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Dueling Social Security Proposals Heard by Senate Finance Committee

Published in RINewsToday on March 6, 2023

Almost eight years ago, Rhode Island lawmakers reduced the tax burden on older Rhode Islanders by tweaking the state’s tax on Social Security in the fiscal year 2016 budget. The exemption to Social Security taxation as it currently stands in statute was put in place in 2015, as part of the FY 2016 budget.

According to Greg Pare, Rhode Island’s Senate Director of Communications, the Assembly expanded a budget proposal by then Governor Gina Raimondo to make Social Security benefits exempt from state taxes for many. “The original proposal would have made them exempt for single filers with federal adjusted gross incomes of up to $50,000 and joint filers up to $60,000,” noted Pare, but lawmakers raised the limit to $80,000 for single and $100,000 for joint filers.

During this current legislative session – 2023 – there are two legislative proposals that, if passed, would decrease the state taxes on Social Security income for up to 175,840 retirees.

Helping Social Security retirees

During the current legislative session, Senator Elaine Morgan (R-Dist. 34, Charleston, Exeter, Hopkinton, Richmond, West Greenwich) introduced SB 84 to completely eliminate the state tax on Social Security income in Rhode Island. The bipartisan legislative proposal specifies for tax years beginning on or after January 1, 2024, an individual may subtract from federal adjusted gross income all Social Security income.

Morgan’s SB 84 has attracted the support of GOP Senate colleagues, along with Democratic Senators on the other side of the aisle.  The senior-friendly, bipartisan legislative proposal sponsors are: Sens. Anthony Phillip Deluca (R-Dist. 29, Warwick), Minority Leader Jessica de la Cruz (R-Dist. 23, Burrillville, Glocester, North Smithfield), Gordon Rogers (R-Dist. 21, Coventry, Foster, Scituate, West Greenwich), Thomas Paolino (R-Dist. 17, Lincoln, North Providence, North Smithfield), Leonidas P. Raptakis (D-Dist. 33, Coventry, West Greenwich), John Burke (D-Dist. 9, West Warwick), Mark  McKenny (D-Dist. 30, Warwick), Frank  Lombardi (D-Dist. 26, Cranston) and Frank Ciccone, III (D- Dist. 7, Providence, Johnston).

“Eliminating state income tax on Social Security benefits will be akin to giving Rhode Island retirees a raise. We must make Rhode Island a better place for retirees and not taxing Social Security income is a large step in that direction. It will help stem the flow of retirees leaving Rhode Island and taking their spending power with them.” says Morgan who made an argument in support of the legislation at the Senate Finance Committee last week, when it was scheduled for consideration, and held for further study.  A fiscal note has been requested, but has not been released.

Time to give older Rhode Islanders tax relief

“Eliminating the tax on Social Security benefits at the state level for seniors who have worked for decades, paying taxes on their hard-earned income, and contributing to Social Security with post-tax dollars, would boost the retirement income for much of Rhode Island’s vulnerable elderly population,” reasoned Morgan. “Social Security is part of the social safety net. It was never meant to fill state coffers; it was meant to carry people throughout their retirement years. It’s time to give our growing older population some tax relief by eliminating the income threshold, beginning with the 2024 tax year,” she said, noting that her legislation will help ensure that even more middle-class retirees and their families can keep more of their hard-earned benefits.

Sen. Walter Felag’s (D-Dist. 10, Bristol, Tiverton, Warren) legislative proposal, SB 246, cosponsored by Sens. Lou DiPalma (D-Dist. 12,  Little Compton, Middletown, Newport, Tiverton), Frank Lombardi (D-Dist. 26, Cranston), V. Susan Sosnowski, (D-Dist. 37, South Kingston) and Frank Ciccone, III (D-Dist. 7, Providence, Johnston), was also heard at the Senate Finance Committee, along with Morgan’s Social Security legislation.  This legislative proposal would not eliminate the state’s Social Security tax but increase income thresholds to $110,000 for single, and $140,000 for joint, filers. Like Morgan’s legislative proposal, the Committee recommended that Felag’s measure be held for further study. No fiscal note has been released yet on this legislative proposal.

With the cost of goods and necessary services increasing, Felag says that it was  crucial to help Social Security beneficiaries by throwing SB 248 into the legislative hopper. “By raising the tax exemption level, we can lessen the financial stress that many retirees on Social Security feel on a daily basis, keeping more of their hard-earned money in their pockets and bank accounts,” he says.

