Tag Archives for Kathleen Gerard

Rhode Island nursing home bill veto response

Published in RINewsToday on July 1, 2024

With the adjourning of the General Assembly on the early morning of June 14, out of thousands of bills thrown into the legislative hopper in this year’s legislative session, 249 bills passed both chambers.  At press time, Gov. Dan McKee has vetoed five bills, including one to create a Rhode Island Nursing Home Workforce Standards Advisory Board (WSB).

Just weeks after the General Assembly overwhelmingly approved the establishment of a 13-member advisory board to keep state leaders informed on current market conditions, wages, benefits and working conditions in Rhode Island’s nursing home industry, McKee vetoed the legislation. The final vote count for H 7733 A was 63-7 in the House and 37-0 in the Senate for S 2621 A.

WSB would advise the General Assembly and the RI Department of Labor and Training on market conditions, wages, benefits and working conditions in the nursing home industry; recommend minimum statewide compensation and working standards for nursing home workers; propose minimum standards for nursing home training programs and assist in ensuring compliance by employers with the recommended standards.

This advisory board would consist of three members representing nursing home employers, three representing nursing home workers, two representing community organizations that work with the Medicaid population, one member representing a joint labor-management multi-employer nonprofit training fund, and representatives of the Health and Human Services secretary, the Department of Labor and Training, the Department of Health and the Long-Term Care State Ombudsman.

Reasons Gov. wielded his veto pen

On June 26, Gov. McKee’s 2-page veto message to House Speaker K. Joseph Shekarchi (D-Dist. 13, Warwick) and Senate President Dominick Ruggerio (D- Dist. 4, Providence, North Providence) outlined his objections to creating the WSB.   

“Rhode Island needs comprehensive solutions to resolve its critical nursing home emergency and support residents, workers and the long-term care facilities,” stated McKee, stressing that the Act didn’t meet that need.

McKee noted that letters submitted by nursing homes and assisted living facilities opposing this legislation charged that the Act didn’t address real issues faced by facilities, including “years of underfunding, increased costs and the lack of available workforce in the state.”

The Board created by the Act focused narrowly on only working conditions and wages without consideration for the key constraints such as reimbursement, the governor told lawmakers.  This will not “generate the comprehensive solutions Rhode Island needs to address the nursing home emergency,” he added.

Aging advocacy groups call for an override of the veto

“Governor McKee’s veto of legislation to create the WSB is a significant setback in our efforts to improve the quality of care in Rhode Island’s nursing homes and to find a way out of the nursing home crisis,” charges Kathleen Gerard, Director of Advocates for Better Care in Rhode Island (ABC-RI) in a statement quickly released after the governor’s veto.

“The veto yet again underscores the reality that the McKee administration has created no framework or plan to stabilize our state’s broken nursing home system,” says Gerard. “Instead of once again catering to the concerns of for-profit facility owners, Governor McKee must prioritize the needs of thousands of nursing home residents and caregivers who continue to suffer from the staffing crisis,” she adds.

According to Gerard, Governor McKee says that the WSB is not a sufficiently comprehensive solution, but the governor himself has proposed no alternative solutions. “In fact, when convening his own closed-door nursing home advisory board, he initially included only industry representatives, then perfunctorily invited union representatives for the final meeting, but failed to include consumer advocates, Long Term Care Ombudsmen, or Medicaid experts,” charged Gerard.  

Gerard notes that the only recommendation from the industry members in this group was to indefinitely suspend enforcement of the Nursing Home Staffing and Quality Care Act—a course of inaction which lacked any basis in evidence and did nothing to ameliorate any of the critical problems with care in Rhode Island nursing homes. “In fact, that course only hurt the facilities that were consistently meeting minimum staffing requirements,” she says.

“Governor McKee’s veto of the WSB is a devastating blow to the residents of Rhode Island’s nursing homes,” says Raise the Bar on Resident Care Coalition in a released statement. Currently, 34 out of 74 nursing homes are rated by the Centers for Medicare & Medicaid Services at two CMS stars or lower, indicating a dire need for improvement in care standards, notes the resident advocacy coalition. 

