Senior groups ask House leadership for an “Age-Friendly Rhode Island” budget

Will House Leadership’s Budget Proposal Create an “Age-Friendly” State?

Published in RINewsToday on February 6, 2023

Over two weeks ago, Gov. Dan McKee unveiled his $13.8 billion proposed FY 24 Budget. To members of the aging community, the reaction is that this budget shortchanges seniors.  In an e-blast sent to 1,800 seniors and aging advocates, the Senior Agenda Coalition of Rhode Island (SACRI) described the proposed budget as unfriendly to seniors.

“Governor McKee’s proposed FY2024 budget that would take effect on July 1, 2023, ignores the needs of Rhode Island’s rapidly-growing older population,” noted SACRI, which represents 21 organizations with allied concerns. The budget document will reflect what lawmaker’s value and “as it stands, this budget fails to value us,” states the email.

Calls for creating an “Age Friendly” budget  

The SACRI legislative alert highlights how McKee’s FY 24 budget proposal is “senior lite,” noting that it provides minimal increases in funding for senior centers and Meals on Wheels.  More concerning, “it does nothing to address the larger investments needed to enable a growing number of seniors to age in the community.”

SACRI says the budget proposal has ignored requests from advocates and the community, even some requests that came from the RI Office of Healthy Aging (RIOHA). Specifically, the Governor’s budget did not include funding for additional RIOHA staff, in particular for its Adult Protective Services that received over 6,000 calls last year.

“For fourteen years we’ve urged the state to invest in improving The Point, but our requests have fallen on deaf ears. At community meetings with seniors and their caregivers of all income levels, we found their most frequent and compelling complaints were about their great difficulties in finding reliable information about available support and service options,” says SACRI, noting that very few seniors, or their adult children caregivers, even know that The Point exists. “But they are very well aware that without reliable and timely information about home and community-based care, their least-desirable and most expensive choice – nursing home care – often becomes the default,” says the legislative alert email,” he stated.

According to SACRI, the FY 2024 budget didn’t include increased Medicaid reimbursements to homecare and nursing home providers to raise their direct care workers’ wages and reduce workforce turnover. Nor did it include financial aid to help low and moderate-income seniors pay their Medicare Part B premiums and co-pays, as many other states have done.

The Ask…

SACRI is calling on House Speaker Joe Shekarchi (D-Warwick) and Senate President Dominick Ruggerio (D-Providence, North Providence) to support an “Age Friendly Budget.”  Why not improve funding for aging programs and services that ultimately benefit everyone in their later years?

More older Rhode Islanders are going to need to access programs and services to allow them to age in place at home. “Seniors strongly desire to “age in the community,” but the services that allow them to do that are often hard to find or simply unavailable. SACRI’s budgetary wish list includes increasing the minimum salaries of senior home care and nursing home care workers to $20 per hour, that’s a 50% federal match.

SACRI also calls for allocating $500,000 in first-time state funding for major improvements to The Point to provide information and referral services for seniors and their caregivers. This increased funding never made it into the FY 2024 budget proposal outlined in Gov. McKee’s Jan. 17th State of the State Address.

“With Rhode Island’s aging population skyrocketing, why not add five staff persons requested by the RIOHA, two of whom will work in its Adult Protective Services Program,” says SACRI. 

Finally, SACRI says the House budget should also include a provision to raise the income level for seniors to qualify for the Medicare Premium Savings Plan to save seniors close to $2,000 per year. Older Rhode Islanders are becoming poorer with higher numbers falling below the 2023 federal poverty level of $14,580 for a single person and with 28% of older households trying to live on less than $28,000 per year.”

The Aging Network speaks…from the front lines

Maureen Maigret, Chairperson of the Aging in Community Subcommittee for the Long-Term Care Coordinating Council (LTCCC), says that the “Age-Friendly Budget” proposed by SACRI is right on target with the needs of Rhode Island’s older population.

“More than ever, we need to address and adequately fund the services and supports that keep older persons living at home as long as possible. It is especially important for those aged 75 and over as one-half may need supports to remain living at home at the same time that their incomes start to decrease while their healthcare costs increase,” she says.

