Tag Archives for Rhode Island Health Care Association

The legislative wish list of Rhode Island’s groups on aging

Published in RINewsToday on April 15, 2024

The Rhode Island General Assembly’s 2024 session kicked off on Jan. 2, 2024, scheduled to adjourn on June 30, 2024.  According to LegiScan, over the last three months 2,164 bills have been thrown into the legislative hopper.

“The state budget will likely be voted upon by the House Finance Committee in late May or early June.  Then a week later it is considered by the full House of Representatives, followed by votes by the Senate Finance Committee and the full Senate, and the final step would be consideration by the Governor. That process is usually completed  by mid-June to late June because the new fiscal year begins on July 1.” says Larry Berman, who has served as House Communication Director for 22 legislative sessions.“

According to Berman, the Senate and House both focus on their priorities within their own chambers first, and once those bills pass, then discussions take place between the leadership teams of both chambers to finalize bills for passage in both chambers before sending them to the Governor.  That time period will be May, and well into June. 

Legislative Wish List

Aging advocates are pushing for their legislative agenda’s to be included in the House budget.  They also are carefully monitoring the status of bills that have been introduced, specifically those that will have an impact on programs and services delivered to older Rhode Islanders.

Maureen Maigret, Policy Advisor, of Senior Agenda Coalition of RI (SACRI) puts the passage of H 7333 and S 2399 on ita priority legislative list to assist financially struggling seniors and persons with disabilities on Medicare. “As many older adults are struggling financially, SACRI is prioritizing H7333 (by Rep. Karen Alzate) and S2399 (by Senator Sandra Cano) to expand the Medicare Savings Program eligibility up to $28,000. These bills would put more money in the pockets of lower-income persons not on Medicaid by covering the Medicare Part B premiums that amount to $2,100 a year and also help them with prescription drug costs,” she says.

To provide financial help to our many unpaid caregivers we also support S2375 (by Rep. Linda L. Ujifusa) and H7490 (by Rep. Susan Donovan) to create a state tax credit up to $1,000 for half the costs incurred to care for an older family member needing supports and S2121 (by Sen. Valarie J. Lawson) and H 7171 (by (by Rep. Joshua J Giraldo) to increase the Temporary Caregiver Insurance program from six to 12 weeks.

According to Maigret, there are a number of bills addressing housing issues that SACRI also supports including those to promote ADU development, funding for affordable senior housing and incorporating accessibility features into new housing.

H. 7062, sponsored by Rep. June S. Speakman has passed the House. This bill would boost hosing production by helping Rhode Islanders to develop  ADUs has been identified by as a high priority this year for House Speaker K. Joseph Shekarchi (D-Dist. 13, Warwick).

“In looking at the Governor’s State FY2025 budget we are advocating to add about $660,000 to the Office of Healthy Aging budget to increase funding to local communities to support local senior centers/programs to reach a level of $10 per each person age 65 and older in the city or town,” notes Maigret. SACRI calls for increased funding to implement the recommended increases for social and human services providers beyond the one-third level proposed by the Governor to help address the long wait list for accessing homecare services and provide more livable homecare staff wages. This is critical as the average private cost of home health aide services in RI is $36/hour, she notes.

“ As our industry continues to fight off the existential threats of inadequate funding and staffing shortages, our Association is staying laser focused on our homes receiving sufficient and sustainable financial reimbursements and supporting all initiatives to improve staff availability. Without substantive help from the General Assembly, we will continue to lose more homes and our ability to care for our most fragile RI citizens,” states John E. Gage, MBA, NHA, president and CEO of the Rhode Island Health Care Association. 

At AARP Rhode Island’s 2024 Legislative reception, State Director Catherine Taylor called for passage of H 7127 to provide an optional, voluntary Roth-IRA plan to the 172,000 Rhode Island employees who do not have access to a convenient, low-cost voluntary retirement savings plan through their employer.

The Secure Choice program, endorsed by Gov. Dan McKee and AARP Rhode Island, would be administered by the office of the General Treasurer, would see retirement savings accumulated in individual accounts for the exclusive benefit of the participants or their beneficiaries.  

