Study Calls for Action on Creating Senior Housing for Middle-Income Seniors

Published in the Woonsocket Call on August 18, 2019

A recently released report sends a stark warning to federal and state policy makers and to the private senior housing sector. The report forewarns that in the coming years, a large number of middle-income seniors, who need assisted living with supportive services, will be priced out of this level of care.

Seniors housing in the United States is paid out of pocket by seniors with sufficient assets. A relatively small percentage of Americans have long-term care insurance policies to defray the costs. For seniors with the lowest incomes, Medicaid covers housing only in the skilled nursing setting, but increasingly also covers long-term services and supports in home and community-based settings. Programs such as low-income housing tax credits have helped finance housing for economically-disadvantaged seniors.

The researchers call on the government and the senior housing sector to step up and to assist the projected 14.4 million middle-income people over age 75, many with multiple chronic conditions, who won’t be able to afford pricey senior housing.

According to this first-of-its-kind study that appears in the April 24 2019 edition of Health Affairs, 54 percent of middle-income older Americans will not be able to meet yearly costs of $60,000 for assisted living rent and other out-of-pocket medical costs a decade from now, even if they generated equity by selling their home and committing all of their annual financial resources. The figure skyrockets, to 81 percent, if middle-income seniors in 2019 were to keep the assets they built in their home but commit the reset of their annual financial resources to cover costs associated with seniors housing and care.

Accompanying the senior housing study are two perspective pieces in Health Affairs on how society can adapt to aging and supporting aging in communities.

The study, “The Forgotten Middle: Many Middle-Income Seniors Will Have Insufficient Resources For Housing And Health Care, was conducted by researchers at NORC at the University of Chicago, with funding provided by the National Investment Center for Seniors Housing & Care (NIC), with additional support from AARP, the AARP Foundation, the John A. Hartford Foundation, and The SCAN Foundation.

Learning About the Needs of the Emerging ‘Middle Market’

“We still have a lot to learn about what the emerging ‘middle market’ wants from housing and personal care, but we know they don’t want to be forced to spend down into poverty, and we know that America cannot currently meet their needs,” said Bob Kramer, NIC’s founder and strategic adviser in a April 24, 2019, statement. “The future requires developing affordable housing and care options for middle-income seniors. This is a wake-up call to policymakers, real estate operators and investors,” he adds.

The report notes that significant financial challenges are expected to coincide with many middle-income seniors seeking seniors housing and care properties due to deteriorating health and other factors, such as whether a family member can serve as a caregiver. The study projects that by 2029, 60 percent of U.S. middle-income seniors over age 75 will have mobility limitations (8.7 million people), 67 percent will have three or more chronic conditions (9.6 million people), and 8 percent will have cognitive impairment (1.2 million people). For middle-income seniors age 85 and older, the prevalence of cognitive impairment nearly doubles.

The researchers say that this ‘middle market’ for seniors housing and care in 2029 will be more racially diverse, have higher educational attainment and income, and smaller families to recruit as unpaid caregivers than today’s seniors. Over the next 10 years, growth in the number of women will outpace men, with women comprising 58 percent of seniors 75 years old or older in 2029, compared to 56 percent in 2014, they say.

Bringing the Public and Private Sector Together

“In only a decade, the number of middle-income seniors will double, and most will not have the savings needed to meet their housing and personal care needs,” said Caroline Pearson, senior vice president at NORC at the University of Chicago and one of the study’s lead authors.

“Policymakers and the seniors housing community have a tremendous opportunity to develop solutions that benefit millions of middle-income people for years to come,” says Pearson.

Researchers say there is an opportunity for policymakers and the seniors housing and care sector to create an entirely new housing and care market for an emerging cohort of middle-income seniors not eligible for Medicaid and not able to pay for housing out of pocket in 2029.

The study’s analysis suggests that creating a new ‘middle market’ for seniors housing and care services will require innovations from the public and private sectors. Researchers say the private sectors can offer more basic housing products, better leverage technology, subsidize ‘middle-market’ residents with higher-paying residents, more robustly engage unpaid caregivers, and develop innovative real estate financing models, among other options.

As to the public sector, the researchers call on government to create incentives to build a robust new market for middle-income seniors by offering tax incentives targeted to the ‘middle market,’ expanding subsidy and voucher programs, expanding Medicare coverage of nonmedical services and supports, creating a Medicare benefit to cover long-term care, and broadening Medicaid’s coverage of home and community-based services.

“This research sets the stage for needed discussions about how the nation will care for seniors who don’t qualify for Medicaid but won’t be able to afford seniors housing,” said Brian Jurutka, NIC’s president and chief executive officer. “This discussion needs to include investors, care providers, policymakers, and developers working together to create a viable middle market for seniors housing and care,” he says.

Adds, Lisa Marsh Ryerson, President of AARP’s Foundation, “All seniors want to live in affordable, safe and supportive housing, and more than 19 million older adults are unable to do so. We must act now to implement innovative solutions – including robust aging-in-community efforts – to accommodate what is sure to be an increasing demand for housing that meets the needs of older adults.”

Is Rhode Island prepared to meet the senior housing needs of the state’s middle-income seniors in 2029? If not, the state’s federal delegation, lawmakers, state policy makers and the senior housing industry must begin to chip away at this looming policy issue.

To view the study, go to http://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05233.

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Bills Passed to Assist Rhode Island’s Seniors, Disabled

Printed in the Woonsocket Call on July 7, 2019

With the dust settling after the adjournment of the Rhode Island General Assembly’s 2019 legislative session on June 30, 2019, Rhode Island Governor Gina Raimondo halfheartedly signed the state’s 2020 fiscal year $9.9 billion budget into law.

