Senate Task Force Calls for Action to Combat State’s Growing Elder Abuse

Published in the Woonsocket Call on June 30, 2019

With the 2019 General Assembly Session ending Friday, June 28, Senator Cynthia Coyne (D-District 32, Barrington, Bristol, East Providence), who led the Senate’s Special Task Force to Study Elderly Abuse and Financial Exploitation, successfully spearheaded an effort to pass legislative proposals to beef up the state’s efforts to combat elder abuse, that is growing and vastly under reported.

“The prevalence and projected growth of elder abuse and exploitation is deeply troubling, particularly in light of our findings that its full extent can’t be known because it is so rarely reported or investigated,” said Coyne in a statement announcing the release of the Senate Task Force’s final report. “As the baby boomers become seniors and our elderly population grows, it’s critical that we do everything we can to protect older Rhode Islanders from this abuse. We are confident we can make significant improvements to prevent elder abuse and exploitation, and I’m grateful for the commitment of my colleagues in the Senate to this issue,” says Coyne.

The Senate Task Force, began studying the prevalence and impact of elder abuse and financial exploitation in Rhode Island last December, releasing its final report June 28, in Room 313 on the third floor of the statehouse, calling for education about elder abuse and monitoring efforts to prevent it.

Rhode Island Elder Abuse Incidents Are Increasing

The 130-page report, citing data supplied by the Rhode Island Division of Elderly Affairs (RIDEA), warns that elder abuse and financial exploitation in the Ocean State is prevalent and incidents are increasing. According to RIDEA, “there were 1,377 confirmed cases of elder abuse in 2017, which is 444 cases more than only five years prior. As the nation’s population of people age 65 and over is expected to double by 2060, the problem is expected to continue growing. Among the recommendations is that the state collaborate with existing community organizations and support outreach and education efforts that specifically focus on seniors and those who interact with them.”

Elder abuse is underreported, too, says the Senate Task Force report, noting that “Only 1 in 23 cases of elder abuse is reported to adult protective services.“ The report recommends strengthening outreach and education efforts for the public, health care workers and others who interact with seniors, and working to dispel stigmas so seniors will be better enabled to report abuse.

The Senate Task Force report also warns that older Rhode Islanders are also extremely vulnerable to financial exploitation, caused by a multitude of factors including a senior’s health, life savings and technology now available to electronically transfer money. With this problem expected to continue growing, it calls for better education for passage of legislation similar to a Connecticut law that requires training for agencies that employ individuals to care for seniors. Another recommendation is to consider a law like one in Delaware to allow financial institutions to place a hold on accounts when they find suspicious transactions.

The Senate Task Force also recommends supporting the Saint Elizabeth Haven for Elder Justice and its enhanced Training and Services to End Abuse in Later Life grant program, and strengthening services available through the POINT, the senior resource service at the Division of Elderly Affairs.

Passed Elder Abuse Legislation Heads to Governor’s Desk for Signature

As the result of this Senate Task Force, in the final days of the General Assembly, Coyne and Rep. David A. Bennett (D-District 20, Warwick, Cranston) introduced legislation (S 0603A, H 5573) to combat tackle the issue of elder abuse in the Ocean State. The legislation, expanding an existing law that requires people who have reasonable cause to believe a person age 60 and over is being abused, neglected or mistreated to report it to the Division of Elderly Affairs, which will report the incident to law enforcement if appropriate and intervene, was passed an now heads for the Governor’s desk for signature. .

Currently, health care providers and others who come into contact with elderly or disabled people in health care facilities are required to report suspected abuse or neglect within 24 hours. The enacted law adds a section of law requiring reporting of suspected abuse, exploitation, neglect or self-neglect of people over age 60, regardless of whether they live in a health care facility. It also expands the list of those required to report suspected abuse to include physician assistants and probation officers and protects employees who report abuse from liability (unless they are found to be a perpetrator) or negative consequences at work for reporting abuse or neglect.

The Rhode Island General Assembly also passed legislation (S 0845A, H 6114) sponsored by Coyne and Rep. Patricia A. Serpa (D-District 27, West Warwick, Coventry, Warwick). The legislation requires the collecting municipal probate data to access the guardianship program, as well as to seek federal grants to support education, monitoring and resources for guardians. It also recommends a nationwide criminal background check for anyone seeking guardianship or limited guardianship of another adult, even temporarily. Under the bill, anyone who is found to have been convicted or plead nolo contendere to charges for a variety of crimes, including violent crimes or crimes involving abuse or neglect of elders, would be disqualified.

Members of the task force include Senator Coyne; Senator Sandra Cano (D-District8, Pawtucket); State Long-Term Care Ombudsman Kathleen Heren; Special Assistant Attorney General Molly Kapstein Cote; Mary Ladd, chief of program development at the Rhode Island Division of Elderly Affairs; AARP- Rhode Island Associate State Director John DiTomasso; State Police Detective Kyle Shibley; Warwick attorney Mark Heffner; and Saint Elizabeth Haven for Elder Justice Director Jeanne Gattegno.
With the release of its report this month, Coyne’s Special Task Force to Study Elderly Abuse and Financial Exploitation, is off to a good start by giving the Rhode Island General Assembly a legislative road map needed to protect vulnerable Rhode Island seniors from physical, emotional and financial abuse. It’s a first step, but hopefully not the last. Senate leadership might consider making the Senate’s Special Task Force to Study Elderly Abuse and Financial Exploitation, permanent, charged with recommending legislative proposals each session, mirroring best practices, gathered from other states, to combat elder abuse.