According to WSB, the legislation creating the Nursing Home Workforce Standards Board would have ensured better training and working conditions for caregivers, which are essential for enhancing the quality of resident care. Rhode Island ranked second in the nation for serious nursing home deficiencies in the last three years, highlighting the urgent need for comprehensive solutions that prioritize the health and safety of residents.

Raise the Bar urges the Rhode Island General Assembly to override McKee’s veto. “The WSB bill was a necessary step towards ensuring better wages, benefits, and training for caregivers, and higher quality care for residents,” says the advocacy coalition, calling on the McKee administration “to remember its promises and create a comprehensive plan to end the nursing home crisis in Rhode Island.”

“The Senior Agenda Coalition of RI (SACRI) is extremely disappointed with Governor Dan McKee’s veto of the legislation passed by the House and Senate to create a Nursing Home Workforce Standards Advisory Board, andn we are calling for the general assembly to override the veto”, said Diane Santos, SACRI’s Chair, in a statement.

There are significant issues impacting the state’s nursing homes from how they are financed; the adequacy of staffing levels, training and wages; and the quality monitoring process, stated Santos. “As the state’s population grows older there will be an ongoing need to provide quality nursing home care for those with high support needs. It is critical that the many issues facing the nursing home industry be addressed,” she said.

ABC-RI and Raise the Bar strongly urge the Rhode Island General Assembly to override McKee’s veto and allow the creation of the WSB. 

In response to the aging advocacy groups calling for a veto override, House Speaker Shekarchi and Senate President Ruggerio issued statements pledging to review the Governor’s veto messages and to confer with each other and lawmakers to determine their response.  

Provider groups give thumbs-up to Gov. McKee’s veto

The state’s largest nursing home provider group agrees with Gov. McKee’s veto of the Workforce Standards Advisory Board, says John E. Gage, President and CEO of the Rhode Island Health Care Association. “This legislation would have set a precedent, establishing an Advisory Board with a narrow and ill-defined mission that failed to recognize the myriad of challenges facing nursing homes in Rhode Island and across the nation,” says Gage,  “these challenges include chronic Medicaid underfunding, skyrocketing costs, a historic workforce shortage, and the existing staffing mandate that is unfunded and fails to address the workforce crisis and includes draconian fines and penalties.”

According to Gage, S 2621A and H 7733A would also have replicated the many layers of existing oversight authority that exists at both state and federal levels – including CMS, the Occupational Safety & Health Administration, the RI Executive Office of Health & Human Services, the RI Department of Health, and the RI Department of Labor & Training, among others.

“There needs to be a comprehensive solution to the current environment of care facing Rhode Island’s nursing homes,” says Gage, stressing that this strategy should include workforce training programs, student loan forgiveness for RI nursing home professionals including RNs, LPNs and CNAs who are trained and choose to remain in RI to work in long-term care settings.

“In addition, reimbursement from Medicaid must become and remain adequate to cover the increasing cost of care in all settings, and changes are needed to address the staffing mandate passed back in 2021,” says Gage, noting that the bill was passed in the midst of the Covid-19 pandemic without addressing the workforce crisis and failing to provide sufficient funding that would be needed to layer in sufficient staff to meet the metrics, if those staff could be found.

Gage says that if fully implemented and enforced, fines would amount to $100 million in the first full year of enforcement – closing the majority of facilities, displacing thousands of vulnerable residents from their homes and devastating access to care for Rhode Island seniors.

LeadingAge RI agrees with RIHCA’s detailed observations about this issue and the Governor’s veto message, which highlight the myriad of entities already in place to oversee and enforce nursing home care, says James Nyberg, Executive Director of LeadingAgeRI. “Furthermore, the Governor noted the need for a more comprehensive solution to the nursing home emergency, and steps are already being taken or are in place towards this goal,” he said.

