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.

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/.

RI Senate Tackles High Cost of Prescription Drugs – Herb Weiss

Published in RINewsToday.com on March 15, 2021

In the shadow of the COVID-19 pandemic, as Governor Dan McKee and the Rhode Island General Assembly move to hammer out their Fiscal Year 2022 budget, Senate lawmakers push a package of eight legislative proposals to put the brakes on skyrocketing cost of prescription drugs.

The Senate resolution (2021-S 0560) sponsored by Senate Majority Whip Maryellen Goodwin (D-District 1, Providence), has already been passed and complements the prescription drug affordability package that will be considered next week that would require health insurers to provide coverage, without cost sharing, for colorectal screenings and follow-up colonoscopies when necessary.

The package of legislation aims to protect Rhode Islanders by limiting copays for insulin, capping out-of-pocket expenses for high deductible plans, requiring health insurers to cover preventive colorectal cancer screening, eliminating clauses hidden in pharmacy contracts that prevent a pharmacist from talking about more affordable options, requiring transparent pricing information, importing wholesale prescription drugs from Canada, and creating a board responsible for evaluating and ensuring drug prices are affordable. 

According to Greg Paré, the state Senate director of communications, this package of legislative proposals was developed in conjunction with AARP during the off session before the 2020 Senate session and first submitted last year, but legislation considered last session was limited due to the pandemic and so it did not pass. The legislation has been resubmitted this year with some small modifications and remains a Senate priority.

Last year, AARP along with 14 groups including, the Alzheimer’s Association, the American Cancer Society Action Network, and Aging in Community, urged lawmakers to pass the package of legislative proposals.  Expect to see some of these groups again call for passage of either the total package or specific bills at a Senate Health and Human Services Committee’s virtual hearing, chaired by Sen. Joshua Miller, on Thursday, at 5:00 p.m. For the hearing’s agenda, go to: For hearing details go to: https://bit.ly/3ezofmJ.

Passage of this legislative package would require action by both the Senate and House. At press time, not all of the Senate bills have companion measures in the House.   

Controlling the Skyrocketing Increase of Prescription Drugs

Here are specifics about the Senate’s prescription drug affordability legislative package that will be considered next week by the Rhode Island’s Senate Health and Human Services Committee:  

Legislation (2021-S-0170 sponsored by Sen. Melissa A. Murray (D–Dist. 24, Woonsocket, North Smithfield), would limit the copay for prescription insulin to $50 for a 30-day supply for health plans that provide coverage for insulin. Additionally, the bill mandates that coverage for prescription insulin would not be subject to a deductible.  

Legislation (2021-S 0381)sponsored by Senate Majority Leader Michael J. McCaffrey (D–Dist. 29, Warwick), would cap out-of-pocket expenses for prescription drugs at the federal minimum dollar amount for high-deductible health plans, currently $1,400 for individual plans and $2,800 for family plans.    

The bill (2021-S-0383), sponsored by Senator Goodwin (D–Dist. 1, Providence), would save lives by requiring health insurers cover preventive colorectal cancer screening in accordance with American Cancer Society (ACA) guidelines. This coverage must be provided without cost-sharing and includes an initial screening and follow-up colonoscopy if screening results are abnormal. The ACA recommends people at average risk of colorectal cancer start regular screening at age 45.  

A bill (2021-S -497) sponsored by Sen. Walter S. Felag Jr. (D–Dist. 10, Warren, Bristol, Tiverton) would allow consumers to pay less for their prescription drugs by banning gag clauses sometimes found in pharmacy contracts that prevent a pharmacist from talking to a customer about more affordable options.   

This bill (2021-S-0494) would require pharmaceutical drug manufacturers, pharmacy benefit managers, health insurers, and hospitals to disclose certain drug pricing information. Such transparency would help payers determine whether high prescription costs are justified. This bill is sponsored by Senate President Dominick J. Ruggerio (D – Dist. 4, North Providence, Providence).  