The legislation has been referred to the House Finance Committee. A similar measure (S 2045) has been introduced in the upper chamber by Sen. Meghan E. Kallman.

According to Taylor, Secure Choice has been enacted in 18 states to date. In Connecticut, the program led to over 25,0000 workers saving over $19 million dollars in the first year of operation. These savings would not have been realized without Secure Choice.

Taylor also noted that Rhode Island is one of only 8 states that tax hard-earned Social Security benefits. “Our state tax on Social Security undermines the purpose of Social Security, which was designed to lift older adults out of poverty – not to fund state government,” she says.

AARP Rhode Island supports the efforts of Sen. Elaine Morgan (S 84) to completely eliminate the state tax on Social Security income and Sen. Walter Felag (S 246) to increase the thresholds to $ 110,000 for single, and $ 140,000 got joint filers, says Taylor.

“We would like to see the passage of S. 2556 [by Senators Lou Dipalma, Bridget Valverde, John Burke, and Pam Lauria] and H. 7493, sponsored by Rep. Scott Slater and Rep. Grace Diaz, that would establish a 20% add-on to the Medicaid per diem rate for nursing homes that have single-occupancy rooms and bathrooms,” says James Nyberg, executive director of LeadingAge RI.

According to Nyberg, there is a growing body of research that shows the benefits of single rooms on residents’ physical ad mental health and well-being, which was clearly exposed by the COVID-19 pandemic.  “There is also the simple fact that it promotes human dignity. Older Rhode Islanders should not have to share a bathroom and shower with strangers during a frail time of life,” he says.

“As for the budget, we want to ensure that the nursing home funding included in the Governor’s budget is maintained, and the Office of the Health Insurance Commissioner recommended rate increases be expedited, if possible, as well,” says Nyberg.

Just a Few More to Watch

Here is a sampling of other bills, of interest to aging advocates, thrown into the legislative hopper this legislative session:

Sen. Linda L. Ujifusa and Rep. Megan Cotter are sponsoring a bill (H 7208, S 2063) to provide relief to some of the state’s most vulnerable households by raising the eligibility limit and the maximum credit for the “circuit breaker” tax credit, which benefits low-income seniors and individuals with disabilities. The bills have been referred to their chamber’s Finance Committee.

The circuit breaker credit program provides an income tax credit to low-income Rhode Island homeowners and renters who are over 65 or disabled, equal to the amount that their property tax exceeds a certain percent of their income. That percent ranges from 3 to 6 percent, based on household income. In the case of renters, a figure representing 20 percent of their annual rent is used in the place of property tax in the calculation.   

The Senate approved S 2082, sponsored by Sen. Melissa A. Murray, to limit insured patients’ co-pays for supplies and equipment used to treat diabetes to $25 for a 30-day supply.

The legislation would apply to private insurers, health maintenance organizations, nonprofit hospital service or medical service corporations and the state employee health insurance plans that cover such supplies. Under the bill, beginning Jan. 1 (or, for state employees, the next time the health plan contract is purchased or renewed by the state), co-pays for insulin administration and glucose monitoring supplies shall be capped at $25 for a 30-day supply, or per item when an item is intended to be used for longer than 30 days.

During this legislative session, S 0089 and H 5417 were introduced by Senator Meghan Kallman and Rep. Evan P. Shanley and take their savings with them when they change jobs. The legislative proposals have been referred to the House Finance and Senate Committees for consideration.

For more details about legislation being considered by the Rhode Island General Assembly, go to https://legiscan.com/RI/legislation/2024.

___

Age beat writer gives us his most important columns in 2023

Published in Blackstone Valley Call and Times, on January 1, 2024

Over the years, like many of the nation’s news organizations, The Pawtucket Times, created an ‘Age Beat’ column in 2002 that allowed this writer for several years to cover a myriad of aging issues, including Social Security and Medicare, ethics, long-term care, consumer issues, spirituality, pop culture, health care and economics. Ultimately, I would return in July, 2012 to resume writing, also picking up other weekly commentaries.

As an ‘age beat’ journalist for over 44 years, I have penned more than 930 stories covering aging, health care and medical issues. These authored and coauthored pieces have appeared in national, state and trade publications.

