Tag Archives for Congressman Seth Magaziner

Senior Agenda Coalition of RI Unveils 2026 Legislative Agenda at Annual Briefing

Published in RINewsToday on March 16, 2026

At its 10th annual Legislative Leader’s Forum, the Senior Agenda Coalition of Rhode Island (SACRI) unveiled its 2026 legislative agenda. More than 160 participants, including older adults, advocates, and state and federal officials, gathered at Gaige Hall at Rhode Island College for the event.

The event, “Voices of Advocacy — Anchors of Hope,” addressed the challenges facing Rhode Island’s growing older population and the policy changes needed to improve affordability, health care access, housing, and community supports.

The briefing opened with remarks by Rhode Island College President Jack R. Warner, SACRI Board Chair, Kathleen McKeon, and Executive Director Carol Anne Costa, who served as host. 

Costa began with a thank you to Rep. Joseph Solomon and Senator Mark McKeeney (who were present) for introducing the bill creating the Office of the Elder Advocate.  SACRI Policy Advisor Maureen Maigret outlined an Affordable Policy Agenda. Other speakers included representatives from the Rhode Island Coalition for Elder Justice, Economic Progress Institute, and Rhode Island Organizing Project.

A number of top elected officials followed, including U.S. Sens. Jack Reed and Sheldon Whitehouse, Congressman Seth Magaziner, Gov. Dan McKee, State Treasurer James Diossa, House Speaker K. Joseph Shekarchi, and Senate Majority Leader Frank Ciccone, who discussed previous and current legislative efforts affecting older Rhode Islanders.

Rhode Island’s Aging Demographics

“One in five Rhode Islanders is 65 or older,” Maigret said, adding the state is also among the top five for residents 85 and older.

The share of residents 65 and older rose from 16% in 2016 to 19% today. Maigret reminded officials that older residents are a powerful voting bloc. In 2024, over one-third of ballots were cast by older voters.

Nearly 73% of households led by those 65 and older own their homes, while 28% rent. Housing costs burden 31% of older homeowners and 52% of renters, who spend over 30% of their income on housing.

Around 4% of older Rhode Islanders live in nursing facilities, and about 485 aged 55+ are unhoused including 164 persons aged 65+.

Older adults drive Rhode Island’s economy: 40% of the workforce is 55+, about 40,000 provide unpaid family care, and approximately 45,000 volunteer formally in their communities.

Residents aged 50 and older contribute $27 billion annually to Rhode Island’s GDP. Social Security brings $3.9 billion into the state each year, with every $1 in benefits generating about $2 in economic output.

Despite these contributions, financial insecurity persists. Older adult poverty has increased and now exceeds 11%, and nearly a quarter of older households live on less than $25,000 a year.

A healthy single older homeowner without a mortgage needs nearly $29,000 annually to cover basic expenses, exceeding what about a quarter of older households have.

SACRI’s Legislative Priorities

Maigret said affordability is the central challenge facing older residents especially those with modest incomes, and SACRI has organized its agenda around four “building blocks”: health care, economic security, housing, and community supports.

Eliminating the $9,950 asset limit for the Medicare Savings Program is a top priority. SACRI recommends removing this limit entirely to allow more low-income residents to qualify for help with Medicare costs.

 “In 2025 the legislature raised the income eligibility to about $27,000, this year we want to take the next step,” Maigret said. “And the next step is to eliminate the very restrictive asset test.”

Maigret also urged lawmakers to fully fund provider rate increases as recommended by the Office of the Health Insurance Commissioner, specifying that these funds are needed to close workforce shortages in home care.

These increases address shortages of home care workers. The coalition also urges nursing home cost-of-living adjustments to the federal 3.1% recommendation, ensuring increases reach frontline workers.

Additional SACRI recommendations include increasing funding for the Long-Term Care Ombudsman Program to expand oversight and supporting an all-payer Primary Care Investment Target to increase access to primary care.

To address Rhode Island’s housing shortage, SACRI recommends a housing bond of at least $120 million, with a requirement that at least 30% be allocated to populations including older adults, persons with disabilities and the homeless. SACRI further urges that new residential developments be required to include more accessible units than the current 8% rate.

