Aging Advocates Call for Override of Governor’s Veto

Published in Pawtucket Times on July 14, 2003

The General Assembly is poised to override  Gov. Don Carcieri’s veto Tuesday.

The political rhetoric has intensified as the governor picks apart the 2004 budget, which was recently passed by the Democratic-controlled legislature, forcing Democratic Majority Leader William J. Murphy and Senate President William V. Irons to explain how they shaped the budget.

Carcieri has called the General Assembly’s 2004 budget flawed because lawmakers have “missed opportunities” to stop the legislature’s habit of deficit spending.

The governor’s media blitz, beginning last week, is intended to build support for his efforts to defeat the legislature’s attempt to override his veto. Carcieri has called for the elimination of subsidies for greyhound kennel owners [also supported by this writer] and the reining in public-employee personnel costs.

Carcieri also opposes the spending of $ 52 million in federal Medicaid expenditure relief funds and the one percent restaurant sales tax.

When the dust settles after Tuesday’s legislative session to override Carcieri’s veto, aging advocates hope for an override. The 2004 budget crafted by the Democratic-controlled General Assembly puts increased state funding into senior programs and services.  Both provider groups and senior advocacy groups expressed disappointment when Carcieri’s budget proposal did not allocate funding for new aging-related initiatives. Moreover, his fiscal blueprint for state spending made cuts to existing senior programs and services.

“Once again, senior advocates have looked to the General Assembly to provide essential programs and services for the state’s growing senior population,” says Susan Sweet, a long-time aging advocate and consultant to nonprofit groups who also serves as a consumer representative to the state’s Long-Term Care Coordinating Council.

“We have not been disappointed,” Sweet said, in reference to the passage of the General Assembly’s 2004 budget.  “It’s sad that the Carcieri administration does not recognize the improvements the General Assembly has made to the budget and the lives of older Rhode Islander.”

Joan Crawley, executive director of Pawtucket’s Leon Mathieu Senior Center, added, “Although I can appreciate Carcieri’s frustration with trying to balance the state budget, as a senior advocate, I applaud the legislators for making the very difficult decision to fund legislative grants on behalf of the state’s  senior centers,” she said.

“At the Pawtucket town meeting, gubernatorial candidate Carcieri assured us that seniors would be a top priority of his administration should he be elected governor. He even distributed a brochure outlining his senior initiatives. So far, he has failed to address any of those initiatives in is budget, Crawley says.

So, what’s in the General Assembly’s 2004 budget that will improve the quality of life of Rhode Island seniors?

The budget will allocate new state funds totaling $ 300,000 to pay for nursing facility care of legal immigrant Rhode Island seniors who are not eligible for Medicaid.

The budget will also allocate $ 50,000 to support the efforts of the Ocean State Adult Immunization Coalition to get the word out about the importance of seniors getting influenza and pneumococcal vaccinations.

Meanwhile, lawmakers have allocated state monies for community grants. Initially, senior centers (in Carcieri’s budget ) were targeted with a 10 precent cut. To the relief of senior center providers, lawmakers passed the 2004 budget with no cuts

As previously reported to All About Seniors, an 18-month study by B.D.O. Seidman, a consulting firm hired by the state Department of Human Services, found Rhode Island was underpaying its nursing facilities in excess of $ 30 million annually.

It seems that the Rhode Island General Assembly agrees with the report’s assessment, because lawmakers made a partial allocation of new Medicaid dollars to overhaul the state’s ailing Medicaid system.

With passage of the budget, nursing facilities will receive a total of $ 18.8 million in state and federal dollars – a three-year phase-in will bring the total federal and state dollars up to $ 30 million.

Finally, the recently passed 2004 state budget has allocated $ 50,000 to provide dental services to nursing facility residents.

The 2003 budget that was supposed to expire June 30 stays in effect until Carcieri signs the 2004 budget into law. Until that time, new programs, policies, or program appropriations will be effectively put on hold.

An override of Carcieri’s veto will result in many new senior programs and services being funded in the 2004 state budget.

If the popular Republican governor is able to rally is troops – both Republican lawmakers and Carcieri Democrats – to support his veto, then lawmakers must begin their efforts to hammer out another budget.

….

As noted in last week’s All About Seniors column, not one dime in state funding was allocated in the state’s 2004 budget to beef up the state Department of Health’s regulatory oversight. Providers, aging advocates, and even state officials have called for new state dollars to fill one full-time surveyor position (a nurse) to ensure that assisted living residences across Rhode Island are inspected on a timelier basis.

