McKee to Unveil Updated State Alzheimer’s Plan

Published in Woonsocket Call on February 10, 2019

Seven months ago with the hiring of Michael Splaine and Kate Gordon of Splaine Consulting, a nationally recognized health policy firm that has provided content matter expertise to over two dozen state Alzheimer’s plans, Lt. Governor Daniel J. McKee, who serves as chair of the state’s Long-Term Care Coordinating Council, rolled up his sleeves to begin his legislative charge to update the 2013 state Alzheimer’s plan.

The hiring of the Columbia, Maryland-based consultants was made possible by two grants totaling $30,000 given by the Tufts Health Plan Foundation and Rhode Island Foundation. When announcing the successful fundraising effort to raise those monies, McKee observed, “Each day, we make great strides in expanding clinical trials and innovating treatments. Over the last few years alone, the local landscape of prevention and treatment has changed dramatically and positively.”

“The updated plan will be an invaluable tool for local leaders, researchers, physicians, advocates and families as we work together to build the momentum in the fight against Alzheimer’s,” says McKee, noting that it is one of the most challenging public health issues facing Rhode Island today. “With the number of affected Rhode Islanders projected to rise to 27,000 by 2025, elected leaders, advocates, caregivers, clinicians and researchers must come together to take unified, targeted action,” he says.

The compilation of the plan is the result of collaboration between McKee, the Alzheimer’s Association Rhode Island Chapter and the state’s Division of Elderly Affairs (DEA). In 2012, the General Assembly directed the Long-Term Care Coordinating Council to serve as the organizational umbrella for a work group that would oversee the development of the plan. In 2013, the state’s five-year Alzheimer’s plan was published. Last year, efforts to update it began.

Last July under the leadership of McKee, Splaine and Gordon worked closely with the Alzheimer’s Association Rhode Island Chapter, DEA, researchers, advocates, clinicians and caregivers sitting on the Lieutenant Governor’s Executive Board on Alzheimer’s,to develop a community-focused strategy for the 2019 State Plan on Alzheimer’s disease and Related Disorders. Over a six-week period, that group held 23 town hall meetings, conducted 45 expert interviews and surveyed (in both England and Spanish) more than Rhode Islanders impacted by Alzheimer’s.

The Official Release…

On Feb. 26 at a press conference in the State Library at 3:30 p.m., McKee will join Sen. Cynthia A. Coyne (D-Barrington) to officially unveil the plan, Rhode Island’s official roadmap to combat the growing Alzheimer’s epidemic. Coyne will announce the introduction of a Senate resolution on behalf of McKee to officially adopt the plan. (House staff are still reviewing the updated plan. There is no House sponsor at this time)

Coyne’s resolution follows her introduction of legislation to create a Rhode Island program to address Alzheimer’s disease within the Department of Health (DOH). The bill would also create an advisory panel to review and make recommendations to improve the state policies, research and care.

Once the Rhode Island General Assembly approves the plan, the Long-Term Care Coordinating Council’s executive board will 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. More than 30 recommendations are detailed in the 35-page plan, which calls for the implementation of three main recommendations.
In order to keep the plan from sitting on a dusty bureaucrat’s bookshelf, the first recommendation calls for the creation of one director-level position within DOH to assist in the coordination of its recommendations. The second urges promoting Alzheimer’s disease and related dementia research opportunities of all types, including federal opportunities to a broad group of Ocean State researchers. Finally, the third calls for the inclusion of brain health in existing publicly-funded promotion and chronic disease management activities.
Many of the recommendation can be easily implemented without additional state funding or legislative approval, says McKee. But, for those that may require state funding, he plans to make it a priority to lobby for those monies.

Taking a Close Look

Maureen Maigret, co-chair, state’s Long-Term Care Coordinating Council, says, “It is terrific to have the plan update completed as it provides direction to our state government leaders and other persons in key positions to proceed with implementation of the recommendations, which can have such far-reaching impacts on the many thousands of individuals with neuro-cognitive conditions and their dedicated caregivers, both those who are unpaid and those in the paid work force.”

Maigret notes that the updated plan’s recommendations also call for assisting family caregivers who provide the vast majority of care for persons with Alzheimer’s and related dementias, expanding subsidies for home and community care services offered by the state’s Division of Elderly Affairs, and making family caregiver support services part of the Medicaid program.

According to Maigret, one issue not mentioned in the updated plan is the need for increasing state funding for the DEA’s respite care program, which has a waiting list. “This is an important program that gives caregivers small subsidies to purchase ‘care breaks.’ Our Aging in Community Subcommittee and the AARP and Senior Agenda Coalition will all be advocating to restore state funds to this program (in the upcoming legislative session),” she says.

“The Alzheimer’s State Plan is a thorough blueprint to address the growing Alzheimer’s crisis by creating an infrastructure and accountability that will help build dementia-capable programs,” said AARP Rhode Island State Director Kathleen Connell. “We applaud the work that has gone into the report and the continuing efforts to address Rhode Island’s growing needs. We are especially encouraged to see that the plan supports community education about caregiver health and caregiver rights under the CARE Act, which is legislation that AARP championed in the General Assembly. AARP also encourages and supports age-friendly communities, which includes dementia-friendly awareness and resources so that people of all abilities can thrive as they age.”

