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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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.

Rhode Island Lawmakers Poised to Give Retirees Financial Tax Relief

Published in Woonsocket Call on May 31, 2015

During the 2014 legislation session, Rep. Robert E. Craven, (District 32) introduced and successfully pushed for passage in the General Assembly. This legislative proposal would ultimately being signed into law by the Governor. Little did the North Kingston law maker realize that door knocking to get reelected in last November’s election would give him an issue to tackle on Smith Hill this year.

At hundreds of homes, he heard the same issue from his older constituents. One such comment was etched sharply in Craven’s memory: “You’re a nice guy, buy I am not going to vote for you because I am leaving the state, the older voter told him. The puzzled lawmaker asked “why?” The response, “We decided the state is so expensive to live in because of taxes we’re going to sell our house and move to Florida. Wanting the specifics, Craven asked, what specific tax bothers you? “We are only of a few states that tax social security benefits, that’s the straw that broke the camel’s back,” said the older voter.

Craven’s legislative proposal, H 5000, was heard Wednesday night before the House Finance Committee. Strongly supported by House leadership, he says, the legislation would ease the tax burdens on Rhode Island retirees by exempting them from paying state income tax all Social Security benefits as well as income received from federal, state and local government retirement plans, disability benefits, military pensions and private pension plans and deferred-compensation plans.

Among its more than 40 co-sponsors are Rep. Stephen M. Casey (D-Dist. 50, Woonsocket), Rep. Michael A. Morin (D-Dist. 49, Woonsocket), Rep. Samuel A. Azzinaro (D-Dist. 37, Westerly) and Rep. Cale P. Keable (D-Dist. 47, Burrillville, Glocester).

If enacted, Rhode Island would join 27 other states – including Massachusetts and Maine – and the District of Columbia that specifically exempt Social Security income from taxation. (Although Rhode Island does not specifically tax Social Security benefits, that income is identified on federal tax returns. Since Rhode Island’s income tax is based on the federal adjusted gross income of federal tax form filers, the end result is that Rhode Island generates a portion of its income tax collections from Social Security benefits.)

According to Craven, his legislative proposal would financially benefit Rhode Island seniors who receive retirement benefits. ”After paying into the Social Security system their entire working lives, or putting a little money away into private pension plans, or working at jobs that provide them with a pension, it doesn’t seem right that retirees are having taxes eat away at benefits they depend on for their very livelihood,” he says.

“Retirees living on a fixed income are probably more severely impacted by taxes and tax increases than other population groups,” observes Craven. “If we are committed to helping retirees have a safe and secure life in their later years, and if we want to help seniors afford to stay in Rhode Island rather than moving to more tax-friendly locations, we need to ease their financial burdens. Exempting retirement income from the state income tax is one step we should take,” he adds.

Tax Exemption in House Budget

Weaving its way through the legislative process Craven ultimately expects his legislative proposal to be modified to not give older tax payers a complete exemption on paying taxes for their social security income. Specifically, the revised language would say, “If your house hold income is under $100,000 or less than your Social Security is tax exempt from state income taxation.”

While a Senate companion measure has been introduced by Senator Walter S. Felag, Jr., representing Bristol, Tiverton and Warren, an amended H 5000 will be placed in the House Budget because of its cost, says Craven.

The price tag could be between $30 and $35 million, Craven says, noting that better than expected revenues enable it to be funded. “It’s a priority to the state’s economic recovery, he says.

Older retirees, making from $35,000 to $100,000, from Social security and their pensions, will just put their dollars in the local economy, adds Craven. “It’s a good investment and we owe it to them. These retirees have been here all their lives, he says, noting that they ask very little for benefits from municipalities. “They have a lot of time on their hands to volunteer [in their communities] and are very philanthropically included in offering money and services to charities.”

Says House Speaker Nicholas Mattiello, “Representative Craven’s bill to exempt the state tax on Social Security will be included as part of the budget that the House Finance Committee will be considering within the next few weeks. Governor Raimondo included this exemption for low-wage earners in her original budget proposal, but the House will be broadening it to assist the middle-class retirees as well. The House budget exempts retirees, age 65 and over, who have income thresholds of up to $80,000 for individuals and $100,000 for joint tax filers.”

“We believe that by incorporating Rep. Craven’s bill into the budget, this will begin to stop the exodus of retirees leaving Rhode Island for many other states where there is no state tax on Social Security benefits,” adds Mattiello.

Gov. Gina M. Raimondo sees Social Security is a key source of income for older Rhode Islanders, noting that her submitted March budget proposal eliminates state taxes on Social Security benefits for low and middle income seniors “to help them make ends meet and stimulate our economy.”
With Rhode Island unions hit hard by the state’s recent pension reform, Craven’s proposal has received thumbs up from some.

James Parisi, field representative and lobbyist for the Rhode Island Federation of Teachers and Health Professionals, says his union supports Craven’s legislative proposal. “Unlike some other tax cut proposals introduced this session, his bill includes state and local government pension benefits. About half of the state’s teachers were never eligible to participate in social security so any tax cut proposal that is limited exclusively to social security benefits would be unfair to thousands of retired public school teachers,” he says.

Jim Cenerini, a lobbyist for Council 94, AFSCME also says his union is squarely behind H 5000. “Council 94 believes that legislation deserves careful consideration and support because: many other states provide some type of income tax exemption to retirement benefits/Social Security; in 2014 Kiplinger ranked Rhode Island as one the least tax friendly states for retirees; and since a significant majority of public employees remain in Rhode Island, and contribute to our local economy by spending on goods and services, it’s important to provide an incentive to remain in-state.”

A Final Note…
Other legislation proposals have also been thrown into the legislative hopper this session to protect older taxpayers. H 5446, introduced by Woonsocket law maker Rep. Stephen M. Casey, would protect the pocket books of retired teachers who are receiving a pension from Massachusetts. “These retirees, whose pension are overseen by Massachusetts Teachers Retirement System, are essentially double taxed because of the state’s tax code,” he says.

On Friday, May 29, the Rhode Island Public Expenditure Council (RIPEC) issued a report noting that the state may have significantly more funds available in fiscal 2015 and 2016 than anticipated when Gov. Raimondo submitted her budget in March. Specifically, state revenues are expected to be up by $106.8 million this year and $36.6 million next year, with additional funds available from expenditure reductions.

For this writer, its sound public policy to use some of the anticipated surplus identified in RIPEC’s report to enact H 5000 and H 5446 to lessen the tax burdens of Rhode Island’s retirees. As mentioned earlier, older taxpayers pull less resources from their cities and towns. But, most important, these retirees have greatly contributed to the quality of life in their communities throughout their working years.

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