CMS Moves to Strengthen Nursing Home Safety and Clarity of Consumer Info

Published in RINewsToday on January 23, 2023

To improve transparency of nursing home consumer information, the federal Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS), will now post Care Compare citations that are under dispute by nursing homes on its website.  CMS will also take steps to protect nursing home residents from being inappropriately diagnosed with schizophrenia which oftentimes leads to improper use of anti-psychotic medications to sedate and chemically restrain residents.

“We have made significant progress in decreasing the inappropriate use of antipsychotic medications in nursing homes, but more needs to be done,” said CMS Administrator Chiquita Brooks-LaSure, announcing the new guidance this week. “People in nursing homes deserve safe, high-quality care, and we are redoubling our oversight efforts to make sure that facilities are not prescribing unnecessary medications,” she says.

CMS’s actions advance President Biden’s goal of reinforcing safeguards against unnecessary medication use and treatments that was outlined in his State of the Union address to create an Action Plan for “Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes.”

Tackling the inappropriate drugging of Nursing Home residents

Beginning this month, CMS will conduct targeted, off-site audits of nursing homes to determine whether facilities are accurately assessing and coding individuals with a schizophrenia diagnosis. Nursing home residents erroneously diagnosed with schizophrenia are at risk of receiving poor care and being prescribed inappropriate anti-psychotic medications. Anti-psychotic medications are especially dangerous to these residents due to their potential devastating side effects, including death.

According to the Washington, DC-based National Consumer Voice for Quality Long-Term Care, in 2008, CMS first introduced a quality measure in its Care Compare rating system that calculates the percentage of long-stay residents (over 100 days) that were receiving anti-psychotic medications. This quality measure was initially introduced to address the practice of some nursing homes of illegally using anti-psychotic medications to sedate residents with dementia or other increased patient care needs, rather than providing appropriate hands-on care interventions.

The measure, excluding residents with certain diagnoses, including schizophrenia, Huntington’s disease, and Tourette’s syndrome, resulted in some nursing homes improperly diagnosing residents with schizophrenia, observed the Consumer Voice, a national organization representing consumers in issues related to long-term care, helping to ensure consumers are empowered to advocate for themselves.      

CMS’s new guidance acknowledges that there has been a steady rise in schizophrenia diagnoses since the quality measure was first introduced, charges the Consumer Voice, noting that it comes on the heels of a report issued by the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) which found that from 2015-2019 there was a 194% increase in the number of residents diagnosed with schizophrenia who did not have that diagnosis prior to admission to the nursing home.

“It is important to note that it is extremely rare for schizophrenia to suddenly occur in older people,” says the Consumer Voice, stating that the onset of schizophrenia generally occurs in someone’s late teens through their twenties.

CMS announced that it will begin to conduct audits of nursing homes with high rates of schizophrenia diagnoses and “examine the facility’s evidence for appropriately documenting, assessing, and coding a diagnosis of schizophrenia.” Facilities that have “inaccuracies” will have their Five-Star Quality Measure Rating adjusted. CMS will downgrade the facility’s Quality Measure ratings to one star, which would drop their Overall Star Rating as well. CMS will monitor each facility’s data to determine whether they have addressed the identified issues. After that, CMS will decide whether any downgrades should be reversed.

While Consumer Voice has expressed significant concern with the accuracy of CMS’s Quality Measure, it supports these actions. The Quality Measure rating often inflates a facility’s overall 5-Star rating on Care Compare. This action will help incentivize compliance and make sure the public is aware of these illegal practices in nursing homes, says the consumer advocacy group.

Increased transparency

Separately, CMS announced it plans to take a new step to increase the transparency of nursing home information provided to consumers by publicly displaying survey citations that facilities are disputing. Currently, when a facility disputes a survey deficiency, that deficiency is not posted to Care Compare until the dispute process is complete. This process usually takes approximately 60 days; however, some cases can take longer. 

