Senior groups ask House leadership for an “Age-Friendly Rhode Island” budget

Will House Leadership’s Budget Proposal Create an “Age-Friendly” State?

Published in RINewsToday on February 6, 2023

Over two weeks ago, Gov. Dan McKee unveiled his $13.8 billion proposed FY 24 Budget. To members of the aging community, the reaction is that this budget shortchanges seniors.  In an e-blast sent to 1,800 seniors and aging advocates, the Senior Agenda Coalition of Rhode Island (SACRI) described the proposed budget as unfriendly to seniors.

“Governor McKee’s proposed FY2024 budget that would take effect on July 1, 2023, ignores the needs of Rhode Island’s rapidly-growing older population,” noted SACRI, which represents 21 organizations with allied concerns. The budget document will reflect what lawmaker’s value and “as it stands, this budget fails to value us,” states the email.

Calls for creating an “Age Friendly” budget  

The SACRI legislative alert highlights how McKee’s FY 24 budget proposal is “senior lite,” noting that it provides minimal increases in funding for senior centers and Meals on Wheels.  More concerning, “it does nothing to address the larger investments needed to enable a growing number of seniors to age in the community.”

SACRI says the budget proposal has ignored requests from advocates and the community, even some requests that came from the RI Office of Healthy Aging (RIOHA). Specifically, the Governor’s budget did not include funding for additional RIOHA staff, in particular for its Adult Protective Services that received over 6,000 calls last year.

“For fourteen years we’ve urged the state to invest in improving The Point, but our requests have fallen on deaf ears. At community meetings with seniors and their caregivers of all income levels, we found their most frequent and compelling complaints were about their great difficulties in finding reliable information about available support and service options,” says SACRI, noting that very few seniors, or their adult children caregivers, even know that The Point exists. “But they are very well aware that without reliable and timely information about home and community-based care, their least-desirable and most expensive choice – nursing home care – often becomes the default,” says the legislative alert email,” he stated.

According to SACRI, the FY 2024 budget didn’t include increased Medicaid reimbursements to homecare and nursing home providers to raise their direct care workers’ wages and reduce workforce turnover. Nor did it include financial aid to help low and moderate-income seniors pay their Medicare Part B premiums and co-pays, as many other states have done.

The Ask…

SACRI is calling on House Speaker Joe Shekarchi (D-Warwick) and Senate President Dominick Ruggerio (D-Providence, North Providence) to support an “Age Friendly Budget.”  Why not improve funding for aging programs and services that ultimately benefit everyone in their later years?

More older Rhode Islanders are going to need to access programs and services to allow them to age in place at home. “Seniors strongly desire to “age in the community,” but the services that allow them to do that are often hard to find or simply unavailable. SACRI’s budgetary wish list includes increasing the minimum salaries of senior home care and nursing home care workers to $20 per hour, that’s a 50% federal match.

SACRI also calls for allocating $500,000 in first-time state funding for major improvements to The Point to provide information and referral services for seniors and their caregivers. This increased funding never made it into the FY 2024 budget proposal outlined in Gov. McKee’s Jan. 17th State of the State Address.

“With Rhode Island’s aging population skyrocketing, why not add five staff persons requested by the RIOHA, two of whom will work in its Adult Protective Services Program,” says SACRI. 

Finally, SACRI says the House budget should also include a provision to raise the income level for seniors to qualify for the Medicare Premium Savings Plan to save seniors close to $2,000 per year. Older Rhode Islanders are becoming poorer with higher numbers falling below the 2023 federal poverty level of $14,580 for a single person and with 28% of older households trying to live on less than $28,000 per year.”

The Aging Network speaks…from the front lines

Maureen Maigret, Chairperson of the Aging in Community Subcommittee for the Long-Term Care Coordinating Council (LTCCC), says that the “Age-Friendly Budget” proposed by SACRI is right on target with the needs of Rhode Island’s older population.

“More than ever, we need to address and adequately fund the services and supports that keep older persons living at home as long as possible. It is especially important for those aged 75 and over as one-half may need supports to remain living at home at the same time that their incomes start to decrease while their healthcare costs increase,” she says.