The newly enacted budget closes a $100 million budget gap while avoiding new taxes for businesses, fully funding the state’s education aid formula, continuing to phase-out the car-tax, maintaining fiscal support for municipalities. And, State lawmakers did not forget older Rhode Islanders and disabled persons, putting tax dollars into programs assisting them.

Included in the state budget signed by Raimondo is $499,397 to fund the Rhode Island Livable Home Modification Grant Act that was introduced by Rep. Joseph M. McNamara, D-Warwick, Cranston and Sen. Walter S. Felag Jr., D -Bristol, Tiverton, Warren.

The grant allows eligible homeowners and renters to retrofit their residence to nationally recognized accessibility standards and receive 50 percent of the total sum spent, up to $5,000, to retrofit their existing residence.

The intent of this state program is to assist older Rhode Islanders and disabled persons to stay safely in their homes longer rather than being admitted to costly nursing homes, which costs taxpayers millions of dollars each year in Medicaid costs. With the graying of state’s population, there is a need for housing that is safe and adapted to the needs of their older occupants. (The Livable Home Modification Grant Application and Post-Retrofit Claim form can be found at http://www.gcd.ri.gov.)

Meanwhile, aging advocates gave the thumbs-up to Rhode Island lawmakers who eliminated a sunset provision in the state budget for a program that provides fare-free bus passes to low-income seniors and elderly Rhode Islanders, making this program permanent.

Awaiting the Governor’s Signature

The General Assembly passed legislation (S 0691A, H 6219), introduced by Senator Frank S. Lombardi, D-Cranston and Rep. Evan P. Shanley, D-Warwick, that would help caregivers to build onto their houses to provide space for relatives. The measure now moves to the governor’s office for consideration.

The passed legislation expands the definition of “family member” for purposes of zoning ordinances to include child, parent, spouse, mother-in-law, father-in-law, grandparents, grandchildren, domestic partner, sibling, care recipient or member of the household.

Under the legislation, the appearance of the home would remain that of a single-family residence with an internal means of egress between the home and the accessory family dwelling unit. If possible, no additional exterior entrances would be added. Where additional entrance is required, placement would generally be in the rear or side of the structure.

This legislative session, State lawmakers also approved legislation sponsored by Sen. Adam J. Satchell D- West Warwick and Rep. Robert E. Craven, D- North Kingstown, to establish a formal process recognizing “supported decision making,” a structure of support for disabled or aging individuals.

The legislation, which now heads to the governor’s desk, establishes a system of personal support that is less restrictive than guardianship to help individuals maintain independence while receiving assistance in making and communicating important life decisions. It is aimed at providing an alternative with more self-determination for individuals who are aging or who have developmental or intellectual disabilities.

Under the bill (2019-S 0031A, 2019- H5909), Rhode Islanders would be able to designate another person, or a team of people, as a supporter who would help them gather and weigh information, options, responsibilities and consequences of their life decisions about their personal affairs, support services, medical or psychological treatment, education and more. The supporter would also help the individual communicate the person’s wishes to those who need to know.

The legislation creates a legal form that establishes the agreement between individuals and their supporters, and designates the types of decisions with which the supporter is authorized to help. The bill establishes that decisions made with support under such an agreement are legally valid, and allows supporters to assist with the accessing of an individual’s confidential health and educational records.

It also requires that any other person who is aware that an individual is being abused, neglected or exploited by their supporter is obligated to report that abuse to the proper authorities.

Protecting Rhode Island’s Seniors and Disabled from Financial Exploitation

Sen. Valarie J. Lawson, D-East Providence and Rep. Joe Serodio’s D-East Providence, legislation (2019-0433A, 2019-H 6091A), “Senior Savings Protection Act,” was passed by the General Assembly and now heads to the Governor’s desk for signature.

The act would require certain individuals to report the occurrence or suspected occurrence of financial exploitation of persons who are age 60 and over or those with a disability between the ages of 18 and 59 years old.

According to the legislation, if a qualified individual, a person associated with a broker-dealer who serves in a supervisory, compliance or legal capacity, believes that financial exploitation is taking place, or being attempted, the individual must notify Rhode Island’s Department of Business Regulation and Division of Elderly Affairs, and law enforcement. The individual may also alert immediate family members, legal guardians, conservators, or agents under a power of attorney of the person possibly being financially exploited.

The legislation also calls for the Department of business Regulation and the Division of Elderly Affairs to develop websites that include training resources to assist in the prevention and detection of financial exploitation against Rhode Island’s seniors and disabled.

Combating Alzheimer’s Disease

With the number of persons with Alzheimer’s Disease expected to increase in the coming years, the General Assembly approved bills to better support Rhode Islanders affected by debilitating mental disorder and to protect against elder abuse. There are an estimated 23,000 Rhode Islanders age 65 and older living with Alzheimer’s disease. In just six years, the number is expected to increase to 27,000.

The Rhode Island General Assembly approved legislation (S 20223, 2019-H 5178) sponsored Sen. Cynthia A.Coyne, D-Barrington, Bristol, East Providence, and House Majority Leader K. Joseph Shekarchi, D-Warwick, to establish a program within the Department of Health dedicated to Alzheimer’s disease, and create a 13-member advisory council that would provide policy recommendations, evaluate state-funded efforts for care and research and provide guidance to state officials on advancements in treatment, prevention and diagnosis. The bill is based on legislation signed into law last year in Massachusetts.

The legislation requires the Department of Health to assess all state programs related to Alzheimer’s, and maintain and annually update the state’s plan for Alzheimer’s disease. It would also require the Department of Health to establish an Alzheimer’s disease assessment protocol specifically focused on recognizing the signs and symptoms of cognitive impairments, and appropriate resource information for effective medical screening, investigation and service planning. The legislation would also require caseworkers working with the Department of Elderly Affairs to become familiar with those protocols. Additionally, the legislation would require a one-time, hourlong training on diagnosis, treatment and care of patients with cognitive impairments for all physicians and nurses licensed in the state.