Although the number of actual deficiencies under dispute is relatively small, they can include severe instances of non-compliance such as Immediate Jeopardy (IJ) citations. This level of citation occurs when the health and safety of residents could be at risk for serious injury, serious harm, serious impairment, or death. Displaying this information while it is under dispute can help consumers make more informed choices when it comes to evaluating and choosing a facility. This new information will begin appearing on Care Compare on January 25th. While citations will be publicly displayed, they will not be included in the Five-Star Quality Rating calculation until the dispute is complete. 

“We support anything that CMS can reasonably do to improve the health and safety of seniors in long-term care, especially those with cognitive impairment. When it comes to the nursing home industry’s concerns about new CMS rules, we think it’s best to err on the side of transparency. Seniors and their families need as much information as possible to make informed decisions about long-term care,” says a spokesperson for the Washington, DC-based National Committee to Preserve Social Security and Medicare, an advocacy group whose mission is to protect Social Security and Medicare.

Local reaction:  “You cannot un-ring a bell”

RI Health Care Association

“We fully support improving nursing home transparency, safety and quality, and accountability regarding our members’ service to the residents and patients entrusted to their care,” says John E. Gage, President and CEO of Rhode Island’s Health Care Association, representing 64 of the 80 nursing facilities in the state. “Eliminating any inappropriate use of psychotropic medications and ensuring the highest quality of care is a shared focus of both CMS and RIHCA,” notes Gage.

“We strongly disagree with CMS’ decision to post of deficiencies that are in the process of being disputed through established CMS policies, regardless of their scope and severity, says Gage. “Posting deficiencies that, in many instances, are incorrect, inaccurately cited or cited at an inappropriate level of scope and severity, during an approved appeals process is unfair and could damage a facility’s reputation unfairly,” he adds.

According to Gage, doing this is akin to convicting someone before their full trial, (prosecution and defense alike) before the verdict is announced. “You cannot “un-ring a bell,” he says.

“As mentioned by CMS, we are just talking about a relatively small number of deficiencies,” states Gage. Rather than potentially posting erroneous deficiencies, he calls on CMS to speed up the process of conducting Informal Dispute Resolutions (IDRs) or Independent Dispute Resolutions (IIDRs) to no more than forty-five (45) days to ensure that accurate information is posted timely. IDRs and IIDRs are two different options from CMS that nursing homes can choose to appeal of cited deficiencies.

“As to the changes to the public reporting and the Five-Star Quality Rating System, we are disappointed that the Biden Administration and CMS have apparently made this determination administratively, without any comment period to allow for an opportunity for nursing homes and the public to provide feedback,” says Gage.

LeadingAge RI

“I appreciate CMS’s goal of increasing oversight of unnecessary antipsychotic medication use, although it should be noted that there has been a National Partnership to reduce the unnecessary use of antipsychotic drugs for years, so the industry has been very engaged in these efforts already,” notes James Nyberg, Executive Director of LeadingAge RI, a not-for-profit membership organization comprised of not-for-profit providers of aging services. 

Nyberg expresses concern about CMS posting deficiencies that are under dispute publicly. “That is taking a guilty before proven innocent approach, which is unfair and detrimental to providers. There is an existing process to resolve disputes over deficiencies, and this seems to short-circuit it, especially when deficiencies can be/and are overturned during the process.  One more blow to a beleaguered industry,” he says.

Long-Term Care Ombudsman

“The inappropriate use of antipsychotic medications in nursing homes has been an on ongoing issue for many years,” observes Kathleen Heren, Rhode Island’s Long-Term Care Ombudsman. “It takes a skilled practitioner who gives a battery of tests to diagnose someone with schizophrenia. This shouldn’t be determined by a hospital intern who spends 20 minutes with an agitated resident in a hospital emergency room,” she says.

According to Heren, schizophrenia has an early onset [about 4% of schizophrenia arise before the age of 15, and about 1% before the age of 10].  A 78-year -old resident does not become schizophrenic all of a sudden because he or she is agitated. “I can say that I have not seen many deficiencies given to Rhode Island nursing homes for overusing anti-psychotic medications,” she says, because of the efforts of  Health Care Centrics, Rhode Island’s Quality Assurance organization, that has provided in-depth staff training on the use of these drugs. The surveyors from the Rhode Island Department of Health (RIDoH) are very quick to cite facilities for not following guidelines in the inappropriate use of these drugs.

