Tag Archives for Gov. Dan McKee

Lawmakers can do more for Seniors next year

Published in RINewstoday on July 11, 2022

Just days before July 1, 2022, Gov. Dan McKee was joined for the signing of the $13.6 billion state budget (2022-H7123aa) for fiscal year 2023 by Lt. Gov. Sabina Matos, House Speaker K. Joseph Shekarchi, Senate President Dominick J. Ruggerio, House Finance Committee Chairman Marvin L. Abney and Senate Finance Committee Chairman Ryan W. Pearson.

Taking a Look at the Budget’s Dollars and Cents

Let us take a look as ho the state’s FY2023 budget, signed by McKee on June 27, 2022, impacts older Rhode Islanders.

The budget doubled the funding for the Livable Homes Modification Program, from $500,000 to $1 million, which reimburses half the total retrofit costs, up to $4,000, to support home modifications and accessibility enhancements to allow individuals to remain in community settings. The increase is intended to address an anticipated surge in applications.

For retirees, the Assembly raised from $15,000 to $20,000 the amount of annual pension income that is exempt from state taxation.

The FY 2023 Budget also allocated an additional  $200,000 to the Office of Healthy Aging’s budget for senior centers, bringing total funding to $1 million. That is a 25% increase.

The budget also makes significant investments in the quality of healthcare for seniors, providing rate increases to many kinds of providers of health care, nursing homes, home and community-based services for elderly (increase in starting pay to $15 hour), in addition to seeking a study by the Office of the Health Insurance Commissioner on appropriate reimbursement rate levels into the future.  The budget also includes substantial increase to reimbursement rates for Meals on Wheel meals ($400,000), ensuring that the program is able to provide high-quality therapeutic and culturally appropriate meals to participants.

Lawmakers also added $4 million to increase the “circuit breaker” tax credit available to qualifying elderly and disabled residents, raising the maximum credit from about $400 to $600 beginning in tax year 2022 and indexing that amount to inflation. They also made credit available to more Rhode Islanders by increasing the income threshold for eligibility from $30,000 to $ 35,000.

Those with military pensions will no longer have to pay any income taxes on them, beginning in the 2023 tax year. The governor had proposed phasing out military pension taxation over five years, but legislators instead made them tax-free in their entirety in one year.

Lawmakers also kept the Governor’s plan to invest $168 million in upgrades to Eleanor Slater Hospital, including $108 million to construct a new long-term care acute care hospital at the Zambarano campus in Burrillville.

The plan accelerates the six-year phase-out of Rhode Island’s motor vehicle excise tax, eliminating what would have been the final year of the tax next year.  The amended budget provides replacement license plates for free.

The state budget included a year-long pilot program to provide free service on the Rhode Island Public Transit Authority’s business route, the “R” line that runs from Pawtucket to Cranston.

It also added $11.5 million general revenue funds to launch a retail Supplemental Nutrition Assistance Program (SNAP) pilot program, beginning Jan. 1, 2023.  Eligible households would receive an incentive payment of 50-cents for every dollar spent on fruits and vegetables, subject to limits.  The state also requested a waiver from the Federal Nutrition Service to streamline the application process for elderly and disabled individuals seeking assistance from the SNAP program.

Lawmakers also allocated $10 million for rebalancing the state’s long-term care continuum, for funding home care agency workforce recruitment, retention and training.  Also, money in Rhode Island’s new budget includes $8.1 million to increase Medicaid Dental rates to increase access to dental services for older adults.

Finally, lawmakers kept in the $250 million total from the American Rescue Plan Act (ARPA) federal funds in the approved budget to address state’s affordable housing crisis.

Taking a peek at new state laws

The Rhode Island General Assembly passed H-7942/S-2623 which increases access and utilization of Accessory Dwelling Units (ADUs) and provides age-friendly housing options for older adults, family caregivers, and people of all ages and abilities.

McKee also signed the Let RI Vote Act into law. This new law makes voting safer, easier, and more accessible for all Rhode Islanders. Some of the major provisions of the bill include no-excuse mail ballots and emergency voting; online mail ballot applications; permanent absentee list opt-in for nursing home residents; no witness or notary requirement to vote by mail;  multilingual voter information hotline, community ballot; and voter registration list maintenance.

