Aging Advocates Call for Override of Governor’s Veto

Published in Pawtucket Times on July 14, 2003

The General Assembly is poised to override  Gov. Don Carcieri’s veto Tuesday.

The political rhetoric has intensified as the governor picks apart the 2004 budget, which was recently passed by the Democratic-controlled legislature, forcing Democratic Majority Leader William J. Murphy and Senate President William V. Irons to explain how they shaped the budget.

Carcieri has called the General Assembly’s 2004 budget flawed because lawmakers have “missed opportunities” to stop the legislature’s habit of deficit spending.

The governor’s media blitz, beginning last week, is intended to build support for his efforts to defeat the legislature’s attempt to override his veto. Carcieri has called for the elimination of subsidies for greyhound kennel owners [also supported by this writer] and the reining in public-employee personnel costs.

Carcieri also opposes the spending of $ 52 million in federal Medicaid expenditure relief funds and the one percent restaurant sales tax.

When the dust settles after Tuesday’s legislative session to override Carcieri’s veto, aging advocates hope for an override. The 2004 budget crafted by the Democratic-controlled General Assembly puts increased state funding into senior programs and services.  Both provider groups and senior advocacy groups expressed disappointment when Carcieri’s budget proposal did not allocate funding for new aging-related initiatives. Moreover, his fiscal blueprint for state spending made cuts to existing senior programs and services.

“Once again, senior advocates have looked to the General Assembly to provide essential programs and services for the state’s growing senior population,” says Susan Sweet, a long-time aging advocate and consultant to nonprofit groups who also serves as a consumer representative to the state’s Long-Term Care Coordinating Council.

“We have not been disappointed,” Sweet said, in reference to the passage of the General Assembly’s 2004 budget.  “It’s sad that the Carcieri administration does not recognize the improvements the General Assembly has made to the budget and the lives of older Rhode Islander.”

Joan Crawley, executive director of Pawtucket’s Leon Mathieu Senior Center, added, “Although I can appreciate Carcieri’s frustration with trying to balance the state budget, as a senior advocate, I applaud the legislators for making the very difficult decision to fund legislative grants on behalf of the state’s  senior centers,” she said.

“At the Pawtucket town meeting, gubernatorial candidate Carcieri assured us that seniors would be a top priority of his administration should he be elected governor. He even distributed a brochure outlining his senior initiatives. So far, he has failed to address any of those initiatives in is budget, Crawley says.

So, what’s in the General Assembly’s 2004 budget that will improve the quality of life of Rhode Island seniors?

The budget will allocate new state funds totaling $ 300,000 to pay for nursing facility care of legal immigrant Rhode Island seniors who are not eligible for Medicaid.

The budget will also allocate $ 50,000 to support the efforts of the Ocean State Adult Immunization Coalition to get the word out about the importance of seniors getting influenza and pneumococcal vaccinations.

Meanwhile, lawmakers have allocated state monies for community grants. Initially, senior centers (in Carcieri’s budget ) were targeted with a 10 precent cut. To the relief of senior center providers, lawmakers passed the 2004 budget with no cuts

As previously reported to All About Seniors, an 18-month study by B.D.O. Seidman, a consulting firm hired by the state Department of Human Services, found Rhode Island was underpaying its nursing facilities in excess of $ 30 million annually.

It seems that the Rhode Island General Assembly agrees with the report’s assessment, because lawmakers made a partial allocation of new Medicaid dollars to overhaul the state’s ailing Medicaid system.

With passage of the budget, nursing facilities will receive a total of $ 18.8 million in state and federal dollars – a three-year phase-in will bring the total federal and state dollars up to $ 30 million.

Finally, the recently passed 2004 state budget has allocated $ 50,000 to provide dental services to nursing facility residents.

The 2003 budget that was supposed to expire June 30 stays in effect until Carcieri signs the 2004 budget into law. Until that time, new programs, policies, or program appropriations will be effectively put on hold.

An override of Carcieri’s veto will result in many new senior programs and services being funded in the 2004 state budget.

If the popular Republican governor is able to rally is troops – both Republican lawmakers and Carcieri Democrats – to support his veto, then lawmakers must begin their efforts to hammer out another budget.

….

As noted in last week’s All About Seniors column, not one dime in state funding was allocated in the state’s 2004 budget to beef up the state Department of Health’s regulatory oversight. Providers, aging advocates, and even state officials have called for new state dollars to fill one full-time surveyor position (a nurse) to ensure that assisted living residences across Rhode Island are inspected on a timelier basis.

The General Assembly has put laws on the books to protect frail Rhode Island seniors who received assisted-living services. Yet, Carcieri and lawmakers have failed to allocate the necessary funding in the 2004 state budget to allow Health Department regulators to comply with    their legislative oversight duties to inspect the state’s 72 assisted-living facilities and 155 assisted-living bed in nursing facilities on a timely basis.

That’s not all.  According to the state’s Department of Health, another seven assisted-living projects are expected to be up and running over the next 18 months.