“The ‘Age-Friendly’ Budget Plan also aligns nicely with the strategic objectives and actions of the Strategic Plan of the LTCCC:s Aging in Community Subcommittee yet to be accomplished,” says Maigret, noting that lawmakers should view funds requested as wise investments that will help older adults remain living at home – where most wish to be – and prevent the use of much higher costs for nursing home care.

“Apparently, the Governor and his staff haven’t fully understood nor been sensitive to the struggles that the aging community has faced since the pandemic – more than 90% of the deaths in RI were individuals over 60, and 52% of the overall deaths were congregate care residents. Many are still frightened, isolated, hungry, and need community homecare or a caregiver,” says Vin Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service Agency.

Marzullo adds, “The Governor’s budget doesn’t provide any vision for an Age Friendly RI – which was to begin in FY2023 according to a 2019 RI OHA Strategic Plan,” adds Marzullo. “We have no coordinated path/strategy to build greater local capacity & support services for our growing aging population.”

“The McKee administration has yet to develop a Comprehensive Master Plan for Aging in RI despite a series of community conversations (Rhode Island 2030) during the Fall of 2021 and commitments made to the elderly during the 2022 Gubernatorial campaign,” charges Marzullo.

Other aging advocates had their views of McKee’s budget proposal

While they are appreciative that the Governor’s budget proposal fully funds the statutory nursing home inflation index of 5.4% plus a 1.5% labor add-on effective October 1, 2023, John Gage, President and CEO of Rhode Island Health Care Association (RIHCA) warns about a major issue facing Rhode Island nursing facilities. “The minimum staffing mandate that was passed in 2021 is largely an unfunded mandate and is impossible to comply with given the 20% reduction in the Rhode Island nursing facility workforce just since the start of the pandemic,” he says.

“RIHCA will work together with the Governor, the House Speaker, and the Senate President for short-term relief from the staggering penalty provisions of the minimum staffing mandate statute – fines estimated at $55-60 million in the first year of full implementation and nearly two-thirds of facilities being prevented from admitting residents after three quarters of their inability to comply by automatic admissions freezes,” he says. There are simply not enough workers to employ to meet the mandate, and fines of this magnitude would devastate the industry and lead to further facility closures,” he adds.

“The Rhode Island Senior Center Director’s Association (RISCDA) is focused on gaining funding requested by RIOHA Director Cimini for increased staffing, fully funding the Point, and supporting senior centers more fully with a funding formula that gets us to the rate of $10/person for non-institutionalized individuals 65 and over residing in each municipality,” says Robert Robillard, RISCDA’s president. “Shoring up services with funding will benefit not just our elders, but their families and caregiver’s alike,” he noted.

According to Robillard, the Governor’s presented budget includes a $200,000 increase for senior centers across our state. This is split between 39 communities based on the number of seniors living in each of the municipalities. “As we are pleased to see this movement to support senior centers more fully, [even with the additional funding] there are gaps within the system of care for our elders here in Rhode Island,” he says.

James Burke Connell, Executive Director, Age-Friendly Rhode Island, agrees with Robillard’s assessment of the key role senior centers play in Rhode Island’s long-term care continuum and the need for increased funding. “No, there isn’t sufficient funding toward the goal of making Rhode Island a great state in which to age, and I’m particularly concerned that the RIOHA will be under resourced to meet the needs of senior centers and older adult Rhode Islanders in general. Senior centers are the hubs of services and programs in every community, and they need greater support from our state, principally through significant increases in RIOHA’s capacity to support our aging population,” he says.

The McKee administration responds…

In responding to SACRI’s charges that McKee’s proposed budget was not “Age Friendly,” Derek Gomes, spokesperson for the state’s Pandemic Recovery Office says, “a single budget cannot address everything that the Administration is committed to accomplishing.” He noted that the Administration will work every year to make meaningful progress toward improving the quality of life for older Rhode Islanders and all the goals in RI 2030.

According to Gomes, the Governor’s proposed budget invests in older Rhode Islanders by including an additional $200,000 for senior centers, an additional $100,000 for Meals on Wheels, and $250,000 to digitalize an essential record of service that military veterans use to receive their benefits. The 2022 November Caseload Estimating Conference increased funding for long-term care by approximately $40 million in all, across Fiscal Year 2023 and Fiscal Year 2024, including a 6.9% rate increase for nursing facilities.

