Tracking legislation of interest to seniors as RI General Assembly wraps up – Herb Weiss

Published in RINewsToday on June 28, 2021

 In the waning days of the 2021 legislative session, RI House lawmakers approved a $13.1 billion state budget for the 2022 fiscal year (by a party-line vote of 64 Democrats to 10 Republicans) that boosts key supports for vulnerable Rhode Islanders — particularly affordable housing and social services— without imposing any broad-based tax increases.

The budget plan also fully funds K-12 education, boosts support for higher education, restores funding to Eleanor Slater Hospital and funds a first-of-its-kind statewide program for police body cameras.  

Additionally, the budget codifies the state’s existing Livable Home Grant Program to provide subsidies (up to 50%) for certain disability and accessibility home modifications, which will enable older people to remain in their homes. The budget includes $500,000 for the Livable Home Grant Program.

At press time, the state budget moves to the Senate for consideration. Once passed by the upper Chamber and signed into law by Gov. Dan McKee, the budget covers the new fiscal year, beginning July 1.

In the Waning Days…

According to Larry Berman, the House’s Communication Director, 1,470 bills were introduced in the House and 978 in the Senate. According to the RI General Assembly’s bill tracker, less than 30 are identified as directly related to seniors.

Here is a sampling of these bills:

The Nursing Home Staffing and Quality Care Act, sponsored by Senate Majority Whip Maryellen Goodwin (D- District 1, Providence) and Rep. Scott A. Slater (D-District 10, Providence), sets minimum staffing levels for Rhode Island nursing homes and was signed into law by Gov. McKee, two days after General Assembly passage. The legislation (S 0002A, H 5012Aaa) will establish a minimum standard of 3.58 hours of resident care per day, initially, and 3.81 hours of resident care per day beginning January 1, 2023. The bill also provides funding to raise wages for direct care staff to help recruit and retain a stable and qualified workforce.

With final votes in both chambers, the General Assembly approved The Elder Adult Financial Act sponsored by Sen. Cynthia A. Coyne (D-District 32, Barrington, Bristol and East Providence) and Rep. Joseph J. Solomon, Jr. (D-District 22, Warwick). The legislation requires financial institutions to report suspected financial exploitation of seniors to the Office of Healthy Aging and authorizing them to temporarily hold transactions they suspect as such. The legislation will be sent to the governor for signature. The legislation (S 0264A, H 5642A) would require financial institutions to train employees to recognize indicators of elderly financial exploitation, and on their obligation to properly report it and place a hold on suspicious transactions. The legislation was the result of recommendations made by the Special Task Force to Study Elderly Abuse and Financial Exploitation, a group led by Sen. Coyne that met in 2018 and 2019 to explore the facets of elder abuse and make policy recommendations to address them.

Rep. Gregg Amore (D-District 65, East Providence) and Sen. Valarie J. Lawson’s (D-District 14, East Providence) legislation, The Uniform Control Substance Act, would exclude chronic intractable pain from the definition of “acute pain management” for the purposes of prescribing opioid medication has been signed into law by Gov. McKee. The legislation (H 5247A, S 0384A) calls for new guidelines for treatment of chronic intractable pain based upon the consideration of the individualized needs of patients suffering from it. The legislation acknowledges that every patient and their needs are different, especially those suffering from chronic pain. Chronic intractable pain is defined as pain that is excruciating constant, incurable, and of such severity that it dominates virtually every constant, moment. It also produces mental and physical debilitation and may produce a desire to suicide for the sole purpose of stopping the pain.