Sen. Coyne added, “Alzheimer’s impacts tens of thousands of Rhode Islanders, and we need a coordinated strategy to improve education among the public and training for providers, and to promote research opportunities. This plan provides a strategic framework for moving forward to bring positive policy change where it is needed.”

See you at the press conference.

For details about the press conference and the Alzheimer’s State Plan, contact Andrea Palagi, Communications Director, Office of Lt. governor Daniel J. Mckee at
Andrea.Palagi@ltgov.ri.gov.

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Funding for Seniors in Raimondo’s FY 2020 Budget Blueprint

Published in the Woonsocket Call on January 27, 2019

By Herb Weiss

Almost two weeks ago, Democratic Governor Gina Raimondo formerly unveiled her $9.9 billion budget proposal to the Rhode Island General Assembly. The House and Senate Finance Committees then begin the task of holding hearings on budget plan, getting feedback from the administration and the public. Once the revised estimates of tax revenue and social-services spending is available in May, negotiations seriously begin between Raimondo, the House Speaker and Senate President to craft the House’s budget proposal. Lawmakers will hammer out and pass a final state budget for the fiscal year that begins July 1.

Local media coverage of Raimondo’s ambitious spending initiatives zeroed in on her call for expanding free tuition to Rhode Island College and adding some public pre-kindergarten, increasing minimum wage from $ 10.50 to $ 11.10 per hour, allowing mobile sports betting and legalizing recreational marijuana.

But, Raimondo’s budget proposal gives state lawmakers a road map for what programs and services are needed for a state with a graying population.

According to Meghan Connelly, DEA’s Spokesperson, a nearly 60 percent increase in the State’s population of residents aged 65 and older from the years 2016 to 2040 highlights the need for continued investments in programs servicing Rhode Island’s older adults and their family caregivers.

Connelly says Raimondo’s budget proposal, released on January 17, elevates Elderly Affairs from a division under the Department of Human Services to an Office within the Executive Office of Health and Human Services. The governor shifts financing for the office and 31.0 FTE positions to EOHHS to accomplish this recommended action.

“The projected increase in the state’s senior population – from 174,000 in 2016 to 265,000 by 2040 – coupled with the proven impact of community-based supports and services, highlights the need for continuing to invest in helping our seniors remain home, connected to their families and networks. Support of aging-related health-promotion initiatives are essential to maintain a high quality of life for Rhode Island seniors while minimizing aging-related healthcare costs,” says Connelly

“We are focused on making it easier for older adults to live independent, fulfilling lives for as long as possible,” said Michelle Szylin, Acting Director of the Division of Elderly Affairs. “The Co-Pay expansion [in the governor’s proposed budget] enables additional older adults to age-in-place, remaining safely in their homes and engaging in their communities.”

The Co-Pay expansion enables additional older adults to age-in-place, remaining safely in their homes and engaging in their communities. The governor’s proposal to expand the state’s Co-Pay program [by $ 550,000] will allow more seniors to reside in their communities, staying connected to their family and network of friends and neighbors.

Providing access to the Co-Pay program to individuals earning up to 250% of the Federal Poverty Level will allow more seniors to age-in-place with a better quality of life and delay nursing home admission. The DEA Co-Pay program was established in 1986 as an option for elders who would otherwise be ineligible for subsidized home and community care assistance because they did not qualify for the Rhode Island Medical Assistance program.

Recognizing the importance of the state’s Elderly Transportation Program to keep older Rhode Islander’s independent, Raimondo’s budget proposal calls for additional funding of $1.8 million from general funds to support the State’s elderly transportation program. This program provides non-emergency transportation benefits to Rhode Islanders age 60 and over who do not have access to any means of transportation. The program provides transportation to and from medical appointments, adult day care, meal sites, dialysis/cancer treatment and the Insight Program.

Raimondo’s proposed budget also increases Health Facilities regulation staffing to increase the number of inspections to state-licensed health care facilities. The governor recommends a $327,383 increase in restricted receipt funds for 3.0 FTE positions. These positions will bolster existing staffing to increase the number of inspections to state-licensed healthcare facilities.

The Governor’s proposed FY 2020 budget also through the Rhode Island Public Transit Authority continues to subsidize the transit of elderly and disabled Rhode Islanders through the Rhode Island Public Transit Authority.

Raimondo’s proposed budget also continues the support for the Independent Provider model P model with almost $200,000 in general revenue funds budgeted (about $770,000 all funds) to cover implementation costs. The goal of this model is to increase workforce capacity and create a new option for delivery of direct support services for both seniors and people with developmental disabilities.

