Can R.I.’s Next Governor Truly Deliver for Seniors and People with Disabilities and Behavioral Health Issues?

Published in Blackstone Valley Call & Times on October 6, 2026

Democratic gubernatorial candidate Helena Buonanno Foulkes and independent candidate Ken Block squared off Friday, Oct. 2, at a gubernatorial candidate forum focused on issues affecting older Rhode Islanders, people with disabilities, family caregivers and those receiving behavioral health services.

Opening the forum, Carol Anne Costa, SACRI’s Executive Director, noted that Republican candidate Aaron Guckian, who had committed to attend, failed to show up after notifying organizers at 3 p.m. that same day. “We’ve adjusted the program, and we will move forward in a focused and streamlined way so that these candidates who have taken the time to be with this audience get the forum they deserve,” she said.

Introducing the Candidates

Foulkes, 62, a Providence resident, emphasized her 25 years at CVS, ultimately becoming president of CVS Pharmacy, where she worked on employment initiatives for people with disabilities and special needs. She said she doesn’t need to be “the smartest person in the room,” but wants to leverage community expertise. She highlighted her relationships with other governors, including Maryland Gov. Wes Moore, as sources of policy ideas. Her policy priorities include housing affordability and healthcare access, and she called for creating a “whole-of-government” approach to senior services.

Block, 60, a Barrington software engineer who founded Simpatico Software Systems, political reformer and author, is an independent candidate who describes himself as an “operational manager” with experience helping large multinational companies reimagine their business operations, contracting and delivery of complicated computer systems. He emphasizes a data-driven approach to problem-solving and decision-making and has firsthand experience with healthcare and aging issues as a caregiver for his mother, who had early-onset Alzheimer’s, and helping his in-laws with aging-in-place challenges.

Block, like Foulkes, has actively sought information from advocacy groups on aging and disability issues throughout his campaign. He focuses heavily on government efficiency, transparency and fixing “friction points” in state operations.

The forum, held at Rhodes on the Pawtuxet in Cranston, was sponsored by the Senior Agenda Coalition of Rhode Island (SACRI), AccessPoint Rhode Island and the Mental Health Association of Rhode Island.

Unlike many gubernatorial forums held throughout the Ocean State that focus heavily on taxes, housing, education and the economy, SACRI’s forum allowed the candidates to address issues that often receive less attention during political campaigns: aging in the community, long-term services and supports, nursing home care, Medicaid, family caregiving, behavioral health and services for persons with disabilities.

Spanning more than an hour, the two candidates fielded questions on strengthening the state’s Office of Healthy Aging, creating a multi-sector plan on aging, establishing a state advocate’s office and expanding long-term care. They also discussed unpaid family caregivers, workforce shortages, accessible housing, the 988 Suicide & Crisis Lifeline, economic security for older adults and transparency in human services.

Where They Stand

During opening remarks, Foulkes emphasized that seniors are an “untapped resource” of wisdom and expertise. She proposed creating a “senior corps”-style effort and intergenerational mentoring programs. Block shared personal caregiving experiences involving his parents and now his in-laws in their 80s, stressing the importance of advocacy organizations in helping families find needed resources and support.

At that point, the two candidates addressed a multitude of topics during the forum. Here is a sampling.

The SACRI forum highlighted that Rhode Island’s 2009 law setting a 50% goal for Medicaid home and community-based services remains unmet, with general home and community services reaching only 20.1%. The state ranks 44th nationally in community support spending for older adults at $28 per adult age 60 and older, compared with the $53 U.S. average and $222 in Massachusetts.

Regarding long-term care, Block called for cost-effective alternatives to nursing homes for residents with lower care needs, including housing options. He also recognized the possibility of severe budget pressures, including potential Medicaid cuts.

Foulkes highlighted the staffing crisis, fueled by low wages and lack of health insurance for many home-care workers. She also raised concerns about the impact of federal immigration policies on the pool of workers available to provide care.

The candidates were asked about a long-term care workforce crisis that includes 512 nursing assistant openings and only 132 trained applicants; Medicaid reimbursement rates; support for unpaid family caregivers who provide an estimated $2.8 billion in annual care; and the need for accessible housing throughout Rhode Island, with only 85 of 2,194 units under development being handicapped accessible.

