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Path to an “age-friendlier” budget

Published in RINewsToday on June 5, 2023

After a 47:10 minute meeting on Friday night, the House Finance Committee approved a $14 billion budget for the 2024 fiscal year that commits funding toward addressing the housing crisis (top priority), supports business development and makes education funding more equitable while limiting the use of one-time revenue to one-time expenditures. 

The passed budget reflects the May revenue estimate that was $61.2 million lower than projected last November. 

On June 2, 2023, the budget passed on a partisan vote of 13-3, sending the budget bill (2023-H 5200A) to the full House of Representatives, which is slated to take it up June 9 at 2:30 p.m. Changes could be made.

Hammering Out a Compromised Budget 

At a news conference held on Friday at 3:30 p.m. before the vote, House Speaker K. Joseph Shekarchi  (D-Dist. 23, Warwick) compared the politics of hammering out the state budget proposal to Democratic and GOP leadership making a deal to avoid a national default earlier this week.  “Nobody, including me and everyone else here, got everything they wanted,” he said, noting that the state budget required “compromise.”  

“Our goal with this budget is to support Rhode Islanders’ needs while responsibly preparing for our future. Our top priority, of course, is addressing our housing crisis, and we have worked hard, in collaboration with Governor McKee and our colleagues in the Senate, to identify the most effective ways we can direct the funding we have toward solutions that will help create more affordable housing access. This budget also strengthens our efforts to provide educational opportunities in K-12 and higher education and supports businesses, working Rhode Islanders, retirees and those struggling to meet their families’ basic needs,” said Shekarchi, in a statement announcing the House Finance Committee’s passage of the budget.

“At the same time, we are being realistic. Given the end of the federal funding related to the pandemic, we need to plan not only for next year, but for the following years, when we are not going to have the level of revenue we’ve been fortunate enough to have for the past few years. We are spending our remaining federal COVID funding and our available revenue on one-time investments rather than creating long-term commitments that we can’t sustain,” he said.  

Adds Marvin L. Abney (D-Dist. 73, Newport, Middletown), chairman of the House Finance Committee: “This budget was carefully crafted so that our residents, particularly our most vulnerable, retain the supports and assistance that they and their families need, so that our businesses have the ability and opportunity to grow, and so that Rhode Island is situated to withstand a very possible financial downtown that will affect both our state and national economies.  Responsible, compassionate and thoughtful decisions were made to create a budget that will benefit all Rhode Islanders and this budget positions the state to be as competitive as possible into the future.”

Taking a Look at Aging Programs and Services 

“I am extremely pleased the budget passed by the House Finance Committee contains important funding that will benefit seniors as well as older adults with disabilities,” says Maureen Maigret, chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council and policy consultant and board member of the Senior Agenda Coalition of RI. “The Office of Healthy Aging (OHA) will receive an additional $250,000 in general revenue for the Aging and Disability Resource Center (ADRC). The ADRC provides counseling about services and benefits and assistance with the application process.  Advocating to strengthen the ADRC (called the POINT) was a high priority for the Senior Agenda Coalition of RI and the Aging in Community Subcommittee of the Long Term Care Coordinating Council,” says Maigret.

According to Maigret, this is the first time that ADRC will receive state funds. To date, it has operated with limited federal dollars and too many persons are not aware of the program. The state funding can be matched by federal Medicaid funds. “ADRC services are critically important for older adults, persons with disabilities and family caregivers, as they attempt to find appropriate services and navigate a sometimes-fragmented system of care, says Maigret.

Maigret says that the budget also adds funds to support two new staff positions for OHA’s protective services unit to deal with increasing reports of elder abuse and exploitation. OHA’s Adult Protective Services received over 6,000 calls last year. The additional funding for these positions will ensure that reports are investigated in a timely manner and protect older adults at risk of abuse and neglect. 

Other notable additions to the budget include an increase in the Personal Needs Allowance (PNA) for nursing home residents on Medicaid to $75/month (from $50.) This amount had not been adjusted since 1999, says Maigret noting that the additional funding will help thousands of nursing home residents pay for such items as haircuts, clothing and, telephone service.

“The House Finance Committee also added $250,000 to increase funding for the Livable Home Modification grant program to $0.8 million,” says Maigret, noting that the program helps pay for costs of support home modifications and accessibility enhancements to allow individuals to remain in community settings. And of course, the funds dedicated to addressing housing affordability although not specific to the older population will benefit them,” adds Maigret. “Overall, these budget additions and the additional funds for community senior services and Meals on Wheels proposed by the Governor demonstrate a continued commitment on the part of our state leaders to address the needs of our growing older population,” she says.