To get a copy of the Senate Task Force’s elder abuse report, to http://www.rilin.state.ri.us/commissions/eafe/commdocs/Special%20Task%20Force%20to%20Study%20Elderly%20Abuse%20and%20Financial%20Exploitation%20REP.pdf.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

General Assembly: It’s Time to Endorse State Alzheimer’s Plan

Published in the Woonsocket Call on May 12, 2019

Just days ago, the Alzheimer’s Association-Rhode Island Chapter, along with over 75 volunteers and supporters gathered for the group’s Advocacy Day, in the Governor’s statehouse at the Rhode Island State, warning state lawmakers about the increasing incidence in Alzheimer’s disease and its impending impact on state programs and services. According to the Alzheimer’s Association 2019 Alzheimer’s Disease Facts & Figures report, there are now 23,000 people living with Alzheimer’s and 53,000 Alzheimer’s caregivers in Rhode Island. This number will skyrocket as Rhode Island’s population continues to age; they say.

During the two-hour rally, Alzheimer’s advocates pushed for the passage of H 5569, sponsored by Rep. Mia Ackerman (D-Cumberland), and S 310, Sen. Cynthia A. Coyne (D-Barrington), companion measures that would legislatively endorse the newly released State Alzheimer’s Plan.

House Majority Leader Joseph Shekarchi also joined in, calling for passage of H. 5189, his legislative proposal that would create a program under the Department of Health and an advisory council to oversee implementation of programming, requiring training for medical professionals, and establishing Alzheimer’s plans in medical facilities. the Senate companion measure is S 223.

Improving Supports for Those Afflicted with Alzheimer’s

Once the Rhode Island General Assembly passes the legislative proposals to endorses the State Alzheimer’s Plan, the state’s Long-Term Care Coordinating Council’s executive board would seek legislative and regulatory changes to carry out its bold set of recommendations for improving supports to those afflicted by Alzheimer’s and other dementias. But this legislation is stalled.
Twenty-three town meetings,45 expert interviews, combined with a survey of 200 Rhode Islanders impacted by Alzheimer’s, enabled Columbia, Maryland-based Splaine Consulting, a nationally recognized health policy firm, to pull together the content for the State Alzheimer’s Plan. More than 30 recommendations are detailed in this 35-page plan to combat the devastating mental disorder which calls for the implementation of three main recommendations.

The updated State Plan provides Rhode Island with the framework to cooperatively address the full range of issues surrounding Alzheimer’s and other dementias. It will be the blueprint that allows us to take unified, targeted action against the disease, says Lieutenant Governor Daniel McKee McKee, who serves as chair of the state’s Long-Term Care Coordinating Council (LTCCC).

McKee’s LTCCC served as the organizational umbrella for a workgroup, including the Alzheimer’s Association– Rhode Island Chapter, the state’s Division of Elderly Affairs, researchers, advocates, clinicians and caregivers oversaw the development of the newly released State Plan.

“Our updated plan will also position the state, local small businesses and nonprofits to take advantage of federal and other funding opportunities aimed at fighting Alzheimer’s disease,” says McKee.

“Unless we move quickly to address this crisis and find better treatments for those who have it, these costs will grow swiftly in lock step with the numbers of those affected, and Alzheimer’s will increasingly overwhelm our health care system. We must decisively address this epidemic,” says Donna M. McGowan, Executive Director of the Alzheimer’s Association–Rhode Island Chapter, who came to the May 7 news conference on Smith Hill to put Alzheimer’s on the General Assembly’s policy radar screen.

Taking Bold Actions to Confront Alzheimer’s Epidemic

“State government must address the challenges the disease poses and take bold action to confront this crisis now. Alzheimer’s is a growing crisis for our families and the economy. That’s why we are unrelenting advocates for public policy that advances research and improves access to care and support services,” says McGowan.

“Alzheimer’s disease and its impact on society is not only a growing public health concern, it very well may be the next biggest public health emergency that we as policymakers need to address,” said Rep. Ackerman. “We’ve already begun crafting legislation that will establish a program in Rhode Island to address the disease,” she says.

Rep. Ackerman used the Alzheimer’s news conference as a bully pulpit, calling on hospitals, researchers, medical professionals, state agencies, and state law makers to act swiftly to address the looming public health crisis.

“There are many factors to be considered in the great work ahead of us,” Rep. Ackerman said. “From early detection and diagnosis, to building a workforce capable of handling the unique health care needs of Alzheimer’s patients. This is something that will take a lot of effort and a lot of time. Now is the time to get to work on this,” she notes.

Like Rep. Ackerman, Sen. Coyne called for the General Assembly to endorse the State Alzheimer’s Plan and also supported Shekarchi’s legislative proposal, too. She also promoted a bill that she put in the legislative hopper that would allow spouses to live with their partners in Alzheimer’s special care units. Allowing couples to live together would help maintain patients’ relationships, connections and personal dignity, she said.

Rose Amoros Jones, Director of the Division of Elderly Affairs(DEA), noted that the power to the Alzheimer’s Association – Rhode Island Chapter’s Advocacy Day creates connections to people that can influence policy and shine light on the supports and information that families need. “Connection is a core value at DEA – as is choice, she said.

Sharing personal stories, Melody Drnach, a caregiver residing in Jamestown, talked about the challenges of taking care of her father with dementia. From her personal caregiving experiences, she agrees with the updated plans assessment that Rhode Island is dramatically under-resourced to address today’s needs.

