New Uniform Act Good News for Rhode Island Caregivers

Published in Woonsocket Call on November 29, 2015

With the quick stroke of her pen, Rhode Island Governor Gina Raimondo signed guardianship legislation into law during the 2015 legislative session that would help Rhode Islanders avoid costly and time-consuming red tape when exercising health care, financial and other legal responsibilities for their out-of-state, elderly loved ones. It takes effect on January 1, 2016.

Like motherhood and apple pie, the changes made to the State’s guardianship law had broad bipartisan support in the Rhode Island General Assembly. The House bill and a similar Senate companion measure (entitled the “Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act”) passed overwhelming by votes of 72-2 and 37 to 1, respectively.

Representative Robert E. Craven (D-North Kingstown) who Chairs the House Committee on Municipal Government, says his legislation (introduced with Representative Michael A. Morin (D-Woonsocket) simply helps to protect those who are unable to protect themselves.  “When appointing guardians and instituting protective orders for adults, the law must be clear and concise to ensure someone’s rights are not violated while also keeping them safe,” he says, noting that the new law makes the rules and procedures very clear for this process and it will offer both the protected persons and petitioning guardians the legal causes and safeguards that are needed in such complex situation,” he said.

Fixes Jurisdictional Issues over Guardianship

According to Division of Elderly Affairs Director Charles J. Fogarty, the new law “provides consistency, reciprocity, and procedural efficiency in the best interest of seniors, creating a hospitable and healthy Rhode Island for our elders.”

Fogarty says that the new law would benefit caregivers in many way.  It clarifies state jurisdiction issues and even facilitates the transfer of guardianship from one state or another.  It also would enhance interstate recognition and enforcement of guardianship orders and simplifies communication and cooperation between courts.

Fogarty notes that Rhode Island’s new guardianship law is a law that 37 other states, as well as the District of Columbia and Puerto Rico, have already enacted, allowing for cooperation on and simplification of inter-state issues.  “It will be easier for out-of-state caregivers to focus on supporting their loved ones as opposed to becoming mired in current laws.  This legislation ensures that seniors and caregivers don’t waste time and resources in cases involving simultaneous and conflicting jurisdiction,” he says.

“We are very pleased that our staff, our terrific State House advocacy volunteers and a strong network of partners worked hard together to ensure that Rhode Island became the 42nd jurisdiction to enact the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act,” said AARP State Director Kathleen Connell. “Now, Rhode Island joins the national effort that focuses on care, not courts, by removing the barriers that prevent caregivers from providing for their loved ones, regardless of where they live.”

According to the AARP Public Policy Institute’s recent report “Valuing the Invaluable: 2015 Update,” the number of caregivers in our state is 134,000. Their work has an economic value of $1.78 million. That, Connell said, is why AARP Rhode Island strongly supported the legislation and was joined by judges, lawyers and families throughout Rhode Island.

Many Benefits, No Cost to Rhode Island Taxpayers

Connell notes that when the uniform guardianship jurisdiction becomes law, it will carry no cost to taxpayers and makes no changes in the state’s substantive guardianship procedures. However, Rhode Islanders will benefit as it will save them time and money. In addition, they will be safeguarding the health and financial well-being of their loved ones.

“It may seem very technical,” Connell continued. “But the bottom line is easy to understand:  We all recognize that we are a mobile society, and with that we need laws pertaining to caregivers and their families to reflect that reality. AARP strongly supports legislation that removes barriers that prevent guardians in Rhode Island from providing for their loved ones, regardless of where they live. “For Rhode Islanders, the uniform guardianship act is a step in the right direction to help protect the interests of vulnerable incapacitated adults who need guardians,” Connell said. “With this law, our guardianship system will function more efficiently, fairly, and cost-effectively.”

Court-appointed guardians step into the shoes of at-risk adults who can no longer make their own decisions, and make judgments about property, medical care, living arrangements, lifestyle and potentially all personal and financial issues. As a judicial proceeding, guardianship can be expensive, time-consuming and combative. It can remove fundamental individual rights. It can prevent or redress elder abuse – or can create an opportunity for exploitation or abuse of vulnerable adults.

This new uniform act addresses initial jurisdiction regarding a guardianship case; recognition of one state’s guardianship orders by another; and interstate transfers of guardianship cases when such transfers would benefit the incapacitated person.

Another key reason AARP strongly supported enactment stems from concern over elder abuse, neglect and exploitation. It will reduce the enticement of a vulnerable person to another state ― to gain control over assets. The law now will permit a court to consider which jurisdiction can best protect a person subject to abuse, and facilitate communication between courts in different jurisdictions about allegations of abuse.

Partners included the Uniform Law Commission. The Commission provides states with non-partisan, well-conceived, and well drafted legislation that brings clarity and stability to critical areas of state statutory law. In addition, the Act has a broad range of support from organizations including the National College of Probate Judges, National Academy of Elder Law Attorneys, National Guardianship Association, Conference of Chief Justices and the Alzheimer’s Association.

With the graying of Rhode Island’s population commonsense laws like the “Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act” need to be enacted.  Last session, state lawmakers worked together to pass this legislation that makes guardianship system more efficient, less time-consuming and costly for Rhode Island caregivers.  At no cost to Ocean State taxpayers.  Hopefully, best policy practices from across the nation can be brought to the Rhode General Assembly for full consideration.  If it happened once it might just happen again.