The budget didn’t reinstate the retiree Cost of Living Adjustments (COLAs) eliminated in 2011.  “Once again, retired state workers, teachers, and municipal retirees who are part of the state retirement system have been shown how little they are valued by state legislators”, comments Susan Sweet, a former state associate director of elderly affairs and an advocate for low-income elders. “Although there were many bills in to restore the COLA or at least provide a token payment to these retirees, it appears that no funds at all are being directed towards that purpose.  This is a great disappointment to so many folks who faithfully performed their duties and were stripped of their promised pensions. No wonder that teachers and government workers are reluctant to spend their career lives in the public sector” she states.

Is Proposed House Budget “Age Friendly” ?

Maigret believes that the state has taken some positive steps toward becoming “age friendly” especially if we think of age-friendly with an intergenerational lens. Items that address children and youth such as expanded tuition assistance of Rhode Island colleges are important.  “However, we still have a long way to go in many of the domains for age friendliness,” she notes, “especially in the area of economic security for older adults as many live with income less than $25,000 relying mostly on fixed incomes.” 

Maigret calls on the Rhode Island General Assembly to fund mini-grants to communities to incentivize them to “look at their comprehensive plans with age-friendly lens.” 

Here is the link to the bill to establish the budget:

Click to access H5200A.pdf

Here is the link to the entire budget and every article (as well as how it compares to the budget as submitted by the Governor in January):  https://www.rilegislature.gov/Budget/SitePages/FY24.aspx.

Here is a link to a press release which contains a summary of the highlights of the budget:

https://www.rilegislature.gov/pressrelease/_layouts/15/ril.pressrelease.inputform/DisplayForm.aspx?List=c8baae31-3c10-431c-8dcd-9dbbe21ce3e9&ID=373660.

To watch the House Finance Committee meeting, go to https://ritv.devosvideo.com/show?video=defebab838c1&apg=52ab780b.

Aging in Place in Your Rhode Island Community

Published in Pawtucket Times on May 2, 2022

As the graying of the nation’s population continues, older persons are choosing to live out their remaining years remaining in their communities in their homes, whenever possible. A new just-released study of adults age 50 and older from the AP-NORC Center for Public Research and the SCAN Foundation, finds a majority of older persons would like to age in place and are confident they can access needed services that will allow them to stay at home in their community for as long as possible.  

Gathering Thoughts About Aging in Place

According to this new national study released last week, two-thirds of the respondents think their communities meet their needs for accessing services like health care, grocery stores and social opportunities. The researchers found that all types of health care services are widely perceived as easy to access in their communities, and most feel that local health care understand their needs (79%) and take their concerns seriously (79%).

But, a closer examination of the small proportion of older Americans (Blacks and Hispanics) who feel less prepared and less supported in their community raises concerns about equity in access to the resources necessary to age in place.

However, the study reported that a few respondents say they had a hard time accessing needed services because of communication obstacles like a language barrier (11%), cultural barrier (8%) or age gap (8%); issues with affordability (15%); or issues of respect for their religious (4%) or cultural (3%) background. 

Those in urban areas—and suburban areas especially—describe their communities as having more supports for aging in place than those in rural areas. Older adults in suburban areas see their communities as doing the best job with meeting needs for healthy food, internet access, and the kinds of foods they want to eat. Suburban areas are also seen as better than rural areas in particular at meeting needs for health care and social activities. Older rural Americans are less likely than those living elsewhere to use a range of services simply because they aren’t available in their area. They are less likely to feel that community services are easy to get and designed for people their age than those in urban or suburban communities as well. And they are less likely to think a variety of health care services would be easy for them to access.

Income disparities are also associated with access to critical aging services. Those with incomes of $50,000 and below are less likely than those earning more to have access to services that are in their language (73% vs. 82%), close by or easy to get to (58% vs. 65%), respectful of their religious beliefs (57% vs. 65%), or designed for people their age (53% vs. 63%). When it comes to medical services, they are also less likely to have easy access to dental care, physical therapy, pharmacies, nursing homes, and urgent care than those earning more.

Additionally, those age 65 and older generally feel more prepared and report better access to important community services than those ages 50-64.

Aging in Place in the Ocean State 

For older adults aging in place, in their own homes, is by far the preferred model, says Mary Lou Moran, Director, Pawtucket Division of Senior Services at the Leon Mathieu Senior Center. “In fact, the theme of this year’s federal observance of Older Americans Month “Age My Way” focuses specifically on this very topic. The coordination, accessibility, and connection to services and programs is critical to the successful delivery of services and is where much work needs to be done,” she says. 

