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.

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Fogarty Retiring as Elderly Affairs Director

Published in Woonsocket Call on January 28, 2018

Just days ago, Director of Rhode Island’s Division of Elderly Affairs (RIDEA), Charles J. Fogarty, announced his retirement to take place at the end of June, after 4 decades of public service. There have been nine directors since the establishment of DEA, including Fogarty.

Fogarty’s plans to retire at the end of the current legislative session. When this occurs, Governor Gina Raimondo will make an appointment to the RIDEA director position. The position requires advice and consent of the RI Senate.

Fogarty began his career in public service in 1978 as a junior policy advisor for Governor J. Joseph Garrahy. He served as lieutenant governor, from 1999 to 2007, having the distinction of being the last lieutenant governor to preside over the State Senate. From 2011 to 2015, Fogarty served as the director of the Department of Labor and Training, ending up his career as the Director of RIDEA.

During his years of public service, Fogarty, 62, has been focused on long term care and home- and community-based services and supports for older Rhode Islanders. He played a key role in steering and expanding the work of the Long-Term Care Coordinating Council during his tenure as Lieutenant Governor for two terms. Under his leadership at the Department of Labor and Training, he reformed the unemployment insurance process. During his stewardship as Director at Elderly Affairs (since January 2015), he has led a division providing services and advocacy for over 166,500 older adults living in Rhode Island.

As a Glocester resident he was elected to the Glocester Town Council in 1984 and in 1990 was elected as a state senator, where he served for eight years. While a state senator, he served as both majority whip and Senate President Pro Tempore.

Fogarty Reflects on RIDEA Tenure

“Throughout my career, I have felt drawn to serve the people of Rhode Island. I look back fondly and feel fortunate to be a part of the forward progress Rhode Island is experiencing–particularly working with Governor Raimondo to empower seniors and help them to remain independent and living in the community,” said Fogarty.

According to Fogarty, under his helm, RIDEA has continued to process of supporting community-and home-based services for seniors and caregivers, but more needs to be done in order to really rebalance Rhode Island’ long-term care system. Aging in the community- in our own homes- is what many Rhode Islanders want for ourselves and our loved ones, he says.

“We’ve restored funding for Meals on Wheels, provided additional funding for respite services, and this year are proposing to double the amount the state invests in senior centers. Senior centers are primary gateways in the community that connect older adults and caregivers to services that can have profound impacts upon their ability to remain healthy and independent,” notes Fogarty.

Fogarty says, “If the general assembly follows Governor Raimondo’s lead and doubles the funding for senior centers, Rhode Island will be taking a huge step in the right direction of providing the appropriate support to these essential senior services.”

“We need to prepare for the shift in demographics that is occurring, and accept that the old model of providing long term care services isn’t working for the large number of Boomers who are marching towards retirement and old-age. RIDEA and other key partners are engaging in the Age-Friendly Rhode Island initiative, and we all need to work together to provide more choices and options for Rhode Islanders as they age, empowering them, and helping them to remain independent and healthy,” adds Fogarty.

Tributes to Fogarty

“Charlie has dedicated his entire professional life to Rhode Island and we thank him for his decades of service to our state,” said Governor Gina M. Raimondo, in a statement, recognizing the key role he played as DEA Director in expanding Meals on Wheels and in repealing the tax that seniors pay on their Social Security.

“As sitting Lt. Governor, I appreciate Charlie being a resource to me on issues important to our state’s seniors. Under his leadership, the Division of Elderly Affairs has been a hands-on partner in executing the initiatives of the Long Term Care Coordinating Council and the Alzheimer’s Executive Board,, says Lt. Governor Dan McKee.

“We are especially grateful for Charlie’s support in launching our Age Friendly RI Report in 2016. In a few weeks, we will be announcing an exciting development in Rhode Island’s Alzheimer’s State Plan that would not be possible without Charlie’s participation. I have enjoyed working with Charlie and I wish him all the best as he begins this exciting new chapter,” adds McKee.