“The ‘Age-Friendly’ Budget Plan also aligns nicely with the strategic objectives and actions of the Strategic Plan of the LTCCC:s Aging in Community Subcommittee yet to be accomplished,” says Maigret, noting that lawmakers should view funds requested as wise investments that will help older adults remain living at home – where most wish to be – and prevent the use of much higher costs for nursing home care.

“Apparently, the Governor and his staff haven’t fully understood nor been sensitive to the struggles that the aging community has faced since the pandemic – more than 90% of the deaths in RI were individuals over 60, and 52% of the overall deaths were congregate care residents. Many are still frightened, isolated, hungry, and need community homecare or a caregiver,” says Vin Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service Agency.

Marzullo adds, “The Governor’s budget doesn’t provide any vision for an Age Friendly RI – which was to begin in FY2023 according to a 2019 RI OHA Strategic Plan,” adds Marzullo. “We have no coordinated path/strategy to build greater local capacity & support services for our growing aging population.”

“The McKee administration has yet to develop a Comprehensive Master Plan for Aging in RI despite a series of community conversations (Rhode Island 2030) during the Fall of 2021 and commitments made to the elderly during the 2022 Gubernatorial campaign,” charges Marzullo.

Other aging advocates had their views of McKee’s budget proposal

While they are appreciative that the Governor’s budget proposal fully funds the statutory nursing home inflation index of 5.4% plus a 1.5% labor add-on effective October 1, 2023, John Gage, President and CEO of Rhode Island Health Care Association (RIHCA) warns about a major issue facing Rhode Island nursing facilities. “The minimum staffing mandate that was passed in 2021 is largely an unfunded mandate and is impossible to comply with given the 20% reduction in the Rhode Island nursing facility workforce just since the start of the pandemic,” he says.

“RIHCA will work together with the Governor, the House Speaker, and the Senate President for short-term relief from the staggering penalty provisions of the minimum staffing mandate statute – fines estimated at $55-60 million in the first year of full implementation and nearly two-thirds of facilities being prevented from admitting residents after three quarters of their inability to comply by automatic admissions freezes,” he says. There are simply not enough workers to employ to meet the mandate, and fines of this magnitude would devastate the industry and lead to further facility closures,” he adds.

“The Rhode Island Senior Center Director’s Association (RISCDA) is focused on gaining funding requested by RIOHA Director Cimini for increased staffing, fully funding the Point, and supporting senior centers more fully with a funding formula that gets us to the rate of $10/person for non-institutionalized individuals 65 and over residing in each municipality,” says Robert Robillard, RISCDA’s president. “Shoring up services with funding will benefit not just our elders, but their families and caregiver’s alike,” he noted.

According to Robillard, the Governor’s presented budget includes a $200,000 increase for senior centers across our state. This is split between 39 communities based on the number of seniors living in each of the municipalities. “As we are pleased to see this movement to support senior centers more fully, [even with the additional funding] there are gaps within the system of care for our elders here in Rhode Island,” he says.

James Burke Connell, Executive Director, Age-Friendly Rhode Island, agrees with Robillard’s assessment of the key role senior centers play in Rhode Island’s long-term care continuum and the need for increased funding. “No, there isn’t sufficient funding toward the goal of making Rhode Island a great state in which to age, and I’m particularly concerned that the RIOHA will be under resourced to meet the needs of senior centers and older adult Rhode Islanders in general. Senior centers are the hubs of services and programs in every community, and they need greater support from our state, principally through significant increases in RIOHA’s capacity to support our aging population,” he says.

The McKee administration responds…

In responding to SACRI’s charges that McKee’s proposed budget was not “Age Friendly,” Derek Gomes, spokesperson for the state’s Pandemic Recovery Office says, “a single budget cannot address everything that the Administration is committed to accomplishing.” He noted that the Administration will work every year to make meaningful progress toward improving the quality of life for older Rhode Islanders and all the goals in RI 2030.

According to Gomes, the Governor’s proposed budget invests in older Rhode Islanders by including an additional $200,000 for senior centers, an additional $100,000 for Meals on Wheels, and $250,000 to digitalize an essential record of service that military veterans use to receive their benefits. The 2022 November Caseload Estimating Conference increased funding for long-term care by approximately $40 million in all, across Fiscal Year 2023 and Fiscal Year 2024, including a 6.9% rate increase for nursing facilities.