Sen. DiPalma, who serves as Chairman of the Senate Finance Committee, reported that a couple of proposals have been submitted and heard in the Senate Finance Committee.  “Both sponsors and witnesses made the case for why we need to continue to assist our seniors, especially during these inflationary and soon to be “slow-cessionary” periods. These proposals must and will be evaluated in the context of the overall budgetary review process, which is currently ongoing,” he says.

When asked if she ever considered becoming a cosponsor of Felag’s legislative proposal, Minority Leader Jessica de la Cruz stated, “I would have loved to, but I was unaware of his bill.”

“It’s not too late to bring Democratic and Republican Senators together to hammer out a compromise legislative proposal,” says de la Cruz, noting she will be discussing this possibility with Senate President Dominick Ruggerio (D-Dist.4, North Providence, Providence). 

Although I do not see eye to eye with my Democratic colleagues 100% of the time, we find common ground on many other issues,” says de la Cruz. ” I believe there would be bipartisan support for crafting a compromise piece of legislation if it ensured tax relief to retirees on Social Security.

Calls for passage of Social Security proposals

AARP State Director Catherine Taylor, representing over 128,000 members in Rhode Island, called for passage of SB 84 and SB 246. “They would protect the Social Security benefits of older Rhode Islanders,” helping them keep the benefits they have earned over a lifetime of hard work,” she said.

“Assuring that our members are financially secure in retirement is a key component of our advocacy,” stated Taylor, noting that Rhode Island is one of only 11 states that still tax hard-earned Social Security benefits. “State taxes on Social Security benefits in Rhode Island undermines the purpose of Social Security, which was designed to lift seniors out of poverty- not to fund state government,” she says.

“Now, when so many Americans are struggling to afford health care and other basic needs, the promise of Social Security is even more important,” adds Taylor.  

“Whether it is raising the income threshold under existing law, or a complete exemption of Social Security benefits from taxation, like 30 other states around the country, AARP supports all efforts to keep hard-earned money in the pockets of older Rhode Islanders,” Taylor told Senate Finance Committee members.

A Call to Action

According to the Healthy Aging 2020 report, Rhode Island’s older population is growing dramatically. Today, more than 240,000 Rhode Island residents are age 60 or older -  that’s 23% of the population. By 2040 that figure is expected to rise to almost 265,000.  In addition, the state has one of the highest proportions of adults aged 85 and older, of any state in the nation, ranking first in New England.

With the expected graying of the Ocean State’s population, now is the time for Rhode Island lawmakers to reduce the financial stress of Rhode Islanders who struggle to pay their bills and want to remain independent at home in the community.   

Although both Social Security legislative proposals have been held for further study, don’t get concerned, says Pare, the Senate’s Communication Director. “It is common to hold bills for further study on a first hearing, and that is almost always the case for bills with a fiscal impact, which would have to be incorporated into the budget bill when it is considered later in the legislative session,” he says. 

“There is an obvious bi-partisan appetite to provide tax relief to our growing aging population who have been greatly impacted during this pandemic. This is a significant opportunity for Senate Finance Chair Lou DiPalma to craft a compromise bill that will advance Rhode Island as an “age-friendly” state, says  Vincent Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service Agency.  Now is the time for both sides of the aisle to come together for a needed public action,” he says.

For details about 9 States With No State Income Tax, go to https://www.aarp.org/money/taxes/info-2020/states-without-an-income-tax.html

For details about 4 States That May Cut Taxes on Social Security Income, go to https://www.aarp.org/retirement/social-security/info-2023/cut-taxes-social-security-benefits.html

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Nursing home workforce crisis deepens with minimum staffing standards

Published in RINewsToday on February 13, 2023

“The long-term care industry is enduring the worst workforce crisis in its history, in Rhode Island, and across the country. Although providers are committed to recruiting and retaining staff to provide quality care for residents, despite our best efforts, many nursing homes have fallen short of the staffing ratio set by the RI Department of Health,” notes James Nyberg, Executive Director of the East Providence-based Leading Age Rhode Island (LARI), representing nonprofit providers of aging services.

“We are extremely  concerned about the impending fines that will be imposed on nursing homes here in Rhode Island as a result of our state’s existing nursing home minimum staffing ratio statute,” said Nyberg. Because of staffing ratio mandates, “the industry would have faced fines of over $11 million, in just one sample quarter (April – June 2022), since over 70% of nursing homes are not in compliance,” he said.  

“While April-June was a sample, the fines go into effect for July-September and we will receive a similar notice in just a few weeks, with only 10 days to pay the fine,” says Nyberg, stressing that these fines will only increase going forward if nursing homes are unable to meet the minimum staffing ratio.

