Tag Archives for Gov. Don Carcieri

Rhode Islanders Will Benefit for Long-Term Care Improvements

Published in Pawtucket times on April 5, 2004

An AARP membership application just arrived last week, inviting me to join the nation’s largest senior advocacy group.

AARP’s invitation to join clearly announces my major milestone in my life, when my June birthday officially pushes me into my 50s.

Celebrating my 50th birthday is no problem for me on a personal level, especially with my philosophy that, as with wine, one gets better with age.

But, as a writer on health care and aging issues, I see problems as to how I might access needed home and community-based services or nursing hoe care in my later years, especially if the state does not fix its problematic long-term care deliverly system.

The graying of Rhode Island’s population is taxing the state’s existing long-term care delivery system and will continue to do so for years to come. In response, state policymakers have taken a Band-Aid approach in trying to fix the fragmented system.

Already the Ocean State’s senior population, ages 60 and over, comprises more than 18 percent of the state’s total population. Gov. Don Carcieri and state lawmakers should be very concerned that Rhode Island’s population continues to age at the same time its long-term care delivery system needs an immediate overhaul.

Everyone knows it is extremely difficult for caregivers and seniors to negative the Ocean State’s long-term care system. Just ask any aging baby boomer (persons born between 1946 and 1964), and many will say that it is extremely difficult to find the needed programs and services to k eep mom and dad at home.

Today, many adult children who are juggling careers and raising children are also shouldering additional caregiving responsibilities to their olde parents. Even if their parents have been able to put a little money aside for their retirement, their children see their inheritance quickly being whittled down by thousands of dollars a month, all spent on costly pharmaceuticals and long-term care services.

Money can buy you anything in life, including home and community-based care and nursing home services.  Staying independent at home is still difficult for may moderate-income Ocean State seniors who cannot pay or find providers , especially with the Department of Elderly Affair’s (DEA) co-pay program not being fully-funded.

DEA’s co-pay program aids more that 1,500 frail seniors who do not qualify for the state’s Medicaid program, but who require ongoing services to remain in their homes. This funding helps pay for certified nursing assistants, who assist seniors with bathing, meals, shopping, laundry and light house keeping. DEA’s co-pay program slso provides subsidies for adult day care.

Last October, DEA’s freeze on new admissions to its co-pay program left more than 200 frail seniors on a waiting list for home and community based services.

While Gov. Carcieri recently gave an additional $ 200,000 in funding to DEA’s co-pay program in his 2005 budget, senior advocates have warned this amount is not enough. It is estimated this additional funding will serve 60 to 80 seniors out of the 200 persons currently on the waiting list.

Meanwhile, DEA has even put a freeze on new admissions to its respite program, which enables caregivers to take a break from the grueling physical and psychological demands of taking care of a frail elderly family resident.  This freeze will continue for the rest of this fiscal year, and nobody is sure how long the freeze for this initiative will last.

Hugh Hall, chair of the R.I. Health Care Association, tells All About Seniors that nursing homes will also be especially hit hard as state funding continues to diminish at the same time as  the cost of services and regulatory requirements increases.

“The state’s budget crisis is causing the governor to not meet a commitment in restructuring an antiquated Medicaid reimbursement system that pays for the care provided to 75 percent of the 10,000 frail residents in nursing homes,” said Hall.

This year, Carcieri, citing budgetary constraints, did not keep his promise to move forward with Part Two of the Medicaid reimbursement restricting, said Hall.

“This will have serious effects on the financial viability and quality of care provided in more than 70 small nursing homes throughout the state,” he said.

The huge budget deficient will continue to force Carcieri’s and state lawmakers hacking of many worthy programs and services previously funded in the state budget.  However, the state’s 2005 budget must adequately fund DEA’s co-pay and respite initiatives that keep frail seniors at home in their communities through the use of less costly home and community-based services.

The state must also keep its promise to adequately fund the state’s nursing homes for providing the needed medical care to those who are too sick to stay at home.

Hopefully, in 15 years, when I reach my next milestone – turning 65 – the state policy makers will have hammered out a much improved long-term care delivery system.

A commitment by Carcieri and state lawmakers to fix today’s fragmented long-term care delivery system will have long-range consequences, ultimately beneiting aging baby boomers, their children, and their children’s children.

Indeed, all future generations in this state will ultimately benefit from sound long-term care policy.

Expanding Vaccinations Initiative Will Save State Money

Published in Pawtucket Times on January 5, 2004

During last year’s legislative session, the Ocean State Adult Immunization Coalition (OSAIC) approached the Rhode Island General Assembly for funding to promote the group’s efforts to get the word out about the importance of Rhode Island seniors getting influenza and pneumococcal vaccinations.

