Sensible Advice from Seasoned Folk to the Class of 2015  

Published in Woonsocket Call on May 17, 2015 — Updated

This month, notable and professionally successful commencement speakers are again gathering at the nation’s Colleges and Universities to give the robed graduating Class of 2015 seniors’ practical tips and advice as to how to have a rewarding personal and professional life.  High profile speakers cam oftentimes translate into big bucks for speaking fees but these widely recognized speakers can bring prestige to the educational institutions.

CNN.web has announced the this year’s high profile speakers for the upcoming commencement season. According to website, like every year these speakers are politicians, journalists, military leaders, entertainers and business CEOs.  Here’s a sampling: President Barack Obama and First Lady Michelle Obama, Oscar winning actors, Anthony Hopkins and Denzel Washington, Novelist and Essayist Author Salmon Rushdie, Bill Nye, the “Science Guy” and Journalist Katie Couric.

May be its time to end the practice of bringing in high-paid commencement speakers.  For this writer, regular folks will do.  Below you might just see many potential commencement speakers, just waiting for the 10 minutes of fame to stand before hundreds of graduating seniors to give their “pearls of wisdom” on living a better life. You may not recognize them on the street, but many in their community know who they are for their achievements of making their Cities and Towns a better place to live.  While not high-profile, through life’s experiences honed every day at work or in their personal worlds, they can give Rhode Island’s college graduates sound, practical advice, to live in a very challenging, and changing world.

Charles Bakst, 71, Providence, retired Providence Journal political columnist. “Stand for something and act upon it.Don’t assume someone else already has done it or will do it.  Work to advance yourself but remember there are plenty of people, even right here in Rhode Island, who have not had the advantages you’ve had. They could use a break too. Help them.”

Dave Barber, 60, East Greenwich, Reporter Capitol Television RI State House. “It’s attitude, not aptitude that will determine your altitude.  There is nothing that will serve you better in the future than a positive mental attitude.  There are two days in life that never exist; yesterday and tomorrow. Yesterday is history, tomorrow a mystery. Live in the moment. Exercise gratitude and kindness in all that you do because there has never been a statue erected of a critic.”

Rick Roth, 61, Cambridge, MA, Owner of Mirror Image.  “Read because if you don’t know anything you are no good to yourself or anybody else and reading is the key to gaining knowledge.  When you are talking (particularly about yourself) you can’t listen. You learn by listening. Try to make the world a better place Pursuit of money is an empty pursuit and will leave you unhappy and dissatisfied.”

Scott A. Davis, 58, Eastside, Owner of the Rhode Island Antique Mall. “In today’s age of information, simply having knowledge is not worth much.  The secret to success in the future will not lie so much in what you know, but in your ability to synthesize information, whether already known or newly acquired, and to draw insightful and valuable conclusions from it.”

Scott Rotondo, 41, Pawtucket, accountant at Tivoli Audio. “Always be willing to expand your intellectual toolbox. Challenge the way things are done, and your own beliefs from time to time. Take in other people’s opposing points of view not with rancor and disdain but with dignity and respect.”

Lisa A. Proctor, 55, East Providence, healer/counselor. “You can not necessarily say all things are possible with God because many do not believe, but I would say a lot of situations we find ourselves in heal when we live honestly, purely, committed and have a merciful and compassionate heart towards others.”

Rudy Cheeks, 65, a musician and columnist of Motif, Providence, “If you can find what you love and make it the center of your life, you’re doing good and will likely be happy.  Whatever you do, “building community” should be an element in your life. Meet your responsibilities (e.g. if you want to create your own family, make sure you are ready for it and committed to it). When you become an “active consumer,” be a smart and thoughtful consumer.”

Kathy Needham, 53, Rumford, Controller, of Pawtucket Times and Woonsocket Call. “Follow this old adage, “Autograph your work with excellence, it is a signature of who you are”.  Take great pride in all you do but always remember to be humble.  Know that success is a personal goal.”

Gayle L. Gifford, 61, Providence, a strategy consultant to nonprofits, “Be an informed citizen of the world.  Read quality news from home and abroad.  Travel. Look. Hear. Participate to create the community you want your children and grandchildren to live in. Hopefully that community is one of justice, peace and inclusion. Don’t work all day in a job that destroys what you value. Play outside.”

Crystal R. Parifitt, 41, Pawtucket, Owner of  FurBabies, a small pet salon. “Live within your means, below if you can…owning the biggest and best is overrated.  Don’t go after financial gain, choose financial stability because in 20 years you will regret the time you spent ‘chasing’ when you should have been living.”