Most importantly, adoption of the legislation would enable Rhode Island to qualify for federal funding that is available to help states with their efforts to support those with Alzheimer’s disease.

Also gaining final Rhode Island General Assembly approval was legislation (2019-S 0302A, 2019-H 5141) sponsored by Sen. Coyne and Rep. Joseph M. McNamara, D-Warwick, Cranston, to allow the spouses or partners of patients residing in Alzheimer’s or dementia special care unit or program to live with them, even if they do not meet the requirements as patients-themselves.

Finally, Sen. Coyne, who lead the Senate’s Special Task Force to Study Elderly Abuse and Financial Exploitation, successfully spearheaded an effort this session to pass legislative proposals to beef up the state’s efforts to combat elder abuse, that is growing and vastly under reported. For details, go to herbweiss.wordpress.com, to access the June 30 commentary, “Senate Task Force Calls for Action to Combat State’s Growing Elder Abuse.”

Some Tips to College Seniors

Published in t he Woonsocket Call on June 2, 2019

Throughout May and June, robed college graduates at Rhode Island’s 11 Colleges and Universities listened to commencement speeches delivered by well-known lawmakers, judges, television personalities, actors, and chief executive officers of businesses. These included: former congressman Patrick J. Kennedy at University of Rhode Island; Bryan Stevenson, a widely acclaimed public interest lawyer, at Rhode Island School of Design; and actor and director John Krasinski, at Brown University. Many of the orators advised the young adults on how to create a more rewarding personal and professional life in their later years.

Members of the Association of Rhode Island Authors (ARIA), from their life experiences, also have insightful tips on aging gracefully in a very challenging and constantly changing world to give to the Class of 2019, and some of what the authors would have said if they had been invited to speak follows.

Co-authors Victoria Corliss, (a resident of Cumberland) and Leigh Brown, (from Warwick) have written three books. The newest book, “The Pendulum’s Truth,” published in 2018, is a story of Ava Dell, a protagonist with a twist. Like many people, Ava firmly believes that everything happens for a reason; but unlike her friends and family, she also believes she knows why they happen. She happily shares her intuitive insights with the people she loves providing them guidance and affirmations until the day her awareness fails her. When tragedy results, Ava suddenly finds herself in a moral and emotional dilemma. For Details, go to http://www.browncorlissbooks.com.

Commencement Tips: “Sometimes, when you think things are falling apart, they’re really just falling into place. So, in times of chaos, of which there will be many, take a deep breath, a step back and be still; it will help you to see the sense of things. One more piece of advice: ‘It’s not what happens to you that matters most, but how you react to it.’ Taking things in stride is a skill that keeps on giving.”

Dana Gambardella, 42, a Reading Specialist, resides in North Providence. She has written two children’s books, “Mama Bear’s Magic” and Grandma’s House,” published in 2018. In “Mama Bear’s Magic, Tiny Bear realizes that bath time is “bear” fun! This humorous, truth-telling tale illustrates how Mama Bear embraces Tiny Bear’s process so he can overcome his apprehension for the bath and discover that bathing is enjoyable. With brother Bear’s modeling and Mama Bear’s clever approach, it’s like magic! Savor the sounds, tastes, smells and feelings that come alive only at “Grandma’s House.” The illustrations in this book replicate the author’s grandmother’s house that still stands in Providence, Rhode Island. Vivid memories come alive through the light, impressionistic watercolor techniques on each page that evoke feelings of nostalgia for readers of all ages. For details, go to http://www.literacychefpublishing.com.
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Commencement Tips: “Always savor your own story. It’s made up of the best ingredients. My two passions, literacy and culinary arts, have nurtured my story since graduating college. Being a reading specialist educating the highest priority reader is not that different from being a chef enthusiast. Experts in both areas must combine the right ingredients and practices to create a successful recipe that reaches many individual learners and palettes. Embrace Literacy. Live to Learn. Love Your Process.”

Gledé Browne Kabongo, 45, author and marketing consultant, living in North Attleboro, Massachusetts. She has written four novels, the latest, the award-winning “Autumn of Fear,” published in 2018. In her tome, College student Abbie Cooper’s dream of becoming a surgeon is shattered when she wakes up in the hospital after a violent assault with no memory of the attack. To uncover the truth of what happened that night, Abbie must confront a stunning web of lies that stretch back decades, and a vicious predator who is willing to kill to protect his secret. For details, go to http://www.gledekabongo.com.

Commencement Tips: “If you live for the approval of others, you will die by their criticism. So, take your time and figure out who you are and what you want in life. It’s OK if it takes a while, the journey is as important as the destination. You will have many failures and make many mistakes. Don’t hide from them. It’s part of the journey. Be kind to yourself and others. Kindness is powerful and can change the world.”

Sheryl Lynn Kimball, 51, a resident of North Smithfield and owner of Kimball Property Maintenance. In 2019, she published “The Witches’ Antidote: Abigail’s.” In this book, when best friends Evan and Valarie hear that a tiny island on the Blackstone River is haunted, they have to see it for themselves. Once there, they discover an enchanted book instructing them how to put Salem Witch Trials victim Abigail Carver to rest. The teens will have to draw on all their strength if they are to survive the night and bring peace to a tortured soul. For details, go to http://www.Amazon.com.

Commencement Tips: “Follow your dreams. Many things will come along to throw you off your intended path. You’ll tell yourself you’re only taking a short detour but suddenly you’ve become just another hamster on the wheel. Understand that a few tiny steps in the direction of your heart are so much more valuable than any strides you make that go against your grain.”