In 2023, my articles appeared weekly in 52 issues of the Pawtucket Times and Woonsocket Call (now combined in one newspaper called the Blackstone Valley Call & Times), and RINewsToday.com, a statewide digital news publication.

As we celebrate the New Year and look forward to 2024, looking back, here are my top five favorite articles published in 2023:

“In the coming years, generations of older Veterans will be leaving us,” – RINewsToday, Nov. 13, 2023  

This commentary published before Veterans Day, had the Department of Veteran Affairs estimate that there will be a couple of hundred World War II veterans, over 1,600 Korean and 14,000 Vietnam veterans still alive in Rhode Island. In the coming years, frailty and health issues will keep these elderly veterans’ from attending Veteran Day celebrations and even at their reunions.     
 
As a generation of Civil War and World War I veterans vanish in 1956 and 2011, this writer urged readers to cherish the surviving older veterans. In the next thirty years, it was stressed that new generations of veterans who fought in World War II, Korea and Vietnam will pass away and these veterans were urged to share their personal stories and oral histories for the sake of America’s future generations. “They have so much to say, and America’s younger generations have much to learn from them,” noted the commentary. 

This commentary was dedicated to the writer’s father, Second Lt. Frank M. Weiss, who died in December 2003, in Dallas, Texas at 89 years old.

“Passages – Life and Times of Morris Nathanson,” RINewsToday, Oct. 7, 2023

Over two decades, this writer would visit Morris Nathanson on Saturday afternoons sitting in his living room drinking cups of freshly brewed coffee.  We would talk about Pawtucket, world events, and he would reminiscence about his amazing life’s journey from his childhood in Pawtucket, to the international world he lived in later in his life.

My friend, 95-year-old Morris Nathanson, a painter, illustrator and restaurant/hospitality designer died last September. My commentary was written to recognize and honor Morris’s incredible life, detailing his World War II experiences, fighting for civil rights, and his impact on the art and design scene.

Growing up poor during the depression in Pawtucket’s Pleasant View neighborhood, Morris, a spitting image of Mark Twine, or maybe Albert Einstein to me, would ultimately have a major impact on Rhode Island’s art and restaurant design scene. 

Morris brought the strategy of adaptive re-use of underutilized and vacant mills to city and state officials, a concept that he picked up from his years of working in New York City, watching the development and transformation of the industrial mills in SOHO.

Witnessing firsthand man’s biases and prejudices motivated him throughout seventy-five years of his long life to fight for the equal rights of all.  Morris participated in the Freedom Rides of 1961, Dr. Martin Luther King’s campaigns in Selma and Birmingham, Alabama, and the March on Washington for Jobs and Freedom.  

At age 24, Morris, head of the design team at Paramount, developed and designed the first franchise in American history, Dunkin Donuts. While working with Friedman he also designed restaurants in the pavilions of the 1964 World’s Fair in Flushing Meadows, New York.

When Morris left Paramount Restaurant Supply Co, his most notable design projects locally include Hemenway’s, Ruth Chris Steak House, 22 Bowen, restaurants and bars for the Inn at Castle Hill, Capital Grill, Pizzeria Uno, Joe’s American Bar & Grill, Mills Tavern, Waterman Grill, Red Stripe and for those who still remember, the beloved Ming Garden and McGarry’s Restaurant in downtown Providence.  He also had clients all over the world.

It would take pages to detail all of Morris’s professional accomplishments while serving on state, city and nonprofit organizations throughout his long-life.  Hopefully I whetted your appetite to learn more about his life by reading this commentary. 

“Will Magaziner fulfill call to reestablish House Aging Committee,” RINewsToday, Oct. 9, 2023.

As reported, with Congressman David Cicilline retiring from Congress, no House lawmaker has yet stepped up to reintroduce, H.R. 583, the Rhode Island lawmaker’s resolution to reestablish the House Select Committee on Aging (HSCoA). Without receiving a vote in the House Rules Committee at the end of the 117th Congress, the resolution was considered “dead.” On his way out Cicilline was not successful in passing the legislative baton and finding a new original sponsor.  The Rhode Island Congressman had introduced this resolution in four Congressional sessions.

