Tag Archives for Rep. David N. Cicilline

Congress Passes RAISE Family Care Givers Act

Published in the Woonsocket Call on January 14, 2018

With the dust finally settling after the heated partisan battles over the dismantling President Obama’s landmark Obamacare and later reforming the nation’s tax code, Congressional Democrats and Republicans put political and philosophical differences aside to overwhelming pass by voice vote the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act of 2017.

The RAISE Family Caregivers Act of 2017, introduced in the U.S. Senate by Senators Susan Collins (R-ME) and Tammy Baldwin (D-WI), was passed on January 8, 2017. Two months earlier a House companion measure (H.R. 3759), introduced by Reps. Gregg Harper (R-MS) and Kathy Castor (D-FL), was passed. At press time, the legislation now heads to the President’s desk to be signed into law.

The caregiver legislation would direct the U.S. Secretary of Health and Human Services to develop and sustain a strategy to recognize and support family caregivers across the nation. This bipartisan legislation has been endorsed by more than 60 aging and disability organizations, including AARP, the Alzheimer’s Association, the National Committee to Preserve Social Security and Medicare, the Elizabeth Dole Foundation, the Michael J. Fox Foundation, and the Arc.

Universal Praise for Congressional Passage

Congress clearly understands that caregiving is not a partisan issue but a life experience for millions of Americans.Yes, everyone at some time in their life may take on the role of caregiver for parents, spouses, children and adults with disabilities, or personally know caregivers.

According to AARP’s Public Policy Institute, there are 40 million family caregivers in the United States who provided an estimated $470 billion in uncompensated long-term care in 2013. In the Ocean State at any time during the year, an estimated 134,000 Rhode Island family caregiver step up to provide 124 million hours of care for an aging parent or loved one, most often helping them to live independently in their own homes.

“Family caregivers play an essential role in our communities by dedicating time and attention and making countless personal and financial sacrifices to care for their loved ones,” said Sen. Collins upon the Senate bills passage. “I am delighted that our bipartisan legislation to develop a coordinated strategic plan to leverage our resources, promote best practices, and expand services and training available to caregivers will now become law,” adds the Maine Senator, who chairs the Senate Special Committee on Aging.

Senator Sheldon Whitehouse sees the value of the RAISE Family Caregivers and its impact to Rhode Island caregivers. “The passage of the bipartisan RAISE Family Caregivers Act is an important first step toward easing the burden on the caregivers who mean the world to the family members they care for.” says the Rhode Island Senator who serves on the Senate Special Committee on Aging.

“Family caregivers play a key role in supporting their loved ones in Rhode Island and throughout the nation. adds Democratic Policy and Communications Committee Co-Chair David N. Cicilline. “The RAISE Family Caregivers Act ensures that family caregivers have the support and the resources they need to do their jobs safely and effectively. As a co-sponsor of H.R. 3759, I made sure my colleagues understood that this bill needed to become law as soon as possible, and I am glad that it passed both Chambers without objection. Now I urge President Trump to sign it and allow this important law to take effect”

“Thanks to the efforts of bipartisan Senate and House champions—Senators Collins and Baldwin and Representatives Harper and Castor—the RAISE Family Caregivers Act will help address the challenges family caregivers face,” said AARP Chief Advocacy & Engagement Officer Nancy A. LeaMond, in a statement. “Family caregivers are the backbone of our care system in America. We need to make it easier for them to coordinate care for their loved ones, get information and resources, and take a break so they can rest and recharge,” she says.

According to LeaMond, family caregivers take on a range of tasks including managing medications, helping with bathing and dressing, preparing and feeding meals, arranging transportation, and handling financial and legal matters. She estimates that the unpaid care that family caregivers provide helps delay or prevent costly nursing home care, which is often paid for by Medicaid.

What’s in the RAISE Family Caregiver Act?

The RAISE Family Caregivers Act directs the Secretary of Health and Human Services to develop and update a national strategy to support family caregivers. The legislation would also create a Family Caregiving Advisory Council comprised of relevant Federal agencies and non-federal members, also including family caregivers, older adults with long-term care needs, individuals with disabilities, employers, health and social service providers, advocacy organizations engaged in family caregiving, state and local officials, and others with expertise in family caregiving.

