manning and others. “I didn’t need to hear those stories because I live those stories every day.  When his 97-year-old father recently fell at home and broke his pelvis, he was admitted to the Bethany House.

“I see how hard they work and the limited staff they have,” says the House Speaker, understanding the labor shortage’s impact on nursing facilities. “I see when my father hits the call button and it takes a long time [to answer] not because they are slow, but because they are doing three or four things at the same time,” he says.

“It’s important that seniors have options so they can choose what’s best for them,” says Shekarchi. “We need to provide supports for seniors to age in place and remain in their homes living independently,” he added, acknowledging that it is not always easy to do.

Shekarchi also recognized his effort with the Senate President made historic investments to require minimum staffing last year. Unfortunately, it hasn’t happened because the nursing facilities are now facing labor shortages, he says. 

According to Shekarchi, last year the General Assembly also provided more funding to make home care more accessible for seniors.  Lawmakers also provided tax relief on pensions for older taxpayers and military veterans, strengthened laws to protect seniors from financial exploitation, and made it easier to apply for SNAP benefits and expanded property tax relief for seniors. He expects to continue his efforts this legislative session.

Shekarchi also reported that he has introduced a bill, supported by AARP RI, to allow zoning for constructing Accessory Dwelling Units (ADUs) in garages or basements. He called on seniors and aging organizations to support his housing bill.

The House Speaker also discussed proposed legislation by Rep. Lauren Carson (D-District 75, Newport) proposed legislation that would create a House Study Commission to coordinate Rhode Island’s programs and services for seniors, expressing the need for such a study commission.  

Like Shekarchi, Senate President Dominick Ruggerio outlined a number of legislative successes last year.  He recognized passage of Sen. Josh Miller’s legislation authoring the creation and implementation of a pharmaceutical redistribution program. Former Sen. Cindy Coyne’s legislation became law, too, lowering the age at which a victim can be considered an elder under the state’s financial exploitation law from 65 to 60.

With the state’s growing number of seniors, Senate President Ruggerio stated that senior issues are more important than ever.

“We need to do everything we can to ensure seniors and retirees can enjoy their older years with dignity and security,” he said. “Because after a lifetime of hard work and contributing to our communities… older Rhode Islanders deserve nothing less.”

“The Senior Agenda Coalition is a powerful tool in its work.  At the Statehouse we rely on your voices to help guide us as leaders,” says Ruggerio, noting “we don’t have all the answers and appreciate your input.”

To watch SACRI’s 2023 Legislative Leaders Forum, go to  https://ritv.devosvideo.com/show?video=7cd34a907d29&apg=c7e3a6c7.

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AARP Report: Unpaid Caregiving Valued at $ 600 Billion

Published in RINewsToday on March 13, 2023

Family caregivers put in over $36 Billion hours in unpaid care taking care of loved ones, a responsibility that takes a heavy toll on them financially, physically, emotionally, and mentally.

But now, a new AARP report reveals that the family caregiver unpaid work is estimated to be valued at more than $600 Billion. This is a $130 Billion increase in unpaid contributions from family caregivers since the last report in the series was released in 2019. The economic impact of $600 Billion is more than all out-of-pocket spending on health care in the U.S. in 2021, notes the AARP report.

The 32-page 2023 update, Valuing the Invaluable, highlights trends in family caregiving, explores the growing scope and complexity of family caregiving, and discusses actions needed to be taken to address the financial, social, and emotional challenges of caring for parents, spouses, and other loved ones. 

AARP continues to put the spotlight on this important aging policy issue as the graying of the nation’s population continues. According to the group, by 2034, adults aged 65 and older will outnumber children under the age of 18 for the first time ever.

The share of available family caregivers is projected to continue shrinking, relative to the number of older adults who will potentially require long-term care. In addition, family caregivers will continue to face the dual demands of employment and caregiving responsibilities, which often includes bringing up children while taking caring of older parents simultaneously.

“Family caregivers are the backbone of long-term care in this country,” said Susan Reinhard, senior vice president, AARP Public Policy Institute, and a lead author of the report. In a March 8, 2023 statement announcing its release, Reinhard said, “The care they provide is invaluable to those receiving it. But this is not just a family issue: it impacts communities, employers, and our health and long-term care systems. We must treat family caregivers as the valuable resource that they are by providing them the support they need to care for loved ones while also caring for themselves.”

AARP, the nation’s largest aging advocacy group representing over 38 million members, says it plans to push this year to turn the National Strategy to Support Family Caregivers into action that provides meaningful, tangible outcomes and support for family caregivers. The National Strategy, delivered to Congress last September, stemmed from the RAISE Family Caregivers Act, which was championed by AARP. The National Strategy highlights nearly 350 actions that the federal government will take and more than 150 that can be adopted by stakeholders and other levels of government to give family caregivers the necessary help they need.

