Tag Archives for Vin Marzullo

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/

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Problem Solvers Caucus may be key to re-establishing Committee on Aging

Published in RINewsToday on Jan. 16, 2023

H.R. Res. 583, Reestablishing the Permanent House Select Committee on Aging (HSCoA), chances were growing slim in getting Congressional attention for passage in the final days of the 117th Congress. Extensive media coverage of the ongoing Ukraine War, the wrap up and issuance of the Jan. 6th hearing’s report and midterm election coverage kept Congressman David Cicilline’s (D-RI) resolution from getting political traction from being considered by the House Rules Committee for ultimate passage and floor action.

The HSCoA was a permanent select committee of the U.S. House of Representatives between 1974 and 1992. The committee was initially created with the intent not of crafting legislative proposals, but of conducting investigations and holding hearings to put the Congressional spotlight on aging issues. Its purpose was to push for legislation and other action, working with standing committees, through regular committee channels. If  H. Res. 583 was passed by the House Rules Committee, it would have brought back the HSCoA. No Senate action was required.

According to the Congressional Research Services, it is a very simple process to create an ad hoc (temporary) select committee by just approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other issues that need to be address.  Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

Taking a Looking Back

Last Congress, Cicilline’s H. Res 583 would reestablish a HSCoA without having legislative jurisdiction, this being no different than when the select committee previously existed. It would be authorized to conduct a continuing comprehensive study and review of aging issues, such as income maintenance, poverty, housing, health (including medical research), welfare, employment, education, recreation, and long-term care. These efforts influenced legislation taken up by standing committees.

H. Res. 583 would authorize the reestablished HSCoA Committee to study the use of all practicable means and methods of encouraging the development of public and private programs and policies which will assist seniors in taking a full part in national life and which will encourage the utilization of the knowledge, skills, special aptitudes, and abilities of seniors to contribute to a better quality of life for all Americans.

It would also allow the HSCoA to develop policies that would encourage the coordination of both governmental and private programs designed to deal with problems of aging and to review any recommendations made by the President or White House Conference on Aging in relation to programs or policies affecting seniors.

Cicilline’s H. Res. 583 drew the support and attention of the Max Richtman, President and CEO of the Washington, DC-based Leadership Council on Aging and a former Staff Director of the Senate Permanent Special Committee on Aging, along with President Nancy Altman of Social Security Works, and Chair of Strengthen Social Security Coalition.   

Robert Weiner, former chief of staff of the HSCoA, Tom Spulak, former staff director and General Counsel of the House Rules Committee and Vin Marzullo, a well-known aging advocate in Rhode Island, including this writer were strong advocates for passage of this resolution.

Although H. Res. 583 had strong backing from the aging network, the bill never was endorsed by House Speaker Nancy Pelosi nor considered by the Democratic controlled House Rules Committee As a result, the resolution never reached the House floor for a vote. As a result, the resolution died at the end of the 117th Congressional session.

The House must reestablish the HSCoA

It is now crucial for Cicilline to reach across the aisle for Republican cosponsors when he reintroduces H. Res. 583 during the new Congress. The need for reestablishing this investigative committee still exists today as when it was first introduced eight years ago.

“America’s seniors have spent a lifetime working hard and moving our country forward and they deserve the financially secure retirement that they worked and paid for. The pandemic disproportionately impacted seniors, and now those with fixed incomes are bearing the burden of inflation and the higher costs food, housing, and other essentials,” says Cicilline.

“I’m extremely proud that we were able to institute a $35 cap on insulin costs and bring down prescription and medical costs for seniors through the Inflation Reduction Act, but there is more work to be done. Reauthorizing the House Permanent Select Committee on Aging will give us the dedicated staff and resources necessary to study and address the issues that affect seniors to make sure they can live the rest of their lives with dignity and security,” adds Cicilline.

“It is vitally important that we ensure Rhode Island seniors have the financial security, access to high quality health care and quality of life they have earned. For this reason, I am proud to support the reestablishment of the HSCoA, and encourage my colleagues on both sides of the aisle make senior citizens’ issues a priority in the 118th Congress,” adds newly elected Congressman Seth Magaziner.

In the article, “Senior’s Need House of Reps to Bring Back Aging Committee,” I previously coauthored with Tom Spulak and Robert Weiner on this statewide news blog last July, provides the rational and reasoning for reestablishing the HSCoA.

Specifically…

“Every day, 12,000 Americans turn 60. By 2030, nearly 75 million people in the U.S.—or 20 percent of the country—will be age 65 or older. As America grows older, the need for support and services provided under programs like Social Security, SSI, Medicare, Medicaid and the Older Americans Act also increases,” and the need for re-establishing the HSCoA becomes even more important.”

“Historically, the HSCoA served as a unique venue that allowed open, bipartisan House debate from various ideological and philosophical perspectives to promote consensus that, in turn, helped facilitate the critical work of the standing committees. Addressing the needs of older Americans in a post-pandemic world will require this type of investigative, legislative oversight, work which can only be advanced and promoted by reestablishing the HSCoA.”

