Tag Archives for Rhode Island Pharmaceutical Assistance to the Elderly Program

Advocacy Groups Support Bills Making Pharmaceutical Drugs More Affordable

Published in the Pawtucket Times on April 21, 2003

The Gray Panthers have been around the Ocean State since 1975.

Richard Bidwell, state coordinator of the Rhode Island Gray Panthers, which represents 400 members state-wide, said his group has fought on behalf of seniors and disable persons on many aging and consumer-related issues.

He recalled one legislative victory that enabled seniors and disabled persons to use a special RIPTA bus pass and ride free during off-peak hours. Later the Gray Panthers would successfully expand this use to all times.

As state coordinator, Bidwell has been involved in lobbying the Rhode Island General Assembly on behalf of the state’s growing senior population for more than 14 years. Last year, the Gray Panthers coordinated their efforts with senior advocacy groups to organize the Senior Agenda Consortium.

This year, the Consortium turns its attention to four legislative proposals that will assist seniors in paying for costly pharmaceuticals.

“We’re trying to get them out of committee with favorable votes,” Bidwell told All About Seniors.

The group has locked horns wit Blue Chip in an attempt to lower prescription drug prices for older beneficiaries who have signed up for that health plan.

S 566, introduced by Sen. James Sheehan (D-North Kingston) would require health plans, such as Blue Chip, to pass on their drug discounts to their members. Blule Chip’s highest premium (costing $148 a month) allows senior beneficiaries to purchase up to $ 1,000 worth of brand-name drugs a year, being charged only a $ 25 co-pay for reach prescription.

This premium also allows a person to purchase up to $ 5,000 in generic drugs, with an $ 8 co-pay charged for each prescription.

Bidwell said that with each purchase of a prescription, Blue Chip subtracts the retail price rather than the actual contracted lower price allowed by the insurance company for the purchase.

As a result,” People are being charged too much,” Bidwell said. “The $ 1,000 coverage is disappearing too quickly with the purchase of each prescription drug.

“Our legislation allows Blue Chip to subtract only the contracted actual price of the prescription rather than the much higher retail price.”

“At press time, the Gray Panthers are attempting to find a House sponsor for this legislation.

A related bill, H 5237, sponsored by Rep. Peter Ginaitt (D-Warwick) and S 374, sponsored by Sen. Elizabeth Roberts (D-Cranston), would allow a person eligible to participate in the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE), who also has prescription drug coverage through a health plan, to use RIPAE to pay for an individual prescription drug once they reach a maximum level of coverage for that drug.  Currently access to RIPAE until he or she uses all of the brand and generic allowance by Blue Chip.

Meanwhile, Bidwell noted that the Gray Panthers are also pushing H 5239, sponsored by Sen. Mary Ellen Goodwin (D-Providence), for expanding RIPAE to allow persons ages 55 to  61 on Social Security Disability Insurance to receive RIPAE co-payments at the same level as Ocean State seniors.

Finally, another legislative proposal, H 5478, sponsored by Rep. Fausto Anguilla (D-Bristol-Warren) and S 299, sponsored by Sen. Rhode Perry (D-Providence), would allow Rhode Island residents to buy prescription drug from Canadian pharmacies, where they are routinely cheaper.

Susan Sweet, an elder rights advocate consultant to non-profit groups and a member of the Senior Agenda Consortium, has called for the passage of these bills, which are key to creating a “responsive and less costly” long-term care system.

“Pharmaceutical drugs may be expensive, but they are certainly less expensive than hospitalization, nursing home care, and other medical services required as a result o a senior not having or taking the prescribed medication,” said Sweet.

“It is primarily the advances in pharmaceutical therapy that have enabled seniors to live longer and healthier lives. By permitting more access for seniors and persons with disabilities to afford their prescriptions, state policy makers can save people’s lives and ultimately save taxpayer money by preventing more costly interventions,” added Sweet.

At the AARP gubernatorial debate, seniors called for state government intervention in putting the brakes of rising pharmaceutical costs.

The calls for action continue to grow. During this legislative session, the Gray Panthers, AARP, the RI Commission on Aging, along with the Forum on Aging and the Senior Agenda Consortium, have made this legislative issue a high priority.

It is time for Gov. Don Carcieri and the leadership of the General Assembly to tackle this senior issue head-on and allocate the necessary state funds to help make prescription drugs more affordable for Rhode Island seniors and persons with disabilities.

Because of the growing costs of medication, a large number of seniors cannot afford to fill their prescriptions, many do not event take their prescriptions as directed by their physicians.”  Noncompliance in taking medications or not taking them at all can result in unnecessary hospitalization, premature admission to nursing facilities, and untimely death.

Even with the state’s looming budget deficit, enabling seniors to afford the purchase of needed pharmaceutical drugs will hopefully be placed on the General Assembly’s short list of bills that must be enacted this legislative session.

