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House Study Commission could create first state plan on aging in Rhode Island

Published in RINewsToday on March 20, 2023

With oversight of the state’s aging programs and services scattered among state agencies charged with overseeing a fragmented long-term care (LTC) system, House Deputy Majority Leader Lauren Carson (D-District 75, Newport) tossed H 5224 into the legislative hopper. The bill calls for the creation of a Special Legislative Commission (to be referred to as House Study Commission), with 14 members, to study and provide recommendations to coordinate the state’s program and services provided to older residents.  The commission, charged with taking a comprehensive look at the funding, coordination and delivery of state agency programs and services to older Rhode Islanders, would be required to report its findings and recommendations to the House no later than Feb. 7, 2024, and it would expire on May 7, 2024.

According to House Communications Director Larry Berman, “Legislation to create commissions are requested when issues need greater study than just one hearing. Commissions usually consist of House members, along with experts in the field, who will meet on multiple occasions and then develop recommendations to the House.”

The Nuts and Bolts

The House Study Commission’s legislative charge would include making a comprehensive study of key statistics that includes compiling demographic and financial statistics, and health status of older Rhode Islanders, and taking a look at their strengths and vulnerabilities to enable them to stay in the community. It would assess federal, state and local programs available, examining duplication of services, and provide recommendations as to how to eliminate red tape and better coordinate services among state agencies to improve the delivery of programs and services.

Its final report would also review and provide recommendations for the funding of services through State, Federal, and private grants, and provide recommendations for more efficient distribution and use of these dollars. It would also include making recommendations for the creation of a portal to provide and coordinate aging programs and services in the areas of employment, education, independent living, accessibility, and advocacy, as well as local older adult centers and services. 

Also, recommendations would be provided on mental health, transportation, food access, and health care. The commission would also explore and provide recommendations for additional regionalization of services.

Aging Organizations and Advocates push for passage

Last week, the primary sponsor of H 5224, and supporters, testified before the House Health and Human Services (HHS) Committee to give their thoughts about the creation of a House Study Commission and its positive impact on the delivery of programs and services to older Rhode Islanders.

Carson, the primary sponsor, opened up the hearing on the legislation telling lawmakers that many programs for older Rhode Islanders fall in different places around the state. “Even professionals are having problems navigating the system, never mind family, friends and parents,” she says, referencing a conversation she had with a Director of a Newport-based Senior Center, discussing the challenges during the COVID pandemic to navigate the system at state-level, providing services to her older clients.

“If we look back over the last 20 years, we used to have a cabinet-level position on Aging, then we had a Division on Aging, and  now we have an Office on Aging,” says Carson, noting that we have an increasing amount of older people in Rhode Island. She called for lawmakers to return the Office of Healthy Aging at a cabinet-level.

By creating a House Study Commission, lawmakers can look in an organizational way at how programs are being offered to seniors,” says Carson.  

According to George Neubauer, Chair of the Senior Agenda Coalition of Rhode Island (SACRI), an advocacy coalition representing 21 organizations, told lawmakers that SACRI had called for candidates at its Gubernatorial forum held last August to create a Rhode Island Strategic Plan on Aging. This plan would help the state look at its infrastructure and coordination of services for its rapidly growing older population, he said. At this time Rhode Island has no such plan, he said. 

In his testimony, Neubauer stated: “While the purpose of this proposed House Study Commission does not specifically call for development of a state Strategic Plan on Aging, it does call for a comprehensive look at our older population. “It would be charged with providing recommendations of collaboration, coordination within agencies, funding of services, and recommendations in areas of importance to older adults’ needs and quality of life, he added.

 “A number of states have developed what are sometimes referred to as Master Plans on Aging (including California, Massachusetts and New York). A Master Plan could be a roadmap to help the state transform its infrastructure and coordinate services for its older persons.  The findings and recommendations of this study Commission could lead to development of such a plan for Rhode Island,” says Maureen Maigret, former Director of the Rhode Island Department of Elderly Affairs (now the Office of Healthy Aging) and Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council.