According to Nyberg, the Governor and General Assembly just made a significant investment in the chronically underfunded industry in this year’s budget, which will benefit all residents and staff.  In addition, the industry has regular meetings with the Health Department and Centers for Medicare & Medicaid Services to  discuss any quality-of-care issues and how to mitigate and resolve them immediately, he says, noting that these meetings are frank and productive. 

Nyberg noted that the industry, and individual nursing homes, also provide countless hours of educational programming to support and improve quality of care.  “All nursing home providers are working to overcome the challenges facing the industry, and demonizing them is disrespectful to the thousands of individuals who work 24/7/365 to care for our older Rhode Islanders,” he says.

As the dust settles…

Last Monday, Gov. McKee’s veto message was sent to House Speaker Shekarchi and Senate President Ruggerio to notify them of his veto. Now they can either let the veto stand or allow it to die.  Overriding the veto can occur if three-fifths of members in both chambers vote to affirm the bill’s passage. This vote would need to take place before the start of the new law-making session in January.

As the dust settles after McKee’s vetoing of legislation to create a WSB, with the overwhelming support of the General Assembly and the lobbying of resident advocacy groups opposing McKee’s veto, will the General Assembly have the political will to act and override the governor’s veto, especially during a time when lawmakers are just beginning their political campaigns? 

We’ll see…

When the dust settles. Looking back at 2024’s legislative days

Published in RINewsToday on June 24, 2024

Over a week ago, after being in session for 49 legislative days (opening day was Jan. 2, 2024), the Rhode Island General Assembly held its final session at 4pm on June 13, 2024, and ended at about 1:30am on June 14, 2024. During this year’s legislative session 1,167 bills and resolutions were introduced in the Senate, and 1,369 in the House. This total does not include Resolutions, which were  congratulatory in nature or noted prominent Rhode Island residents who have passed away.

With the dust settling at the end of this year’s session, there were 249 bills that passed both the House and Senate, and that are now sitting on Gov. Dan McKee’s desk for his signature to enact, or to pass without signature, or to be rejected.

“This was an outstanding legislative year for Rhode Island’s seniors,” observes House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick). “In addition to all the investments for seniors made in the state budget that has been signed by Governor McKee, there were excellent bills that will be of great benefit to our aging population, he says. 

Attacking the housing crisis head on

In a joint statement, the House Speaker and Senate President Dominick Ruggerio said, “It is critical to attack our housing crisis from many different angles. Allowing ADUs in other states has been proven to make a significant impact by immediately increasing available housing supply.  We are confident that ADUs will be beneficial for the many Rhode Islanders who need flexibility in housing options, particularly seniors wishing to age in place in their communities,” they say.

Shekarchi points out the enactment of ADU legislation sponsored by House Commission on Housing Affordability Chairwoman June S. Speakman (D-Dist. 68, Warren Bristol) and Sen. Victoria Gu (D-Dist. 38, Westerly, Charlestown, South Kingston) that would boost the development of accessory dwelling units (ADUs), which are also known as in-law apartments. The House Speaker is the House bill’s top co-sponsor.

“I have heard from so many seniors who would like to downsize and continue to live independently, but would enjoy the extra assurance of living on the property of their children,” he noted, thanking AARP Rhode Island and housing advocates, including Rhode Island Housing, Grow Smart RI and Housing Network RI, who pushed this “significant legislation” across the finish line. 

The bills (2024-H 7062A, 2024-S 2998A) would provide homeowners statewide the right to develop a single ADU on an owner-occupied property or within the existing footprint of their structures or on any lot larger than 20,000 square feet, provided that the ADU’s design satisfies building code, size limits and infrastructure requirements.

The purpose of the bill is to encourage the development of rental units that are likely to be more affordable than many other apartments, and also to provide opportunities for homeowners with extra space to generate income that helps them maintain ownership of that property.

To ensure that the bill achieves its goal of housing Rhode Islanders, the legislation prohibits ADUs constructed under this provision from being used as short-term rentals, and streamlines the permitting process.