The battle of Rhode Island’s Fiscal Year 2024 budget moves to the House Finance Committee and ultimately for a vote on the House and Senate floor. It’s crucial that House Leadership begin the process of increasing funding for aging programs and services to move Rhode Island closer to becoming an “Age Friendly” state. Every taxpayer will ultimately benefit, because each one will ultimately have to access programs and services to allow them to age in place at home in their community.  

SACRI is planning a Legislative Leadership Forum scheduled for March 22, 2023, at Warwick’s Crowne Plaza. Save the Date. Stay tuned for details. https://senioragendari.org/

Advocates on aging issues review their priorities for Gov. McKee’s policy agenda

Published in RINewsToday on Nov. 14, 2022

Over 3 months ago, the Senior Agenda Coalition of Rhode Island (SACRI) invited the six Gubernatorial candidates to give the details of their aging policy positions to hundreds gathering at East Providence High School, and watching virtually. With the dust settling after the Nov. 8 midterm elections, aging advocates are asking the winner, Gov. Dan McKee, to place a high priority on enacting aging policies that he supported during SACRI’s 143-minute forum.

McKee goes on the record

McKee addressed the issue that Rhode Island nursing home and home care providers can’t provide sufficient and sustainable wages to attract and retain workers because of low state reimbursement. When questioned about how he would rebuild and sustain a viable workforce to provide services to seniors and persons with disabilities, the Governor stated he has addressed staffing issues at home health agencies and nursing homes by expanding the Wavemaker Fellowships to include healthcare workers and increasing reimbursement rates for home health agencies by $900,000 annually.

More seniors prefer to age in place at home in their community rather then enter nursing homes. McKee gave his thoughts about Medicaid rebalancing and expanding the program to keep seniors at home. He touted the $10 million invested this year to rebalance the long-term care continuum, announcing his plans to soon issue an Executive Order to direct state agencies to review existing policies through

At the forum, McKee stated he will also direct all state agencies to appoint a representative to a task force, also including municipalities and community-based nonprofits, that will create a Statewide Aging Plan to determine where federal monies and grants can be utilized to support older Rhode Islanders.

During the mid-1990s the Department of Elderly Affairs (DEA) had a staff of 65. Demoted to the Office of Healthy Aging within the state’s Department of Health and Human Services, Gov. McKee went on record that he will support legislation next year to make the state’s Office of Healthy Aging a full cabinet department. He pledged to provide an adequate budget and staffing to oversee its programs and services to Rhode Island’s growing senior population.   

Gov. McKee also supported a yearly cost-of-living increase to the state Supplemental Security Income payment in the 2024 proposed budget. He also supported the increasing of eligibility for the Medicaid Savings Programs for seniors and people with disabilities in the proposed 2024 budget by eliminating the asset test and increasing eligibility to at least 185% Federal Policy Level. 

With the state passing $250 million in funding for housing, Gov. McKee agreed to provide an adequate amount to support senior housing.  He stated: “we’re off and running”, noting that he recently announced an investment of $80 million to construct 825 units in 17 communities.  The Governor noted that his 2030 plan speaks specifically on the issue of senior housing.

Make aging policy a priority

“With the growing needs of seniors throughout the country and within our state it is time to return to a function of government which “had teeth” to enact change for elders who were at risk,” says Bob Robillard, LMHC, President of Rhode Island Senior Center Directors Association, representing 34 Senior Centers, noting that his aging group is pushing for the passage of bipartisan legislation next session that will elevate the Office of Healthy Aging to a full department – cabinet – status. 

According to Robillard, having a seat at the table as a cabinet position, the Director would directly advocate with the Governor’s Office to address unmet needs and seek creative solutions for our seniors. 

Robillard also urged the Governor to continue efforts to develop secure and affordable housing that meets the need for increased  homelessness of Rhode Island seniors. ”Their income level and having to make difficult choices to survive each month is seen in our interactions with seniors every day, and they are increasingly utilizing food banks, emergency services, and our centers, and funding these basic services needs to be a top priority,” he says.