Marc Archambault of South Kingstown, who has been diagnosed with the disease, came, too, talking about his efforts to cope with the devastating disorder.

At press time, both Rep. Shekarchi and Rep. Ackerman’s Alzheimer’s proposals have been heard at the committee level and have been held for further study, some call legislative purgatory.

Alzheimer’s Impacts Almost Everyone

The devastating impact of Alzheimer’s may well touch everyone in Rhode Island, the nation’s smallest state. Everyone knows someone who either has Alzheimer’s or dementia or is a care giver to these individuals. It’s time for the Rhode Island General Assembly to endorse the State’s Alzheimer’s Plan especially with no fiscal cost. We need a battle plan now more than ever to effectively deploy the state’s resources to provide better programs and services to those in need and to support caregivers.

Call your state representatives and Senators and urge that H 5569 and S 310 are passed and sent to Governor Gina Raimondo to be signed. For contact information, call Eric Creamer, Director of Public Policy and Media Relations, Alzheimer’s Association – Rhode Island Chapter, (401) 859-2334. Or email ercreamer@alz.org.

Funding for Seniors in Raimondo’s FY 2020 Budget Blueprint

Published in the Woonsocket Call on January 27, 2019

By Herb Weiss

Almost two weeks ago, Democratic Governor Gina Raimondo formerly unveiled her $9.9 billion budget proposal to the Rhode Island General Assembly. The House and Senate Finance Committees then begin the task of holding hearings on budget plan, getting feedback from the administration and the public. Once the revised estimates of tax revenue and social-services spending is available in May, negotiations seriously begin between Raimondo, the House Speaker and Senate President to craft the House’s budget proposal. Lawmakers will hammer out and pass a final state budget for the fiscal year that begins July 1.

Local media coverage of Raimondo’s ambitious spending initiatives zeroed in on her call for expanding free tuition to Rhode Island College and adding some public pre-kindergarten, increasing minimum wage from $ 10.50 to $ 11.10 per hour, allowing mobile sports betting and legalizing recreational marijuana.

But, Raimondo’s budget proposal gives state lawmakers a road map for what programs and services are needed for a state with a graying population.

According to Meghan Connelly, DEA’s Spokesperson, a nearly 60 percent increase in the State’s population of residents aged 65 and older from the years 2016 to 2040 highlights the need for continued investments in programs servicing Rhode Island’s older adults and their family caregivers.

Connelly says Raimondo’s budget proposal, released on January 17, elevates Elderly Affairs from a division under the Department of Human Services to an Office within the Executive Office of Health and Human Services. The governor shifts financing for the office and 31.0 FTE positions to EOHHS to accomplish this recommended action.

“The projected increase in the state’s senior population – from 174,000 in 2016 to 265,000 by 2040 – coupled with the proven impact of community-based supports and services, highlights the need for continuing to invest in helping our seniors remain home, connected to their families and networks. Support of aging-related health-promotion initiatives are essential to maintain a high quality of life for Rhode Island seniors while minimizing aging-related healthcare costs,” says Connelly

“We are focused on making it easier for older adults to live independent, fulfilling lives for as long as possible,” said Michelle Szylin, Acting Director of the Division of Elderly Affairs. “The Co-Pay expansion [in the governor’s proposed budget] enables additional older adults to age-in-place, remaining safely in their homes and engaging in their communities.”

The Co-Pay expansion enables additional older adults to age-in-place, remaining safely in their homes and engaging in their communities. The governor’s proposal to expand the state’s Co-Pay program [by $ 550,000] will allow more seniors to reside in their communities, staying connected to their family and network of friends and neighbors.

Providing access to the Co-Pay program to individuals earning up to 250% of the Federal Poverty Level will allow more seniors to age-in-place with a better quality of life and delay nursing home admission. The DEA Co-Pay program was established in 1986 as an option for elders who would otherwise be ineligible for subsidized home and community care assistance because they did not qualify for the Rhode Island Medical Assistance program.

Recognizing the importance of the state’s Elderly Transportation Program to keep older Rhode Islander’s independent, Raimondo’s budget proposal calls for additional funding of $1.8 million from general funds to support the State’s elderly transportation program. This program provides non-emergency transportation benefits to Rhode Islanders age 60 and over who do not have access to any means of transportation. The program provides transportation to and from medical appointments, adult day care, meal sites, dialysis/cancer treatment and the Insight Program.

Raimondo’s proposed budget also increases Health Facilities regulation staffing to increase the number of inspections to state-licensed health care facilities. The governor recommends a $327,383 increase in restricted receipt funds for 3.0 FTE positions. These positions will bolster existing staffing to increase the number of inspections to state-licensed healthcare facilities.

The Governor’s proposed FY 2020 budget also through the Rhode Island Public Transit Authority continues to subsidize the transit of elderly and disabled Rhode Islanders through the Rhode Island Public Transit Authority.

Raimondo’s proposed budget also continues the support for the Independent Provider model P model with almost $200,000 in general revenue funds budgeted (about $770,000 all funds) to cover implementation costs. The goal of this model is to increase workforce capacity and create a new option for delivery of direct support services for both seniors and people with developmental disabilities.

Finally, the governor’s FY 2020 budget also allocates funding to an array of programs and services for seniors. Here’s a sampling: $800,000 to support the state’s senior centers through a grant process (the amount was doubled last year); $ 530,000 to support Meals on Wheels; $ 85,000 to implement security measures in elderly housing complexes; $ 169,000 for the long-term care ombudsman through the Alliance for Better Long Term Care, which advocates on behalf of residents of nursing homes, assisted living residences and certain other facilities, as well as recipients of home care services; and $ 500,000 funds the state’s Home Modifications program at Governor’s Commission on Disabilities.