Richard T. Rook, 71, a lawyer from Wrentham, Massachusetts. The basic plot of his book, “Tiernan’s Wake,” is a real-life historical mystery. An unlikely team apply their different skills to locate the only identifiable portrait, and maybe the missing treasure, of the iconic 16th-century Irish Pirate Queen (and political operative) Grace O’Malley. But it’s also a story of damaged adults confronting their mortality and looking for the “missing portraits” of themselves. Sometimes the important messages are delivered by ancestral spirits, if we’re smart enough to listen. For details, go to http://www.richardrook.com.

Commencement Tips: “Advice: Congratulations! You’ve accomplished a great deal, but not enough. Savor it, then start thinking about your obituary. By that I mean your legacy, how you want to be remembered. If you’re not careful, life will eat your dreams one small bite at a time, and you won’t even notice. I put off writing for 50 years, one day at a time. Be smarter. Draft your legacy now, then go make it happen.”

Angelina Singer, 22, an entrepreneur and crochet artist, lives in Boson, Massachusetts. She is author of “The Sorting” (Book 1 of the Upperworld Series), published in 2017. When asked to describe her book, Singer says: “Who decides where we are born and who we love? Luna is an immortal entity in the Upperworld learning how to assign human souls to bodies. Everything goes well until Luna’s friend makes a major mistake and Luna is sent to Earth after covering for her. For details, go to angelinasingerauthor.wordpress.com.

Commencement Tip: “Life is a lot like writing a book. Even if you haven’t formally published anything in the literal sense (or even want to), everyone has the power to write their own life story. This is both equal parts exciting and scary, but that’s why I write – to make sense of everything I can’t understand or even to get a second chance at something I’d like to redo.”

Dana Vacca, a college instructor, residing in Narragansett. Her historical fiction tome, “A Civil War Slave Escapes by Sea,” was published in 2018. When asked to describe this book, she says: “A storm at sea, a voyage aboard a whaling ship, the battlefields of Virginia, the Great Dismal Swamp, perilous escapes, a forbidden romance, – change the life of a run-away slave, forever. This epic journey to freedom in the midst of the Civil War is an unforgettable story of strength, determination and love. Historically accurate, action-packed adventure.” For details, go to http://www.amazon.com.

Commencement Tips: “You have come of age with purpose, with desires, with resolve and probably, also with fears. Do not be ashamed of those fears. Do not merely react to them letting them dictate your journey or paralyze you into stasis. But, do not expect to find a magic potion to make them disappear. Instead, dominate fear; – take up the reins and steer your life, in spite of it. The face of fear may change with age, but it will always be your traveling companion. If you keep your eyes on what is honest, what is just and forge ahead, you can be its master.”

Mary Catherine Volk, over age 55, is a life coach residing in Narragansett. In her book, “Believe in Forever: How to Recognize Signs from Departed Loved Ones,” published in 2015, she details firsthand experiences of people being contacted by their deceased family members and friends. She says that the humorous and heartwarming stories will give you chills as they touch your heart; teaching you to trust your own intuition. It was not just your imagination or an odd coincidence. Our loved ones are near shortly after passing to help us with our grief and to let us know their consciousness and love for us is eternal. For details, go to http://www.marycatherinevolk.com.

Commencement Tips: “What did you enjoy playing as a child in the third or fourth grade? What gave you Joy? Your answer holds a valuable key to your unique gift. Embrace your uniqueness! Follow your dreams, you will have support along the way, it’s all part of the journey to discover you and your special gifts. Don’t be afraid to share your gift with the world. Humanity needs you!”

For more information about the ARIA go to http://www.riauthors.org.

Student Loan Debt Takes a Huge Financial Toll on Seniors

Published in the Woonsocket Call on May 26, 2019

As the 2020 presidential campaign heats up, Democratic candidates are zeroing in on a key domestic issue for 44 million voters, carrying $1.5 trillion in student-loan debt. Their proposals range from free-public college for anybody, forgiveness of all college loans up to $50,000, free community college, to refinancing college loans.

With the national political spotlight put on student-loan debt, many are assuming that this issue impacts only younger Americans. That is not the case. A newly released AARP Public Policy report says it’s a skyrocketing problem impacting multiple age groups. Over recent decades, the report highlights the important role that older Americans play in financing college education for their children, grandchildren and other family members.

Federal Reserve data show that Americans owed $1.5 trillion in student loan debt as of December. An updated analysis shows people aged 50 and older owed 20 percent of that total, or $289.5 billion, a more than fivefold increase from $47.3 billion in 2004.

According to the PPI findings, of those age 50 and over who helped pay for ‘someone else,’ 80 percent helped a child, compared with 6 percent who helped a spouse or partner; 8 percent, a grandchild, and even smaller percentages ‘who helped other relatives or friends.’

Student Loan Debit Hits Seniors Hard in their Pocketbooks

“It is stunning that more families are taking on such sharply greater amounts of student debt than in the past,” says Lori Trawinski, director of Banking and Finance at the AARP Public Policy Institute, in a May 15 statement released with the report, “The Student Loan Debt Threat: An Intergenerational Problem.”

“For younger families, this burden impedes their ability to save for other purposes, such as for a home, their children’s education or for their own retirement,” adds Trawinski, who warns that the long-term financial security of seniors can be threatened by student loan debt.

The researchers noted that most older borrowers hold loans taken out for their own education, and the percentage of borrowers aged 50 and older in default is much higher than for younger borrowers. Data also show that Parent PLUS (direct federal loan) borrowers aged 65 and over are facing higher rates of default than younger age groups, they say.

The 10-page PPI report includes survey results that focus on the key role played by age 50 and older Americans in helping “someone else pay for college and other post high school education.”
(The survey specifically included only those individuals who have not yet fully paid off the debt or who have paid it off within the past five years.)

Of those 50 and over who helped “someone else,” 80 percent helped a child, compared with 6 percent who helped a spouse or partner; 8 percent, a grandchild and even smaller percentages “who helped other relatives or friends.”