Taking a Closer Look at Home

AARP’s latest report in the Valuing the Invaluable series also provides us data for the Ocean State as to the value of unpaid caregiving provided here. The unpaid care provided by the 121,000 Rhode Island caregivers is valued at $2.1 Billion. This amount was calculated at an $18.95 hourly value to the estimated 113 million hours of unpaid care that family caregivers provided in 2021 – a $300 million increase in unpaid contributions since the last report was released in 2019.

“Family caregivers play a vital role in Rhode Island’s health care system, whether they care for someone at home, coordinate home health care, or help care for someone who lives in a nursing home,” said Catherine Taylor, AARP Rhode Island State Director. “We want to make sure all family caregivers have the financial, emotional and social support they need, because the care they provide is invaluable both to those receiving it and to their community,” she says.

At the Rhode Island State Capitol, AARP Rhode Island says it will continue its fight for assisting family caregivers and the loved ones they care for. During the 2021 Rhode Island General Assembly Session, AARP Rhode Island, along with other aging advocacy groups, successfully lobbied to enhance the Temporary Caregiver Insurance program by increasing the number of weeks a worker can take annually to care for a loved one from 4 to 6 weeks.

During the current legislation session, AARP Rhode Island calls for state lawmakers to support family caregivers who work because caring for a loved one shouldn’t mean losing pay—or even their job. House Bill 5781/Senate Bill 139 will increase the number of weeks that one can take annually to 12. These bills would also expand the definition of family in Rhode Island’s existing paid family leave law to include siblings, grandchildren and other care recipients to fit the reality of Rhode Island’s diverse and multigenerational families.

“Too often our unpaid caregivers are not acknowledged. We need to show the many thousands of unpaid caregivers in Rhode Island we value their contributions with sound policies, programs and laws that support them,” says Maureen Maigret, Policy Advisor for Senior Agenda Coalition of RI.

Maigret also calls for expanding the state Temporary Caregiver Insurance law from six to twelve weeks as most states that have such programs allow, and for including siblings, grandchildren and care recipients – important steps in making Rhode Island a more family-friendly state. “I have personally been a caregiver for a number of family members and know how challenging it can be to navigate our long-term care system,” Maigret says.

“Another important step to support our caregivers is to provide state funding to strengthen The POINT, the state Aging and Disability Resource Center, so that caregivers have a single place they can go to get timely, reliable information and person-centered counseling about the services, supports and benefits available to them as caregivers,” says Maigret. “Too often caregivers are not aware of programs such as subsidized respite and adult day or benefits available to care recipients. That is why the Senior Agenda Coalition of RI is asking the legislature to add $.5 Million to the state budget as The POINT currently receives no state funds and relies entirely on insufficient federal dollars,” she adds.

“It is also important that caregivers be viewed as part of a person’s healthcare team. Healthcare providers, especially those in primary care, need to ask patients if they are getting care from a family member or if they themselves are a caregiver,” says Maigret, noting that this action will provide an opportunity for providers to offer information and guidance about available services and supports.

Resources for Caregivers

“We know that everyone’s path to aging is different and it’s our paid and unpaid caregivers that provide critical supports to our loved ones,” said Office of Healthy Aging Director Maria Cimini. “At the Office of Healthy Aging, we are committed to supporting our caregivers in a variety of ways encouraging self-care through respite programs, informational workshops, and our senior companion volunteer program,” says Cimini.  She suggests that family caregivers go to https://oha.ri.gov/resources/oha-resource-center to download OHA’s 2023 Pocket Manual, detailing resources available programs and services that the state agency provides to family caregivers.

Dementia and Alzheimer’s care

“Dementia caregiving is challenging emotionally, physically, and financially. The care that family members provide is priceless, really. We want people to know they are not alone and that the Alzheimer’s Association, Rhode Island chapter has both in person/virtual support groups and community based educational programs for people who are caring for a person living with a diagnosis of Alzheimer’s disease or a related dementia throughout the state,” says Donna McGowan, Executive Director, Alzheimer’s Association Rhode Island Chapter, noting that there are 24 thousand people living with Alzheimer’s in Rhode Island and 39,000 caregivers, many unpaid family members.

“The Alzheimer’s Association believes that understanding how the diagnosis will affect the entire family is truly important to know what resources the family may/will need and how to pay for care must be considered starting right from when a diagnosis is made,” says McGowan.

