Rhode Island Leads Nation with First Ever U.S. Menopause Workplace Protections

Published in Blackstone Valley Call & Times on July 1, 2025

In 2012, Rhode Island became the first state to pass a Homeless Bill of Rights. Three years later, it led again by banning the use of bullhooks on elephants. In 2021, the state once more broke ground by establishing legally sanctioned, medically staffed drug injection facilities to combat overdose deaths. As the General Assembly concludes its 2025 session, lawmakers mark yet another national first—enacting workplace protections for women experiencing menopause.

Most women begin the menopause transition in their 40s or 50s, with symptoms typically lasting between three and seven years. During this time, they may experience hot flashes, insomnia, night sweats, migraines, heart palpitations, anxiety, panic attacks, brain fog, and other debilitating symptoms caused by declining estrogen. 

Many are unprepared for the onset and lack sufficient support or guidance—particularly when it comes to managing symptoms in the workplace.

Governor Dan McKee has signed into law legislation (S 0361), introduced by Sen. Lori Urso (D-Dist. 8, Pawtucket), to support women experiencing menopause under the state’s fair employment statute—making Rhode Island the first state to explicitly enact such workplace protections. A companion bill (H 6161) was introduced by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls) and passed by concurrence.

Rhode Island law already prohibits workplace discrimination related to pregnancy, childbirth, and associated conditions. This includes requiring employers to provide reasonable accommodations and protecting individuals from being denied employment opportunities or promotions—or from being terminated—due to these conditions. The new law adds menopause to this list of protected health conditions.

“Menopause is a difficult and personal subject that has been stigmatized in this country,” said Sen. Urso in a statement announcing the bill’s passage. “But as something that affects half our population, it’s time we recognize it as a workforce issue—especially as our workforce ages along with our population. The current lack of protections contributes to inadequate retirement savings and lost leadership opportunities for women and poses an economic challenge for employers facing workforce shortages and the loss of experienced employees,” she says.

“Menopause is not something women choose to experience, and its effects on the mind and body can significantly impact daily life and job performance,” said Rep. Alzate. “Women should not have to risk being penalized or discriminated against at work due to a naturally occurring biological transition.”

“Women’s health care is a vital component of a healthy workplace,” said Patrick Crowley, president of the Rhode Island AFL-CIO. “That’s why it’s essential to extend the fair employment practices law to include menopause-related conditions. All workers deserve to be treated with dignity and respect, regardless of their health status.”

Madalyn McGunagle, policy associate at the Rhode Island ACLU, added, “Menopause is a natural and common phase of life, yet its symptoms can have profound and lasting impacts. By extending legal protections, we ensure women are afforded the accommodations they need to continue working effectively.”

Growing Recognition of Menopause in the Workplace

According to Urso, Rhode Island is home to 917,000 working-age residents. Of these, 13% are between the ages of 45 and 54, and 16.5% are between 55 and 65. The state has a higher percentage of older workers compared to the national average, with women representing 45% of workers aged 55 and older. Based on this data, it is estimated that there are 64,000 women between the ages of 45 and 54, and 35,000 women aged 55 to 59.

Urso further estimates that nearly 100,000 women in the state may experience menopausal symptoms at any given time, accounting for more than 10% of Rhode Island’s entire working-age population.

According to the U.S. Bureau of Labor Statistics, 75% of women in the U.S. labor force are working during their menopause transition years, making workplace engagement around women’s health issues vital.

“Addressing menopause in employment practices is critical because it affects employee well-being, retention, and productivity,” said Angela Lima, policy and advocacy program director at the Women’s Fund of Rhode Island. “These changes benefit both workers and employers.”

A Mayo Clinic study estimated that menopause symptoms cost U.S. businesses $1.8 billion in lost productivity annually. The study’s coauthors urged employers to update workplace policies to better support their female employees.

In Sept. 2024, Bloomberg news tackled the issue of menopause, putting the spotlight on millennial women.  The findings indicate that 70% of these individuals would consider either reducing their hours, changing jobs, or retiring early due to their symptoms.

Urso noted that this study also found that 61% expressed concerns about dealing with menopause while working, and a third worried it would damage their career  growth.  “If this is indeed the case, employers will lose more in the long-run if they’re losing leadership and trying to rehire in those situations,” she says.

And in Jan. 2024, January, the Society for Women’s Health Research released findings from its Employee Perspective and Challenges Concerning the Transition of Menopause (EMPACT Menopause) Study. The goal was to better understand the workplace experiences of those who have gone through menopause, as well as their colleagues and supervisors.