Nursing Facility Provides Take a Hit

Raimondo’s proposed budget plan seeks to freeze the state’s Medicaid payment rates to hospitals, slashing funding by an estimated $15 million overall for the year, and to limit the rate increase for nursing homes to 1%, costing them nursing home providers about $4 million.
“We are beginning the budget process with a 1 percent increase in the COLA (Cost of Living Adjustment), says Scott Fraser, President and CEO of Rhode Island Health Care Association (RIHCA), warning that “this is not enough.”

“Since 2012, nursing facility costs have risen 21.6 percent while Medicaid payment rates have only gone up by 9.6 percent, adds Fraser, noting that by statute, rates are supposed to be adjusted annually for inflation. “We will be advocating for additional funding for nursing facilities throughout the remainder of the budget process,” he warns.

Jim Nyberg, Director LeadingAge RI, an organization representing not-for-profit providers of aging services, joins with RIHCA in calling on Rhode Island lawmakers to restore the full inflation adjustment. “Ongoing increases in minimum wage (up 42 percent since 2012) make it harder for publicly funded providers to compete for skilled workers,” says Nyberg, noting that most of his nonprofit nursing homes have 60 percent to 70 percent of their residents on Medicaid. “A rate increase is needed help nursing homes recruit and retain the direct care workers that are so critical to providing quality care,” he says.

“Since 2016, our nursing homes and consumers have been severely disrupted by UHIP, financially and operationally. The ongoing problems with Medicaid application approvals and payments has resulted in significant increases in staff workload just to maintain operations, let alone the impact on cash flow and financial stability, adds Nybrg.

Nyberg’s group is also advocating to expand the CoPay program for individuals under the age of 65 with dementia. “This has been proposed in the past but not included in this budget. We think that such an expansion will help this at-risk population for whom no publicly-funded programs and services currently exist,” he says.

Lawmakers, AARP Rhode Island Gives Comments

AARP Rhode Island is encouraged to see that the Governor placed an increase in the State Budget for the Department of Elderly Affairs home healthcare Co-Pay program,” said AARP Rhode Island Advocacy Director John DiTomasso. “By increasing the income eligibility from 200% of the poverty level to 250%, more older Rhode Islanders will be able to obtain home care services at reduced hourly rates,” he added. “This will help large numbers of people to extend the time they can age in place in their home and in their community rather than in more costly state-paid long-term care facilities,” says DiTomasso.

Senate President Dominick J. Ruggerio says, “Upon a first look at the budget, I am very pleased that some of the Senate’s top priorities are incorporated. The Governor had to close a significant deficit, and difficult choices had to be made. However, the budget is a statement of priorities, and initiatives like the no-fare bus pass program for low-income seniors and disabled Rhode Islanders are a priority for us in the Senate. I am very pleased to see this program funded in the budget, along with many other services for seniors, and I look forward to deeper analysis of all aspects of the budget in the months ahead.”

AddsD House Speaker Nicholas Mattiello, “The House Finance Committee will soon begin holding public hearings and reviewing every aspect of the Governor’s budget proposal. We will make certain that the level of care and services to older adults will be maintained and hopefully enhanced. We are facing significant budget challenges this year, but we will always keep the needs of our seniors at the forefront of the discussions.”

Older Rhode Islanders and aging groups must continue to push the House to at a minimal maintain the governor’s senior agenda. Hopefully, as Mattiello said, senior programs and services can be enhanced.

For a Senate Fiscal Analysis of Raimondo’s FY 2020 budget, go to http://www.rilegislature.gov/sfiscal/Budget%20Analyses/FY2020%20SFO%20Governor’s%20Budget%20-%20First%20Look.pdf.

Caregivers Can Take Advantage of Free Credit Freeze Law

Published in the Woonsocket Call on October 14, 2018

Attorney General Peter F. Kilmartin touts a new federal consumer protection law, signed into law by President Donald Trump on May 24, 2018, that protects seniors from becoming victims of financial exploitation. Rhode Island’s Attorney General says that this law enhances Rhode Island’s law prohibiting credit reporting agencies from charging fees for credit freezes,(also referred to as a security freeze).

With enactment of the Economic Growth, Regulatory Relief, and Consumer Protection Act, all consumers can now freeze and unfreeze their credit file for free for one year. Before this new law, fees were assessed, usually costing from $3 to $10 (though some states were free) to restrict access to your credit file, making it harder for others to open new accounts in another person’s name.

The new law lets people with certain legal authority to act on someone else’s behalf to freeze and unfreeze their credit file. It defines a “protected consumer” as an incapacitated person, someone with an appointed guardian or conservator, or a child under the age of 16. In addition, it extends the duration of a fraud alert on a consumer’s credit report from 90 days to one year. A fraud alert requires businesses that check a consumer’s credit to get the consumer’s approval before opening a new account.

“Many instances of financial exploitation include a person opening up credit cards or using the credit file of another for personal gain and identity theft. This added layer of protection will allow a guardian or financial caregiver the ability better safeguard the older person from being taken advantage of by a stranger or even someone they know and thought they could trust,”says Kilmartin.

To place a credit freeze on their accounts, consumers will need to contact all three nationwide credit bureaus: Equifax, Experian, and TransUnion. If you’re acting on behalf of a protected consumer, you must give the credit reporting agencies proof of authority before you can freeze and unfreeze the protected consumer’s credit. Proof of authority includes: a court order (such as an order naming you guardian or conservator; a valid power of attorney, and proof of your identity, which can be a Social Security card, birth certificate, driver’s license or other government issued identification.