Maigret called for stronger support for caregivers and community services. Proposed policies include a caregiver tax credit up to $1,000, increasing the Medicaid home care asset limit, funding homemaker services, awarding a state grant to the Village Common of Rhode Island to aid aging in place, and establishing an Office of the Elder Advocate.

Other Policy Concerns

Nina Harrison, policy director at the Economic Progress Institute, argued that Rhode Island’s tax system places a heavier burden on lower-income residents.

“The lowest-income earners in the state pay a higher portion of their wages in taxes than the top income earners,” Harrison said. She supports creating a new tax bracket for annual income above $640,000, which she said could generate about $203 million annually for public services.

Ray Gagné of the Rhode Island Organizing Project called for restoring recent service cuts at the Rhode Island Public Transit Authority and creating a stable, long-term funding source for the system.

Lawmakers Respond

House Speaker Shekarchi shared a personal story about caring, along with his siblings, for their 100-year-old father with Alzheimer’s disease, stressing the importance of allowing older adults to age in place.

“Everything is a compromise. Everything is a negotiation,” Shekarchi said of the legislative process. He highlighted recent state investments, including $18 million to keep Roger Williams and Fatima hospitals operating, $12 million added last year to nursing home funding to address workforce shortages, and more than $40 million to increase reimbursement rates for primary care physicians.

Shekarchi also pointed to legislation allowing Accessory Dwelling Units (ADUs) as a step toward addressing the state’s housing shortage.

“That’s a big benefit,” he said.

Senate Majority Leader Ciccone said lawmakers are considering 17 bills to make health care more affordable and accessible. “Throughout this session, we will evaluate the financial burdens facing Rhode Islanders and the programs they rely on,” Ciccone said.

Gov. McKee argued that his “affordability for all” plan would benefit all Rhode Islanders, with key provisions for seniors, including the complete elimination of the state tax on Social Security and policies to control rising utility costs.

The Governor outlined several proposals in his budget, including increasing funding for senior centers by $200,000 for a total of $1.8 million and phasing out the state tax on Social Security income over three years, beginning with lower-income residents.

His budget also includes $9.5 million to assist nearly 10,000 residents whose HealthSource RI insurance premiums have increased sharply.

State Treasurer Diossa gave an overview of agency programs spanning the age spectrum, from baby bonds to retirement planning. He noted that his Secure Choice retirement program addresses the needs of the 40% of private-sector workers who lack access to retirement benefits.

At the federal level, Sens. Reed and Whitehouse warned that changes to federal policies could threaten Social Security, Medicare, and Medicaid.

U.S. Rep. Seth Magaziner also called for federal action to lower costs, including expanding Medicare drug price negotiations and creating tax incentives to increase the housing supply. He also announced plans to pursue bipartisan legislation to establish a permanent House Select Committee on Aging. “Seniors deserve a dedicated forum in Congress focused on the challenges they face,” Magaziner said.

SACRI’s Costa ended the Forum with a call to collective action, urging attendees to leverage their influence for unified advocacy on behalf of older adults and people with disabilities in Rhode Island.

Let’s make our voices heard and ensure Rhode Island’s leaders are held accountable for advancing these critical priorities. Together, we can drive lasting change and truly roar for progress.

Two Attendees’ Perspectives

Mary Lou Moran, director of Pawtucket’s Division of Senior Services/Leon Mathieu Senior Center, said the briefing successfully brought together leaders from across government to focus on the needs of older residents.

“The continued work to eliminate the Medicare Savings Program asset limit, create an Office of the Elder Advocate, and expand funding for programs such as the Long-Term Care Ombudsman and Medicaid home care was all highlighted,” Moran said.

Moran emphasized legislative and federal efforts to support older adults and expressed optimism that the initiatives discussed will drive progress in the next session.

“The Governor’s FY 2027 State budget is fully committed, has little new revenue & substantial federal cuts in the Affordable Care Act, Medicaid, Housing Voucher & food subsidies will leave an unresolved budget hole,” says North Kingston Resident David R Kaloupek. Kaloupek, 87, asks: “How will the Rhode Island General Assembly narrow its spending targets for the state’s most vulnerable, frail older adults, nursing home residents, home care beneficiaries, and unhoused older Rhode Islanders?  When the dust settles after the upcoming legislative sessions conclude, we’ll see who will be helped and who will be abandoned.”