In the HEALTH arena

According to Senate President Dominick J. Ruggerio, several legislative proposals in the Senate’s health care package passed the General Assembly.

“Few issues are as important as health care, and right now, our health care system is in critical condition. Health care absolutely must be accessible and affordable for all Rhode Islanders,” says Ruggerio, noting that for too many people in the Ocean State is too expensive or too difficult to get. “And we know that many health care providers are feeling enormous strain due to many factors,” he adds.

“Like providers and consumers, our community hospitals, including Fatima in my district, are facing difficult circumstances,” said the Senate President, who recognized his Senate colleagues in the development of this package of legislation.

“As we celebrate our victories in the 2024 session, we are committed to continuing our work on this issue and accomplishing all the objectives of the HEALTH initiative. “

According to Ruggerio, several legislative proposals in the Senate leadership’s HEALTH (Holistic Enhancement and Access Legislation for Total Health) initiative include legislative proposals to join five interstate licensing compacts to make it easier for Rhode Islanders to access the care they need and budget provisions to use $1 million of general revenue to purchase debts of struggling Rhode Islanders and incentivize providers to enter primary care fields.

Advocates on aging give their recap of the 2024 Legislative Session

“The Senior Agenda Coalition of RI supported several housing-related bills (that did not pass) that would benefit older adults including those sponsored by Rep. Meghan Cotter (D-Dist. 39, Exeter, Richmond, and Hopkinton)  and Sen. Linda Ujifusa (D-Dist. 11, Portsmouth, Bristol) to increase the income cap for the Property Tax Relief program to $50,000 and the credit or refund to $850 to help offset the cost, of property taxes and rents for older adults and persons with disabilities,” says Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of RI (SACRI), noting the Coalition plan to continue to advocate for them next year.

Maigret warned that with a growing older population the need for more accessible housing will increase and the Coalition supported and will continue to support bills to create greater accessibility in new housing.  

Maigret stated that SACRI will also continue to support legislation to create a caregiver tax credit as provided for in 2024 legislation sponsored this year by Rep. Susan Donovan and Sen. Linda Ujifusa. “Our caregivers are valued and deserve our support. A caregiver tax credit will help the many R.I. family caregivers who provide thousands of hours of care for spouses and parents often spending thousands of dollars of their own money to give their loved ones a better, more comfortable life,” she says.

She noted that SACRI also plans to build on its efforts to further expand the Medicare Savings Program to help more lower-income persons on Medicare afford needed healthcare by covering required co-pays and deductibles and to continue its work to promote quality long term care through support for staffing standards, worker training programs and Medicaid enhanced reimbursement for private rooms to help with infection control issues that became so apparent during the Covid pandemic.

SACRI will also push next legislative session to enact legislation to establish a formula for state funding to support local senior centers and programs based on a community’s population of those 65 years and over.  

Raise the Bar on Resident Care and other advocates successfully pushed the passage of H 7733 and S 2621 legislation sponsored by Rep. Scott Slater (D-Dist. 10, Providence) and Sen. Bridget Valverde (D-Dist. 35, (East Greenwich, North Kingstown, South Kingstown) that would establish the Nursing Home Work Standards Board (NWSB). According to Raise the Bar, NWSB will help stabilize the nursing home system by establishing training standards, promoting caregiver rights, depoliticizing funding allocations and implementing financial oversight of nursing homes.  A 13-member board (including frontline staff, nursing home management representatives, state government and community organizations will work with Medicaid to ensure comprehensive and informed decision-making.

“In 2023, Minnesota passed its own Nursing Home Workforce Standards Board and just voted to raise wages for caregivers to over $23 an hour in 2027 while guaranteeing 11 paid holidays. Here in Rhode Island, the Workforce Standards Board is a critical step toward transforming nursing home jobs into sustainable careers that can support a family and provide quality resident care. Now we need Governor McKee to show his support and sign this bill into law,” said Jesse Martin, Executive Vice President of SEIU 1199 New England, member of Raise the Bar on Resident Care.

