New Legislative Commission to work on improving programs, services to seniors 

Published in RINewsToday on June 19, 2023

During May, designated as Older Americans Month, the Rhode Island House of Representatives approved H 5224-SUB A, sponsored by House Deputy Majority Leader Lauren H. Carson (D-District 75, Newport), creating a legislative commission to study the services and programs for 240,000 older adults in Rhode Island – and to make recommendations for ways to improve and coordinate them. The number of seniors is expected to skyrocket to almost 265,000 by 2040, constituting an increase of nearly 75% since 2010.

On May 11, 2023, over three months since the resolution was dropped in the legislative hopper, it passed by a whopping bipartisan vote of 69 to 0 (with 6 members absent). There was no opposition to H 5224- SUB A from any organization. It seems that any House lawmaker or organization opposing this resolution would also oppose “motherhood and apple pie.”

With a number of House GOP concerns addressed in the state’s $14 billion budget, House Minority Leader Michael Chippendale directed his caucus to support passage. The House Republican Caucus also unanimously voted for H5224 – SUB A, and fully supported the mission of a legislative commission which is charged with collecting and analyzing the current state of affairs in regard to Rhode Island’s growing senior population.

Carson’s resolution calls for “a collaborative study of Rhode Island’s current services, and recommendations for potential initiatives that would help residents, agencies, providers, and the government to better assist the growing population of older adults in our state achieve well-being and maximum independence in ways that value, empower and engage them,” adding that such an effort is essential to the state’s future resilience and prosperity.

According to House Communications Director Larry Berman, 21 House legislative Commissions will be operational when Carson’s legislative commission becomes operational. The House Policy Office will staff the Commission.  The number of meetings (open to the public) has not yet been determined. The meeting agenda will be determined by its Chair, with input provided by the 16 Commission members, House lawmakers, members of the public, and aging advocates. 

Because H 5224 – SUB A only creates a House legislative commission, there is no need for a companion measure to be introduced in the Senate,” says Berman who notes that this Commission will begin in the Fall of 2023. It is charged to report its findings and recommendations to the House of Representatives no later than May 7, 2024. The Commission would then expire on August 7, 2024.

Providing a Road Map to Fix Systemic Policy Flaws

“This commission will provide valuable information to the House next year to provide a roadmap for providing service and programs for older Rhode Islanders, including funding options that will be strongly considered,” stated House Speaker K. Joseph Shekarchi  (D-Dist. 23, Warwick), after passage of the special legislative committee.

“We have had excellent results with other commissions that have studied housing and shoreline access that have led to legislation that the General Assembly has adopted.  Representative Carson is an extremely thoughtful and dedicated legislator who will work hard with commission members to develop great plans for the future,” says Shekarchi.

“Rhode Island should invest much more than we do in services that enable people to age in place and safely remain in their communities. Those services are far more cost-efficient overall, and encourage an active, more fulfilling lifestyle for people as they age. Considering that nearly a quarter of our population is over 60, and Baby Boomers will continue to swell those ranks, now is the time,” said Carson. “This commission will take a look at the services we have, how we could improve and better coordinate them and offer them to more individuals, where the gaps and needs are, and what we need to do to better enable our population, as we grow older, to safely remain in the community and lead full lives,” she says.

The 16-member commission, all appointed by the House Speaker, will include three members of the House of Representatives, two Rhode Island residents over the age of 65, three directors from the Rhode Island Senior Center Director’s Association, a community action program director from the Rhode Island Association of Community Action Agencies, a member of the Long-Term Care Coordinating Council, and a member of a Rhode Island organization representing adults with disabilities.

In addition, the directors of the Office of Healthy Aging, the Department of Health, AARP Rhode Island, Age-Friendly RI and the Senior Agenda Coalition of RI or their designees will participate.

H 5224 – SUB A instructs the commission to study key statistics about services for older adults in Rhode Island, examining strengths, vulnerabilities, and demographic and financial statistics; assess the current state, federal and local services currently available, as well as any duplication of services; recommend ways to coordinate services within agencies and focus on better service delivery, including housing options and various living arrangements, health status and health care resources; provide recommendations for the creation of a portal to coordinate aging services in employment, education, independent living, accessibility and advocacy, as well as local older adult centers and services; provide recommendations on mental health, transportation, food access, and health care; provide recommendations for the funding of services through state, federal and private grants and for more efficient distribution and use of these dollars; and explore more regionalization of services.