Nancy Thomas, Cranston, President of Tapestry Communications.  “What you have done has largely been expected of you.  Now, what do you expect of yourself!  Find more than one thing you can do.  Pursue your education.  You’re not done.  Read, discuss, have opinions. Let the negative inspire you, and the positive be your lens. And, as it has always been, there is no work as important as that of raising a child.  Find your path to doing well at both.”

Barbara Peters, Newport, former AARP RI Communications Director, “Life is full of successes and disappointments. When we are young we tend to “cry” when the material things we want don’t immediately come our way. Forget the disappointments and concentrate on your successes. Nobody will hand you what you think you deserve.  [Only] hard work, dedication to your craft and sensitivity to the feelings of others will bring the rewards to you that are truly deserved.”

Cheryl Babiec, Pawtucket, Pawtucket School Teacher. “As an old saying goes….’One Man’s Junk is Another Man’s Treasure’ continues to hold true with the test of time. One of my yard sale “finds” had the following inspirational verse (though the author is unknown):‘Life is not measured by the number of breaths we take, but by the number of moments that take our breath away.’”

Herb Weiss, LRI ’12 is a Pawtucket writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com.

 

Palliative Care Can Provide Comfort to Dying Residents

Published in Woonsocket Call on May 10, 2015

           A recently published study, by Brown University researchers, takes a look at end-of-life care in America’s nursing facilities, seeking to answer the question, is knowledge and access to information on palliative associated with a reduced likelihood of aggressive end-of-life treatment?

Brown researchers say when a nursing facility resident is dying, oftentimes aggressive interventions like inserting a feeding tube or sending the patient to the emergency room can futilely worsen, rather than relieve, their distress. While palliative care can pull resources together in a facility to provide comfort at the end of a resident’s life, the knowledge of it varies among nursing directors.  A new large national study found that the more nursing directors knew about palliative care, the lower the likelihood that their patients would experience aggressive end-of-life care.

Susan C. Miller, professor (research) of health services, policy and practice in the Brown University School of Public Health and lead author of the study in the Journal of Palliative Medicine, published March 16, 2015, worked with colleagues to survey nursing directors at more than 1,900 nursing facilities across the nation between July 2009 and June 2010.  The researchers hoped to learn more about their knowledge of palliative care and their facility’s implementation of key palliative care practices.

Knowledge Is Power

According to the findings of the Brown study, the first nationally representative sample of palliative care familiarity at nursing homes, more than one in five of the surveyed directors had little or no basic palliative care knowledge, although 43 percent were fully versed.

“While the Institute of Medicine has called for greater access to skilled palliative care across settings, the fact that one in five U.S. nursing home directors of nursing had very limited palliative care knowledge demonstrates the magnitude of the challenge in many nursing homes,” Miller said. “Improvement is needed as are efforts to facilitate this improvement, including increased Medicare/Medicaid surveyor oversight of nursing home palliative care and quality indicators reflecting provision of high-quality palliative care,” she said, noting that besides quizzing the directors the researchers also analyzed Medicare data on the 58,876 residents who died during the period to identify the type of treatments they experienced when they were dying.

When researchers analyzed palliative care knowledge together with treatment at end of life, they found that the more directors knew about basic palliative care, the lower likelihood that nursing facility residents would experience feeding tube insertion, injections, restraints, suctioning, and emergency room or other hospital trips. Meanwhile, residents in higher-knowledge facilities also had a higher likelihood of having a documented six-month prognosis.

The study shows only an association between palliative care knowledge and less aggressive end-of-life care, the authors say, noting that knowledge leads to improved care, but it could also be that at nursing facilities with better care in general, there is also greater knowledge.  But if there is a causal relationship, then it could benefit thousands of nursing facilities residents every year for their nursing home caregivers to learn more about palliative care, the authors conclude.

Progress in Providing End-of-Life Care

Virginia M. Burke, J.D. President and CEO of the non-profit Rhode Island Health Care Association, said, “We were gratified that the authors found that most of the nursing directors who responded to their survey gave correct answers on all (43% of respondents) or most (36%of respondents) of the “knowledge” questions on palliative care.  We were also gratified to see that the number of hospitalizations during the last thirty days of life has declined significantly over the past ten years, as has the number of individuals who receive tube feedings during their last thirty days.  The need for continued progress is clear.”

Burke, representing three-quarters of Rhode Island’s skilled nursing and rehabilitation centers, adds, “It is not at all surprising that greater understanding of palliative care leads to better application of palliative care.”

The states’s nursing facilities are committed to providing person-centered end of life care, says Burke, noting that according to the National Palliative Care Research Center, Rhode Island’s hospitals are among the top performers for palliative care.  “We suspect that our state’s nursing facilities are as well.  We would be very interested in state specific results in order to see any areas where we can improve.”