The House passed legislation sponsored by Rep. June S. Speakman (D-District 68, Warren, Bristol) to allow visitation for nursing home residents by a designated family member or caregiver during a state of emergency. Under the Rights of Nursing Home Patients legislation, an essential caregiver would be an individual—whether a family member or friend of a resident of a nursing home or long-term care facility – who is designated to provide physical or emotional support to the resident during a declaration of disaster emergency. The legislation (H 5543aa) would require the Department of Health to create rules and regulations providing for the designation of essential caregivers to provide in-person physical or emotional support to a resident of a nursing home or long-term care facility during the period of 15 days after a declaration of disaster emergency and until 60 days after the termination of the declaration. The bill would require DOH to develop rules and regulations on designating an essential caregiver and the criteria to qualify. Those rules would include health and safety regulations as well as requirements allowing an essential caregiver to have regular and sustained in-person visitation and physical access to a resident of the nursing home or long-term care facility. The bill now goes to the Senate, which on June 1st passed companion legislation (S 0006A) sponsored by introduced by Sen. Frank S. Lombardi (D-District 26, Cranston).

As part of its ongoing efforts of addressing the cost of prescription drugs, the RI Senate passed legislation that requires pharmaceutical companies to disclose drug pricing information and legislation would prohibit an annual or lifetime dollar limit on drug benefits. The first legislative proposal (S 0494A), which was introduced by Senate President Dominick J. Ruggerio (D-District 4, North Providence, Providence) would require the pharmaceutical manufacturers disclose to the Office of the Health Insurance Commissioner the wholesale acquisition costs of drugs if this cost is at least $100 for a 30-day supply. It would also require the disclosure of pharmacy benefit management information to include rebates, price protection payments and other payments that are saved by the pharmacy, health plan issuer or enrollees at the point of the drug. The second one, (S 0381A), which was introduced by Senate Majority Leader Michael J. McCaffrey (D-District 29, Warwick), would require that health plans that provide prescription drug coverage not include an annual or lifetime dollar limit on drug benefits. It would also cap out-of-pocket expenses that some consumers would be required to pay for prescription drugs.  The measures now move to the House for consideration.

The Senate also approved legislation sponsored by Sen. Melissa A. Murray (D-District 27, Woonsocket, North Smithfield) limiting insured patients’ copays for insulin used to treat diabetes to $40 for a 30-day supply. The legislation (S 0170A), which is part of the Senate’s prescription drug affordability legislative package, would apply to all insurance plans that cover insulin. Under the legislation, insurers would be required to cap the total amount that any covered person is required to pay for covered insulin at $40 for a 30-day supply, regardless of the amount or type of insulin prescribed. It also forbids that coverage from being submit to any deductible. The bill does allow insurers to charge less if they choose. The cost of insulin has risen sharply over the years, and the cost is much higher in the United States than in other countries.  Millions of Americans depend on insulin for the management of diabetes. The legislation goes to the lower chamber, where House Speaker Pro Tempore Brian Patrick Kennedy (D-District. 38, Hopkinton, Westerly) is sponsoring a companion bill (H 5196A).

Finally, the passed legislation sponsored by Sen. Valarie J. Larson (D-District 14, East Providence) would increase temporary caregiver benefits for Rhode Islanders. The bill (S 0688) increases temporary caregiver benefits to six weeks in a benefit year starting Jan. 1, 2022, and would increase temporary caregiver benefits to eight weeks in a benefit year beginning Jan. 1, 2023.Rhode Island was the third state in the nation to pass a paid family leave programs when it enacted the Temporary Caregiver Insurance program in 2013.  It provides up to four weeks of partial (about 60%) wage replacement for workers who need to take time from their jobs to care for a serious ill family member or to bond with a newborn, adopted or foster child.  The worker’s job and seniority are protected while the worker is on leave.An amended companion measure (H 6090A), sponsored by House Majority Whip Katherine S. Kazarian (D-District 63, East Providence) passes the House and now heads to the Senate for consideration.