While some federal funds have been used to address this issue, Robillard says there is a “global need for a full and comprehensive Aging Plan for Rhode Island including the voices of direct service providers like the Senior Centers, senior advocates, caregivers and, of course, seniors, themselves.” 

Finally, Robillard believes that there should be a strong focus on transportation for seniors to access their community. “Safe, respectful and person-centered transportation in our rural areas throughout our state needs to be a focus,” he says, noting that if you cannot access your community in these ways then you cannot participate in them either.

With Rhode Island experiencing a critical shortage of homecare workers, Maureen Maigret, chair of the Long-Term Care Coordinating Council’s Aging in Community Subcommittee, calls on Gov. McKee to provide funding in the FY2024 budget to increase wages for CNAs working in home care. “The current budget includes $10 million to rebalance long term care. These funds should be used for wage increases for homecare direct care staff as an initial step to bring these invaluable workers fair wages,” says Maigret.

“It is also important to provide more resources to the Office of Healthy Aging and support for local senior services. Governor McKee started to increase funds for local aging services in the current budget and the Office of Healthy Aging has requested funding to provide each community ten dollars per person aged sixty-five and over next year,” adds Maigret, urging the Governor to include this in the budget he presents to the legislature for FY2024 as well as other funding requested by the Office including $.5million to support the state’s Aging and Disability Resource Center known as THE POINT. 

Gerontologist Deb Burton calls for the Governor to move forward to pass an Olmstead Plan to create opportunities for individuals to live in the least restrictive environments. “The Olmstead Plan would fit hand in glove with providing resources for individuals to age in the community, and not in institutions,” says Burton, who serves as Executive Director of RI Elder Info.  

Finally, Vincent Marzullo, well-known aging advocate who served as a federal civil rights and national service administrator, suggests that McKee direct the RI Commission for National/Community Service to identify AmeriCorps (national service) opportunities that would help build capacity and service delivery for our local senior centers and human services offices.  “Their needs have grown considerably during COVID,” says the West Warwick resident.

Editor’s Note: During the COVID weekly press conference time, Gov. Raimondo noted that changes need to be made in how people live in Rhode Island’s nursing homes, both from a communicable disease point of view, and from a humanity point of view. She announced a fund of $5 million to be put aside to support nursing homes transitioning their physical “plants” to be single room – single bathroom accommodations. Since Raimondo left office, there has been acknowledgement that this fund was set aside, but no action taken to address the mandate moving forward.

Tele-Town Hall Gets the Word Out About COVID-19

Published in Woonsocket Call on May 3, 2020

This week alone, AARP in some 30 states conducted tele-town halls and 123 state calls have taken place since the pandemic surfaced. AARP Rhode Island, representing 132,000 members age 50 and over, was among the very first states to address the pandemic in a tele-town hall over two weeks ago.

At the AARP Tele-Town Hall, held Wednesday, April 22, during the 56-minute live event, state officials came to answer questions about how to cope with the devastating COVID-19 pandemic and how seniors can protect their health and stay safe. AARP Rhode Island’s John Martin, Communication Director, served as host and the panel of experts featured Office of Healthy Aging (OHA) Director Rosamaria Amoros Jones and Rhode Island Department of Health Medical Director Jim McDonald.

“We had 3,050 participants and, at one time, 974 people were on at the same time,” says Martin, who hosted the call. “We took 18 live calls in 55 minutes and, unfortunately had close to 20 people waiting to speak when time expired,” he adds, noting that it was AARP Rhode Island’s largest tele-town hall audience ever.

According to Martin, “Our in-call interactive poll revealed that nearly three quarters of those who cast votes were most interested in local resources and information on how to prevent the spread of the coronavirus, About a quarter said they were looking for help caring for family and loved ones, and information on insurance.”

Adds AARP State Director Kathleen Connell, “We were extraordinary pleased with the response to the tele-town hall,” who said she expects more statewide calls. “Just as important, however, is our virtual engagement with members and especially our volunteers. We are getting used to communicating online because that is where all of our ‘personal’ contact will be taking place, at least in the next few months — and that will include video conferencing, which we are testing now. We are impressed at how eager people 50 and older are ready to master the technology and join in.”

