Tag Archives for Rhode Island Office of Healthy Aging

Senior groups ask House leadership for an “Age-Friendly Rhode Island” budget

Will House Leadership’s Budget Proposal Create an “Age-Friendly” State?

Published in RINewsToday on February 6, 2023

Over two weeks ago, Gov. Dan McKee unveiled his $13.8 billion proposed FY 24 Budget. To members of the aging community, the reaction is that this budget shortchanges seniors.  In an e-blast sent to 1,800 seniors and aging advocates, the Senior Agenda Coalition of Rhode Island (SACRI) described the proposed budget as unfriendly to seniors.

“Governor McKee’s proposed FY2024 budget that would take effect on July 1, 2023, ignores the needs of Rhode Island’s rapidly-growing older population,” noted SACRI, which represents 21 organizations with allied concerns. The budget document will reflect what lawmaker’s value and “as it stands, this budget fails to value us,” states the email.

Calls for creating an “Age Friendly” budget  

The SACRI legislative alert highlights how McKee’s FY 24 budget proposal is “senior lite,” noting that it provides minimal increases in funding for senior centers and Meals on Wheels.  More concerning, “it does nothing to address the larger investments needed to enable a growing number of seniors to age in the community.”

SACRI says the budget proposal has ignored requests from advocates and the community, even some requests that came from the RI Office of Healthy Aging (RIOHA). Specifically, the Governor’s budget did not include funding for additional RIOHA staff, in particular for its Adult Protective Services that received over 6,000 calls last year.

“For fourteen years we’ve urged the state to invest in improving The Point, but our requests have fallen on deaf ears. At community meetings with seniors and their caregivers of all income levels, we found their most frequent and compelling complaints were about their great difficulties in finding reliable information about available support and service options,” says SACRI, noting that very few seniors, or their adult children caregivers, even know that The Point exists. “But they are very well aware that without reliable and timely information about home and community-based care, their least-desirable and most expensive choice – nursing home care – often becomes the default,” says the legislative alert email,” he stated.

According to SACRI, the FY 2024 budget didn’t include increased Medicaid reimbursements to homecare and nursing home providers to raise their direct care workers’ wages and reduce workforce turnover. Nor did it include financial aid to help low and moderate-income seniors pay their Medicare Part B premiums and co-pays, as many other states have done.

The Ask…

SACRI is calling on House Speaker Joe Shekarchi (D-Warwick) and Senate President Dominick Ruggerio (D-Providence, North Providence) to support an “Age Friendly Budget.”  Why not improve funding for aging programs and services that ultimately benefit everyone in their later years?

More older Rhode Islanders are going to need to access programs and services to allow them to age in place at home. “Seniors strongly desire to “age in the community,” but the services that allow them to do that are often hard to find or simply unavailable. SACRI’s budgetary wish list includes increasing the minimum salaries of senior home care and nursing home care workers to $20 per hour, that’s a 50% federal match.

SACRI also calls for allocating $500,000 in first-time state funding for major improvements to The Point to provide information and referral services for seniors and their caregivers. This increased funding never made it into the FY 2024 budget proposal outlined in Gov. McKee’s Jan. 17th State of the State Address.

“With Rhode Island’s aging population skyrocketing, why not add five staff persons requested by the RIOHA, two of whom will work in its Adult Protective Services Program,” says SACRI. 

Finally, SACRI says the House budget should also include a provision to raise the income level for seniors to qualify for the Medicare Premium Savings Plan to save seniors close to $2,000 per year. Older Rhode Islanders are becoming poorer with higher numbers falling below the 2023 federal poverty level of $14,580 for a single person and with 28% of older households trying to live on less than $28,000 per year.”

The Aging Network speaks…from the front lines

Maureen Maigret, Chairperson of the Aging in Community Subcommittee for the Long-Term Care Coordinating Council (LTCCC), says that the “Age-Friendly Budget” proposed by SACRI is right on target with the needs of Rhode Island’s older population.