The HSCoA was a permanent select committee of the U.S. House of representatives between 1974 to 1992.  The committee was initially created with the intent of not crafting legislative proposals, but of conducting investigations and holding hearings to put the Congressional spotlight on aging issues. Its purpose was to push for legislation and other actions, working with standing committees, through regular committee channels.

This writer asks who will ultimately pick up the legislative baton from Cicilline to become Rhode Island’s fiery aging advocate?  Will it be Congressman Seth Magaziner, or the newly elected Congressman Gabe Amo, from Rhode Island’s Congressional District 1 to step to the plate?

The article asks why shouldn’t a Rhode Island Congressman follow in the footsteps of former Rhode Island Congressman John E. Fogarty (dec.) and be the original sponsor of legislation that will have a major impact on national aging policy. The lawmaker would become a hero to America’s seniors.  

“Unique partnership creates Senior Fellows pilot program,” RINewsToday, Dec. 11, 2023

This commentary announced that the success of a pilot Senior Fellows Program, created by Leadership Rhode Island (LRI) and Age-Friendly Rhode Island (AFRI), the organizations are seeking funding to offer another session in the summer of 2024.

The unique initiative prepared 25 Senior Fellows to advocate for improvements that address age-related challenges in Rhode Island. The initial eight-week program was tuition-free. The first crop of Senior Fellows, residents of 13 different cities and towns in Rhode Island, ranged in age from 62 to 83. Nearly half were retired.

The idea to develop a senior advocates program came from Marianne Raimondo, a graduate of LRI’s Core Program, who made the connection between Leadership Rhode Island and James Burke Connell. Connell is the executive director of Age-Friendly Rhode Island, an initiative at Rhode Island College that represents a coalition of public and private agencies, organizations and individuals committed to healthy aging.

Connell proposed the pilot program because, he says, empowering seniors to become advocates, activists and champions of age-friendly thinking and practices “will result in a Rhode Island where older adults thrive and live their best lives.”  He was inspired by similar programs in Maine and New Hampshire.

Age-Friendly RI raised the funds for the pilot program, and relied on LRI’s “talented team” to handle recruiting, participant selection, curriculum planning, and guiding participants in the development of individual community commitments, Connell says.

Most session days were divided into two parts, with half focused on knowledge-building around relevant issues, such as housing, food insecurity, transportation needs, and health care. The other half focused on skill-building, such as writing persuasively, public speaking and network building, to enable the Fellows to develop and eventually execute their own Civic Commitments.

The Fellows took turns describing their Civic Commitments during their final session, held at the RI State House.  The presentations, which included several “poignant and pin-drop moments,” were well received.

“Increased funding must be tied to nursing home mandated minimum staffing“, RINewsToday, September 25, 2023

The commentary announced that the Centers for Medicare and Medicaid Services (CMS) had issued a proposed rule to establish comprehensive staffing requirements for nursing homes—including, for the first time, national minimum nurse staffing standards. CMS officials said that the requirement would improve both safety and promote high-quality care in the nation’s 18,700 skilled nursing facilities delivering care to 1.2 million residents each day.

National and Rhode Island nursing home trade groups pushed back on the unfunded mandate requiring more staffing especially during a severe labor shortage forcing hundreds of facilities across the nation to close because of lack of workers.

​John E. Gage, President, and CEO of the Rhode Island Health Care Association, reported that six Rhode Island-based facilities have closed since the beginning of the pandemic in March 2020. Three others are currently in receivership. He warns that arbitrary federal staffing mandates will result in more closures, and residents will be displaced from their homes just as they were most recently when Charlesgate Nursing Center in Providence.

James Nyberg, president, and CEO of LeadingAge Rhode Island, with offices in East Providence, sees a staffing ratio mandate as a blunt enforcement tool that does not consider the numerous challenges facing providers, including Medicaid underfunding, lack of workforce, and the diversity of resident needs. Moreover, he charged that fining for being unable to meet a staffing ratio is counterproductive by siphoning off scarce resources that facilities need as they seek to address their workforce and resident care needs.