Whether consumers ask for a freeze online or by phone, the credit bureau must put the freeze in place within one business day. When consumers request to lift the freeze by phone or online, the credit bureaus must take that action within one hour. (If consumers make these requests by mail, the agency must place or lift the freeze within three business days).
To place a fraud alert, consumers need only contact one of the three credit bureaus, which will notify the other two bureaus.

Rhode Island’s Credit Freeze Law

Filed at the request of Kilmartin and enacted earlier this year, the Rhode Island law eliminates a provision of existing state law that allows reporting agencies to charge up to $10 to consumers who ask for a credit freeze.

The legislation, which the sponsors introduced on behalf of Rhode Island Attorney General Kilmartin, stems from the Equifax security breach last year during which the credit information of 143 million Americans was exposed. Initially, Equifax was charging consumers who asked for a credit freeze to protect themselves from its own security breach, although it stopped after intense public outcry and pressure from numerous attorneys general.

At the time the law was enacted, Kilmartin said, “This is a big victory for Rhode Island consumers, giving them greater control over who can access their personal and financial information. Credit bureaus make money from selling our personal information to third parties. They should not be able to profit off consumers who decide to take control over who has access to their personal data.”

Protecting Rhode Island’s Seniors

“AARP applauds all efforts to protect older Rhode Islanders from phone and online credit scams that lead to identity theft,” says AARP Rhode Island State Director Kathleen Connell. “Clearly, many consumers, and especially many of Rhode Island’s 134,000 caregivers, will consider taking advantage of this new option. It certainly complements the work we are doing as part of AARP Fraud Watch to thwart con artists who prey relentlessly on people of all ages.

“In the case of older Rhode Islanders, life savings can be at risk. “The new federal law allows caregivers to acquire legal authority to freeze a loved one’s credit reports, and that’s a good thing. But it is important to note that there are many things a caregiver should consider. Basically, caregivers need to have conversations about the threat and what everyone should be doing to protect against credit theft,” she added.

AARP’s John Martin said when he presents the Fraud Watch program to community groups he urges people to think about fraud prevention in the same way training and professional development is part of their work experience. “In the workplace, your job includes being up to speed on the latest policies, regulations and best practices,” Martin tells audiences. “Lawyers read law reviews, doctors read medical journals, tugboat captains read The Shipping News. Failure to do so could lead to a missed opportunity or a big mistake. Given the enormous threats out there, we all should consider keeping up on the latest scams and implementing precautions something like a part-time job that requires similar diligence. To do otherwise increases your risk and the stakes are frighteningly high.”

Connell warns not to forget the basics. “AARP provides common-sense advice, awareness and precautions as well as alerts when new scams are exposed or an old one reappears,” she says. “Don’t be passive and please do encourage older family members to be on guard. We are all in this together.”

Anyone can sign up for the free Fraud Watch Network service at http://www.aarp.org/RIFraudwatch to receive alerts and report scams or other suspicious activity.

Reporting Financial Exploitation

The Rhode Island Office of the Attorney General recommends that if you believe you or an older relative are victims of financial exploitation, contact your local police department, the Rhode Island Division of Elderly Affairs, or the Elder Abuse Unit at the Rhode Island Office of the Attorney General.

If you would like an investigator at the Elder Abuse Unit or an investigator with the Consumer Protection Unit to speak with your organization on the signs of elder abuse or how to protect from being a victim of a scam, please contact Mickaela Driscoll, Elder Abuse Investigator, at mdriscoll@riag.ri.gov or Martha Crippen, Director of the Consumer Protection Unit, at mcrippen@riag.ri.gov or by calling 401-274-4400.

Fogarty Retiring as Elderly Affairs Director

Published in Woonsocket Call on January 28, 2018

Just days ago, Director of Rhode Island’s Division of Elderly Affairs (RIDEA), Charles J. Fogarty, announced his retirement to take place at the end of June, after 4 decades of public service. There have been nine directors since the establishment of DEA, including Fogarty.

Fogarty’s plans to retire at the end of the current legislative session. When this occurs, Governor Gina Raimondo will make an appointment to the RIDEA director position. The position requires advice and consent of the RI Senate.

Fogarty began his career in public service in 1978 as a junior policy advisor for Governor J. Joseph Garrahy. He served as lieutenant governor, from 1999 to 2007, having the distinction of being the last lieutenant governor to preside over the State Senate. From 2011 to 2015, Fogarty served as the director of the Department of Labor and Training, ending up his career as the Director of RIDEA.

During his years of public service, Fogarty, 62, has been focused on long term care and home- and community-based services and supports for older Rhode Islanders. He played a key role in steering and expanding the work of the Long-Term Care Coordinating Council during his tenure as Lieutenant Governor for two terms. Under his leadership at the Department of Labor and Training, he reformed the unemployment insurance process. During his stewardship as Director at Elderly Affairs (since January 2015), he has led a division providing services and advocacy for over 166,500 older adults living in Rhode Island.

As a Glocester resident he was elected to the Glocester Town Council in 1984 and in 1990 was elected as a state senator, where he served for eight years. While a state senator, he served as both majority whip and Senate President Pro Tempore.

Fogarty Reflects on RIDEA Tenure

“Throughout my career, I have felt drawn to serve the people of Rhode Island. I look back fondly and feel fortunate to be a part of the forward progress Rhode Island is experiencing–particularly working with Governor Raimondo to empower seniors and help them to remain independent and living in the community,” said Fogarty.