Block supported elevating the state’s Office of Healthy Aging (OHA) to a cabinet-level position to ensure seniors have a direct voice to the governor. His rationale: A substantial portion of the Ocean State’s population has interests that align directly with OHA.

Foulkes advocates for a “whole-of-government approach” to providing senior services, with a potential cabinet-level position for aging, looking to Maryland as a model.

Foulkes emphasized the need for creating a master plan on aging with accountability and deadlines. Block also pledged to either issue an executive order or support legislation to develop the state’s aging policies, programs and services.

The candidates split on how to provide sustainable funding for the 988 Suicide & Crisis Lifeline. Rhode Island’s 988 system has handled nearly 75,000 calls since its launch while maintaining a 98% answer rate.

Block explained his opposition to using a telephone fee to fund the program, citing the regressive burden such fees place on low-income residents. He has no opposition to the program itself. Foulkes supported a small monthly telephone fee, similar to 911 funding, to provide a dedicated funding source for the state’s 988 response system.

Both candidates emphasized government inefficiency and data-access problems. Block described himself as “an operational manager” who specializes in “understanding where an organization doesn’t work well” and called Rhode Island government “a target rich environment.”

He expressed frustration with “Rhode Island state government’s ability to provide data” and promised “dashboards and other things that will ultimately really let us understand much better than we can now where we’re spending the money.”

Foulkes similarly stated, “we need way more transparency everywhere in the state” and endorsed the Inspector General concept to track how government funds are spent.

Direct-care workforce challenges appeared across multiple questions. Foulkes identified “the gap in terms of the number of community healthcare workers” and how “low paid” the work is, noting that “most of them that I speak to don’t even have healthcare insurance themselves.”

Foulkes connected federal immigration policy to the state’s capacity to provide care, raising concerns about home-care providers and healthcare workers who are immigrants. Block pointed again to the nursing assistant shortage during the lightning round.

Foulkes proposed creating a state website to assist families in navigating the long-term care continuum, acknowledging “it’s really hard right now” to find appropriate services. She also called for helping Rhode Islanders at risk of losing Medicaid coverage, proposing a “Medicaid navigator system” using faith-based communities and senior centers to help people complete eligibility paperwork.

Both candidates warned about the severe stress on Rhode Island’s healthcare system. Block noted that Roger Williams Medical Center and Our Lady of Fatima Hospital were “on life support,” stressing their importance to the state’s healthcare system. Foulkes pointed to Rhode Island’s more than $156 million first-year federal Rural Health Transformation Program award as an opportunity to strengthen healthcare delivery.

Foulkes and Block also supported creating a dementia services coordinator position at the Department of Health. They supported continuing the overdose task force’s progress and having dedicated substance-use and mental-health policy staff in the governor’s office.

Finally, in lightning-round responses, both candidates supported continuing Medicaid reimbursement rate efforts for direct-care staff; using 30% of state housing bond funds for accessible housing for older adults and people with disabilities; creating an Office of the Elder Advocate; and developing a multi-sector plan on aging.

While Foulkes supports eliminating the Medicare Savings Program asset limit and providing an annual cost-of-living adjustment to the state’s SSI supplemental payment, Block gave no answer because he did not have a cost estimate.

Here’s the Bottom Line

With federal funding uncertainty, the state’s ongoing structural budget deficit and fiscal limitations, will Foulkes and Block be able to make good on their policy commitments?

Block repeatedly declined to make specific funding promises on a number of policies, stating, “I don’t know what’s coming at us” and “my answer to you, with all sincere respect, is I just don’t know.”

Foulkes also acknowledged Block’s concerns about reduced federal funding and the fiscal limitations facing the next governor. “I need to understand at the end of the day what all of this costs and make sure that I’m not making promises to you that I can’t keep,” she said.

For older Rhode Islanders, people with disabilities and behavioral health issues, family caregivers and the organizations that serve them, that may ultimately be the most important question coming out of  SACRI’s forum: not just what the candidates promise to do, but whether the next governor will have the resources and political will to do it.

Stay tuned.