Finally, the governor’s FY 2020 budget also allocates funding to an array of programs and services for seniors. Here’s a sampling: $800,000 to support the state’s senior centers through a grant process (the amount was doubled last year); $ 530,000 to support Meals on Wheels; $ 85,000 to implement security measures in elderly housing complexes; $ 169,000 for the long-term care ombudsman through the Alliance for Better Long Term Care, which advocates on behalf of residents of nursing homes, assisted living residences and certain other facilities, as well as recipients of home care services; and $ 500,000 funds the state’s Home Modifications program at Governor’s Commission on Disabilities.

Nursing Facility Provides Take a Hit

Raimondo’s proposed budget plan seeks to freeze the state’s Medicaid payment rates to hospitals, slashing funding by an estimated $15 million overall for the year, and to limit the rate increase for nursing homes to 1%, costing them nursing home providers about $4 million.
“We are beginning the budget process with a 1 percent increase in the COLA (Cost of Living Adjustment), says Scott Fraser, President and CEO of Rhode Island Health Care Association (RIHCA), warning that “this is not enough.”

“Since 2012, nursing facility costs have risen 21.6 percent while Medicaid payment rates have only gone up by 9.6 percent, adds Fraser, noting that by statute, rates are supposed to be adjusted annually for inflation. “We will be advocating for additional funding for nursing facilities throughout the remainder of the budget process,” he warns.

Jim Nyberg, Director LeadingAge RI, an organization representing not-for-profit providers of aging services, joins with RIHCA in calling on Rhode Island lawmakers to restore the full inflation adjustment. “Ongoing increases in minimum wage (up 42 percent since 2012) make it harder for publicly funded providers to compete for skilled workers,” says Nyberg, noting that most of his nonprofit nursing homes have 60 percent to 70 percent of their residents on Medicaid. “A rate increase is needed help nursing homes recruit and retain the direct care workers that are so critical to providing quality care,” he says.

“Since 2016, our nursing homes and consumers have been severely disrupted by UHIP, financially and operationally. The ongoing problems with Medicaid application approvals and payments has resulted in significant increases in staff workload just to maintain operations, let alone the impact on cash flow and financial stability, adds Nybrg.

Nyberg’s group is also advocating to expand the CoPay program for individuals under the age of 65 with dementia. “This has been proposed in the past but not included in this budget. We think that such an expansion will help this at-risk population for whom no publicly-funded programs and services currently exist,” he says.

Lawmakers, AARP Rhode Island Gives Comments

AARP Rhode Island is encouraged to see that the Governor placed an increase in the State Budget for the Department of Elderly Affairs home healthcare Co-Pay program,” said AARP Rhode Island Advocacy Director John DiTomasso. “By increasing the income eligibility from 200% of the poverty level to 250%, more older Rhode Islanders will be able to obtain home care services at reduced hourly rates,” he added. “This will help large numbers of people to extend the time they can age in place in their home and in their community rather than in more costly state-paid long-term care facilities,” says DiTomasso.

Senate President Dominick J. Ruggerio says, “Upon a first look at the budget, I am very pleased that some of the Senate’s top priorities are incorporated. The Governor had to close a significant deficit, and difficult choices had to be made. However, the budget is a statement of priorities, and initiatives like the no-fare bus pass program for low-income seniors and disabled Rhode Islanders are a priority for us in the Senate. I am very pleased to see this program funded in the budget, along with many other services for seniors, and I look forward to deeper analysis of all aspects of the budget in the months ahead.”

AddsD House Speaker Nicholas Mattiello, “The House Finance Committee will soon begin holding public hearings and reviewing every aspect of the Governor’s budget proposal. We will make certain that the level of care and services to older adults will be maintained and hopefully enhanced. We are facing significant budget challenges this year, but we will always keep the needs of our seniors at the forefront of the discussions.”

Older Rhode Islanders and aging groups must continue to push the House to at a minimal maintain the governor’s senior agenda. Hopefully, as Mattiello said, senior programs and services can be enhanced.

For a Senate Fiscal Analysis of Raimondo’s FY 2020 budget, go to http://www.rilegislature.gov/sfiscal/Budget%20Analyses/FY2020%20SFO%20Governor’s%20Budget%20-%20First%20Look.pdf.

Caregivers Can Take Advantage of Free Credit Freeze Law

Published in the Woonsocket Call on October 14, 2018

Attorney General Peter F. Kilmartin touts a new federal consumer protection law, signed into law by President Donald Trump on May 24, 2018, that protects seniors from becoming victims of financial exploitation. Rhode Island’s Attorney General says that this law enhances Rhode Island’s law prohibiting credit reporting agencies from charging fees for credit freezes,(also referred to as a security freeze).

With enactment of the Economic Growth, Regulatory Relief, and Consumer Protection Act, all consumers can now freeze and unfreeze their credit file for free for one year. Before this new law, fees were assessed, usually costing from $3 to $10 (though some states were free) to restrict access to your credit file, making it harder for others to open new accounts in another person’s name.

The new law lets people with certain legal authority to act on someone else’s behalf to freeze and unfreeze their credit file. It defines a “protected consumer” as an incapacitated person, someone with an appointed guardian or conservator, or a child under the age of 16. In addition, it extends the duration of a fraud alert on a consumer’s credit report from 90 days to one year. A fraud alert requires businesses that check a consumer’s credit to get the consumer’s approval before opening a new account.