Heren says that there have been cases where RIDOH has rescinded a deficiency based on the input received by the survey team during the Informal Dispute Resolution process. “There are some facilities that are continually receiving deficiencies and that families should be able to see why a deficiency was given and a facilities response as to why it was considered unfair,” she says.

CMS Actions promote quality of care

RI Department of Health

“At the Rhode Island Department of Health (RIDoH), one of our major focus areas is monitoring and ensuring that nursing homes and other healthcare facilities provide the highest quality of care and services in a clean and safe environment, says Joseph Wendelken, RIDoH’s Public Information Officer. 

“We will continue to do everything we can to protect patients and residents, which includes following any new CMS protocols and partnering with CMS on new initiatives,” Wendelken says. 

Senior Agenda Coalition of RI

Adds Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of RI, “Rhode Island nursing homes have generally provided good quality of care over the years,” acknowledging that improvements can always be made. “Both of these changes are intended to promote better quality care,” she says. “If people are erroneously coded as having schizophrenia, they may be subject to poorer care and harmed by being prescribed inappropriate medication. Posting inspection citations under dispute on Nursing Home Compare with a notation they are under dispute is important in that resolution of the dispute could take 60 days or longer and in the meantime the public remains unaware of what could be significant deficiencies which could impact their decisions,” states Maigret says.

The QSO memo — Updates to the Nursing Home Care Compare website and Five-Star Quality Rating System: Adjusting Quality Measure Ratings Based on Erroneous Schizophrenia Coding, and Posting Citations Under Dispute — is available here for review:

https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/policy-and-memos-states/updates-nursing-home-care-compare-website-and-five-star-quality-rating-system-adjusting-quality

RI Gubernatorial Forum to ask, “what’s your Senior Agenda”

Published in RINewsToday on August 1, 2022

The Senior Agenda Coalition of RI (SACRI) has joined 17 organizations to bring you Rhode Island’s 2022 Gubernatorial Forum where candidates will talk about senior issues. The event is scheduled for Wednesday, August 3, 2022, at 10:00 a.m. at the East Providence High School’s new 900-seat capacity auditorium. Seating is limited to 450 people, leaving space for social distancing. Doors will open at 9:30 a.m. At press time, 350 seniors and aging advocates have registered to attend in person or virtually.    

“Senior issues must be viewed as a public policy priority because Rhode Island’s older population is growing dramatically,” says Bernard J. Beaudreau, SACRI’s Exec. Director, and one of the event’s organizers. According to Beaudreau, the U.S. Census Bureau estimates that the state’s total population of 65 years and older has grown by 20% from 152,183 in 2010 to 182,486 in 2020, adding 30,303 people in this age group. Rhode Island’s statewide planning projections also indicate that people sixty-five and older will grow to over 247,000 by 2030, an increase of 65,000 seniors over the 2020 census.

Gubernatorial candidates to delineate positions on key Senior Issues

“During the 90-minute forum, the gubernatorial candidates will share their positions on seven questions, hammered out by event cosponsors, as to how they would address a variety of policy issues impacting older Rhode Islanders,” says Beaudreau.  “Attendees will learn how candidates would rebuild and sustain a viable workforce for nursing homes and homecare providers. They will also be asked about their plans for Medicaid rebalancing and expansion to improve home and community-based care opportunities while ensuring the financial viability of nursing homes,” he says. 

Beaudreau says the forum also gives the gubernatorial candidates an opportunity to detail their strategies on how resources can be increased to significantly support healthy aging in the community. They will be asked by the moderator what type of assistance will be given to low-income seniors, and will they support a yearly cost-of-living adjustment to the state SSI payment and increase eligibility for the Medicare Savings Programs for seniors and people with disabilities to at least 185% FPL.

The attendees will also learn how the candidates, if elected governor, will ensure that an adequate amount of the $250 million in funding for affordable housing is allocated for seniors and how they will work to ensure equal access to high quality healthcare and information about available health care resources.