A final note…  The coming together of aging advocates and Gov. McKee, the House Speaker, and Senate Majority Leader might just create the political will to support key parts of SACRI’s legislative agenda, such as eliminating the Medicare Savings Plan asset limit, the state tax on Social Security, or creating an Office of Elder Advocate, which could significantly boost the chances of those proposals becoming law. The agreement between aging advocates and state lawmakers on several fronts suggested a strong potential for legislative progress on senior issues in the upcoming session.

SACRI’s 2026 Legislative Leaders’ Forum was sponsored by: Age-Friendly Rhode Island, Delta Dental, United Healthcare, Neighborhood Health Plan, SEIU Local 580 and Capitol TV.

https://capitoltvri.cablecast.tv/show/11856

Pandemic Lessons: “Essential Caregivers Act” Can’t Wait. A Merciful, Bipartisan Bill for a Voiceless Population

Published in RINewsToday on January 19, 2026

As COVID-19 spread rapidly across the country in March 2020—entering nursing homes largely through community transmission and staff movement—the Centers for Medicare & Medicaid Services (CMS) issued guidance calling for nationwide visitor bans in nursing homes. These strict restrictions barred all visitors and non-essential health care personnel, with limited exceptions for hospice care.

According to March 29, 2025 article, “Changes in Federal and State Policies on Visitation Restrictions in Nursing Homes During the COVID-19 Pandemic,” published in the Journal of Applied Gerontology, 31 states enacted statewide indoor visitation bans through executive orders between March 9 and April 6, 2020, and the end dates were between 6/15/2020 and 3/24/2021. CMS would later relax its guidance, permitting indoor visitation when facilities reported no new COVID-19 cases for 14 days and community positivity rates were low.

Charlie Galligan, a licensed criminal defense investigator in Rhode Island, knows firsthand the toll those restrictions took. He and his wife, Kerry, provided daily care for his parents for 13 years—his father, Jack, who died from Alzheimer’s disease in 2022, and his mother, Audrey, who lives with a traumatic brain injury. Balancing work with caregiving became the catalyst that pushed Galligan to lobby Congress to prevent the prolonged and unnecessary isolation of nursing home residents during future pandemics, including advocating for policies that allow designated family caregivers to visit.

“Long-term care lockdowns continued well after humane safety measures were established and family caregivers had been vaccinated,” Galligan claimed, noting that countless residents died alone as a result. “Daughters were forced to say goodbye to mothers with Alzheimer’s over FaceTime—often staring at their phones as exhausted staff struggled to provide even minimal connection.”

A Legislative Effort Revisited

The initial legislative proposal—the Essential Caregivers Act (H.R. 3733)—was introduced in June 2021 to reaffirm and enforce the right of nursing home residents to receive visits from family and friends during declared emergencies. When that proposal stalled due to the absence of a Senate companion bill, a second attempt followed the next year with the introduction of S. 4280/ H.R. 8331.  Political insiders say that these bills stalled due to the legislative process, timing, and competing priorities not because Congress rejected the process. Most recently, the Essential Caregivers Act of 2025 was reintroduced last month.

On Dec. 16, 2025, U.S. Senator Richard Blumenthal (D-CT) and U.S. Representative Claudia Tenney (R-NY) introduced bipartisan legislation in their respective chambers to prevent a repeat of the prolonged isolation and reduced care nursing home residents faced during the COVID-19 pandemic. U.S. Senator John Cornyn (R-TX) and U.S. Representative John B. Larson (D-CT) joined them in cosponsoring the Essential Caregivers Act.

The Senate bill, S. 3492, currently with seven cosponsors, was referred to the Senate Finance Committee. That same day, the companion measure, H.R. 6766, with 35 cosponsors, was introduced in the House and referred to the Ways and Means Committee and the Energy and Commerce Committee.

“Our movement to enact the Essential Caregivers Act is not led by professionals or lobbyists,” Galligan said. “We are simply a determined group of family caregivers—primarily brilliant, tenacious women from across the country, and one token guy from Rhode Island—who love our mothers and fathers and refuse to accept silence and separation as acceptable standards of care.”

Congressional Supporters Call for Passage

“During the COVID-19 pandemic, we experienced how dangerous and inhumane it is to isolate seniors and vulnerable patients from the people who care for them the most, say Rep. Tenney, in a statement announcing the introduction of the bill.  “Families were locked out, residents declined rapidly, and farm to many suffered alone,” she said.