“More than ever, we need to address and adequately fund the services and supports that keep older persons living at home as long as possible. It is especially important for those aged 75 and over as one-half may need supports to remain living at home at the same time that their incomes start to decrease while their healthcare costs increase,” she says.

“The ‘Age-Friendly’ Budget Plan also aligns nicely with the strategic objectives and actions of the Strategic Plan of the LTCCC:s Aging in Community Subcommittee yet to be accomplished,” says Maigret, noting that lawmakers should view funds requested as wise investments that will help older adults remain living at home – where most wish to be – and prevent the use of much higher costs for nursing home care.

“Apparently, the Governor and his staff haven’t fully understood nor been sensitive to the struggles that the aging community has faced since the pandemic – more than 90% of the deaths in RI were individuals over 60, and 52% of the overall deaths were congregate care residents. Many are still frightened, isolated, hungry, and need community homecare or a caregiver,” says Vin Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service Agency.

Marzullo adds, “The Governor’s budget doesn’t provide any vision for an Age Friendly RI – which was to begin in FY2023 according to a 2019 RI OHA Strategic Plan,” adds Marzullo. “We have no coordinated path/strategy to build greater local capacity & support services for our growing aging population.”

“The McKee administration has yet to develop a Comprehensive Master Plan for Aging in RI despite a series of community conversations (Rhode Island 2030) during the Fall of 2021 and commitments made to the elderly during the 2022 Gubernatorial campaign,” charges Marzullo.

Other aging advocates had their views of McKee’s budget proposal

While they are appreciative that the Governor’s budget proposal fully funds the statutory nursing home inflation index of 5.4% plus a 1.5% labor add-on effective October 1, 2023, John Gage, President and CEO of Rhode Island Health Care Association (RIHCA) warns about a major issue facing Rhode Island nursing facilities. “The minimum staffing mandate that was passed in 2021 is largely an unfunded mandate and is impossible to comply with given the 20% reduction in the Rhode Island nursing facility workforce just since the start of the pandemic,” he says.

“RIHCA will work together with the Governor, the House Speaker, and the Senate President for short-term relief from the staggering penalty provisions of the minimum staffing mandate statute – fines estimated at $55-60 million in the first year of full implementation and nearly two-thirds of facilities being prevented from admitting residents after three quarters of their inability to comply by automatic admissions freezes,” he says. There are simply not enough workers to employ to meet the mandate, and fines of this magnitude would devastate the industry and lead to further facility closures,” he adds.

“The Rhode Island Senior Center Director’s Association (RISCDA) is focused on gaining funding requested by RIOHA Director Cimini for increased staffing, fully funding the Point, and supporting senior centers more fully with a funding formula that gets us to the rate of $10/person for non-institutionalized individuals 65 and over residing in each municipality,” says Robert Robillard, RISCDA’s president. “Shoring up services with funding will benefit not just our elders, but their families and caregiver’s alike,” he noted.

According to Robillard, the Governor’s presented budget includes a $200,000 increase for senior centers across our state. This is split between 39 communities based on the number of seniors living in each of the municipalities. “As we are pleased to see this movement to support senior centers more fully, [even with the additional funding] there are gaps within the system of care for our elders here in Rhode Island,” he says.

James Burke Connell, Executive Director, Age-Friendly Rhode Island, agrees with Robillard’s assessment of the key role senior centers play in Rhode Island’s long-term care continuum and the need for increased funding. “No, there isn’t sufficient funding toward the goal of making Rhode Island a great state in which to age, and I’m particularly concerned that the RIOHA will be under resourced to meet the needs of senior centers and older adult Rhode Islanders in general. Senior centers are the hubs of services and programs in every community, and they need greater support from our state, principally through significant increases in RIOHA’s capacity to support our aging population,” he says.

The McKee administration responds…

In responding to SACRI’s charges that McKee’s proposed budget was not “Age Friendly,” Derek Gomes, spokesperson for the state’s Pandemic Recovery Office says, “a single budget cannot address everything that the Administration is committed to accomplishing.” He noted that the Administration will work every year to make meaningful progress toward improving the quality of life for older Rhode Islanders and all the goals in RI 2030.