Finally, the gubernatorial candidates will be asked to make a pledge to address the needs of Rhode Island’s older population and provide the leadership and resources necessary to create and implement a Rhode Island Strategic Plan on Aging.

Recognizing the political clout of Seniors

“SACRI’s upcoming Gubernatorial Candidates’ Forum is important as older adults historically have high turnout in elections and the Forum provides an opportunity to hear the candidates’ views on issues important to seniors,” says Maureen Maigret, Chair of the Long-Term Care Coordinating Council’s Aging in Community Subcommittee. “The Forum should cause candidates to take a serious look at the state’s demographics, to note how the older population is growing, and to reflect on how government can best support older adults’ desire to remain healthy and living in the community and provide quality facility care when needed,” says Maigret.

“The Forum allows us to set forth policy priorities and hold whoever is elected accountable for addressing them. An example of this is when former Governor Raimondo was elected. She had been presented with priorities for restoring budget cuts to senior services such as Meals on Wheels and some of the cuts were restored in her budgets,” Maigret noted.

SACRI’s Beaudreau says that the senior vote will influence the outcome of the upcoming primary and mid-term. “Rhode Island seniors 60 years of age and older represent 34% of all registered voters and accounted for 42% of the vote in the 2020 general election. Rhode Island seniors have higher voter participation rates than the rest of the population,” says Beaudreau, this being 77% compared to 57% for voters under 60 years of age. “We have a powerful voice to be exercised to impact public policy,” he says.

Political pundit Wendy J. Schiller sees seniors as a crucial voting bloc in American politics. “On average, 72% of voters over the age of 65 turn out to vote in presidential elections, as compared to about 48.6% of voters under the age of 30. Seniors are consistent and typically well-informed voters on issues concerning Social Security and Medicare,” says Schiller, Royce Family Professor of Teaching Excellence in Political Science and Director of the Taubman Center on American Politics and Policy, Brown University. 

According to Schiller, in the past 3 elections, “seniors have split about 55-56% for the Republicans, and 45-46% for Democrats. Seniors have been viewed as more conservative (Sun City AZ, the Villages FL) but the data do not really bear that out as you can see. There is a tilt, but not a full lean toward the GOP; this midterm season might be different though. If the 22 midterm elections were held tomorrow, you might expect to see even a bigger swing toward GOP candidates than usual because of inflation alone. Inflation is just one area where there is a gap in issue concerns between older and younger voters. Older voters worry a great deal about inflation eating into their savings and pensions that are not adjusted for inflation while younger voters may be as concerned with climate change and abortion rights as much or even more than they are worried about inflation,” she says.  

Schiller says that seniors are like all other voters in that they are highly influenced by their political party affiliation, even in cases where the party proposes policies that run against their interests. “The GOP has proposed cutting Medicare ever since it was created, most recently under President Trump, but they are not careful to say that such cuts would not affect current recipients or even people aged 55 or over and the majority of seniors voted for Donald Trump in 2020. Democrats ran into some trouble with seniors when Bernie Sanders and others proposed Medicare for All because seniors thought it would dilute their own services through Medicare, and/or raise their premiums,” adds Schiller.      

Adds well-known Rhode Island Political Strategist, Rob Horowitz, “As a group, seniors vote more regularly than any other age group. In the 2020 presidential election, for example, more than 3-in-4 people eligible voters between the ages of 65 to 74 voted as compared to about 2-in-4 eligible voters between the ages of 18 to 24. Since Rhode Island has an older population, seniors are a key group in pretty much every state and local election.  Winning campaigns in Rhode Island and throughout the nation devote time and advertising dollars to reaching seniors.”

According to Bob Weiner, former chief of staff director of the House Select Committee on Aging under Florida Congressman Claude Pepper and former spokesman for both the Clinton and Bush White Houses, no one can forget the clout of older voters because they are the most motivated demographic group to vote. “They can’t be broken out by political parties as people expect,” observes Weiner, noting that it is a very close 50-50 split vote. “Older voters vote Democratic and Republican; the Democrats must do more to capture the senior vote.  It’s close. In 2020, while Joe Biden won the popular vote by 7 million, Donald Trump won the senior vote 52% to 47%. It’s not a matter of party. Seniors’ quality of life is not political,” he says.

