Use ARPA Funds to Make Rhode Island “Age Friendly”

Published on the November 1, 2021 in RINewsToday

With the first public hearing cancelled because of Wednesday’s nor’easter on Oct. 26, Gov. Dan McKee and Lt. Gov Sabina Matos, along with Commerce Director Stefan Pryor and their staff, came to Warren’s Hope & Main to kick off the second public hearing to gather comments about the recently released “Rhode Island 2030: Charting a Course for the Future of the Ocean State.”  The 55-page “working” paper studied and analyzed options for spending the funds authorized by the American Rescue Plan Act (ARPA).

Over 50 people came to Warren to give their suggestions as to how the COVID-19 federal dollars should be spent. Problems to address included: lack of affordable housing, the growing homeless program, recovering from the pandemic and rebuilding the state’s economy, and creating an age-friendly state.  

During his testimony, West Warwick resident Vincent Marzullo advised McKee and Matos not to forget Rhode Island’s increasing aging population. According to Marzullo, for the first time in recorded history, there are more people over the age of 64 in the world than children under five. In Rhode Island, over 31 percent of residents are age 55 or older, and by 2030 one-quarter of our population will be over 65. 

While many of the Rhode Island’s 2030 report’s draft recommendations, as well as suggestions from the RI Foundation and AFL-CIO, are worthy, “what is obvious in the current draft is the lack of specific attention, focus and strategy needed to get to an age-friendly designation, said Marzullo, a well-known aging advocate who served as a federal civil rights and social justice Director in Rhode Island for the Corporation for National & Community Service.

“Don’t we now have an obligation to insure better healthcare, safety, housing, livability, caregiving, etc. for this aging population?” Marzullo asked.  

One way for Rhode Island to accomplish this is to join the AARP Age-Friendly Network of States and Communities, which defines eight interconnected domains that can help to identify and address barriers to the well-being and participation of older people. 

State Director Catherine Taylor says that AARP Rhode Island has been working toward making Rhode Island age-friendly for most of the past three years and in a letter back in mid-July urged the governor and state leaders to use ARPA to accelerate AARP’s effort.  

“We are on the cusp of an opportunity to improve livability dramatically,” adds Taylor. “AARP Rhode Island has urged Governor McKee and state leaders to designate a substantial portion of the $1.8 billion in federal ARPA funds to areas that contribute to further development of age-friendly cities and towns — prioritizing healthcare, housing, public transportation, and the long-term services and supports that are essential to older Rhode Islanders,” she says.

The defined domains of AARP Age-Friendly cities are: Outdoor Spaces and Buildings (people need public places to gather — indoors and out); Transportation (driving shouldn’t be the only way to get around); Housing; Social Participation; Respect and Social Inclusion; Work and Civic Engagement; Communication; and Information and Community and Health Services.

Eight other states have obtained “Age-Friendly” status in collaboration with AARP and The World Health Organization (WHO).  

“Well-designed, livable communities promote well-being, sustain economic growth, and make for happier, healthier residents — of all ages,” said Taylor. “That is why AARP has guided Newport, Cranston, Providence and, most recently, Westerly into membership in the AARP Network of Age-Friendly States and Communities. While we are in discussion with other towns and cities who have shown interest, it has been our goal for some time to see that the State of Rhode Island also joins,” she says.

“A key benefit of the Network is the abundance information and support that membership provides. State leaders would have access to global resources on age-friendly best practices, models of assessment and implementation, and the experiences of other states, cities and towns around the world,” notes Taylor.

“The Network helps participating communities become great places for people of all ages by adopting features such as safe, walkable streets; better housing and transportation options; access to key services; and opportunities for residents to participate in civic and community activities. We believe that Rhode Islanders of all ages prefer living in an age-friendly environment. Many, especially older people, are eager to be involved in the process,” adds Taylor.

Marzullo urged McKee to issue an Executive Order, charging the Lt. Governor to convene representatives from the aging community to design and develop an operational plan for Rhode Island to be designed as an “Age Friendly State.”  The groups should include AARP, Age Friendly RI (RIC), the Long-Term Care Coordinating Council (LTCCC), RI Office of Healthy Aging, United Way RI, RI Senior Center Directors Association, RI Elder Info, Senior Agenda Coalition/RI & the RI Commission on National & Community Service (RIDE). 

Creating a Well-Designed Livable Community for Seniors

Maureen Maigret, policy consultant and chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council, notes that the Subcommittee has worked successfully to address “age friendly” domains for several years and that Rhode Island’s 2023 State Plan on Aging also calls for the state to be designated as ‘Age Friendly’ and to work with its partners to promote livable communities for all ages.