Towards the Creation of a Strategic State Plan on Aging

“The newly established legislative commission to study the services and programs for our rapidly growing older population can become the launching pad for the state to move forward to create a multi-sector Strategic State Plan on Aging to coordinate Rhode Island’s programs and services for older Rhode Islanders, says Maureen Maigret chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council who also serves as a policy consultant and board member of the Senior Agenda Coalition of RI.  She notes that 10 states have already developed this “master plan” and she hopes Rhode Island will also join their ranks. 

At the Senior Agenda Coalition  of RI’s August 2022 Gubernatorial Forum, she warned that the state’s aging and long-term services were fragmented, spread across a number of state agencies, charging that these agencies often lacked stable leadership and a coherent and overarching vision. Creating a Strategic Plan on Aging builds on work being done now by the Office of Healthy Aging and Subcommittees of the Long Term Care Coordinating Council, and would be a fix for this,” says Maigret. 

According to Maigret, at the August Forum Gov. Dan McKee stated he would issue an Executive Order for initiating a Master Plan on Aging, but that has not happened. Aging advocates are still waiting for this to happen.

“We look forward to joining with older-adult focused direct service, advocacy, non-profit, and state colleagues, and older adults themselves, to discuss how Rhode Islanders want to age and what we can build collectively to make that possible, says Director Maria Cimini, of the state’s Office of Health Aging (OHA).

“At the OHA we are thrilled there is interest and a commitment of time and resources to understand and plan for our state’s aging population, from where we sit, this opportunity will equip us to advocate for policies that empower and uplift our senior population, fostering dignity, purpose, and respect for all older adults,” adds Cimini.

Don’t Forget the Rhode Island’s Poor and Minority Elders

Susan Sweet, long-time advocate for poor and disadvantaged elders and the founder of The R. I. Minority Elder Task Force which provides limited financial assistance to low-income seniors in crisis reports: “We are seeing a large uptick in elders in crisis situations lacking basic needs such as food, utilities, housing, and personal items. Minority group members, immigrants, retirees as well as general population seniors are suffering more intensely since Covid, inflation, and lack of affordable housing matters have exacerbated the existing poverty among elders. In particular, homelessness among elders is at a peak we have not seen before.”

Sweet is hopeful that this new Legislative Commission will consider and react to the particularly difficult situations that confront the poor and minority elder populations. “I have seen many plans for services to elders that either ignore or do not implement agenda items addressing these populations and I hope that this commission will prioritize the severe privations that they face on a daily basis,” she says.

“With the lessons learned over the past 2 years and the devastating impact of COVID on our older adults, it’s critical that we reexamine our aging infrastructure, the needs for services, and the local service capabilities to this growing population,” Vin Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service agency.

“A serious, adult conversation is long overdue with the aging community, service providers and lawmakers about designing our plan for a more “Age-Friendly” RI, – which supports local senior centers as the local hub for the delivery of services,” suggests Marzullo.

The nursing home industry supports the mission of the newly enacted legislation committee. “Included in their charge is to, among other things, provide recommendations regarding available health care services.  Rhode Island’s nursing facilities play a vital role in health care for our older adults – providing care and services to over 18,500 seniors each year.  Many of these individuals are provided with short-term skilled nursing, physical, occupational and/or speech therapy following a hospitalization – enabling them to safely transition from the acute hospital level of care back home with continued services,” says John E. Gage, President and CEO of the Rhode Island Health Care Association.

“Of course, every Rhode Islander wants to remain independent, healthy and in their home for as long as possible.  When this is no longer viable, however, our state needs a strong spectrum of care, including home care, assisted living residences and skilled nursing facilities to support them as their care needs change.  Workforce is perhaps the most daunting challenge facing these health care providers, and this will need to be a focus for years to come,” notes Gage.

H 5224 A cosponsors are Representatives Samuel A. Azzinaro (D-District 37, Westerly), Thomas E. Noret (D-District 25, West Warwick), Susan R. Donovan (D-District 69, Bristol, Portsmouth), House Majority Whip Katherine S. Kazarian (D-District, East Providence), Karen Alzate (D-District 60, Central Falls, Pawtucket), Jason Knight (D-District 67, Barrington, Warren),  and Kathleen Fogarty (D-District 35, South Kingston.

A copy of H 5224 A may be accessed here: http://webserver.rilegislature.gov/BillText/BillText23/HouseText23/H5224A.pdf.

The House Floor vote (5/11/23) – 48 minute 48 second mark may be accessed here: https://ritv.devosvideo.com/show?video=d12583542bad&apg=84a99049.