It is now time for the creation of the House Study Commission, says Vincent Marzullo, who served 31 years as a career federal civil rights and social justice administrator at the National Service Agency, and a well-known aging advocate. “For the first time in recorded history, there are more people over the age of 64 in the world, than children under five. In Rhode Island, over 31 percent of residents are age 55 or older, and by 2030 one-quarter of our population will be over 65,” he says.

“Don’t we now have an obligation to ensure better healthcare, safety, housing, livability, caregiving, etc. for this aging community?” asked Marzullo, noting that during the pandemic more than 90% of the deaths were individuals over 60 —- and 53% of overall deaths were congregate care residents.

“With the lessons learned over the past two years and the devastating impact of COVID on our older adults, it’s critical that we reexamine our aging infrastructure, the needs for services, and the local service capabilities to this growing population, adds Marzullo, calling for “a serious, adult conversation that is long overdue to take place with the aging community, service providers and lawmakers about designing our plan for a more ‘Age-Friendly’ RI, which supports local senior centers as the local hub for the delivery of services.”

Deborah Burton, Executive Director of RI Elder Info, said that enacting H 5224 is “an essential step” towards improving the lives of older Rhode Islanders. “By studying our current services and initiatives, identifying future needs, and identifying potential areas for improvement, we can ensure that all older adults in our state have access to the resources they need to achieve wellbeing and maintaining maximum independence in ways that value, empower and engage them,” she said.

Carmela Greer, Executive Director of Edward King House Senior Center, gave her views as to why it is important to establish a House Aging Commission authorized by H 5224. “This opportunity to document who does what, when, for whom, with what dollars is a common-sense approach to building a comprehensive cost-effective way to care for the other of our most vulnerable populations second only to children,” she said.

According to Greer, who also serves as Policy Committee Lead for the RI Senior Center Directors Association, once this policy road map is designed, “smart decisions can be made to establish where the money can be saved, where duplication can be eliminated, and where existing funding can be re-directed, where duplication can be eliminated, and where existing funding can be re-directed to serve all parties involved.”

In concluding her testimony, Greer said: “We don’t want to re-invent the wheel.  We want to fix the one we have.”

Where House Leadership Stands…

House Minority Leader Michael L. Chippendale (R-District 40, Coventry, Foster, Glocester), goes on the record supporting Carson’s call to create a special legislative commission to study aging policy in the state. “House Republicans recognize the fact that RI is aging and how important it is to coordinate our services to cut duplicity and inefficiencies. A study commission establishes a deep dive public discussion into an understanding of our statewide need, and lessens the possibility of bureaucratic, unintended consequences, which can occur in the submission of haphazard bills,” he says, noting that “Republicans also believe that this is an area, where if the topics are properly vetted, the state can cut costs and bring efficiency to our core government senior services.”

“I support the concept of this commission and I am certainly open to it, but I need to discuss it further with the sponsor, Representative Lauren Carson, before recommending further action. I look forward to speaking with her in the coming weeks of the legislative session,” says House Speaker K. Joseph Shekarchi (D-District 23, Warwick).

Shekarchi and his leadership team will evaluate all legislative resolutions creating House Study Commissions introduced this legislative session to determine which one(s) will be allowed to proceed for a committee, and ultimately, floor vote.  At press time, there is no fiscal note. Creating House Study Commissions must have adequate resources and staffing for their operations. 

With H 5224 having bipartisan support, aging organizations hope that Speaker Shekarchi sees the importance of allowing a committee and floor vote on this resolution.  Democratic and Republican lawmakers must lobby the House Speaker for his endorsement to support passage of this very important commission. Every Rhode Islander will ultimately need to access comprehensive aging programs and services in their later years.

House debate on Carson’s Health Study Commission may well create the political will down the road after it releases its report leading to the creation of Rhode Island’s first Strategic Plan on Aging.

H 5224 cosponsors are Representatives Samuel A. Azzinaro (D-District 37, Westerly), Thomas E. Noret (D-District 25, West Warwick), Susan R. Donovan (D-District 69, Bristol, Portsmouth), House Majority Whip Katherine S. Kazarian (D-District, East Providence), Karen Alzate (D-District 60, Central Falls, Pawtucket), Jason Knight (D-District 67, Barrington, Warren),  and Kathleen Fogarty (D-District 35, South Kingston.