According to Gomes, the Governor’s proposed budget invests in older Rhode Islanders by including an additional $200,000 for senior centers, an additional $100,000 for Meals on Wheels, and $250,000 to digitalize an essential record of service that military veterans use to receive their benefits. The 2022 November Caseload Estimating Conference increased funding for long-term care by approximately $40 million in all, across Fiscal Year 2023 and Fiscal Year 2024, including a 6.9% rate increase for nursing facilities.

The battle of Rhode Island’s Fiscal Year 2024 budget moves to the House Finance Committee and ultimately for a vote on the House and Senate floor. It’s crucial that House Leadership begin the process of increasing funding for aging programs and services to move Rhode Island closer to becoming an “Age Friendly” state. Every taxpayer will ultimately benefit, because each one will ultimately have to access programs and services to allow them to age in place at home in their community.  

SACRI is planning a Legislative Leadership Forum scheduled for March 22, 2023, at Warwick’s Crowne Plaza. Save the Date. Stay tuned for details. https://senioragendari.org/

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New resources to protect Seniors before, during and after Natural Disasters

Published in RINewsToday on July 18, 2022

Just last year alone, the Washington, DC-based AARP noted that the nation experienced more than 1,300 tornadoes, 21 named storms (with winds of 39 mph or greater), nearly 59,000 wildfires that burned more than 7.13 million acres, along with numerous ice storms and other weather events that caused major damage and fatalities. With hurricane season now approaching, AARP teamed up with the U.S. Federal Emergency Management Agency (FEMA), announcing the release of new resources specifically designed to help local and state officials and Emergency Management Agency (EMA) officials protect seniors in their communities.

“By 2034, adults ages 65 and over will outnumber those under 18 in the United States for the first time. This has profound implications during natural disasters and extreme weather events,” said Nancy LeaMond, Executive Vice President and Chief Advocacy & Engagement Officer at AARP, in a statement announcing the released resources. “State and local leaders and emergency officials must be better equipped and prepared to ensure that older adults are kept safe and their needs are met when a disaster strikes,” warns LeaMond.

The 9-page, Guide to Expanding Mitigation: Making the Connection to Older Adults, released by FEMA, highlights how natural hazards uniquely affect seniors and provides specific remedies as to how local mitigation and emergency planners can include seniors in community efforts to lower their risks.

Throughout its 44 pages, the AARP Disaster Resilience Took Kit features strategies to help local, state and community leaders and aging advocates reduce the risk and impact of disasters on older persons. 

The guide and tool kit are the result of a multi-year collaboration between AARP and FEMA to identify and provide resources, spark ideas and encourage organizations to better engage older Americans in disaster mitigation, preparedness, response and recovery operations. This long-term, strategic alliance aims to advance accessible, safe and livable communities for people of all ages, says AARP.

“Adults aged 65 and older are a growing demographic who are often disproportionately impacted by severe weather. These disparities can be compounded by other factors, such as low-income or chronic illness, producing inequitable results for this vulnerable population when it comes to disaster preparedness,” said FEMA Administrator Deanne Criswell in a statement. 

“Effective mitigation planning requires that we consider the needs of all populations, and FEMA’s partnership with AARP on these guides will help community planners ensure our older communities are more resilient in the face of hurricanes and other natural disaster,” she said.

According to AARP, a growing body of evidence compiled shows that seniors are disproportionately impacted by the types of weather-related emergencies and natural disasters that are becoming increasingly frequent and severe. Individuals who have chronic illnesses, functional limitations or disabilities are especially vulnerable, as evidenced by the impact of the global COVID-19 pandemic on seniors.  Not only are older people at a higher risk of death from infectious diseases and disasters, but the long-term effects on those who survive often undermine their physical and mental health, economic security and overall well-being.