OSAIC’s message was quite simple – “Avoid a Hospital Stay: Get Your Flu Shot Now!”

The Providence-based nonprofit, a coalition of 40 agencies including hospitals, nursing facilities, vaccine manufacturers, medical societies, managed care groups, the R.I. Department of Health, the R.I. Health Care Association, and Blue Cross Blue Shield of R.I., call vaccinations a cost-effective way to prevent these unnecessary hospitalizations and deaths.

According OSAIC, pneumonia and influenza deaths together are considered the  sixth-leading cause of death in the nation. Since 1999, when this initiative began, there have been more than 300 deaths and 6,800 hospitalizations that were attributed to influenza and pneumococcal diseases in the Ocean State.

OSAIC stated that the cost of a flu shot is $ 15 and a pneumonia shot is $ 30.

On the other hand, the average length of stay for an older person with influenza is five days, costing $ 12,000. Treatment in a hospital for pneumonia lasts six days and costs $ 12,000l

At the conclusion of last year’s General Assembly session, lawmakers allocated $ 50,000 to OSAIC to push its many immunization initiatives. Charles Harris, owner of Harris Health Centers and an OSAIC executive board member, noted last year’s funding enabled his group to work closely with providers to create a system to identify vaccine recipients.

“We also were able to assist the state’s Health Department to expand the statewide vaccine record system,” he said.

OSAIC also worked with managed care providers to assist them in informing their beneficiaries through newsletters and reminders about the many benefits of flue and pneumonia vaccinates,” Harris added.

Furthermore, Harris said OSAIC reached out to the state’s media outlets to educate Ocean State seniors as to the importance of vaccine shots and the locations where they could get those shots. Meanwhile, an outreach program, utilizing both providers and pharmacists, also encouraged older Rhode Islanders to get their shots.

To get the  facts out, OSAIC senior volunteers even managed the nonprofit’s group’s flue hot line.

“Last year’s funding appropriation has even allowed us to begin our work this spring to urge seniors to get their pneumonia vaccines,” Harris noted.

“It also enabled OSAIC to bring its message into the state’s nursing facilities. Most nursing facility residents or staff who requested a shot got one, even with the flue vaccine shortage,” he said.

OSAIC is now posed to ratchet up its efforts to protect more of the state’s seniors. Look for the nonprofit group to push for making vaccinations a standard of care, Harris told All About Seniors.

“Rhode Island’s age 65 and over uninsured should receive these inoculations either free or at a nominal cost,” Harris said.

Senate Finance Committee Chair Stephen D. Alves, and Rep. Stephen M. Constantino (D-Providence), who serves as vice chair of the House Finance Committee, were key in getting OSAIC’s $ 50,000 funding allocation last year.

When the 2004 legislative session kicks off this columnist hopes that Sen. Alves and Rep. Costantino will again bring their passion for this preventative care issue to their respective committees and to the House and Senate floors during budget debates.

Even with a huge budget deficient looming, Gov. Don Carcieri and state lawmakers must see that preventative medicine is a worthy cost containment approach for reining in skyrocketing health care costs. Even with state dollars allocated up front, the savings will be ultimately realized down the road.

If Gov. Carcieri and state lawmakers choose to act “penny-wise” but pound-foolish” Rhode Islanders taxpayers will ultimately become the losers in the upcoming legislative session.

Aging Advocates Call for Override of Governor’s Veto

Published in Pawtucket Times on July 14, 2003

The General Assembly is poised to override  Gov. Don Carcieri’s veto Tuesday.

The political rhetoric has intensified as the governor picks apart the 2004 budget, which was recently passed by the Democratic-controlled legislature, forcing Democratic Majority Leader William J. Murphy and Senate President William V. Irons to explain how they shaped the budget.

Carcieri has called the General Assembly’s 2004 budget flawed because lawmakers have “missed opportunities” to stop the legislature’s habit of deficit spending.

The governor’s media blitz, beginning last week, is intended to build support for his efforts to defeat the legislature’s attempt to override his veto. Carcieri has called for the elimination of subsidies for greyhound kennel owners [also supported by this writer] and the reining in public-employee personnel costs.

Carcieri also opposes the spending of $ 52 million in federal Medicaid expenditure relief funds and the one percent restaurant sales tax.