Says spokesperson Director Michael Raia, of Rhode Island’s Health & Human Services Agency, “We need to provide the right care in the right place at the right time for all patients.”

When it comes to nursing facilities, Raia calls for reversing the payment incentives so that facilities are rewarded for providing better quality care and having better patient outcomes.  He notes that the Reinventing Medicaid Act of 2015 reinvests nursing home reimbursement rate savings into newly created incentive pools for nursing homes and long-term care providers that reward facilities for providing better quality care, including higher quality palliative care.

Bringing Resources to Families

With caregiving one of AARP’s most important issues, it’s no surprise that the organization provides a great deal of guidance on palliative care, stressing that “it involves organizations and professionals coming together to meet a person’s needs both in terms of pain management, along with emotional and spiritual perspectives,” said AARP State Director Kathleen Connell.

Connell says that “It’s is truly a team effort in which nursing home staff become key players. The resources are important to patient with chronic and terminal issues. Their families need help, too. So it is important any time we learn more about ways we can address this very important healthcare need.”

Adds Connell, “In Rhode Island, I’m confident that we have nursing homes that are dedicated to easing the difficulty of this particularly stressful stage of life. They give patients and their families enormous comfort. We certainly applaud their compassion and hope the report is helpful anywhere it identifies a need for improvement,” adds Connell.

AARP’s Caregiving Resource Center (http://www.aarp.org/home-family/caregiving/) includes an End of Life section. Check out a specific palliative care resource at  http://assets.aarp.org/external_sites/caregiving/multimedia/EG_PalliativeCare.html

To read the Brown Palliative Care Study go to http://online.liebertpub.com/doi/abs/10.1089/jpm.2014.0393.

Herb Weiss, LRI ’12 is a Pawtucket writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com.

Ex-Marathoner Shines at Wellness Event

Published in Senior Digest in the May 2015 Issue

The stars were in alignment. Just as the staff of Saint Elizabeth Community was organizing its first 5K run and walk as part of an employee fit to care wellness program, workers discovered that they were caring for an accomplished former marathon runner.

Bill McNulty, a 72-year-old afflicted with Alzheimer’s disease, had 45 marathons races, including two in Australia, under his belt. He was the perfect choice to be named an honorary starter for the nonprofit’s 5K Run-Walk for Wellness at Slater Memorial Park in Pawtucket. The event was organized with assistance from volunteer students from the Career Partnership Center at Roger Williams University in Bristol.

McNulty’s wife, Deborah, 56, shared stories of her husband’s love of marathon racing with staff at the Cornerstone Adult Services Memory Care Center, Warwick, which ultimately led to his participation in the recent wellness event.

McNulty, a Warwick resident, ran in the Boston Marathon 15 times, the New York Marathon twice and the Mount Washington Road Race 26 times. Before the onset of Alzheimer’s, he easily logged 100 miles per week just to relax and keep in shape. Earlier in his life when he lived in North Kingstown, McNulty ran more than nine miles to his job at Brown & Sharpe, also in North Kingstown, regularly stopping along the way to pick up a box of Allie’s donuts.

At the 5K event, McNulty, wearing running pants and an official T-shirt, geared  up for the upcoming race, surrounded by his wife, Debra; his son, Ian; and eight other family members. With a big smile on his face, the former marathon runner was stretching and lip syncing to the song, “Royals” by Lorde, waiting for his run.

Steven J. Horowitz, president and chief executive officer of Saint Elizabeth Community, kicked off the event by welcoming the 200 runners and walkers. By participating in the 3.1 mile race, they came to get in better physical shape and to honor McNulty. Horowitz noted how pleased he was to have Saint Elizabeth’s event added to McNulty’s prestigious list of races.

Richard Kyle, 64, a daily jogger, came to the Saint Elizabeth Community’s event on the invitation of an employee. “It’s unbelievable to me,” the Burrillville resident said of McNulty’s accomplishments.

“I can’t hold a candle to him,” says Kyle, who calculates that he runs about 31 miles a week in the Burrillville area.

McNulty’s obsession with running began while he was a high school student in Warwick, says Ian, who traveled from New Orleans to Pawtucket’s largest park to join his father for the run and celebrate Bill being named honorary starter.

Ian says even in harsh winters, his father would remain committed to running. “While some people had personal trainers to get them in shape to run, dad always had this inner drive,” Ian recalled. “It was something he had to do, and he didn’t over think it. He and his running buddies were tough and dedicated. They would just get up, have a donut and a beer and go run a marathon.”

“Racing can seem like a solitary experience,” says Ian, but over the years that belief would change. Bill began to see running as a community experience, even having a social side to it.

