Tag Archives for Bureau of Labor Statistics

AARP report: States’ care for seniors “painfully inadquate”. Major gaps in RI

Published in RINewsToday on October 2, 2023

Last week, the Washington, DC-based AARP released its latest Long-Term Services and Supports (LTSS) Scorecard, calling care provided to seniors and persons with disabilities during the last three years after the COVID-19 pandemic “painfully inadequate.”  This nine-page report detailed state specific data, finds major gaps in providing care in every state, including Rhode Island, especially in these categories:  “Housing for Older Adults”, “Home Care Costs” and “Home Health Aide Supply”. 

The LTSS Scorecard, consisting of 50 indicators, focused on: affordability and access; choice of setting and provider; safety and quality; support for family caregivers; and community integration, using data from a variety of publicly available sources, such as the Centers for Medicare and Medicaid Services, American Community Survey, and Bureau of Labor Statistics.

Many benefits of accessing the data

According to AARP, this Scorecard can be a roadmap for improving the LTSS systems and the lives of those who rely on assistance.  Many others will benefit by reviewing this data, too. Federal, state, and local policy makers can identify priorities and ensure resources are allocated equitably. Aging advocates can glean public data and hold government officials accountable. Family caregivers can identify needed resources and become actively involved in policy discussions and advocacy. Seniors relying on long-term care programs and services can learn to inspire culture change and demand available tools. Finally, employers can improve workplace policies and practices to assist caregivers and healthcare groups so they can explore public-private partnerships and alliances. 

Like the findings reported in AARP’s LTSS Scorecard in 2020, Rhode Island ranked 12th in the country in 2023, but this year’s Scorecard reveals that the state has made some progress in improving care options for older Rhode Islanders, specifically the enrollment in the Program of All-Inclusive Care for the Elderly (PACE), as well as the availability of Adult Day Services.

“The pandemic reinforced the need to strengthen long-term care for countless loved ones across the country, including here in Rhode Island,” said AARP Rhode Island State Director Catherine Taylor in a Sept. 28th statement announcing the release of the 2023 LTSS Scorecard. 

“AARP’s Scorecard shows that there are many roads to meet the needs of all Rhode Islanders who deserve the very best care, including the 121,000 family caregivers in our state. The overwhelming majority — 87% — of Rhode Islanders age 45+ would prefer to receive care for themselves or loved ones at home with caregiver assistance. Yet, our low rankings in Housing for Older Adults (51st), Home Care Costs (43rd) and Home Health Aide Supply (41st) underscore how difficult it is for them to age the way they choose. It’s time to accelerate our efforts, for the sake of saving more lives,” she says.  

RI is dead last in housing

“In particular, Rhode Island’s dismal ranking for Housing for Older Adults – dead last – points to the urgent need to increase the supply of affordable, accessible housing. We can do that by passing legislation early in 2024 to strengthen homeowners’ ability to build an accessory dwelling unit (ADU) to allow them to age in place, support a family member, or house a caregiver,” Taylor said.

A national snapshot of the LTSS Scorecard’s 2023 Data

According to Scorecard, 12 states, including Rhode Island, have enacted paid family leave laws and 18 states have paid sick day laws, which can be used to assist caregivers. AARP’s latest Scorecard also reported that only 6 states provide a tax credit for family caregivers’ out-of-pocket expenses. Rhode Island does not provide a tax credit – nor is it among the 7 states that have statewide laws protecting caregivers from discrimination in the workplace that ensure they are not unfairly treated due to caregiving duties outside of work.

Meanwhile, it was reported that dozens of states experienced declines in the number of care choices that help support family caregivers. For instance, 16 states, including Rhode Island, had declines of 10% or more in access to home health aides since 2019. 

Regarding Home and Community-Based Services (HCBS), the LTSS Scorecard reported that 11 states, including Rhode Island, had state policies that improve presumptive eligibility for Medicaid HCBS at the time of data collection, making it possible for people to go home to receive care after being in the hospital – rather than having to be admitted to a nursing home while their eligibility for Medicaid payments is being determined.