“The Essential Caregivers Act ensures that this never happens again,” says Rep. Tenney, noting that they are loved ones, not visitors.  “They are caregivers, advocates, and lifelines. This bipartisan legislation protects dignity, safeguards patient rights, and makes sure compassion and comment sense guide our response during an future emergency,” she adds.

Sen. Blumenthal emphasized the bill’s bipartisan intent. “By allowing at least one designated essential caregiver to have safe, in-person access to their loved ones during an emergency, our legislation ensures that residents will never again face the devastating isolation experienced by so many during COVID-19,” he said.

Rhode Island Sen. Jack Reed, a cosponsor of the Senate bill, echoed that sentiment. “We want to keep people safe from germs, but we also want to keep them connected—because isolation can take a real toll on health,” Reed said. “Essential Caregivers Act would ensure that even during limited visitation, residents can still have in-person contact with a loved one.”

Sen. Sheldon Whitehouse has expressed support and is on a waiting list to cosponsor it – cosponsors are being added in bipartisan pairs. “Loneliness can take a real toll on residents of long-term care facilities,” he said. “This legislation recognizes the critical role loved ones play in supporting residents’ well-being, even during public health emergencies.”

Not yet committed to cosponsoring are Rhode Island’s two Representatives

At press time, Rep. Gabe Amo, had not yet committed to cosponsoring the bill. “I am reviewing the Essential Caregivers Act of 2025,” Amo said. “Family caregivers are the backbone of our long-term care system, and I remain committed to advancing policies that support patients, caregivers, families, and health care providers.”

Like his House colleague, Rep. Seth Magaziner (D-RI), has not yet committed to sponsoring the bill. Magaziner acknowledges the importance of allowing nursing home residents access to their loved ones and is open to considering the legislation. However, he is also working to understand what safeguards would be in place to ensure resident safety during emergencies, according to Noah Boucher, the lawmaker’s communications director.

The Nuts and Bolts

Recognizing that family members are essential to residents’ care and well-being, S. 3492 and H.R. 6766 aim to prevent the emotional, psychological, and physical harm caused by prolonged separation during public health emergencies.  This bill strikes a balance protecting public health while safeguarding the wellness of residents.

The Essential Caregivers Act requires nursing facilities receiving Medicare or Medicaid funding to participate. It guarantees that at least one designated essential caregiver may access a resident during periods of restricted visitation, provided the caregiver follows the same safety protocols as facility staff. If a resident is unable to designate a caregiver, a representative may do so on the resident’s behalf.

The legislation also affirms caregivers’ rights to advocate for residents, participate in care planning, and ensure residents’ civil rights are protected. Additional provisions address roommate rights, as well as exemptions for end-of-life and compassionate care.

Facilities must provide written justification if caregiver access is denied, with appeals overseen by state survey agencies.

The bill has been endorsed by the AARP and Consumer Voice.

Rhode Island Advocates Call for Passage

Calling for passage of the legislation, Rhode Island Long-Term Care Ombudsman Lori Light said the COVID-19 pandemic made painfully clear how critical family caregivers are to residents’ health, safety, and well-being.

“During extended lockdowns, we witnessed firsthand the profound impact isolation had on residents, including increased depression, anxiety, cognitive decline, weight loss, and loss of engagement in daily life. For many residents, family members are not simply visitors—they are essential partners in care – they provide emotional support, help residents communicate their needs, notice subtle changes in medical conditions, and advocate when something doesn’t seem right. When access was cut off, residents lost a vital layer of protection and connection. The lessons we learned during COVID-19 must guide future policy decisions,” Light said. “No resident should ever again experience prolonged isolation from the people who know them best,” said Light.

According to Deb Burton, MS, executive director of RI Elder, the isolation imposed on long-term care residents during the pandemic was devastating. While infection control was essential, she said, the complete separation of residents from their families caused profound and lasting harm. Burton, a gerontologist, noted that residents experienced rapid physical, cognitive, and emotional decline.

“Families endured anguish knowing their loved ones were frightened, confused, and alone during the most vulnerable moments of their lives. Family members are not simply visitors—they truly are essential caregivers. They provide a familiar face, a steady hand to hold, and an understanding of a resident’s routines, preferences, and communication needs. This is especially true for individuals living with dementia or other forms of memory loss, for whom familiarity and connection are critical to well-being and safety,” Burton said.

