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 28^th, 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 17^th 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 28^th 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/

House Budget Committee Plan Calls for Privatization of Medicare

Published in Woonsocket Call on July 23, 2017

Over four months ago President Trump released his draconian FY 2018 Budget, now Congress begins to hammer out its budgetary spending plan. Last Wednesday, the House Budget Committee, chaired by Rep. Diane Black (R-TN), sent the Republican drafted budget plan to the House floor for consideration. After a 12-hour markup held in Room 1334 Longworth HOB, the budgetary blueprint passed by a vote of 22 to 14, along party line. Rep. Black’s GOP controlled panel defeated 28 amendments offered by Democrats.

Once the House and Senate pass their budget resolutions, the House and Senate Appropriations subcommittees “markup” appropriations bills. The House and Senate vote on appropriations bills and reconcile differences.

Rep. Black says that the GOP FY 2018 Budget Resolution, “Building a Better America,” passed on July 19, will balance the federal budget within 10 years by cutting spending, reforming government and growing the economy. According to the House Budget chair, the recently released budget achieves $ 6.5 trillion in total reduction over 10 years. It sets overall discretionary spending for the fiscal budget at $1.132 trillion ($621.5 billion in defense discretionary spending and $511 billion in non-defense discretionary spending).

The House budget plan is the first step that Republicans must take to begin their efforts to overhaul the nation’s tax code to grow the economy. It also provides increased funding for defense and the building of Trump’s border wall. It also requires food stamp recipients to work for their benefits.

Although the Social Security program is spared, it bars recipients from receiving Social Security Disability Income recipients from also receiving unemployment benefits. But, most worrisome to aging group advocates, the passed House Budget Committee budget makes major cuts to Medicaid, turning the Medicare program into a voucher program. But, Medicare is targeted for major changes.

In the Eyes of the Political Beholder

Upon passage, the House Budget Chair, Rep. Black, said in a statement, “I am proud of the work done by the members of the committee. We’ve spent months reviewing all aspects of the federal government and have put together a plan that will balance the budget, promote economic growth, strengthen our national defense, and make Washington more accountable to taxpayers. Our budget also takes the crucial first step in the reconciliation process to fix our broken tax code and make long overdue mandatory spending cuts and reforms.”

But, Rep. John Yarmuth (D-KY), Ranking Member of the House Budget Committee, in a statement expressed a vastly different opinion as to the impact of the panel’s passed budget resolution. “Republicans on the House Budget Committee just approved a budget that the American people do not want and do not deserve from their government. Their budget adopts the worst extremes of the Trump proposal by cutting taxes for millionaires and billionaires at the expense of everyone else. It cuts at least $1.5 trillion from Medicare and Medicaid, and puts at risk investments in nearly every national priority, from education and veteran services, to transportation, environmental protections, and medical research. Democrats believe we should be investing in the American people, our economy, and greater opportunity for all, and we will continue to fight against this irresponsible budget when—or if—it is brought to the House floor,” he said.

House Budget Plan Calls for Substantial Changes to Medicare

Medicare takes a huge hit, $ 487 billion over a ten-year period, in the House Budget Committee’s passed FY 2018 Budget, says Paul N. Van De Water, in a blog post on the website of Center on Budget and Policy Priorities (CBPP). The Senior Fellow serving as CBPP’s Director, Policy Futures, says that the budget plan’s changes to Medicare include higher income-related premiums for those making $85,000 and over (twice the amount for couples), limits on malpractice awards, raising Medicare’s eligibility age from 65 to 67, also increasing cost sharing of beneficiaries.

In his posting, Van De Water details the substantial changes made to Medicare, one of the nation’s largest entitlement programs, in the House Budget Committee’s passed budget. He notes, it would “replace Medicare’s guarantee of health coverage with a flat premium support payment or voucher, [starting in 2024] that beneficiaries would use to help buy either private health insurance or a form of traditional Medicare.” Although there are no details in the House Budget Committee’s plan to determine its impact on beneficiaries, he says that most people enrolled in traditional Medicare would pay more with the new changes than under the current law, according to a previous Congressional Budget Office analysis.

NCPSSM Sounds the Alarm About Privatization of Medicare

As the House Budget Committee began its markup of the FY 2018 budget, Max Richtman, President of the National Committee to Preserve Social Security and Medicare (NCPSSM) warned in a statement that the GOP-controlled panel “is targeting the health and financial well-being of America’s seniors by making another attempt to privatize Medicare.”