The General Assembly has put laws on the books to protect frail Rhode Island seniors who received assisted-living services. Yet, Carcieri and lawmakers have failed to allocate the necessary funding in the 2004 state budget to allow Health Department regulators to comply with    their legislative oversight duties to inspect the state’s 72 assisted-living facilities and 155 assisted-living bed in nursing facilities on a timely basis.

That’s not all.  According to the state’s Department of Health, another seven assisted-living projects are expected to be up and running over the next 18 months.

Meanwhile, at Tuesday’s veto override, lawmakers will also take up legislative issues were not addressed in their haste to adjourn two weeks ago.  Maybe the state Health Department’s urgent need for more funding to adequately perform its oversight duties of assisted-living facilities will be acted on by lawmakers in both chambers.

Carcieri can become the white knight and save the day. He can choose to move forward and fix this policy flaw by either using contingency funds in his office budget or to take administrative action to hire one more full-time assisted living inspector.

Acting decisively to fix tis identified policy glitch is sound public policy that will ultimately protect the health and well-being of 1,700 assisted-living residents. Even with Carcieri’s calls for balancing the budget, taxpayers especially seniors won’t oppose allocated tax dollars to protect older Rhode Islander.

Lawmakers to Consider Funding for Vaccine Immunizations for Seniors

Published in Pawtucket Times on May 12, 2003

Even with a state budget deficit looming, sometimes putting a little money into a statewide initiative can ultimately save big dollars.  It’s just the right thing to do.

For the second year, the Ocean State Adult Immunization Coalition (OSAIC) has approached the Rhode Island General Assembly for funding to promote the group’s efforts to get the word out about the importance of Rhode Island seniors  getting influenza and pneumococcal vaccinations.

OSAIC’s message is quite simple: “Avoid a Hospital Stay: Get Your Flu Shot Now!”

According to OSAIC, pneumonia and influenza deaths together are considered the six-leading cause of death in the nation.

Since 1999, there have been 300 deaths and 6,800 hospitalizations that were attributed to influenza and pneumococcal disease in the Ocean State.

OSAIC said vaccinations are a cost-effective way to prevent these unnecessary hospitalizations and deaths.

OSAIC, a coalition of 40 agencies, including hospitals, nursing facilities, vaccine manufacturers, medical societies, managed care groups, the Rhode Island Department of Health, Rhode Island Quality Partners, the Visiting Nurses Association, and Blue Cross Blue Shield of Rhode Island, call on Gov. Don Carcieri and lawmakers to see the big picture – preventative medicine care can ultimately save tax dollars.

Anne Marie Beadsworth, OSAIC’s chair, said the cost of a flu shot is $ 15 and a pneumonia shot is $ 30.

On the other hand, she added that the average length of stay for an older person with influenza is five days, costing $ 12,000.

Since OSAIC was established in 1997, Beadsworth has seen a steady progress in the coalition’s efforts to get more older Rhode Islanders immunized to prevent the influenza and pneumonia.

“The immunization coverage rates for those age 65 and over has increased by eight precent (from 67 percent to 75 percent) for influenza vaccine and 24 percent (from 43 percent to 67 percent) for pneumococcal vaccine,” she noted.

Beadsworth said OSAIC is working to reach the Healthy People 2010 goal of a 90 percent immunization rate for influenza and pneumococcal  for people age 65 and over.

“Through promotional efforts in five languages in 2002, more than 350 flu clinics were conducted throughout Rhode Island with the guarantee that any person age 65 and older, regardless of insurance status, could get a flu shot without any out-of-pocket expenses,” she said.

Furthermore, OSAIC’s gains have propelled the Rhode Island-based initiative into top 10 standings in the United States, says Beadsworth.

“We rank number seven for both flu and pneumococcal vaccination rates,” she added.

Beadsworth said that during last year’s legislative session, OSAIC’s efforts for the state funding fizzled because of state funding fizzled because of state budget cuts. The coalition was just not effective in getting its message out to lawmakers, she added.

During this year’s legislative session, OSAIC is pushing for $ 103,169 in new funding in Fiscal Year 2003-2004 to expand the coalition’s educational outreach efforts and to hire a part-time staffer to oversee its ongoing programs to improve the state’s immunization rates.

Currently, OSAIC is a volunteer-driven organization with its $ 50,000 working budget coming from member organizations and from the community.

It seems things may be different this year at the Rhode Island General Assembly. Support among lawmakers is growing for OSAIC’s ongoing preventative medicine initiatives.