The Health & Human Services Committee heard this resolution on March 15, 2023.  See the 1hour and 50-minute hearing by going to https://ritv.devosvideo.com/show?video=e3ea82fcb949&apg=6aae3d42

Herb Weiss, LRI -12, is a Pawtucket-based writer who has covered aging, health care and medical issues for over 43 years.  To purchase his books, Taking Charge: Collected Stories on Aging Boldly and a sequel, compiling weekly published articles, go to herbweiss.com.

House Study Commission could create first state plan on aging in Rhode Island

Published in RINewsToday on March 20, 2023

With oversight of the state’s aging programs and services scattered among state agencies charged with overseeing a fragmented long-term care (LTC) system, House Deputy Majority Leader Lauren Carson (D-District 75, Newport) tossed H 5224 into the legislative hopper. The bill calls for the creation of a Special Legislative Commission (to be referred to as House Study Commission), with 14 members, to study and provide recommendations to coordinate the state’s program and services provided to older residents.  The commission, charged with taking a comprehensive look at the funding, coordination and delivery of state agency programs and services to older Rhode Islanders, would be required to report its findings and recommendations to the House no later than Feb. 7, 2024, and it would expire on May 7, 2024.

According to House Communications Director Larry Berman, “Legislation to create commissions are requested when issues need greater study than just one hearing. Commissions usually consist of House members, along with experts in the field, who will meet on multiple occasions and then develop recommendations to the House.”

The Nuts and Bolts

The House Study Commission’s legislative charge would include making a comprehensive study of key statistics that includes compiling demographic and financial statistics, and health status of older Rhode Islanders, and taking a look at their strengths and vulnerabilities to enable them to stay in the community. It would assess federal, state and local programs available, examining duplication of services, and provide recommendations as to how to eliminate red tape and better coordinate services among state agencies to improve the delivery of programs and services.

Its final report would also review and provide recommendations for the funding of services through State, Federal, and private grants, and provide recommendations for more efficient distribution and use of these dollars. It would also include making recommendations for the creation of a portal to provide and coordinate aging programs and services in the areas of employment, education, independent living, accessibility, and advocacy, as well as local older adult centers and services. 

Also, recommendations would be provided on mental health, transportation, food access, and health care. The commission would also explore and provide recommendations for additional regionalization of services.

Aging Organizations and Advocates push for passage

Last week, the primary sponsor of H 5224, and supporters, testified before the House Health and Human Services (HHS) Committee to give their thoughts about the creation of a House Study Commission and its positive impact on the delivery of programs and services to older Rhode Islanders.

Carson, the primary sponsor, opened up the hearing on the legislation telling lawmakers that many programs for older Rhode Islanders fall in different places around the state. “Even professionals are having problems navigating the system, never mind family, friends and parents,” she says, referencing a conversation she had with a Director of a Newport-based Senior Center, discussing the challenges during the COVID pandemic to navigate the system at state-level, providing services to her older clients.

“If we look back over the last 20 years, we used to have a cabinet-level position on Aging, then we had a Division on Aging, and  now we have an Office on Aging,” says Carson, noting that we have an increasing amount of older people in Rhode Island. She called for lawmakers to return the Office of Healthy Aging at a cabinet-level.

By creating a House Study Commission, lawmakers can look in an organizational way at how programs are being offered to seniors,” says Carson.  

According to George Neubauer, Chair of the Senior Agenda Coalition of Rhode Island (SACRI), an advocacy coalition representing 21 organizations, told lawmakers that SACRI had called for candidates at its Gubernatorial forum held last August to create a Rhode Island Strategic Plan on Aging. This plan would help the state look at its infrastructure and coordination of services for its rapidly growing older population, he said. At this time Rhode Island has no such plan, he said. 

In his testimony, Neubauer stated: “While the purpose of this proposed House Study Commission does not specifically call for development of a state Strategic Plan on Aging, it does call for a comprehensive look at our older population. “It would be charged with providing recommendations of collaboration, coordination within agencies, funding of services, and recommendations in areas of importance to older adults’ needs and quality of life, he added.

 “A number of states have developed what are sometimes referred to as Master Plans on Aging (including California, Massachusetts and New York). A Master Plan could be a roadmap to help the state transform its infrastructure and coordinate services for its older persons.  The findings and recommendations of this study Commission could lead to development of such a plan for Rhode Island,” says Maureen Maigret, former Director of the Rhode Island Department of Elderly Affairs (now the Office of Healthy Aging) and Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council.