According to Fogarty, under his helm, RIDEA has continued to process of supporting community-and home-based services for seniors and caregivers, but more needs to be done in order to really rebalance Rhode Island’ long-term care system. Aging in the community- in our own homes- is what many Rhode Islanders want for ourselves and our loved ones, he says.

“We’ve restored funding for Meals on Wheels, provided additional funding for respite services, and this year are proposing to double the amount the state invests in senior centers. Senior centers are primary gateways in the community that connect older adults and caregivers to services that can have profound impacts upon their ability to remain healthy and independent,” notes Fogarty.

Fogarty says, “If the general assembly follows Governor Raimondo’s lead and doubles the funding for senior centers, Rhode Island will be taking a huge step in the right direction of providing the appropriate support to these essential senior services.”

“We need to prepare for the shift in demographics that is occurring, and accept that the old model of providing long term care services isn’t working for the large number of Boomers who are marching towards retirement and old-age. RIDEA and other key partners are engaging in the Age-Friendly Rhode Island initiative, and we all need to work together to provide more choices and options for Rhode Islanders as they age, empowering them, and helping them to remain independent and healthy,” adds Fogarty.

Tributes to Fogarty

“Charlie has dedicated his entire professional life to Rhode Island and we thank him for his decades of service to our state,” said Governor Gina M. Raimondo, in a statement, recognizing the key role he played as DEA Director in expanding Meals on Wheels and in repealing the tax that seniors pay on their Social Security.

“As sitting Lt. Governor, I appreciate Charlie being a resource to me on issues important to our state’s seniors. Under his leadership, the Division of Elderly Affairs has been a hands-on partner in executing the initiatives of the Long Term Care Coordinating Council and the Alzheimer’s Executive Board,, says Lt. Governor Dan McKee.

“We are especially grateful for Charlie’s support in launching our Age Friendly RI Report in 2016. In a few weeks, we will be announcing an exciting development in Rhode Island’s Alzheimer’s State Plan that would not be possible without Charlie’s participation. I have enjoyed working with Charlie and I wish him all the best as he begins this exciting new chapter,” adds McKee.

Maureen Maigret, Vice Chair Long Term Care Coordinating Council, sees Fogarty’s experience as oversight as Lt. Governor of the state’s Long-Term Coordinating Council, gave him the insight ad understanding of long term care issues and the needs of older Rhode Islanders.

Maigret says that professionals in the aging network will remember Fogarty for his strong support for and educating the community about need to expand services that help older persons to stay at home and live independently for as long as possible and to pay attention to caregiver support needs.

Adds AARP Rhode Island State Director Kathleen Connell, “I have known Charlie for many years and know him to be a worthy heir of his uncle, the late-great RI Congressman, who was a leading champion of legislation and policy benefiting older Americans.”

“At Elderly Affairs, he utilized many skills and resourcefulness acquired through his time as a legislator, Lt. Governor and Labor & Training director — not to mention his personal interest in the health and wellbeing of all Rhode Islanders. His leadership has been an enormous asset at the Division of Elderly Affairs,” says Connell.

After his retirement from four decades of state service, he will continue to serve on the faculty at Johnson & Wales University, as Adjunct Professor of Leadership Studies. He also plans to volunteer with Meals on Wheels, having seen the significant impact the home-delivery meal program has on combatting senior isolation. He will also continue to be involved at his church.

On a personal level, Fogarty plans to “learn to cook,” by enrolling in cooking classes, travel and perhaps learn to speak Spanish.

 

New Approach to Support Caregivers Needed

Published in Woonsocket Call on September 18, 2016

Currently 18 million people across the nation provide assistance with activities of daily living, transportation, finances, wound care and giving injections to their aging parents, spouses, family and friends. AARP Rhode Island estimates that 148,000 Rhode Islanders are caregivers. The future is bleak for those requiring caregiving assistance in the near future. According to a recently leased report by The National Academies of Sciences, Engineering, and Medicine (NASEM), the need for family caregivers will drastically increase but demographic shifts reduce the potential pool of caregivers to tap.

Being a Caregiver in America

The 340 page NASEM report (taking 20 months to produce) calls for the retooling of the nation’s health and long-term care delivery system through team based care (using a person and family care model approach) and policy changes to better support family caregivers in the delivery of care to older Americans.

The recommendations detailed in Families Caring for an Aging America, released on September 13, 2016, challenges policy makers “to transform the health care experience for older adults and their family caregivers,” says Nancy Morrow-Howell, PhD, president of the Washington, D.C.-based The Gerontological (GSA) Society of America, the nation’s largest interdisciplinary organization devoted to the field of aging. “The approach requires a multidimensional, interdisciplinary effort that spans diverse settings of care. GSA strongly supports this effort to create a person- and family-centered model for team-based care that recognizes and rewards the role of the family caregiver,” she notes.

Adds Richard Schulz, who chaired NASEM’s Committee on Family Caregiving for Older Adults (consisting of 19 caregiving experts) that oversaw this study and who serves as Distinguished Service Professor of Psychiatry, University of Pittsburgh, “Ignoring family caregivers leaves them unprepared for the tasks they are expected to perform, carrying significant economic and personal burdens.”

Schultz adds, “Caregivers are potentially at increased risk for adverse effects in virtually every aspect of their lives – from their health and quality of life to their relationships and economic security. If the needs of the caregivers are not addressed, we as a society are compromising the well-being of elders. Supporting family caregivers should be an integral part of the nation’s collective responsibility for caring for its older adult population.”