“While a formal state commitment through an Executive Order has not happened a number of state agencies such as Environmental Management have been working to embrace age-friendly principles in their work, says Maigret, noting our Rhode Island municipalities have made a commitment to make their communities age-friendly.

In a Sept. 23 Providence Journal op-ed, Maigret called for making Rhode Island age-friendly, recommending that the General Assembly invest in the state’s growing older population. “Knowing that 50-70% of older persons will need some type of long-term services as they age, our most important immediate challenge is to stabilize the paid workforce that helps with the supports needed to remain living at home and to ensure we provide quality congregate care,” says Maigret. 

“We must take immediate steps to secure competitive, living wages for our direct care workers who assist with these tasks and to provide more supportive services for our hundreds of unpaid caregivers who care for loved ones, adds Maigret.  “By looking ahead to 2030, it makes sense to direct a small portion of the federal ARPA funds to communities to both enhance the work of our local senior centers and local Villages and volunteer programs as well as to initiate other age-friendly effort,” she says. 

Maigret calls on Rhode Island’s 39 Cities and Towns to use some of the significant ARPA funds to complement any state funds coming their way for such activities. But for now, stabilizing the long-term care workforce is critical.

A Final Thought…

“The COVID pandemic demonstrated the vulnerability and inequities within both our communities of color and older adults.  In formulating policy and budget investments for the future, Rhode Island has a unique opportunity to promote a statewide “Age Friendly” environment and incorporate the principles of a “beloved community” – a prescription for a healthy society,” says Jim Vincent, President of NAACP’s Providence Branch.

Vincent calls on the Governor and Lt. Governor to give serious attention to not only rebooting our economy, but to strengthening our social fabric and public education to foster a more equitable and civil society. 

Make your voices heard. Now is the time for creative ideas and reactions to the McKee-Matos’ Rhode Island 2030 draft report, which is why they are holding public input sessions. Please take the time to be an advocate for seniors in Rhode Island – and for other causes and issues that are important to you.

Public input sessions will be held at 5 p.m. on the following dates:

Tuesday, Nov. 2 at the Community College of Rhode Island, Warwick

Thursday, Nov. 4 at Innovate Newport (513 Broadway, Newport)

Tuesday, Nov. 9 at United Theatre (5 Canal Street, Westerly)

You can also submit your feedback, online, at www.RI2030.com

For a copy of the McKee-Matos working paper, go to https://ri2030.com/_files/public/RI%202030_final.pdf.

For details about AARP Livable Communities Network (age-friendly communities, to to https://www.aarp.org/livable-communities/network-age-friendly-communities/.

Senate Aging Committee Tackles COVID-19’s Devastating Impact on Seniors

Published in the Woonsocket Call on May 24, 2020

In the midst of bipartisan bickering on Capitol Hill as to what should be included in the fifth coronavirus (COVID-19) stimulus package, the Senate Aging Committee holds Congress’s first hearing in Senate Russell Office Building 301 on the disproportionate toll the COVID pandemic is having on the nation’s seniors, particularly those who reside in nursing homes.

Adults ages 65 years and older represent two out of every five hospitalizations and eight out of every 10 deaths from the virus. The 1.5 million nursing home residents and seniors residing in group care settings (including assisted living facilities) are especially at risk. Nationwide, residents and workers in nursing homes and other long-term care settings represent more than one-third of all COVID-19 deaths. According to reports, to date more than 34,000 nursing home residents have died from COVID-19.

COVID-19’s Deadly Toll on Seniors

The Senate hearing, “Caring for Seniors Amid the COVID-19 Crisis,” held on Thursday, March 21, 2020, explored what can be done to better protect this vulnerable population. Over two hours, Senators heard testimony from a panel of experts who are supporting older adults in hospitals, nursing homes, home health settings, and the community. (Due to the limited access to the Capitol Complex, the public is only able to view the morning hearing live on the committee’s website at https://www.aging.senate.gov/hearings/caring-for-seniors-amid-the-covid-19-crisis.

“COVID-19 has brought tremendous hardship and tragedy, placing a heavy burden on the frontline workers, straining our healthcare and distribution systems, and imposing a deadly toll on our seniors in particular,” said Senator Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Those in nursing homes and congregate care centers are especially at risk. Nationwide, nursing home residents represent one-third of all coronavirus deaths. In Maine, the toll on nursing home residents is even higher,” adds Collins.