The newly established Advisory Council (meetings open to the public) would be charged with making recommendations to the Secretary. The strategy would be updated to reflect new developments. The Advisory Council’s initial report would include an initial inventory and assessment of federally funded caregiver efforts that would be incorporated into the initial strategy. The strategy would then identify recommended actions that government, providers, communities, and others could take to support family caregivers.

The development of the initial strategy would take up to 18 months, followed by updates of the strategy biennially. The bill would improve the collection and sharing of information, including information related to evidence-based or promising practices and innovative models regarding family caregiving; better coordinate, assess, maximize the effectiveness, and avoid unnecessary duplication of existing federal government activities to recognize and support family caregivers. The strategy and work around it could help support and inform state and local efforts to support family caregivers, promoting greater adoption of person- and family-centered care in all health and Long-Term Service and Support (LTSS) settings, with the person and the family caregiver (as appropriate) at the center of care teams

In addition to requiring the development of a strategy to support the nation’s family caregivers, the bill also establishes an advisory body that will bring together stakeholders from the private and public sectors to make recommendations that communities, providers, government, and others are taking and may take to help make the big responsibilities of caregiving a little bit easier.

The activities under the bill would be funded from existing funding appropriated for the Department of Health and Human Services. No new funding is authorized and it would sunset in five years.

Calls for More Caregiver Assistance

“In Rhode Island, we’re working hard at staying ahead on legislation supporting caregivers,” said AARP Rhode Island State Director Kathleen Connell. “We passed temporary caregiver insurance, which covers thousands of working caregivers with salary protection much like TDI (Temporary Disability Insurance). Earned-paid sick leave fills in a gap that caregiver TDI may not cover in emergency situations. The AARP-back CARE Act now requires hospitals, upon admitting patients, identify a designated caregiver, inform that person on discharge and provide training for at-home medical tasks. We have passed legislation making it easier for caregivers to modify their homes. And just this month, the state opened applications for a grant program we fought for in the current budget that provides up to $5,000 in hard cash for caregivers who make qualifying home improvements.” (Download a grant application at http://www.aarp.org/ricaregiving)

“We cannot stop here,” added Connell. “And the RAISE Act keeps the need for ongoing strategic planning and smart policymaking on the front burner. The numbers demand escalating action that will improve conditions not just for people who need care, but their family caregivers as well. But it is very important to emphasize that all taxpayers benefit when someone with chronic illness or aging disabilities can stay in their homes, rather than move into Medicaid-supported nursing homes. We all win when we support caregivers.”

NOTE: “The Rhode Island Chapter of the Alzheimer’s Association has a commitment to assisting caregivers navigate the various challenges of caring for someone living with Alzheimer’s and other related dementias,” says Donna McGowan, Executive Director of the Alzheimer’s Association, RI Chapter. Call 1-800-272-3900 for details about caregiver and provider services (including confidential support, information, and referrals to local resources via access to a 24/7 Helpline, care consultation, caregiver support groups, education programs for families, and online information (www.alz.org/ri ).

GOP Health Care Proposal Pulled at Last Moment

Published in Woonsocket Call on March 26, 2017

Days ago, unified Democratic lawmakers combined with a deep philosophical wedge between the conservative House Freedom Caucus and moderate Republicans over policy details of the American Health Care Act (AHCA), forced the Trump Administration and House Speaker Paul Ryan to pull the AHCA proposal minutes from a floor vote to steer it away from a humiliating legislative defeat last Friday. Interestingly, the seventh anniversary of President Barack Obama signing the Affordable Care Act (ACA), his signature health care law, took place one day before the House vote.

A day before Friday’s scheduled vote to dismantle and repeal Obama’s ACA, President Donald Trump taking a high-risk negotiation tactic straight out of his bestselling book, “The Art of the Deal,” gave a late-Thursday night ultimatum to the House GOP lawmakers. Trump told to them to vote up or down on AHCA or he would be prepared to move on to other legislative agenda items.