“Many instances of financial exploitation include a person opening up credit cards or using the credit file of another for personal gain and identity theft. This added layer of protection will allow a guardian or financial caregiver the ability better safeguard the older person from being taken advantage of by a stranger or even someone they know and thought they could trust,”says Kilmartin.

To place a credit freeze on their accounts, consumers will need to contact all three nationwide credit bureaus: Equifax, Experian, and TransUnion. If you’re acting on behalf of a protected consumer, you must give the credit reporting agencies proof of authority before you can freeze and unfreeze the protected consumer’s credit. Proof of authority includes: a court order (such as an order naming you guardian or conservator; a valid power of attorney, and proof of your identity, which can be a Social Security card, birth certificate, driver’s license or other government issued identification.

Whether consumers ask for a freeze online or by phone, the credit bureau must put the freeze in place within one business day. When consumers request to lift the freeze by phone or online, the credit bureaus must take that action within one hour. (If consumers make these requests by mail, the agency must place or lift the freeze within three business days).
To place a fraud alert, consumers need only contact one of the three credit bureaus, which will notify the other two bureaus.

Rhode Island’s Credit Freeze Law

Filed at the request of Kilmartin and enacted earlier this year, the Rhode Island law eliminates a provision of existing state law that allows reporting agencies to charge up to $10 to consumers who ask for a credit freeze.

The legislation, which the sponsors introduced on behalf of Rhode Island Attorney General Kilmartin, stems from the Equifax security breach last year during which the credit information of 143 million Americans was exposed. Initially, Equifax was charging consumers who asked for a credit freeze to protect themselves from its own security breach, although it stopped after intense public outcry and pressure from numerous attorneys general.

At the time the law was enacted, Kilmartin said, “This is a big victory for Rhode Island consumers, giving them greater control over who can access their personal and financial information. Credit bureaus make money from selling our personal information to third parties. They should not be able to profit off consumers who decide to take control over who has access to their personal data.”

Protecting Rhode Island’s Seniors

“AARP applauds all efforts to protect older Rhode Islanders from phone and online credit scams that lead to identity theft,” says AARP Rhode Island State Director Kathleen Connell. “Clearly, many consumers, and especially many of Rhode Island’s 134,000 caregivers, will consider taking advantage of this new option. It certainly complements the work we are doing as part of AARP Fraud Watch to thwart con artists who prey relentlessly on people of all ages.

“In the case of older Rhode Islanders, life savings can be at risk. “The new federal law allows caregivers to acquire legal authority to freeze a loved one’s credit reports, and that’s a good thing. But it is important to note that there are many things a caregiver should consider. Basically, caregivers need to have conversations about the threat and what everyone should be doing to protect against credit theft,” she added.

AARP’s John Martin said when he presents the Fraud Watch program to community groups he urges people to think about fraud prevention in the same way training and professional development is part of their work experience. “In the workplace, your job includes being up to speed on the latest policies, regulations and best practices,” Martin tells audiences. “Lawyers read law reviews, doctors read medical journals, tugboat captains read The Shipping News. Failure to do so could lead to a missed opportunity or a big mistake. Given the enormous threats out there, we all should consider keeping up on the latest scams and implementing precautions something like a part-time job that requires similar diligence. To do otherwise increases your risk and the stakes are frighteningly high.”

Connell warns not to forget the basics. “AARP provides common-sense advice, awareness and precautions as well as alerts when new scams are exposed or an old one reappears,” she says. “Don’t be passive and please do encourage older family members to be on guard. We are all in this together.”

Anyone can sign up for the free Fraud Watch Network service at http://www.aarp.org/RIFraudwatch to receive alerts and report scams or other suspicious activity.

Reporting Financial Exploitation

The Rhode Island Office of the Attorney General recommends that if you believe you or an older relative are victims of financial exploitation, contact your local police department, the Rhode Island Division of Elderly Affairs, or the Elder Abuse Unit at the Rhode Island Office of the Attorney General.

If you would like an investigator at the Elder Abuse Unit or an investigator with the Consumer Protection Unit to speak with your organization on the signs of elder abuse or how to protect from being a victim of a scam, please contact Mickaela Driscoll, Elder Abuse Investigator, at mdriscoll@riag.ri.gov or Martha Crippen, Director of the Consumer Protection Unit, at mcrippen@riag.ri.gov or by calling 401-274-4400.

Calls for Strengthening Medicare as it Hits 53

Published in the Woonsocket Call on August 5, 2018

Just before Summer recess House Democratic Leader Nancy Pelosi (D-CA) joined Seniors Task Force co-chairs Congresswomen Jan Schakowsky (D-IL) and Doris Matsui (D-CA), Democratic Policy and Communications Committee co-chair Congressman David Cicilline (D-RI) and seniors’ advocates gathered in the historic Rayburn Room of the U.S. Capitol, one of the largest rooms on Capitol Hill, to celebrate the 53rd anniversary of Medicare and Medicaid being signed into law by President Lyndon Johnson.