Deputy House Republican Minority Leader, George Nardone (R-Dist. 28, Coventry, Rep. Michael Chippendale (R-Dist. 40, Coventry, Foster, and Glocester and Rep. Raymond A. Hull (R-District 6, Providence) submitted H 5547 to ensure proper, safe, and personal contact with loved ones in congregate care facilities.  The legislation addresses the COVID-19 mandates that denied access to individuals in hospitals, group homes, nursing homes, assisted living facilities and Veterans homes. The purpose of this legislation is to entitle all residents of healthcare facilities and group homes the opportunity to designate a support person for regular, in-person visits. The policy is designed to balance disease transmission protocols with the benefits of having a loved one present during a lockdown. The House Health & Human Services Committee recommended the legislation be held for further study.

Senate Minority Whip Jessica de la Cruz (R-Dist. 23, Burrillville, Glocester, North Smithfield, introduced S 644 to provide medical assistance coverage for medical services provided qualifying eligible recipients for community-based care. The Senate Health & Human Services Committee has also recommended the legislation be held for further study.

Thoughts from the Sidelines at AARP

AARP Rhode Island says they “…are thrilled that the Livable Home Modification Grant Program, which provides matching funds for needed construction to ensure that Rhode Islanders with disabilities can remain safely and comfortably at home, was included in the FY22 budget,” said AARP Rhode Island State Director Catherine Taylor. “That was the highlight of the budget for us. Codifying this program has been a major priority.

“Another important win was enactment of the Elder Adult Financial Exploitation Prevention Act. This law is an important new tool to fight for the one-in-five older Rhode Islanders who is a victim of financial exploitation, with an average loss of $120,000. AARP-RI wrote to Governor McKee urging him to sign this critical legislation and they are delighted that he has done so.  This will be a game-changer in the effort to protect the life savings of older Rhode Islanders.

“Now we have our eye on the number of prescription drug bills that we’ve been working hard on, and we’re hopeful they will see passage before the end of the session. At this time, there are four Senate-approved Rx bills that need action in the House, and we are eagerly awaiting House passage of Rep. Brian Patrick Kennedy’s insulin cap bill.

The Legislative session is expected to end by the end of next week. Stay tuned to see what legislative proposals ultimately make it to the Governor’s desk for signature.

UPDATE:

‘According to Maureen Maigret, Vice Chair of Rhode Island’s Long-Term Care Coordinating Council, a former state representative and Director of Rhode Island’s Elderly Affairs, one of the biggest wins for older adults in the budget — the expansion of the Office of Healthy Aging @Home Cost Share program to increase income eligibility from 200% of the federal poverty level to 250% and to include persons under age 65 with Alzheimer’s/dementia. “Over $2Mil in all funds was added to the budget to do this. It was promoted by legislation sponsored by Sen. Walter Felag and Rep. Joseph Solomon. An estimated 500 persons will get subsidized home care and/or adult day services with this expansion. It was a priority of the Aging in Community Subcommittee for several years,” she says. 

Maigret also notes that the budget also includes Medicaid rate increases for a number of home and community care providers designed to increase access to these options for persons needing care. “These include assisted living, adult day services, shared living and home care. Importantly, with the cost of so many basic services such as rent and food increasing it raises the amount of money a person on home care can keep to pay for living expenses before they must pay a share of the cost of the services,”

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State Lawmakers to Tackle High Prescription Drug Costs

Published in the Woonsocket Call on February 16, 2020

The Washington, DC-based AARP began its call for reducing prescription drug prices nationally in the late spring of 2019. At the same time, state legislatures around the country began taking up legislation. However, in Rhode Island, where the legislature meets only once a year, from January to June, it was too late to introduce bill in last year’s session.

AARP’s Elaine Ryan, VP of State Advocacy and Strategy reports: “We’re seeing an unprecedented number of states tackling the problem of high prescription drug prices. About 45 states expect to engage on prescription drug legislation or regulations this year. Right now, AARP is actively engaged in legislation in 25 states to address rising prescription drug prices. A variety of bills are moving through state legislatures, including bills on cost-sharing caps on insulin, price transparency, importation, price gouging, and affordability boards.”

Now, AARP Rhode Island is gearing up its lobbying efforts on Smith Hill this legislative session to put the brakes on rising prescription drug costs.

