Tag Archives for Carol Anne Costa

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.

Advocates call for Governor to reject budget cuts they say would harm older adults

Published in RINewsToday on Oct. 28, 2024

As the state’s Office of Management and Budget (OMB) holds its Revenue & Caseload Estimate Conference to discuss the economic and revenue outlook for the upcoming legislative session, the Senior Agenda Coalition of RI (SACRI) warns of “onerous budget cuts” proposed by state agencies overseeing programs and services for Rhode Islanders. At press time, the state’s Medicaid and the Office of Healthy Aging offices proposed 7.5 percent budget cuts to be included in the upcoming fiscal year 2026 budget. 

“It is unconscionable that at a time when our older population is growing – projected to reach one out of every four Rhode Islanders in a few years — to propose budget cuts for programs proven to keep them healthy and safe and that in the long term can save taxpayers money,” says SACRI Board Chair, Diane Santos.

According to Santos, the requests put forward by the Office of Healthy Aging (OHA) include a reduction in state funds for the Meals on Wheels home-delivered meals program projected to cause 13,000 fewer meals to be delivered to persons unable to shop and prepare meals; cuts in funding for local Senior Centers and programs for older adults; elimination of grants to provide security services in elderly housing; and decreased funding to support the Elderly Transportation program. 

Santos warns that proposed changes in Medicaid eligibility guidelines are projected to cause hundreds of vulnerable older adults and persons with disabilities to lose state Medicaid coverage for their nursing home care and cause nursing homes, many of which are already struggling financially and face critical worker shortages, to lose millions of dollars if implemented. In addition, changes in the Medicaid CNOM (Costs Not Otherwise Matchable) program could reduce federal dollars that match state funding and impact hundreds of persons receiving home care and adult day services that help keep them living at home, the proposed cuts could result in greater spending in other areas.

For example, says Maureen Maigret, SACRI Policy Advisor, “Brown University researchers have shown that funds spent on home-delivered meals can delay or even prevent costly nursing home care.”

Over the years, Maigret noted that SACRI has worked to boost state funding to communities to assist them to operate local senior centers and programs. These serve hundreds of older adults and families across the state with a wide range of programs that keep older adults healthy, informed and connected to their communities, she noted.

SACRI has called for the state’s budget to provide ten dollars for each person aged 65 and over to Rhode Island’s 39 cities and towns, says Maigret, calculating that this amounts to about $20 per older adult. “The proposed cuts now being considered fail to recognize the increased need for these services due to the significant growth of our older population,” says Maigret.

Drawing a line in the sand

At press time, SACRI and its partners delivered a letter to Gov. McKee urging him to not balance the state budget on the back of Rhode Island’s older adults, stressing that the “potential ripple impact on families will be significant.

“Nonprofits and those who will be impacted need to know that SACRI and its partners are closely watching this process and are ready to advocate to protect programs and services which may impact our varied constituencies,” says Carol Anne Costa, SACRI Executive Director.

Costa continued, “The fastest growing demographic in RI is people over the age of 65. That is an obstinate fact. And cuts to the budget must be re-prioritized.” The Office of the State Ombudsman agreed, “If anything, OHA should be getting an increase, as they manage to complete all of their obligations on a shoestring budget. And kudos to Maria Cimini and her team at OHA for the outstanding work they do,” says Kathleen Heren, the RI Ombudsman.

Costa noted that OHA is Rhode Island’s designated state unit on aging. It serves as the chief advocate for older Rhode Islanders, adults living with disabilities, and family caregivers. “Prioritizing reductions in spending in areas not directly tied to OHA’s core mission or that would not harm vulnerable older adults and persons with disabilities dependent on Medicaid to meet their long-term care needs is clearly a place to start [in determining budget cuts]. Administrative expenses and the millions of dollars being paid out to consultants could be heavily scrutinized for budget reductions,” she says. 

Adds Mirelle Sayaf, Executive Director of Ocean State Center for Independent Living (OSCIL), “The proposed budget cuts pose a serious threat to the mission of the OSCIL, which is dedicated to supporting individuals with disabilities. Reducing funding, along with changes to Medicaid eligibility and essential programs, will harm those we serve. These cuts jeopardize vital services such as home care, nutritional support, and community engagement initiatives that empower individuals to live independently and maintain their quality of life.”

“Cutting the budget for the OHA when its resources are already extremely stressed to fully meet the needs of a growing older population is unjustified,” charges SACRI’s Maigret, who is also a former Director of the Department of Elderly Affairs.”

Maigret also opposes changes to Medicaid eligibility after advocates have spent years to ensure persons in need of long term supports and services have access to a range of affordable options, and avoidance of long wait lists for service. She calls for increasing resources to the Rhode Island’s cities and towns to help them support local programs for older adults and increasing eligibility for the Medicare Savings Program so lower-income persons on Medicare can afford needed healthcare.  But, Maigret also says that housing needs of older adults must be considered when allocating housing funds.

Food & Shelter important, too

Gerontologist Deb Burton, Executive Director of RI Elder Info also has some thoughts about the state’s proposed budget cuts.

“Cuts to Meals on Wheels that cause our most vulnerable, at-risk, elders to go hungry are simply unconscionable. Taking meals away from our elders cannot happen,” says Burton.

“We must bring back the housing stabilization unit for older adults. Older adult homelessness has increased more than 400% since COVID hit and rents skyrocketed. Rising housing costs, fixed incomes, and wait lists of 2-8 years for affordable elderly housing have all contributed to this crisis. In addition to these challenges, the application process for getting an apartment is onerous and nearly impossible if one does not have access to the internet,” adds Burton.

Eviction prevention is critical in addressing the elder homelessness issue, says Burton, noting that private sector partnerships and philanthropic donations can support a housing stability unit for older adults, ensuring sustainable funding for eviction prevention programs.