According to a release, NASEM’s highly anticipated report noted that by 2030, 72.8 million U.S. residents – more than 1 in 5 – will age 65 or older. According to the National Survey of Caregivers, in 2011, 17.7 million people – or approximately 7.7 percent of the total U.S. population aged 20 and older – were caregivers of an older adult because of health problems or functional impairments. This estimate does not include caregivers of nursing home residents.

Furthermore, being a caregiver is not a short-term obligation, says the report, noting that the median number of years of family care for older adults with high needs is around five years. The proportion of older adults who are most likely to need intensive support from caregivers – those in their 80s and beyond – is projected to climb from 27 percent in 2012 to 37 percent by 2050.

A Shrinking Pool of Caregivers

The NASEM’s Family Caregiving Committee says that little policy action has been taken to prepare the nation’s health care and social service delivery systems for this demographic shift. While the need for caregiving is rapidly increasing, the number of the potential family caregivers is shrinking. Current demographic trends – including lower fertility, higher rates of childlessness, and increases in divorced and never-married statuses – will decrease the pool of potential caregivers in the near future. Unlike past years, aging baby boomers and seniors will have fewer family members to rely on for their care because they will more likely be unmarried or divorced and living alone, and may be even geographically separated from their children.

The in-depth report found that family caregivers typically provide health and medical care at home, navigate a very complicated and fragmented health care and long-term services and support systems, and serve as surrogate decision makers. Although these individuals play a key role caring for older adults with disabilities and complex health needs, they are oftentimes marginalized or ignored by health care providers. Caregivers may be excluded from treatment decisions and care planning by providers who assume that they will provide a wide range of tasks called for in the older adult’s care plan.

Confirming other research studies, the committee found that caregivers have higher rates of depressive symptoms, anxiety, stress, social isolation, and emotional difficulties. Evidence also suggests that they experience lower physical well-being, elevated levels of stress hormones, higher rates of chronic disease, and impaired preventive health behaviors.

Those taking care of very impaired older adults are at the greatest risk of economic harm, because of the many hours of care and supervision they provide. However, caregiving can provide valuable lessons, helping the caregiver deal with difficult problems and bringing them closer to the recipient of care.

Next Steps

NASEM’s report calls for the next presidential administration to take immediate action to confront the health, economic, and social issues facing family caregivers. Also, the committee urges the secretary of the U.S. Department of Health and Human Services, in collaboration with other federal agencies, and private-sector organizations, to develop and implement a National Family Caregiver Strategy that recognizes the essential role family caregivers play in the well-being of older adults.

The report recommends that the nation’s health and long-term care systems must support caregiver’s health, values, and social and economic well-being, as well as address the needs of the of a growing caregiver population that is both culturally and ethnically diverse.

Federal programs (such as Medicare, Medicaid and Veterans Affairs) must also develop, test and implement effective mechanisms to ensure that family caregivers are routinely identified, assessed, and supported. Payment reforms can motivate providers to engage caregivers in the delivery of health care, too.

AARP Rhode Island State Director Kathleen Connell agrees with the NASEM’s report’s assessment that the importance of a caregiver’s role in an aging society cannot be overstated. At her organization she clearly sees an increased demand for caregivers and knows all-to-well the impact of a shrinking pool of potential caregivers on those in need.

“It is essential that we take action now to do all we can to remove obstacles and additional financial strain and mitigate physical and mental stress where possible for caregivers,” says Connell. AARP has compiled a wealth of research and information on aging issues that can be accessed on http://www.AARP.org.

Final Thoughts…

On Jan. 1, 2016, a new Rhode Island law took effect that would help Rhode Islanders avoid costly and time-consuming red tape when exercising health care, financial and other legal responsibilities for their out-of-state, elderly loved ones.

Why reinvent the wheel? Rhode Island law makers, the state’s Division on Elderly Affairs and the Lt. Governor’s Long-Term Care Coordinating Council can do more to support the state’s growing caregiver population. With the next session of the Rhode Island General Assembly starting in January 2017, state officials and lawmakers can reach out to other states to learn what state-of-the art caregiver programs can be implemented here.

For a copy of the report go to: nationalacademies.org/caregiving

LTC Must Be Placed on Candidates’ Radar Screen

Published in the Woonsocket Call on May 29, 2016

Presidential candidates might just think twice about their political campaign positions on long-term care. With the graying of nation’s voters, Congress will be pushed to put long-term care on its policy agenda. When the dust settles after the Democratic and GOP conventions, the winning candidates must address long-term care issues in their debates before the November election.

In 2013, America’s age 65 or older population made up only 14 percent of the total population, but by 2040, this demographic group will nearly double to comprise about 22 percent. According to the U.S. Department of Health and Human Services the majority of these individuals will require some form of long-term care services (specifically, help with activities of daily living—such as cooking, bathing, or remembering to take medicine—that can be provided in a home or institutional setting.)

Misconceptions About Medicare and Social Security

Survey results in a 17 page report, “Long-Term Care in America: Expectations and Preferences for Care and Caregiving, released by Associated Press (AP)-NORC Center for Public Affairs Research, notes that most older Americans expect Medicare and Social Security to pay for long-term care services while these federal programs generally do not. The survey findings also indicate that respondents, age 40 and over, strongly supported public policies that help a person save for long-term care services and for those that defray the cost of care giving, including state paid family leave programs.