To show your support for H 5224, contact your House Representative.  Go to https://www.rilegislature.gov/representatives/default.aspx. You can also contact House Speaker Shekarchi by calling (401) 222-2447.  Or email, rep-shekarchi@rilegislature.gov.

Volunteering: Your Single New Years Resolution 

Published in RINewstoday on January 10, 2023

As the ball dropped in New York’s Time Square, many Americans have already penned New Year’s resolutions for 2023.  Making these resolutions as January approaches has become a very common tradition for millions.

According to the Statista 2022 Consumer Survey (413 adults ages 18 to 89 years old surveyed from Oct. 25 to Nov. 2, 2022) living a healthier life style by going to the gym, eating nutritious meals and even losing weight were the top three New Year’s resolutions for 2023.

While resolutions provide us with a road map as to how we can make improvements in our lives, many can’t overcome obstacles to keep them. An Inc. web article, written by Marcel Schwantes, noted only 9 percent will be successful in achieving their goals.

Just “Pick One” – Resolution

Second Harvest Heartland, one of the nation’s largest hunger relief organizations, calls on people to just put one resolution, “becoming a volunteer” on their list. “Picking a cause and getting out to volunteer turns out to be the one single, achievable, sustainable and widely beneficial resolution for New Year,” says the Minnesota-based company.

That’s a great suggestion.

According to Project Helping, research tells us that “volunteering helps improve mood, makes you feel healthier, increases your sense of purpose, and reduces your stress levels. Volunteering can also give us a deep sense of happiness both immediately and long-term,” the research studies say.

“Our volunteers give their time to help others, and rarely ever think about how it can impact their own lives in so many ways,” said Julie Greene, director of volunteer engagement at Second Harvest Heartland. “Of course, they feel a tremendous sense of satisfaction knowing their contributions are making a difference in people’s lives, but the benefits of their actions go way beyond that. 

Given the camaraderie people feel by coming together and the satisfaction of working on a common goal, I’m not surprised at all that research has proven the benefits of volunteering—we see it every day with the smiles on our volunteers’ faces,” says Greene.

“Volunteering is Medicine for the Soul”

Being a volunteer can also be a protective buffer from the curve balls that life may throw at us as we age. “Volunteering can be medicine for the soul. It allows you to connect with other people, explore and remedy emerging community issues, make a difference as a caregiver or mentor and change lives.

Volunteering is powerful and can define and redirect your life’s journey,” says Vincent Marzullo, who for 31 years served as RI’s National Service Director and still volunteers weekly at Hasbro Children’s Hospital.

Adds, James Connell, Executive Director, of Age-Friendly Rhode Island:  “There’s no better way to reduce tension, combat social isolation, and feel tremendous self-satisfaction than by connecting with others and giving back to the community and your neighbors by volunteering.”

Connell says Rhode Islanders as a population are aging, nearly one in three of us will become age 65 and over by the end of the decade. “Volunteers and volunteerism will be key factors in creating a great state in which to age. Older adults want to stay active, engaged, and remain in their homes; as a volunteer or by being the recipient of volunteers services we can achieve this and so much more,” he says.

“Aging Rhode Islanders need you,” says Connell.  “Volunteer to provide supports to stay at home, to connect and provide company to combat social isolation, and to positively impact their overall health and well-being trough connection and service,” he adds.

A sampling of Rhode Island volunteer opportunities

For volunteer opportunities, Connell calls on seniors to contact Retired Senior and Volunteer Program (RSVP), the nation’s largest volunteer network for those age 55 and over.  RSVP volunteers serve the community at non-profits, community programs, and service agencies. Volunteers mentor school children, prepare tax returns, knit caps for newborns, participate in volunteer transportation networks, and visit homebound Rhode Islanders, he says.

Why not  contact a Community Action Program (CAP) in your region to find out more about volunteer opportunities, suggests Connell, noting that they are located in East Bay (EBCAP), West Bay CAP, East Bay (EBCAP) and at Federal Hill House Providence.