McGowan says that the Alzheimer’s Association’s  24/7 Helpline clinicians guide callers to financial assistance programs that may help pay for respite or a needed break. For details, go to https://www.alz.org/ri

Chris Gadbois, DNP, RN, PHNA-BC, PMH-BC, Chief Executive Officer of the East Providence-based CareLink, says AARP’s report highlights the critical need for support for caregivers in Rhode Island. “At CareLink, we see firsthand the impact on the health and well-being of caregivers and are working hard to provide programs to provide resources. Our Administration on Community Living grant funded program to support individuals with dementia and their care partners is just one example of services that can help people to remain safely in their homes,” she says. 

The program, delivered by a trained Occupational Therapist, during five ninety-minute home visits, includes techniques to reduce challenging behaviors, promote functioning, improve caregiver communication, home environment safety, and tips focused on caregiver self-care, including problem solving and teaching stress management techniques. For more details, go to https://carelinkri.org/member-services/therapeutic-services-for-dementia/.

AARP provides a comprehensive listing of resources and information on family caregiving.  Go to aarp.org/caregiving.

For a 2023 copy of Valuing the Invaluable, go to https://www.aarp.org/content/dam/aarp/ppi/2023/3/valuing-the-invaluable-2023-update.doi.10.26419-2Fppi.00082.006.pdf.

Resources and information on family caregiving are available at aarp.org/caregiving.

Dueling Social Security Proposals Heard by Senate Finance Committee

Published in RINewsToday on March 6, 2023

Almost eight years ago, Rhode Island lawmakers reduced the tax burden on older Rhode Islanders by tweaking the state’s tax on Social Security in the fiscal year 2016 budget. The exemption to Social Security taxation as it currently stands in statute was put in place in 2015, as part of the FY 2016 budget.

According to Greg Pare, Rhode Island’s Senate Director of Communications, the Assembly expanded a budget proposal by then Governor Gina Raimondo to make Social Security benefits exempt from state taxes for many. “The original proposal would have made them exempt for single filers with federal adjusted gross incomes of up to $50,000 and joint filers up to $60,000,” noted Pare, but lawmakers raised the limit to $80,000 for single and $100,000 for joint filers.

During this current legislative session – 2023 – there are two legislative proposals that, if passed, would decrease the state taxes on Social Security income for up to 175,840 retirees.

Helping Social Security retirees

During the current legislative session, Senator Elaine Morgan (R-Dist. 34, Charleston, Exeter, Hopkinton, Richmond, West Greenwich) introduced SB 84 to completely eliminate the state tax on Social Security income in Rhode Island. The bipartisan legislative proposal specifies for tax years beginning on or after January 1, 2024, an individual may subtract from federal adjusted gross income all Social Security income.

Morgan’s SB 84 has attracted the support of GOP Senate colleagues, along with Democratic Senators on the other side of the aisle.  The senior-friendly, bipartisan legislative proposal sponsors are: Sens. Anthony Phillip Deluca (R-Dist. 29, Warwick), Minority Leader Jessica de la Cruz (R-Dist. 23, Burrillville, Glocester, North Smithfield), Gordon Rogers (R-Dist. 21, Coventry, Foster, Scituate, West Greenwich), Thomas Paolino (R-Dist. 17, Lincoln, North Providence, North Smithfield), Leonidas P. Raptakis (D-Dist. 33, Coventry, West Greenwich), John Burke (D-Dist. 9, West Warwick), Mark  McKenny (D-Dist. 30, Warwick), Frank  Lombardi (D-Dist. 26, Cranston) and Frank Ciccone, III (D- Dist. 7, Providence, Johnston).

“Eliminating state income tax on Social Security benefits will be akin to giving Rhode Island retirees a raise. We must make Rhode Island a better place for retirees and not taxing Social Security income is a large step in that direction. It will help stem the flow of retirees leaving Rhode Island and taking their spending power with them.” says Morgan who made an argument in support of the legislation at the Senate Finance Committee last week, when it was scheduled for consideration, and held for further study.  A fiscal note has been requested, but has not been released.

Time to give older Rhode Islanders tax relief

“Eliminating the tax on Social Security benefits at the state level for seniors who have worked for decades, paying taxes on their hard-earned income, and contributing to Social Security with post-tax dollars, would boost the retirement income for much of Rhode Island’s vulnerable elderly population,” reasoned Morgan. “Social Security is part of the social safety net. It was never meant to fill state coffers; it was meant to carry people throughout their retirement years. It’s time to give our growing older population some tax relief by eliminating the income threshold, beginning with the 2024 tax year,” she said, noting that her legislation will help ensure that even more middle-class retirees and their families can keep more of their hard-earned benefits.