“My father was able to relive his glory days and even see some of his former racing buddies,” Ian said of the Slater Park event. “A lot of changes have taken place since my father was running in his prime. … He knows this event is very special, and that people are here to support him.”

By Herb Weiss, a Pawtucket-based writer who covers aging, health care and medical issues. Reach him at hweissri@aol.com.

Report: Hiring Older Workers Makes Good Business Sense

Published in Woonsocket Call on May 3, 2015

Here’s a sound strategy for America’s CEOs to follow to improve their corporation’s bottom line. AARP’s recently released study suggests, just hire or retain older workers.

An AARP study, released on April 27, discredits widespread myths and misconceptions about age 50+ employees, showing that they have skills and abilities that can make them key to operating a successful business. The report, “A Business Case for Workers Age 50+: A Look at the Value of Experience 2015,” says that the argument for employing older employees has grown even stronger during the last decade, reinforcing a 2005 AARP study that found that these experienced workers are highly motivated, productive and even cost-effective.

Researchers claim that this study documents for the “first time why attracting and retaining experienced age 50+ workers is critical for businesses seeking an advantage in the labor market.”

Older Workers Sound Investment

“Leading employers across all industries value the expertise and experience of workers 50+ and know that recruiting, retaining and engaging them will improve their business results,” said AARP CEO Jo Ann Jenkins in her statement on the releasing the 92 page report.

Just as today’s 50+ population is disrupting aging and eroding negative stereotypes, today’s 50+ workforce is adding value by exhibiting traits that are highly sought after in today’s economy,” Jenkins added.

Adds Roselyn Feinsod, senior partner at Aon Hewitt, a multinational company providing human resources, retirement and health solutions, that prepared this report, “Workers age 50+ are highly valuable within many organizations – particularly in those industries that require highly skilled workers or workers with unique skill sets, such as health care or energy.”

Researchers say that the AARP report comes at a time when experienced workers are playing an increasing role in America’s workplace. In 2002, workers age 50+ made up only 24.6 percent of the workforce. By 2012, they were 32.3 percent. By 2022, they are projected to represent 35.4 percent of the nation’s total workforce.

The AARP new study addresses a widespread misconception that older workers cost “significantly more” than younger workers. In fact, adding more talented older employees to your workforce can result in only minimal labor cost increases, says the researchers, noting that 90 percent of large employers now base pay in part on job performance, rather than exclusively on length of employment.

In addition, in terms of retirement costs, only 22 percent of large companies now offer a defined benefit pension plan, down significantly from the 68 percent in 2004.
Looking at the 50+ segment of the workforce from a performance standpoint, AARP and Aon Hewitt say that older workers remain the most engaged age group. The study reports that 65 percent of workers age 55+ are considered “engaged”, based on survey data, while younger employee engagement averages 58 to 60 percent.

Although the generational differences in engagement might not seem large, “it takes only a five percent increase in engagement to achieve three percent incremental revenue growth,” the report finds. This can translate into a large company with $5 billion in revenue achieving a $150 million revenue increase as a result of even a five percent engagement improvement, the study says.

The report concludes “An engaged older workforce can influence and enhance organizational productivity and generate improved business outcomes.” Other advantages of older workers include their job experience, professionalism, strong work ethic, lower turnover, and knowledge.
AARP commissioned the study to assess the advantages of both retaining and attracting older workers. The analysis relies primarily on data from Aon Hewitt databases, an extensive literature review and interviews with 18 large employers to obtain anecdotal information on how they approach older workers.

Contributing to Rhode Island’s Economy

“We have noted in the past the relevance of Rhode Island’s so-called Longevity Economy,” said AARP Rhode Island State Director Kathleen Connell. “Despite being just 36% of Rhode Island’s population in 2013 (expected to grow to 38% by 2040), the total economic contribution of the state’s 50-plus population accounted for 46% of Rhode Island’s GDP ($24 billion). Now we see another reason to embrace the older population.

Connell notes that “This new report reinforces the value of older Rhode Islanders as they continue to be a key asset in the workforce. It is especially good to have reliable data that exposes the false concept that older workers cost significantly more than younger workers. The truth is, that older workers increase labor costs minimally while contributing experience and stability to businesses across the spectrum.

“Many employers in Rhode Island understand this. AARP Rhode Island gets frequent calls from business actively seeking older workers. They know the value and the wisdom they bring to the workplace,” says Connell.

According to Charles Fogarty, Director of the Division of Elderly Affairs (DEA), the recently released AARP study helps his agency spread this message, “older workers are expected to play a key role in sparking Rhode Island’s comeback.”