AARP Report: Unpaid Caregiving Valued at $ 600 Billion

Published in RINewsToday on March 13, 2023

Family caregivers put in over $36 Billion hours in unpaid care taking care of loved ones, a responsibility that takes a heavy toll on them financially, physically, emotionally, and mentally.

But now, a new AARP report reveals that the family caregiver unpaid work is estimated to be valued at more than $600 Billion. This is a $130 Billion increase in unpaid contributions from family caregivers since the last report in the series was released in 2019. The economic impact of $600 Billion is more than all out-of-pocket spending on health care in the U.S. in 2021, notes the AARP report.

The 32-page 2023 update, Valuing the Invaluable, highlights trends in family caregiving, explores the growing scope and complexity of family caregiving, and discusses actions needed to be taken to address the financial, social, and emotional challenges of caring for parents, spouses, and other loved ones. 

AARP continues to put the spotlight on this important aging policy issue as the graying of the nation’s population continues. According to the group, by 2034, adults aged 65 and older will outnumber children under the age of 18 for the first time ever.

The share of available family caregivers is projected to continue shrinking, relative to the number of older adults who will potentially require long-term care. In addition, family caregivers will continue to face the dual demands of employment and caregiving responsibilities, which often includes bringing up children while taking caring of older parents simultaneously.

“Family caregivers are the backbone of long-term care in this country,” said Susan Reinhard, senior vice president, AARP Public Policy Institute, and a lead author of the report. In a March 8, 2023 statement announcing its release, Reinhard said, “The care they provide is invaluable to those receiving it. But this is not just a family issue: it impacts communities, employers, and our health and long-term care systems. We must treat family caregivers as the valuable resource that they are by providing them the support they need to care for loved ones while also caring for themselves.”

AARP, the nation’s largest aging advocacy group representing over 38 million members, says it plans to push this year to turn the National Strategy to Support Family Caregivers into action that provides meaningful, tangible outcomes and support for family caregivers. The National Strategy, delivered to Congress last September, stemmed from the RAISE Family Caregivers Act, which was championed by AARP. The National Strategy highlights nearly 350 actions that the federal government will take and more than 150 that can be adopted by stakeholders and other levels of government to give family caregivers the necessary help they need.

Taking a Closer Look at Home

AARP’s latest report in the Valuing the Invaluable series also provides us data for the Ocean State as to the value of unpaid caregiving provided here. The unpaid care provided by the 121,000 Rhode Island caregivers is valued at $2.1 Billion. This amount was calculated at an $18.95 hourly value to the estimated 113 million hours of unpaid care that family caregivers provided in 2021 – a $300 million increase in unpaid contributions since the last report was released in 2019.

“Family caregivers play a vital role in Rhode Island’s health care system, whether they care for someone at home, coordinate home health care, or help care for someone who lives in a nursing home,” said Catherine Taylor, AARP Rhode Island State Director. “We want to make sure all family caregivers have the financial, emotional and social support they need, because the care they provide is invaluable both to those receiving it and to their community,” she says.

At the Rhode Island State Capitol, AARP Rhode Island says it will continue its fight for assisting family caregivers and the loved ones they care for. During the 2021 Rhode Island General Assembly Session, AARP Rhode Island, along with other aging advocacy groups, successfully lobbied to enhance the Temporary Caregiver Insurance program by increasing the number of weeks a worker can take annually to care for a loved one from 4 to 6 weeks.

During the current legislation session, AARP Rhode Island calls for state lawmakers to support family caregivers who work because caring for a loved one shouldn’t mean losing pay—or even their job. House Bill 5781/Senate Bill 139 will increase the number of weeks that one can take annually to 12. These bills would also expand the definition of family in Rhode Island’s existing paid family leave law to include siblings, grandchildren and other care recipients to fit the reality of Rhode Island’s diverse and multigenerational families.

“Too often our unpaid caregivers are not acknowledged. We need to show the many thousands of unpaid caregivers in Rhode Island we value their contributions with sound policies, programs and laws that support them,” says Maureen Maigret, Policy Advisor for Senior Agenda Coalition of RI.