Comments from the American Health Care Association 

While expressing support for family involvement, the nursing home industry has raised concerns about certain provisions of the bill.

From Holly Harmon, senior vice president of quality, regulatory, and clinical services at the American Health Care Association: “While we wholeheartedly support family members taking an active role in their loved one’s care, there are certain provisions of this bill where we have concerns. Mainly, we believe each situation, including public health emergencies, requires a collaborative process among public health officials and stakeholders to determine the most appropriate way to keep residents safe and loved ones connected, rather than implementing a blanket, inflexible process for all situations. We hope to work with lawmakers to make improvements to these proposals as the engagement of loved ones is critical to our residents’ wellbeing.

“Despite our caregivers doing everything they could to step in for family members during the pandemic, we were deeply concerned about the prolonged isolation of our residents. Public health officials were put between a rock and a hard place on how to best protect those in long term care, and due to the vicious nature of the virus on our resident population, it was determined best to restrict visitors and social interactions. Nursing homes were required to follow these restrictions until March 2021, and even then, CMS and CDC had strict guidelines due to the ongoing spread of the virus.

“The best way to prevent this global tragedy again is for officials to prioritize long term care residents and staff during public health emergencies, so that they can remain protected, active, and engaged with their loved ones and the community.”

A Final Note…

The best way to prevent another tragedy is to prioritize long-term care residents and staff during public health emergencies, so they can remain protected, active, and connected to loved ones. We must learn from the painful lessons of COVID-19. No one should be forced to decline alone, grieve alone, or die alone because of a lack of clear policy, RIElder’s Burton added. She noted that the Essential Caregivers Act ensures that in the next public health emergency” when it could be any one of us in a facility” we will not be separated from the person who knows us best and stands ready to advocate for us.

Caregiver Galligan remains hopeful. “This is simply a merciful bill for a voiceless population”, he said.

(updated 1-21-26)

43 Days to Reauthorize the Older Americans Act

Published in RINewsToday on August 18, 2025

The clock is ticking. Funding for the Older Americans Act (OAA) is currently secured only through September 30, 2025—that’s just 43 days away. Unless Congress acts to reauthorize the law or approve new appropriations before the start of FY 2026 on October 1, funding could lapse. A bipartisan effort must be made on Capitol Hill to ensure both reauthorization and the FY 2026 budget are addressed, avoiding any interruption in services for America’s older adults.

Last reauthorized in 2020, the OAA expired during the 118th Congress. S. 4776, spearheaded by Sen. Bill Cassidy, M.D. (R-LA), chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and Sen. Bernie Sanders (I-VT), the committee’s ranking member, passed the Senate by unanimous consent last year. However, the House failed to pass a companion measure due to unrelated political disagreements.

Two months ago, Chairman Cassidy and nine co-sponsors reintroduced the OAA Reauthorization Act of 2025. The 91-page bill, S. 2120, would renew funding and strengthen services for older Americans. It was referred to the Senate HELP Committee the day it was introduced, where hearings, markups, and a committee vote are expected. If approved, it will move to the full Senate for consideration. As of press time, a companion bill had not yet been introduced in the House.

Chairman Cassidy’s co-sponsors include Senators Bernie Sanders, Kirsten Gillibrand (D-NY, Rick Scott (R-FL), chair of the Senate Special Committee on Aging, Lisa Murkowski (R-AK), Tim Kaine (D-VA), Ben Ray Luján (D-NM), Ed Markey (D-MA), Markwayne Mullin (R-OK), and Susan Collins (R-ME).

Since its passage in 1965, the OAA has provided vital nutrition, social, and health services to millions of seniors. The legislation was originally sponsored by Rep. John E. Fogarty (D-RI) in the House and Sen. Lister Hill (D-AL) in the Senate, and signed into law by President Lyndon B. Johnson on July 14, 1965.

Strengthening Programs for the Future

Although S. 2120 closely mirrors last year’s S. 4776, there are notable differences. The legislation would reauthorize OAA programs through FY 2030 and increase funding by 18% over the next four years. It also includes measures to promote innovation, strengthen program integrity, and provide better support for family caregivers and direct care workers. The bill aims to improve services for Tribal elders and older adults with disabilities, ensuring these populations can remain active and supported in their communities.