The research indicated that many states also have large numbers of people with low care needs living in nursing homes, indicating a lack of HCBS access and services. More than 20% of nursing home residents in Rhode Island have low needs – compared to 9% nationally.

Data confirms Major Workforce Crisis in nursing facilities across US

As to nursing homes and institutional care, the AARP’s 2023 Scorecard confirmed that a  major workforce crisis exists in facilities across the country. Across all states, wages for direct care workers are lower than wages for comparable occupations, with shortfalls ranging from $1.56 to $5.03 per hour. In Rhode Island, wages are $1.79 lower than other entry level jobs.   

Nationally, more than 50% of nursing staff in nursing facilities leave their job within a year (53.9% turnover rate). However, in Rhode Island, the rate is slightly better than the average, at 49.3% – with Montana, Vermont, and New Mexico experiencing the highest averages in staffing turnover.  

Staffing disparities are also a significant challenge, say researchers, noting that residents of nursing facilities with high admissions of Black residents receive almost 200 fewer hours of care per year compared to residents of facilities with high admissions of white residents. 

According to the LTSS Scorecard, only 22% of nursing facility residents live in a facility with a 5-star rating in the US – with less than the national average, about 20.2%, of Rhode Island residents living in a 5-star facility. Gaps in workforce and equity result in persistent problems in care, say the researchers. One measure, pressure sores, can be life-threatening as they can lead to bone or joint infections, cancer, and sepsis. In this measure, 10% of facility residents nationwide experienced a pressure sore.

Finally, this year’s Scorecard announced that there is progress being made to create innovative and effective alternatives to traditional nursing facility models. Specifically, the researchers say that 10 states, including Rhode Island, made strides in nursing home innovations, such as by utilizing Green House® Nursing Home availability and policies, which includes small facilities, private rooms, and other best practices.

AARP’s 2023 LTSS Scorecard identified recommendations that can fix the nation’s delivery of long-term care programs and services to enable seniors to age in place in their communities. It called for increasing support to the nation’s 48 million family caregivers, “who are the backbone of the long-term care system, providing over $600 billion in unpaid care, such as with paid leave, tax credits, and other mechanisms to address health and financial needs.”

AARP Rhode Island continues to call on the Rhode Island General Assembly to support the state’s 121,000 family caregivers by advocating for enhancements to the state’s Temporary Caregivers Insurance program.

Recommendations on enhancing Long-Term Services and Supports

The Scorecard’s recommendations also called for investing in states’ Home and Community-based Care Infrastructure, by increasing support and training for home health aides and home visits, supporting the ability to access and use medical devices and equipment, and updating key Medicaid regulations and payment models.  

To tackle the workforce crisis, a recommendation suggests that it is crucial to support both nursing facility and in-home workforce by improving recruitment and training, increasing pay, and expanding the ability of trained nurses, aides, community health workers and other paraprofessionals to take on some aspects of care. States can choose to enact and enforce staffing and related care standards.

A recommendation also calls on States to expand the use of innovative, effective models for nursing homes can improve both quality of care and quality of life, such as with smaller facilities and private rooms and to address inequities by investing to close the staggering gaps in access to quality care and facilities and staffing shortages.

(Editor’s Note:  During the pandemic, then Governor Gina Raimondo allocated $5 million towards 2 changes in nursing homes – making all rooms private and providing non-shared, private bathrooms – for all residents – efforts to follow up on this effort have not resulted in what happened to that initiative according to the RI Department of Health).

Another recommendation urges states to create multisector plans for aging and building of coalitions and age-friendly health systems, to help seniors to age in place at home by having affordable and accessible housing and transportation, improved community design, and comprehensive emergency preparedness plans.

Researchers also suggested the advancing innovation in cities, counties, and states by supporting comprehensive state- and community-wide aging plans and piloting new approaches and programs, like Green House® Nursing Homes and presumptive eligibility, that can then be scaled.

Finally, Climate Change is increasing national disasters, and the LTSS Scorecard recommends that every state have a sound emergency preparedness plan to support nursing home residents, in particular, in times of crisis – including natural disaster.