Sen. Walter Felag’s (D-Dist. 10, Bristol, Tiverton, Warren) legislative proposal, SB 246, cosponsored by Sens. Lou DiPalma (D-Dist. 12,  Little Compton, Middletown, Newport, Tiverton), Frank Lombardi (D-Dist. 26, Cranston), V. Susan Sosnowski, (D-Dist. 37, South Kingston) and Frank Ciccone, III (D-Dist. 7, Providence, Johnston), was also heard at the Senate Finance Committee, along with Morgan’s Social Security legislation.  This legislative proposal would not eliminate the state’s Social Security tax but increase income thresholds to $110,000 for single, and $140,000 for joint, filers. Like Morgan’s legislative proposal, the Committee recommended that Felag’s measure be held for further study. No fiscal note has been released yet on this legislative proposal.

With the cost of goods and necessary services increasing, Felag says that it was  crucial to help Social Security beneficiaries by throwing SB 248 into the legislative hopper. “By raising the tax exemption level, we can lessen the financial stress that many retirees on Social Security feel on a daily basis, keeping more of their hard-earned money in their pockets and bank accounts,” he says.

Sen. DiPalma, who serves as Chairman of the Senate Finance Committee, reported that a couple of proposals have been submitted and heard in the Senate Finance Committee.  “Both sponsors and witnesses made the case for why we need to continue to assist our seniors, especially during these inflationary and soon to be “slow-cessionary” periods. These proposals must and will be evaluated in the context of the overall budgetary review process, which is currently ongoing,” he says.

When asked if she ever considered becoming a cosponsor of Felag’s legislative proposal, Minority Leader Jessica de la Cruz stated, “I would have loved to, but I was unaware of his bill.”

“It’s not too late to bring Democratic and Republican Senators together to hammer out a compromise legislative proposal,” says de la Cruz, noting she will be discussing this possibility with Senate President Dominick Ruggerio (D-Dist.4, North Providence, Providence). 

Although I do not see eye to eye with my Democratic colleagues 100% of the time, we find common ground on many other issues,” says de la Cruz. ” I believe there would be bipartisan support for crafting a compromise piece of legislation if it ensured tax relief to retirees on Social Security.

Calls for passage of Social Security proposals

AARP State Director Catherine Taylor, representing over 128,000 members in Rhode Island, called for passage of SB 84 and SB 246. “They would protect the Social Security benefits of older Rhode Islanders,” helping them keep the benefits they have earned over a lifetime of hard work,” she said.

“Assuring that our members are financially secure in retirement is a key component of our advocacy,” stated Taylor, noting that Rhode Island is one of only 11 states that still tax hard-earned Social Security benefits. “State taxes on Social Security benefits in Rhode Island undermines the purpose of Social Security, which was designed to lift seniors out of poverty- not to fund state government,” she says.

“Now, when so many Americans are struggling to afford health care and other basic needs, the promise of Social Security is even more important,” adds Taylor.  

“Whether it is raising the income threshold under existing law, or a complete exemption of Social Security benefits from taxation, like 30 other states around the country, AARP supports all efforts to keep hard-earned money in the pockets of older Rhode Islanders,” Taylor told Senate Finance Committee members.

A Call to Action

According to the Healthy Aging 2020 report, Rhode Island’s older population is growing dramatically. Today, more than 240,000 Rhode Island residents are age 60 or older -  that’s 23% of the population. By 2040 that figure is expected to rise to almost 265,000.  In addition, the state has one of the highest proportions of adults aged 85 and older, of any state in the nation, ranking first in New England.

With the expected graying of the Ocean State’s population, now is the time for Rhode Island lawmakers to reduce the financial stress of Rhode Islanders who struggle to pay their bills and want to remain independent at home in the community.   

Although both Social Security legislative proposals have been held for further study, don’t get concerned, says Pare, the Senate’s Communication Director. “It is common to hold bills for further study on a first hearing, and that is almost always the case for bills with a fiscal impact, which would have to be incorporated into the budget bill when it is considered later in the legislative session,” he says. 

“There is an obvious bi-partisan appetite to provide tax relief to our growing aging population who have been greatly impacted during this pandemic. This is a significant opportunity for Senate Finance Chair Lou DiPalma to craft a compromise bill that will advance Rhode Island as an “age-friendly” state, says  Vincent Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service Agency.  Now is the time for both sides of the aisle to come together for a needed public action,” he says.

For details about 9 States With No State Income Tax, go to https://www.aarp.org/money/taxes/info-2020/states-without-an-income-tax.html

For details about 4 States That May Cut Taxes on Social Security Income, go to https://www.aarp.org/retirement/social-security/info-2023/cut-taxes-social-security-benefits.html