One key provision strengthens the Long-Term Care Ombudsman Program (LTCOP). The bill would establish a full-time National Director position and require the National Academies of Sciences, Engineering, and Medicine to conduct a study of state ombudsman programs. This study would assess program effectiveness, staffing challenges, recommendations for improvement, and the adequacy of current staff-to-bed ratios. The legislation also calls for updated training standards for long-term care ombudsman volunteers.

The National Family Caregiver Support Program would also be expanded. The bill encourages easier access to caregiver services, removes barriers to obtaining help, and ensures supports are both accessible and practical. It specifically requires trauma-informed services and elder abuse prevention programs to be available, helping caregivers better manage challenges in their roles.

On elder abuse prevention, S. 2120 authorizes a clearinghouse for best practices, focusing on legal and protective services to strengthen state ombudsman programs, adult protective services, and related legal supports.

Bipartisan Support and Legislative Momentum

“The Older Americans Act is crucial in helping American seniors live healthy and independent lives in the settings they choose,” said Chairman Cassidy. “This legislation strengthens these programs, ensuring they meet the needs of older Americans now and in the future,” he says.

Sen. Scott also underscored the urgency of passing S. 2120 in a released statement. “I’m proud to help lead this bipartisan legislation to strengthen support for America’s older adults and reaffirm our commitment to helping them enjoy their golden years with dignity and independence,” he said. “As Chair of the U.S. Senate Special Committee on Aging, I understand how essential it is that more than 59 million older Americans have access to critical services made possible through the Older Americans Act. Our seniors have spent their lives building and serving this country, and this bill is one way we ensure they continue to be supported, respected, and valued,” he added.

“The OAA has been a lifeline for American seniors since its passage over half a century ago,” said Sen. Gillibrand in a statement on June 18. “This landmark legislation helps our nation’s seniors thrive by supporting programs that provide nutrition assistance, home-delivered and congregate meals, transportation, caregiver support, disease prevention, and more. We owe it to seniors to continue funding these programs so they can age with dignity and respect. As ranking member of the Senate Aging Committee, I am firmly committed to getting this bill passed with bipartisan support.”

Sen. Sanders’s statement echoed that message, highlighting the broad scope of OAA-funded services: “The Older Americans Act provides federal funding for many essential programs, including combating loneliness and isolation, job training, protections from abuse, rides to the doctor and grocery store, disease prevention, caregiver support, and help for older adults to live independently at home. Not only does the Act save lives and ease human suffering, it saves money. We can waste billions on emergency room visits and unnecessary hospital stays, or we can provide seniors with the resources they need to live healthier, more dignified lives.”

“The failure to reauthorize the OAA in 2024 had tragic consequences in 2025. One in particular was the elimination of the Administration of Community Living which runs OAA programs.  Also proposals (since rejected) to end funding for Adult Protective Services and ombudsman programs. When you are in legislative limbo bad stuff can happen. It’s time for that to end,” says Robert “Bob” Blancato, serving as National Coordinator of the bipartisan 3,000-member Elder Justice Coalition, the Executive Director of the National Association of Nutrition and Aging Services Programs and National Coordinator of the Defeat Malnutrition.

Advocacy and the Call to Action

National advocacy groups—including Consumer Voice, Argentum, the National Council on Aging, the National Association of Development Organizations, USAging, and the National Association of Nutrition and Aging Services Programs—are urging swift passage of S. 2120. These organizations stress that delaying re-authorization would put millions of vulnerable seniors at risk of losing essential supports.

With the many benefits the OAA delivers to Rhode Island’s older adults—and considering that the late Rep. John Fogarty of Rhode Island played a pivotal role in securing passage of the original legislation in 1965—it is only fitting that the state’s current senators take a leading role today. Senators Jack Reed (D-RI) and Sheldon Whitehouse (D-RI) should cosponsor S. 2120 and work closely with their Senate colleagues to ensure its passage. Since there is currently no companion measure in the House, Rhode Island’s Representatives Seth Magaziner and Gabe Amo must take the initiative—by urging their colleagues to introduce one, or by stepping forward themselves to lead the effort.

Congress must act before September 30 to prevent a lapse in funding. The well-being of millions of older Americans—and their ability to age in place at home with dignity — depends on it.