“We support policies and programs to help this crucial segment remain active in the labor force by connecting older workers to services and training,” says Fogarty, noting that AARP’s study confirms, “our seniors are a valuable asset in our workforce given their wealth of knowledge, ability to mentor younger colleagues, and commitment to hard work.”

Deputy Director Lisa D’Agostino, of the state’s Department of Labor and Training agrees with DEA’s Fogarty. “Age 50+ workers are a talented segment of our workforce that is often overlooked and untapped when businesses seek workforce solutions. Given today’s demand for a skilled workforce the solution is simple – mature workers can bring the talent, leadership and work ethic employers need,” she says, noting that labor force participation for this group is on the rise and unemployment rates are lower than that of the prime working age population and have been for the last ten years.

Oak Hill resident Hank Rosenthal, 64, confirms the importance and value of hiring older workers. But, during his two-year job search, after being laid off, he experienced job discrimination, he claims. “Having been interviewed by numerous Human Resource professionals, they just seem incapable of understanding that the years of experience someone has gained is an asset. They seem unable to appreciate that knowledge, experience, and even skills acquired over a lifetime can be transferred and used in virtually any organization or business,” he says.

Rosenthal, now gainfully employed, views his older contemporaries as being “more stable, reliable, have better work ethics and generally make great employees, in line with the observations of the AARP report. With the difficulty in finding employment he believes that companies have not figured this out yet. “What a terrible waste of human capital,” he says.

While older workers may be forced to continuing working to pay their bills, many employees will take jobs for both psychological and social fulfillment. Hiring and retaining older workers may be a simple way for American businesses to maintain their competitiveness in a world economy. The report says that this can easily be accomplished by having “flexible workplaces, options for transitioning to retirement and fostering generational diversity and inclusion.” The AARP report is a must read for any CEO or Human Resource Director.

For the full report, go to http://www.aarp.org/research/topics/economics/info-2015/business-case-older-workers.html.

Herb Weiss, LRI ’12, is a Pawtucket-based writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.

Making Genocide and Holocaust Education Mandatory

Published in Woonsocket Call on April 26, 2015

By Herb Weiss

With newspapers reporting an increase of religious and cultural intolerance and hate crimes, it is refreshing to see the Rhode Island General Assembly pass resolutions condemning the systematic and barbarous murder of Armenians and Jews.

On Friday, April 24, Armenians across the nation stopped to remember the Ottoman authorities eight-year brutal campaign taking place 100 years ago to eliminate their ethnic group from its homeland in what is now Turkey. Both chambers of the Rhode Island General Assembly passed resolutions calling this day, “Armenian Genocide Remembrance Day” and urging President Obama and Congress to officially recognize the genocide which resulted in the estimated death of 1.5 million Armenians and to make restitution for the loss of lives, confiscated properties, those who endured slavery, starvation, torture, and unlawful deportations.

Taking Responsibility for Your Actions

On April 6, it was a personal and professional triumph for Rep. Katherine S. Kazarian (D-Dist. 63, East Providence), a fourth-generation Armenian-American, to take the lead in sponsoring Rhode Island’s House resolution to commemorate the 100th Anniversary of the Armenian Genocide of 1915. In the afternoon before the vote, the East Providence lawmaker unveiled her resolution at a ceremony in the State House State Room attended by elected state officials and fellow lawmakers.

“The only thing worse than trying to eliminate an entire generation and culture is to deny that such a genocide ever took place,” said Kazarian. “For the past 100 years, the government of Turkey has continually refused to acknowledge their part in the ethnic cleansing of the Armenian people, “she said. Until the Armenian genocide that happened 100 years ago on her ethnic group is recognized by the government of Turkey, Kazarian promised to return to the State House every year to keep the issue alive.

Rhode Island Attorney General Peter Kilmartin says, “On this 100th anniversary, it is more important than ever to remember the horror and tragedy that the Armenian people went through, and it is long overdue that as a nation, we recognize the Armenian Genocide. Hopefully, through recognition, vigilance and education, this type of history will cease to repeat itself.”

“From my first days as a legislator to today as Attorney General, I have always advocated for recognition of the Armenian Genocide, and more recently filed an amicus brief in support of the Armenian fight to seek the return of stolen Armenian Genocide era assets through the United States Courts,” says Kilmartin.

“There are many parallels between the Armenian Genocide and the Holocaust carried out by Adolf Hitler, which ultimately killed six million Jews,” says the Attorney General, stressing that the Armenian Genocide served as an example for Hitler, who used the lack of consequences for the perpetrators of the Genocide as encouragement for the Nazis in planning the Holocaust.