Maureen Maigret, Vice Chair Long Term Care Coordinating Council, sees Fogarty’s experience as oversight as Lt. Governor of the state’s Long-Term Coordinating Council, gave him the insight ad understanding of long term care issues and the needs of older Rhode Islanders.

Maigret says that professionals in the aging network will remember Fogarty for his strong support for and educating the community about need to expand services that help older persons to stay at home and live independently for as long as possible and to pay attention to caregiver support needs.

Adds AARP Rhode Island State Director Kathleen Connell, “I have known Charlie for many years and know him to be a worthy heir of his uncle, the late-great RI Congressman, who was a leading champion of legislation and policy benefiting older Americans.”

“At Elderly Affairs, he utilized many skills and resourcefulness acquired through his time as a legislator, Lt. Governor and Labor & Training director — not to mention his personal interest in the health and wellbeing of all Rhode Islanders. His leadership has been an enormous asset at the Division of Elderly Affairs,” says Connell.

After his retirement from four decades of state service, he will continue to serve on the faculty at Johnson & Wales University, as Adjunct Professor of Leadership Studies. He also plans to volunteer with Meals on Wheels, having seen the significant impact the home-delivery meal program has on combatting senior isolation. He will also continue to be involved at his church.

On a personal level, Fogarty plans to “learn to cook,” by enrolling in cooking classes, travel and perhaps learn to speak Spanish.

 

Housing Report Supports Push to Approve Question 7

Published in Woonsocket Call on October 30, 2016

Earlier this year, Rhode Island Housing (RIH) released a 44 -page report detailing the Ocean State’s current and future housing needs. One thing was clear to those attending this event: over the next decade the state will need more affordable housing for its residents.

Over the last 7 months, RIH’s Executive Director Barbara Fields has crisscrossed the Ocean State calling for increased housing opportunities for working Rhode Islanders. During this period of time she has presented the study’s findings to more than a dozen civic and government groups, including AARP Rhode Island, the Providence City Council and United Way.

During the last legislative session Rhode Island housing advocates were successful in their push for the enactment of a bond initiative that would make a significant state investment in affordable housing. As part of the omnibus statewide budget package, a $50 million Housing Opportunity Bond initiative for housing programs was passed by the House and Senate chambers, ultimately to be signed into law by Governor Gina Raimondo (D) and put to voter approval on the November ballot.

With the November election fast approaching, Fields has not let her report, compiled by HousingWorks RI, a research program at Rogers Williams University, sit on a dusty shelf but is using it to push for passage of the housing bond initiatives.

RIH Releases its Comprehensive Housing Study

On April 6, Fields gathered with state housing advocacy groups at the Rhode Island Commerce Corporation to unveil RIH’s landmark housing study, Projecting Future Housing Needs. Fields warned that the state’s economic comeback must be tied to new and existing housing that stays within the financial reach of Rhode Islanders. “Today in Rhode Island, the demand for housing is high while the supply is much too low. This imbalance simply makes the cost of housing too expensive for what our residents earn. This report provides critical insight into what the future needs of Rhode Islanders will be and that information will allow us to develop a plan to address those needs,” she said.

At this event, Rhode Island Commerce Secretary Stefan Pryor tied adequate housing for working Rhode Islanders as key to bringing businesses to the Ocean State. “Companies looking to expand or relocate consider how well they will be able to retain and attract their workforce, and a key part of doing so is ensuring that employees of all income levels have high quality housing opportunities,” said Pryor. “It’s vital to our state’s economic success and our quality of life that we preserve and produce high quality housing options for our residents,” he added.

The RIH report’s findings indicate that Rhode Island’s population is projected to grow between 3 and 5 percent from 2015 to 2025. Researchers warn that new housing demand will outpace population growth, and anticipate a 12 to 13 percent increase in the number of households, driven by a growing population and simultaneous decline in household size tied to both lower birth rates and an aging population. Researchers also predict housing demand will be driven by a large population growth in two demographic groups that tend to have lower incomes – namely aging baby boomers and seniors and young millennials.