A new law also seeks to develop broadband in Rhode Island by creating a Broadband Advisory Committee. It’s director will be responsible for connecting with federal agencies to access funds for broadband infrastructure deployment pursuant to federal grants, facilitating broadband service adoptions, expanding digital literacy for residents (especially seniors), experiencing economic hardship, and for future economic development.

Following the passage of S-2228, the definition of an elderly person in regard to exploitation has changed from someone 65-years-old to someone who is 60 years old, making the definition of an elderly person consistent with state law.

Finally, the proposed Perry Sullivan one-year exemption has been eliminated. This preserves $38.6 million for home and community-based services for 2023.

Gearing up for next year’s legislative session

“Despite the lack of passage of H-7616 sponsored by Rep. Lauren Carson to elevate the Rhode Island Office of Healthy Aging to full Department status, I’m confident that it will be reintroduced early in 2023. I also anticipate broad community conversations to fine tune the design and identify the needed resources,” says Vin Marzullo, a well-known aging advocate who served as a federal civil rights and national service administrator.

“AARP Rhode Island worked hard on Smith Hill during the 2022 legislative session to achieve a number of important wins for the age 50 and over Rhode Islanders,” stated Catherine Taylor, AARP Rhode Island State Director. “We will find it easier to vote, have access to more housing options and assistance for accessibility modifications, see our direct care workforce better paid and better trained, and so much more. And, as always, AARP Rhode Island is committed to ensuring that those age 50 and our families know about these changes and how they will improve our lives,” she says.

 “Although there was some very good news for seniors coming out of the 2022 legislative session, overall, the results were modest when we think about the projected growth of our older population, that 42% of older Rhode Island households have income less than $ 40,000 and that our Office of Healthy Aging is under resourced. So much advocacy work remains,” warns Maureen Maigret, chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council and Policy Advisor for the Senior Agenda of Rhode Island, representing 21 organizations to mobilize people to enhance the quality of life of older Rhode Islanders.

However, Maigret sees a big win in the state budget language calling for rate review for state contracted providers as far too many services important for all ages have become so difficult to access due to poor payment rates to providers for many years. One example is that dental rates under Medicaid have not increased since the early 1990’s so older adults have had an extraordinarily hard time getting detail care, she says.

“Another big win that the Senior Agenda worked tirelessly for was removing the suspension of the $38.6 millions of “Perry-Sullivan” funds for FY 2023 that was in Gov. McKee’s proposal,” says Maigret.

However, Maigret expressed disappointment that the state’s budget only calls for minimum wage for home care direct care staff of $15 per hour. “Advocates tried to get this up to at least $17 to address the homecare workforce crisis that leaves some seniors waiting months for service,” she says.

According to Maigret, other items that will help older adults and persons with disabilities with rising housing costs are the expansion of the Property Tax Relief program sponsored by Rep. Ruggiero and Sen. Coyle.

“While we are appreciative overall for the gains that have been made for Rhode Island’s seniors in this legislative session, it is just a start toward what our state needs to do to meet the needs of our aging population,” says Bernie Beaudreau, Executive Director of Senior Agenda Coalition of Rhode Island. “I am disappointed that the minimum wage of $15 per hour was set so low.  This wage level will not do much to attract workers and solve the severe workforce shortages that home care agencies are facing. We also have to be vigilant about the administration of this new law as we have already seen a draft regulation suggesting that $15 will be the “average wage,” not the “minimum wage” of home care workers.

Calls for Rhode Island to become more “Age Friendly”

Published in Pawtucket Times on January 24, 2022

On Aug. 3, 2020, The Decade of Healthy Aging 2020-2030 proposal was endorsed by the 73rd World Health Assembly. It was presented to the U.N. General Assembly Dec. 14, 2020, (Resolution 75/131), leading to the proclamation of a U.N. Decade of Healthy Aging (2021-2030).

The four-page Resolution expressed concern that, despite the predictability of population aging and its accelerating pace, the world is not sufficiently prepared to respond to the rights and needs of older people. It acknowledges that the aging of the population impacts our health systems but also many other aspects of society, including labor and financial markets and the demand for goods and services, such as education, housing, long-term care, social protection and information. It thus requires a total whole-of-society approach to make changes.