It is now time for the creation of the House Study Commission, says Vincent Marzullo, who served 31 years as a career federal civil rights and social justice administrator at the National Service Agency, and a well-known aging advocate. “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,” he says.

“Don’t we now have an obligation to ensure better healthcare, safety, housing, livability, caregiving, etc. for this aging community?” asked Marzullo, noting that during the pandemic more than 90% of the deaths were individuals over 60 —- and 53% of overall deaths were congregate care residents.

“With the lessons learned over the past two years and the devastating impact of COVID on our older adults, it’s critical that we reexamine our aging infrastructure, the needs for services, and the local service capabilities to this growing population, adds Marzullo, calling for “a serious, adult conversation that is long overdue to take place with the aging community, service providers and lawmakers about designing our plan for a more ‘Age-Friendly’ RI, which supports local senior centers as the local hub for the delivery of services.”

Deborah Burton, Executive Director of RI Elder Info, said that enacting H 5224 is “an essential step” towards improving the lives of older Rhode Islanders. “By studying our current services and initiatives, identifying future needs, and identifying potential areas for improvement, we can ensure that all older adults in our state have access to the resources they need to achieve wellbeing and maintaining maximum independence in ways that value, empower and engage them,” she said.

Carmela Greer, Executive Director of Edward King House Senior Center, gave her views as to why it is important to establish a House Aging Commission authorized by H 5224. “This opportunity to document who does what, when, for whom, with what dollars is a common-sense approach to building a comprehensive cost-effective way to care for the other of our most vulnerable populations second only to children,” she said.

According to Greer, who also serves as Policy Committee Lead for the RI Senior Center Directors Association, once this policy road map is designed, “smart decisions can be made to establish where the money can be saved, where duplication can be eliminated, and where existing funding can be re-directed, where duplication can be eliminated, and where existing funding can be re-directed to serve all parties involved.”

In concluding her testimony, Greer said: “We don’t want to re-invent the wheel.  We want to fix the one we have.”

Where House Leadership Stands…

House Minority Leader Michael L. Chippendale (R-District 40, Coventry, Foster, Glocester), goes on the record supporting Carson’s call to create a special legislative commission to study aging policy in the state. “House Republicans recognize the fact that RI is aging and how important it is to coordinate our services to cut duplicity and inefficiencies. A study commission establishes a deep dive public discussion into an understanding of our statewide need, and lessens the possibility of bureaucratic, unintended consequences, which can occur in the submission of haphazard bills,” he says, noting that “Republicans also believe that this is an area, where if the topics are properly vetted, the state can cut costs and bring efficiency to our core government senior services.”

“I support the concept of this commission and I am certainly open to it, but I need to discuss it further with the sponsor, Representative Lauren Carson, before recommending further action. I look forward to speaking with her in the coming weeks of the legislative session,” says House Speaker K. Joseph Shekarchi (D-District 23, Warwick).

Shekarchi and his leadership team will evaluate all legislative resolutions creating House Study Commissions introduced this legislative session to determine which one(s) will be allowed to proceed for a committee, and ultimately, floor vote.  At press time, there is no fiscal note. Creating House Study Commissions must have adequate resources and staffing for their operations. 

With H 5224 having bipartisan support, aging organizations hope that Speaker Shekarchi sees the importance of allowing a committee and floor vote on this resolution.  Democratic and Republican lawmakers must lobby the House Speaker for his endorsement to support passage of this very important commission. Every Rhode Islander will ultimately need to access comprehensive aging programs and services in their later years.

House debate on Carson’s Health Study Commission may well create the political will down the road after it releases its report leading to the creation of Rhode Island’s first Strategic Plan on Aging.

H 5224 cosponsors are Representatives Samuel A. Azzinaro (D-District 37, Westerly), Thomas E. Noret (D-District 25, West Warwick), Susan R. Donovan (D-District 69, Bristol, Portsmouth), House Majority Whip Katherine S. Kazarian (D-District, East Providence), Karen Alzate (D-District 60, Central Falls, Pawtucket), Jason Knight (D-District 67, Barrington, Warren),  and Kathleen Fogarty (D-District 35, South Kingston.

To show your support for H 5224, contact your House Representative.  Go to https://www.rilegislature.gov/representatives/default.aspx. You can also contact House Speaker Shekarchi by calling (401) 222-2447.  Or email, rep-shekarchi@rilegislature.gov.