“As Americans are aging, we also face a variety of intergenerational concerns that merit the investigation by the HSCoA, such as growing demands on family caregivers and a burgeoning retirement security crisis.”

“Restoring the HSCoA would provide the House with an opportunity to more fully explore a range of aging issues and innovations that cross Standing Committee jurisdiction of importance to both Republicans and Democrats, while holding field hearings, convening remote hearings, engaging communities and promoting understanding and dialogue.”

“Today, the Senate Permanent Special Committee on Aging is working on everything from scams against seniors to increasing HCBS services, to calling out questionable billing practices by Medicare Advantage insurers. Seniors have been better off over the last 30 years with a Senate Aging Committee in existence — and the Senate investigative committee would benefit from a reestablished HSCoA, whose sole mission would be to look out for older American.”

“Over 30 years ago, working closely with authorizing committees with jurisdiction over aging programs and services, the HSCoA put an end to mandatory retirement.  Alzheimer’s became a household word because of its investigative hearings. Legislation was passed to improve the quality of care in the nation’s nursing homes, even creating the nation’s National Institute’s for Health.“

Centralist to play key role in passage 

“This is a unique moment in time where centrists from both sides in the House could influence legislative action thru genuine bipartisan collaboration”, said Vin Marzullo, who served 31 years as a career federal civil rights & social justice administrator at the National Service agency.   “I am urging our newly elected Congressman, Seth Magaziner, to join with the lead sponsor, Congressman David Cicilline, in the re-introduction of the House Resolution to re-establish HSCoA. 

Additionally, I would advise that bipartisan efforts begin by reaching out to Congressmen Brian Fitzpatrick (R-PA and Josh Gottheimer (D-NJ), co-chairs of the “Problems Solvers Caucus,” for their co-sponsorship/support”, added Marzullo.  “That could be a pathway for better legislating and governing and Congressman Magaziner stated during the campaign that he’d look for common ground with members on the other side of the aisle.  This is it — we need an adult conversation about the Aging of America and how we intend to aid and support our elders, caregivers, and long term care options.”

We’ll see if Cicilline and Magaziner tag-team for a fifth attempt to reestablish the HSCoA.  For the sake of improving the quality of life of America’s seniors, House Speaker Kevin McCarthy (R-Calif) must put politics aside and work with a Bi-Partisan Coalition and the Democratic Caucus, to achieve real results for our nation’s older adults. 

For details about the House Problem Solvers Caucus, go to  https://problemsolverscaucus.house.gov/.

Lawmakers can do more for Seniors next year

Published in RINewstoday on July 11, 2022

Just days before July 1, 2022, Gov. Dan McKee was joined for the signing of the $13.6 billion state budget (2022-H7123aa) for fiscal year 2023 by Lt. Gov. Sabina Matos, House Speaker K. Joseph Shekarchi, Senate President Dominick J. Ruggerio, House Finance Committee Chairman Marvin L. Abney and Senate Finance Committee Chairman Ryan W. Pearson.

Taking a Look at the Budget’s Dollars and Cents

Let us take a look as ho the state’s FY2023 budget, signed by McKee on June 27, 2022, impacts older Rhode Islanders.

The budget doubled the funding for the Livable Homes Modification Program, from $500,000 to $1 million, which reimburses half the total retrofit costs, up to $4,000, to support home modifications and accessibility enhancements to allow individuals to remain in community settings. The increase is intended to address an anticipated surge in applications.

For retirees, the Assembly raised from $15,000 to $20,000 the amount of annual pension income that is exempt from state taxation.

The FY 2023 Budget also allocated an additional  $200,000 to the Office of Healthy Aging’s budget for senior centers, bringing total funding to $1 million. That is a 25% increase.

The budget also makes significant investments in the quality of healthcare for seniors, providing rate increases to many kinds of providers of health care, nursing homes, home and community-based services for elderly (increase in starting pay to $15 hour), in addition to seeking a study by the Office of the Health Insurance Commissioner on appropriate reimbursement rate levels into the future.  The budget also includes substantial increase to reimbursement rates for Meals on Wheel meals ($400,000), ensuring that the program is able to provide high-quality therapeutic and culturally appropriate meals to participants.

Lawmakers also added $4 million to increase the “circuit breaker” tax credit available to qualifying elderly and disabled residents, raising the maximum credit from about $400 to $600 beginning in tax year 2022 and indexing that amount to inflation. They also made credit available to more Rhode Islanders by increasing the income threshold for eligibility from $30,000 to $ 35,000.

Those with military pensions will no longer have to pay any income taxes on them, beginning in the 2023 tax year. The governor had proposed phasing out military pension taxation over five years, but legislators instead made them tax-free in their entirety in one year.

Lawmakers also kept the Governor’s plan to invest $168 million in upgrades to Eleanor Slater Hospital, including $108 million to construct a new long-term care acute care hospital at the Zambarano campus in Burrillville.

The plan accelerates the six-year phase-out of Rhode Island’s motor vehicle excise tax, eliminating what would have been the final year of the tax next year.  The amended budget provides replacement license plates for free.