As to Trump’s ultimatum to GOP House lawmakers, CNN Presidency Historian Timothy Naftali noted on CNN Newsroom with Fredricka Whitfield, “He played chicken and he blinked.”

House GOP Making Legislative Sausage

In a report issued on March 13, the Congressional Budget Office (CBO), detailed the drastic impact of the initial AHCA legislative proposal. CBO, a federal agency that provides budget and economic information to Congress, found that AHCA would result in 24 million losing health insurance coverage by 2026, Medicaid would be cut by $880 billion over the next ten years, and premiums and out-of-pocket costs would skyrocket increase, particularly for older adults and individuals with lower incomes.

Earlier this week, on Monday, Ryan and his House GOP Leadership team made eight amendments to AHCA to pull in skeptical GOP moderate and conservative lawmakers, including the controversial speeding up tax cuts while whittling down the Medicaid program. Later, on March 23, CBO confirmed that these amendments would lead to essentially the same level of coverage losses, about 24 million people and cost increases for individuals and would yield $187 billion less in savings than the original GOP health care proposal.

Meanwhile, on Wednesday, Senator Wyden and Congressman Pallone revealed that the Center for Medicare & Medicaid Services’ independent Actuary “estimated that the repeal of the tax on prescription medications, known as the ‘pharma fee,’ beginning January 1, 2017 would increase Medicare Part B premiums by $8.7 billion through fiscal year 2027.” noted the Center for Medicare Advocacy.

On Thursday, three more amendments were offered to sway GOP House critics. One would strip the requirement that insurance companies cover essential health benefits (EHB). This amendment would effectively eliminate annual out-of-pocket caps, reinstate annual and lifetime coverage limits, and gut protections for pre-existing conditions. Another would delay – but not remove – the Medicare payroll tax cut that will undermine Medicare’s financing and its future stability.

After the defeat of AHCA, Trump blamed the Democrats for the House GOP’s failure to pass its health care proposal to scrap Obamacare. “The Democrats were not going to give us a single vote,” he said, warning that “Obamacare will explode” forcing the opposition party back to the negotiation table to craft a better health care law.

House Speaker Ryan also noted that “We are going to be living with Obamacare for the foreseeable future.”

“We just really did not get a consensus today,” say Ryan. “That’s why I thought the wise thing to do was not proceed with a vote but to pull the bill. When asked if he was going to try “to prop it up, Ryan responded by saying “it is so fundamentally flawed, I don’t know that that is possible.”

Sighs of Relief from Aging Groups, Democrats

“The American Health Care Act is not American in spirit or health care in substance. In fact, it’s a tax cut bill for the wealthy, not a health care bill for the people. It will make America sicker. Congress should reject this charade and this disaster of a bill today,” states Judith Stein, Executive Director of the Center for Medicare Advocacy.

“The House Congressional leadership was destined to lose on their disastrous American Health Care Act, which would have effectively repealed Obamacare and hurt seniors, including beneficiaries of Medicare and Medicaid. It doesn’t matter whether they pulled or failed to pass the bill,” says Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare in a statement. “It needed to go down and we thank the millions of National Committee members and supporters – and those of other senior advocacy organizations – whose protests were loud, numerous, and furious.”

“No one knew’ that health care could be so complicated. Hopefully, he has learned a lesson… that health legislation is built on a complex foundation that considers the real human needs – and costs – of changes to the system. A common refrain from Donald Trump during the campaign was, ‘What do you have to lose by electing me?’ Now we know what’s at stake: affordable health care for older Americans, Medicare, and Medicaid,” says Richtman.

“The leadership’s decision to withdraw the bill from consideration proves that the voices of Americans are very powerful. This harmful legislation would have added an Age Tax on older Americans and put vulnerable populations at risk,” says AARP Executive Vice President Nancy LeaMond, in a statement.

LeaMond calls on Congress to focus on the issues important to older Americans and their families, including: protecting and improving Medicare’s benefits and financing; providing access to affordable quality coverage; preventing insurers from engaging in discriminatory practices; lowering prescription drug costs; providing new incentives to expand home and community based services; and strengthening efforts to fight fraud, waste, and abuse.