The battle of Rhode Island’s Fiscal Year 2024 budget moves to the House Finance Committee and ultimately for a vote on the House and Senate floor. It’s crucial that House Leadership begin the process of increasing funding for aging programs and services to move Rhode Island closer to becoming an “Age Friendly” state. Every taxpayer will ultimately benefit, because each one will ultimately have to access programs and services to allow them to age in place at home in their community.  

SACRI is planning a Legislative Leadership Forum scheduled for March 22, 2023, at Warwick’s Crowne Plaza. Save the Date. Stay tuned for details. https://senioragendari.org/

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Alzheimer’s Disease Initiative Program Grant Now Recruiting Rhode Island Participants

Published in RINewsToday on August 15, 2022

Last January, CareLink, a nonprofit network of post-acute and community-based providers, received a grant from the Administration for Community Living, a division of the U.S. Department of Health and Human Services. After the required planning period, and identifying community resources and referral organizations, and training staff, CareLink is now able to recruit program participants. Carelink, an East Providence-based healthcare organization, received funding for a three-year grant that offers innovative therapeutic services and programs. In addition, it connects participants with resources and provides caregiver education.  

CareLink’s services and programs will support older people with ADRD who live in the community alone or with a care partner, individuals with intellectual and developmental disabilities who are at greater risk for developing dementia, and persons living in ethnically and culturally diverse communities with limited access to medical care due to economic, language, or other barriers. 

The $904,133 Alzheimer’s Disease Program Initiative (ADPI) grant enables the nonprofit to better support the 24,000 Rhode Islanders with Alzheimer’s Disease and Related Disorders (ADRD). These services are even more critical as this number is projected to double by 2040. In addition to individuals with ADRDs, the grant targets services for individuals with intellectual and developmental disorders and those living at home alone with a diagnosis of cognitive impairment. 

Grant funds will be used to deliver two nationally recognized, non-pharmacological, evidence-based treatment programs – Cognitive Stimulation Therapy (CST) and Skills2Care®. These programs are provided to individuals living with ADRD, and when appropriate to their caregivers, at no cost. Specially trained CareLink occupational therapists and speech-language pathologists who have experience working with individuals with Dementia and their caregivers provide these interventions.   

Two Nationally Recognized Therapeutic Interventions to be Offered

CST addresses memory, thinking skills, and quality of life thru 14-biweekly sessions of structured 45-minute therapy sessions, featuring different topics.  Each session includes a warm-up activity, a song, and a “reality orientation board” that details the date, time, place, and weather.  Sessions include a variety of activities including the discussion of current news, listening and singing to music, playing word games, and participating in activities such as baking. This program can be provided using both individual and group sessions meant to foster social engagement and community. Both Speech-Language Pathologists and Occupational Therapists provide this beneficial program.

Skills2Care® provides training for the individual and their caregiver on managing challenging behaviors. This program, delivered by a trained Occupational Therapist, during five ninety-minute home visits, includes techniques to reduce challenging behaviors, promote functioning, improve caregiver communication, home environment safety, and tips focused on caregiver self-care, including problem solving and teaching stress management techniques. 

“Our focus is on providing innovative treatment for individuals with dementia and their caregivers,” explains Dr. Chris Gadbois, chief executive officer of CareLink, Inc. “We’re integrating interventions and supports for patients and caregivers within the home environment, building upon the recommendations of the individual’s medical professional and resources within the community.” 

“The strong relationships CareLink has with a wide array of community partners will enable this program to reach Rhode Islanders from different backgrounds across the state. We have been overwhelmed by the enthusiastic support of the community for this effort to improve the lives of patients and their caregivers,” says Gadbois. 

“The Rhode Island Alzheimer’s Disease and Related Disorders Advisory Council congratulates CareLinkRI on securing this competitive funding for these important services,” said Council Chair Nancy Sutton, MS, RD.

“A diagnosis of Alzheimer’s or a related dementia is a devastating diagnosis for an individual, their family, and their loved ones. People need to talk to their healthcare provider about any concerns of memory loss, regardless of their age. We know that an early diagnosis allows patients and caregivers to connect with services and resources right away—before they experience a crisis.”