“Recent polling indicates that large majorities of Americans across party lines prefer that Medicare be kept the way it is, not to mention that President Trump repeatedly promised to protect the program during the 2016 campaign,” says Richtman.

Richtman says that converting Medicare into a voucher program is an existential threat to the program itself. “Over time, giving seniors vouchers to purchase health insurance would dramatically increase their out of pocket costs since the fixed amount of the voucher is unlikely to keep up with the rising costs of health care,” he says. “And, as healthier seniors choose less costly private plans, sicker and poorer seniors would remain in traditional Medicare, leading to untenable costs, diminished coverage, and an eventual demise of traditional Medicare, plain and simple. Of course, raising the eligibility age to 67 – as the House spending plan also proposes – is a drastic benefit cut.”

Undermining Medicare has been a long-held dream of fiscal conservatives. Their “premium support” proposal is a thinly veiled scheme to allow traditional Medicare to “wither on the vine,” as former House Speaker Newt Gingrich once put it,” adds Richtman.

Privatization is being sold as “improving customer choice,” but based on the way current Medicare Advantage plans work, private insurance will continue to offer fewer choices of doctors than traditional Medicare does. If traditional Medicare is allowed to shrink and collapse, true choice will disappear, too, says Richtman.

Stay tuned….

Herb Weiss, LRI’12 is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Inaction on RIPAE Proposals Would Be a State Tragedy

Published in the Pawtucket Times on May 20, 2002

Lawmakers are rushing to finalize the state’s business, hoping to adjourn as early as the end of May.

With thousands of proposals in the legislative hopper, each representative was directed by House leadership to choose three of their own sponsored bills to push for in the Senate.

All legislative proposals that do not make the “priority” lists are as good as dead for the year.

At press time, one proposal, Pharmaceutical Assistance for the Elderly Program (RIPAE) moves closely to passage.

The House Finance Committee has put the proposal (H 7291) into the state budget article. Susan Sweet, a consultant and aging advocate said she expects full House passage of the state budget article by the end of the week.

Once passed by the House, the state budget article goes to the Senate for their consideration and approval. Sweet told All About Seniors that she believes that the Senate will quickly pass the budget, too.

With passage, the final state budget will be forwarded to Governor Lincoln Almond.

Under H 7291, the state Department of Human Services would seek a waiver from the federal government, allowing Rhode Island to use Medicaid funding to pay for prescription drugs for low-income seniors with incomes up to $ 17,720 and couples with incomes up to $ 23,880.

The legislative proposal, authored by Lt. Governor Charles Fogarty and sponsored by Rep. Constantino and House Finance Chairman Gordon Fox, would enroll about 90 percent of the 37,000 seniors now enrolled in RIPAE. Because seniors would now qualify for prescription drug coverage under Medicaid all U.S. Food and Drug Administration (FDA) drugs would be covered not just those currently covered by RIPAE.

Seniors would pay a small copayment rather than the 40 percent co-payment currently charged.

With the passage of the state budget article, then “cleanup” begins on all legislative proposals, Sweet noted, adding that the two other RIPAE proposals have not been acted upon yet.

These legislative proposals would make prescription drugs more affordable to seniors and persons with disabilities who are not covered by the Medicaid waiver.

One bill (H 7290) would allow seniors enrolled in the RIPAE program to buy prescription drugs not currently covered by RIPAE at the discounted state price.

The other (H 7524) would allow low-income disabled persons on Social Security Disability Income who are between ages of 55 and 65 to become members of RIPAE and purchase prescription medications at the state discounted rate. Under booth, the state would be able to obtain the manufacturer’s rebate available through RIPAE.

Sweet along with other aging advocate groups, has called on the Rhode Island General Assembly to pass the three RIPAE proposals, which don’t cost the state one penny.

Not acting on them will continue a tragic trend that is well-documented in Rhode Island and nationwide.

That is, the high cost of prescription drugs forces many seniors on fixed incomes into not taking their prescribed medications at all or using only partial doses.

Moreover, noncompliance can lead to unnecessary hospitalization, nursing home admission and premature death.

Even in the shadow of a huge state budget deficit, lawmakers have the opportunity to lower the spiraling out-of-pocket costs of costs of prescription drugs, at no cost to the state.

The Ocean State is now posed to enact sound public policy that will result in no fiscal impact to state coffers.

If Congress is not ready to tackle this aging policy issue through the creation of a Medicare pharmaceutical benefit, then the Rhode Island General Assembly must take the lead and pass the three RIPAE proposals.

Simply put, it is the right thing to do on behalf of older and disabled constituents.