According to the RIH report, cost burden problems of paying rent do not just impact older Rhode Islanders and Millennials, but have become more mainstream issues over the last ten years and now affect all income brackets. The findings found that Rhode Islanders already pay more than 30 percent of their income on housing costs, and that more than half of the increase in cost burden from 2000 to 2012 impacted households earning more than $57,700.

From 2000 to 2014, the researchers found that the state’s total population grew marginally at 0.11 percent, but the number of households grew by 0.28 percent. Rhode Island’s smaller household sizes are due, in part, to a larger proportion of older persons and a smaller proportion of persons of color when compared to national rates. Younger households are likely to have more people than those headed by people aged 65 and older, primarily because they are more likely to be family households with children. As this demographic shift continues, the future population will need more housing units to meet the increased household need caused by smaller household sizes typical of older householders.

Pushing for Passage of Question 7

Like Fields, Chris Hunter, campaign manager for the Yes On 7 Campaign, sees the RIH report’s findings as crucial information that voters need to know about the impending housing crisis. “As Rhode Island Housing’s recent report shows, we’re simply not creating enough new housing to meet projected population growth. At the same time we’re facing an affordability crunch as our young workers just starting their careers, families, veterans, and seniors are having a difficult time paying for housing while also making ends meet,” says Hunter.

“That’s why Question 7 and the $50 million Housing Opportunity bond is such a smart investment in housing and Rhode Island’s economy,” says Hunter, stressing that if approved by the voters the $50 million bond initiative will leverage an additional $160 million in federal and private investments.

According to Hunter, if approved, $40 million of the bond dollars will be allocated to the construction of affordable homes and apartments across Rhode Island, while the remaining $10 million will be used to help cities and towns revitalize blighted and foreclosed properties. The bond will also fund the construction of 800 affordable homes and apartments across Rhode Island and create 1,700 good paying local construction jobs.

Over 60 percent of Rhode Island voters passed housing bond initiatives in put on the ballot in 2006 ($50 million) and 2012 ($25 million), says Hunter. “Funding from these last two affordable housing bonds created 1,943 affordable units in 30 communities around the state, and leveraged more than $300 million in federal and private investment in these projects,” he says.

RIH‘s housing report has sounded the alarm, giving a stark warning to local and state officials that a housing crisis exists and will only get worse with the shifting of the state’s demographics. With the election looming, RIH’s Fields continues to push for passage on Question 7. Hunter works to mobilize his housing advocates and supporters of Question 7 to get the word out to every voter in Rhode Island’s 39 cities and towns that this bond initiative must be passed. Hopefully, their message will get across to Rhode Island voters. We’ll see when the votes are counted.

For more details on Question 7, visit http://www.yeson7ri.com.

Herb Weiss, LRI’12 is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Aging Report is “Rhode Map” for Change

Published on June 27, 2016 in Pawtucket Times

Next year look for the policy debate in the Rhode Island General Assembly to heat with Governor Dan McKee’s Aging in Community Subcommittee of the Long Term Care Coordinating Council (LTCCC) release of a sixty page report in June documenting the sky rocketing growth of the state’s older population and identifying strategies to allow these individuals to age in place and stay in their communities.

The Aging in Community Subcommittee was mandated by the enactment of the Aging in Community Act of 2014, sponsored by Senate Majority Whip Mary Ellen Goodwin and Representatives Christopher Blazejewski and Eileen Naughton. The Subcommittee, chaired by Maureen Maigret, Vice Chair of the Long Term Care Coordinating Council, and former Director of the Division of Elderly Affairs, staff from Rhode Island College, Brown University and the University of Rhode Island, representatives from state agencies, members of the senior community, and senior service providers.