One interesting finding of the PPI report was that the most common involvement by people aged 50 and older was cosigning a loan (45 percent), while a smaller percentage (34 percent) ran a balance on a credit card and 26 percent took out a Parent PLUS loan.

Among those who co-signed a private student loan, nearly 49 percent made a payment on the loan, often because they wanted to proactively assist the student borrower. Twenty-five percent said they had to make a payment after the student failed to do so.

The survey asked the one quarter of survey respondents who had taken out a Parent PLUS federal loan, and who had made a payment over the prior five years, whether they ever had any difficulty making payments. Nearly a third 32 percent did have a problem with at least one payment. The breakdown by race/ethnicity for those having a problem with a payment was: African-American/Blacks, 46 percent; Hispanics, 49 percent and whites, 29 percent.

Rhode Island Lawmakers Put Student Loan Debt on Radar Screen

Over a week ago, the Senate Finance Committee took testimony on S 0737, titled the Student Loan Bill of Rights. The legislative proposal, sponsored by Sen. Dawn Euer (D), a lawyer representing parts of Newport and Jamestown, would protect student loan borrowers and establish oversight of student loan services operating in the Ocean State. House Health, Education and Welfare Chairman Joseph M. McNamara has introduced the companion measure (H 5936) in the lower chamber.

“The heavy burden of student debt is challenging enough for the majority of college graduates. Incompetent, inefficient or even deceitful loan servicers should not be allowed to exacerbate their struggles. Student loan servicers must be held accountable to ensure that they are providing honest, reliable information and services to their borrowers,” said Senator Euer (D-District 13, Newport, Jamestown), in a Senate press release announcing the held Senate Committee hearing.

According to a press statement, more than 133,000 Rhode Islanders, including 16,000 senior citizens, have a combined $4.5 billion in student loan debt. Over $470 million of Rhode Islanders’ student loan debt is delinquent.

S 0733 would set standards for student loan serving, both prohibiting predatory behavior and providing best practices for protecting consumers’ rights. It also requires student loan servicers register with the state and allows state regulators to examine servicers’ business practices. Additionally, the Senate bill allows both the Attorney General and department of business Regulation to penalize servicers who violate borrow rights and to seek restitution on behalf of borrowers in Rhode Island. It would also require better communication from lenders to borrowers about any transfer of their loans to another institution and about any alternative repayment or forgiveness program for which the borrower may qualify.

Borrowers in Rhode Island report being double-charged or incorrectly marked as delinquent in payment, with loan servicers taking months, or ever years, to correct mistakes. Additionally, many student loan borrowers eligible for the national “Public Service Loan Forgiveness” program have received incorrect and contradictory information from their loan servicers, leading to improper denials of loan forgiveness.

Calling for Passage of Rhode Island’s “Student Loan Bill of Rights

Bill sponsors Euer and McNamara were joined by Treasurer Seth Magaziner, Attorney General Peter Neronha, Commissioner of Postsecondary Education Brenda Dann-Messier and department of business Regulation Director Liz Tanner, on March 28 at the statehouse to push for legislative fix to protect Rhode Islanders who are shouldering crushing student loan debt.

“By several measures, student loan debt has increased greatly in the last 10 years,” said McNamara at the news conference. “It has surpassed the amount households owe on auto loans, home equity loans and credit cards. This legislation will help to address the crisis by establishing oversight of the student loan process and prohibiting predatory practices,” he noted.

Euer added, “The heavy burden of student debt is challenging enough for the majority of college graduates. Incompetent, inefficient or even deceitful loan servicers should not be allowed to exacerbate their struggles. Student loan servicers must be held accountable to ensure that they are providing honest, reliable information and services to their borrowers.”

Treasurer Magaziner threw in his two cents. “Too many Rhode Islanders are vulnerable to deceptive and predatory practices by their student loan servicers, who make it hard for borrowers to keep their loan payments affordable.” He added, “Too often, borrowers aren’t receiving accurate information about their loan, which can result in higher interest, leave them in debt longer, and make them more likely to default. This legislation will hold student loan servicers accountable and help Rhode Islanders choose the options that are best for them.”

Finally, Attorney General Neronha touted the importance of passing the Student Loan Bill of Rights. “If and when borrowers have issues with their loans or loan servicers, this legislation provides them with a place to go to address those issues. While our primary focus will be on helping Rhode, Islanders get the information they need to solve their student loan problems, my office will be ready, on behalf of mistreated borrowers, to investigate and enforce violations of the student loan standards outlined in this bill.”

If Congress can’t tackle the student loan debt crisis, in a timely fashion, it is now time for Rhode Island lawmakers to offer assistance to Rhode Islanders faced with crippling student loan debt. The Rhode Island General Assembly should pass Euer and McNamara’s “Student Loan Bill of Rights.” and the legislative proposals should not “be held for further study. It’s the right thing to do.

General Assembly: It’s Time to Endorse State Alzheimer’s Plan

Published in the Woonsocket Call on May 12, 2019

Just days ago, the Alzheimer’s Association-Rhode Island Chapter, along with over 75 volunteers and supporters gathered for the group’s Advocacy Day, in the Governor’s statehouse at the Rhode Island State, warning state lawmakers about the increasing incidence in Alzheimer’s disease and its impending impact on state programs and services. According to the Alzheimer’s Association 2019 Alzheimer’s Disease Facts & Figures report, there are now 23,000 people living with Alzheimer’s and 53,000 Alzheimer’s caregivers in Rhode Island. This number will skyrocket as Rhode Island’s population continues to age; they say.

During the two-hour rally, Alzheimer’s advocates pushed for the passage of H 5569, sponsored by Rep. Mia Ackerman (D-Cumberland), and S 310, Sen. Cynthia A. Coyne (D-Barrington), companion measures that would legislatively endorse the newly released State Alzheimer’s Plan.