Moran says that senior centers located in communities throughout the state deliver needed information and assistance to older adults on accessing the needed  services to age in place.  Social isolation, access to transportation, food and housing insecurity, economic stability, and connectivity to services, are obstacles to enabling a person to stay in the community in their homes, adds Moran.

Over the years, Rhode Island’s inadequate Medicaid rates have become major obstacles to allowing a person to stay at home. However, recent state legislation, H 7616, to recreate a Department of Healthy Aging, spearheaded by Reps Carson, Ruggiero, McLaughlin, Contvriend, Speakman, Ajello and Potter, addresses some of the challenges that service providers are facing when trying to assist individuals to age in place. Moran adds, as the number of older adults continues to grow exponentially, the time has come to fully put the needs of our elders in the fore front to enable them to age with choice, dignity and respect.

According to Maureen Maigret, policy consultant and Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council, “Rhode Island is fortunate to have a number of government-funded programs that help older adults to age in place.” These programs include Meals on Wheels home-delivered meals program; Medicaid home and community services including home care, adult day services; assisted living and self-directed programs; Caregiver respite and support services; Home Modification grants to help make homes accessible; and elder transportation assistance for those age 60+ for medical trips, to get to adult day.  She also mentioned the Office of Healthy Aging’s Home Cost Share program for persons age 65+ and persons underage 65 with dementia who are not Medicaid eligible with income up to 250% of the federal poverty level and the wonderful programs offered at the state’s senior centers.

However, Maigret says that for some of these services such as home care there may be wait lists due to worker shortages. (People can find out about these programs or to find out what benefits they may be entitled to by calling the POINT at 401-462-4444).

There are also private services available for almost any service needed to help people age in place if they have the financial means to pay for them,” says Maigret.  

The National Village to Village Movement Comes to Rhode Island

While some of these volunteer programs in RI may offer some type of services such as transportation, a relatively new initiative has come to Rhode Island. “The Village Common of Rhode Island (TVC) provides a variety of supports through the efforts of almost 200 trained and vetted volunteers,” says Maigret. 

Maigret says that the goal of TVC is to help older persons to stay in their own homes and connected and engaged with their community. “This “neighbor helping neighbor” model started 20 years ago in Beacon Hill Boston and now there are 300 nonprofit “villages” operating across the country. TVC supports include transportation, running errands, home visits and telephone assurance, minor home repairs and light yard work, assistance with technology, and a virtual caregiver support program. A robust weekly calendar offers virtual events, and a monthly newsletter keeps members and guests informed. All this is done with a lean 1.5 person staff, a working board of directors and almost 200 volunteers,” she notes. 

“I had heard about the “village” model some years back and supported efforts to start a “village” in Rhode Island, she says. “It amazes me that a small band of committed volunteers were able to put all the pieces in place to operationalize a “village” and to see what has been accomplished. There are now active “villages” in Providence, Barrington, Edgewood/Cranston and Westerly with almost 300 members and more “villages” are under development. One of the priority goals of the Board is to reach out to underserved neighborhoods in our urban and rural areas to listen to people and find out what is important to them and what type of “village” program might work in their area,” she says. 

“We know that transportation is a huge issue for folks living in our rural areas and that is a huge concern. And, based on findings of the 2021 RI Life Index: Older Adults in Rhode Island(from RI Blue Cross Blue Shield//Brown University School of Public Health), we know that older persons of color living in our core cities have lower perceptions of community life, access to healthcare and experience lower food security and access to technology,” adds Maigret.  

“Research on the fairly new “village” programs shows promise in fostering feelings of being connected to others and suggest older women living alone with some disability most likely to experience improved health, mobility and quality of life (https://pubmed.ncbi.nlm.nih.gov/28509628/.),” says Maigret, noting that this is an important finding as Rhode Island has such a high portion of older adults living alone.

TVC President Anne Connor (74) says she has been a member and volunteer since 2015. “That we are volunteer supported is noteworthy and having an Executive Director, Caroline Gangji, (formerly acting Executive Director at Age Friendly RI), improves our ability to serve our members”, says the retired librarian and paralegal.

As TVC founder Cy O’Neil once said, ” …you don’t create a fire house when the house is burning.”  TVC is more than services – it is the relationships we build that are key to our success, says Connor.  

For details about The Village Common Rhode Island, go to https://www.villagecommonri.org/.

For specifics programs and services offered by the Rhode Island Office of Healthy, go to  https://oha.ri.gov/.