“AARP’s LTSS Scorecard shows some progress and innovation, but there’s still a long way to go before we have systems that allow people to age well, and independently, for as long as possible and support the nation’s 48 million family caregivers. It’s also clear some emerging issues deserve more attention – from whether nursing homes are prepared to confront natural disasters, to whether they have plans in place to maintain and grow their workforces,” says Susan Reinhard, Senior Vice President, AARP Public Policy Institute.

The LTSS Scorecard is a charitable project made possible by a grant from AARP Foundation, with support from The SCAN Foundation, The Commonwealth Fund, and The John A. Hartford Foundation, and has been updated every three years since 2011.

To view the full Scorecard and state-by-state information visit https://ltsschoices.aarp.org/ 

To view the Scorecard for specifically Rhode Island, go to:  https://ltsschoices.aarp.org/scorecard-report/2023/states/rhode-island.

To view Previous Scorecards (2011, 2014, 2017 and 2020) go to https://ltsschoices.aarp.org/scorecard-report/report-archive/

Job Hunting No Easy Chore as You Grow Older

Published in the Pawtucket Times, November 29, 2013

Last Friday, the U.S. Bureau of Labor Statistics brought bad news to over 57,000 job-less Rhode Islanders. According to the federal agency, Rhode Island’s unemployment rate of 9.2 percent is the nation’s second highest, followed by Nevada’s rate that is one percent higher. Compare this to 7.3 percent, the national jobless rate for that month.

When hearing about the Ocean State’s national distinction of having one of the highest unemployment rates among fifty states, Henry Rosenthal, an Oak Hill, Pawtucket resident since 1955, who has been unemployed for 16 months, called it a “real disgrace. The dismal statistics released only confirmed what the older job hunter personally knows from sending out hundreds of resumes, it’s an extremely tough job market.

Older Job Seeker Can’t Find Work

But, to make matters worse, 63-year-old Rosenthal, and other aging baby boomers, will bluntly tell you that age discrimination is derailing their efforts of finding meaningful work that pays a decent wage and benefits.

Even if you totally believe that your age keeps you from getting a job, it is not always easy to sue because it is tough to prove, says Rosenthal.

In April 2012, his Dallas-based employer downsized, which led to Rosenthal losing his sales job of selling loan origination software to banks. Throughout his 45 year employment career, he had a very stable employment record. He only recalls two other jobs that were lost due to his lack of seniority when corporate mergers occurred.

Rosenthal, a graduate of Temple University, had always been able to find a new position quickly when losing a job because of his “skill set and previous work experience,” he says.

But today things are different.

Rhode Island’s puttering economy has kept Rosenthal from easily landing a new position. In the few times he was able to get his foot in the door for an interview, he was told afterwards that he was “perfectly qualified” for the position, in some instances even over-qualified, but ultimately he received no job offer.

“I honestly believe that jobs have not been offered to me because of age,” charges Rosenthal, who believes that ”younger people who oversee the hiring tend to be intimated with the older job applicants and feel threatened.”

Although it is against federal law [The Age Discrimination in Employment Act of 1967] to ask applicants how old they are, “it’s easy to figure out how old a person is,” notes Rosenthal. “By asking when you graduated high school and college a company can figure out your age,” he says.

It’s About Who You Know

During his ongoing job search, Rosenthal quickly realized that in many cases it might just take a personal relationship in a company to get an interview. With all of his previous employers based either across the nation or located all over the world, he has very few contacts with the local business community, he notes.

“Unless you get a direct reference or have a personal connection with a potential employer, they just might hire a younger applicant because they can pay less money or think they won’t take time off because of health issues,” he quips.

“Research findings will tell you that older workers are more responsible and loyal than their younger colleagues, and have a better work ethic, too,” Rosenthal is quick to say. Don’t believe that older workers take more time off then younger employees, he adds.

