Tag Archives for Rhode Island Division of Elderly Affairs

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..

Conference on Aging Planned for Summer 2015

Published in Pawtucket Times, December 5, 2015

It seems that aging advocates will have many celebrations to attend throughout 2015. This year is the 50th anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th anniversary of Social Security. Last July, the White House announced the scheduling this summer of the White House Conference on Aging (WHCoA). This once-in-a-decade is an opportunity to recognize the importance of these key federal programs as well as to look ahead to the issues that will help shape the quality of life for older Americans for the next decade.

With Nora Super named as the Conference’s new Executive Director in July combined with its website up and running in October, planning for the event is gearing up.

A Look Back

The first White House Conference on Aging (WHCoA) was held in 1961, with following conferences in 1971, 1981, 1995, and 2005. Over the past 40 years, professionals in the aging network have viewed these decennial conferences to be catalysts for development of aging policy. The conferences generated ideas and ultimately political momentum to establish or make significant improvements to many of the nation’s domestic programs, including Medicare, Medicaid, the Older Americans Acts and even to Social Security.

The four-day 2005 WHCoA was geared to provide the nation’s73 million baby boomers plan for their decades in retirement. That year, Pre-WHOCoA Forums (listening, solutions and mini conferences) were held around the country, to develop proposed solutions to the challenges of aging and the Main Conference itself, ultimately resulted in 73 resolutions with 50 of them being presented to the president and Congress.

Ten years ago, Governors of all 50 States, Puerto Rico, the District of Columbia and the Territories, Members of the 109th Congress, the National Congress of American Indians and the Policy Committee, selected 1,200 bipartisan delegates. At press time, delegate selection details have not been announced. But, like previous Conferences, I expect that incoming Governor, Gina Raimondo, to have some slots to appoint. Stay tuned.

In the past, processes for the five conferences were created by federal statute with the form and structure directed by Congressional lawmakers through legislation authorizing the Older Americans Act. To date, a deeply divided Congress has not reauthorized this program, and the pending bill does not include a statutory requirement or framework for the 2015 conference.

WHCoA organizers say that without a Congressionally defined framework, the White House begins to plans, still strongly committed to hosting a White House Conference on Aging in 2015. The American public will be engaged and involved in developing the conference, they say, by utilizing technology, by using web tools and social media, can encourage the nation’s Baby Boomers and seniors to participate.
Super Takes the Reins

Nora Super, the executive director of the upcoming WHCoA, says on the event’s website, “the coming months will be a time for us to engage in a dialogue and build a shared vision on how to continue to maximize the contributions of Americans as we age, and how to advance priorities such as healthy aging, a secure retirement, accessing the services and supports older Americans need to remain in their communities, and protecting older Americans from financial exploitation, abuse, and neglect.”

Super, who has over 20 years working in the federal government, and a lobbyist for AARP and represented Kaiser Permanente’s eight regional Permanente Medical Groups, believes, “The White House Conference on Aging represents an important step in working to ensure that Americans throughout the lifespan have the opportunity to learn and develop skills, engage in productive work, make choices about their daily lives, and participate fully in community life.”

According to Super, “the Conference is designed to assist the public and private sectors to be responsive to the needs of a diverse aging population and to promote the dignity and independence of and expand opportunities for current and future generations of older persons and their families.”
Listening session, beginning last July that will continue up to and during the Conference, have produced some common themes, including: retirement security; healthy aging; long-term services and supports to help older adults remain in their communities; and preventing financial exploitation, abuse, and neglect of older adults.

A Call for Participation

Sign up to receive regular updates and emails to stay informed. You will learn more about the planned WHCoA listening sessions, regional forums, webinars and opportunities for public engagement. Provide your thoughts as to what’s most important to you and your ideas for actions that can help to improve the lives of older Americans.

Don’t sit on the sidelines. Bring your comments to the table, especially share personal stories and life experiences about your aging, either from the frame of reference as an older adult or caregiver. Give your thoughts about the different federal programs that have enhanced the quality of your life or those family members, friends, and neighbors around you.

Last October, the WHCoA website, http://www.WhiteHouseConferenceOnAging.gov, was launched as a way to engage the public about aging issues. It provides regular updates on Conference activities, more important it serves as a way to easily provide your comments and input.

This columnist, writing for McKnight’s LTC News, one of the oldest trade publications covering the long-term care sector, covered the 1995 WHCoA for the prestigious publication. As a journalist it was an exciting assignment, to report on a national Conference that brought together aging advocates, long-term care providers, academicians, and researchers. This synergy ultimately would create formal resolutions to be shared with President William Clinton and Congress as to how to direct the nation’s resources and federal programs to better serve older Americans.

Summer 2015 kicks off the WHCoA. Hopefully, Rhode Island Governor Gina Raimondo, the state’s Division of Elderly Affairs and RI AARP will be in the forefront to gather comments from Rhode Island’s Aging Baby Boomers and Seniors about aging issues and problems that impact them. Rhode Islanders must be at the table and have a voice at the nation’s most important aging conference.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

 

New Uniform Act Good News for Rhode Island Caregivers

Published in Woonsocket Call on November 29, 2015

With the quick stroke of her pen, Rhode Island Governor Gina Raimondo signed guardianship legislation into law during the 2015 legislative session 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. It takes effect on January 1, 2016.