“When giving a speech to Nazi leaders one week before the invasion of Poland, which effectively began World War II, Hitler reportedly noted, ‘who, after all, speaks today of the annihilation of the Armenians?,’ notes Kilmartin, saying that “some historians have even suggested that if more had been done to thwart the Ottomans’ massacre of Armenians, perhaps the Holocaust could have been prevented.”

Eradicating Religious and Cultural Bigotry

Marking the 70th anniversary of the liberation of Auschwitz, Buchenwald, Dachau and Bergen-Belsen concentration camps, Rep. Mia Ackerman (D-Dist. 45, Cumberland, Lincoln) submitted a resolution commemorating Holocaust Remembrance Day (Yom Ha’Shoah). The resolution was passed by the House of Representatives.

“The citizens of Rhode Island have a rich tradition of fighting those who would trample individual liberty and human dignity,” said Representative Ackerman. “We must never allow anyone to forget the time when a handful of evil people tried to turn the earth into a graveyard by systematically exterminating an entire race of people.”

The resolution, which was passed by both the House and Senate, also applauded the courageous efforts of those who took part in the Warsaw Ghetto Uprising of 1943, stating “the brave actions in April and May of 1943 stand as testimony to a rare and indomitable human spirit and extraordinary courage exhibited in the darkest hours of man’s inhumanity.”

According to the Conference on Jewish Material Claims Against Germany, by 2020 there will be only 67,000 Holocaust survivors left, 57 percent who will be at least 85 years old. How can the story of the horrific holocaust be told to the younger generation when the eye witnesses are dying off?

Andy Hollinger, Director of Communications for the Washington, D.C.-based U.S. Holocaust Memorial Museum, makes an obvious comment. “No one who did not live through the Holocaust can experience its horrors, he says, noting that “Holocaust survivors are our best teachers.”

Today, about 80 Holocaust survivors are still telling their stories and working to educate new generations about this history at the U.S. Holocaust Memorial Museum.

“When they are no longer here we will rely on the collections — artifacts, documents, photographs, films, and other materials to tell this story,” says Hollinger, noting that the Museum is “racing to collect the evidence of the Holocaust.”

“We’re working in 50 countries on six continents to ensure this proof [witness testimonies, artifacts, and documents] is secured, preserved and made available through exhibitions and, increasingly, digitally, adds Hollinger.

Marty Cooper, Community Relations Director, Jewish Alliance of Greater Rhode, believes it is “vitally important that the next generations learn about the holocaust and other genocides and atrocities that have taken place and continue to take place.” He calls for genocide education to be mandatory and part of the middle and high school curriculum.

One of the great lessons we can learn from the Holocaust and Armenian genocide is that hatred cannot go unchallenged. It must be immediately confronted wherever it emerges, by governments, religious leaders, nonprofit and business organizations, more important by each and every one of us. We must avow that these horrendous atrocities will never happen again to future generations.

Herb Weiss, LRI ’12 is a Pawtucket writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.

“Doc Fix” Law Brings Permanent Changes to Medicare Physician Payments

Published in Woonsocket Call on April 19, 2015

Congress put aside its fierce partisan bickering and came together to pass H.R. 2 – the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This week President Obama took the opportunity to sign the legislation package into law.

The Congressional fix repeals and replaces the flawed Medicare physician reimbursement system known as the sustainable growth rate or Sustainable Growth Rate (SGR). For the past 13 years, physicians have faced the possibility of an arbitrary cut in their Medicare payments unless Congressional lawmakers passed a so-called “Doc.fix” Medicare bill. Since 2003, Congress has passed 17 short-term bills to block these cuts in Medicare doctors’ fees that were called for under the existing law.

On April 14, the U.S. Senate passed the MACRA by a whopping 92 to 8 (the House passing its version of the bill in late March by a large margin, 392-37). Two days later, at an outdoor signing ceremony in the Rose Garden, President Obama signed the legislation into law, with the House bill brokers, Speaker John Boehner (R-Ohio) and House Minority Leader Nancy Pelosi (D-Calif.) in attendance. .

A Permanent Fix Prevents Payment Cuts

Just hours before a cut in reimbursement that would take place this week, a rare bipartisan Congressional effort prevented a 21 percent cut in Medicare payments to occur. It’s a permanent fix. And the new law extends the Children’s Health Insurance Program, which has provided coverage to millions of American children.

At the signing, Obama called the passage “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs,” noting that it would also strengthen the nation’s health care delivery system for the long run.

Obama stated this new law “creates incentives to encourage physicians to participate in new, innovative payment models that could further reduce the growth in Medicare spending while preserving access to care.”