Although many communities support older adults in preparation for disasters, expanded mitigation planning can help reduce the loss of life and property by minimizing the impact of disasters before they happen, says AARP, noting that mitigation actions and strategies that make cities, towns and neighborhoods safer for older adults can benefit all residents and increase community resilience overall.

Protecting Seniors from Natural Disasters in the Ocean State

“One standout recommendation from the AARP/FEMA report was the adoption of more resilient and efficient building and land use standards, including the consideration of hazards in siting senior living facilities,” says RI Lieutenant Governor Sabina Matos, who oversees the Emergency Management Advisory Council that reviews information and programs regarding emergency management and makes recommendations to the Governor on these issues.

“One of my highest priorities is the creation of more affordable housing of every kind, and we have to walk the line of growing not only quickly, but thoughtfully. As we consider how to use this budget’s $250 million investment in housing, we want to ensure that new developments meet FEMA standards and will keep Rhode Islanders safe. We’re already working with local communities’ EMA departments to review their community disaster preparedness plans, as well as their applications for FEMA Hazard Mitigation Grants — funding to help implement exactly the strategies outlined in this report,” she says.

“One omission that stands out to me is resources for unhoused seniors. According to the Rhode Island Coalition to End Homelessness’s 2021 State of Homelessness report, over 500 Rhode Islanders aged 55 or older experienced homelessness over the course of a year. We need to strongly consider what kinds of hazard mitigation strategies could help this uniquely vulnerable population. Additionally, Rhode Island must especially focus on preparing sustainable mitigation and response systems that account for the effect of climate change on our coastal communities, which we know have large senior populations and will become increasingly vulnerable to flooding,” says Matos.

”FEMA has provided a very valuable tool with the Guide to Expanding Mitigation – Making the Connection to Older Adults guide. At the Rhode Island Emergency Management Agency,  we work with our local emergency managers, non-profits (Rhode Island Community Food Bank, Red Cross of Rhode Island, United Way and more) and other state agencies including the Department of Health and the Office of Healthy Aging to ensure older Rhode Islanders have the resources they need when disaster strikes. These reports will help us in our efforts to continue to support individuals in this vulnerable group,” says Director Marc Pappas, of the Rhode Island Emergency Management Agency.

“Preparedness is a core function of public health. This is especially true when it comes to climate change and older adults. As these resources highlight, it is critical that the unique needs of older adults are considered when planning for weather-related emergencies and natural disasters. This is already a priority for us at the Rhode Island Department of Health when it comes to emergency preparedness, and it will continue to be a focus,” says Joseph Wendelken, Public Relation Officer for the Rhode Island Department of Health.

“Before, during and after a natural disaster, the safety and wellbeing of older Rhode Islanders must always be a top concern,” said AARP Rhode Island State Director Catherine Taylor. 

“Emergency planners and managers at the state and especially local levels, along with first responders and many others, play a critical role in reducing anxiety and any subsequent harm when disaster strikes. Whether it’s a hurricane, flooding, extreme heat or infectious disease, ongoing planning and the coordination of all available resources is necessary to minimize consequences,” says Taylor.

“The AARP/FEMA guide and toolkit can go a long way towards mitigating deaths and long-term impacts among Rhode Island’s most vulnerable citizens. We encourage all leaders involved in Rhode Island public safety and public health to take advantage of this new resource. There are many aspects of age-friendly, livable communities – resilience in the face of disaster is chief among them,” Taylor adds.

AARP Rhode Island Volunteer State President Marcus Mitchell has firsthand disaster management experience. “As a former Division Commander with the US Coast Guard Auxiliary and Community Emergency Response Team Instructor for Providence Emergency Management Agency, I am actively involved with emergency & disaster mitigation, response and recovery efforts that dramatically and profoundly impact our older population physically, emotionally and financially,” he said. 

“Not only are seniors often hit first and hardest but their families are deeply affected as well,” Mitchell added. “We hope to save lives throughout the community, mitigate damages and reduce injury by vigorously distributing the new guide and toolkit to our members and the community at large.”