“But on the issues, they will tear apart a candidate who doesn’t support Social Security, Medicare and the rights of seniors to have continued employment and privileges in society,” Weiner notes.

“So, anybody who thinks they can get away with some horrible position, such as cutting back Social Security or Medicare in five years or utilizing the myth that Social Security is in deficit crisis, they can’t  because it has a 2 trillion surplus resulting from Claude Pepper negotiations to keep the program fully solvent through 2034,” Weiner says, noting that it only needs a “little repair” to keep it going.    

“Anybody who thinks that they are going to use Social Security and seniors to fund other federal government operations is badly mistaken,” says Weiner. “When President Bush wanted to privatize Medicare and Social Security and made a campaign out of that he actually helped lose congressional seats in an off-year election,” said Weiner, warning political candidates to think twice when thinking about balancing the federal budget on the backs of the nation’s elderly. 

“Voting Gives You Power”

“In Rhode Island and across the country, the data clearly show that voters aged 50+ will be the deciders in the 2022 elections,” said AARP Rhode Island State Director Catherine Taylor. “We are working with dozens of advocacy volunteers who are fighting for voters 50+ to make their voices heard on the issues that matter – especially in Rhode Island where we are in the midst of a housing crisis, nursing homes are in jeopardy, the cost of long-term care is skyrocketing and where people want leaders who are committed to making local communities more livable.

“At the federal level, older voters want to know candidates’ positions on protecting and strengthening the Social Security benefits Americans have paid into and earned through years of hard work, protecting and improving Medicare benefits, lowering prescription drug prices, and supporting family caregivers who risk their careers and financial futures to care for parents, spouses, and other loved ones,” Taylor said.

“Voting gives you the power to decide what our future looks like,” she continued “But you have to be in the know to vote. AARP Rhode Island has collected the most up-to-date election information, including key dates and deadlines, to make sure that the voices of voters 50+ are heard. We are doing everything we can to make sure older Rhode Islanders are prepared to vote and know the safe and secure voting options included in the new, AARP Rhode Island-backed Let RI Vote Act. In mid-August, we will offer a Video Voter Guide posted along with all the latest election information at aarp.org/RIvotes,” Taylor said.

Co-sponsoring this event is 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.

in the high school’s new 900-seat capacity auditorium. 

To read AARP web blog articles discussing the impact of senior voters at the polls, go to: 

www.aarp.org/politics-society/government-elections/info-2022/older-voters-midterm-issues.html

www.aarp.org/content/dam/aarp/research/surveys_statistics/politics/2022/aarp-targeted-congressional-districts-survey-voters-18-older.doi.10.26419-2Fres.00550.033.pdf

https://press.aarp.org/2022-4-6-Women-Voters-Age-50-Over-Will-Decide-Balance-Power-Next-Election

New resources to protect Seniors before, during and after Natural Disasters

Published in RINewsToday on July 18, 2022

Just last year alone, the Washington, DC-based AARP noted that the nation experienced more than 1,300 tornadoes, 21 named storms (with winds of 39 mph or greater), nearly 59,000 wildfires that burned more than 7.13 million acres, along with numerous ice storms and other weather events that caused major damage and fatalities. With hurricane season now approaching, AARP teamed up with the U.S. Federal Emergency Management Agency (FEMA), announcing the release of new resources specifically designed to help local and state officials and Emergency Management Agency (EMA) officials protect seniors in their communities.

“By 2034, adults ages 65 and over will outnumber those under 18 in the United States for the first time. This has profound implications during natural disasters and extreme weather events,” said Nancy LeaMond, Executive Vice President and Chief Advocacy & Engagement Officer at AARP, in a statement announcing the released resources. “State and local leaders and emergency officials must be better equipped and prepared to ensure that older adults are kept safe and their needs are met when a disaster strikes,” warns LeaMond.

The 9-page, Guide to Expanding Mitigation: Making the Connection to Older Adults, released by FEMA, highlights how natural hazards uniquely affect seniors and provides specific remedies as to how local mitigation and emergency planners can include seniors in community efforts to lower their risks.