“We usually celebrate Medicare’s anniversary at the U.S. Capitol with balloons and cake. This year, the 53rd anniversary, was a more solemn occasion because of relentless attacks on the program by the Trump administration and Congressional Republicans, says Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, one of the advocacy groups in attendance.

When signing the landmark legislation into law on July 30, 1965, President Lyndon B Johnson said, “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime. No longer will young families see their own incomes and hopes eaten away simply because they are carrying out their deep moral obligations to their parents.”

At the July 25 birthday commemoration, Leader Pelosi called Medicare and Medicaid “the pillars of health and security for the nation,” noting that for years these two programs have been under unrelenting and constant attacks from Republicans.

“For years, Republicans have sought to deny seniors and working families the healing miracle of medicine. Republicans want Medicare, in their words, to ‘wither on the vine.’ They want to cut and cap Medicaid into oblivion. They want to give massive tax handouts to big pharma who are denying seniors lower prescription drug prices,” says Pelosi.

According to Pelosi, the Democrats plan, A Better Deal, provides a legislative strategy for lowering the price of prescription drugs. “Our plan calls for tough new enforcement of drug price gauging, allowing Medicare part D to negotiate drug prices,” she said, noting that President Donald Trump had promised that during his presidential campaign, “We’re going to negotiate like crazy.”

Echoing Pelosi, at the press conference Rhode Island Congressman Cicilline also called for the reining in of prescription drug costs to put the brakes on rising Medicare expenditures. “Democrats believe that seniors shouldn’t have to cut pills in half to afford prescription drugs. We need a president who will work with us to allow Medicare to negotiate drug prices, to compel drug makers to justify cost increases, and to crack down on price gougers,” said Cicilline.

Cicilline reminded those attending that the President once promised to take on the drug companies but now has decided to appoint a former drug company executive as his Secretary of the Department of Health and Human Service. “And right now, he’s pretty much letting the pharmaceutical lobby have the run of the place,” he charged.

At the press conference, the Democratic lawmakers were joined by ten yellow t-shirted senior volunteers from the National Committee to Preserve Social Security and Medicare’s Capitol Action Team (CAT), who demanded that the program be strengthened. One of the CAT members, Patricia Cotton, gave a powerful personal testimonial about the importance of Medicare in her life. Cotton, a Medicare beneficiary who suffers from a blood cancer known as Myelofibrosis, said she wouldn’t be alive today without the health care program.

“My cancer meds started at $10,000 every 30 days and have gone up twice in two years. Cancer meds are very expensive. My Medicare Part B and D premiums have gone up, and that is coming out of my Social Security check. That is why, without Medicare and Social Security, the rich will live and the poor will die,” said Cotton.
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Democratic Report Spotlights GOP’s Ongoing Attacks on Medicare

At this event, the House Democratic Seniors Task Force unveiled a new 24 page report, “The Republican Record on Medicare, Medicaid and Social Security: Attacks on Benefits Seniors Have Earned and Deserve,” detailing years of Republican’s attacks on seniors and demanded the GOP take action on lowering pharmaceutical prices.

“This report shows how the passage of the GOP tax bill was just one step in a long line of Republican attacks on seniors,” says Congressman Matsui (D-CA). “In budget after budget, year after year, Republicans have reaffirmed their commitment to gutting Medicaid, scaling back Medicare, and cutting seniors’ earned Social Security benefits. Democrats are focusing on efforts that help seniors and families, like lowering drugs prices, and fighting to ensure that these vital programs are here for current and future generations.”

“The House GOP budget proposal includes more than $500 billion in Medicare cuts, a higher eligibility age, and privatization of the program through a voucher system,” the National Committee’s Max Richtman explains. “The President’s 2019 budget would inflict similar harm on Medicare. The Trump administration is undermining the program through skillfully worded enrollment information that favors private Medicare Advantage plans over traditional Medicare. These actions are contrary to the mission of Medicare so eloquently stated by President Lyndon Johnson is when he signed it into law 53 years ago,” says Richtman.

AARP Calls Medicare an Economic Engine for Rhode Island

Last year, Medicare, which helps pay the health care costs of 56 million beneficiaries, is a critical part of the country’s economic infrastructure, investing about $ 710 billion in the national economy that year, says AARP.

On July 25th, the same day that House Democratic Leadership and aging groups celebrated the 53rd anniversary of the signing of Medicare, AARP released fact sheets illustrating Medicare’s contribution to the economies of each state and the District of Columbia.

Let’s take a close look at the Ocean State.

Medicare contributes $2.5 billion to Rhode Island’s economy, equivalent to 21% of state and local government spending in the state, according to the released AARP Rhode Island fact sheet, noting that the program also covers 192,186 beneficiaries in the state. In polls, older Americans have said Medicare is one of their top issues in the 2018 mid-term elections, and AARP Rhode Island is working to encourage older Rhode Island voters to participation this election season.

