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/

A call to Congress to strengthen, expand Social Security & Medicare 

Published in Rhode Island News Today on September 6, 2021

The 2021 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance (OASI)) and the Social Security Disability trust fund (SSDI), released last week, gives Congress this stark warning: the Social Security Trust fund is heading toward insolvency in 13 years while SSDI will see its reserve funds depleted in 2057, eight years sooner than last year’s estimate. As a whole, combined, the two Social Security trust fund reserves will be depleted in 2034, a year earlier than estimated made in last year’s Trustee report.

However, there is good news. This year’s report notes that there is more than enough time for lawmakers to make up shortfalls by immediately shoring up the ailing Social Security Old-Age and Survivors Insurance (OASI) trust fund and the Social Security Disability trust fund (SSDI) by Congress increasing revenues or cutting costs to these programs.

“The theoretical combined trust funds will exhaust their reserves by 2034, when today’s 54-year-olds reach the full retirement age and today’s youngest retirees turn 75. Upon insolvency, all beneficiaries will face a 22% across-the-board benefit cut,” says a detailed analysis released by the Washington, DC-based Committee for a Responsible Federal Budget (CRFB), a non-partisan, nonprofit organization committee that addresses federal budget and fiscal issues.

According to this year’s Medicare Trustee’s report, there was no change from last year’s projections that noted Medicare Hospital Insurance trust funds would be deleted in 2026. If this occurs, physicians, acute care facilities and nursing homes would not receive their full compensation of the program (only 91% of scheduled payments), pushing the uncompensated costs on the patients to pay.

Total Medicare expenditures are projected to increase in the future at a faster pace than both total workers’ earnings and the overall economy, says the newly released Medicare Trustee report.

In light of the projected insolvency of Social Security, this year’s Trustee’s report notes that beneficiaries may receive an estimated 3.1% cost-of-living adjustment (COLA) for benefits in 2021, the highest COLA in a decade. This large increase was triggered by higher inflation rates caused by the ongoing pandemic.

Beltway Insiders Respond

“The Trustees’ projections in this year’s report include the best estimates of the effects of the COVID-19 pandemic on the Social Security program,” said Kilolo Kijakazi, Acting Commissioner of Social Security. “The pandemic and its economic impact have had an effect on Social Security’s Trust Funds, and the future course of the pandemic is still uncertain. Yet, Social Security will continue to play a critical role in the lives of 65 million beneficiaries and 176 million workers and their families during 2021.”

“The Trustees Report confirms that Social Security’s financing is strong in the near-term yet underscores why it is so important that Congress take action now to prevent 22% in cuts across the board on all benefits in 2034,” says House Ways and Means Social Security Subcommittee Chairman John B. Larson (D-CT) in a released statement. “With the loss of traditional pensions, rising health care costs, and many people unable to save enough for retirement, there is a growing retirement crisis. 65 million Americans currently rely on Social Security benefits, yet millions are suffering and can’t make ends meet, adds Larson.

Furthermore, the Trustees Report shows that this year the cost of paying out benefits will exceed the income from the Federal Insurance Contribution Act (FICA) payments,” states Larson.

The released 2021Trustee reports on the financial solvency of Medicare and Social Security trust funds once again identify unsustainable benefit promises in Medicare and Social Security programs, stated senator Mike Crapo (R-Idaho) said in a released statement.

 “The Hospital Insurance trust fund [Medicare] is projected to be exhausted around 2026; there are $60 trillion of unfunded liabilities in Social Security programs; and unfunded liabilities increased by trillions of dollars over the last year alone,” adds Crapo.

Crapo urges Congress and the White House to “work closely together with a sense of urgency to address the challenges detailed in the Social Security and Medicare Trustees Reports. However, “most Democrats want only to expand benefit promises further without generating sustainable trust fund solvency,” he said.

Seniors Depend on Social Security on Most of Their Income

“There is no need to sound the alarm, but now is the time to address Social Security’s long-term solvency – and provide an overdue boost in benefits. Phone calls and emails to Congress are definitely warranted at this critical juncture,” says Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare, responding to the Social Security Trustee Report released August 31.

According to Richtman, Social Security has never missed a benefit payment in its 86-year history, but remains strong. Even if no Congressional action is taken and the Trust fund becomes deleted, Social Security could still pay 79% of the benefits with revenue coming from regular worker’s payroll contributions. “But that poses a huge financial risk for the millions of retirees who depend on Social Security for most if not all of their income.  It also raises a serious political risk for members of Congress who fail to boost the program’s finances so that the trust fund remains solvent beyond 2034,” he says. 