West Warwick resident Vincent Marzullo gives a thumbs up to AARP/FEMA’s released resources, saying that their information will be extremely valuable to the State and local EMA officials charged with protecting the state’s aging and vulnerable population during natural disasters. “Several barriers prevent older adults from evacuating when needed. Many older adults cannot drive and do not have access to reliable, accessible public transportation, depend on home-based medical equipment, require specialized accessibility supports, or cannot bring pets when evacuating. Some older adults are caregivers to spouses or partners with one or more vulnerabilities that may also hinder their ability to take timely action and remain safe, says Marzullo, who served for 31 years as a federal civil rights & social justice director for the Corporation for National & Community Service and a Federal Disaster Cadre Coordinator for the National Service Agency.

“State and local EMA officials must regularly outreach to the older Rhode Islander on the Rhode Island Department of Health’s “Special Needs Emergency Registry” to check their status/needs, especially individuals who are isolated and immobile.  There are approximately 15,000 individuals with chronic illnesses that have opted-in to the registry in order to be checked in times of emergency/disasters.  These older adults are vulnerable and need periodic support,” says Marzullo.

Marzullo calls for on-going disaster resilience webinars to be available to better prepare State and local EMA officials and organizations to respond to sudden natural disasters.  Targeted organizations might include the Red Cross, AARP RI, Senior Agenda Coalition of RI, Senior Center Directors Association, AARP members, RIElder Info, 211/The Point, and the Emergency Management Advisory Council (EMAC).

Melissa Carden, RIEMA’s Chief Public Affairs Officer says while winter storms, hurricanes and flooding are most common in the Ocean State, expect climate change to have a profound effect on the weather, including more storms and greater precipitation. “This fuels other extreme weather events like flooding (coastal and inland – remember the flooding in RI in 2010). Although scientists are uncertain whether climate change will lead to an increase in the number of hurricanes, there is more confidence that warmer ocean temperatures and higher sea levels are expected to increase their intensity and impacts.”

 To view and download the Guide to Expanding Mitigation: Making the Connection to Older Adults, visit  https://www.fema.gov/sites/default/files/documents/fema_mitigation-guide_older-

adults.pdf

To download a PDF of the AARP Disaster Resilience Tool Kit, featuring strategies to help local, state and community leaders and advocates reduce the risk and impacts of disasters on older adults, go to  https://www.aarp.org/content/dam/aarp/livable-communities/tool-kits-resources/2022/AARP%20Disaster%20Resilience%20Tool%20Kit-singles-060122-.pdf

The following (free) Livable Publication booklets and guides, go to https://www.aarp.org/livable-communities/tool-kits-resources/livable-publications-order-form/https://www.homecareassistancerhodeisland.com/

The crafting of Rhode Island’s first State Plan on Caregiving

Published on February 28, 2022 in Rhode Island News Today

Rhode Island has the distinction of having one of the highest percentages of adults aged 85 and over in the country. In 2017, out of a population of 1,060,00 there are more than 136,000 caregivers providing 114 million hours of care, says AARP Rhode Island.  More Rhode Islanders will be thrust into caregiving roles in the coming years.

In response to the continued aging of Rhode Island’s population, the Rhode Island Office of Healthy Aging (OHA) and Family Caregiver Alliance of Rhode Island officially released Rhode Island’s first State Plan on Caregiving.  The state’s new Plan for Caregivers serves as the framework for the crafting and implementation of new policies, as well as the expansion of various existing programs and partnerships to assist caregivers. The Plan serves to strengthen and advance the shared mission of OHA and the Family Caregiver Alliance of Rhode Island at the United Way (FCARI)  to promote choice, independence, empowerment, and the overall well-being of older adults, individuals with disabilities, and their caregivers.  FCARI is supported with funds from OHA.

As an advocate for caregivers throughout the state, The FCARI serves as the administrator of the 29-page Plan which extends through Sept. 2023. 