To review ALL of Herb’s articles published by RINewstoday, go to https://rinewstoday.com/herb-weiss/

Hail Mary PR Effort Puts Spotlight on Inadequate RI Nursing Home Medicaid Plan

Published in RINewsToday on December 4, 2023

Last week, a campaign by Linn Health & Rehabilitation told of its efforts to keep its doors open.  With no immediate state reimbursement fix in sight, the nonprofit nursing home, established 52 years ago, launched a savvy PR move, calling it a “Hail Mary” effort to find its Christmas miracle donors and funding to prevent it from closing or forcing the displacement of 71 residents and the laying off of 150 staff members. A clever twist on the message resulted in a story on Rhode Island television stations, talk radio, and pick up by other media outlets.

For over 10 years, Linn Health, which had only recently been named a 2024 “Best Nursing Home” and “High-Performing” short-term rehabilitation home in the nation by U.S. News & World Report, has been fighting rampant inflation, rising food and utility costs, high temporary staffing agency rates, and low state Medicaid reimbursement rates that haven’t kept pace with increasing expenses – as most nursing homes have been as well. 

Linn Health & Rehabilitation is currently losing $100,000 a month, notes Richard Gamache, MS, FACHCA, chief executive officer of Aldersbridge Communities which is the nonprofit that operates the nursing facility, senior housing, affordable assisted living, and outpatient rehab for older Rhode Islanders.

“For years, we’ve operated with a slight loss, but the other Aldersbridge entities were able to subsidize that loss.  As a mission-driven provider for low-income people and those on Medicaid, we aren’t here to make money, we’re here to serve our community’s needs,” he says, noting that the gap between the facility’s costs and its daily Medicaid rate is now just too great.

“Bleeding Cash” drastically impacts facility’s bottom line

Gamache noted that Aldersbridge Communities had been able to support its nursing home but it has now reached a “tipping point.”  During COVID the federal and state governments were very generous with grants. “That’s no longer an option, and the money is running out quickly,” he says.

“We’re in dire straits, financially,” admits the seasoned CEO, who has been in the long-term care field for over 43 years.  “We’re struggling.  We have some vendors who understand and are being patient with us, and others who tack on charges if we don’t pay on  time,” he says.

“Eighty-two percent of our residents are on Medicaid and don’t have families who can take care of them. We are their family and support system, and some have been discharged from other assisted living communities because they ran out of money,” he says. 

In recent months, Gamache reports he has meet with peers, East Providence lawmakers, state officials, and even nursing facility trade groups seeking a viable solution to the state’s Medicaid reimbursement issues. “I have proposed options such as bridge funding and higher Medicaid reimbursement rates, as many other states have done, to address this nationwide problem. It seems only nursing home residents, their families, employees, leaders of surviving homes that are hanging by their fingernails, and some advocacy groups care about the financial predicament we are in. We’ve made everyone aware and we will not stop fighting for funding that we need,” he says.  

According to Jamie L. Sanford, LNHA, LCSW, administrator of Linn Health & Rehabilitation, since 2022, six nursing homes in Rhode Island have shut their doors permanently, not counting the four that closed prior to the COVID-19 pandemic. Three more have filed for bankruptcy, she says, noting that many nursing homes throughout the nation are in the same financial predicament. 

“Linn’s Medicaid reimbursement rate averages $255 per patient per day, and it costs $411 to care for each patient per day,” states Sanford. “The general population thinks that nursing homes make a lot of money. Perhaps that’s true in some for-profit organizations where they are owned by large corporations, but nonprofit homes are robbing Peter to pay Paul. These are the homes – like us – that are on life support, operationally speaking,” she notes.

Joseph Wendelken of the RI Department of Health says that the state is attempting to ease the financial burden of facilities providing care to Rhode Island nursing facility residents. “Nursing homes in Rhode Island received an increase in Medicaid reimbursement rates on October 1, 2023. The increase varied by facility, but it was approximately 6.9%. Per Rhode Island legislation, there is a mandatory review of nursing home expenses every three years called the ‘re-array.’ The current re-array is in progress and any potential increase in the nursing home rates would begin as of October 1, 2024,” he noted.  