Or you can contact the Diocese of Providence, or other faith communities, to learn more about volunteer opportunities. 

The Neighborhood Friendly Visitor Program, a community-based volunteer program, provides weekly visitors to isolated elderly and disabled adults in Rhode Island, seeks older volunteers, says Connell. “The program was developed in 1978 by Sister Rhea Lachapelle of the Sisters of Saint Ann to address the needs of a growing and diverse population of seniors living alone with little or no social support. Any senior age 60 and over, or disabled person who is homebound, residents of any nursing home or assisted living, or patients at hospitals, is eligible for this program. There are no income guidelines and there is no fee for this service,” adds. Connell.

Connell says that Friendly Visitor volunteers are available state-wide. Volunteers have supplied personnel references and passed a background check through the Office of the Attorney General. The program has on-going recruitment of volunteers who make a commitment to visit or call seniors for at least one hour each week. This program is funded in Partnership with the Rhode Island Office of Healthy Aging, he says.

The Senior Companion Program, sponsored by the Rhode Island Office of Healthy Aging (RIOHA) and the federally funded by the Corporation for National & Community Service, also seeks volunteers, says Connell. “Senior companions are over the age of 55 and provide companionship and reassurance with seniors and adults with special needs, he says, noting that these companions visit, and listen.

To request a Senior Companion or to apply to be a Senior Companion contact RIOHA at 401-462.0569.  

Connell also directs seniors to investigate volunteer opportunities at The Village Common of Rhode Island (TVC). The nonprofit, volunteer-driven membership organization supports seniors who wish to age in their home via a network of local villages – communities of mutual support – in Rhode Island.

“We currently have villages in Barrington, Edgewood, Providence and Westerly. Our volunteers assist members in a myriad of ways, from driving to medical appointments and running errands, to doing household chores and minor repairs, to providing technology support for TVs, phones and computers, to making friendly calls and visits,” says Connell, noting that TVC and its local villages host an array of social and educational events for our members and volunteers (live, and via zoom).

Finally, Connell also notes that local Senior Centers, Child and Family Rhode Island, located in Newport and Providence, Meals on Wheels, the Rhode Island Food Bank (or local food banks in every city and town, can be a great source for volunteering, too. 

For details about the benefits of becoming a volunteer, go to 

https://projecthelping.org/benefits-of-volunteering/.

To learn about volunteer opportunities, go to:

A listing of senior volunteer activities, Office of Healthy Aging, go to https://oha.ri.gov/get-involved/volunteer/

AARP Rhode Island, go to https://states.aarp.org/rhode-island/volunteering-aarp-rhode-island

Rhode Island Food Bank, go to https://rifoodbank.org/get-involved/volunteer-in-the-community/ or 

Local food banks, https://dhs.ri.gov/sites/g/files/xkgbur426/files/Documents-Forms/FoodAssistanceProviderListFAL-October-16-2020.pdf

Children@FamilyRI, go to https://childandfamilyri.com/

Rhode Island Community Action Programs, go to  https://www.ricommunityaction.org/find-your-community-action-agency/

Rhode Island Senior and Volunteer Program, go to https://americorps.gov/serve/americorps-seniors

United Way of Rhode Island, go to https://volunteer.uwri.org/

RI Elder Info, Advocacy Agencies, go to https://rielderinfo.com/advocacy-assistance/

Diocese of Providence, go to https://dioceseofprovidence.org/elder-services

Gubernatorial Candidates Put Spotlight on Rhode Island’s Fragmented LTC Continuum

Published in Pawtucket Times on August 8, 2022

Last week, hundreds of seniors and aging advocates gathered at East Providence High School to learn more about aging policy positions from 6 Rhode Island Gubernatorial candidates. Many more watched virtually as the event was streamed online.

During the 143-minute forum, the invited Gubernatorial candidates (five Democratic and one Republican, gave two-minute responses to seven questions previously given to them and hammered out by the Senior Agenda Coalition of Rhode Island (SACRI) and its 17 cosponsors, that would elicit how each, if elected Governor, would fix Rhode Island’s fragmented long-term care continuum and provider payment systems.