“Medicare is a major economic engine in our economy security, as well as a key part of, providing health security to Rhode Islanders,” said AARP State Director Kathleen Connell in a statement. “Older Americans have said Medicare is one of their top issues in this election, yet too many politicians fail to recognize the contributions Medicare makes to the economy and our residents. Any candidate who fails to talk about how they would strengthen Medicare for future generations does so at their peril,” says Connell.

Below the AARP fact sheet breaks down some of Medicare’s spending in Rhode Island:
• $1.1 billion for hospitals
• $551 million for doctors
• $338 million for prescriptions and medical supplies
• $198 million for skilled nursing facilities
• $159 million for home healthcare agencies
• $92 million health professionals
• $24 million for medical equipment

Also, businesses in Rhode Island receiving Medicare dollars use them to pay employees’ salaries, rent, state and local taxes, and buy equipment, and make capital improvements to their facilities, says the AARP fact sheet.

With the mid-term elections looming, it is now time to send a clear message to Congress and President Donald Trump, “Stop Attacking Medicare.” Lawmakers on both side of the aisle must work to craft a bipartisan solution to strengthen the program for the benefit of America’s retirees. Consider sending this message when you vote…

AARP’s “Be The Difference. Vote” campaign includes a one-stop online portal – aarp.org/vote – to provide people with information (about Social Security, Medicare, Medicaid and aging issues} they need to. know about before voting in the upcoming November elections.

To see the House Democratic Senior Task Force report, “The Republican Record on Medicare, Medicaid and Social Security: Attacks on Benefits Seniors Have Earned and Deserve,” go to
http://www.schakowsky.house.gov/uploads/Seniors%20Task%20Force%20Report%207.24.18.pdf

GOP House Budget Fray’s Nation’s Safety Net

Published in the Woonsocket Call on June 24, 2018

Just six months ago, the Republican-controlled House passed their massive $1.5 trillion tax cuts for the nation’s largest corporations and to the wealthiest 1 percent. The day of reckoning has now come as the GOP spells out how it will rein in the nation’s spiraling deficit through its recently released FY 2019 budget resolution. On Tuesday, the House Budget Committee unveiled its 85-page budget resolution, making trillions in spending cuts to Medicare and Medicaid, he nation’s two largest entitlement programs, health care, and programs benefiting veterans, students and working families. ‘

The budget titled, “A Brighter American Future,” calls for $8.1 trillion of deficit reduction while including reconciliation instructions for 11 House authorizing committees to enact at least $302 billion over nine years. Consistent with levels signed into law in February 2018, this budget sets topline discretionary spending at $1.24 trillion ($647 billion for defense spending and $597 billion for non-defense discretionary spending).

The budget blueprint cleared the House Budget Committee by a partisan vote of 21-13, with a vote, with a Democratic and Republican lawmaker absent from the vote. Political insiders Fortunately, Capitol Hill-watchers say the 2019 House GOP Budget proposal is unlikely to make it before the full House or pass this year. But, it sends a message out to voters about the Republican’s legislative priorities to rein in a skyrocketing deficits and debt by slashing entitlement and popular domestic programs.

Putting the Wealthy and Powerful Ahead

When unveiling the House GOP’s budget, Chairman Steve Womack of Arkansas, notes that it addresses “unsustainable mandatory spending, continues economic growth, encourages better government and greater accountability, and empowers state and local governments.”

During a CNBC interview on June 22, 2018, Womack said, “We have done our job and it is a reflection of what we believe is the stark reality of the fiscal condition of our country right, unstable deficits year over year and $21 trillion in debt that is going to continue to grow over time. We just felt like it was time to sound the alarm and do something about and this and this particular budget resolution does it.”
Democratic Policy and Communications Committee Co-Chair David N. Cicilline counters Womack’s rosy assessment of the House GOP budget. ““If a budget is a statement of your values, then this budget shows Republicans are putting the wealthy and powerful ahead of working people. Just a few months after passing a massive tax cut for billionaires and corporate special interests, Republicans are proposing to repeal the Affordable Care Act; cut funding for road repairs and other infrastructure projects; cripple Medicare and Social Security; make deep cuts to Pell grants; and repeal Dodd-Frank so the big banks can do whatever they want once again. In fact, this budget is so terrible, it’s hard to imagine Republicans will ever bring it to the floor,” says the Rhode Island lawmaker.

“But despite an extraordinary past and a booming economy thanks to tax reform, there are real fiscal challenges casting a shadow of doubt on the nation’s future, including $21 trillion of debt that is rapidly on the rise. We must overcome the challenges,” says Womack.

Womack says that his budget plan “offers a balanced and responsible plan to not only address the challenges but give rise to the nation’s prosperity.”

Medicare and Medicaid on Budgetary Chopping Block

Numerous federal programs affecting old Americans would be put on the budgetary chopping block, which includes another call for full repeal of the Affordable Care Act (ACA), leaving 23 million Americans without health coverage. $5.4 trillion of cuts would come from mandatory or automatic spending programs such as Medicare and Medicaid. The plan calls for raising the Medicare eligibility age to 67, as well as combining Medicare Parts A and B, and allowing for privatization of the entitlement program. The projected cuts for Medicare alone add up to $537 billion.