According to Maigret, it has taken almost 18 months to gather data, host focus groups and to write the “Aging in Community” report. The report provides demographic data snapshot on the state’s older population and also inventories current services and resources. It also identifies challenges faced by older Rhode Islanders and recommends strategies to promote successful aging in community in these nine issue areas.

Maigret believes that this report may take the most comprehensive look at what aging programs and services are available to assist older Rhode Islanders age in place in their communities and it identifies what programs and services are lacking. “The State Plan on Aging does have some data and actions planned but does not comprehensively cover all the domains covered in the “Aging in Community” report,” she says.

A Demographic Snap Shot

In 2010, the report notes that over 152,000 Rhode Islanders were age 65, predicting that this number will sky rocket to 247,000 in 2030. By 2025, Rhode Island will be considered to be a “Super Aging” state where 20 percent of its population will be over age 65. The report noted that two years ago the population of New Shoreham, Little Compton, North Smithfield, North Providence and Tiverton had already reached “Super Aging” status.

The report added that 42 percent of over age 65 household incomes amounted to less than $30,000. Only 49 percent of the retirees have non Social Security retirement income. Fifty two percent of the older renters and 39 percent of the home owners were financially burdened with covering housing costs. Poverty levels for older Rhode Islander vary, from 7 percent in Bristol County to 18 percent in Providence County.

The LTCCC report notes that even with lower incomes older Rhode Islanders have a major impact on the state’s economy. They bring in over $2.9 billion dollars from Social Security pensions and $281 million in taxes into the state’s economy. Older workers account for 33,750 jobs throughout all job sectors.

Rhode Island’s retirees provide an estimated $ 149 million by volunteering and an estimated $ 2 billion in providing caregiving services to family and friends.

A Spotlight on Priority Recommendations

The Subcommittee’s findings were the result of interviews held with aging service providers, an examination of age-friendly best practices in other states and ten focus groups conducted with older Rhode Islander from across the state.

The focus groups attendees gave the Subcommittee valuable information. They stressed that Senior Centers were “highly valued.” Many expressed financial concerns for their current situation and into the future. Attendees were very concerned about the lack of transportation and lack of affordable housing. State customer service employees were viewed by many as “unfriendly.”

Dozens of strategies were listed in the LTCCC report for state policy makers to consider to better assist older Rhode Islanders to successfully age in their community in these nine issue areas: Information and Communication, Community Engagement, Transportation, Economic Security, Food Security and Nutrition, Housing, Supports at Home, Healthcare Access and Open Spaces/Public Buildings

The LTCCC report identifies priority strategies including the restoring of senior center funding based on a population-based formula and continuing RIPTA’s no-fare bus pass program for low income seniors and persons with disabilities. It also calls for increase payments for homecare and for restoring state funding for Elder Respite.

Maigret says that creating a coalition of aging groups to “build an age-friendly Rhode Island” is the next step to take. Businesses can also become “age friendly” and better understand the economic value of older Rhode Islanders bring to the state and its educational institutions, she says.

Political Will Required to Implement LTCCC Report Strategies

There must be a political will to implement the strategies of the LTCCC report, says Maigret, starting with the state’s top elected official. “Governor Raimondo’s proposed budget had added $600,000 in funding for senior centers but the Rhode Island General Assembly removed it,” she said, noting that the decrease in funding got caught up in the negativity surrounding Community Service grants. “We were fortunate the 2017 budget will still have $400,000 in funding for senior centers,” she says.

“Rhode Island’s older adult population contributes a great deal socially, economically, and intellectually to our communities. Ensuring that those Rhode Islanders who desire to age-in-place are able to do so only enriches our society,” said Governor Raimondo. “I’m pleased that Director Fogarty, and members of his senior staff, serve and work with the Long Term Care Coordinating Council and the Subcommittee on Aging in Community. The insight they gain from service with these committees helps to shape State policy and programs related to services for seniors.

