Tag Archives for Rhode Island Pharmaceutical Assistance for the Elderly Program

Governor’s Budget is Silent Regarding Many Senior Issues

Published in Pawtucket Times on March 24, 2003

Many of Gov. Don Carcieri’s policy initiatives can be found sprinkled throughout Fiscal Year 2004 Budget address.

While Carcieri’s 3,200-word speech identified his administration’s priorities – that is, maintaining human services, investing in education and creating jobs and fixing the state’s crumbling roads and bridges- it was silent on issues of interest to aging advocates and seniors.

At an AARP debate of gubernatorial candidates, Carcieri was asked if he would budget $15 million to overhaul the existing Medicaid payment system. The additional funding would greatly improve the quality of care and services provided to 10,000-plus nursing home residents.

With this additional $ 15 million in state funding, the federal government would pick up another $ 15 million, for a total increase of $ 30 million.

At the debate, Carcieri acknowledged it would be difficult to find $15 million to fix the system because of the state’s looming budget deficit.

After a first read, Alfred Santos, executive director of the Rhode Island Health Care Association, found the recently released administration budget did not allocate the $ 15 million in new funding to allow nursing facilities to be reimbursed for the actual cost of care that they provide to frail residents.

Santos hopes to schedule a meeting with Gov. Carcieri and his policy staff to discuss Medicaid reimbursement and staffing issues.

“One of the biggest disappointments for seniors in the governor’s budget is his failure to include funding to allow more low-income persons to choose Medicaid waiver-funded assisted living,” noted Maureen Maigret, who serves as Lt. Governor Fogarty’s director of policy and executive director of the state’s Long-Term Care Coordinating Council.

“This has been a priority for the senior advocacy community, and the governor was supportive of this funding during his campaign,” says Maigret.

Maigret told All About Seniors that more than a year ago, the federal government had approved an additional 180 units in the state’s Medicaid assisted living waiver to respond to Rhode Islander consumer demands.

“Failure to fund these units is short-signed in terms of saving taxpayer dollars and denies low-income seniors the option to choose a less restrictive care setting,” said Maigret, who calls the state’s current assisted living waiver program a great success.

According to Maigret, in the last fiscal year, there was a decrease in state-funded nursing home use of about 50,000 days and an increase in Medicaid funded Assisted Living of about the same number of days. “We have reached the funding cap for these Medicaid-funded assisted-living units and have a waiting list of 35 persons,” she said, noting that some of these persons will now be forced to enter nursing facilities at twice the cost of the state.

Meanwhile, Maigret added that the governor’s budget does not address the dire need of more regulatory staff in the Health Department to monitor assisted living and enforce state standards.

On the other hand, the Rhode Island Pharmaceutical Assistance for the Elderly Program (RIPAE) is intact, Maigret said.

“With the costs of prescription drugs increasing at such alarming rates, RIPAE is a vital safety net for thousands of Rhode Island seniors.

Maigret noted that changes this year in Blue Chip and United Health senior plans may further impact many seniors’ accesses to prescription drugs, as these plans have new features which limit benefits for brand name drugs. Legislation proposed by Fogarty and introduced by Sen. Elizabeth Roberts and Rep. Peter Ginaitt will address this pharmaceutical issue, she said.

Finally, Maigret said senior advocates must watch other areas of the state budget that will ultimately impact seniors. Some community grants, such as those that support senior centers, are targeted for 10 percent cuts. While nursing homes are in line for an annual cost of living increase (COLA) in their Medicaid rates, no similar COLA is included for home and community care providers.

Maigret added the governor’s budget cuts about $ 10 million (state and federal funds) to continue its efforts of downsizing the Eleanor Slater Hospital Cranston campus, with a proposal to close two more wards. To offset these closures, the budget includes about $ 800,000 to fund about 20 more nursing home placements and new funds to increase capacity to serve persons with mental illness in community residential settings.

The push to get residents back into the community concerns Roberta Hawkins, state ombudsman and executive director of the Alliance for Better Long-Term Care. She opposes the closure of wards because there are persons in the community who require a higher level of care, a level that is only available at the Eleanor Slater Hospital.

Hawkins noted the administration budget does not include Medicaid funding to pay for dental services to seniors in the community and those residing in nursing facilities.

“The short-sidedness of this fiscal policy ultimately will increase care costs when the resident must be hospitalized for malnutrition, dehydration and bed sores, all caused by dental problems,” Hawkins said. “On a human level, who would want to constantly suffer from pain all night because of a toothache or gum problems?” she added.