As Thanksgiving approaches, Rosenthal keeps plugging along sending out resumes hoping to reel in that full-time job. With being two years shy of age 65, he says, “I am just not interested in retiring because I don’t have enough hobbies or interests to keep me busy.”

Like many other long-term unemployed Rhode Islanders, Rosenthal just tries to keep the faith, realizing that “sooner or later something will turn up. To survive, “you don’t look backward you just look forward.”

What Some Polls Say

It seems that Rosenthal is not alone in his belief that age can make a job search more challenging to find full-time employment. According to an Associated Press-NORC Center poll results, detailed in “Working Longer: Older Americans’ Attitudes on Work and Retirement,” 55 percent of those 50 and over who searched for employment in the past five years viewed their search as difficult, and 43 percent thought employers were concerned about their age.

The poll found that 69 percent of the older job seekers reported few available jobs 63 percent say the jobs did not pay well, nor did they offer good benefits (53 percent). Around one-third of the respondents were told they were over qualified [like Rosenthal].

But the October 2013 poll also revealed that some employers do value older workers. Forty three percent of the older respondents seeking employment in the last five years say they encountered a high demand for their skills, and 31 percent say there was a high demand for their experiences.

According to the poll’s findings, “unemployed people aged 45 to 54 were out of work 45 weeks on average, those 55 to 64 were jobless for 57 weeks and those 65 and older an average of 51 weeks.”

Meanwhile, an AARP poll also released last month, found age discrimination “rampant” in New York City for those age 50 and over. The researchers found that when an aging baby boomer loses a job it may take them about 4 months longer than younger job seekers to find another one.

Forty eight percent of the survey respondents claim they either personally experienced age discrimination or witnessed it directed at a family member or friend who has turned fifty years old. Almost half of these respondents either personally or witnessed a person not being hired because of their age.

Increasing Your Odds of Finding Work

Kathy Aguiar, principal employment and training interviewer at West Warwick-based Network Rhode Island Career Center. agrees with Rosenthal’s personal observations and the above cited poll results that indicate that older job seekers can be blocked from gaining meaningful employment by age discrimination. However, Aguiar, who has 25 years of assisting Rhode Island’s unemployed get work, tells me that there are job hunting skills and techniques that you can use to increase your odds in finding that job.

“It’s not the 1980s and with a 9.3 percent unemployment rate you must change with the times,” urges Aguiar, stressing that the 80s way of writing a resume is totally outdated today.

If your resume is not formatted correctly, computer systems, called Applicant Tracking Systems, won’t identify you as a potential candidate, says Aguiar, who says that “75 percent of the applicants applying by internet will be thrown out of the selection process because of this problem.”

Applicant Tracking Systems will skip over employment history if you put that information under “career development” instead of “work experience,” on your resume, adds Aguiar. “Always put the company’s name first, followed by job title, and employment dates.”

Aguiar warns applicants not to save resumes as PDF files because Applicant Tracking Systems cannot read this documents. Save it on a word file, she recommends.

Today, one resume does not fit all, notes Aguiar. Especially in Rhode Island you have to target your resume to the position you are seeking. You have to revise your resume to the position you are seeking. .

A well-written resume combined with using Social Media, including Linkedin, Facebook, and Twitter, and good networking skills can lead to a successful job search, adds Aguiar.

Finally, one of the best ways to get an interview and ultimately becoming gainfully employed is by finding someone within a company to be a personal reference. “Who you know is still important, especially in Rhode Island.” You may even get extra points when your resume is reviewed because of the internal reference, she says.

National polls tell us that ageism is running rampant in the employment sector. You can not deny its existence when you continue to hear stories from those age 50 and over unemployed family members, friends, neighbors, and acquaintances, who tell you about their frustrating and very challenging experiences of seeking gainful employment.

Only in this country do we not value the wisdom and knowledge that our elders provide us. It is time for a change in our thinking and attitudes.

If an employer is worried about his bottom line, just consider hiring an older worker. You will most certainly will get the bang for your buck by bringing in an aging baby boomer who is loyal, dependable, and brings a skill set and life experience that most certainly will benefit your company. To me, it’s a no brainer.