But facilities can’t wait a year for the state’s Medicaid adjustment to kick-in and immediate action must be taken. “Essentially, the state is breaking its own law by not conducting the re-array every three years, which was put in place to keep up with the national nursing home inflation index. The last re-array was in October of 2012. Even with an increase next fall, it won’t be enough to help close the funding gap now,” charges Michael Cole, vice president of the Board of Trustees for Aldersbridge Communities.

It’s time for a savvy PR campaign   

With no immediate financial solutions in sight, Gamache and his management team staff have been working on their own grassroots PR campaign, calling it a “Hail Mary” effort, to save Linn Health from having to displace its staff and residents.  

Linn Health’s PR campaign was seen as the next logical step to quickly tackle its financial problems, after months of alerting staff officials of the need for action. 

“Everyone with the authority to do something to help has all the information they need. Now we need action. I often hear, ‘there’s not enough money in the budget’ but the fact is, these are policy decisions. It’s about priorities,” says Gamache. 

“Do we value our older adults enough to provide for their basic needs? What kind of values do we have as a state and as a society?” asks Gamache. 

“Now it’s time to get the story into the public domain. Many people feel that nursing homes are making money hand over fist and that we’re all diverting funds to pay for yachts,” says Gamache. “Although it’s true that there are some bad apples in this profession, I believe most of us want to do what’s right, and for Linn Health and Aldersbridge Communities, a mission-driven non-profit, we’ve always cared more about better outcomes for our people than more income. We just can’t afford to operate much longer,” he warns.

The residents and staff at Linn are doing everything they can, including holding baked goods sales to raise funds. “No one wants to leave Linn, and no one wants us to be sold to another organization,” Sanford comments. “During this season of holiday miracles, we’re working to find donors who believe in what we’re doing now, and for our future. There must be a donor out there who can help us fight the proverbial ‘grinch’ that is causing nursing homes to disappear throughout the country and in our state. All we want for Christmas is to keep caring for our residents who depend on us,” she says.

“This situation exemplifies the dire straits that RI nursing homes are in, especially the community-based ones like non-profit providers.  We have been working with state officials, including the Governor’s office, EOHHS, the Health Department, and other stakeholders to highlight the crisis and the need for immediate action,” says James Nyberg, president and CEO of LeadingAge Rhode Island.  LeadingAge, founded in 1989, is a not-for-profit membership organization of not-for-profit providers of aging services, including not-for-profit nursing homes, assisted living residences, and senior housing providers, and adult day health services. 

“They have recognized our concerns and we are hopeful that some action will be taken ASAP to provide an infusion of funding.  Any nursing home closure has profound and disruptive consequences for residents, staff, families, and the broader community.  With six nursing homes closing and three in receivership, how many more proverbial canaries in the coal mine do we need?” adds Nyberg.

“Unfortunately, Linn Health’s story is emblematic of a wider crisis facing Rhode Island nursing facilities.  Nursing facilities are facing unprecedented increases in nearly all aspects of providing care – staffing costs, energy prices, inflation on food, medical supplies, etc. At the same time, Medicaid rates have not kept pace,” says John Gage, president and CEO of the Rhode Island Health Care Association.  In 2023, RI’s nursing homes are being paid by Medicaid based on the actual allowable cost of care from 2011 with an average of approximately 1% increase annually,” he said.  RIHCA was founded in 1972, and has 63 skilled nursing facilities who are members.

Finally, Maureen Maigret, former Director of the RI Department of Elderly Affairs who serves as a member of the Long-Term Care Coordinating Council and chair of its Aging in Community Subcommittee, weighs in. “The financial challenges faced by Linn Health are worrisome and point to a need for the State to take a very close look at the financial status of Rhode Island nursing homes in general,” she said, noting that few persons can afford privately paid nursing home care at an average cost of $113,000 per year. 

“So unless skilled care is paid by Medicare, Medicaid becomes the payer for a large percent of nursing home care in Rhode Island and rates must be adequate to provide the quality care we expect our loved ones to receive if they need the round the clock care provided in nursing homes,” Maigret adds. 

Linn is asking that interested charitable organization and donors willing to help Linn Health & Rehabilitation’s financial situation to contact Aldersbridge Communities Director of Development, Elise Strom at estrom@aldersbridge.org, 401-438-4456 ext. 136.