“Quite a few advocates are coming to the Senate asking for funding,” said Sen. Stephen D. Alves (D-West Warwick), who said there is now growing support for OSAIC’s funding request.

Alves, who serves as chair in the Senate Finance Committee, told All About Seniors the funding request will be brought up during the chamber’s budget debates.

“Everyday, we talk about preventative medicine – funding this program is a step in the right direction,” said Alves.

Rep. Steven M. Costantino (D-Providence), who sits on the House Finance Committee, told me he sees the value of OSAIC’s efforts, too, and plans to call for funding OSAIC’s initiative during House budget deliberations.

Health Director Patricia A. Nolan also sees the positive benefits of OSAIC’s prevention campaign.

“Adults need their shots, too – especially people aged 50 and older or people with chronic health conditions. Vaccinations are one of the easiest and most effective ways to stay healthy,” she says.

As state revenue estimators meet to determine the breath and scope of the state’s budget deficit, Gov. Carcieri’s staff continue their ‘Big Audit” to identify ways to save taxpayer dollars.

When the dust settles, even with a projected budget deficit, it may be time for the governor and the General Assembly to view preventative medicine as a worthy cost containment approach for reining in skyrocketing health care costs. Even though state dollars have to be allocated up front, large savings might be realized down the road.

As the state’s final budget is being crated, we must not be “penny wise but pound foolish” when determining what bills live or die in the 2004 legislation hopper. Taxpayers will ultimately lose if this happens.

Senior must beware of heat, humidity

Published in Pawtucket Times on August 13, 2001

Temperatures reaching the mid-90s, combined with high humidity represent a serious health hazard for seniors.  But many seniors are heeding the advice of experts, gleaned from radio and newspaper articles, about how to cope with the scorching summer heat.

As to the heat wave, “we can’t control it but we certainly can deal with it,” says Pawtucket resident Paul Audette, who notes he has learned how to cope by listening to health experts.

The 71-year old senior staff manager at Pawtucket-based Providence Metalizing has consciously slowed down his activities, is drinking plenty of liquids and is staying out of the hot sun.

During the heat wave, Audette relaxed in the afternoon and goes out later in the evening when it becomes cooler.

Rep. Mabel Anderson, (District 77) also heeds the advice of health experts on radio programs and is coping well with the intense summer heat.

“I stay quiet, avoid going outside to run errands,” says the Pawtucket resident, noting that she drinks plenty of water to keep from becoming dehydrated. 

Anderson’s son, Jon, has also installed an air conditioner in her bedroom.  With three overhead fans in other rooms, Anderson keeps cool and comfortable.

Seniors, small children and the mentally ill are the most susceptible to health problems from the searing summer heat wavers, according to Dr. Patricia Nolan, director of Rhode Island’s Department of Health.

According the Nolan, the early systems of heat-related illnesses include muscle cramps in arms, hands, abdomen and legs.  Muscle cramps are a result of dehydration and salt loss, this being one of the primary problems associated with heat stress.

Additionally, Nolan says that fainting in the heat is another early symptom.

A person who has fainted due to heat should be taken to a cool place and refreshed using a wet cool cloth.  Nolan recommends, “You want to sponge people down and fan them to reduce their body heat,” she says.

Heat exhaustion or heat stroke is a more serious problem related to dehydration caused from high temperatures, Nolan stated.  Feelings of complete exhaustion, confusion, nausea or vomiting are real danger signs, she said.  Treatment involves bringing down the victim’s body temperature by adding fluids through intravenous methods.

To successfully beat the heat, Nola recommends that seniors cut back on outside physical activity and drink plenty of water.

While water is the best fluid to drink on a hot day fruit juice can be considered a viable substitute.  “Cooling off with a cold beer is not the best plan, “Nolan says, because alcohol, coffee tea and soda, loaded with caffeine, can dehydrate you.

Nolan warns that with temperatures in the mid-90s, staying indoors in an uncooled house or apartment is not the best thing for seniors to do.

“Go to an air-conditioned shopping mall, see a movie, visit a restaurant, or get yourself into an air-conditioned space.” She recommends. “If you can do this for an hour on a really hot day you can protect yourself from serious heat-related problems”.

Sometimes seniors get into trouble during days with high temperatures because they just don’t realize the danger, Nolan notes.

During these days it becomes important to monitor your elderly parent or older friends, she says, “Call on them every day to make sure they are coping with the heat.  Take them out to a cool place, like shopping mall, a library or a restaurant to let them cool off.”