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

Returning Veterans Need a Helping Hand from Employers

Published November 30, 2012, Pawtucket Times

When the time came to end his seven month tour of duty in Afghanistan, Michael Cremin envisioned a future with the military.  With his tour of duty now behind him, this Staff Sergeant in the United State Marine Corps Reserves had well-laid out plans to re-enlist and become a full-time Marine.  The ambitious Quincy, Massachusetts resident did the calculations – he would first reenlist, then attend Officer Candidate School and ultimately become a Marine Corps Officer.   However, in a New York second, at the age of 32, this reservist was dealt a harsh blow that left dreams shattered forever.

Last April, Cremin entered a medical facility to treat a nagging back problem that  doctors diagnosed as being caused by the strenuous work endured over those months of  active combat – jumping in and out of military convoy vehicles carrying either heavy gear or injured Marines away to safety from blown up vehicles.    He welcomed the responsibility and at a relatively young age, was charged with overseeing convoys of over 90 vehicles carrying over 100 military personnel, whose mission was to bring needed food, parts, and fuel from Camp Leather Neck, Afghanistan to the various forward operating bases. However, heavy pain caused by three bad disks resulting in nerve disorders would medically-drum Cremin out of military service.  “This medical problem will affect me for the rest of my life,” he said.

Being medically retired was bittersweet for Cremin.  He loved being a Marine but his back injuries would be exacerbated if he stayed in the military.   His doctor’s would later say,  that he might have difficulty moving as he aged and the effects would be life-altering. On the other hand, being officially retired has many benefits, specifically for his 27 year old wife, Carol, an administrator for a staffing agency, who would now be eligible to receive health benefits for life.

Military in His Blood

In 1986 at the age 6, Cremin immigrated to America from Cork City, Ireland with his mother and younger brother to join their father, who had left Ireland earlier to come to the United States to escape an economic recession at home.  For the father, America offered promise and hope with a better way to support a family. With the family together, both parents would ultimately work 90 hours a week to keep their family together.

As a young child, Cremin had always wanted to join the Marines.  He recalls as a youngster, the first poster on his bedroom wall was a Marine recruiting poster, instead rather than the typical sports teams poster you might expect to see.

“Why not be a Marine?,”  he asked.  Military service spanned generations in Cremin’s family tree, stretching to his grandfather’s enlistment in the Irish army early in the century.  Uncles would serve under the United Nation’s flag in Lebanon, Cyprus, the Congo and even Yugoslavia.

In 2003, during Operation Iraqi Freedom, Cremin would enlist in his beloved Marine Corps.  For all active duty recruits who lived east of the Mississippi, the young Marine’s basic training took place at Parris Island, South Carolina.  This would be followed by combat training in at Camp Lejuene, North Carolina where he was then sent to Amphibious Assault School, Camp Pendleton in California.

Until 2007 Cremin would be stationed in 29 Palms, California in the hot Mojave Desert.  From the West coast military base, he would be deployed for a 9 month tour in Iraq, serve on the 31st Marine Expeditionary Unit on amphibious LSD for ten months and take a 10 month tour of South East Asia.  Leaving active duty in 2007 he returned to Quincy, Massachusetts, where he would take care of family business.  Missing the ‘esprit de corps’ of belonging to the Marine Corps, he would reenlist in the reserves in less than 1 year, which would bring him back to war in Afghanistan in 2011.

The New Year Brings Retirement

Over his decade long military career, Cremin has also found time to volunteer in the community.   When he was stationed in California, he began to do volunteer work in the Marine Corps’ “Toys for Tots” initiative.  In 2010 he decided to step forward to volunteer running the state’s Toys for Toys initiative. When he came back to the east coast after his Afghanistan tour, he would again volunteer to take the reins and oversee Rhode Island’s efforts to collect toys for the needy OceanState children.