The GOP’s efforts to privatize Medicare runs counter to what Americans want, preserving the program in its current form. The Kaiser Family Foundation released poll results in 2015, celebrating Medicare’s 50th Anniversary, the respondents by a margin of more than two to one, do not want to see their traditional Medicare privatized.

As to Medicaid, a joint federal and state program that helps with medical costs for some people with limited income and resources, the GOP budget plan limits per capita payments and allows states to turn it into a block grant. It also introduces stricter work requirements for beneficiaries and shifting to a capped system linked to medical inflation rates, these changes cutting about $1.5 trillion. Additionally, Womack’s budget would no longer allow people on Social Security disability to receive unemployment insurance at the same time, slashing $4 billion for the FY 2019 budget.

Outside of mandatory spending programs, the budget would cut trillions from “welfare,” federal retirement programs and veterans programs, while overhauling rules for medical liability lawsuits.

“This budget proposal is a direct attack on the quality of life of America’s seniors,” said Robert Roach, Jr., President of the Alliance of Retired Americans. “We must hold our elected officials accountable for their actions. We predicted cuts to our hard-earned benefits after the GOP passed their unfunded tax cuts for billionaires and corporations. Unfortunately, that reality is now staring us in the face,” he says.

Adds Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, “Speaker Ryan is obviously making good on his promise to come after safety net programs to pay for the reckless Trump/GOP tax reform. In so doing, he and his party are sending a clear message: older, poorer, and disabled Americans are not as important as the billionaires and big corporations who are the main beneficiaries of a tax scheme that is blowing up our nation’s debt.”

Before the House Budget Committee vote, Joyce A. Rogers, AARP’s Senior Vice President Government Affairs, urged that Medicare not be cut. She called for good changes such as “reducing prescription drugs costs, enhancing payment and delivery reforms, and addressing the widespread fraud, waste, and abuse in the program.”

According to Rogers, “The typical senior, with an annual income of approximately $26,000 and already spending one out of every six dollars on health care, counts on Social Security for the majority of their income, and on Medicare for access to affordable health coverage.”

Finally, Rogers notes that the Supplemental Nutrition Assistance Program (SNAP) plays vital role in providing nutritional assistance to millions of eligible, low-income individuals and families, many seniors. “In 2016, 8.7 million (over 40 percent of) SNAP households had at least one adult age 50 or older. Proposals to block grant the program, or expand work requirements, will make SNAP less responsive and accessible in times of need,” she says.

Educate Yourself About the Issues

With the upcoming Rhode Island primary on September 12, and midterm elections just 135 days, AARP Rhode Island State Director Kathleen Connell urges all registered Rhode Island voters to review candidates’ positions on the issues and go to the polls and cast your ballot. “The 2018 midterms will be among the most historic elections in a generation,” she said.

Nationwide, the balance of power in both houses of Congress, as well as in many state legislatures and governorships, could shift because of the results in the fall’s general elections, says Connell.

While the most common way to vote is for registered voters to go to their local polling place on Election Day, Connell said that many family caregivers and others who may have difficulty voting on that day may be eager to take advantage of other methods of casting a ballot.

“With all that unpaid family caregivers have on their plates each day, it can often be hard for them to get to the polls on Election Day,” said Connell. “If a caregivers’ loved one is voting, it can be even harder, especially if their loved one has mobility issues. When available, alternative methods of casting a ballot (a mail ballot) are essential to allowing our state’s family caregivers and others to participate in this important election.” To learn more about mail ballots, visit https://vote.sos.ri.gov/

To mobilize it’s 35 million members, AARP has launched “Be the Difference. Vote,” a campaign designed to maximize the political influence of over age 50 voters. The initiative seeks to get the largest possible turnout of older voters to the polls during the ongoing primaries and in the November general election. It will also put front and center issues like Medicare security and family caregiving, along with other topics of particular interest to older voters.

To learn more about “Be the Difference. Vote,” check out aarp.org/vote to see how to get involved and state informed.

2050 and the Caregiver Dilemma

Published in the Woonsocket Call on April 22, 2018

The year 2030 marks an important demographic turning point in U.S. history according to the U.S. Census Bureau’s 2017 National Population Projections, released last month. By 2030, older people are projected to outnumber children. In the next twenty years, when these aging baby boomers enter their 80s, who will provide informal caregiving to them.

Almost three years earlier, in a July 2015 report, “Valuing the Invaluable: 2015 Update Undeniable Progress, but Big Gaps Remain,” the AARP Public Policy Institute warned that fewer family members will be around to assist older people with caregiving needs.

According to AARP’s 25-page report, coauthored by Susan C. Reinhard, Lynn Friss Feinberg, Rita Choula, and Ari Houser, the ratio of potential family caregivers to the growing number of older people has already begun a steep decline. In 2010, there were 7.2 potential family caregivers for every person age 80 and older. By 2030, that ratio will fall sharply to 4 to 1, and is projected to drop further to 3 to 1 in 2050.