“Dementia care is complex and requires a full team to assist patients and their families navigate the healthcare system and community resources. This funding helps to support and expand a much-needed program where providers can refer patients and caregivers as soon as they receive a diagnosis.”

Christine Gadbois, representing CareLinkRI, is an active member of the Rhode Island Alzheimer’s Disease and Related Disorders Advisory Council, and has informed the Council on this newly funded initiative. Other Council members include the Rhode Island Department of Health, Office of Healthy Aging, Butler Hospital, and Rhode Island Hospital’s memory clinics, and the Alzheimer’s Association – Rhode Island Chapter, and they are all collaborating with CareLinkRI to ensure easy access.

“Alzheimer’s disease and related dementias take such a toll on our communities, and support services like those provided through CareLink and its partners are essential for thousands of constituents and their families,” states Senator Louis DiPalma (D-District 12). “I’m extremely grateful for this award to CareLink which will make an enormous difference in the lives of Rhode Islanders in the years to come.” 

While CareLink is the grant recipient and manager, they have partnered with numerous local agencies, including The Cove Center, Avatar, Trudeau Center, Accesspoint RI, and Meals on Wheels. CareLink is also reaching out to local medical providers, including specialty clinics such as RI Mood and Memory. “We know it is critical to engage community partners to successfully reach a diverse group of individuals who will benefit from these services across the state,” says Robyn Earley, Chief Growth Officer of CareLink. 

“We know these programs are impactful and we are working to integrate these services into the larger landscape of resources for persons with dementia and related disorders, adds Earley. 

Looking for Participants

On May 26, 2022, Earley reports that CareLink began its recruitment efforts for study participants in the community through general outreach. “We are now working on outreach to Rhode Island medical providers, senior centers, intellectual and developmental disability service organizations, senior housing, and other community agencies that serve individuals with cognitive impairments. We are targeting individuals at home through outreach/partnership with MOW, Hope Health, etc.” she says, noting that a plan is in place to outreach to Resident Services Coordinators at senior high-rises to reach the live-alone population.

“The investment in these therapeutic tools has a significant impact on the quality of life and independence of those with dementia,” she says. These interventions enable individuals with cognitive impairments such as ADRD to live longer and more successfully in the community. 

Ultimately, CareLink intends to provide services to over 300 people by the end of grant, three years from now.  

“We have already learned so much from the first month of service and I anticipate continued growth and learning throughout,” says Earley.

For details about this study or for referrals, please contact CareLink at ADPLdementia@carelink.org.  Or call 401 490-7610, Ext. 116.  

To learn more about CareLink, go to www.carelinkri.org/

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

RI Gubernatorial Forum to ask, “what’s your Senior Agenda”

Published in RINewsToday on August 1, 2022

The Senior Agenda Coalition of RI (SACRI) has joined 17 organizations to bring you Rhode Island’s 2022 Gubernatorial Forum where candidates will talk about senior issues. The event is scheduled for Wednesday, August 3, 2022, at 10:00 a.m. at the East Providence High School’s new 900-seat capacity auditorium. Seating is limited to 450 people, leaving space for social distancing. Doors will open at 9:30 a.m. At press time, 350 seniors and aging advocates have registered to attend in person or virtually.    

“Senior issues must be viewed as a public policy priority because Rhode Island’s older population is growing dramatically,” says Bernard J. Beaudreau, SACRI’s Exec. Director, and one of the event’s organizers. According to Beaudreau, the U.S. Census Bureau estimates that the state’s total population of 65 years and older has grown by 20% from 152,183 in 2010 to 182,486 in 2020, adding 30,303 people in this age group. Rhode Island’s statewide planning projections also indicate that people sixty-five and older will grow to over 247,000 by 2030, an increase of 65,000 seniors over the 2020 census.

Gubernatorial candidates to delineate positions on key Senior Issues

“During the 90-minute forum, the gubernatorial candidates will share their positions on seven questions, hammered out by event cosponsors, as to how they would address a variety of policy issues impacting older Rhode Islanders,” says Beaudreau.  “Attendees will learn how candidates would rebuild and sustain a viable workforce for nursing homes and homecare providers. They will also be asked about their plans for Medicaid rebalancing and expansion to improve home and community-based care opportunities while ensuring the financial viability of nursing homes,” he says. 