When the dust settles after Tuesday’s legislative session to override Carcieri’s veto, aging advocates hope for an override. The 2004 budget crafted by the Democratic-controlled General Assembly puts increased state funding into senior programs and services.  Both provider groups and senior advocacy groups expressed disappointment when Carcieri’s budget proposal did not allocate funding for new aging-related initiatives. Moreover, his fiscal blueprint for state spending made cuts to existing senior programs and services.

“Once again, senior advocates have looked to the General Assembly to provide essential programs and services for the state’s growing senior population,” says Susan Sweet, a long-time aging advocate and consultant to nonprofit groups who also serves as a consumer representative to the state’s Long-Term Care Coordinating Council.

“We have not been disappointed,” Sweet said, in reference to the passage of the General Assembly’s 2004 budget.  “It’s sad that the Carcieri administration does not recognize the improvements the General Assembly has made to the budget and the lives of older Rhode Islander.”

Joan Crawley, executive director of Pawtucket’s Leon Mathieu Senior Center, added, “Although I can appreciate Carcieri’s frustration with trying to balance the state budget, as a senior advocate, I applaud the legislators for making the very difficult decision to fund legislative grants on behalf of the state’s  senior centers,” she said.

“At the Pawtucket town meeting, gubernatorial candidate Carcieri assured us that seniors would be a top priority of his administration should he be elected governor. He even distributed a brochure outlining his senior initiatives. So far, he has failed to address any of those initiatives in is budget, Crawley says.

So, what’s in the General Assembly’s 2004 budget that will improve the quality of life of Rhode Island seniors?

The budget will allocate new state funds totaling $ 300,000 to pay for nursing facility care of legal immigrant Rhode Island seniors who are not eligible for Medicaid.

The budget will also allocate $ 50,000 to support the efforts of the Ocean State Adult Immunization Coalition to get the word out about the importance of seniors getting influenza and pneumococcal vaccinations.

Meanwhile, lawmakers have allocated state monies for community grants. Initially, senior centers (in Carcieri’s budget ) were targeted with a 10 precent cut. To the relief of senior center providers, lawmakers passed the 2004 budget with no cuts

As previously reported to All About Seniors, an 18-month study by B.D.O. Seidman, a consulting firm hired by the state Department of Human Services, found Rhode Island was underpaying its nursing facilities in excess of $ 30 million annually.

It seems that the Rhode Island General Assembly agrees with the report’s assessment, because lawmakers made a partial allocation of new Medicaid dollars to overhaul the state’s ailing Medicaid system.

With passage of the budget, nursing facilities will receive a total of $ 18.8 million in state and federal dollars – a three-year phase-in will bring the total federal and state dollars up to $ 30 million.

Finally, the recently passed 2004 state budget has allocated $ 50,000 to provide dental services to nursing facility residents.

The 2003 budget that was supposed to expire June 30 stays in effect until Carcieri signs the 2004 budget into law. Until that time, new programs, policies, or program appropriations will be effectively put on hold.

An override of Carcieri’s veto will result in many new senior programs and services being funded in the 2004 state budget.

If the popular Republican governor is able to rally is troops – both Republican lawmakers and Carcieri Democrats – to support his veto, then lawmakers must begin their efforts to hammer out another budget.

….

As noted in last week’s All About Seniors column, not one dime in state funding was allocated in the state’s 2004 budget to beef up the state Department of Health’s regulatory oversight. Providers, aging advocates, and even state officials have called for new state dollars to fill one full-time surveyor position (a nurse) to ensure that assisted living residences across Rhode Island are inspected on a timelier basis.

The General Assembly has put laws on the books to protect frail Rhode Island seniors who received assisted-living services. Yet, Carcieri and lawmakers have failed to allocate the necessary funding in the 2004 state budget to allow Health Department regulators to comply with    their legislative oversight duties to inspect the state’s 72 assisted-living facilities and 155 assisted-living bed in nursing facilities on a timely basis.

That’s not all.  According to the state’s Department of Health, another seven assisted-living projects are expected to be up and running over the next 18 months.

Meanwhile, at Tuesday’s veto override, lawmakers will also take up legislative issues were not addressed in their haste to adjourn two weeks ago.  Maybe the state Health Department’s urgent need for more funding to adequately perform its oversight duties of assisted-living facilities will be acted on by lawmakers in both chambers.

Carcieri can become the white knight and save the day. He can choose to move forward and fix this policy flaw by either using contingency funds in his office budget or to take administrative action to hire one more full-time assisted living inspector.

Acting decisively to fix tis identified policy glitch is sound public policy that will ultimately protect the health and well-being of 1,700 assisted-living residents. Even with Carcieri’s calls for balancing the budget, taxpayers especially seniors won’t oppose allocated tax dollars to protect older Rhode Islander.