Maigret also calls for expanding the state Temporary Caregiver Insurance law from six to twelve weeks as most states that have such programs allow, and for including siblings, grandchildren and care recipients – important steps in making Rhode Island a more family-friendly state. “I have personally been a caregiver for a number of family members and know how challenging it can be to navigate our long-term care system,” Maigret says.

“Another important step to support our caregivers is to provide state funding to strengthen The POINT, the state Aging and Disability Resource Center, so that caregivers have a single place they can go to get timely, reliable information and person-centered counseling about the services, supports and benefits available to them as caregivers,” says Maigret. “Too often caregivers are not aware of programs such as subsidized respite and adult day or benefits available to care recipients. That is why the Senior Agenda Coalition of RI is asking the legislature to add $.5 Million to the state budget as The POINT currently receives no state funds and relies entirely on insufficient federal dollars,” she adds.

“It is also important that caregivers be viewed as part of a person’s healthcare team. Healthcare providers, especially those in primary care, need to ask patients if they are getting care from a family member or if they themselves are a caregiver,” says Maigret, noting that this action will provide an opportunity for providers to offer information and guidance about available services and supports.

Resources for Caregivers

“We know that everyone’s path to aging is different and it’s our paid and unpaid caregivers that provide critical supports to our loved ones,” said Office of Healthy Aging Director Maria Cimini. “At the Office of Healthy Aging, we are committed to supporting our caregivers in a variety of ways encouraging self-care through respite programs, informational workshops, and our senior companion volunteer program,” says Cimini.  She suggests that family caregivers go to https://oha.ri.gov/resources/oha-resource-center to download OHA’s 2023 Pocket Manual, detailing resources available programs and services that the state agency provides to family caregivers.

Dementia and Alzheimer’s care

“Dementia caregiving is challenging emotionally, physically, and financially. The care that family members provide is priceless, really. We want people to know they are not alone and that the Alzheimer’s Association, Rhode Island chapter has both in person/virtual support groups and community based educational programs for people who are caring for a person living with a diagnosis of Alzheimer’s disease or a related dementia throughout the state,” says Donna McGowan, Executive Director, Alzheimer’s Association Rhode Island Chapter, noting that there are 24 thousand people living with Alzheimer’s in Rhode Island and 39,000 caregivers, many unpaid family members.

“The Alzheimer’s Association believes that understanding how the diagnosis will affect the entire family is truly important to know what resources the family may/will need and how to pay for care must be considered starting right from when a diagnosis is made,” says McGowan.

McGowan says that the Alzheimer’s Association’s  24/7 Helpline clinicians guide callers to financial assistance programs that may help pay for respite or a needed break. For details, go to https://www.alz.org/ri

Chris Gadbois, DNP, RN, PHNA-BC, PMH-BC, Chief Executive Officer of the East Providence-based CareLink, says AARP’s report highlights the critical need for support for caregivers in Rhode Island. “At CareLink, we see firsthand the impact on the health and well-being of caregivers and are working hard to provide programs to provide resources. Our Administration on Community Living grant funded program to support individuals with dementia and their care partners is just one example of services that can help people to remain safely in their homes,” she says. 

The program, delivered by a trained Occupational Therapist, during five ninety-minute home visits, includes techniques to reduce challenging behaviors, promote functioning, improve caregiver communication, home environment safety, and tips focused on caregiver self-care, including problem solving and teaching stress management techniques. For more details, go to https://carelinkri.org/member-services/therapeutic-services-for-dementia/.

AARP provides a comprehensive listing of resources and information on family caregiving.  Go to aarp.org/caregiving.

For a 2023 copy of Valuing the Invaluable, go to https://www.aarp.org/content/dam/aarp/ppi/2023/3/valuing-the-invaluable-2023-update.doi.10.26419-2Fppi.00082.006.pdf.

Resources and information on family caregiving are available at aarp.org/caregiving.

Uncompensated Cost of Caregivers is a Whopping $470 Billion

Published in the Woonsocket Call on November 17, 2019

Approximately 41 million unpaid family caregivers provided an estimated 34 billion hours of care in 2017 — worth a whopping $470 billion — to their parents, spouses, partners, and friends, according to the latest report in AARP’s Valuing the Invaluable series. The 2019 estimated value of family caregiving is based on 41 million caregivers providing an average of 16 hours of care per week, at an average value of $13.81 per hour. Previous AARP Public Policy reports were released in 2006, 2008, 2011 and 2015.