High Prescription Costs Top AARP Rhode Island’s Issues

State Director Kathleen Connell, of AARP Rhode Island, led the charge against skyrocketing drug costs by taking the group’s “Stop Rx Greed: Cut Drug Prices Now” campaign to four Rhode Island communities. At its AARP RI Community Conversations kickoff event in Warwick on Oct. 15, she called on Congress and the Rhode Island General Assembly to make prescription drugs more affordable a legislative priority. “We pay not only at the pharmacy counter, but through higher insurance premiums, and through the higher taxes we need to pay to fund programs like Medicare and Medicaid. Older Americans are hit especially hard. Medicare Part D enrollees take an average of 4 to 5 prescriptions per month, and their average annual income is around $26,000. One in three Americans has not taken a medication as prescribed because of the cost,” she said.

Connell reported that a recent AARP Rhode Island’s survey revealed that 79 percent of the member respondents called for lowering the price of prescription drugs, considering it the organization’s top priority.

During these events, using state-by-state specific data released last summer by AARP researchers, Connell was able to use Rhode Island data to document an increase in drug costs for seniors, identifying these drugs, the number of Rhode Islanders who need them and how much costs have risen.

Rhode Island’s state specific data revealed that the average annual cost of brand name prescription drug treatment increased 58 percent between 2012 and 2017, while the annual income for Rhode Island increased only 5.6 percent. Prescription drugs don’t work if patients can’t afford them, says the aging advocacy group, says Connell.

AARP Rhode Island also held Community Conversations in North Providence (Oct. 29), East Providence (Nov. 21) and Newport (Dec. 5). About 80 people attended these events, including in the legislative districts in those communities, along with Senate President Dominick J. Ruggerio (D-District 4, North Providence, Providence) and House Majority Leader Joseph Shekarchi (D-District 23, Warwick).

AARP Rhode Island Calls for Lower Prescription Drug Costs

On Feb. 5, over 120 people, including state lawmakers, Secretary of State Nellie M. Gorbea, and AARP Rhode Island staff and members, gathered in the State Room to attend the AARP Rhode Island Annual Reception. The event would become the backdrop to announce the Rhode Island Senate’s legislative agenda to tackle increasing prescription drug costs, the unveiling of package of eight bills supported by AARP Rhode Island.

At the event, Connell said: “This is an issue we are pounding on and I think you are going to see progress this year on this stellar important issue – Stop Rx Greed. I don’t need to go through the list of hardships suffered as these prices escalate way beyond reason. And we know this can’t continue the way it is. It’s probably not going to be a silver bullet that will solves this, but a lot of lot more work of the kind you have seen to make this iceberg move.”

Senate President Ruggerio along with 14 Senators from his chamber came to announce their support of the AARP sponsored legislation that would provide a pathway to import less-costly drugs from Canada, increase more market transparency, raise senior’s awareness around price changes and limit patients’ share of the costs.

House Majority Leader Shekarchi, came to the legislative reception with 20 House lawmakers, to share their concern about the lack of affordability of prescription. Shekarchi personally knows about high drug costs. “I am a Type II Diabetic and I have a lot of prescriptions. I feel the pain because I pay $30 a pill with the copay. I know what it costs and it is ridiculous,” he says.

“Patients deserve to know what drugs will cost, how they can pay for them in a fair and reasonable way, and how they can take advantage of any or all opportunities to save on those costs,” said Shekarchi, stressing that “people living on fixed incomes should not have to skimp between doing what is essential in buying prescription drugs, or food or housing.”

Shekarchi noted that he has already put in legislation with House colleagues, calling for Rhode Island’s insurers to completely cover the cost of copays for epinephrine injectors, or EpiPens. The bill would help reduce the high cost of the injectors, which has prevented some people with allergies from obtaining the life-saving device. The Warwick lawmaker also cosponsored a bill to create a prescription drug affordability board to protect Rhode Islanders from the high costs of prescription drug products.