Meanwhile, at Tuesday’s veto override, lawmakers will also take up legislative issues were not addressed in their haste to adjourn two weeks ago.  Maybe the state Health Department’s urgent need for more funding to adequately perform its oversight duties of assisted-living facilities will be acted on by lawmakers in both chambers.

Carcieri can become the white knight and save the day. He can choose to move forward and fix this policy flaw by either using contingency funds in his office budget or to take administrative action to hire one more full-time assisted living inspector.

Acting decisively to fix tis identified policy glitch is sound public policy that will ultimately protect the health and well-being of 1,700 assisted-living residents. Even with Carcieri’s calls for balancing the budget, taxpayers especially seniors won’t oppose allocated tax dollars to protect older Rhode Islander.

Advocacy Groups Support Bills Making Pharmaceutical Drugs More Affordable

Published in the Pawtucket Times on April 21, 2003

The Gray Panthers have been around the Ocean State since 1975.

Richard Bidwell, state coordinator of the Rhode Island Gray Panthers, which represents 400 members state-wide, said his group has fought on behalf of seniors and disable persons on many aging and consumer-related issues.

He recalled one legislative victory that enabled seniors and disabled persons to use a special RIPTA bus pass and ride free during off-peak hours. Later the Gray Panthers would successfully expand this use to all times.

As state coordinator, Bidwell has been involved in lobbying the Rhode Island General Assembly on behalf of the state’s growing senior population for more than 14 years. Last year, the Gray Panthers coordinated their efforts with senior advocacy groups to organize the Senior Agenda Consortium.

This year, the Consortium turns its attention to four legislative proposals that will assist seniors in paying for costly pharmaceuticals.

“We’re trying to get them out of committee with favorable votes,” Bidwell told All About Seniors.

The group has locked horns wit Blue Chip in an attempt to lower prescription drug prices for older beneficiaries who have signed up for that health plan.

S 566, introduced by Sen. James Sheehan (D-North Kingston) would require health plans, such as Blue Chip, to pass on their drug discounts to their members. Blule Chip’s highest premium (costing $148 a month) allows senior beneficiaries to purchase up to $ 1,000 worth of brand-name drugs a year, being charged only a $ 25 co-pay for reach prescription.

This premium also allows a person to purchase up to $ 5,000 in generic drugs, with an $ 8 co-pay charged for each prescription.

Bidwell said that with each purchase of a prescription, Blue Chip subtracts the retail price rather than the actual contracted lower price allowed by the insurance company for the purchase.

As a result,” People are being charged too much,” Bidwell said. “The $ 1,000 coverage is disappearing too quickly with the purchase of each prescription drug.

“Our legislation allows Blue Chip to subtract only the contracted actual price of the prescription rather than the much higher retail price.”

“At press time, the Gray Panthers are attempting to find a House sponsor for this legislation.

A related bill, H 5237, sponsored by Rep. Peter Ginaitt (D-Warwick) and S 374, sponsored by Sen. Elizabeth Roberts (D-Cranston), would allow a person eligible to participate in the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE), who also has prescription drug coverage through a health plan, to use RIPAE to pay for an individual prescription drug once they reach a maximum level of coverage for that drug.  Currently access to RIPAE until he or she uses all of the brand and generic allowance by Blue Chip.

Meanwhile, Bidwell noted that the Gray Panthers are also pushing H 5239, sponsored by Sen. Mary Ellen Goodwin (D-Providence), for expanding RIPAE to allow persons ages 55 to  61 on Social Security Disability Insurance to receive RIPAE co-payments at the same level as Ocean State seniors.

Finally, another legislative proposal, H 5478, sponsored by Rep. Fausto Anguilla (D-Bristol-Warren) and S 299, sponsored by Sen. Rhode Perry (D-Providence), would allow Rhode Island residents to buy prescription drug from Canadian pharmacies, where they are routinely cheaper.

Susan Sweet, an elder rights advocate consultant to non-profit groups and a member of the Senior Agenda Consortium, has called for the passage of these bills, which are key to creating a “responsive and less costly” long-term care system.

“Pharmaceutical drugs may be expensive, but they are certainly less expensive than hospitalization, nursing home care, and other medical services required as a result o a senior not having or taking the prescribed medication,” said Sweet.

“It is primarily the advances in pharmaceutical therapy that have enabled seniors to live longer and healthier lives. By permitting more access for seniors and persons with disabilities to afford their prescriptions, state policy makers can save people’s lives and ultimately save taxpayer money by preventing more costly interventions,” added Sweet.

At the AARP gubernatorial debate, seniors called for state government intervention in putting the brakes of rising pharmaceutical costs.

The calls for action continue to grow. During this legislative session, the Gray Panthers, AARP, the RI Commission on Aging, along with the Forum on Aging and the Senior Agenda Consortium, have made this legislative issue a high priority.

It is time for Gov. Don Carcieri and the leadership of the General Assembly to tackle this senior issue head-on and allocate the necessary state funds to help make prescription drugs more affordable for Rhode Island seniors and persons with disabilities.