Call Senate President Bill Irons at 401-222-2447 and House Speaker Bill Murphy at 401- 222-2466 to tell them of your concerns about this issue and how   the high cost of prescription drugs hits you in your pocketbook.

Urge these key lawmakers to pass legislation that makes pharmaceuticals more affordable to all seniors and persons with disabilities

Senior Advocates Push Legislation That Would Save State Money

Published in the Pawtucket Times on April 14, 2003

While the Rhode Island General Assembly is tackling hot-potato political issues like separation of powers and gambling, hundreds of bills have been thrown into the legislation hopper. Senior advocates are tracking about 13 legislative priorities in the 2003 legislative session.

Lawmakers are considering a wide array of legislation -creating long-term care tax credits, expending the Rhode Island Pharmaceutical Assistance to the Elderly Program, strengthening the state’s ombudsman’s office and ratcheting up Medicaid payments to nursing facility providers. One bill would establish special funds to care for severely disabled (age 65 and over) legal immigrant elders who are not eligible for Medicaid.

As they deal with a huge state budget deficit, Gov. Don Carcieri and lawmakers will be wary of enacting legislation that will have a fiscal impact on the state coffers.

But senior advocates are pushing for enactment of several legislative proposals that are either budget neutral or will actually save taxpayer dollars.

One legislative proposal (H 5841/S 876) that would create revisions to the state long-term care ombudsman law to expand the scope and authority for this state’s elderly advocate.

“Previously, the Rhode Island state statute has not reflected federal law, and this bill remedies that oversight,” said Roberta Hawkins, executive director of the Alliance for Better Long-Term Care and  state ombudsman, who noted federal law requires each state’s ombudsman statute to reflect the federal Older American Act.  Currently, Rhode Island’s statute does not.

Hawkins said the proposed statute changes also add additional duties authorized by the federal Older Americans Act to those required of the ombudsman under Rhode Island law. Companion bills introduced in the House and Senate call for the state ombudsman to represent the interest of nursing facility residents or clients of service providers before  government agencies, and to seek administrative, legal and  other remedies to protect their health, safety, welfare and rights.

They also mandate that the state ombudsman review and comment on any existing and proposed laws, regulations and state policies impacting nursing facility residents and clients of service providers.

The legislative proposals would make a new section of the state ombudsman law that fines a person up to $ 1,000 who willfully interferes with the ombudsman duties.

At press time, these bills were approved by the House’s Health Education and Welfare Committee and the Senate’s Health and Human Services Committee for consideration for floor action at a later date.

Meanwhile, Susan Sweet, an elder rights advocate who also consults for nonprofit agencies, noted two legislative proposals would actually save the state money while providing more appropriate services to older Rhode Islanders.

Sweet said these legislative proposals (H 5246/ S 314) would require the Department of Human Resources to reallocate funds to support already federally-approved assisted-living support services. At present, more than 35 people have qualified for this program but still remain in costly nursing facilities (at $ 130 per day) rather than reside in assisted living facilities which cost approximately 50 percent what the state is paying for nursing facility services.

At press time, these legislative proposals are still under consideration in the Senate and House Finance committees.

“If the General Assembly fails to enact funding for federally approved assisted living services, I would hope they would reallocate resources to at least allow those currently on the waiting list – some of whom are already in  nursing facilities costing the state twice as much = to be under the waiver,” said Sweet. “This would save half of the money currently being paid while providing these elders a better quality of life.”

Another legislative proposal (H 5418/ S 506) said Sweet, would establish a fund for severely disabled elderly legal immigrant Rhode Island residents who are not eligible for Medicaid.

Presently, these legal elderly immigrants receive care only from hospital. Sweet said there are currently four or five of these disabled elders residing at Eleanor Slater Hospital at a cost to taxpayers of $ 749 per day per person. If this legislation were enacted, these severely disabled elders could be transferred to a nursing home at the Medicaid rate of less than $100 per day.

At press time, these legislative proposals are still under consideration in the Senate and House finance committees.

Sweet noted the requested allocations for placement in nursing facilities for disabled elders who are legal immigrants is just $ 250,000 a year.

“Considering that we know that care for one persona at Eleanor Slater Hospital costs the state $ 749 per day, more than $ 273,000 annually passage of this bill is a no-brainer,” says Sweet. “In times when money is tight, there is more reason to save money while providing more appropriate services to our elders.”

In the shadow of a huge budget deficit, the Rhode Island General Assembly now has the opportunity the state money. They should seize the day by enacting they legislative proposals.

Seniors Held Their Ground During Legislative Session

Published in Pawtucket Times on July 16, 2001

As the dust settles with the aftermath of the 2001 General Assembly session, senior advocates and providers held their ground with the state legislature allocating small funding increases in some existing programs, but no major expansions or new programs were implemented.