“We must find the strength and compassion to provide the funding necessary for food and shelter for our most vulnerable friends and neighbors. If we don’t, what does the future hold for ourselves?” asks Burton.  

A Final Call

“The November Revenue and Caseload Estimating Conferences will provide updated projections to inform budget development which will help set priorities. However, RI’s most vulnerable and fastest growing demographic must be prioritized in finalizing the FY2026 budget,” urges Costa.

Costa takes helm of SACRI, Crafts Vision for Upcoming Conference

Published in RINewsToday on September 9, 2024

The Senior Agenda Coalition of Rhode Island (SACRI), an independent and diverse coalition of over 20 agencies and individual members who advocate for older Rhode Islanders, gears up for the planning of its 16th Annual Conference and Expo with the recent appointment of its new Executive Director, Carol Anne Costa.

Bringing a Wealth of Experience to SACRI

According to Diane Santos, SACRI Board  Chair, Costa brings a wealth of experience from her positions in the Raimondo administration and most recently as the Constituent Service Coordinator for the Rhode Island Office of Attorney General. Her institutional knowledge at the state and federal levels gained in her past positions in the Rhode Island Judiciary, as well as Executive Director of National Utility Contractors of RI (NUCARI) and her managerial role at the Johnston Housing Authority, is a great asset.

“Most importantly, Carol is passionate about helping others, not only through her work but also through her volunteerism in the community. This commitment is exemplified by her serving on many Boards and committees, most notably as a member of the Board of Directors of Wiggin Village for the past 20 years,” says Santos.

The conference will bring together important voices: people from across the state together with the politicians who serve their interests at the levers of power, says Costa. “To achieve progress on any issue the participation of decision makers along with those they represent is the best way to meet budget, legislative and policy goals,” notes Costa.

SACRI Conference is Just a Month Away

In July, Costa stepped into the role of managing SACRI’s upcoming annual conference, “A Bridge to a Secure Future,” to be held on October 9, 2024, from 7:30 a.m. to 12:00 noon, at the Warwick-based Crown Plaza.  This major task remains on her desk as do many of the other tasks to move the organization forward to prepare for the upcoming General Assembly session.

We must embrace the future and respect the past,” says Costa, in developing strategies to advocate for legislative proposals that enhance the lives older persons.

 “My goal is to fill the ballroom at the Crowne Plaza to capacity with older Rhode Islanders, aging advocates, partners and coalition members to educate them about legislative proposals that SACRI supports during next year’s legislative session.

According to Costa, the conference theme, “A Bridge to a Secure Future,” focuses on the kitchen table issues facing older adults and adults with disabilities: economic security, healthcare, and housing. Presenting the keynote address is US Senator Sheldon Whitehouse who will be followed by a panel including US Congressman Seth Magaziner, RI Attorney General Peter F. Neronha and Housing expert, Julie Leddy, she says.

“The conference will be informative and opportune.” said Costa, noting that SACRI’s mission is helping to better the lives of older Rhode Islanders and adults with disabilities and the conference helps us to expand our outreach into the community.

“Empowering people by giving their voice to pertinent issues is something I value, and this conference is the perfect way to begin my tenure at the helm,” she continued.

“In Rhode Island, the healthcare system is under great stress. Older Rhode Islanders face a system rife with worker shortages, long wait times and a dwindling pool of doctors. Solving these problems requires the voices of our coalition and its partners to bring attention to them and the impact they have on people,” said Costa.

In speaking about housing issues, Costa noted, “The housing situation in the state is at a crisis point where new stock is virtually nonexistent and underfunded agencies tasked with building, managing, and easing rental spikes are the only bulwark to help ordinary folks.”

But the big question which looms is will the monies allocated for new development be proportionally distributed, particularly for our older adults as threats to Medicare and Social Security at the federal level compound the stress they feel?” asks Costa.

“This advocacy work is in my DNA, and I am enjoying every minute of it,” says Costa, stressing that she looks forward to moving SACRI forward to accomplish its legislative and policy goals that will impact Rhode Island’s older population.

“And I would be remiss if I did not ask everyone to join us on October 9, 2024,” she said.

Building on Last Year’s  Success

Looking back, over 300 people attended last year’s conference, says Maureen Maigret, SACRI’s Policy Advisor, who assisted its Board members to organize the 2023 conference.  After educating the attendees, the coalition mobilized its troops composed of older Rhode Islander, aging and health care organizations, educators, unions, and Medicare insurance providers to push for change. “

How did that conference impact SACRI’s lobbying efforts?

“Last year’s legislative agenda reflected policy issues discussed by the keynote speaker and panelists at the conference,” noted Maigret, a former Director of the State’s Office on Aging.   According to Maigret, SACRI’s lobbying efforts resulted in the General Assembly enacting SACRI’s legislative priorities that included increasing home and community service provider rates, increasing funding for the state’s senior centers and the streamlining of zoning requirements for the building of Accessory Dwelling Units.  Lawmakers also put a $120 million housing bond program on the November ballot, she said.

“Feedback from Conference attendees about the presentations was excellent and they liked the variety of exhibitors, too,” says Maigret, noting that some participants did say they would have liked more time to ask questions to the presenters. This year’s conference does build in additional time for Q&A, she adds. 

Maigret says SACRI’s Board took charge in organizing the successful event.  This year, Costa and her Board continue its efforts to organize and prepare for the upcoming legislative session, she says.

The cost of SACRI’s upcoming conference is $25.00 per person for Members and $35 per person for nonmembers.  And any organization who wishes to exhibit their work at the Expo, the tables are $350.00. To register go to  https://senioragendari.org/2024-conference-and-expo.

For more details about SACRI, to https://senioragendari.org/.