State Officials Talk COVID-19

“We are at a point where we are starting to see the benefits of our collective efforts of [maintaining] physical distancing, states OHA Director Jones. It is flattening the curb where the peak number of people requiring care at a time is reduced and the health care system is not overwhelmed, she says.

“It is really important for us that social or physical distancing as we also refer to it does not equal social isolation,” says Jones, noting that innovative approaches can keep people engaged with each other during this time of physical distancing.

Jones also gave a plug for Project Hello (http://oha.ri.gov/get-involved/volunteering/), a program that matches older adults with someone in the community for regular chats and for mutual support. “We’re in it for the long haul and it is going to take all of us working together neighbors helping neighbors,” she says.

“Effective quarantine and isolation efforts are critical today,” says Jones. “Our focus is on making it as easy and as comfortable as possible right now to stay home as we ready ourselves for the new normal that is on the other side of the pandemic,” she adds.

Jones called for those in quarantine and self-isolation reach out to Shopping Angels (www.facebook.com/shoppingangelsinc/) for assistance in personal shopping.

One caller expressed strong concern about Governor Gina Raimondo’s comment that people over age 60, at greater risk of severe COVID-19 illness, would be required to stay home for a longer period of time before being allowed to return to work or participate in community activities. “There have been no definitive decisions to implement restrictions at this time,” said Jones trying to reassure the caller.

Although there are programs and services detailed on the internet that can assist older Rhode Islanders to cope with the COVID-19 pandemic, one caller asked how these could be accessed without a laptop, computer or smart phone. Jones noted that The Point (http://oha.ri.gov/get-help/), operated by United Way Rhode Island and linked through 211 or by dialing (401) 462-4444, could provide information, referrals to needed programs and services.

How would people age 60 and over be protected against age discrimination when the governor is stating that it might take a longer time for these individuals to return to work? asked a caller. “It’s something we are thinking a lot about and a lot more [will] come as we talk about what the new normal is going to look like as we come through the peak of the pandemic, says Jones, stressing that age discrimination would not be tolerated.

Jones called for listeners to visit NextDoor.com, a website that promotes volunteer opportunities (including the delivery of groceries for seniors and those in quarantine), to see how they could help those impacted by COVID-19. For those seeking information about housing, Jones recommended a site, RI Havens, that provides a listing of hotels with affordable room rates for front line workers and for those persons stranded because of the virus and might need a safe place to stay. Details about food delivery options and food assistance programs can be found at the site, RI Delivers, that connects those in quarantine or isolation due to COVID-19 with opportunities to have food delivered by local and big-box grocery stores.

One caller asked Dr. James McDonald, Medical Director at RI Department of Health (DOH), about how a person could improve their immunity to assist them to successfully combat COVID-19. “You can’t always control the virus but you can control yourself,” says McDonald, stressing the importance of eating a healthy diet, regularly exercising and losing weight are actions to take to improving your health.

Making COVID-19 Transparent in Rhode Island’s Nursing Homes

During the Tele-Town Hall, McDonald was asked a question, “Why can’t the Health Department provide a list of long-term care and assisted living facilities that will show the number of patients/residents who have tested positive for COVID-19 and the number of facilities.” Twenty-four hours later this list appeared on the DOH Coronavirus Data Hub. (https://ri-department-of-health-covid-19-data-rihealth.hub.arcgis.com/).

McDonald noted that this particular virus has been so effective in causing the pandemic because it takes so long for a person to show symptoms and that other people who have it sometimes spread the virus before they even have symptoms and they don’t even know they should isolate because they don’t feel ill. It becomes important for a person to wear a mask when going outside to stop the spread of the virus, he says.

MacDonald says that it is highly unlikely to catch COVID-19 by touching grocery bags placed on your porch or through picking up a letter or package. He suggests constantly using hand sanitizer and washing your hands before and after picking up items touched by others.

AARP has created a special web page, http://www.aarp.org/RICOVID for coronavirus information and resources,” says AARP Rhode Island’s Martin added. “There you will find information about our ‘Community Connections’ program, aimed at combating isolation and loneliness, and a direct link to http://www.aarp.org/coronovirus, where all of AARP’s resources can be found.