Family caregivers assisting relatives or close friends afflicted with chronic, disabling, or serious illness, to carry out daily activities (such as bathing or dressing, preparing meals, administering medications, driving to doctor visits, and paying bills), are key to keeping these individuals in their homes and out of costly nursing facilities. What is the impact on care of aging baby boomers when family caregivers no longer provide assistance in daily activities?

“In 2013, about 40 million family caregivers in the United States provided an estimated 37 billion hours of care to an adult with limitations in daily activities. The estimated economic value of their unpaid contributions was approximately $470 billion in 2013, up from an estimated $450 billion in 2009,” notes AARP’s caregiver report. What will be the impact on the nation’s health care system without family caregivers providing informal care?

The Census Bureau’s 2017 National Population Projections, again puts the spot light on the decreasing caregiver ratio over the next decades identified by the AARP Policy Institute, one that must be planned for and addressed by Congress, federal and state policy makers.

Who Will Take Care of Aging Baby Boomers?

With the expansion in the size of the older population, 1 in every 5 United States residents will be retirement age. Who will provide informal caregiving in our nation with a larger adult population and less children to serve as caregivers?

“The aging of baby boomers means that within just a couple decades, older people are projected to outnumber children for the first time in U.S. history,” said Jonathan Vespa, a demographer with the U.S. Census Bureau. “By 2035, there will be 78.0 million people 65 years and older compared to 76.4 million under the age of 18.”

The 2030s are projected to be a transformative decade for the U.S. population, says the 2017 statistical projections – the population is expected to grow at a slower pace, age considerably and become more racially and ethnically diverse. The nation’s median age is expected to grow from age 38 today to age 43 by 2060.

The Census Bureau also observed that that as the population ages, the ratio of older adults to working-age adults, also known as the old-age dependency ratio, is projected to rise. By 2020, there will be about three-and-a-half working-age adults for every retirement-age person. By 2060, that ratio will fall to just two-and-a-half working-age adults for every retirement-age person.

Real Challenges Face Congress as the Nation Ages

Jean Accius, Ph.D., AARP Policy Institute’s Vice President, Independent Living, Long-Term Services and Supports, says, “The recent Census report highlights the sense of urgency to develop innovative solutions that will support our growing older adult population at a time when there will likely be fewer family caregivers available to help. The challenges that face us are real, but they are not insurmountable. In fact, this is an opportunity if we begin now to lay the foundation for a better system of family support for the future. The enactment of the RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act, which would create a strategy for supporting family caregivers, is a great path forward.”

Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare, gives his take on the Census Bureau’s 2017 statistical projections, too.

“Despite how cataclysmic this may sound, the rising number of older people due to the aging of baby boomers is no surprise and has been predicted for many years. This is why the Social Security system was changed in 1983 to prepare for this eventuality. Under current law, full benefits will continue to be paid through 2034 and we are confident that Congress will make the necessary changes, such as raising the wage cap, to ensure that full benefits continue to be made well into the future,” says Richtman.

Richtman calls informal caregiving “a critical part of a care plan” that enhances an older person’s well-being. “While there currently are programs such as the Medicaid Waiver that will pay family members who provide caregiving support more can be done to incentivize caregiving so that loss of personal income and Social Security work credits are not barriers to enlisting the help of younger individuals to provide informal support services,” he says.

Adds Richtman, the Medicare and Medicaid benefits which reimburse for the home-based services and skilled nursing care “will be unduly strained ”as the diagnosed cases of Alzheimer’s disease skyrockets with the growing boomer population. He calls on Congress to “immediately provide adequate research funding to the National Institutes of Health to accelerate finding a cure in order to save these programs and lower the burdens on family caregivers and the healthcare system. “

Finally, AARP Rhode Island State Director Kathleen Connell, says “Our aging population represents challenges on many, many fronts, including healthcare, housing, Social Security, Medicare and, of course, caregiving. It would be nice to think everything would take care of itself if there were more younger people than older people. But that misses the point entirely. The needs of older Americans are a challenge to all Americans, if for no other reason than most of us end up with multiple late in life needs. And too many reach that point without savings to cover those needs.”

“It’s worth noting, by the way, that many of the solutions will come from people 50 and older — many of whom will work longer in their lives to improve the lives of older Americans. We need to stop looking through the lens of ‘old people’ being the problem and instead encourage and empower older Americans to take greater control over their lives as they help others,” says Connell.

“Congress needs to focus on common sense solutions to assure families that Social Security and Medicare are protected. The healthcare industry needs to face the medical challenges. And at the state and local level, we must focus on home and community-based health services,” adds Connell.

For details about the Census Bureau’s 2017 statistical projections, co to http://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html.

For more information about AARP’s July 2015 caregiver report, go to http://www.aarp.org/content/dam/aarp/ppi/2015/valuing-the-invaluable-2015-update-new.pdf.

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