Living on an average monthly benefit of $1,540 is tough to do, says Richtman, as retirement savings dwindle, pensions disappear and the soaring cost of senior housing and medical care.  

Nancy Altman, President of Social Security Works (SSW) and chair of the Strengthen Social Security Coalition, agrees with Richtman’s assessment of Social Security’s fiscal solvency and impact on the retiree’s income. “Today’s report shows that Social Security remains strong and continues to work well, despite the once-in-a-century pandemic. That this year’s projections are so similar to last year’s proves once again that our Social Security system is built to withstand times of crisis, providing a source of certainty in uncertain times,” she says.

“We don’t have a Social Security crisis, but we do have a retirement income crisis — made worse by the pandemic, which, among other economic impacts, forced millions of workers to retire earlier than planned. The solution is to expand Social Security, as President Joe Biden has promised to do,” suggests Altman.

According to SSW, “about one out of two married senior beneficiaries and seven out of 10 unmarried senior beneficiaries and almost one out of tow unmarried beneficiaries rely on Social Security for virtually all their income.”

Mustering the Political Will 

Richtman calls for Congress to closely look at Congressman John Larson (D-CT) legislation to fix and expand the nation’s ailing Social Security program. “For over six years, Congressman John Larson has been driving efforts to strengthen Social Security by adjusting the payroll wage cap so that high income earners begin paying their fair share,” he notes.

Larson has also proposed an across-the-board boost for all retirees, enhanced benefits for the most vulnerable seniors, and a more accurate formula for calculating annual cost-of-living adjustments (COLAs) so that benefits truly keep pace with inflation, says Richtman, noting that the Connecticut Congressman’s  proposals also align with President Biden’s initiatives to strengthen and expand Social Security. 

“Of course, the default response from conservatives will be to suggest, indirectly or otherwise that Social Security benefits must be cut to address the program’s funding shortfall,” states Richtman said. “Some will insist that Social Security be privatized, which would gamble workers’ hard-earned retirement benefits on Wall Street. Meanwhile, conservatives likely will oppose common sense revenue-side measures that would actually boost benefits, including Rep. Larson’s proposed adjustment of the payroll wage cap.”  For Congress to act to advance legislation to strengthen and expand Social Security, voters must put political pressure on their elected officials “to muster the political will to get it done,” says Richtman.

A Final Note…

It’s better to make changes to ensure Social Security’s solvency now, rather than waiting, suggests CRFB, a delay only adds more costs to fixing trust fund shortfalls in a timely fashion.“ Acting now allows more policy options, lets policymakers phase in changes more gradually, and provides more time for workers to adjust their work and savings, if necessary,” the fiscal advocacy group says.

The clock is ticking. There are almost 4,500 days until the project insolvency of the Social Security trust fund. It is now time for Congress to find viable, bipartisan solutions to fixing Social Security and Medicare, once and for all. 

The 276-page 2021 Social Security Trust Fund report is available by going to https://www.ssa.gov/oact/TR/2021/tr2021.pdf.

Trump’s Budget Proposal Comes ‘Dead on Arrival’ to Aging Groups

Published in Woonsocket Call on February 18, 2018

Last Monday, President Donald Trump released his 2019 budget proposal, “An American Budget,” providing guidance to Congress on how to spend hundreds of billions of dollars in new federal spending plan authorized by the Bipartisan Budget Act recently passed into law. Trump’s federal spending wish list clearly shows that many programs and services for older Americans will take a huge hit if any of these proposals are picked up by the Republican-controlled Congress.

The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) expresses concern that Trump’s budget proposal contains many of the same harmful proposals that the Administration and Republican-controlled Congress has pushed before, including $1.4 trillion in Medicaid cuts, $490 billion in Medicare cuts, and repeal of the Affordable Care Act.

Social Security on the Chopping Block

According to the NCPSSM’s analysis released this month, the President’s budget blue print calls for deep cuts to Social Security Disability Insurance, breaking his campaign promise not to touch Social Security.

Trump proposes to slash up to $64 billion from Social Security Disability Insurance (SSDI) benefits through eight demonstrations “ostensibly” geared toward helping disability beneficiaries to stay at work or return to work, says NCPSSM, noting that these Social Security Administration’s (SSA) demonstration projects, established in 1980, had only “a modest effect on beneficiaries’ workforce participation.”

NCPSSM’s analysis warns that the President’s proposed budget also calls for other benefit cuts for disabled seniors, including limiting the retroactivity of applications for disability benefits from 12 months to six months. It would also deny unemployment compensation payments to SSDI beneficiaries who work but get laid off. Social Security Income recipients that live together, even with families, would see their benefits reduced, too.