Shekarchi concluded, by announcing that House lawmakers will shortly join the Senate in introducing AARP’s package of legislation (from five up to eight bills).

In a statement announcing the introduction of Senate bills to lower prescription drug costs, Ruggerio said: “Rhode Island’s population is one of the oldest in the nation, and the high prices consumers pay for prescriptions have a significant impact on us. Most older Rhode Islanders have limited means, and the high costs mean many people are cutting back on essentials of living or taking less than their prescribed amount of expensive drugs. The pharmaceutical industry is not going to address this on its own, so it’s up to the state and federal governments to take action.”

Tackling the High Cost of Prescription Drugs

After AARP Rhode Island’s Annual Legislative Reception, the following legislative proposals were thrown into the legislative hopper that day and companion measures have now been introduced in the House.

Senate legislative proposals included:

A bill limiting changes to a health plan’s drug formulary — its list of covered drugs — to protect consumers. Sponsored by Sen. Elizabeth A. Crowley (D-District 16, Central Falls, Pawtucket), this legislation (S 2324) would generally limit plans to modifying formularies at renewal time with 60 days’ notice and require that modification be identical among all substantially identical benefit plans.

Legislation (S 2319) sponsored by Senate Majority Leader Michael J. McCaffrey (D-District 29, Warwick) to cap out-of-pocket expenses for prescription drugs at the federal limits for high-deductible health plans, currently $1,400 for individual plans and $2,800 for family plans.

A bill (S 2317) sponsored by Senate Majority Whip Maryellen Goodwin (D-District 1, Providence) to prohibit cost sharing for patients 45 or older for colorectal screening examinations, laboratory tests and colonoscopies covered by health insurance policies or plans.

Legislation (S 2322) sponsored by Sen. Melissa A. Murray (D-District 24, Woonsocket, North Smithfield) to limit the copay for prescription insulin to $50 for a 30-day supply for health plans that provide coverage for insulin.

A bill sponsored by Sen. Walter S. Felag Jr. (D-District 10, Warren, Bristol, Tiverton) requiring pharmacists to advise patients about less-expensive generic alternatives to their prescriptions or when it would cost them less to pay for their drugs outright instead of using their insurance. The bill (S 2323) would also bar pharmacy benefits managers from imposing gag orders on pharmacists that prevent them from making such disclosures.

A prescription drug transparency act (S 2318), sponsored by Senate President Ruggerio. This bill would requires pharmaceutical drug manufacturers to provide wholesale drug acquisition cost information to the Department of Health and pharmacy benefit managers to provide information related to drug prices, rebates, fees and drug sales to the health insurance commissioner annually. Such transparency would help payers determine whether high prescription costs are justified.

A bill (S 2321) sponsored by Sen. Louis P. DiPalma (D-District 12, Middletown, Little Compton, Tiverton, Newport) to create a state-administered program to import wholesale prescription drugs from Canada, which has drug safety regulations similar to those of the United States. Such programs are allowed under federal law, with approval from the U.S. Food and Drug Administration.

Legislation (S 2320) sponsored by Sen. Cynthia A. Coyne (D-District 32, Barrington, Bristol, East Providence) to create a prescription drug affordability board tasked with investigating and comprehensively evaluating drug prices for Rhode Islanders and possible ways to reduce them to make them more affordable.

As the 2020 Presidential election looms, Congress and state law makers are very aware that lowering skyrocketing prescription drug costs is a top priority for their older constituents. With more than 250 bills passed by the Democrats in the House (some of these bills would lower prescription drug costs) sitting in Senate Majority Leader Mitch McConnell’s “legislative graveyard,” the Rhode Island General Assembly must take the lead to legislatively fix the problem.

Connell anticipates that there might be more than 15 drug bills in the House and Senate, 10 submitted by AARP. Rhode Island lawmakers must seriously consider these legislative proposals and join the 26 states that have already passed new laws aimed at lowering prices for prescription medications.