Nyberg calls on the Rhode Island General Assembly to rescue Rhode Island’s nursing homes and provide relief from these penalties by delaying them and exploring an alternative approach to support the efforts of nursing homes to meet the ratio.  He warns that the current fine-based approach is excessive and counterproductive and will lead to reduced access to care and threaten the survival of the state’s nursing homes.

Nyberg points out that the current workforce shortages are already preventing nursing homes from filling open positions, limiting new admissions, and forcing organization closures (five nursing homes have already closed since the COVID pandemic began).  These challenges are also resulting in backlogs at hospitals, which are unable to discharge patients due to reduced capacity in nursing homes.  

“We are working with numerous stakeholders on various initiatives to develop a pipeline of workers, but the simple fact is that it will take time.  In addition, as you know, the industry has faced years of underfunding from Medicaid, which pays for the majority of nursing home care.  This has made recruiting and retaining workers more difficult than ever,” says Nyberg. 

John Gage, President of the Rhode Island Health Care Association (RIHCA) agrees with Nyberg’s assessment of the nursing home workforce.  “Nursing homes across the nation are facing an historic labor shortage as the direct result of chronic Medicaid underfunding and the devastating impact of the Covid-19 pandemic on the workforce, he says, noting that the state’s nursing home workforce is down 20% since the start of the pandemic, with 2,000 workers lost from Jan. 2020 to June 2022.  Nationwide, the nursing home workforce is down 210,000 workers.

According to Gage, Rhode Island’s staffing mandate, while well-intentioned, will siphon tens of millions of dollars from resident care. In the first year of full implementation of the state’s minimum staffing mandate, RIHCA estimates that facilities will be fined upwards of $60 million. “These fines will imperil care, not bolster it,” he warns.  

Without legislative action, Rhode Island nursing homes will be fined an estimated $11 million on or about February 28, 2023, because of their inability to attract workers to meet the mandate from July 1, 2022, through September 30, 2022, Gage charges. “There are simply not enough available workers to fill the open staff positions, and resources are scarce.  Nursing homes will be devastated by these fines.  Facilities will reduce admissions, backing up hospital referrals and clogging hospital beds.  More nursing facilities will close – five have already closed since the beginning of the pandemic,” he predicts.  

Gage asks, “Who will care for Rhode Island’s frailest elders?” To recreate a minimum staffing mandate in nursing homes on the federal level would be a huge mistake, especially given the historic workforce crisis here in Rhode Island and nationwide,” he says.  

Gage’s comments echo concerns expressed by another group of US Senators in Jan. 20 correspondence (https://www.tester.senate.gov/wp-content/uploads/1-20-23-Nursing-Home-Staffing-Mandate-Letter-FINAL.pdf) sent to CMS by Senators John Bourasso, Jon Tester, and eleven other US Senators.  They caution the agency that a one-size fits all mandate would undermine access to care for patients, and they encouraged CMS to work with Congress on tailored solutions that address the workforce challenges facing nursing facilities.

At the federal level

Just days ago, U.S. Senators Bob Casey (D-PA), Chairman of the Senate Committee on Aging, and Ron Wyden (D-OR), Chairman of the Senate Finance Committee, called on the Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to encourage the federal agency to establish minimum staffing standards in nursing homes to ensure high-quality care for nursing home residents. In Feb. 10 correspondence, Casey and Wyden, along with Senators Sherrod Brown (D-OH), Kirsten Gillibrand (D-NY), Richard Blumenthal (D-CT), Cory Booker (D-NJ), and Elizabeth Warren (D-MA) urged CMS to advance the agency’s ongoing study to determine adequate staffing requirements in nursing homes.

“We appreciate the work that CMS has undertaken to promote safety and quality in nursing homes and applaud the Biden-Harris Administration’s commitment to protecting our nation’s seniors,” said the senators in Feb. 10 correspondence, urging CMS to “bring this work to completion.” 

“In our view, that means continuing the agency’s ongoing study to determine the level of staffing that is necessary to ensure safe and high-quality care for nursing home residents, developing an evidence-based and actionable proposal for mandatory minimum staffing levels, and a robust and transparent process—including direct stakeholder engagement— that will allow for further discussion and fine-tuning of requirements before the proposal is finalized,” wrote the senators.

The senators noted that studies have shown a correlation between inadequate staffing levels and lower quality of care. More recent studies have demonstrated that higher nurse staffing ratios mitigated the effect of COVID-19 outbreaks in nursing homes and resulted in fewer deaths. A recent Department of Health and Human Services Office of Inspector General report examining the high level of COVID-19 infections in nursing homes also pointed to the need for the establishment of minimum staffing requirements.  