Key findings from the EMPACT study include:

  • 59% of women felt uncomfortable requesting accommodations.
  • Only 31% felt comfortable discussing menopause at work.
  • 2 in 5 women considered leaving or did leave their jobs due to symptoms.
  • 1 in 6 supervisors expressed discomfort providing accommodations.
  • While half of supervisors had spoken with employees about menopause, 14% had not but wanted to.

Bringing Menopause Out of the Closet

In her article “It’s Time to Address Menopause at Work,” Claire Hastwell, content program manager at Great Place to Work, calls for employers to support women with menopausal symptoms. She notes this can improve employee well-being, retention, and business outcomes.

“But women who grapple with menopause rarely find workplace support, official company guidelines, or a sympathetic ear,” she writes. “Employees experiencing menopause need to know their employer has their back. Without support, businesses risk losing some of their most senior and skilled workers.”

Supporting menopausal women in the workplace can enhance retention and engagement, boost productivity, reduce health risks, and improve morale, Hastwell adds.

It’s time to stop sweeping menopause under the carpet. Rhode Island’s new law creates a menopause-friendly workplace—and offers a model for other states to follow.

For a copy of the EMPACT Menopause Study, visit:
http://swhr.org/wp-content/uploads/2024/03/FINAL-Menopause-Workplace-Fact-Sheet-02012024.pdf

To read more on creating supportive workplaces, visit:
https://www.greatplacetowork.com/resources/blog/support-menopausal-women-workplace

House Finance Committee’s FY 26 Budget boosts support for older Rhode Islanders

Published in RiNewsToday on June 16, 2025

Last Wednesday evening, the House Finance Committee voted 11–3 to approve a balanced $14.33 billion budget for fiscal year 2026—approximately $500 million less than the current year’s budget.

Lawmakers were tasked with closing a $250 million deficit without resorting to broad tax hikes or cuts to essential services. Faced with a slowing state economy and looming federal funding reductions, they focused squarely on bridging the budget gap while improving access to health care, increasing reimbursement rates for primary care providers, nursing homes, and hospitals, and addressing the state’s housing crisis.

The budget proposal also boosts funding for housing and homelessness services, supports municipalities through increased revenue sharing, expands Rhode Island Public Transit Authority (a.k.a. RIPTA) funding, invests in education, imposes new EV registration fees, restores highway tolls, and extends childcare subsidies while setting distinct rates for toddlers and infants.

“Despite the very significant challenges we face in this fiscal year, this budget reflects our commitment to our priorities: not only protecting, but strengthening the vital Medicaid programs that provide health and safety to Rhode Island’s seniors, children, individuals with disabilities, and working families; supporting our health care system, particularly the hard-working primary care providers and frontline caregivers; and addressing our housing crisis,” said House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick), in a statement announcing the budget’s passage by the House Finance Committee.

Vote Set

According to House Communications Director Larry Berman, the 435-page budget proposal (2025-H 5076A) now moves to the full House for a vote scheduled for Tuesday, June 17, at 3:30 p.m. If passed, the budget will be sent to the Senate, where action is expected by the end of next week as the legislative session concludes.

If the Senate makes no changes, the bill will go directly to Governor Dan McKee for his signature. However, if revisions are made, it must return to the House for final approval before being sent to the Governor.

Berman and his Senate counterpart, Greg Paré, Director of Senate Communications, do not anticipate any major issues—but note that nothing is ever guaranteed.

Funding Aging Programs and Services

The Senior Agenda Coalition of Rhode Island (SACRI) and its allied aging advocacy groups didn’t get everything they lobbied for —but they made progress, according to SACRI Executive Director Carol Anne Costa, who praised the proposal as a “moral budget.”

“This budget represents a moral compass pointing toward a healthier, more equitable Rhode Island,” said Costa, crediting the group’s advocacy efforts, particularly those of SACRI Policy Advisor Maureen Maigret.

Costa highlighted new language in Article 8 that expands the Medicare Savings Programs, enhancing healthcare access for vulnerable older adults and individuals with disabilities. The House Finance Committee recommended adding $7.1 million—$700,000 of that from general revenues—for this critical expansion.

Unlike a narrower 2024 Assembly proposal that faced implementation barriers, the FY 2026 budget expands eligibility to 125% of the federal poverty level for the Qualified Medicare Beneficiary (QMB) group and up to 168% for the Qualified Individuals (QI) group.

“This crucial change is estimated to assist thousands of Medicare enrollees, helping them cover burdensome co-payments and deductibles, and potentially saving them at least the $185 monthly Part B premium—which can now go toward food and other essentials. For many, this means the difference between delaying care and receiving timely treatment,” Costa noted.