House Majority Leader Joseph Shekarchi also joined in, calling for passage of H. 5189, his legislative proposal that would create a program under the Department of Health and an advisory council to oversee implementation of programming, requiring training for medical professionals, and establishing Alzheimer’s plans in medical facilities. the Senate companion measure is S 223.

Improving Supports for Those Afflicted with Alzheimer’s

Once the Rhode Island General Assembly passes the legislative proposals to endorses the State Alzheimer’s Plan, the state’s Long-Term Care Coordinating Council’s executive board would seek legislative and regulatory changes to carry out its bold set of recommendations for improving supports to those afflicted by Alzheimer’s and other dementias. But this legislation is stalled.
Twenty-three town meetings,45 expert interviews, combined with a survey of 200 Rhode Islanders impacted by Alzheimer’s, enabled Columbia, Maryland-based Splaine Consulting, a nationally recognized health policy firm, to pull together the content for the State Alzheimer’s Plan. More than 30 recommendations are detailed in this 35-page plan to combat the devastating mental disorder which calls for the implementation of three main recommendations.

The updated State Plan provides Rhode Island with the framework to cooperatively address the full range of issues surrounding Alzheimer’s and other dementias. It will be the blueprint that allows us to take unified, targeted action against the disease, says Lieutenant Governor Daniel McKee McKee, who serves as chair of the state’s Long-Term Care Coordinating Council (LTCCC).

McKee’s LTCCC served as the organizational umbrella for a workgroup, including the Alzheimer’s Association– Rhode Island Chapter, the state’s Division of Elderly Affairs, researchers, advocates, clinicians and caregivers oversaw the development of the newly released State Plan.

“Our updated plan will also position the state, local small businesses and nonprofits to take advantage of federal and other funding opportunities aimed at fighting Alzheimer’s disease,” says McKee.

“Unless we move quickly to address this crisis and find better treatments for those who have it, these costs will grow swiftly in lock step with the numbers of those affected, and Alzheimer’s will increasingly overwhelm our health care system. We must decisively address this epidemic,” says Donna M. McGowan, Executive Director of the Alzheimer’s Association–Rhode Island Chapter, who came to the May 7 news conference on Smith Hill to put Alzheimer’s on the General Assembly’s policy radar screen.

Taking Bold Actions to Confront Alzheimer’s Epidemic

“State government must address the challenges the disease poses and take bold action to confront this crisis now. Alzheimer’s is a growing crisis for our families and the economy. That’s why we are unrelenting advocates for public policy that advances research and improves access to care and support services,” says McGowan.

“Alzheimer’s disease and its impact on society is not only a growing public health concern, it very well may be the next biggest public health emergency that we as policymakers need to address,” said Rep. Ackerman. “We’ve already begun crafting legislation that will establish a program in Rhode Island to address the disease,” she says.

Rep. Ackerman used the Alzheimer’s news conference as a bully pulpit, calling on hospitals, researchers, medical professionals, state agencies, and state law makers to act swiftly to address the looming public health crisis.

“There are many factors to be considered in the great work ahead of us,” Rep. Ackerman said. “From early detection and diagnosis, to building a workforce capable of handling the unique health care needs of Alzheimer’s patients. This is something that will take a lot of effort and a lot of time. Now is the time to get to work on this,” she notes.

Like Rep. Ackerman, Sen. Coyne called for the General Assembly to endorse the State Alzheimer’s Plan and also supported Shekarchi’s legislative proposal, too. She also promoted a bill that she put in the legislative hopper that would allow spouses to live with their partners in Alzheimer’s special care units. Allowing couples to live together would help maintain patients’ relationships, connections and personal dignity, she said.

Rose Amoros Jones, Director of the Division of Elderly Affairs(DEA), noted that the power to the Alzheimer’s Association – Rhode Island Chapter’s Advocacy Day creates connections to people that can influence policy and shine light on the supports and information that families need. “Connection is a core value at DEA – as is choice, she said.

Sharing personal stories, Melody Drnach, a caregiver residing in Jamestown, talked about the challenges of taking care of her father with dementia. From her personal caregiving experiences, she agrees with the updated plans assessment that Rhode Island is dramatically under-resourced to address today’s needs.

Marc Archambault of South Kingstown, who has been diagnosed with the disease, came, too, talking about his efforts to cope with the devastating disorder.

At press time, both Rep. Shekarchi and Rep. Ackerman’s Alzheimer’s proposals have been heard at the committee level and have been held for further study, some call legislative purgatory.

Alzheimer’s Impacts Almost Everyone

The devastating impact of Alzheimer’s may well touch everyone in Rhode Island, the nation’s smallest state. Everyone knows someone who either has Alzheimer’s or dementia or is a care giver to these individuals. It’s time for the Rhode Island General Assembly to endorse the State’s Alzheimer’s Plan especially with no fiscal cost. We need a battle plan now more than ever to effectively deploy the state’s resources to provide better programs and services to those in need and to support caregivers.

Call your state representatives and Senators and urge that H 5569 and S 310 are passed and sent to Governor Gina Raimondo to be signed. For contact information, call Eric Creamer, Director of Public Policy and Media Relations, Alzheimer’s Association – Rhode Island Chapter, (401) 859-2334. Or email ercreamer@alz.org.

Caregivers Flying Blind in Providing Complex Medical and Nursing Care

Published in the Woonsocket Call on April 21, 2019

Half of the nation’s 40 million family caregivers are performing intense and complicated medical and nursing tasks, managing multiple health conditions for their family members and friends, says a newly published AARP report.