This bill (2021-S-0499), sponsored by Sen. Louis P. DiPalma (D–Dist. 12, Middletown, Little Compton, Newport, Tiverton), would create a state-administered program to import wholesale prescription drugs from Canada, which has drug safety regulations similar to those of the United States. Such programs are allowed under federal rules, with approval from the U.S. Department of Health and Human Services. 

This legislation (2021-S0498) would create a prescription drug affordability board tasked with investigating and comprehensively evaluating drug prices for Rhode Islanders and possible ways to reduce them to make them more affordable. The bill is sponsored by Sen. Cynthia A. Coyne (D–Dist. 32, Barrington, Bristol, East Providence). 

The bill (2021-S 0496) introduced by Sen. Felag (D-District 12, Bristol, Tiverton, Warren) aims to protect consumers from unexpected changes in their health plan’s formularies (list of covered drugs). Under the legislation, formulary changes can only be made at the time of health plan renewal, if the formulary change is made uniformly across all identical or substantially identical health plans, and if written notice is provided 60 days or more before the change. 

Seniors Hit Hard by High Price of Prescriptions

“The high price of prescriptions is having a severe impact on Rhode Islanders, particularly older residents,” said Ruggerio, noting the state’s population is one of the oldest in the nation.  “Many older Rhode Islanders have limited means, and the high cost of prescriptions means people are 

Ruggerio warns that the pharmaceutical industry is not going to address this on its own, so it’s up to the state and federal governments to take action.”

Maureen Maigret, Co-Chair, Long Term Care Coordinating Council, observes that with Medicare paying the tab for costly pharmaceuticals, controlling rising drug costs is a federal issue.  “But this is a big issue to address for those with low and moderate incomes under-insured for prescription drugs,” she says. “I applaud the Senate legislative package aimed at controlling the cost of prescription drugs for Rhode Islanders, says Maigret, who cites the findings of a Kaiser Family Foundation survey that shows one out of four persons take four or more prescription drugs and more than one-third say that have difficulty taking their medication properly due to cost.  “Seniors may fail to get prescriptions filled, resort to pill splitting or skipping doses. Some may end up with costly hospital Emergency Rooms or inpatient visits as health conditions worsen due to the inability to afford their medications, notes Maigret, calling for lawmakers to make necessary prescription drugs affordable for all who need them. Maigret says, “It is time to make necessary prescription drugs available for all who need them.”

“AARP Rhode Island is eager to work with both the Senate and the House of Representatives to pass this important legislation designed to lower prescription drug costs,” said AARP State Director Kathleen Connell. “The high cost of drugs leads families – and particularly older Rhode Islanders on fixed and limited incomes — to often make impossible decisions. No one should have to choose between paying rent, providing food for themselves or their family and vital prescription medications that keep them healthy,” she says.

We look forward to working with legislators from across the state to help improve the health and financial stability of everyone by lowering the cost of prescription drugs. We thank Senate President Ruggerio for once again bringing forth this very important legislation,” adds Connell.

It’s mid-March. Lawmakers turn their attention now to passing the state budget.  Even if the Senate passes every bill in the prescription drug affordability package, the lower chamber must pass companion measures for these bills.  When passed, Governor Dan McKee must sign the legislation to become law.  Right now, it’s an uphill battle and Rhode Islanders must call on their state lawmakers to get on board to support bills to reduce the high cost of pharmaceuticals.  It’s the right thing to do. 

Things that You Should Know 

This meeting will be streamed live online through Capitol TV:

http://www.rilegislature.gov/CapTV/Pages/default.aspx

Written testimony is encouraged and can be submitted prior to 2:00 PM on Thursday, March 18, 2021, in order for it to be provided to the members of the committee at the hearing and to be included in the meeting records. Finally, if you are interested in providing verbal testimony to the committee at this hearing, please go to the following link and make your request by 4:00 p.m., on Wednesday, March 17, 2021:  https://bit.ly/3bIJAs2