Beaudreau says the forum also gives the gubernatorial candidates an opportunity to detail their strategies on how resources can be increased to significantly support healthy aging in the community. They will be asked by the moderator what type of assistance will be given to low-income seniors, and will they support a yearly cost-of-living adjustment to the state SSI payment and increase eligibility for the Medicare Savings Programs for seniors and people with disabilities to at least 185% FPL.

The attendees will also learn how the candidates, if elected governor, will ensure that an adequate amount of the $250 million in funding for affordable housing is allocated for seniors and how they will work to ensure equal access to high quality healthcare and information about available health care resources.

Finally, the gubernatorial candidates will be asked to make a pledge to address the needs of Rhode Island’s older population and provide the leadership and resources necessary to create and implement a Rhode Island Strategic Plan on Aging.

Recognizing the political clout of Seniors

“SACRI’s upcoming Gubernatorial Candidates’ Forum is important as older adults historically have high turnout in elections and the Forum provides an opportunity to hear the candidates’ views on issues important to seniors,” says Maureen Maigret, Chair of the Long-Term Care Coordinating Council’s Aging in Community Subcommittee. “The Forum should cause candidates to take a serious look at the state’s demographics, to note how the older population is growing, and to reflect on how government can best support older adults’ desire to remain healthy and living in the community and provide quality facility care when needed,” says Maigret.

“The Forum allows us to set forth policy priorities and hold whoever is elected accountable for addressing them. An example of this is when former Governor Raimondo was elected. She had been presented with priorities for restoring budget cuts to senior services such as Meals on Wheels and some of the cuts were restored in her budgets,” Maigret noted.

SACRI’s Beaudreau says that the senior vote will influence the outcome of the upcoming primary and mid-term. “Rhode Island seniors 60 years of age and older represent 34% of all registered voters and accounted for 42% of the vote in the 2020 general election. Rhode Island seniors have higher voter participation rates than the rest of the population,” says Beaudreau, this being 77% compared to 57% for voters under 60 years of age. “We have a powerful voice to be exercised to impact public policy,” he says.

Political pundit Wendy J. Schiller sees seniors as a crucial voting bloc in American politics. “On average, 72% of voters over the age of 65 turn out to vote in presidential elections, as compared to about 48.6% of voters under the age of 30. Seniors are consistent and typically well-informed voters on issues concerning Social Security and Medicare,” says Schiller, Royce Family Professor of Teaching Excellence in Political Science and Director of the Taubman Center on American Politics and Policy, Brown University. 

According to Schiller, in the past 3 elections, “seniors have split about 55-56% for the Republicans, and 45-46% for Democrats. Seniors have been viewed as more conservative (Sun City AZ, the Villages FL) but the data do not really bear that out as you can see. There is a tilt, but not a full lean toward the GOP; this midterm season might be different though. If the 22 midterm elections were held tomorrow, you might expect to see even a bigger swing toward GOP candidates than usual because of inflation alone. Inflation is just one area where there is a gap in issue concerns between older and younger voters. Older voters worry a great deal about inflation eating into their savings and pensions that are not adjusted for inflation while younger voters may be as concerned with climate change and abortion rights as much or even more than they are worried about inflation,” she says.  

Schiller says that seniors are like all other voters in that they are highly influenced by their political party affiliation, even in cases where the party proposes policies that run against their interests. “The GOP has proposed cutting Medicare ever since it was created, most recently under President Trump, but they are not careful to say that such cuts would not affect current recipients or even people aged 55 or over and the majority of seniors voted for Donald Trump in 2020. Democrats ran into some trouble with seniors when Bernie Sanders and others proposed Medicare for All because seniors thought it would dilute their own services through Medicare, and/or raise their premiums,” adds Schiller.      