“I applaud the members of the Subcommittee for their dedication to creating a clear, comprehensive report on aging that can be a catalyst for change in our state. Their work recognizes that Rhode Island’s older population is growing dramatically and that we must direct public policy to help them remain active and in their homes,” said Lt. Governor McKee. I look forward to supporting the strategies detailed in the Subcommittee’s report to help build stronger, healthier communities for all Rhode Islanders.”

Finally, House Speaker Nicholas Mattiello, also says that the Subcommittee report’s recommendations will also be studied closely next legislative session. “I will be reviewing the findings of the report in greater detail and I will confer with Representatives Chris Blazejewski and Eileen Naughton, who sponsored and advocated for the Aging in Community Act of 2014. Our older population in Rhode Island is a growing one and it is important that we continue to listen to their needs and be responsive. I commend the work of the subcommittee, as well as all those who participated in the focus groups. I would anticipate that any policy and financial recommendations will be fully analyzed by the members of the General Assembly in the 2017 session.”

The LTCCC’s “Aging in Community” report gives our policy makers a road map in reconfiguring the state’s fragmented aging programs and services. With the Governor, House Speaker and Senate President on board, we might just see legislative changes in the next years that might just be what we need to keep people at home and active in their community. Lawmakers must not act penny-wise and pound foolish when considering legislative fixes.

Both the executive summary and the full Subcommittee “Aging in Community” report are available on the Lieutenant Governor’s website at: http://www.ltgov.ri.gov and the general assembly website at: http://www.rilin.state.ri.us/Pages/Reports.aspx.

Retirement Survey Bleak for Ocean State

Published in Pawtucket Times on February 1, 2016

Here we go again. This month, America’s tiniest state gets outed as being the most unfavorable state to live out your retirement years. According to a new WalletHub study, “2016’s Best & Worse States to Retire,” when compared to all 50 U.S. states and the District of Columbia, Rhode Island came in dead last when compared against 24 metrics falling in one of these three categories (Affordability, Quality of Life and Health Care).

WalletHub, an internet site that calls itself “a personal finance Web site, taps Florida as being the top state to live your retirement years, followed by Wyoming, South Dakota, South Carolina and Colorado. The in-depth analysis, geared to identifying the most retirement-friendly states, gives the Ocean States the distinct of being the worst place to live in your later years, followed by the District of Columbia, Hawaii, Connecticut and Vermont.

As to affordability, WalletHub looked at the adjusted cost of living, tax friendliness of a state, it’s taxation on pensions and Social Security income, and annual cost of in-home services. Rhode Island was ranked 51 (the worst) in affordability for retirees. In zeroing in on this specific variable, the state came in 41st in adjusted cost of living; 45th in annual cost of in-home services and 48th in taxpayer rankings.

For a state’s quality of life, WallettHub zeroed in on an array of variables including the number of theatres, museums, music venues, golf courses. The researchers also checked out crime rates, weather, the number people age 65 and older and whether the state’s labor is elderly friendly. A sampling of Rhode Island specific rankings for this variable include a ranking of 35th for Museums per Capita; 42nd for Theaters per Capita; and 48th for the number of golf courses per Capita; and 32nd in having employed residents age 65 and over.

As for health care, the study examined the number of family physicians, dentists, nurses, and health-care facilities per 100,000 residents, the ranking of the state’s public hospitals, the resident’s life expectancy and emotional health, even taking a look at the death rate for people age 65 and older. Rhode Island ranks 49th in number of family physicians per 100,000 Residents.

WallettHub analyst, Jill Gonzalez, says that for Rhode Island to become a mecca for retirees, state lawmakers must reconsider how they tax Social Security and pensions. The state’s current tax policy “is not at “all friendly toward retirees,” she adds.

