Tag Archives for Susan Sweet

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.

Confronting the Long-Term Care Dilemma in Uncertain Times

Published in the Pawtucket Times on January 14, 2002

 Aging advocates are about to find out how many slides you can cut the Rhode Island budgetary pie, especially when lawmakers are predicting that the state’s deficit could soar to hundreds of millions.

With the backdrop of a recession, pushing to keep funding at current levels for existing programs and services this legislative session may be their only hope as advocates for affordable health care and housing, education, disabled persons, seniors, and low-income families call for their fair share, too.

Meanwhile, CHOICES, a broad-based coalition of provider organizations and advocate organizations, will push this legislative session for more funding to keep Rhode Island seniors in their homes.

The coalition representing home care agencies, assisted-living facilities, adult day care, housing, senior center, disabled and senior advocates and Meals on Wheels, will continue its efforts to urge the General Assembly for reforms to Rhode Island’s long-term care system, said Paula Parker, Executive Director of Rhode Island Partnership of Home Care and a CHOICES member.

“Consumers must have options to choose programs and services that can provide them with greater independence in familiar surroundings,” Park told ALL About Seniors, adding that this is an underlying principle of CHOICE’S philosophy.

During the state’s prosperous years, Rhode Island’s allocation for home and community-based services slowly inched up from seven to eight percent of the state’s total long-term care budget.  Parker noted, however, that General Assembly funding for long-term care services continued to be heavily weighted toward funding institutional facility care.

“The challenge today is to continue the momentum of increasing state support for home and community-based services in less prosperous times,” Parker said, because the start’s rising elderly population creates a need to expand options in long-term care.

Susan Sweet, a consultant, long-time consumer advocate and CHOICES member, added that the seven-year-old coalition plans to continue its education efforts to inform legislators and the public about the cost savings of home and community care for elders as opposed to institutional care.

For example, Sweet stated that full-time adult day care five days a week may cost up to $ 10,000 annually as compared to an average $38,000 bill for nursing facility care.

Options in the state’s continuum of care include assistance with the costs of pharmaceutical drugs, community-based programs, rehabilitation facilities and nursing facility care. Sweet said, “A menu of available choices allows seniors and their families to seek out and receive the most appropriate and cost-effective care for their current situation. That’s what CHOICES is all about.”

Can long-term care options assist lawmakers in controlling the state budget while providing needed services for seniors?

Yes, said Sweet. “Not only is the quality of life greatly enhanced for elders and their families when institutionalization is delayed or eliminated, but also individual assets and state contributions to care through the Medicaid program are greatly reduced or eliminated,” she said.

Recognizing that lawmakers must work within severe budgetary constraints. Sweet said she believes it should be fiscally short-sided not to recognize the significant budgetary savings that home and community-based care- and preventative care- bring to situations that, without intervention, would lead to costly health care such as hospitalization and protracted institutional stays.

“The challenge for Rhode Island is to continue progress on creating less restrictive and less expensive community services while continuing funding for needed acute and long-term care,” Sweet said, stressing that in a tie of decreasing revenues, this will not be an easy task.

Lawmakers must either conform the long-term care crisis now for today’s seniors in the shadow of the state’s current budget deficit or in later years, when the state’s demographic time bomb I ready to explode. For today’s seniors and for the aging baby boomers who follow in their footsteps, lawmakers, state agencies, providers and seniors  must cooperate in crafting a seamless long-term care system with options that enhance quality of life and provide independence. This may take years.

But until then, amid competing interests for limited state dollars, advocates for better long-term care will have to roll up their shelves with the support of senior and disabled constituents to get this year’s slice of the state budget pie.

The Best of…New Strategies Needed to Reach Minority Seniors

Published April 16, 2001, Pawtucket Times

As expected, the U.S. Census Bureau’s 2000 census data reveals that the United States of America has truly become a “tossed salad” of races and ethnic groups.Rhode Island’s growing minority population reflects this national trend.  Minority groups represent about 25 percent of the state’s total population.  In Providence, minority groups are now in the majority.

The Hispanic population in Rhode Island, now representing 8.7 percent of the state’s total population, has doubled in the past ten years, climbing from 45,752 in the 1990 census to 90,820 in the latest census figures.  Eighty percent of this increase has occurred in Providence, Pawtucket and Central Falls.

Aging service providers will need to adopt new strategies and ways to enhance access to programs and services to a growing Hispanic senior population.

Census data does not always give us an accurate demographic snap shot of the nation’s population, warned Edgar E. Rivas, Vice President for Policy at the National Hispanic Council on Aging.  “We really don’t know how many Latino elders are out there because of the potential undercount of immigrant Latino elders,” he stated.

Oftentimes, Hispanic families are not accurately reflected in census data because of their own distrust of the U.S. Census Bureau, Rivas told The Times.  . “Even those aging service providers who have a knowledge base of serving this population will have a very hard time if the undercounted seniors come out of the wood work,” he said.

“Aging service providers will have to relearn how to conduct culturally appropriate outreach and to provide services in ways that are comfortable to their Hispanic clients,” Rivas added.  To often Latino elders may be eligible for services but because of the way the services are delivered, they don’t feel welcome to the services, he noted, ultimately the choose to rely on informal caregivers or just go without services.

According to Rivas, informational materials about programs and services will have to be rewritten to reflect the specific needs of older Hispanics.  For instance, the Health Care Finance Administration offers bilingual materials to explain federal programs, like Medicare and Medicaid.  Even with this material written in Spanish, many aging Hispanic elders are intimidated by the way the information is presented.  This problem can easily be corrected if Hispanic aging advocates develop more user-friendly materials (e.g., using Spanish language videos, peer educators or literature using pictures to illustrate issues).

Ann Hill, former director of the Providence-based Saint Martin de Porres Senior Center and well-known aging advocate, states that with a more ethnically diverse population, nonprofit agencies must hire personnel that can reach out, understand and meet the needs of various ethnic groups.  She calls for more public dollars to be provided to the agencies to help them accomplish this goal.

,Joan Crawley, Senior Center Director at the Leon Mathieu Senior Center, agrees.   With interpreters who speak Spanish and Cape Verdian Creole at Pawtucket’s senior center, non-English speaking CapeVerdian and Hispanic seniors can now come in to see a primary care physician, with a social worker on hand to interpret their medical complaints and to explain treatment plans.  The social work is also available to case manage any of the other social service needs that the Hispanic or CapeVerdian client may have.

“We’re always trying to increase the trust level between our staff and the ethnic seniors who come to our senior center,”Crawley added, noting that she wants them to feel comfortable bringing their problems to her staff.

Susan Sweet, Chairperson of the Rhode Island Elder Minority Task Force and a consultant for minority and nonprofit agencies, commented that she applauds “the efforts of agencies serving elders to diversity their staff and services to serve all the elders in their communities.  However, it is extremely important to acknowledge, support, and strengthen those agencies that have been and continue to be the basic resource for minority elders, such as Progreso Latino, Cape Verdian Community Development Association (CACD), and Projecto Esperanza, to name a few in the Pawtucket/Central Falls area.”

“No longer can we do business as in the past.  We must update our strategies of delivering programs and service to meet the new century of diversity,” Sweet said.