“This survey provides much-needed data on how people perceive the issue of long-term care in the United States,” says Trevor Tompson, director of The AP-NORC Center, in a statement released on May 16, 2016 with the survey findings… “The need for long-term care services and support to assist seniors with activities of daily living is increasing exponentially. Financing high-quality services so that the costs are manageable for families and governments will remain a big challenge for decision-makers,” he added.

“Older Americans of today and tomorrow have a 50 percent chance of living with substantial and often expensive daily needs,” adds Dr. Bruce A. Chernof, President and CEO of The SCAN Foundation. “Medicare and Social Security were not built to cover long-term care, leaving American families unprotected, and as the survey shows, unaware of this fact,” he says.

The AP-NORC survey found that while older Americans’ confidence in being financially prepared to pay for long-term care services remains low overall, there has been a slight increase in public confidence over the past four years, consistent with other measures of consumer confidence post-recession, according to the Consumer Confidence Index. In 2013, 27 percent reported feeling very or extremely confident in their ability to pay for long-term care, increasing to 29 percent in 2014, 32 percent in 2015, and 36 percent in 2016.

The polling finds reveal that a widespread misconception as to what Medicare covers for long-term care services. Older respondents, with an annual household incomes less than $50,000, are more likely to expect to rely on government programs such as Social Security, Medicare, and Medicaid, while those with higher incomes expect to rely more on personal savings to pay for their needed long-term care services. Still, 3 in 10 of these wealthier older Americans report that they will rely on Medicare to support their care as they age. This reflects common misperceptions among older Americans about the long-term care services that Medicare covers, notes the AP-NORC survey.

Thumbs Up to Aging in Place

Seventy seven percent of the survey respondents would prefer to “age in place” and receive care in their own home, w with far fewer preferring to receive care in a senior community (11 percent), a friend or family member’s home (4 percent), or a nursing home (4 percent). Among those respondents who prefer to receive care at home, there are gender differences in preferences for who provides that care: men would prefer to receive care from a spouse (51 percent vs. 33 percent), and women would prefer to receive care from their children (14 percent vs. 35 percent).

There is widespread support for policies to help caregivers face the costs of providing long-term care, with 72 percent supporting state programs to provide paid family leave, 83 percent supporting tax breaks for caregivers, and 73 percent supporting a Social Security earnings credit for caregivers taking time out from the workforce to provide care.

According to the AP-NORC survey, forty-three percent of the survey respondents have either been caregivers in the past or currently providing long-term care to a family member or close friend. Among those with experience as caregivers, 4 in 10 report having to miss work to provide care.

The researchers found that prior experience with long-term care is associated with greater support for several public policies to help people finance long-term care and to help alleviate costs for caregivers. These individuals expressed higher levels of concern about aging and are more likely to anticipate that it is at least somewhat likely that a loved one will need care in the next five years, compared to those without direct care giving experience.

Finally, one-third of the survey respondents reported having done no planning at all for their own long-term care needs. This 2016 finding is similar to the 31 percent who said the same in 2015 and remains lower than the 47 percent and 44 percent who said they had done no planning in 2014 and 2013, respectively.
One Size Does Not Fit All

Meghan Connelly, Chief Program Development at Rhode Island’s Division of Elderly Affairs, provides some thoughts about the findings of the AP-NORC survey. “Long-term care options are not “one-size-fits-all”. In Rhode Island, there are a number of choices one can make, ranging from living independently and receiving care at home to nursing home care. This report highlights that consumers want options when it comes to making these decisions for themselves, or assisting loved ones with long term care choices,” she says…

Connelly adds, the AP-NORC survey “supports the findings of past research: that the overwhelming majority of people want to receive long term care services at home,” noting that in the Ocean State there are many home- and community-based care options. She says that”home care may be available through a physician’s office; at the time of discharge from a hospital or nursing home; or through referrals to state-subsidized programs administered by agencies under the Executive Office of Health and Human Services.”

“The AP-NORC survey also underscores the need to adopt progressive financial policies that support family caregivers who provide the greatest percentage of needed long term care to their elderly or disabled loved ones at home,” warns Connelly.

Greg Crist, Senior Vice President of Public Affairs at the Washington, D.C.-based American Health Care Association (AHCA), notes, “This data generally tracks what our own research has shown: Americans don’t think of this topic every day, and honestly, this is a topic they’d rather avoid. No one likes the thought of aging, and with that aging, the increasing likelihood they will help in their later years. No one welcomes a loss of independence. But here’s the good news – the sector is adapting and innovating.”

Crist asserts nursing homes are meeting the challenge of caring for aging baby boomers. “We’re meeting the growing demands of Boomers, particularly as clinical needs grow, but also in offering amenities such as custom dietary menus, social media communities, and personal rehab care plans that speed recovery times. Whether in Rhode Island or elsewhere, this is an evolving health practice, recognizing that change is needed to meet the new preferences of older Americans,” notes Crist.

Listen to the Older Voters

The AP-NORC survey findings mirror other “long-term care perception” studies released by AHCA and AARP. Democratic presidential candidates Hillary Clinton, Bernie Sanders, and GOP standard bearer Donald Trump must not forget the needs of America’s exponentially growing older population. These older voters do not want to fall through the nation’s public policy safety net when they require the most assistance, paying for costly long-term care services. As the survey report notes, older Americans strongly support Family Leave programs and also call for government administered Long Term Care Insurance programs.

For a copy of the report go to http://www.longtermcarepoll.org/Pages/Polls/long-term-care-in-america-expectations-and-preferences-for-care-and-caregiving.aspx..