Two weeks ago, Cremin officially found out that he would was being retired from the Marine Corps, and his retirement would come at the beginning of 2013. Before this last combat tour, his Associate Degree in Criminal Justice that he earned at QuincyCollege might just have been a stepping stone to a law enforcement career if he was not to stay in the military.   However, his current medical disability would reduce the probability that he could enter that career. Not knowing where he will ultimately live, or work, makes it difficult for Cremin to choose a University to complete his bachelor’s degree.

“Things are up in the air now,” Cremin says, noting that with the economic downturn in Rhode Island, the young war veteran is not sure where he will ultimately end up. Five of his fellow Marines volunteering their time to work on this toy collection project, all who were injured in Afghanistan, will also be looking for work, too.  .

But for now, before he joins the rank and file of unemployed veterans with his five fellow Marines, he will concentrate on overseeing the completion of this year’s Toy’s for Tot’s Campaign. It keeps his mind off the uncertainly of not knowing where his next pay check will come from. “I really don’t want to think about the future.”

Reaching Out to Unemployed Veteran

           According to the U.S. Bureau of Labor Statistics, the employment rate for all Veterans nationwide fell to 6.3 percent last month —well below the national employment average of 7.9 percent.  However, for post-9/11 veterans, America’s newest veterans, the rate reached 10 percent.

However, “the picture is even worse in the Ocean State”, notes Consultant Dan Cahill.  “In our work we found the unemployment rate among veterans was higher than the general population,” says Cahill, who coauthored a report released in November 2011, entitled Initial Needs Assessment and AmeriCorps State Service Plan.  Funded by Serve Rhode Island, Cahill noted that issues of unemployment are predominant in the veteran population between 35 to 54 years of age. “Approximately 13 percent of veterans in this group are unemployed, compared with a 9 percent unemployment rate among non-veterans in this cohort,” he says.

Cremin and the growing number of unemployed Rhode Island veterans now can turn to a Department of Defense (DOD) program that will assist these individual’s find work.

According to Rebecca Sanderson, Rhode Island’s  H2H Hero to Hire                  Employment Transition Coordinator, this program unveiled in 2011, offers valuable resources for military veterans members by way of hiring fairs, job training, career assessment and military skills translation.  With more than 400 Hiring Our Heroes job fair events, Sanderson noted that one was recently held in the Ocean State to assist current service members, retirees and veterans find civilian jobs.

Sanderson stated that 64 employers came to CCRI in Warwick, on November 9, 2012, to meet the 176 job seekers who attend this event. During the day, company’s received 526 resumes with 103 interviews being conducted.  Seventeen job offers were made that day, she noted.

“We expect more job offers to be made by companies who attended the job fair as they sort through the resumes they collected and finish their interview process of the participants,” says Sanderson. Rhode Island usually hosts two Hirer Our Heroes (HoH) job fairs per year, one in the fall and one in the spring. (Information on these job fairs, including dates and locations can be found by following the links for live hiring fairs on www.H2H.jobs,  the organization’s website).  “At this internet site employers can post jobs, and service members, post resumes and make a job connection,” she says.

One of the biggest challenges that veterans face in finding jobs after returning from active military service involves the translating of their military skills into terms that civilian employers will understand, says Sanderson.  “Service members return with many “soft” skills such as leadership, problem solving, and team work, but may not have the training in the “hard” skills the employers are looking for,” she says.

Sanderson continues to work hard toward creating better networking opportunities that will allow military veterans from active duty and reservists to better interact with employers to break down barriers to communication which will allow businesses to better recognize the value of those who have served in the nation’s military.

Hopefully, Rhode Island companies will see the value of hiring Cremin, a war veteran who could bring his military leadership skills, problem-solving and expertise in organizing large scale events, to their operation.

Veterans fought  for our nation’s freedom.  May be its time for employers to give them a break, by easing them into civilian life and giving them decent employment.  If this happens, everyone becomes a winner.

For more info about the H2H Program, contact Rebecca Sanderson, Employment Transition Coordinator at 401 275-4359; Rebecca.Sanderson@us.army.mil.

Herb Weiss, LRI ’12, is a Pawtucket-based freelance writer who covers aging, medical and health care issues.  He can be reached at hweissri@aol.com.