More than 2,500 bills were introduced during the 2001 General Assembly session, with lawmakers considering a small handful of proposals that specifically targeted senior programs and services.

Pawtucket Rep. Antonio J. Pires, who heads the House Finance Committee, gives his take to The Times on the session as it related to older Rhode Islanders.

During this year’s legislative session senior advocates called on the General Assembly to consider increased funding for Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE).

Recognizing the high cost of prescription drugs and its adverse impact on the elderly, lawmakers ratcheted up the $10.3 million RIPAE program by $ 2 million. With the passage of the state’s Fiscal Year 2002 budget, the size of a large phone book, lawmakers appropriated a 20 percent increase to support the RIPAE program, stated Pires.

The General Assembly expanded the drug formulary lists of drugs to include prescription drugs to treat osteoporosis,” Rep. Pires noted. Additionally, he added that the state’s budget now provides 100 percent of covered drug costs incurred once the program’s poorest clients spend more than $ 1,500 in coo-payments in a year.

While senior advocates had pushed for more drugs to be covered by RIPAE drug formulary, Pires stated, “We can’t afford to pay for an o pen formulary program yet because of budgetary limitations.” In next year’s legislative session, when more state monies are available, coverage for gastrointestinal drugs will seriously be considered, he added.

“It’s a trade-off,” Pires said, in explaining why lawmakers choose not to add drugs to the RIPAE formulary list but rather to increase the eligibility income limits to allow an estimated 3,l50 seniors and disabled persons to participate in the state’s Medical Assistance Program. This program pays for nursing home care for low-income eligible seniors. The enacted state budget included $ 1.8 million from all sources of funds, including $ 857,485 in general revenues to increase the eligibility income for those who are 65 years old or disabled. Now individual income limits increased from $ 576 to $  686 per month, he said, noting that income limits for couples also increased from $ 889 to $ 921 per month.

According to Pires, the Fiscal 2002 State budget also includes $ 85,000 to continue funding the state’s elder guardianship program enacted last year. “The program brings volunteer guardians to assist frail elderly who are cognitively impaired and without families or friends in decision making,” he said. This year’s funding would allow a full-tie coordinator to be hired who will recruit and train the volunteer guardians. Ultimately, the funding would also allow the program to be phased in statewide over a three-year period, he said.

“We also continue to fund the state’s Elder Information Network Program,” Pires added, noting that the FY 2002 budget includes $ 425,000, a $ 12,300 increase over last year’s budget. Funding for this program provides grants to 15 community-based agencies to employe specialists to link information and services across the state.

This session Rhode Island lawmakers also moved to soften the blow of federal cutbacks to RIPTA by providing an additional $ 2.5 million to the state’s transportation agency. “RIPTA found itself in need of cutting routes to balance it’s budget,” Pires stated, noting that the General Assembly responded to the federal cuts by appropriating one-half cent of the state’s gasoline tax to help the agency keep its exiting bus routes.

“RIPTA may have to make some adjustments to their bus routs but not to the extent that they had fared,” Pires said. Ensuring that buses continue to run throughout the state are important because this mode of transportation provides older riders their mobility and independence, he said.

Finally, on the heel of calls by the nursing home industry and senior advocates, Pires noted that the General Assembly allocated $ 4.5 million with a $ 4.5 million federal match, to provide higher salaries for certified nursing assistants to keep them in their profession.

While nursing home providers did not get the $ 14.1 million, they requested, the 2002 state budget called for a funded study to develop a new plan on how nursing homes would be funded, Pires said. “We anticipate that the modern payment principles that will be developed will ensure continued quality of care for the elders in facilities,” he added.

But the funding allocated by the General Assembly to alleviate the direct care staff shortage and a study to develop a new payment methodology still leaves many nursing home providers and senior advocates seriously concerned about the direction of quality care with the inadequate paid to a shrinking work force.

Based on an independent study, providers found that last year health care worker turnover approached 92 percent in Rhode Island facilities due to low wages in relation to the work performed, stated Hugh Hall, chair of the  Direct Care Staffing Coalition and administrator of Cherry Hill Manor.

Hall noted that certified nursing assistants must complete 125 hours of training followed by a state licensing exam, both written and practical, to perform this type of work. These workers have found they can make as much or more working in local retail establishments than in nursing facilities, he says.

While nursing home providers appreciate the funding that the legislature has approved, it doesn’t go far enough, says Hugh, to address the inadequate wages that the state is funding for direct care workers. “The state continues to cut the same size of the pie for an ever-increasing aging population,” he noted.

In response to those seeking better funded programs this year, Pires stated, “We had limited resources to expend so there wasn’t a lot of new programming this year but quality of life and independence remains my top priority as chairman of the House Finance Committee.” The eight-term Democrat noted that this year’s focus was to ensure that the existing level of senior services would not be cut but maintained with some incremental expansion.