The passed Resolution called on the World Health Organization (WHO) to lead the implementation of the decade, in collaboration with the other U.N. organizations. Governments, international and regional organizations, civil society, the private sector, academia and the media are urged to actively support the decade’s goals.

According to WHO,  the world’s population is aging at a swifter pace than any time in the past and this will have an impact on all aspects of society.  There are more than 1 billion people aged 60 years or older, most of these individuals living in low- and middle-income countries. “Many do not have access to even the basic resources necessary for a life of meaning and of dignity. Many others confront multiple barriers that prevent their full participation in society,” says WHO.  

In a December 14, 2020, statement announcing the passage of Resolution 75/131, Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, stated that it “sends a clear signal that it is only by working as one, within the United Nations system and with governments, civil society and the private sector that we will be able to not only add years to life, but also life to years.”

“By adopting a U.N.-wide approach in support of healthy aging, we will be able to galvanize international action to improve the lives of older people, their families and communities, both during the COVID-19 pandemic and beyond,” Dr Etienne Krug, Director of the Department of Social Determinants of Health at added World Health Organization (WHO).

The WHO says that the ongoing COVID-19 pandemic highlights the seriousness of existing gaps in policies, systems and services and a decade of concerted global action is urgently needed to ensure that older people can fulfil their potential in dignity and equality and in a healthy environment.  

WHO’s worldwide initiatives would seek to change “how we think, feel and act toward age and aging; facilitate the ability of older people to participate in and contribute to their communities and society; deliver integrated care and primary health services that are responsive to the needs of the individual; and provide access to long-term care for older people who need it.” 

Healthy Aging Baseline Data Released

Just days ago, WHO released, “Decade of Healthy Ageing: Baseline Report,” in all official U.N. languages, to support member states, academia, civil society, U.N. partners and others to aid in evidence-based decision making on the policies, programmes and services needed to support all people, in particular older persons, to live long and healthy lives.

The Baseline report, released January 20, 2021, brings together data available for measuring healthy aging, defined by WHO as “the process of developing and maintaining the functional ability that enables well-being in older age.”

According to WHO, optimizing “functional ability” is the goal of the Decade of Healthy Aging, which began in 2021 and addresses five interrelated abilities that all older people should enjoy:  the ability to meet basic needs; to continue to learn and make decisions; to be mobile; to build and maintain relationships; and to contribute to society. The report also takes a look at people’s capacities (including physical and mental) and the environments (spanning attitudes, services, natural and built) in which people live, which contribute to functional ability.

The 203-page baseline report, now available in Arabic, Chinese, English, French, Russian and Spanish, introduces the concepts of health aging and strategies for achieving the initiatives goals by 2030. It provides a first-time baseline (in 2020) for healthy aging worldwide and takes a look at what improvements that can be made by 2030.  It documents progress and scenarios for improvement. The report addresses how stakeholders can work together and impact the functional abilities of older people. Finally, it outlines next steps detailing opportunities that can increase collaboration and impact by 2023, the next reporting period.

Is Rhode Island Becoming Age Friendly?   

Maureen Maigret, policy consultant and chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council, says that many Rhode Island communities are involved to 1 degree or another in what we consider age-friendly activities. “The initiative is usually led by the local senior center and in some instances volunteer programs such as RSVP and AARP and The Village Common of RI,” she says.

According to Maigret, over the last five years the state’s Long-Term Care Coordinating Council Aging (LTCCC) in Community Subcommittee has adopted and continues to work to support WHO’s decadelong initiative, adding the domains of Food & Nutrition and Economic Security and Supports to Remain at Home.

Maigret noted that Newport was the first community to join the AARP age-friendly network; Cranston, Providence and Westerly following. The state’s Office of Healthy Aging has adopted its State Plan on Aging, calling for Rhode Island to become an age-friendly state.

Governor Dan McKee’s proposed budget for FY2023 includes an additional $200,000 for local senior programs increasing the total amount to $1 million. Maigret calls for adding an additional  $800,000 so each municipality would be allocated $10 per person aged 65 and over to support local senior programs. Advocates had promoted this since at least 2018 to make up for prior budget cuts and inflation, she says.