In the correspondence, the senators cite the Social Security Act, which requires skilled nursing facilities to “provide 24-hour licensed nursing service which is sufficient to meet nursing needs of its residents,” including the services of a registered nurse at least 8 consecutive hours per day, 7 days a week. The letter commends CMS for working to update this vague standard that has led to substantial variation in staffing levels and quality of patient care across facilities.

“Achieving the shared goal of ensuring quality care in nursing homes nationwide is a complex undertaking, says LeadingAge’s Ruth Katz, senior vice president, policy. LeadingAge is an association of nonprofit providers of aging services, including nursing homes.

“As our Get Real on Ratios proposal highlights, a number of conditions must be met in advance of any mandate implementation,” suggests Katz. “The senators correspondence to CMS is a promising development; it covers many of the same points as our Get Real on Ratios proposal – a recognition of the critical need for adequate reimbursement; that one size does not fit all, and that workforce shortages will need to be addressed with additional support. Without addressing these, staffing mandates are impossible. We look forward to continuing our discussions with Congressional leaders on this critical issue so that older adults and families can access much-needed care and services,” she says.

“The Senior Agenda Coalition of RI fully supports the need to develop national staffing standards to ensure quality care is provided to nursing home residents across our nation. It is important to note that Rhode Island has been a leader in this area. For many years our state has required 24/7 RN coverage in nursing homes and in 2021 the legislature passed the Nursing Home Staffing and Quality Care Act that includes staffing standards,” says Maureen Maigret, Policy Advisor to Senior Agenda Coalition of RI. “Now we must work to address workforce shortage issues and ensure that adequate government resources are provided especially through Medicaid payments so the standards can be met, and our critical direct care workers receive competitive living wages in order to keep them working in long term care,” she adds.

As the House Leadership hammers out the FY 2024 budget, it is crucial that adequate Medicaid funding is allocated to allow nursing homes to attract the necessary staff to meet the state’s minimum nursing standards that it codified into law. We must address this policy problem now rather than just kick the can down the road.

Senior Agenda Coalition of RI zeros in on key aging legislation 

Published in RINewsToday on May 30, 2022

As the General Assembly winds down, the Senior Agenda Coalition of Rhode Island (SACRI) is tracking 16 House and Senate Bills along with FY 24 Budget Articles that have an impact on the state’s senior population. In a legislative alert, SACRI details a listing of 16 House and Senate bills and FY23 Budget Articles relating to care givers, mobile dental services, supplemental nutrition, housing, tax relief and home care worker wages. 

The state’s largest organization of aging groups is focusing and pushing for passage of the following four bills during the upcoming weeks.

SCARI puts on its radar screen S-2200/H-7489 to push for passage. The legislation (prime sponsors Senator Louis DiPalma (D-District 12) and Representative Julie Casimiro (D-District 31), establishes a process which would require Executive Office of Health and Human Services (EOHHS), assisted by a 24-member advisory committee, to provide review and recommendations for rate setting, and ongoing review of medical and clinical service programs licensed by state departments, agencies and Medicaid.  

Meanwhile, DiPalma and Casimiro have also introduced S-2311/H-7180 to require a 24-member advisory committee to provide review/recommendations for rate setting/ongoing review of social service programs licensed by state departments/agencies and Medicaid. The House and Senate Finance Committees have recommended these measures be held for further study.

Ratcheting Up the Pay for Rhode Island’s Home Care Workers

In testimony on April 28th, SACRI’s Executive Director Bernard J. Beaudreau says, “Because payment levels for services have not been updated in years, especially in our current inflation ,levels, the low-pay level of direct care workers has created workforce shortages, impoverished workers and has put at risk our ability to provide proper care for our aging elder population.”

“Shamefully, an estimated 1 in 5 Rhode Island home care workers live in poverty and most have insufficient incomes to meet their basic needs,” says Beaudreau, calling for enactment of this bill to raise the wages of the lowest paid care workers as a top priority. 

S-2200 was referred to the Senate Finance Committee and companion measure, H 7489, was referred to the House Finance committees for review.  After hearings in their respective chambers, both bills are being held for further study. 

At press time, the Rhode Island General Assembly is hammering out its state budget for Fiscal Year 2023, taking effect July 1, 2022, to June 30, 2023.  SACARI calls on the state to make it a budgetary priority to address Rhode Island’s home care crisis.