According to Bernard J. Beaudreau, Executive Director of the Providence-based SACRI about 300 seniors and aging advocates came to personally see the Gubernatorial candidates outline their position on aging issues. Multiple platforms on Facebook and YouTube were promoted by a variety of senior advocacy groups that resulted in the over 300 virtual audience. Some held “watch parties” at one or more of the 12 senior centers, with approximately 135 people participating from throughout the state.

Before the forum began at 10:00 a.m., Deborah Burton, Executive Director of RI Elder Info, one of the forum’s sponsors, provided the welcome, explaining why it was so important for older voters to understand the aging agenda of the next Rhode Island Governor and their commitment to funnel funding and resources to the state’s aging program and services. “The policies of the incoming Governor will impact a large number of baby boomers in the state,” said Burton, noting that the Gen X’s, often forgotten, are right behind them. “We need to have a system [long-term care continuum] in place that is effective, that is funded, and is what we need and want as we age,” she said.

“It was very evident that these candidates came prepared and took the forum and all the issues impacting older Rhode Islanders very seriously,” said a very pleased Beaudreau.

Talking the Talk about Senior Issues

Here is a sampling of policy issues touched on by the candidates:

The attending candidates gave their thoughts as to how they would rebuild and sustain a viable workforce of nursing homes and homecare providers.

Two term Secretary of State Nellie Gorbea said she felt that we, as a society, do not value caregiving. She called for investing in the workforce of nursing home providers by increases tothe state’s Medicaid rates. The educational sector can become a pipeline to “nurture and grow” jobs for this sector, she said.

Governor Dan McKee stated he addressed staffing issues at home health agencies and nursing homes by expanding the Wavemaker Fellowships to include healthcare workers and increasing reimbursement rates for home health agencies by $ 900,000 annually. McKee also noted that in last year’s budget it gave the state’s nursing facilities a cost-of-living increase to ensure funding to increase their workforce.

Healthcare provider businesswoman Ashley Kalus, a Republican candidate, also called for increasing the Medicaid reimbursement rate. “Respect long-term care as a career choice which means there needs to be a path from home health care aide, to certified nursing assistant, licensed practical nursing, registered nurse and Nurse Practitioner through apprenticeship and training programs,” she said.

Former CVS Executive Helena Foulkes supports expanding Medicaid, but we must hold the nursing homes accountable to make sure that the increases of state funding go to workers and not to equity owners of nursing homes.

Healthcare advocate Dr. Luis Daniel Luis Muñoz says we should increase reimbursement rates for providers. He calls for the creation of a state-based medical school to create more dental professionals and physicians. “That is how we can increase the providers necessary to serve Rhode Islanders,’ he says.

Former Secretary of State Matt Brown blamed Rhode Island’s staffing shortage on the General Assembly slashing Medicaid reimbursement rates over the years. He called for an increase in Medicaid reimbursement rates and increasing minimum wage to direct care workers in Medicaid nursing facilities to $20 per hour. This would attract workers from Southern Massachusetts, he predicted.

The attending candidates also gave their thoughts as to their strategies for Medicaid rebalancing and the program’s expansion to improve home and community-based care opportunities along with ensuring financial viability of nursing homes.

Muñoz called for a targeted approach to supplementing wages for providers taking care of seniors, noting that “twenty dollars is not a livable wage. We lost the culture of taking care of people,” he said, “but it will take money, increasing providers; but programmatically the state needs to make a commitment to expand its community and home-based programs working with multiple departments, to bring back this culture of care.”

Brown warns that 87 percent of nursing homes are in risk of closing and the state must address this by increasing Medicaid rates so as to give these facilities the financial stability they need. As to home care, pay must be increased to direct home care workers. But do not forget about family caregivers.

“We do not have an adequate paid Family Leave program in the state,” he says. As Governor, Brown would call for creation of a program to give 16 weeks of adequate pay.

Kalus calls for seniors to be placed in the least restricted setting. There should be adequate senior housing available to allow a person to live independently in the community. “We must reimage the continuum of care,” says Kalus, stressing that different types of care must be working together.