“It’s encouraging to see greater recognition of the emotional, physical and financial struggles that caregivers face,” said Susan Reinhard, senior vice president, AARP Public Policy Institute, in an April 14th statement announcing the release of the 32-page report. “But the demands on family caregivers are not just a family issue and we must continue to push for meaningful support and solutions,” says Reinhard.

Every caregiver, as well as their families, know the value of their efforts,” said AARP Rhode Island State Director Kathleen Connell. “In Rhode Island, the estimated total value of 114 million hours of work by the state’s 136,000 caregivers is $1.8 billion. The aggregate is astounding, making a clear case for supporting this vital commitment made by family and loved ones.”

“These numbers inspire our members who spend many hours at the State House as AARP Rhode Island advocacy volunteers,” Connell added. “They have helped pass key legislation — the CARE Act, paid caregiver leaves and many other key bills — that have given caregivers resources and opportunities to make their task less daunting. Caregivers are truly invaluable,” she says.

Putting a Spotlight on the Nation’s Caregivers

AARP’s report notes that the estimated $470 billion equates to about $1,450 for every person in the United States (325 million people in 2017). Its economic impact is more than all out-of-pocket spending on US health care in 2017 ($366 billion). Uncompensated care provided by caregivers is also three times as much as total Medicaid spending on long-term services (LTSS) and supports ($154 billion in 2016) and even the total spending from all sources of paid LTSS, including post-acute care ($366 billion in 2016).

The AARP researchers say that the estimate of $470 billion in economic value of uncompensated care is consistent with nearly two decades of prior research studies, all of which found (like the current study) that the value of unpaid family care vastly exceeds the value of paid home care.

The AARP report, Valuing the Invaluable: 2019 Update Charting a Path Forward, also explores the growing scope and complexity of caregiving, including an aging population, more family caregivers in the paid workforce, and the increasing amount of medical and nursing tasks entering the home.

According to the AARP report, family care givers, who provide day-to-day supports and services and manage complex care tasks, are becoming more diverse. While most family caregivers are women, about 40 percent are men who are providing more assistance than just driving to doctor’s appointments and grocery stores or paying bills. Like all caregivers, they are assisting a parent, spouse or friend with bathing and dressing, pain management, managing medication, changing dressings, helping with incontinence and even preparing special diets.

While a majority of baby boomers are providing caregiving services, a growing number of younger adults are now shouldering this responsibility, too. Nearly 1 in 4 (24 percent) are millennials (born between 1980 and 1996). Despite their low salaries, the young adults are spending more of their salary on caregiving expenses than other generations. The researchers estimated that this spending in 2016 was about 27 percent of their income.

About 60 percent of family caregivers are juggling a job and providing care, too. This will continue as aging baby boomers choose to remain in the labor force to bring additional income into their household. Workplace benefits for caregivers becomes become even more important as they face economic and financial strain in their later years.

For those employees who choose to leave their job to become a full-time caregiver, they risk both short-and long-term financial difficulties, say the researchers.

Finally, the researcher’s recommendations to better support family caregivers included developing a robust and comprehensive national strategy with the needs of an increasingly diverse caregiver population included; providing financial relief and expanding workplace policies; developing caregiver training programs; and expanding state and federal funding for respite programs.

More Work Needs to Be Done

The AARP report warns that the rising demand for caregivers with the graying of the nation’s population, shrinking families will drastically reduce the supply. In 2010, there were 7.1 potential family caregivers for every person age 80 and over. By 2030, there may be only 4.1 potential caregivers for every person age 80 and over, they say.

Although significant federal and state policy are already in place to assist the nation’s caregivers, more work needs to be done, say the researchers. They call on Congress and state lawmakers to keep pace with the changing demographic, social trends and needs of the family caregiver.

Resources and information on family caregiving, including AARP’s Prepare to Care
Guides, are available at http://www.aarp.org/caregiving.