Adds well-known Rhode Island Political Strategist, Rob Horowitz, “As a group, seniors vote more regularly than any other age group. In the 2020 presidential election, for example, more than 3-in-4 people eligible voters between the ages of 65 to 74 voted as compared to about 2-in-4 eligible voters between the ages of 18 to 24. Since Rhode Island has an older population, seniors are a key group in pretty much every state and local election.  Winning campaigns in Rhode Island and throughout the nation devote time and advertising dollars to reaching seniors.”

According to Bob Weiner, former chief of staff director of the House Select Committee on Aging under Florida Congressman Claude Pepper and former spokesman for both the Clinton and Bush White Houses, no one can forget the clout of older voters because they are the most motivated demographic group to vote. “They can’t be broken out by political parties as people expect,” observes Weiner, noting that it is a very close 50-50 split vote. “Older voters vote Democratic and Republican; the Democrats must do more to capture the senior vote.  It’s close. In 2020, while Joe Biden won the popular vote by 7 million, Donald Trump won the senior vote 52% to 47%. It’s not a matter of party. Seniors’ quality of life is not political,” he says.

“But on the issues, they will tear apart a candidate who doesn’t support Social Security, Medicare and the rights of seniors to have continued employment and privileges in society,” Weiner notes.

“So, anybody who thinks they can get away with some horrible position, such as cutting back Social Security or Medicare in five years or utilizing the myth that Social Security is in deficit crisis, they can’t  because it has a 2 trillion surplus resulting from Claude Pepper negotiations to keep the program fully solvent through 2034,” Weiner says, noting that it only needs a “little repair” to keep it going.    

“Anybody who thinks that they are going to use Social Security and seniors to fund other federal government operations is badly mistaken,” says Weiner. “When President Bush wanted to privatize Medicare and Social Security and made a campaign out of that he actually helped lose congressional seats in an off-year election,” said Weiner, warning political candidates to think twice when thinking about balancing the federal budget on the backs of the nation’s elderly. 

“Voting Gives You Power”

“In Rhode Island and across the country, the data clearly show that voters aged 50+ will be the deciders in the 2022 elections,” said AARP Rhode Island State Director Catherine Taylor. “We are working with dozens of advocacy volunteers who are fighting for voters 50+ to make their voices heard on the issues that matter – especially in Rhode Island where we are in the midst of a housing crisis, nursing homes are in jeopardy, the cost of long-term care is skyrocketing and where people want leaders who are committed to making local communities more livable.

“At the federal level, older voters want to know candidates’ positions on protecting and strengthening the Social Security benefits Americans have paid into and earned through years of hard work, protecting and improving Medicare benefits, lowering prescription drug prices, and supporting family caregivers who risk their careers and financial futures to care for parents, spouses, and other loved ones,” Taylor said.

“Voting gives you the power to decide what our future looks like,” she continued “But you have to be in the know to vote. AARP Rhode Island has collected the most up-to-date election information, including key dates and deadlines, to make sure that the voices of voters 50+ are heard. We are doing everything we can to make sure older Rhode Islanders are prepared to vote and know the safe and secure voting options included in the new, AARP Rhode Island-backed Let RI Vote Act. In mid-August, we will offer a Video Voter Guide posted along with all the latest election information at aarp.org/RIvotes,” Taylor said.

Co-sponsoring this event is a broad coalition of 18 service providers and advocates: 

A Community Together, Alzheimer’s Association of RI, Carelink, Community Partners Network of RI, Economic Progress Institute, Leading Age RI, NAACP Providence Branch, Ocean State Center for Independent Living, PACE, Progreso Latino, RI Assisted Living Association, RI Elder Info, RI Health Care Association, RI Organizing Project, RI Senior Centers Directors Association, SEIU Healthcare 1199, Senior Agenda Coalition of RI and Village Common of RI.

in the high school’s new 900-seat capacity auditorium. 

To read AARP web blog articles discussing the impact of senior voters at the polls, go to: 

www.aarp.org/politics-society/government-elections/info-2022/older-voters-midterm-issues.html

www.aarp.org/content/dam/aarp/research/surveys_statistics/politics/2022/aarp-targeted-congressional-districts-survey-voters-18-older.doi.10.26419-2Fres.00550.033.pdf

https://press.aarp.org/2022-4-6-Women-Voters-Age-50-Over-Will-Decide-Balance-Power-Next-Election