Don’t forget improving and expanding the state’s transportation options for older Rhode Islanders who have mobility needs and are no longer able to drive. “This could be accomplished by adding trip types to the state funded Elderly Transportation Program,” she says, noting that trips are now limited for trips to medical appointments, adult day care services, meal sites and Insight. Why not provide trips for older adults to access volunteer activities, she adds.

“We also need to adequately fund our subsidized home care programs by providing realistic reimbursement to address the huge workforce challenges we face,” warns Maigret, noting that seniors are waiting over two months to get service. “This is a travesty,” she says.

“It is tragic that the state’s Office of Healthy Aging is so under resourced in so many areas,” says Maigret, putting the spotlight on the lack of affordable home maintenance and chore services to keep people in their homes. “There is also a need to provide greater supports for our family caregivers who provide the vast majority of caregiving in our state and nation,” she adds. 

Getting Municipalities Involved

Maigret suggests that Rhode Island’s cities and towns review their community’s Comprehensive Plans to see how age-friendliness is addressed. “This is what Newport did. They can also form local Steering Committees to identify local needs and develop recommendations to address them both at the local and state level,” she says.

Governor Dan McKee can also issue an Executive Order directing all state departments and agencies to review programs and policies for age-friendliness and provide incentive funding for local communities to assess their communities. Several states have done this. NY, MA, CO, FL, MI, ME, CA, she says. 

While aging advocates pushed for McKee and lawmakers to allocate ARPA COVID-19 federal funds to make Rhode Island a more age friendly, it’s gotten little attention, says West Warwick resident Vin Marzullo. “Quite frankly its shocking — that there is yet an explicit acknowledgement that the aging community needs resources, support, more collaborative arrangements, to extend living in-place. There seems not to be any sensitivity to the fact that 90% of the COVID deaths were adults 60 and over – and 53% were in congregate care,” says Marzullo, a  well-known aging advocate who served as a federal civil rights and national service administrator.

“The ARPA funds were authorized to be used to ameliorate the impact on the populations, communities, sectors, etc. that were adversely impacted. Our older adults must be in the conversation and not neglected,” says Marzullo.

Maigret agrees. “It is tragic that neither the McKee-Matos’ “Rhode Island 2030 Plan” nor the Rhode Island Foundation report outlining the use of ARPA funds gave sufficient attention to the needs of our state’s older population, she says, warning that this population is increasing, and getting more economically insecure and diverse,” she says.

“When we look at the exceedingly high cost of residential institutional care,  much of which is paid for taxpayers through government programs, we can make a strong case that funding programs helping older persons remain healthy and living in their homes and communities are important investments,” says Maigret. 

To obtain a copy of WHO’s “Decade of Healthy Ageing: Baseline Report,” go to:

https://www.who.int/publications/i/item/9789240017900.

Watching over Nursing Homes once again – time for mandated Boosters

Published on December 20, 2021 in RINewsToday

Colder weather is keeping people more indoors now, and Thanksgiving and pre-Christmas gatherings are drawing people together in groups, small and large. Like other states across the country, Rhode Island is seeing a growing transmission of the COVID-19 Delta, and now Omicron variants. Some national sources say Rhode Island’s case rate is the highest.

According to WPRI’s COVID-19 tracking page, 73.7% of Rhode Island’s population, totaling 1,097,379 are fully vaccinated, 9.2 % are partially vaccinated, and 17 % have received no vaccination at all. “But some back-of-the-envelope math based on the state’s tally of daily doses shows nearly 251,000 people have received booster shots or third doses. And earlier this week, RI Gov. McKee publicly said the number is closer to 260,000 people,” says WPRI.

Taking a Snapshot of Vaccination Rates in Rhode Island’s Facilities

Just days ago, AARP Rhode Island called for increased boosters in the state’s nursing homes after releasing its new analysis of the latest data from AARP’s Nursing Home COVID-19 Dashboard.  The Dashboard revealed that only 54% of nursing home residents and 19% of staff in 79 Rhode Island nursing homes have received a COVID- 19 booster.