Strengthening Primary Care Access

“The state’s primary care system is at a crisis point. We’ve heard that our reimbursement rates are low, and that’s the main cause of the health care shortage. We wanted to address that immediately,” said Speaker Shekarchi.

SACRI applauded the Speaker’s efforts to address both the shortage of primary care physicians and the funding shortfall for direct-care staff in nursing homes. “This budget recognizes the critical importance of primary care—especially for older adults and those managing chronic conditions—and addresses provider rate increases through several key initiatives,” said Costa.

The proposal includes over $40 million—$15 million from the state and the rest from federal funds—to increase Medicaid reimbursement rates for primary care providers, currently lower than in neighboring states.

Additionally, the budget proposes a new healthcare assessment similar to the state’s immunization program assessments. This broad-based assessment, applied per member per month to all covered lives (including self-insured plans), is expected to raise $30 million annually to support primary care and related services. The estimated state cost is $1.4 million, including $800,000 in general revenues.

The committee also recommended $26.4 million ($8.3 million in general revenue) to raise Medicaid primary care rates to 100% of Medicare rates beginning Oct. 1, 2025. This significant increase aims to incentivize providers to serve more Medicaid patients and improve access to foundational care.

Furthermore, the Office of the Health Insurance Commissioner (OHIC) must submit a one-time report by September 2026 to recommend further adjustments to primary care reimbursement rates.

“To address fiscal challenges facing our community health centers, the budget also includes $10.5 million—$4 million of that from general revenues,” Costa added.

Attacking Persistent Staffing Issues in Rhode Island’s Nursing Homes

SACRI, the Rhode Island Health Care Association (RIHCA), SEIU 1199NE, and the state’s Long-Term Care Ombudsman praised the House Finance Committee’s decision to allocate funds aimed at addressing persistent staffing issues in Rhode Island’s 73 nursing homes. The committee approved a $12 million funding package—including $5 million from general revenues—for a base rate staffing adjustment to improve compensation, wages, benefits, and employer costs for direct-care staff. These investments are designed to enhance the quality of resident care and improve workforce stability.

According to John E. Gage, President and CEO of RIHCA, following months of negotiations, RIHCA and SEIU 1199NE reached a compromise to amend the 2021 nursing home staffing law. The revised agreement establishes a more achievable staffing target of 3.58 hours of care per resident per day and adjusts penalties to support facilities in reaching consistent compliance. It also introduces flexibility for high-performing facilities and those with site-specific challenges. “The state budget passed by the House Finance Committee invests $5 million, which unlocks an additional $7 million in federal matching funds,” noted Gage.

“On behalf of RIHCA and its members, we are pleased that the Speaker and House Finance Committee members recognized the dire conditions facing the industry,” Gage added. “We are encouraged that their actions will help stabilize Rhode Island’s nursing facilities and ensure access to high-quality care and services.”

Rhode Island currently ranks second in the nation for “Immediate Jeopardy” violations—the most serious federal nursing home deficiencies. Both SEIU 1199NE and RIHCA believe the budget provisions will help reverse this alarming trend.

SEIU 1199NE’s Patrick Quinn and SACRI’s Costa praised the inclusion of the $12 million investment in the FY 2026 budget, viewing it as a crucial step in helping nursing homes recruit and retain essential staff.

Lori Light, Rhode Island’s State Long-Term Care Ombudsman, also commended House lawmakers for allocating new funding to improve pay and staffing levels—critical measures for enhancing care quality and creating safer, more stable environments for vulnerable residents. “These are issues our office has consistently advocated for, and we’re encouraged to see real movement in the right direction,” she said.

Finally, the budget proposal also includes an increase of $1.86 million for the Office of Healthy Aging, raising its funding from $37,091,920 to $38,948,518. This includes:

  • A $200,000 boost for Senior Services Support (from $1.4 million to $1.6 million)
  • A $50,000 increase for Meals on Wheels (from $630,000 to $680,000)
  • $325,000 to provide elder services, including respite care, through the Diocese of Providence
  • $40,000 to fund ombudsman services provided by the Alliance for Long Term Care

The Missing Millionaire’s Tax

SACRI and progressive advocacy groups had hoped the budget would include HB 5473, introduced by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls) on Feb. 12, 2025 and S329 introduced on by Sen. Melissa Murray (D-Dist. 24, Woonsocket, North Smithfield, on February 21, 2025. The bill proposed a 3% surtax on taxable income above $625,000—on top of the existing 5.99% rate—targeting the top 1% of Rhode Island filers. The tax was projected to raise roughly $190 million annually and impact only 5,700 of the state’s 500,000 taxpayers.

