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.

Caregivers Can Take Advantage of Free Credit Freeze Law

Published in the Woonsocket Call on October 14, 2018

Attorney General Peter F. Kilmartin touts a new federal consumer protection law, signed into law by President Donald Trump on May 24, 2018, that protects seniors from becoming victims of financial exploitation. Rhode Island’s Attorney General says that this law enhances Rhode Island’s law prohibiting credit reporting agencies from charging fees for credit freezes,(also referred to as a security freeze).

With enactment of the Economic Growth, Regulatory Relief, and Consumer Protection Act, all consumers can now freeze and unfreeze their credit file for free for one year. Before this new law, fees were assessed, usually costing from $3 to $10 (though some states were free) to restrict access to your credit file, making it harder for others to open new accounts in another person’s name.

The new law lets people with certain legal authority to act on someone else’s behalf to freeze and unfreeze their credit file. It defines a “protected consumer” as an incapacitated person, someone with an appointed guardian or conservator, or a child under the age of 16. In addition, it extends the duration of a fraud alert on a consumer’s credit report from 90 days to one year. A fraud alert requires businesses that check a consumer’s credit to get the consumer’s approval before opening a new account.

“Many instances of financial exploitation include a person opening up credit cards or using the credit file of another for personal gain and identity theft. This added layer of protection will allow a guardian or financial caregiver the ability better safeguard the older person from being taken advantage of by a stranger or even someone they know and thought they could trust,”says Kilmartin.

To place a credit freeze on their accounts, consumers will need to contact all three nationwide credit bureaus: Equifax, Experian, and TransUnion. If you’re acting on behalf of a protected consumer, you must give the credit reporting agencies proof of authority before you can freeze and unfreeze the protected consumer’s credit. Proof of authority includes: a court order (such as an order naming you guardian or conservator; a valid power of attorney, and proof of your identity, which can be a Social Security card, birth certificate, driver’s license or other government issued identification.

Whether consumers ask for a freeze online or by phone, the credit bureau must put the freeze in place within one business day. When consumers request to lift the freeze by phone or online, the credit bureaus must take that action within one hour. (If consumers make these requests by mail, the agency must place or lift the freeze within three business days).
To place a fraud alert, consumers need only contact one of the three credit bureaus, which will notify the other two bureaus.

Rhode Island’s Credit Freeze Law

Filed at the request of Kilmartin and enacted earlier this year, the Rhode Island law eliminates a provision of existing state law that allows reporting agencies to charge up to $10 to consumers who ask for a credit freeze.

The legislation, which the sponsors introduced on behalf of Rhode Island Attorney General Kilmartin, stems from the Equifax security breach last year during which the credit information of 143 million Americans was exposed. Initially, Equifax was charging consumers who asked for a credit freeze to protect themselves from its own security breach, although it stopped after intense public outcry and pressure from numerous attorneys general.

At the time the law was enacted, Kilmartin said, “This is a big victory for Rhode Island consumers, giving them greater control over who can access their personal and financial information. Credit bureaus make money from selling our personal information to third parties. They should not be able to profit off consumers who decide to take control over who has access to their personal data.”

Protecting Rhode Island’s Seniors

“AARP applauds all efforts to protect older Rhode Islanders from phone and online credit scams that lead to identity theft,” says AARP Rhode Island State Director Kathleen Connell. “Clearly, many consumers, and especially many of Rhode Island’s 134,000 caregivers, will consider taking advantage of this new option. It certainly complements the work we are doing as part of AARP Fraud Watch to thwart con artists who prey relentlessly on people of all ages.

“In the case of older Rhode Islanders, life savings can be at risk. “The new federal law allows caregivers to acquire legal authority to freeze a loved one’s credit reports, and that’s a good thing. But it is important to note that there are many things a caregiver should consider. Basically, caregivers need to have conversations about the threat and what everyone should be doing to protect against credit theft,” she added.

AARP’s John Martin said when he presents the Fraud Watch program to community groups he urges people to think about fraud prevention in the same way training and professional development is part of their work experience. “In the workplace, your job includes being up to speed on the latest policies, regulations and best practices,” Martin tells audiences. “Lawyers read law reviews, doctors read medical journals, tugboat captains read The Shipping News. Failure to do so could lead to a missed opportunity or a big mistake. Given the enormous threats out there, we all should consider keeping up on the latest scams and implementing precautions something like a part-time job that requires similar diligence. To do otherwise increases your risk and the stakes are frighteningly high.”

Connell warns not to forget the basics. “AARP provides common-sense advice, awareness and precautions as well as alerts when new scams are exposed or an old one reappears,” she says. “Don’t be passive and please do encourage older family members to be on guard. We are all in this together.”

Anyone can sign up for the free Fraud Watch Network service at http://www.aarp.org/RIFraudwatch to receive alerts and report scams or other suspicious activity.

Reporting Financial Exploitation

The Rhode Island Office of the Attorney General recommends that if you believe you or an older relative are victims of financial exploitation, contact your local police department, the Rhode Island Division of Elderly Affairs, or the Elder Abuse Unit at the Rhode Island Office of the Attorney General.

If you would like an investigator at the Elder Abuse Unit or an investigator with the Consumer Protection Unit to speak with your organization on the signs of elder abuse or how to protect from being a victim of a scam, please contact Mickaela Driscoll, Elder Abuse Investigator, at mdriscoll@riag.ri.gov or Martha Crippen, Director of the Consumer Protection Unit, at mcrippen@riag.ri.gov or by calling 401-274-4400.