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.

Real Heroes Need to Be Recognized   

Published in Pawtucket Times on November 3, 2003

Sometimes the actions of real heroes are not reported by newspapers, radio or television newscasts. While stories of poor care and abuse in the state’s nursing facilities quickly make headline news in local media outlets, the good deeds oftentimes go unreported.

Here’s a story about a fire in an East-Providence independent living facility that made the local news one evening in October, but the real story was left untold.

Although the Rhode Island Chapter of the Red Cross ultimately go the ink for being on the scene, there were others – nursing facility administrators, firefighters, police officers and the Alliance for Better Long-Term Care – who also came to the assistance of the elderly tenants that fall night.

On Friday, Oct. 3, a boiler fire at Taunton Plaza forced 117 elderly and handicapped residents from their heated apartments into the chilly night. The elderly tenants residing in this independent living facility  were ultimately not allowed to return until Monday, because of a power outage, smoke damage and concerns regarding environmental contamination by polychlorinated biphenyls (PCBs).

Although the Santa Maria Club, on Broadway, offered a brief respite from the cool fall weather that evening, these residents needed overnight accommodations because they could not immediately return to their apartments. For that weekend, the majority of the elderly tenants went to the homes of family and friends, while others slept on cots at a temporary shelter site.

Roberta Hawkins, state ombudsman and executive director of the Alliance for Better Long-Term Care, remembered getting a phone call while watching a local television newscast about the fire.

“We really could use your help,” the Red Cross official said, asking her to immediately come to East Providence.

Ultimately, Hawkins and Kathy Heren, her agency’s staff nurse, quickly arrived at the Portuguese club and got down to the business of interviewing residents to learn about their medications, special needs and current health status. Some of the displaced elderly tenants were diabetic on insulin, while others were taking high blood pressure and heart medications.

Nursing home administrators, along with their directors of nursing, were also summoned to the fire site after receiving phone calls from Hawkins and Heren. These facilities would ultimately provide free accommodations for 18 elderly tenants whose health status required medical care  monitoring until they could return to their apartments.

Meanwhile, with information provided by Hawkins and Heren, East Providence firefighters and police officials entered smoke-filled apartments to retrieve prescription drugs. “Some of these seniors need to take their medications at the time of the fire,” said Hawkins.

Responding to a visibly shaken woman, an East Providence policeman even went into a smoke-filled apartment to rescue her cockatoo, a pet that might have died from smoke inhalation.

“The sobbing woman was so grateful that one would have thought the policeman had just rescued her child,” Hawkins said.

Administrator Orlando Bisbano Jr., of Orchard View Manor, came to Taunton Plaza that night of the fire with his director of nursing. He ultimately would take seven elderly tenants  back to his East Providence-based facility.

“We were willing to help in any way we could,” said Bisbano, noting the uncompensated care his facility provided totaled $ 2,300.

According to Bisbano, nursing assistants with wheelchairs were positioned outside Orchard  View Manor for more than a half an hour in the chilly night after the fire, waiting for the arrival of the traumatized elderly tenants.

“We called staff back to the facility who would later help to get them settled down and ready for bed,” he said. Management staff even came back to the facility to process the necessary paperwork that included a list of the new admission’s medications.

Ultimately, administrator Donna Amaral, of Eastgate Nursing and Recovery Center, along with administrators from Waterview Villa Nursing and Rehabilitation Center and Hattie Ide Chaffee Home, responded to Hawkins pleas for help for facilities to temporarily admit the displaced elder tenants.

“This was the first time in my 22 years as an administrator that I opened up my facility to help out in a crisis,” Amaral told All About Seniors, estimating  her East Providence-based facility provided at least $ 2,500 in free care, food and lodging, to six elderly residents.

Besides getting the residents fed and ready for bed, Amaral stressed how her staff had to locate medications for one of her unanticipated guests. One of her newly admitted tenants came without his insulin, and she quickly made arrangements with a local pharmacy for replacement insulin.

Hawkins recounted one elderly man was ultimately too confused to return to his apartment at Taunton Plaza and was late admitted to Amaral’s facility, Eastgate Nursing and Recovery Center.

Upon arriving with no shoes or jacket, Jack Heren, the facility’s food manager, took off his brand-new  sports jacket and gave it to a shivering man. “He sept wearing his new jacket that first night,” said Hawkins, who noted the man treasures the gifted jacket and has not taken it off since his admission to the facility.

Although the R.I. Red Cross and Picerne Management Group, the owners of Taunton Plaza, along with some of the elderly tenants and their families thanked the Alliance and nursing facilities for their assistance, local media did not report the acts of kindness.


It is disappointment the local press did not recognize the local nursing facilities were there and ready to take all of the residents, if necessary,” said Bisbano. “While it ultimately does not matter that we weren’t recognized, nursing facilities are here to serve the community and are prepared to deal with disasters like that fire.”

Hugh Hall, president of the R.I. Health Care Association, a trade group representing a majority of the state’s nursing facilities, added, “I don’t think that there is much positive news in general as we would like to see including positive articles about nursing facilities.

“When this type of crisis [fire] happens, the long-term care community rises to the occasion, to assist, and always will,” says Hall.

Hawkins weighted in on the issue of positive news coverage of nursing facilities, too.

“While local television stations covered this fire, they never really identified the real heroes, that is the nursing facilities, the police and firefighters, who in times of disaster help people they don’t even know,” she said.

“Couples fall in love and even get married in facilities with the assistance of staff. Nursing assistants oftentimes become family to residents, comforting them when they are sad, frightened or dying. We hardly read about these good deeds either,” said Hawkins.

For this columnist, hats off to the East Providence police and firefighters, the nursing facilities and their dedicated staff who briefly provided quality of care for the displaced traumatized elderly tenants and to the Alliance for Better Long-Term Care. Positive news and acts of kindness will be reported and real heroes recognized in this column.