Adds, Justice in Aging Executive Director, Kevin Prindiville, “Congress tried to rush this disastrous bill through Congress without regard for the health and safety of older Americans and their families, and such a bill cannot and should not be revived. Older adults and their families rely on Medicaid and Medicare and these programs must be protected.”

Compromise might well be the way to make sound changes to the nation’s health care law, says Rep. David N. Cicilline (D-RI), who serves as House Democratic Policy and Communications Committee. “The Affordable Care Act is a good law, and Republicans and Democrats should be working together to make it even better. If Republicans ever decide to come to the table, we should work together to increase competition, expand coverage, and bring down premiums. That’s a decision that Republicans have to make – whether to work with Democrats or continue down the path they’re on,” he says.

Rep. James Langevin (D-RI) also stresses the importance of reaching over the aisle to create a better health care law and getting away from partisan bickering. “It’s time for Republicans to move on from their misguided crusade to dismantle the ACA. The health care law has brought insurance coverage to millions of Americans. Its consumer protections, premium assistance, essential health benefits, and countless other provisions that were at risk of elimination have improved our nation’s health and saved lives. We must work together in a bipartisan manner to strengthen and improve the ACA, not risk the health and wellbeing of everyday Americans for an empty, partisan victory,” he says.

Cicilline: Let’s Bring Back the House Permanent Select Committee on Aging

Published in the Woonsocket Call on March 5, 2017

Twenty-three years after the House eliminated the House Permanent Select Committee on Aging, Rep. David N. Cicilline (D-RI) introduced a House resolution days ago to reestablish the House select committee, once charged with investigating and putting a spotlight on aging policy, spurring legislation and other actions. During the last Congressional session, Cicilline, attracting 63 cosigners (no Republicans) out of 435 lawmakers, threw his simple resolution into the House legislative hopper only to see no action taken.

During the 115th Congress, on March 1, 2016, Cicilline introduced House Resolution 16, which would bring back the House Permanent Select Committee on Aging. Its charge would be to conduct a continuing comprehensive studies on specific aging policy to identify issues, problems and trends. Like the former House Select Committee, its work would not be limited by narrow jurisdictional boundaries of the standing committees but broadly at the targeted aging issue.

According to Cicilline, all standing and select committees of the House (except Appropriations) are authorized by a simple House resolution, detailing purpose, defining membership and any other issue that needs to be addressed, and funding is then provided through appropriations.

House Aging Panel to Play Important Role in Today’s Congress

It is extremely obvious to Cicilline and his 24 Democratic cosigners that included Rep. James R. Langevin (D-RI), about the important role the House Permanent Select Committee on Aging would play in today’s Congress. In explaining why he introduced the simple resolution, Cicilline tells this writer that, “Our nation’s seniors deserve dedicated attention by lawmakers to consider the legislative priorities that affect them, including Social Security and Medicare, the rising cost of prescription drugs, poverty, housing issues, long-term care, and other important issues.”

“As you know, the House Permanent Select Committee on Aging was active in the House of Representatives between 1974 and 1993 with the purpose of “advising Congress and the American people on how to meet the challenge of growing old in America,” noted Cicilline, who represents the state’s First Congressional District. “ The select committee did not have legislative authority, but conducted investigations, held hearings, and issued reports to inform Congress on issues related to aging,” he said.

Cicilline says, “The reestablishment of this Select Committee would emphasize Congress’ commitment to our current and future seniors and would allow us to focus our energy to ensure that they are able to live with dignity and enjoy a high quality of life,”

A newly operational House Permanent Select Committee on Aging would be charged with conducting ongoing comprehensive studies to examine the myriad of problems that older Americans face, taking a look at income maintenance, poverty and welfare, housing, health (including medical research), employment, education, recreation, and long-term care.

The newly established House Select Committee would also study ways that would encourage the development of public and private sector programs and policies that would keep older Americans active in their community. Finally, hearings would generate federal policies to encourage coordination of both governmental and private sector programs designed to deal with problems of aging. House Lawmakers and staff on this Select Committee would also review any policy recommendations made by the President or by the White House Conference on Aging that impact the nation’s older population.’