According to Gonzalez, the state’s cost of living index is also high at 122 while the national index is 100. This means that if the cost of goods and services nationwide is $100, the Rhode Island retirees will pay $122. Annual costs to pay for home care are nearly $54,000 per year in Rhode Island and state policy makers must find a way to reduce this key community-based service.
Statewide Reactions to Web site Survey

These surveys aggregate data that does not encourage retirement here,” observes AARP Rhode Island State Director Kathleen Connell. “They do not fully measure quality of life or how the proximity to Boston and New York City make Rhode Island attractive to many retirees. But you often hear people talk about retiring in states where lower taxes and deflated housings prices suggest that retirement income will go dramatically farther.

“The tax issue is a reality driven by the state’s so-called ‘structural deficits’ that have resulted in cities and towns raising property and excise taxes. Meanwhile, hikes in fees and new surcharges have added to the tax burden. Legislative leaders face a great challenge in reversing this trend.

“Many people in their 40s and 50s who want to retire in Rhode Island can save more wisely for retirement and find a way to make it work. Anyone entering retirement now with little savings and expecting to rely primarily on Social Security is faced with difficult decisions.

“So, clearly the survey means different things to different people. Few would disagree that Rhode Island is a great place to retire – maybe one of the best places in the nation. If you can afford it.”

Edward Mazze, Distinguished University Professor of Business Administration, says, “I cannot disagree with the quantitative findings in the study. Behind the numbers are two critical factors that have an impact on retiring in Rhode Island – first, the Rhode Island economy has barely grown in the last eight years – second, the negative reputation of the state with government leaders going to jail, high property taxes, poor school systems and unfunded public pension and health programs.”

Mazze calls on the Rhode Island General Assembly to raise the state estate tax level to the same level as the federal estate tax level and exempt social security benefits from state taxes no matter what the income level. “The legislature has to reduce sales taxes and fees, be more transparent in its operations so that individuals trust government actions and fund the social services that retirees need,” he says.

But even with these negative findings retirees should Rhode Island as place to live because of its strategic location, transportation facilities and cultural and recreational activities. However, he acknowledges that “with the high cost of living in Rhode Island and fewer part-time job opportunities for retirees it is difficult to promote the state as a place to retire.”

Ernie Almonte, Rhode Island’s former auditor and partner at RSM US, LLP, a company that performs audit, tax and consulting services, says the changes in how the state taxes Social Security made by lawmakers last year was a good first step. But the former candidate for State Treasurer urges Governor Gina Raimondo and House and Senate Leadership to take a look at the state’s estate tax in the upcoming session. “I believe last year’s changes made by lawmakers was a move in the right direction but we cannot forget the legislative change to the estate cliff effect. “This certainly is a deciding factor for retirees looking to a place to settle down in their retirement years,” he adds.

Almonte also encourages state lawmakers to sit down with the Rhode Island Society of CPA’s to discuss tax policy. “Having a robust discussion on the role of tax policy to pay for necessary services and investments balanced by the ability to pay and the need to pay would be quite helpful to the long run,” he says.
House Speaker Nicholas Mattiello sees the business climate and economic outlook improving as he works to make the state’s tax structure more competitive with neighboring states. He says that the WallettHub survey did not take into account the repeal of state income tax for most Social Security recipients. The State offers retirees “a great quality of life with easy access to our beaches and we have excellent cultural attractions, restaurants, hospitals and universities, he says.

As she has said over her first year, Governor Gina Raimondo is “laser focused” on improving the quality of life for all Rhode Islanders, says deputy press secretary Katie O’Hanlon. “We’ve made a lot of progress over the past year, including eliminating state taxes on Social Security benefits for low and middle-income seniors and increasing funding for Meals on Wheels. However, we can always find ways to improve, says O’Hanlon.

It’s time for the Rhode Island General Assembly to get serious with enacting legislative proposals to attract retirees, more important to keep them from leaving for other retirement havens. Why not do a thorough review of tax policies of WalletHub’s best five places to retire and seek out best tax practices of other states? In the upcoming legislative session, Governor Raimondo and House and Senate leadership might consider reaching out to AARP Rhode Island and aging groups, along with the Rhode Island Society of CPAs, to organize a tax summit, seeking creative ways to tweak the state’s tax code to retain and attract retirees.