Throughout its 44 pages, the AARP Disaster Resilience Took Kit features strategies to help local, state and community leaders and aging advocates reduce the risk and impact of disasters on older persons. 

The guide and tool kit are the result of a multi-year collaboration between AARP and FEMA to identify and provide resources, spark ideas and encourage organizations to better engage older Americans in disaster mitigation, preparedness, response and recovery operations. This long-term, strategic alliance aims to advance accessible, safe and livable communities for people of all ages, says AARP.

“Adults aged 65 and older are a growing demographic who are often disproportionately impacted by severe weather. These disparities can be compounded by other factors, such as low-income or chronic illness, producing inequitable results for this vulnerable population when it comes to disaster preparedness,” said FEMA Administrator Deanne Criswell in a statement. 

“Effective mitigation planning requires that we consider the needs of all populations, and FEMA’s partnership with AARP on these guides will help community planners ensure our older communities are more resilient in the face of hurricanes and other natural disaster,” she said.

According to AARP, a growing body of evidence compiled shows that seniors are disproportionately impacted by the types of weather-related emergencies and natural disasters that are becoming increasingly frequent and severe. Individuals who have chronic illnesses, functional limitations or disabilities are especially vulnerable, as evidenced by the impact of the global COVID-19 pandemic on seniors.  Not only are older people at a higher risk of death from infectious diseases and disasters, but the long-term effects on those who survive often undermine their physical and mental health, economic security and overall well-being.

Although many communities support older adults in preparation for disasters, expanded mitigation planning can help reduce the loss of life and property by minimizing the impact of disasters before they happen, says AARP, noting that mitigation actions and strategies that make cities, towns and neighborhoods safer for older adults can benefit all residents and increase community resilience overall.

Protecting Seniors from Natural Disasters in the Ocean State

“One standout recommendation from the AARP/FEMA report was the adoption of more resilient and efficient building and land use standards, including the consideration of hazards in siting senior living facilities,” says RI Lieutenant Governor Sabina Matos, who oversees the Emergency Management Advisory Council that reviews information and programs regarding emergency management and makes recommendations to the Governor on these issues.

“One of my highest priorities is the creation of more affordable housing of every kind, and we have to walk the line of growing not only quickly, but thoughtfully. As we consider how to use this budget’s $250 million investment in housing, we want to ensure that new developments meet FEMA standards and will keep Rhode Islanders safe. We’re already working with local communities’ EMA departments to review their community disaster preparedness plans, as well as their applications for FEMA Hazard Mitigation Grants — funding to help implement exactly the strategies outlined in this report,” she says.

“One omission that stands out to me is resources for unhoused seniors. According to the Rhode Island Coalition to End Homelessness’s 2021 State of Homelessness report, over 500 Rhode Islanders aged 55 or older experienced homelessness over the course of a year. We need to strongly consider what kinds of hazard mitigation strategies could help this uniquely vulnerable population. Additionally, Rhode Island must especially focus on preparing sustainable mitigation and response systems that account for the effect of climate change on our coastal communities, which we know have large senior populations and will become increasingly vulnerable to flooding,” says Matos.

”FEMA has provided a very valuable tool with the Guide to Expanding Mitigation – Making the Connection to Older Adults guide. At the Rhode Island Emergency Management Agency,  we work with our local emergency managers, non-profits (Rhode Island Community Food Bank, Red Cross of Rhode Island, United Way and more) and other state agencies including the Department of Health and the Office of Healthy Aging to ensure older Rhode Islanders have the resources they need when disaster strikes. These reports will help us in our efforts to continue to support individuals in this vulnerable group,” says Director Marc Pappas, of the Rhode Island Emergency Management Agency.

“Preparedness is a core function of public health. This is especially true when it comes to climate change and older adults. As these resources highlight, it is critical that the unique needs of older adults are considered when planning for weather-related emergencies and natural disasters. This is already a priority for us at the Rhode Island Department of Health when it comes to emergency preparedness, and it will continue to be a focus,” says Joseph Wendelken, Public Relation Officer for the Rhode Island Department of Health.

