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.