Because of the growing costs of medication, a large number of seniors cannot afford to fill their prescriptions, many do not event take their prescriptions as directed by their physicians.”  Noncompliance in taking medications or not taking them at all can result in unnecessary hospitalization, premature admission to nursing facilities, and untimely death.

Even with the state’s looming budget deficit, enabling seniors to afford the purchase of needed pharmaceutical drugs will hopefully be placed on the General Assembly’s short list of bills that must be enacted this legislative session.

Call Senate President Bill Irons at 401-222-2447 and House Speaker Bill Murphy at 401- 222-2466 to tell them of your concerns about this issue and how   the high cost of prescription drugs hits you in your pocketbook.

Urge these key lawmakers to pass legislation that makes pharmaceuticals more affordable to all seniors and persons with disabilities

Senior Advocates Push Legislation That Would Save State Money

Published in the Pawtucket Times on April 14, 2003

While the Rhode Island General Assembly is tackling hot-potato political issues like separation of powers and gambling, hundreds of bills have been thrown into the legislation hopper. Senior advocates are tracking about 13 legislative priorities in the 2003 legislative session.

Lawmakers are considering a wide array of legislation -creating long-term care tax credits, expending the Rhode Island Pharmaceutical Assistance to the Elderly Program, strengthening the state’s ombudsman’s office and ratcheting up Medicaid payments to nursing facility providers. One bill would establish special funds to care for severely disabled (age 65 and over) legal immigrant elders who are not eligible for Medicaid.

As they deal with a huge state budget deficit, Gov. Don Carcieri and lawmakers will be wary of enacting legislation that will have a fiscal impact on the state coffers.

But senior advocates are pushing for enactment of several legislative proposals that are either budget neutral or will actually save taxpayer dollars.

One legislative proposal (H 5841/S 876) that would create revisions to the state long-term care ombudsman law to expand the scope and authority for this state’s elderly advocate.

“Previously, the Rhode Island state statute has not reflected federal law, and this bill remedies that oversight,” said Roberta Hawkins, executive director of the Alliance for Better Long-Term Care and  state ombudsman, who noted federal law requires each state’s ombudsman statute to reflect the federal Older American Act.  Currently, Rhode Island’s statute does not.

Hawkins said the proposed statute changes also add additional duties authorized by the federal Older Americans Act to those required of the ombudsman under Rhode Island law. Companion bills introduced in the House and Senate call for the state ombudsman to represent the interest of nursing facility residents or clients of service providers before  government agencies, and to seek administrative, legal and  other remedies to protect their health, safety, welfare and rights.

They also mandate that the state ombudsman review and comment on any existing and proposed laws, regulations and state policies impacting nursing facility residents and clients of service providers.

The legislative proposals would make a new section of the state ombudsman law that fines a person up to $ 1,000 who willfully interferes with the ombudsman duties.

At press time, these bills were approved by the House’s Health Education and Welfare Committee and the Senate’s Health and Human Services Committee for consideration for floor action at a later date.

Meanwhile, Susan Sweet, an elder rights advocate who also consults for nonprofit agencies, noted two legislative proposals would actually save the state money while providing more appropriate services to older Rhode Islanders.

Sweet said these legislative proposals (H 5246/ S 314) would require the Department of Human Resources to reallocate funds to support already federally-approved assisted-living support services. At present, more than 35 people have qualified for this program but still remain in costly nursing facilities (at $ 130 per day) rather than reside in assisted living facilities which cost approximately 50 percent what the state is paying for nursing facility services.

At press time, these legislative proposals are still under consideration in the Senate and House Finance committees.

“If the General Assembly fails to enact funding for federally approved assisted living services, I would hope they would reallocate resources to at least allow those currently on the waiting list – some of whom are already in  nursing facilities costing the state twice as much = to be under the waiver,” said Sweet. “This would save half of the money currently being paid while providing these elders a better quality of life.”

Another legislative proposal (H 5418/ S 506) said Sweet, would establish a fund for severely disabled elderly legal immigrant Rhode Island residents who are not eligible for Medicaid.

Presently, these legal elderly immigrants receive care only from hospital. Sweet said there are currently four or five of these disabled elders residing at Eleanor Slater Hospital at a cost to taxpayers of $ 749 per day per person. If this legislation were enacted, these severely disabled elders could be transferred to a nursing home at the Medicaid rate of less than $100 per day.

At press time, these legislative proposals are still under consideration in the Senate and House finance committees.

Sweet noted the requested allocations for placement in nursing facilities for disabled elders who are legal immigrants is just $ 250,000 a year.

“Considering that we know that care for one persona at Eleanor Slater Hospital costs the state $ 749 per day, more than $ 273,000 annually passage of this bill is a no-brainer,” says Sweet. “In times when money is tight, there is more reason to save money while providing more appropriate services to our elders.”

In the shadow of a huge budget deficit, the Rhode Island General Assembly now has the opportunity the state money. They should seize the day by enacting they legislative proposals.