According to Maureen Maigret, Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council, who also serves SACRI as a volunteer policy adviser and Board Member, says that the Governor’s budget calls for suspending use of an estimated $38.6 million in state funds which, by law, should be used to enhance home and community-based services. This law, says Maigret, is referred to as the “Perry-Sullivan” law after its sponsors.

Maigret calls for these funds to be used to increase home care provider rates so they may be fair and competitive to home care workers and increase rates for independent providers.  Many of these workers are low-income, women, and women of color, she says.

Lowering the property taxes for Rhode Island’s low-income seniors

SACRI also calls for the Rhode Island General Assembly to provide property tax relief for low-income seniors and Social Security Disability Income (SSDI) recipients. As housing costs rise and property taxes increase, more older Rhode Islanders with limited or fixed incomes and those on SSDI are becoming housing tax burdened, says the Providence-based the aging advocacy coalition. 

In SACRI’s legislative alert, Maigret calls for the passage of H-7127 and S-2192, with primary sponsors Representative Deborah Ruggiero (D-District 74) and Senator Cynthia Armour Coyne (D-32), charging that Rhode Island’s property tax relief law needs urgent updating.

Rhode Island’s Property Tax Review Law, sometimes referred to as the Circuit Breaker Law, needs serious updating. Initially the law was enacted to help provide property tax relief for persons aged 65 and over and to those on SSDI, says Maigret.  It is currently available to those with incomes up to $30,000 (set in 1999) and provides a credit or refund up to $415 against a person’s state taxes owed.  Both homeowners and renters are eligible to a apply. 

H-7127 and S-2192 would make hundreds of older Rhode Islanders eligible to participate by increasing the income cap from $30,000 to $ 50,000. Maigret notes that if these bills pass, a person with household incomes of $35,000 who is not eligible now could be eligible to get a refund of up to $850 next year. “These changes would provide direct relief against high property taxes and make Rhode Island more in line with our neighboring states of Connecticut and Massachusetts,” she says.

Finally, Executive Director Beaudreau testified on May 17th before the House Finance Committee, calling for the passage of H-7616, Reinstating the Department of Healthy Aging. “The time is long overdue for the state to re-invest in serving the needs of aging population,” he says, noting that “the state’s total population of 65 years and older has grown by 20% from 152,283 in 2010 to 182,486 today.”

Beaudreau testified that the “data clearly indicates that Rhode Island should be increasing plans, resources and services to meet the need of the state’s aging population, not cutting back.” The state’s budget has not kept up with the growth needed in the Office of Healthy Aging, charged with overseeing the state’s programs and services for older Rhode Islanders. “Additional funding is needed for increasing the Department’s staffing capacity and increasing financial support of Senior Centers serving thousands of older Rhode Islanders every say,” he adds.

But do not forget oral health of seniors, says SACRI.  According to the aging coalition, the importance of accessing quality oral health care in nursing homes is key to a nursing facility resident’s health, well-being and quality of life. Poor oral health care results in a higher incidence of, pneumonia cardiovascular disease diabetes, bone loss and cancer; all situations increasing the frequency of accessing medical care resulting in higher costs. 

Improving oral health care to Rhode Island’s seniors and special populations

SACRI calls for the passage of S-2588 and H-7756, bills that would provide for reimbursement for patient site encounter mobility dentistry visits to be increased to $180 per visit. The state’s reimbursement for mobile dentistry site visits began in 2008, only in nursing homes, but failed to provide funding for dental care in other settings. 

These bills would also expand the availability of this service to additional community-based group homes, assisted living facilities, adult day health and intellectual and developmental disability day programs. Passage of these bills will increase access to special populations who have difficulty in accessing basic dental services.

S-2588, referred to the Senate Finance Committee, was held for further study.  The House companion measure is scheduled to be heard on May 28th at a House Finance Committee hearing. 

Reimbursement for this service has not increased since it was initially funded over 14 years ago and does not cover the cost of delivering this critical service, says SACRI.

SACRI says “Make your voice heard!  Call House Speaker Joseph Shekarchi (401 222-2466) and Senate President Dominick J. Ruggerio (401 222-6555) and your legislative delegation to urge supporting SACRI’s priority legislation. 

To see a listing of SACRI’s 2022 Priority Legislation, go to https://img1.wsimg.com/blobby/go/049a7960-1c2a-4880-afdd-8d1e0e283acc/downloads/SACRI%20Bill%20Tracker%202022.pdf?ver=1653052514912.

For more details about SACRI, go to https://senioragendari.org/