But the surtax didn’t make it into the final budget.

Asked why, Speaker Shekarchi explained: “There is still a great deal of uncertainty at the federal level. We don’t know what changes are going to be made in the federal tax code. We felt comfortable enough to move forward with the non-owner-occupied property tax on homes valued at over $1 million, and we will revisit the millionaire’s tax when we have more clarity from Washington.”

While Costa wished the surtax had been included to fund additional initiatives, she said, “The bottom line is the budget is balanced and people-focused. In particular, older adult concerns were seriously considered.” As the session winds down, SACRI will continue to monitor remaining legislative proposals that affect Rhode Island’s older residents.

Senior Agenda Coalition of RI pushes wealth tax to fund programs for older residents

Published in RINewsToday on June 2, 2025

With the recent passage of the House Republican budget—which cuts some programs and services for seniors, veterans, people with disabilities, and families with children—Sulma Arias, Executive Director of Chicago-based People’s Action (PA), is calling on billionaires and large corporations to finally pay their fair share of taxes.

Senator Bernie Sanders has echoed similar sentiments on the national stage, urging lawmakers to ensure that ultra-wealthy individuals and powerful corporations contribute more equitably to the nation’s economic well-being, rather than shifting the burden to everyday Americans by cutting essential services.

In Rhode Island, Democratic lawmakers are advancing legislation this session that would increase taxes on the state’s highest earners to generate vital revenue for public programs and services.

Proposed Legislation Targets Top Earners

HB 5473, introduced on February 12, 2025, by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls), was referred to the House Finance Committee. The bill proposes a 3% surtax on taxable income above $625,000—on top of the existing 5.99% rate—targeting the top 1% of Rhode Island tax filers. The surtax is projected to raise approximately $190 million annually and would affect about 5,700 of the state’s more than 500,000 filers. If enacted, the tax would apply to income earned in tax years beginning in 2026 and would not be retroactive.

As of the May 6 House Finance Committee hearing, about 140 pieces of written testimony had been submitted on HB 5473. The committee held the bill for further study, with no additional action yet taken. The proposal remains under consideration as part of ongoing budget negotiations.

A companion bill, S. 329, was introduced in the Senate by Sen. Melissa Murray (D-Dist. 24, Woonsocket, North Smithfield) and referred to the Senate Finance Committee. A hearing on the measure was held last Thursday, and the bill was also held for further study.

As the volume of testimony indicates, the battle lines are clearly drawn. Progressive groups and unions support the legislation, while businesses and business organizations, such as the Greater Providence Chamber of Commerce and the Northern Rhode Island Chamber of Commerce, have voiced strong opposition. Governor Dan McKee has not yet taken a public position on the bills.

The Pros and Cons

Supporters argue that with Rhode Island facing a $220 million budget deficit, HB 5473 and S. 329 could raise nearly $190 million annually to fund critical services, including: K-12 and higher education; health care; housing; public transportation; affordable child care; infrastructure, and programs for older adults

They contend that the proposals would bolster the state’s safety net, particularly in light of uncertain federal funding. A more progressive tax structure, they argue, would make the system fairer by reducing the burden on middle- and lower-income residents. Currently, the top 1% of Rhode Island taxpayers control a disproportionate share of the state’s wealth but, when accounting for sales and property taxes, pay a smaller share of their income than lower-income households.

Opponents, however, warn of unintended consequences. They claim the bills would drive wealthy residents and businesses out of the state, eroding the tax base.Supporters dispute this, pointing to IRS and Stanford University studies indicating that wealthy individuals typically relocate for family or climate-related reasons—not for tax considerations. States like California and New Jersey, they note, have implemented similar surtaxes without experiencing significant outmigration.

Morally, proponents argue, those with more resources have a responsibility to help those with less—especially in a post-COVID era when many low-income families continue to struggle.

Yet critics, including the Rhode Island Public Expenditure Council (RIPEC) along with the Greater Providence Chamber of Commerce, Northern Rhode Island Chamber of Commerce and businesses, warn that such a tax could signal to entrepreneurs and investors that Rhode Island is “business unfriendly.” They contend that higher income taxes might discourage business investment and hiring, harming the state’s long-term economic prospects.

Some opponents cite Connecticut’s experience in the early 2010s, when a handful of wealthy taxpayers reportedly relocated after tax hikes, resulting in noticeable revenue loss. Given that a small number of high earners contribute a significant share of state income tax revenue, even limited outmigration could have an outsized fiscal impact, critics argue.