According to Kalus, if you go to a hospital there should be an incentive to discharge you to a nursing home with rehab, if that is possible, and then provide an incentive to move a person to less restricted continuum of care from there, such as home care and then independent living. An organization, like an Accountable Care Organization, must ensure there are no incentives to keep you in one type of care environment, over a less restrictive one, she says.

McKee touted the $10 million dollars invested this year to rebalance the long-term care continuum. He announced that he plans to shortly issue an Executive Order to direct state agencies to review existing policies through a healthy aging lens and address accessibility and impacts on Rhode Island’s aging population. He will also direct state agencies to appoint a representative to the task force that will create a Statewide Aging Plan.

Foulkes called for the state to create a long-term comprehensive plan for providing programs and services for seniors. Politicians seem to implement short term fixes year to year, making small timeframe moves. She urges improving discharge planning and technology and compensating family members to keep seniors at home. Nursing home care should be changed to provide single rooms with single-use bathrooms to ensure their dignity of living in a nursing home, and prevent spread of infectious diseases, a lesson learned from the pandemic.

Gorbea says Rhode Island is “clearly off the mark” as to how it spends its Medicaid dollars on home care services. Twenty six percent of the state’s Medicaid budget is spent on home care, compared to many states allocating over 41 percent. “That’s where we have to go,” she says. “If you are going to encourage people to stay at home, you must have housing and transit options,” she notes.

In Retrospect…

“While there were similar opinions, each candidate presented their own perspective,” said SACRI’s Beaudreau, noting that he did not hear anything anyone said that would be objectionable to aging advocates. “We now have on record their pledge and commitment that there will be a plan and anaction agenda that will benefit all seniors of the state,” says Beaudreau, “if they are elected Rhode Island’s 77th Governor next November.

“It is clear we have a slate of very quality candidates,” says Beaudreau at the conclusion of the forum.

Maureen Maigret, chair of the Long-Term Care Coordinating Council’s Aging in Community Subcommittee and SACRI Board Member stated, “the Forum exceeded my expectations in terms of attendance (in-person and virtual), and I consider it an absolute success.”

Maigret reported that all candidates supported: “making the Office of Healthy Aging a full cabinet/department with review of sufficiency of resources; expansion of Medicare Savings Program which I have been advocating for at least 5 years and adding a state COLA to SSI payments; requiring better data on minority older adult inclusion; addressing community living, housing and transportation needs of older persons and developing and implementing a comprehensive, interdepartmental strategic Plan on Aging.

What was most important is that this event made them really pay attention to the fact the state has a significantly growing number of older persons which calls for transformative change. By highlighting some policies needed to address these demographic changes and getting candidates on record in support of them, they can be held accountable,” says Maigret. “The other significant outcome was to have so many co-sponsors come together in support of the policies put forward,” she added.

“There needs to be immediate leadership and follow-thru with all appropriate stakeholders to design and implement a seamless state/local delivery system for “aging in place” services, including increased care payments and efficient reimbursement to providers,” says Vincent Marzullo, well-known aging advocate who served as a federal civil rights and national service administrator. “With vision and commitment, Rhode Island can be a more appealing retirement community by aggressively addressing healthcare disparities and elevating the RI Office on Healthy Aging to full Departmental status with broader authority/responsibilities. This conversation must now include our General Assembly leaders,” said Marzullo, a West Warwick resident who serves on SACRI’s Board.

Co-sponsoring this event was a broad coalition of 18 service providers and advocates: 

A Community Together, Alzheimer’s Association of RI, Carelink, Community Partners Network of RI, Economic Progress Institute, Leading Age RI, NAACP Providence Branch, Ocean State Center for Independent Living, PACE, Progreso Latino, RI Assisted Living Association, RI Elder Info, RI Health Care Association, RI Organizing Project, RI Senior Centers Directors Association, SEIU Healthcare 1199, Senior Agenda Coalition of RI and Village Common of RI.

To watch the forum, go to https://www.youtube.com/watch?v=okQ5FguKMao.

For info about the Senior Agenda Coalition of Rhode Island, go to https://senioragendari.org/.