“With holiday gatherings on the horizon, these numbers are a cause for concern for state policy makers, as more than a year and a half into the pandemic, rates of COVID-19 cases in nursing homes are rising again nationally, along with increased community spread,” says AARP Rhode Island. While case rates declined slightly compared to the same time period last month, in AARP’s dashboard, looking week to week, the number of cases increased each week during the four weeks ending November 2, notes the state’s largest aging advocacy group serving more than 132,000 members aged 50 and older.

The Rhode Island-specific AARP Nursing Home Database says that resident cases grew from a rate of 0.64 per 100 residents in mid-October to 1.19 in mid-November. Staff cases decreased slightly from a rate of 0.96 to 0.82 during this same time period. Nursing home resident deaths from coronavirus rose slightly from a rate of 0.06 in mid-October to 0.11 in mid-November.

“COVID-19 continues to infiltrate America’s nursing homes with more than 1,500 new nursing home resident deaths nationally for the third consecutive month,” said AARP’s Rhode Island State Director Catherine Taylor. “Increasing vaccination rates—including boosters — among nursing home residents and staff is key to protecting our loved ones and getting the pandemic under control,” she says.

“AARP calls on nursing homes, state and federal authorities, and others to increase access to and receipt of COVID-19 boosters for both nursing home staff and residents,” Taylor added.

“As new variants emerge and vaccine immunity wanes, the low number of residents and staff who have received a booster creates an unacceptable level of risk since the disease spreads so easily in these environments,” says Tayler, urging Gov. Dan McKee “to prioritize the state’s most vulnerable population and take immediate action to addresses the relatively low percentage of nursing home residents and staff who have not received COVID-19 booster shots.”

According to AARP Rhode Island, while the percentage of residents and staff who have received boosters remain low, rates of those fully vaccinated—those who have received two COVID-19 shots—continue to slowly rise as of November 21. In Rhode Island, 99.10% of nursing home staff are fully vaccinated (the highest rate of any state in the nation) and 94.10% of nursing home residents.

The number of Rhode Island facilities reporting a shortage of nurses or aides rose sharply from 34.7% to 41.7% in the four weeks ending November 21, says the advocacy group. 

Rhode Island’s high vaccination rates can be tied to Rhode Island mandating all healthcare workers be vaccinated by Oct. 1, 2021, say John E. Gage, President and CEO of the Rhode Island Health Care Association. When the 30 day-compliance period ended, those who were unvaccinated were banned from entering the state’s healthcare facilities, he says, noting that termination resulted from failure to follow a reasonable policy set forth by their employer in compliance with Health Department’s emergency order. 

Yet, in at least one large nursing home facility, RINewsToday has learned, staff who refused to be vaccinated were either moved to non-patient-facing positions, or already worked in those positions, and allowed to keep working. An administrator said they are still working on encouraging 100% vaccination. Residents also have the right to refuse vaccination, and masks are required for patients outside of their rooms.

Families visiting had been restricted to the lobby, and at one time received a test in the parking lot prior to being able to enter. Today they are still screened for temperature, and they must wear a mask and complete a health symptom questionnaire. After a federal regulation went into effect several weeks ago easing access for families to visit, the screening also eased up and now tests are not required.

Any patient who is positive for COVID is moved to a quarantine area until fully recovered, and regular testing for patients and staff continues.

Some nursing homes are allowing families to take their loved one’s home for a Christmas holiday and then return after being with outside family and friends.

Gage notes that Rhode Island is ranked at No. 11 of states at a booster rate among residents of 54.1% compared to a national average of 38.4%.  Staff are boosted at 19.1% (#16) compared to a national average of 15.0%.  “Remember, individuals are not eligible for a booster until six months after their second dose of the vaccine series.  This will preclude some residents and staff, he says, stressing more credit should be given to the state’s health care facilities having the highest vaccine rates among staff and the second highest vaccination rate among residents.

According to Gage, the data released by the Centers for Medicare and Medicaid Services on Nov. 28, 2021 showed 99.38% of all workers in Rhode Island facilities are vaccinated – the highest (#1) vaccination rate for nursing homes in the country. Residents in Rhode Island nursing homes are 95.02% vaccinated – the second highest rate in the country.