According to the Center for Medicare Advocacy (CMA), a national nonprofit, nonpartisan law group that provides education, advocacy and legal assistance to older people and people with disabilities, the estimated cost of the new law is roughly $214 billion over 10 years. CMA says roughly half (approximately $35 of the total $70 billion over 10 years) will come from Medicare beneficiaries through changes that will increase their out-of-pocket costs for health care.(through means testing of higher-income Medicare beneficiaries, increased Part B premiums, and added deductibles to Medigap plans purchased in the future.”

CMA adds that the nation’s pharmaceutical and insurance industries were not required to pay for any of this law, although doing so would have paid for a major portion of the SGR replacement.

On the Back of Medicare Beneficiaries

Aging advocacy groups, including the Center for Medicare Advocacy and AARP, failed in their attempts to improve the Senate bill Medicare beneficiaries, including a repeal of the annual therapy caps, raising eligibility standards for low-income programs and permanently extending outreach and education funding for critical programs aimed at low-income beneficiaries. The Senate bill passed without amendments.

While many gave thumbs up to the new law, Max Richtman, President and CEO of the Washington, DC –based National Committee to Preserve Medicare and Medicaid, sees big problems with MACRA. “The Senate ‘Doc Fix’ vote has traded one bad policy for another, shifting the costs of Congress’ failed Medicare payment formula for physicians to seniors who can least afford to foot that bill. Contrary to claims by supporters, on both sides of the aisle, this ‘doc fix’ will hit millions of seniors who aren’t ‘wealthy’ by any stretch of the imagination. Seniors at all income levels who are already paying steep premiums for Medigap plans to help control their health care costs will now be hit with even higher costs. Forty-six percent of all Medigap policy holders have incomes of $30,000 or less.”

Richtman added, “Medicare beneficiaries will also be forced to contribute nearly $60 billion in premiums over the next decade thanks to passage of this so-called ‘fix.’

It’s no surprise that conservatives applaud this legislation as ‘the first real entitlement reform in two decades’ because it fulfills their political goal of shifting costs to seniors, cutting benefits and expanding means-testing to push Medicare further and further away from being the earned benefit seniors have long valued and depended on.”.

“Trading a bad deal for doctors for a bad deal for seniors is not a legislative victory and it is a surprising move from so many in Congress who have previously vowed to protect Medicare from harmful benefit cuts and seniors from cost-shifting,” says Richtman. .

AARP CEO Jo Ann Jenkins also expressed strong disappointment in the Senate not passing an amendment that would have removed Medicare’s arbitrary cap on physical therapy, speech language pathology, and occupational services. “Many Medicare patients, particularly stroke victims and people with Parkinson’s and Multiple Sclerosis would have benefited,” says Jenkins. With a majority of the Senate agreeing with this amendment, Jenkins says that AARP will continue to lobby to remove the arbitrary coverage cap.

But, Jenkins sees the positives. “Passage of MACRA moves Medicare in the right direction toward better quality health care and greater transparency for patients. These changes will benefit Medicare beneficiaries, as well as physicians and other providers, hospitals, and the overall health care system,” she says.
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Through the enactment of MACRA Congress put aside its political differences that made a permanent fix to a flawed law. If you can do it once, let’s see our lawmaker do this again, to provide improved programs and services to our nation’s older population.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

Rethinking Rhode Island’s LTC Delivery System

Published in the Woonsocket Call on April 12, 2015

AARP Rhode Island releases a state-specific analysis, of the 2014 edition of “Raising Expectations: A State Scorecard on Long-Term Services and Supports (LTSS) for Older Adults, People with Physical Disabilities, and Family Caregivers” that just might give state officials cause for concern, a low rating on its long-term care delivery system, when compared to other states.

The 2011 Scorecard was the first multidimensional assessment of state performance of LTSS. Like this earlier version, the release of the 109 page 2014 report, referred to as the LTSS Scorecard, and its state-specific analysis (prepared by policy consultant Maureen Maigret), measuring how well the nation and each of the states is doing in providing long-term care services, does not bode well for the nation’s littlest state. It finds the Ocean State ranks 38th nationally on 26 performance indicators, with it achieving the lowest rank of all New England States.

“Our analysis provides a closer look at where Rhode Island is keeping pace and where we fall short,” said AARP State Director Kathleen Connell. “The report indicates that, as the state with the highest percentage of persons 85 and older, we face exceptional challenges. It is our hope that the General Assembly and state policymakers find the analysis to be a valuable tool,” she says.

Failing Grades

The 2014 LTTS Scorecard indicates that Rhode Island:

• Ranks 4th highest among states in nursing home residents per 1,000 persons age 65 and over

• Has a high percent of low-care nursing home residents and spends a far higher percent of its LTSS dollars than the national average on nursing home care as opposed to home and community-based services.