AARP’s special report, “Home Alone Revisited: Family Caregivers Providing Complex Care,” released April 17, 2019, takes a close look at specific medical and nursing tasks (including giving injections, preparing special diets, managing tube feedings and even handling medical equipment) that family caregivers are currently doing. It’s a follow-up report to AARP’s 2012 Home Alone Study that took the first in-depth look at how caregivers managed providing complex medical and nursing care that was formerly offered by trained professionals.

Changes in the Health Care System Can Support Family Caregivers

“This report shows the extent of complex tasks that millions of family caregivers are providing every day. They are largely alone in learning how to perform these tasks,” said Susan Reinhard, RN, Ph.D., Senior vice president and Director, AARP Policy Institute, in a statement announcing the release of the a 56-page report. “About half of family caregivers are worried about making a mistake. We need to do a lot more across the health care system—with providers and hospitals—to help support these family caregivers,” says Reinhard.

Adds Rani E. Snyder, program director at The John A. Hartford Foundation, “Family caregivers are the linchpin in our health care system, particularly for older adults,” “This study shines new light on the diversity of family caregivers performing complex tasks—from men to millennials to multicultural populations—and is a rallying cry for an all hands-on-deck approach to creating age-friendly health systems that better support and prepare these often forgotten members of the health care team.”

The new statistics in this report shed more light on the demands of family caregiving,” said AARP Rhode Island State Director Kathleen Connell, a former nurse. “These described caregiving responsibilities sound like a task list for a team of home nurses, aides, dieticians, physical therapists and personal drivers who work without weekends off, much less vacations. Is there any question that people worry about making a mistake that compounds existing issues?,” she says.

“The takeaway is quite clear,” Connell added. “Caregiving is stressful and we need to expand efforts to provide assistance. And it’s a very big ‘we’ that I am speaking of. Families need to help out and share more responsibilities as well as offer respite for primary caregivers. Neighbors and extended family also can lend a hand. And we need government to continue to provide assistance through legislation that supports family caregivers. Caregiving responsibilities can be both daunting and exhausting. It’s the new reality. The good news is that as we raise awareness we can work together to improve the lives of caregivers, “ says Connell.

A Sampling of the AARP Report’s Findings

AARP’s Home Alone Revised Report report found that almost half of the caregiver respondents (48 percent) prepare special diets multiple times per day. Preparing these meals often involved taking precise measurements, following specific dietary guidelines, constant monitoring, and the use of special equipment for preparation and feeding.

Thirty percent of the respondents say preparing special diets are hard to manage, this being more challenging to men. Younger caregivers found it more difficult to manage this task than older caregivers.

The caregivers also reported that 54 percent of the survey’s respondents say they manage incontinence multiple times a day. Most say managing incontinence is more difficult than managing medications, helping with assistive devices and performing wound care. Seventy-six percent say they learned how to manage incontinence on their own. More than one in four would appreciate having assistance from another person to help.

According to AARP’s report, 70 percent of these caregivers are dealing with the emotional stress of managing pain relief in the middle of a national opioid crisis. More than four in 10 expressed concerns about giving the optimal dose. About four in 10 faced difficulties in controlling the pain of the care recipient.

Finally, 51 percent of the survey respondents assisted with canes, walkers, and other mobility devices while over a third (37 percent) dealt with wound care.

The researchers conclude that “uncomplicated world of ‘informal’ caregiving” no longer applies” to the nation’s caregivers. “In the current health care environment, it is presumed that every home is a potential hospital and every service that the person needs can be provided by an unpaid family member, with only occasional visits by a primary care provider, nurse or therapist,” say the researchers,” they say.

AARP’s Home Alone Revised Report is a must read for Congress and state lawmakers who can easily address the challenges caregivers face when providing medically complex care by crafting policies and programs that will provide support and resources to the nation’s growing number of caregivers.

This caregiving issue might be a good one for the U.S. Senate Special Committee Aging to study.

A Final Note…

AARP gathered the study’s data through a nationally representative, population-based, online survey of 2,089 family caregivers. This study employed an oversampling of multicultural groups, taking a closer look at difficult tasks, and putting greater attention on available resources and outcomes. The study’s sampling strategy ensured multicultural representation and investigated generational differences. Additionally, the researchers also explored certain topics in greater depth, including special diets, incontinence, pain, and the impact of social isolation on the caregiver.

The AARP Home Alone Study is a special report from the Founders of the Home Alone Alliance℠ (AARP, United Hospital Fund, Family Caregiver Alliance and UC Davis-Betty Irene Moore School of Nursing). With funding from The John A. Hartford Foundation to the AARP Foundation, the study took an in-depth look at the specific medical/nursing tasks that family caregivers are doing.

To read the full report, go to: https://www.AARP.org/ppi/info-2018/home-alone-family-caregivers-providing-complex-chronic-care.html.

Note: Updated April 22, 2018…

Attacking Rising Prescription Drug Costs

Published in the Woonsocket Call on April 7, 2019

The Washington, DC-based AARP timed the release of its latest Rx Price Watch report as the House Energy Commerce Committee marked up and passed a dozen bills just days ago, six that would lower prescription drug costs. The legislative proposals now go to the House floor for consideration.

AARP’s new report, a continuation of a series that has been tracking price changes for widely used prescription drugs since 2004, was circulated to House Committee members before their markup and vote and its findings sent a message to the lawmakers that they hear from their older constituents, that is the costs of pharmaceutical drugs is skyrocketing, making it difficult to fill needed prescriptions.

Poll after poll findings reflect the concerns of seniors about their ability to pay for prescribed medications. According to a Kaiser Family Foundation poll released last month, 79 percent of survey respondents view drug prices to be “unreasonable,” while just 17 percent found the costs to be “reasonable.” Twenty-four percent of these respondents found it difficult to pay the costs of their prescription drugs.