Hammering the Nail in the Casket

Claude Pepper’s death in 1989, who had served as a former Chairman of the House Permanent Select Committee on Aging, might have been an omen to aging groups of the bleak future of the House Aging panel. In 1993, Congress moved to tighten its belt to match President Clinton’s White House staff cuts. Democratic House leadership’s efforts to streamline its operations by slashing $1.5 million from its budget jurisdictions over aging policy would lead to its elimination in that year.

If alive in 1993, Rep. Pepper (D-Florida), serving as the House Permanent Select Committee on Aging, its chair for six years and considered by many to be the nation’s most visible Congressional advocate for the nation’s seniors, would have fought tooth and nail to save his beloved Select Committee.
House lawmakers who opposed the elimination of this Select Committee warned that standing committee staff did not have the time nor resources to thoroughly investigate aging policy but this select committee did. Even with these arguments and the intense lobbying of aging groups, including AARP, National Council on Aging, National Council of Senior Citizens, and Older Woman’s League, the House Permanent Select Committee on Aging could not be saved. No vote was scheduled to continue its existence on March 31, 1993 when its authorization automatically expired.

The former House Permanent Select Committee on Aging did have an impact on crafting national aging policy. In 1993, with the demise of this select committee staff, writer Rebecca H. Patterson reported on March 31, 1993 in the St. Petersburg Times that Staff Director Brian Lutz said that during its 18 years, the House Aging panel “has been responsible for about 1,000 hearings and reports.”

Throughout its existence, the House Permanent Select Committee on Aging prodded Congress to abolish forced retirement, reform nursing home operations and reduce abuse against patients, to increase home care benefits, cover breast screening for older women, combat elder abuse, improve elderly housing as well as establish research and care centers for Alzheimer’s Disease.

Support from the Trenches

It’s about time that Congress brings back the House Permanent Select Committee on Aging, say long time aging advocates.

As a former Staff Director of the Senate Select Special Committee on Aging, Max Richtman, CEO and President of the Washington-DC based National Committee to Preserve Social Security and Medicare, says bringing back the House Permanent Select Committee on Aging is “long overdue.” The House Aging panel will once again provide serious oversight and lay the ground work for House legislative proposals impacting Social Security, Medicare and Medicaid, he says.

According to Richtman, the Rhode Island Congressman is highly regarded by House Democratic lawmakers and was recently appointed to a Democratic leadership position,” he says. “America’s seniors have been looking for “a champion in the mold of the late Rep. Claude Pepper for a very long time, he says, noting that Cicilline “may well be just the person to fill his shoes.”

Fernando Torres-Gil, M.S.W., Ph.D., Director of the Center for Policy Research on Aging at the UCLA Luskin School of Public Affairs, says “The U.S. House Select Committee on Aging was a leading voice for older persons and an aging society and with illustrious champions for the elderly. Claude Pepper and Edward Roybal were examples of congressional leadership on protecting Social Security and enhancing nursing home protections.” As a former staff director of this select committee during the l980s, Torres-Gil remembered how important it was to have this committee “gerontologize” Congressional lawmakers. “It became in its time the largest committee in the Congress with members on both sides of the aisle vying to be appointed to this committee,” he said.

After the elimination of the House Permanent Select Committee on Aging in 1993, a brief effort was undertaken by Rep. Nancy Pelosi (D-California) when she became House Speaker to bring back the Aging panel but this attempt was not successful. It’s time for Pelosi and her Democratic lawmakers to make a full court press to make it happen in 2017.

Cicilline’s legislative efforts to resurrect the House Permanent Select Committee on Aging is in the hands of GOP House Speaker Paul Ryan who controls the chamber. The Washington, DC-based Leadership Council of Aging Organizations, a coalition of 72 national nonprofit aging advocacy groups, could play a key role in advocating for and supporting the Resolution that would establish, once again, a House Select Committee focused on the issues of aging in America.