The Trump Administration also proposes $12.393 billion for SSA’s FY 2019 appropriation for administrative funding, says NCPSSM, warning that this $89 million funding cut will result in longer waits for decisions on initial disability claims and time to speak to a representative from SSA’s 800 number. “With 10,000 baby boomers reaching age 65 every day, SSA needs substantial yearly increases just to keep pace with increased workloads, says NCPSSM.

President Trump’s budget plan only funds production and mailing of only 15 million Social Security statements. “This proposal is part of SSA’s overall plan to limit sending statements only to individuals who are 60 or older rather than sending them to all workers every five years,” says the aging advocacy group, urging the Administration “to send these important financial planning documents to all workers, as is required in section 1143 of the Social Security Act.”

Medicare Takes a Blow

President Trump’s draconian budget calls for over $500 billion in cuts to Medicare, many of these savings coming from cuts to Medicare providers and suppliers. This is another campaign promise broken.

NCCPSSM warns that President Trump’s 2019 budget proposal also includes policy changes to the prescription drug benefit that would impact Medicare’s spending and beneficiary costs. It would create an out-of-pocket maximum for Part D. Medicare t beneficiaries with very high drug costs would no longer have cost sharing responsibility once they hit the catastrophic threshold. This would add $7.4 billion in costs over 10 years.

Trump’s budget proposal would also change the way the threshold for moving out of the coverage gap or “donut hole”” is calculated that would make it more costly to seniors to move through it. “Taken together with an out-of-pocket cap, it will mean savings for some seniors with very high drug costs, but costs will climb for a larger number of seniors. This saves $47.0 billion over 10 years,” reports NCPSSM.

Finally, Trump’s 2019 budget proposal saves $210 million over 10 years by eliminating the cost-sharing on generic drugs for low-income beneficiaries.

Hurting Medicaid Recipients

In FY 2015, federal and state governments spent about $158 billion or 30 percent of Medicaid spending on long-term services and supports (LTSS). The federal and state partnership pays for about half of all LTSS for older adults and people with disabilities.

The President’s 2019 budget proposal slashes the program’s funding by changing the structure of the program into either a per capita cap or Medicaid block grant, with a goal of giving states more flexibility of managing their programs. Through 2028, the president’s budget would cut $1.4 trillion from the Medicaid program through repealing the Affordable Care Act, restructuring the program.

NCPSSM expresses concern that if states lose money under per capita caps or block grants, state law makers would have to make up the funding themselves if federal funds do not keep up with their Medicaid population’s needs. This can happen by either by cutting benefits and/or limiting eligibility, requiring family members to pick up more nursing home costs, or scaling back nursing home regulations that ensure quality, service and safety protections.

And That’s Not All

NCPSSM’s analysis says that Trump’s budget proposal also calls for the elimination of the Older Americans Act Title V Senior Community Service Employment Program (SCSEP). The program, funded $ 400 million in FY 2017. provides job training to nearly 70,000 low-income older adults each year.

Community Services Block Grants ($715 million), the Community Development Block Grant ($3 billion) and the Social Services Block Grant ($1.7 billion) programs are also targeted to be eliminated. Some Meals on Wheels programs rely on funding from these federal programs, in addition to OAA funding, to deliver nutritious meals to at-risk seniors.

Trump’s 2019 Budget proposal would also eliminate funding for the Low-Income Home Energy Assistance Program (LIHEAP) This program received $3.39 billion in FY 2017. “Of the 6.8 million households that receive assistance with heating and cooling costs through LIHEAP each year, 2.26 million or one-third are age 60 or older,” says NCPSSM.

Trump’s budget plan also eliminates funding for Senior Corps programs including the Retired and Senior Volunteer Program, Foster Grandparents and Senior Companions. Current Senior Corps funding at the FY 2017 level is $202.1 million. “These programs enable seniors to remain active and engaged in their communities, serving neighbors across the lifespan, and benefitting their own health in the process. In 2016, 245,000 Senior Corps volunteers provided 74.6 million hours of service,” says NCPSSM. .

Finally, research into cancer, Alzheimer’s Parkinson’s and other diseases affecting older persons will be negatively impacted with $ 46 million in funding cuts to National Institute on Aging at the National Institutes of Health.

Aging advocacy groups view Trump’s second budget “flawed,” jam-packed with “damaging policies” for Congress to enact with an aging population. It’s “Dead on Arrival.” If Trump and GOP lawmakers choose not to listen to their older constituents, the results of the upcoming mid-term elections might just get their attention.