“Before, during and after a natural disaster, the safety and wellbeing of older Rhode Islanders must always be a top concern,” said AARP Rhode Island State Director Catherine Taylor

“Emergency planners and managers at the state and especially local levels, along with first responders and many others, play a critical role in reducing anxiety and any subsequent harm when disaster strikes. Whether it’s a hurricane, flooding, extreme heat or infectious disease, ongoing planning and the coordination of all available resources is necessary to minimize consequences,” says Taylor.

“The AARP/FEMA guide and toolkit can go a long way towards mitigating deaths and long-term impacts among Rhode Island’s most vulnerable citizens. We encourage all leaders involved in Rhode Island public safety and public health to take advantage of this new resource. There are many aspects of age-friendly, livable communities – resilience in the face of disaster is chief among them,” Taylor adds.

AARP Rhode Island Volunteer State President Marcus Mitchell has firsthand disaster management experience. “As a former Division Commander with the US Coast Guard Auxiliary and Community Emergency Response Team Instructor for Providence Emergency Management Agency, I am actively involved with emergency & disaster mitigation, response and recovery efforts that dramatically and profoundly impact our older population physically, emotionally and financially,” he said. 

“Not only are seniors often hit first and hardest but their families are deeply affected as well,” Mitchell added. “We hope to save lives throughout the community, mitigate damages and reduce injury by vigorously distributing the new guide and toolkit to our members and the community at large.”

West Warwick resident Vincent Marzullo gives a thumbs up to AARP/FEMA’s released resources, saying that their information will be extremely valuable to the State and local EMA officials charged with protecting the state’s aging and vulnerable population during natural disasters. “Several barriers prevent older adults from evacuating when needed. Many older adults cannot drive and do not have access to reliable, accessible public transportation, depend on home-based medical equipment, require specialized accessibility supports, or cannot bring pets when evacuating. Some older adults are caregivers to spouses or partners with one or more vulnerabilities that may also hinder their ability to take timely action and remain safe, says Marzullo, who served for 31 years as a federal civil rights & social justice director for the Corporation for National & Community Service and a Federal Disaster Cadre Coordinator for the National Service Agency.

“State and local EMA officials must regularly outreach to the older Rhode Islander on the Rhode Island Department of Health’s “Special Needs Emergency Registry” to check their status/needs, especially individuals who are isolated and immobile.  There are approximately 15,000 individuals with chronic illnesses that have opted-in to the registry in order to be checked in times of emergency/disasters.  These older adults are vulnerable and need periodic support,” says Marzullo.

Marzullo calls for on-going disaster resilience webinars to be available to better prepare State and local EMA officials and organizations to respond to sudden natural disasters.  Targeted organizations might include the Red Cross, AARP RI, Senior Agenda Coalition of RI, Senior Center Directors Association, AARP members, RIElder Info, 211/The Point, and the Emergency Management Advisory Council (EMAC).

Melissa Carden, RIEMA’s Chief Public Affairs Officer says while winter storms, hurricanes and flooding are most common in the Ocean State, expect climate change to have a profound effect on the weather, including more storms and greater precipitation. “This fuels other extreme weather events like flooding (coastal and inland – remember the flooding in RI in 2010). Although scientists are uncertain whether climate change will lead to an increase in the number of hurricanes, there is more confidence that warmer ocean temperatures and higher sea levels are expected to increase their intensity and impacts.”

 To view and download the Guide to Expanding Mitigation: Making the Connection to Older Adults, visit  https://www.fema.gov/sites/default/files/documents/fema_mitigation-guide_older-

adults.pdf

To download a PDF of the AARP Disaster Resilience Tool Kit, featuring strategies to help local, state and community leaders and advocates reduce the risk and impacts of disasters on older adults, go to  https://www.aarp.org/content/dam/aarp/livable-communities/tool-kits-resources/2022/AARP%20Disaster%20Resilience%20Tool%20Kit-singles-060122-.pdf

The following (free) Livable Publication booklets and guides, go to https://www.aarp.org/livable-communities/tool-kits-resources/livable-publications-order-form/https://www.homecareassistancerhodeisland.com/