Skeptics also question whether new revenue will be reliably dedicated to education, infrastructure, and social programs. They point out that in the past, even funds placed in restricted accounts were sometimes redirected to fill budget shortfalls.

Aging Programs and Services at a Crossroads

“Rhode Island stands at a crossroads,” warns Carol Anne Costa, Executive Director of the Senior Agenda Coalition of Rhode Island (SACRI). With a projected $220 million deficit and potential federal cuts to programs such as Medicaid, SNAP, and services provided by the Office of Healthy Aging, Costa insists that passing HB 5473 and S. 329 is essential to preserve and expand supports for older adults and people with disabilities.

“Most of our state’s older residents are not wealthy,” Costa notes, citing Census data showing that one in four older households earns less than $25,000 annually, and 45% earn less than $50,000. Only about 8% of older households earn more than $200,000.

In FY 2023, 27,535 Rhode Islanders aged 65 and older were enrolled in Medicaid, which funds the majority of long-term services not covered by Medicare. In addition, 14% of older adults in the state relied on SNAP benefits to help cover food costs.

Costa argues that revenue from the proposed surtax could ensure continued funding for these essential programs and expand the Medicare Savings Program. Such an expansion could save low-income seniors and adults with disabilities up to $185 per month in Medicare Part B premiums—money they need for food, housing, and transportation.

While critics warn of wealthy residents fleeing Rhode Island if taxes increase, Costa cites a comprehensive report by the Economic Progress Institute refuting this claim. “In fact, the data suggests the opposite,” she says. “Higher-income tax filers are moving into Rhode Island more than they are leaving.”

Costa also points to Massachusetts as a real-world example. After voters approved a 4% surtax on income over $1 million in 2022, the number of Massachusetts residents with a net worth over $1 million increased from 441,610 to 612,109 by 2024, according to an April report from the Institute for Policy Studies and the State Revenue Alliance.

Business Community Pushes Back

At the House Finance Committee hearing, Laurie White, President of the Greater Providence Chamber of Commerce, voiced strong opposition to the proposed tax.

“Our views reflect those of thousands of local businesses statewide,” she said. “Rhode Island is already in fierce competition with neighboring states to attract and retain businesses, residents, and talent.”

White warned that the surtax would send the wrong message, particularly as Rhode Island invests in high-wage sectors like life sciences and technology. “Tax burden is a key factor in business decisions, and an increase in personal income tax would significantly reduce Rhode Island’s appeal,” she stated.

House GOP Minority Leader Michael W. Chippendale (R-Dist. 40, Coventry, Foster, Gloucester) echoed White’s sentiments: “Taxing people who have worked hard and become prosperous is an insult to the American dream. We shouldn’t be punishing success—we should be creating an economic environment where everyone can thrive. Driving away high-income residents with more taxes is backward thinking.”

Chief of Staff Sue Stenhouse confirmed that the entire 10-member House Republican caucus stands united in opposition to the surtax.

The Washington, DC-based Tax Foundation also weighed in. In written testimony on S. 329, Senior Policy & Research Manager Katherine Loughead stated that if the surtax were enacted, Rhode Island would move from having the 14th-highest to the 8th-highest top marginal state income tax rate in the nation—excluding the District of Columbia. She warned that this could make Rhode Island less attractive to high-income earners than even Massachusetts.

So What’s Next?

Costa maintains that taxing the wealthiest residents may be both a necessary and viable solution to protect the state’s safety net amid budget shortfalls and looming federal cuts.

However, with HB 5473 and S. 329 still being held for further study, it remains unclear whether they will be included in the final state budget.

“As we approach the final weeks of the session, there is no shortage of meritorious proposals that affect state resources,” said House Speaker Joseph Shekarchi (D-Dist. 23, Warwick). “The uncertainty of the federal funding picture and the numerous holes in the Governor’s proposed budget complicate both balancing this year’s budget and planning for the unknown. I continue to keep many options on the table for this challenging task.”

Stay tuned—SACRI and other aging advocacy groups are watching closely to see what options will be considered by the House Speaker when he releases FY 2026 state budget to address funding for programs and services that support Rhode Island’s growing older population in this difficult fiscal year.

To read submitted emails and testimony on S. 329, go to https://www.rilegislature.gov/senators/SenateComDocs/Pages/Finance%202025.aspx.

To read written testimony submitted on HB 5473, go to https://www.rilegislature.gov/Special/comdoc/Pages/House%20Finance%202025.aspx.