The state budget included a year-long pilot program to provide free service on the Rhode Island Public Transit Authority’s business route, the “R” line that runs from Pawtucket to Cranston.

It also added $11.5 million general revenue funds to launch a retail Supplemental Nutrition Assistance Program (SNAP) pilot program, beginning Jan. 1, 2023.  Eligible households would receive an incentive payment of 50-cents for every dollar spent on fruits and vegetables, subject to limits.  The state also requested a waiver from the Federal Nutrition Service to streamline the application process for elderly and disabled individuals seeking assistance from the SNAP program.

Lawmakers also allocated $10 million for rebalancing the state’s long-term care continuum, for funding home care agency workforce recruitment, retention and training.  Also, money in Rhode Island’s new budget includes $8.1 million to increase Medicaid Dental rates to increase access to dental services for older adults.

Finally, lawmakers kept in the $250 million total from the American Rescue Plan Act (ARPA) federal funds in the approved budget to address state’s affordable housing crisis.

Taking a peek at new state laws

The Rhode Island General Assembly passed H-7942/S-2623 which increases access and utilization of Accessory Dwelling Units (ADUs) and provides age-friendly housing options for older adults, family caregivers, and people of all ages and abilities.

McKee also signed the Let RI Vote Act into law. This new law makes voting safer, easier, and more accessible for all Rhode Islanders. Some of the major provisions of the bill include no-excuse mail ballots and emergency voting; online mail ballot applications; permanent absentee list opt-in for nursing home residents; no witness or notary requirement to vote by mail;  multilingual voter information hotline, community ballot; and voter registration list maintenance.

A new law also seeks to develop broadband in Rhode Island by creating a Broadband Advisory Committee. It’s director will be responsible for connecting with federal agencies to access funds for broadband infrastructure deployment pursuant to federal grants, facilitating broadband service adoptions, expanding digital literacy for residents (especially seniors), experiencing economic hardship, and for future economic development.

Following the passage of S-2228, the definition of an elderly person in regard to exploitation has changed from someone 65-years-old to someone who is 60 years old, making the definition of an elderly person consistent with state law.

Finally, the proposed Perry Sullivan one-year exemption has been eliminated. This preserves $38.6 million for home and community-based services for 2023.

Gearing up for next year’s legislative session

“Despite the lack of passage of H-7616 sponsored by Rep. Lauren Carson to elevate the Rhode Island Office of Healthy Aging to full Department status, I’m confident that it will be reintroduced early in 2023. I also anticipate broad community conversations to fine tune the design and identify the needed resources,” says Vin Marzullo, a well-known aging advocate who served as a federal civil rights and national service administrator.

“AARP Rhode Island worked hard on Smith Hill during the 2022 legislative session to achieve a number of important wins for the age 50 and over Rhode Islanders,” stated Catherine Taylor, AARP Rhode Island State Director. “We will find it easier to vote, have access to more housing options and assistance for accessibility modifications, see our direct care workforce better paid and better trained, and so much more. And, as always, AARP Rhode Island is committed to ensuring that those age 50 and our families know about these changes and how they will improve our lives,” she says.

 “Although there was some very good news for seniors coming out of the 2022 legislative session, overall, the results were modest when we think about the projected growth of our older population, that 42% of older Rhode Island households have income less than $ 40,000 and that our Office of Healthy Aging is under resourced. So much advocacy work remains,” warns Maureen Maigret, chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council and Policy Advisor for the Senior Agenda of Rhode Island, representing 21 organizations to mobilize people to enhance the quality of life of older Rhode Islanders.

However, Maigret sees a big win in the state budget language calling for rate review for state contracted providers as far too many services important for all ages have become so difficult to access due to poor payment rates to providers for many years. One example is that dental rates under Medicaid have not increased since the early 1990’s so older adults have had an extraordinarily hard time getting detail care, she says.

“Another big win that the Senior Agenda worked tirelessly for was removing the suspension of the $38.6 millions of “Perry-Sullivan” funds for FY 2023 that was in Gov. McKee’s proposal,” says Maigret.

However, Maigret expressed disappointment that the state’s budget only calls for minimum wage for home care direct care staff of $15 per hour. “Advocates tried to get this up to at least $17 to address the homecare workforce crisis that leaves some seniors waiting months for service,” she says.

According to Maigret, other items that will help older adults and persons with disabilities with rising housing costs are the expansion of the Property Tax Relief program sponsored by Rep. Ruggiero and Sen. Coyle.

“While we are appreciative overall for the gains that have been made for Rhode Island’s seniors in this legislative session, it is just a start toward what our state needs to do to meet the needs of our aging population,” says Bernie Beaudreau, Executive Director of Senior Agenda Coalition of Rhode Island. “I am disappointed that the minimum wage of $15 per hour was set so low.  This wage level will not do much to attract workers and solve the severe workforce shortages that home care agencies are facing. We also have to be vigilant about the administration of this new law as we have already seen a draft regulation suggesting that $15 will be the “average wage,” not the “minimum wage” of home care workers.