To Booster or Not Booster, that is the Question

“With vaccines mandated in healthcare facilities and proof of vaccination being required to enter public places under the new Executive Order, it seems this would be a reasonable requirement for visitors to nursing homes,” says Gage, noting that this is not allowed according to the most recent guidance issued by the Centers for Med Centers for Medicare and Medicaid Services.

As to mandating booster shots for nursing facility staff, however, Gage warns, “staffing is at a crisis level already. We cannot afford to lose more staff with another mandate,” he says.

“The first rounds of vaccines were given most commonly by third-party sources such as CVS medical staff who came into the homes, similar as they do every year for flu shots”, said one nursing home administrator to RINewsToday – “For the boosters, we did them using our own staff, and ordering our supply from the RI Department of Health.”  Boosters were advised to be given 4-5 months from original vaccination completion – yet in the nursing homes most didn’t get them until 8 to 9 months – as late as the end of October.

However, Joseph Wendelken, Rhode Island’s Department of Health’s Public Information Officer, says that CVS and Walgreens are working to make COVID-19 vaccine booster doses available to all nursing facilities,. “If any facility is looking for additional support getting residents and workers vaccinated, we can provide that support,” he says.

Wendelken notes that there is a requirement for nursing home workers to complete a primary COVID-19 vaccine series, but there is no [federal or state] requirement for booster doses. “The data are becoming clearer and clearer that – especially with the Omicron variant – booster doses are absolutely critical,” says Wendelken.

“Residents [of nursing homes and assisted living facilities] were among the first to get vaccinated so that means their immunity has waned and boosters are needed to avert significant outbreaks and deaths,” says  Maureen Maigret, former director of the R.I. Department of Elderly Affairs and chair of the Aging in Community Subcommittee of the Long Term Care Coordinating Council. “It is critical that booster shots are offered to all nursing home and assisted living residents especially now that visitation has opened up and visitors do not have to show proof of vaccination,” she says.

As of December 15th, the RI Department of Health Department shows at least 114 new cases in nursing homes and assisted living facilities in the past seven days, says Maigret. “We must  remember that over 1,700 residents died as a result of COVID in these facilities and providing booster shots is our best defense against more fatalities for this vulnerable population.”  

Even though it is not a federal policy, a growing number of state officials across the country are calling for the definition for being fully vaccinated to now include the booster shot. With Rhode Island seeing a surge in COVID-19 cases and an increase in hospitalizations due to Delta and Omicron variants spreading throughout the state, many (including this writer) express it’s time for Governor Dan McKee to now mandate booster shots for nursing facility staff.  More important, it must become a priority for the Rhode Island Health Department to make sure that every consenting nursing facility resident receives a booster, too.

President Biden is set to address the country on Tuesday, at a time to be announced. There is speculation whether the term “fully vaccinated” will now include not just the two original vaccinations but the booster as well.

The AARP Nursing Home COVID-19 Dashboard analyzes federally reported data in four-week periods going back to June 1, 2020. Using this data, the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the dashboard to provide snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner.

The full Nursing Home COVID-19 Dashboard is available at  www.aarp.org/nursinghomedashboard. For more information on how coronavirus is impacting nursing homes and AARP’s advocacy on this issue, visit www.aarp.org/nursinghomes. Medicare.gov’s Care Compare website now offers information about vaccination rates within nursing homes and how they compare to state and national averages.

RI Nursing Homes with new cases (more than 5) in the past 14 days:

Berkshire Place, Providence – 10 to 15

Jeanne Juga Residence, Pawtucket – 5 to 9

Oak Hill Health Center, Pawtucket – 20 to 24

Pawtucket Falls Healthcare, Pawtucket – 10 to 14

Summit Commons, Providence – 5 to 9

West View Nursing, West Warwick – 10 to 14

The full Nursing Home COVID-19 Dashboard is available at  www.aarp.org/nursinghomedashboard. For more information on how coronavirus is impacting nursing homes and AARP’s advocacy on this issue, visit www.aarp.org/nursinghomes. Medicare.gov’s Care Compare website now offers information about vaccination rates within nursing homes and how they compare to state and national averages.