Like motherhood and apple pie, the changes made to the State’s guardianship law had broad bipartisan support in the Rhode Island General Assembly. The House bill and a similar Senate companion measure (entitled the “Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act”) passed overwhelming by votes of 72-2 and 37 to 1, respectively.

Representative Robert E. Craven (D-North Kingstown) who Chairs the House Committee on Municipal Government, says his legislation (introduced with Representative Michael A. Morin (D-Woonsocket) simply helps to protect those who are unable to protect themselves.  “When appointing guardians and instituting protective orders for adults, the law must be clear and concise to ensure someone’s rights are not violated while also keeping them safe,” he says, noting that the new law makes the rules and procedures very clear for this process and it will offer both the protected persons and petitioning guardians the legal causes and safeguards that are needed in such complex situation,” he said.

Fixes Jurisdictional Issues over Guardianship

According to Division of Elderly Affairs Director Charles J. Fogarty, the new law “provides consistency, reciprocity, and procedural efficiency in the best interest of seniors, creating a hospitable and healthy Rhode Island for our elders.”

Fogarty says that the new law would benefit caregivers in many way.  It clarifies state jurisdiction issues and even facilitates the transfer of guardianship from one state or another.  It also would enhance interstate recognition and enforcement of guardianship orders and simplifies communication and cooperation between courts.

Fogarty notes that Rhode Island’s new guardianship law is a law that 37 other states, as well as the District of Columbia and Puerto Rico, have already enacted, allowing for cooperation on and simplification of inter-state issues.  “It will be easier for out-of-state caregivers to focus on supporting their loved ones as opposed to becoming mired in current laws.  This legislation ensures that seniors and caregivers don’t waste time and resources in cases involving simultaneous and conflicting jurisdiction,” he says.

“We are very pleased that our staff, our terrific State House advocacy volunteers and a strong network of partners worked hard together to ensure that Rhode Island became the 42nd jurisdiction to enact the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act,” said AARP State Director Kathleen Connell. “Now, Rhode Island joins the national effort that focuses on care, not courts, by removing the barriers that prevent caregivers from providing for their loved ones, regardless of where they live.”

According to the AARP Public Policy Institute’s recent report “Valuing the Invaluable: 2015 Update,” the number of caregivers in our state is 134,000. Their work has an economic value of $1.78 million. That, Connell said, is why AARP Rhode Island strongly supported the legislation and was joined by judges, lawyers and families throughout Rhode Island.

Many Benefits, No Cost to Rhode Island Taxpayers

Connell notes that when the uniform guardianship jurisdiction becomes law, it will carry no cost to taxpayers and makes no changes in the state’s substantive guardianship procedures. However, Rhode Islanders will benefit as it will save them time and money. In addition, they will be safeguarding the health and financial well-being of their loved ones.

“It may seem very technical,” Connell continued. “But the bottom line is easy to understand:  We all recognize that we are a mobile society, and with that we need laws pertaining to caregivers and their families to reflect that reality. AARP strongly supports legislation that removes barriers that prevent guardians in Rhode Island from providing for their loved ones, regardless of where they live. “For Rhode Islanders, the uniform guardianship act is a step in the right direction to help protect the interests of vulnerable incapacitated adults who need guardians,” Connell said. “With this law, our guardianship system will function more efficiently, fairly, and cost-effectively.”

Court-appointed guardians step into the shoes of at-risk adults who can no longer make their own decisions, and make judgments about property, medical care, living arrangements, lifestyle and potentially all personal and financial issues. As a judicial proceeding, guardianship can be expensive, time-consuming and combative. It can remove fundamental individual rights. It can prevent or redress elder abuse – or can create an opportunity for exploitation or abuse of vulnerable adults.

This new uniform act addresses initial jurisdiction regarding a guardianship case; recognition of one state’s guardianship orders by another; and interstate transfers of guardianship cases when such transfers would benefit the incapacitated person.

Another key reason AARP strongly supported enactment stems from concern over elder abuse, neglect and exploitation. It will reduce the enticement of a vulnerable person to another state ― to gain control over assets. The law now will permit a court to consider which jurisdiction can best protect a person subject to abuse, and facilitate communication between courts in different jurisdictions about allegations of abuse.

Partners included the Uniform Law Commission. The Commission provides states with non-partisan, well-conceived, and well drafted legislation that brings clarity and stability to critical areas of state statutory law. In addition, the Act has a broad range of support from organizations including the National College of Probate Judges, National Academy of Elder Law Attorneys, National Guardianship Association, Conference of Chief Justices and the Alzheimer’s Association.

With the graying of Rhode Island’s population commonsense laws like the “Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act” need to be enacted.  Last session, state lawmakers worked together to pass this legislation that makes guardianship system more efficient, less time-consuming and costly for Rhode Island caregivers.  At no cost to Ocean State taxpayers.  Hopefully, best policy practices from across the nation can be brought to the Rhode General Assembly for full consideration.  If it happened once it might just happen again.