“Our nation is facing the greatest public health crisis it has seen in a century. This terrible virus is causing death and destruction at lightning speed, especially among older Americans who are most vulnerable for complications from COVID-19,” added Ranking Member Bob Casey (D-Pennsylvania). “We have added unprecedented amounts of funding to purchase personal protective equipment, testing and ensure seniors in the community have access to home and community-based services that keep them out of congregate settings, but this is not nearly enough. We cannot stop working we cannot stop legislating, we cannot stop appropriating dollars to help our seniors,” says Casey.

“This unprecedented time calls for equally unprecedented action. The Administration has to do more and Congress has to do more to help our seniors and their families at every turn,” said Casey. During the hearing, the Senator highlighted his bill (S.3768), the Nursing Home COVID-19 Protection and Prevention Act, introduced with Senator Sheldon Whitehouse (D-Rhode Island, which would help mitigate the pandemic’s disproportionate impact on nursing homes by helping states purchase personal protective equipment (PPE) and testing and fund premium pay, overtime and other essential benefits for nursing home workers.

Taking a Look at Universal Testing of Nursing Home Residents

Collins directed her first question at the hearing to Dr. Tamara Konetzka, a professor of health services research at the University of Chicago, who has conducted research on the disproportionate impact of COVID-19 on nursing home residents and staff. She asked Dr. Konetzka to explain how universal testing can protect residents and eventually allow family members to safely visit their loved ones.

“Dr. Konetzka, I want to have you expand a little bit more on what we can do,” said Collins. “I believe that you recommended universal testing for every nursing home resident and staff, which I think is a good idea and have been recommending. How often, however, would you have to do that, and would that allow family members who have been tested to finally be able to visit their loved ones?”

“[I]t is very important to test all residents, and not wait until residents are…symptomatic, because by then it’s too late,” replied Dr. Konetzka. “[W]hat I’ve heard from geriatricians is generally weekly [testing] would be good or at least biweekly, so that residents can then be separated and the transmission can be stopped.”

Collins also emphasized that testing was needed at every long-term care facility, since even the highest rated nursing homes have been susceptible to outbreaks.

At the hearing, Senator Collins called for the release of additional health care provider funding that was made available through the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act.

“[T]he ratings by CMS, the number of stars, has not proven to be a reliable indicator of which nursing homes are safest in this environment. And indeed, one of the worst outbreaks in Maine was at a nursing home that had five stars,” remarked Collins. “[W]hen we hear the statistics, which are so devastating…my heart just goes out not only to these patients, but to their families and to the staff of nursing homes and other assisted living facilities, congregate care settings. They’re all praying that COVID-19 does not find its way into their facility,”she said.

As the chief infectious disease specialist for New York University, Dr. Mark J. Mulligan oversees the treatment of COVID-19 patients at the University’s health system hospitals. At the hearing, he explained that seniors are at increased risk due to aging-related decline of the immune system as well as chronic conditions such as cancer, heart disease, lung disease, and diabetes, and that older adults who reside in nursing homes are the most vulnerable.

Medical Countermeasures to Combat COVID-19

Dr. Mulligan provided an overview of the medical countermeasures under development—diagnostics, monoclonal antibodies, and potential treatments such as remdesivir.

“For physicians, scientists, and leaders, the virus has continued to humble us. There’s so much we don’t know yet about diagnosis, prevention, and treatment,” said Dr. Mulligan. “The nurses and doctors I have worked with are incredibly dedicated and caring, but they have not had the medical countermeasures needed to effectively help many vulnerable seniors who have died of this disease,” he adds.

Finally, the final panelist, Dr. Steven Landers, the President and CEO of Visiting Nurse Association Health Group who oversees a team of 3,000 caregivers that cares for 9,000 people daily, provided a home health perspective on the public health crisis. According to Landers, maintaining this a supply of Personal Protective Equipment (PPE) is both challenging and expensive. “We are using over 17,000 surgical masks and over 3,500 N95 masks each week and we are also using thousands of isolation gowns, gloves, goggles and face shields. We have had to pay 7-10 times the usual prices and reach out to vendors all over the world, vendors who we couldn’t fully vet and verify, sometimes just hoping that shipments would arrive,” he say, calling on Congress to find ways prioritize home health and hospice agencies getting needed PPE.

“I have never seen the system so strained, but I also have never felt prouder of the skilled, compassionate, and courageous people I work with,” he said.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.