 

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Unpaid Caregiver Care Saves State Money

Published in Woonsocket Call on July 26, 2015

With the graying of state’s population, Ocean State caregivers provided 124 million hours of care—worth an estimated 1.78 billion —to their parents, spouses, partners, and other adult loved ones in 2013, according to a new AARP Policy Institute’s report.  The total estimated economic value of uncompensated care provided by the nation’s family caregivers surpassed total Medicaid spending ($449 billion), and nearly equaled the annual sales ($469 billion) of the four largest U.S. tech companies combined (Apple, Hewlett Packard, IBM, and Microsoft) in 2013, says the 25 page report.

AARP’s report, Valuing the Invaluable: 2015 Update, noted that family caregiving for relatives or close friends with chronic, disabling, or serious health problems – so they can remain in their home – is nearly universal today.  In 2013, about 134,000 family caregivers in Rhode Island helped another adult loved one carry out daily activities (such as bathing or dressing, preparing meals, administering medications, driving to doctor visits, and paying bills), says the report issued on July 16.

Log on to AARP Rhode Island’s caregiving Web page (www.aarp.org/ricaregiving) to download the report as well as access information on recent caregiver legislation passed by the General Assembly and other resources: www.aarp.org/ricaregiving.

The Difficulty of Caregiving

The AARP report detailed how caregiving can impact a person’s job, finances and even their health, says the researchers.   More than half (55%) of family caregivers report being overwhelmed by the amount of care their family member needs, says the report.  Nearly 4 in 10 (38%) family caregivers report a moderate (20%) to high degree (18%) of financial strain as a result of providing care. In 2014, the majority (60%) of family caregivers had full- or part-time jobs, placing competing demands on the caregivers’ time.

According to AARP Rhode Island State Director Kathleen Connell, AARP’s study on caregiving affirms the state’s record as a trailblazer in the field of caregiving. In 2013, Rhode Island became just the third state to enact paid family leave, which is known as Temporary Caregiver Insurance (TCI). Also in 2013, Rhode Island enacted the Family Caregivers Support Act, which requires a family caregiver to receive an assessment,” she said.

Connell said that this year the Ocean State remained in the forefront of helping caregivers with passage of the Caregiver Advise, Record, Enable (CARE) Act, which calls for hospitals to provide instruction to designated caregivers. Additionally, Rhode Island became the 42nd state to enact the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act. In Rhode Island, a court-appointed guardian can make important decisions across state lines.

“This new report, however, does demonstrate that we need and can do more to assist the many caregivers in our state,” said Connell. “Some of the ways we can help family caregivers include continuing efforts to improve workplace flexibility, respite care, tax credits and home care services,” she says.

Adds Charles Fogarty, Director of the state’s Division of Elderly Affairs (DEA), “This study demonstrates that the backbone of long-term services and supports are family members and informal caregivers.  Quantifying the hours and economic value of caregiving provided by Rhode Island families and informal caregivers raises public awareness of the impact these services have upon Rhode Island’s health system and economy.  It is clear that there is a significant need to support caregivers who, at a cost to their own health and economic well-being, work to keep their family members in the community.”

DEA works with the state’s Aging Disability and Resource Centers and local nonprofits and agencies such as the RI Chapter of the Alzheimer’s Association, Office of Catholic Charities of the Diocese of Providence, local YMCAs and Adult Day Care programs, to provide programming, support groups and information to Rhode Island’s caregivers, according to Fogarty.  “Rhode Island also requires that a caregiver assessment be conducted when a recipient of Medicaid-funded Home and Community Based Services has a caregiver providing support in the home,” he says.

Improving State Support for Caregiving

            Although Maureen Maigret, policy consultant for the Senior Agenda Coalition of Rhode Island acknowledges Rhode Island as being a leader with progressive laws on the books supporting caregivers, specifically the Temporary Caregiver Insurance Program, more work needs to be done.

Maigret calls for better dissemination of information to caregivers about what services and programs are available.  “In this day and age we should have a robust Rhode Island specific internet site that offers caregiving information about state specific resources,” she says, noting that too often caregivers “just do not know where to turn to find out about programs like DEA’s co-pay program.”  This program pays a share of the cost for home care and adult day care for low-income persons whose incomes are too high to meet Medicaid eligibility.

          Rhode Island also falls short in providing subsidies to caregivers of frail low income elderly to keep them out of costly nursing homes, says Maigret, noting that the program’s funding was cut by 50 percent in 2008, creating waiting lists which have occurred over the years, It’s “short sided” to not allocate adequate resources to this program. The average annual cost of $ 1,200 per family for the caregiver subsidy program can keep a person from going on Medicaid, at far greater expense to Rhode Island taxpayers, she says.

          This AARP report must not sit on a dusty shelf.  It gives an early warning to Congress and to local lawmakers.  As Americans [and Rhode Islanders} live longer and have fewer children, fewer family members will be available for caregiving duties. Researchers say that 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.

With less caregivers in the trenches providing unpaid care to keep their loved one at home, the state will have to step in to provide these programs and services – for a huge price tag to taxpayers.  State lawmakers must not be penny wise and pound foolish when it comes to caregiver programs.  Funding should not be slashed in future budgets, rather increases might just make political sense especially to tax payers.

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