A Call for Supporting Rhode Island’s Caregivers

“The COVID-19 crisis has exacerbated many of the challenges faced by our older adults and their caregivers, particularly social isolation,” said Interim Director Michelle Szylin announcing the release of this report on Sept 24, 2021. “Caregivers have a tough job and often receive little support. Through the development of this State Plan, we’re showing our commitment to strengthening resources available for our caregivers and better supporting the important work they do across our state,” she says.

Adds Maryam Attarpour, Program Manager, Family Caregiver Alliance of Rhode Island at the UWRI, “Caregiving has been and will always be a major part of the fabric of our society.” Attarpour says that the new State plan puts the needs of family caregivers first. “Our goal is to create a state that is equitable, inclusive, and supportive of our family caregivers, and the loved-ones they care for,” she says.

According to the statement, the State Plan on Caregiving also builds on the state’s existing efforts to meet the needs of Rhode Island caregivers of any age.  It provides an overview of the existing support network available for family caregivers to access as well as addresses the work that remains to ensure equitable access to resources and advocacy. 

One of the key areas of support that the plan focuses on is developing a comprehensive, robust website and social media presence for FCARI that will serve as a hub of information for resources and information for caregivers. It will also ensure diversity, equity, and inclusion for Rhode Island Caregivers and those for whom they care, too.

The State Plan will also ensure that the caregivers of Rhode Island seeking long term services and supports are identified and provided with information assistance and advance  opportunities for digital access (iPads, notebooks, computers and phones) to better serve and support Rhode Island Caregivers.

Over the years, the Rhode Island General Assembly has worked closely with aging advocates to enhance supports and resources for the state’s caregivers.  The State Plan calls on lawmakers to review existing laws to determine if they need to be refined or better funded.  It also suggests that legislation that has been submitted and not passed as well as laws and policies from other states be reviewed for “relevancy for supporting Rhode Island family caregivers.

Putting a Face on Family Caregivers

On Feb. 15th, Maureen Maigret, Chair of the state’s Long-Term Care Coordinating Council’s Aging in Community Subcommittee, told members of the Rhode Island House Oversight Subcommittee on Aging & Senior Services, the importance of hammering out sound policy to support the state’s growing number of caregivers.

Maigret painted a picture of the typical care recipient, citing the 2020 Report, Caregiving in the U.S., to the attending House lawmakers. “Eighty nine percent of the care recipients are a relative, with 50% being either a parent or parent-in-law, spouse/partner (12%), grandparent/grandparent-in-law (8%), sibling/sibling-in-law (7%), adult child (6%) or nonrelative (10%), she said, noting that the average care recipient’s age is 68.9.

While 61% of the caregivers are women, 39% are men, adds Maigret, noting that 61% are white, 14% African American and 17% Hispanic.  The age of most caregivers falls between ages 60-65, says Maigret, noting that younger adults also find themselves having to provide caregiving chores.  Twenty-four percent of persons ages 18-34 and 23% of person’s ages 35-49.

It’s not easy to be a caregiver, says Maigret. She warned that caregivers should be considered “the hidden patient” because they are at risk for becoming depressed, extremely fatigued, stressed, feeling overwhelmed, being socially isolated, losing income and having physical health problems.

Maigret’s presentation was followed by a panel led by Acting OHA Director, Michelle Szylin, and her staff who provided information on programs OHA offers to assist caregivers including subsidized respite, home care and adult day services and special pilots to support those caring persons with Alzheimer’s disease.

“Although our legislature and Governor have been supportive of funding programs to support caregivers, the growth of our older population means more persons will need to become caregivers,” said Maigret. “We need better state programs and services to provide physical, emotional and financial support, and enhanced access to information about available resources,” she said.

Maigret adds: “There is also an urgent need to address the direct care worker crisis by providing the workers with fair and competitive wages.  Many caregivers need to supplement the services they provide with paid caregivers if they are in the workforce, or need to take care of other family needs. Yet due to the low wages paid for personal care workers, it is not always possible to find such help.”

For a copy of the State Plan on Caregiving go to https://fcari.org/state-plan-on-caregiving/