This WebHub study can be found at  http://www.wallethub.com/edu/best-and-worst-states-to-retire/18592/.

 

 

Rhode Islanders Share ’16 Resolutions

Published in Woonsocket Call on January 3, 2016

 

Each New Year, on January 1, we make promises to ourselves to start doing something good or stop doing something bad, either way on a personal and/or professionally level. Here’s a listing of Rhode Islanders, many who you may know, who reflect on their successes of keeping last year’s resolutions and they even share their 2016 New Year Resolutions, too.

Ernie Almonte, 60, Partner at RSM, LLP and former candidate for Rhode Island Treasurer.  The Scituate resident’s 2015 resolution was to find a firm with a “great work culture.”  Did he succeed? Yes, “wildly beyond his expectations,” he says. For his 2016 New Year’s Resolution, he plans to create a great future for his family.

Jonathan Bissonnette, 28, a reporter covering the Pawtucket Beat for the Pawtucket Times. In 2015, the journalist looked to cut back on junk food from fast food restaurants.  He did not succeed.  For this year, he repeats last year’s resolution and continues to look for ways to improve his nutrition.  He again looks to stay away from fast food restaurants.

Rep. David N. Cicilline, 54, representing Rhode Island’s First Congressional District.  Last year, the lawmaker backed legislation that helps create jobs and grow the economy and worked to ensure that government was “fair and more efficient” for his constituents  He was successful in enacted that strengthens America’s manufacturing sector, a bill that renamed a local post office for the late Sister Ann Keefe, provisions in the new education legislation that enhance after school partnerships across the nation, and ensuring Rhode Island receives funding for infrastructure as part of the new multi-year federal highway funding bill fund. This coming year Cicilline looks to curb the skyrocketing costs prescription and education.  He will also focus his attention on fixing the broken campaign finance system and making our communities safer from gun violence.

Scott Davis, 58, owner of Rhode Island Antiques Mall and an Entrepreneur.  The Providence resident worked last year to “eliminate stressors” in his life.  Did he succeed?  “Mostly,” he responded. For 2016, Davis says he will “figure out how to make a living once stressors are eliminated.”

Linda Dewing, ageless, is a broker associate at Places & and Spaces Realty and a seasoned artist.  The Pawtucket resident’s 2015 New Year’s Resolution was “to grow in business and wisdom.”  When asked if she succeeded, Dewing responded “somewhat.”  For next year, 2016 she plans to finish two pieces of art work and continue to contribute to Pawtucket’s growth by bringing more businesses into the City’s historic downtown.

Josh Fenton, 52, CEO and Co-Founder of GoLocal24.  Last year Fenton made a resolution to get up earlier in the morning to be more productive. The Providence resident believes he generally succeed by getting up by 4:45 a.m. “I saw a lot of good sunrises,” he says.  For 2016, his New Year Resolution is to spend more time with close family and friends.

Charlie Fogarty, 60, is the Director of the Rhode Island Division of Elderly Affairs.  Last year the Glocester resident resolved to be mindful of his health and wellness. .He made small lifestyle changes, such as adding a 30-minute walk to each day, resulting in improved health. In the New Year he resolves to promote physical, social, and mental well-being. He says healthy lifestyles for seniors, supported by family, friends, caregivers and the community enables these individuals to remain at home.

Attorney General Peter Kilmartin, 53, Office of the Attorney General.  When asked about his 2015 resolutions he responds “I typically don’t make New Year’s resolutions, as I try to work on improving myself throughout the year.”  For 2016, he says, “I will try to work on improving myself and the Office of Attorney General each and every day.  Every morning I read a spiritual piece which is aimed at recognizing not only what is good in our lives, but also how to keep a positive attitude and improve our lives.  It is my goal to continue this practice each day for 2016.”