Sandy Centazao, president and CEO of Meals on Wheels of Rhode Island, is still waiting to see if Carcieri will ultimately institutionalize her nonprofit group’s funding rather than continue to allocate it as a legislative grant. She expects this decision to be made before the enactment of the state’s FY 2004 budget on July 1.

With a looming recession and a nation at war, Carcieri and the General Assembly must ultimately make difficult decisions as to how to slice the state’s FY 2004 budget. The state’s final budget must  provide the funding and adequate resources to enable long-term care providers to take care of the state’s burgeoning older population. It’s the right thing to do, even n times of uncertainly.

Lawsuits Filed to Put Brakes on Rising Pharmaceutical Costs

Published in Pawtucket Times on June, 2, 2002

In conjunction with seniors advocates lobbying Congress for Medicare prescription drug benefits and state legislatures for financial relief in paying for the spiraling costs of pharmaceuticals, the AARP and other aging groups, along with state attorney generals, are going to court to put the brakes on spiraling prescription drug costs.

Ron Pollack, executive director of Families USA, called for pharmaceutical companies to not delay generic drugs from coming quickly to market during an April forum on Capitol Hill, which was held to spotlight the anti-competitive practices of the prescription drug industry.

Delaying or preventing the widespread use of generic drugs endlessly increases costs for consumers, including Medicare beneficiaries as well as  third-party payers of health care, Pollack stated.

“It improperly extends drug monopolies that enables the drug companies to profit at the expense of everyone else,” he said.

The lawsuits bring litigated are intended to make the pharmaceutical marketplace work for everyone,” Pollack said, noting that it was ironic that the drug industry goes to great lengths to prevent the regulation of prices in the name of promoting a free market.

Legal initiatives are now a part of a broad AARP drive to reduce high drug costs that hit seniors hard in their pocketbooks. Washington’s largest aging advocacy group is ratcheting up its efforts to lower drug costs by joining three important cases against prescription drug manufacturers that have blocked the availability of lower-priced generic equivalents.

AARP CEO Bill Novelli has announced that his group’s attorneys will serve as co-counsel in three lawsuits that involve charges of patent abuse, suppression of generic competition and collusive agreements with generic manufacturers.

“Geriatric drugs approved by the Food and Drug Administration (FDA) at equivalents give consumers quality drug alternatives at reasonable prices,” Novelli said today. “Our aim is to help people get affordable access to the drugs they need.”

The lawsuits mark the first time that AARP attorneys will co-counsel in federal anti-trust litigation against drug manufacturers, he said.

AARP’s legal actions come against a backdrop of rising prescription drug costs. Spending for brand-name drugs has tripled in the last decade, rising from $ 40.3 billion in 1990 to $ 121.8 billion in 2000, and is expected to more than triple to $ 414 billion in this decade. Generic drugs typically cost 50 percent or less than brand-name drugs.

According to the AARP, millions of dollars are at stake annually for older Americans, who account for 42 percent of the U.S. prescription drug consumption, and other consumers who purchased prescription drugs.

The three ongoing class action cases – all in federal court – are In Re: Buspirone Antitrust litigation, In Re: K-Dur Antitrust and In Re: Tamoxifen. The AARP chose the cases because they involve important drugs that are widely used by Americans age 50 and over.

AARP attorneys are participating in these cases as co-counsel in order to ensure that a strong consumer voice is represented throughout the proceedings, including any settlement.

AARP attorneys will serve as co-counsel in the three above-mentioned cases with attorney’s associated with the Prescription Access Litigation Project (PAL), a coalition of consumer and health care organizations that was launched last year by Boston-based Catalyst.

With AARP name recognition, resources and clout, it is easy to see why Community Catalyst Executive Director Rob Restuccia is ecstatic about AARP’s decision to joint three of PAL’s class action lawsuits.

“The PAL coalition welcomes the firepower of the AARP, firepower that will strengthen our capacity to challenge the anti-competitive activities of some drug companies,” he said.

In the midst of AARP’s lawsuits here in Rhode Island, low-and moderate-income seniors and disabled will now see lower pharmaceutical costs with the passage of the three legislative proposals that would expand drug coverage of the state’s Rhode Island Pharmaceutical Assistance for the Elderly program.

A thumbs-up goes to the Rhode Island General Assembly for the wisdom of acting on these legislative proposals.

Meanwhile, at the federal level, Rhode Island U.S. Reps. Patrick J. Kennedy and James R. Langevin are gearing up for expected House debates in early June over legislation to create a drug benefit for the Medicare Program. Stay tuned for this one.