Generic Drugs Can Save Dollars

According to the new AARP Public Policy Institute (PPI) report, by Leigh Purvis and Dr. Stephen W. Schondelmeyer, the average annual cost of therapy for one widely used brand-name prescription drug in 2017 was over 18 times higher than the cost of therapy for one generic drug. The cost for a generic medication used on a chronic basis averaged $365 per year. In contrast, the average annual cost for a brand-name prescription drug was $6,798. But, four years earlier the price differential between these same market baskets was substantially smaller ($4,308 verses $751 respectively).

“Generics account for nearly nine out of every 10 prescriptions filled in the U.S. but represent less than a quarter of the country’s drug spending,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP, in a statement released with the PPI’s 28 page report “These results highlight the importance of eliminating anticompetitive behavior by brand-name drug companies so that we get more lower-priced generic drugs on the market,” says Whitman.

AARP’s PPI report, entitled “Trends in Retail Prices of Generic Prescription Drugs Widely Used by Older Americans,” found that retail prices for 390 generic prescription drugs commonly used by older adults, including Medicare beneficiaries, decreased by an average of 9.3 percent in 2017, compared to the general inflation rate of 2.1 percent. The decline follows two consecutive years of substantial generic drug price decreases; the previous two consecutive years saw increases in generic drug prices. All but three of the 390 generic prescription drugs analyzed in AARP’s report had a retail price change in 2017. While prices for 297 (76 percent) drug products decreased, 90 (23 percent) products had price increases.
Six commonly used generic drug products had retail price increases of greater than 70 percent, including a nearly 200 percent increase for sertraline HCL, an antidepressant, finds the AARP.

AARP’s PPI report found that with older adults taking an average of 4.5 prescription drugs every month, those using generic prescription drugs were likely to have an average annual retail cost of $1,642 in 2017.

“The gap between average annual brand-name and generic drug prices has increased dramatically—brand name drug prices were six times higher than generic drug prices in 2013 but more than 18 times higher in 2017,” said Leigh Purvis, Director of Health Services Research, AARP Policy Institute, and co-author of the report. “As long as brand name drug prices continue to skyrocket, the value of prohibiting brand name drug company practices that slow or prevent competition from generic and biosimilar drugs cannot be overstated.”

AARP Pushes for Passage of Bills to Lower Drug Costs

Before the Committee on Energy and Commerce vote on April 3, in correspondence AARP urged Chairman Frank Pallone, Jr. (D-N.J.) and Ranking Member Greg Walden (R-Ore) to enact two bills (along with four other proposals) being considered at the morning markup session. These legislative proposals would lower prescription drug costs and had previously been approved by the Energy and Commerce Health Subcommittee.

In the correspondence, AARP’s Nancy A. LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer, pushed for passage of H.R., 1499. the “Protecting Consumer Access to Generic Drugs Act of 2019.” introduced by Rep. Bobby Rush (D-IL). This proposal would make it illegal for brand-name and generic drug manufacturers to enter into agreements in which the brand-name drug manufacturer pays the generic manufacturer to keep a generic equivalent off the market. The bill was passed by voice vote.

LeaMond also supported H.R., 965, the “Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019,” introduced by Reps. David Cicilline (D-RI), Jim Sensenbrenner (R-WI), Jerrold Nadler (D-NY), Doug Collins (R-GA), Peter Welch (D-VT), and David McKinley (R-WV). The proposal would establish a process by which generic manufacturers could obtain sufficient quantities of brand drug samples for testing thereby deterring gaming of safety protocols that brand manufacturers use to delay or impede generic entry. The bill passed by a bipartisan vote of 51-0.

At the markup, Pallone and Walden were able to work out philosophical differences on H.R. 1499 and H.R. 965. The two lawmakers also hammered out a compromise on H.R. 1503, the “Organize Book Transparency Act of 2019,” that would ensure that the Orange book, which identifies drug products approved on the basis of safety and effectiveness by the Food and Drug Administration, is accurate and up-to-date.

Washington Insiders say that Democratic control of the House will ensure the passage of these legislative proposals on the House floor and the bipartisan vote on the CREATES Act in the lower chamber creates an opportunity for Senate Finance Committee Chairman Chuck Grassley (R-Iowa) to successfully push his CREATES Act companion measure in the Senate.

Grassley says the broad, bipartisan action by the House Energy and Commerce Committee to advance the CREATES Act is a major win for consumers. “I look forward to advancing this bill because it will cut down on abuses in the system that keep prices high for patients. I’m also pleased that the committee advanced a bill to address pay-for-delay schemes. Although that bill is not identical to the bill I’ve sponsored in the Senate, the bill’s movement shows that the committee is serious about addressing the pay-for-delay problem,” says the Senator.

As They See It…

AARP’s LeaMond, says “Brand-name drug companies want to stifle generic competition to protect their monopolies and profits. AARP believes that eliminating these deliberate anticompetitive behaviors will result in a more robust generic drug market and greater savings for both patients and taxpayers. The Congressional Budget Office estimated that legislation such as the CREATES Act could save taxpayers more than $3 billion over a decade, and the Federal Trade Commission estimated pay-for-delay deals cost consumers and taxpayers $3.5 billion a year.

“We have long supported the CREATES Act and banning pay-for-delay agreements, and are heartened that Congress is acting to improve access to generic drugs. These bills will promote competition driving down costs for seniors,” says Lisa Swirsky, Senior Policy Analyst, at the National Committee to Preserve Social Security and Medicare.

“Congressman Cicilline has been a leader in our caucus for putting prescription drug prices at the front of our agenda. Moving generics to market faster is an important step to lower prescription drug costs for every American,” said House Speaker Nancy Pelosi. “House Democrats have made it a top priority to lower Americans’ health costs by reducing the price of prescription drugs, and these bipartisan bills show we mean to deliver,” she says.