• Has some of the highest long-term care cost burdens in the country making private pay long-term services unaffordable for the vast majority of older households.
But, on a positive note, the state-specific analysis noted that Rhode Island’s best progress was made in the Legal and System Supports dimension largely due to the 2013 passage of the Temporary Caregiver Insurance program and Caregiver Assessment requirements for Medicaid Home and Community Based Services (HCBS).

In addition, to revisiting the 19 recommendations made following the release of AARP’s 2011 Scorecard, the more recent 2014 analysis recommends five new major policy initiates to improve the littlest state’s LTSS. Among the recommendations: funding of an Aging and Disability Resource Center; the developing an online benefits screening tool to allow access to income-assistance benefits and conducting outreach programs to increase participation; reviewing the Rhode Island’s Nurse Practice Act to allow nurse delegation of certain health maintenance and nursing tasks to direct care workers; requiring hospitals to provide education and instruction to family caregivers regarding nursing care needs when a patient is being discharged; and exploring emerging medical technologies to better serve home and community based clients.

The current analysis finds that only four recommendations out of the 2011 recommendations have been implemented, most notably those to promote coordination of primary, acute and long-term care and to strengthen family caregiver supports.

Meanwhile, only six recommendations were partially implemented, including the expansion of the home and community co-pay program and authority (but not implementation) under the 1115 Medicaid waiver renewal to provide expedited eligibility for Medicaid HCBS and for a limited increase in the monthly maintenance allowance for persons on Medicaid HCBS who transition out of nursing homes. Finally, nine recommendations, although still relevant, have not been implemented.

Response and Comments

Responding to the release of AARP’s 2014 Scorecard and state-wide analysis, Governor Gina Raimondo says, “we need to ensure that we have a strong system of nursing home care for those who truly need those services, but we must invest our Medicaid dollars more wisely to support better outcomes. We cannot continue to have the fourth highest costs for nursing home care (as a percent of median income of older households) and also rank near the bottom of all states in investments in home and community-based care.”

According to Raimondo, the state’s Working Group to Reinvent Medicaid is looking closely at AARP’s Scorecard and state-specific analysis and Rhode Island’s spending on nursing home and long-term care. Health & Human Services Secretary Elizabeth Roberts has directed her staff to look directly at the proposals recommended by AARP Rhode Island.

“I expect the Working Group will include specific proposals stemming from these findings in their April budget recommendations and their long-term strategic report they will complete in July,” says the Governor.

AARP Rhode Island Executive Director Connell, representing over 130,000 Rhode Island members, was not at all surprised by the findings of the recently released 2014 Scorecard. “Based on benchmarks set in the 2011 Scorecard, it was apparent that there was much work to do,” she says, recognizing that there are “limited quick fixes.”

“Some steps in the right direction will not lead to an immediate shift in the data. This is a big ship we’re trying to steer on a better course. We were encouraged, however, by ‘improving’ grades for lower home-care costs and the percentage of adults with disabilities ‘usually or always’ getting needed support rising from 64 percent to 73 percent,” adds Connell.

Connell says that the Rhode Island General Assembly is considering legislation to improve the delivery of care, which might just improve the state’s future AARP ‘report’ cards.” “In this session, there is an opportunity to improve long-term supports and services with passage of several bills, including one that would provide population-based funding for senior centers,” she says, stressing that it’s a “responsible investment that will help cities and towns provide better services.”

Connell adds, “The proposed CARE Act gives caregivers better instruction and guidance when patients are discharged and returned to their homes. This can be a cost saver because it can reduce the number of patients returned for treatment or care.”

The larger mission for state leaders is the so-called ‘re-balancing’ of costs from nursing care to home to community-based care. That’s where real savings can occur and home is where most people would prefer to be anyway.”

Finally, Virginia Burke, Executive Director of the Rhode Island Health Care Association, a nursing facility advocacy groups, supports the implementation of the policy initiatives recommended by AARP’s state-specific analysis. But, “The primary driver of our state’s nursing facility use is the extremely advanced age of our elders,” Burke says, noting that the need for nursing facility care is more than triple for those aged 85 and older than for seniors just a decade younger. Due to the state’s demographics you probably won’t see a change of use even if you put more funding into community based home services, she adds.

Governor Gina Raimondo and the General Assembly leadership will most certainly find it challenging to show more improvement by the time the next Scorecard ranks the states. Older Rhode Islanders deserve to have access to a seamless system, taking care of your specific needs. Creative thinking, cutting waste and beefing up programs to keeping people in their homes as long as can happen might just be the first steps to be taken. But, the state must not turn its back on nursing facility care, especially for those who need that level of service.

Herb Weiss, LRI ’12 is a Pawtucket writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.