Nicholas A. Mattiello, 52, is a self-employed Cranston attorney who serves as Speaker of the House in the Rhode Island General Assembly.  Last year the lawmaker resolved to pass a State budget that would include an exemption from the State income tax for many Social Security recipients.  “Retirees have worked their whole lives and do not deserve to be taxed on Social Security,” he said.  He was pleased to see his chamber pass the budget unanimously, and the Governor sign into law.  For the upcoming year, his resolution is to continue to work hard in improving the State’s economy and job climate.  “I want to see the economic momentum we have built-in the last few years continue to grow and to make Rhode Island once again competitive with other states in the region,” he says.

Edward M. Mazze, 74, Distinguished University Professor of Business Administration, at University of Rhode Island.  In 2015, the Narragansett resident’s New Year’s resolution was to lose weight (become more healthy) and be more optimistic about Rhode Island’s Economic Growth.  He believes that he succeeded.  In 2016, he is looking to continue losing weight and hopes to be more patient with Rhode Island’s Economic Growth.

Lt. Governor Daniel J. McKee, 64, a former Mayor of Cumberland who served 6 terms.  Last year he resolved “to be champion of the family’s annual holiday ping-pong tournament.  “Let’s just say there’s a next year,” he says.  As to 2016 resolutions, McKee says, “While many people are resolving to hit the gym and lose weight, I want to build on my “39 Cups of Coffee” tour (one in every city and town) and support our economy by dining at as many local restaurants as I can.“

John J. Partridge, 75, is Senior Counsel at Partridge Snow & Hahn, LLP.  In 2015, the Providence resident worked “on patience.”  When asked if he succeed, Partridge responded “impatiently yes.”  For 2016, the lawyer who has published three murder mystery thrillers plans on publishing his fourth Algy Temple mystery, “Hanger.”

Governor Gina Raimondo, 44, is the highest elected state official in Rhode Island.  Last year the governor’s resolution was to “bring Rhode Islanders together to grow our economy.”  It’s too early to make judgements if she has succeed, says Raimondo, but the signs of improvement are there.  She resolves to come back in January, “re-energized to keep fighting for Rhode Islanders.

“There are crucial challenges ahead, including our under-performing schools, and our crumbling roads and bridges. We’ve just got to keep the momentum going with more work, more action, and more results,” she says.

Scott Rotondo, 42, is the Accounting Manager at Tivoli Audio in Boston, Massachusetts and a radio talk show host.  The Pawtucket resident’s 2015 resolution was to challenge his own assumptions and opinions.  He believes he “mostly succeeded.”  For the upcoming year his New Year’s Resolution is “to be more patient with others and with myself.”

Ron St. Pierre, over 21, is the Morning Drive host for News radio 920/I Heart Media.

The East Greenwich resident’s 2015 resolution was “to make it to 2016.  Was he successful?  He responds, “to be determined by making it to January 1, 2016.   This year’s New Year Eve’s resolution is “to make it to 2017.”

Charles Steinberg, 57, President of PawSox, at McCoy Stadium.  The baseball executive’s 2015 resolution was to help the Boston Red Sox “enhance bonds with fans through experiences and events at the ballpark and outreach to the community.  Did he feel he succeed?  “I hope so, but the fans are the best judge of that.”  As to this year’s New Year resolution, he hopes to help the PawSox, Pawtucket’s AAA Team bond with its fans by giving them great, memorable experiences and events at the ball park and to reach out to the community.

To all my loyal readers, may you have a Happy New Year and a great 2016.

 

 

 

Rethinking Rhode Island’s LTC Delivery System

Published in the Woonsocket Call on April 12, 2015

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

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

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

Failing Grades

The 2014 LTTS Scorecard indicates that Rhode Island:

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

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

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

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

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

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

Response and Comments

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

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

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

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

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

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

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

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

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

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

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