Raise the Bar also advocated for the passage of the Financial Transparency Act (S 2604 | H 8204) but ultimately pulled the bill in order to re-adjust some of its language. This legislative proposal, S 2604, sponsored by Sen. Dawn Euer (D-Dist.13, Newport, Jamestown) and its companion measure, H 8204, sponsored by Rep. Matthew Dawson (D-Dist.65, East Providence) would require nursing homes to provide annual, audited financial statements that include detailed income, expenses, and cash flow, alongside transparent ownership information to prevent for-profit owners from misusing Medicaid and Medicare dollars. “We look forward to advocating for its passage in next year’s legislative session to ensure all for-profit nursing homeowners are held accountable to investing public dollars appropriately in direct care,” continued Jesse Martin. 

Advocates for Better Care in Rhode Island, a grassroots community organization founded to advocate for the rights and interests of residents of long-term care facilities in RI, celebrates the passage of S. 2263. The Long-Term Care Residents Rights Camera Bill, notes Director Kathleen Gerard. 

“The legislation gives residents of nursing homes and assisted living facilities and their legal representatives the right to install a monitoring device in their room provided all residents in the room consent. The consent can be withdrawn at any time, and a variety of safeguards exist to protect resident privacy,” says Gerard.

The legislation, S 2263 A, sponsored by Sen. Dawn Euer (D-Dist. 13, Newport, Jamestown, who chairs the Senate Committee on Judiciary and H 7969 A, sponsored by Deputy Majority Leader Jason Knight (D-Dist. 67, Barrington and Warren) has been signed by the governor and will take effect Jan. 1, 2025.  

According to Gerard, the legislation was first introduced in this form in 2021, but the care staffing crisis and massive 138% increase in serious deficiencies cited in RI long-term care facilities since 2022 made it even more urgent to finally pass it this year.

“Speaker Shekarchi worked tirelessly to reach a compromise that was acceptable to the various parties supporting and opposing the bill, and long-term care residents will consequently soon be able to have their care and condition monitored remotely by loved ones and care-partners, resulting in more peace of mind for everyone,” she says. 

“A legislative proposal we backed this year and that we hope to see enacted next year was introduced by the Rhode Island Department of Health.  The legislation, (S 2818 sponsored by Sen. Joshua Miller (D-Dist. 28, Cranston, Providence and H. 7819 sponsored by Rep. June S. Speakman), would improve financial transparency in nursing home ownership and prevent the rapid extraction of equity from facilities that we see with many private equity firms, real estate investment trusts, and investor groups,” says Gerard.

Next legislative session, Gerard says Advocates for Better Care in Rhode Island will also continue to advocate for legislation requiring assisted living facilities to support family councils.   This requirement already applies to nursing homes, she notes.

“We’ve Only Just Begun, says Sandra Paquette, representing Advocates for COLA Restoration and Pension Reform, a non-profit representing 4,700 retirees. “Our group numbers continue to increase, along with our determination and commitment, to fight for the justice which was so unnecessarily and ruthlessly taken away,” she says. .

According to Paquette, there were legislative proposals pertaining to current and future state and teaching retirees, which did not reach the floor of the House or Senate. One legislative proposal applied to those active employees whose retirement is based upon an arbitrary “rule of 95”. This translates into a calculation where the years of service and the age of those wishing to retire must add up to 95. The law would have changed this total to 90. Another one for which we strongly advocated, and for which we provided thousands of letters, verbal testimony and volunteer lobbying sessions was Pat Serpa’s (D-Dist. 27, West Warwick, Coventry and Warwick), H-8193, would have restored a compounded Cost of Living Adjustment (COLA) to all current and future retirees, and would have been enacted as of July of this year.

“Our goals for next year will remain— to advocate through testimony, letters, media and lobbying–for the passage of the two bills which will provide the now essential support to the victims of the 2011 Rhode Island Retirement Security Act,” says Paquette.

And here are specifics about other bills that impact seniors:

Benefits for seniors from Rhode Island’s next budget

Published in RINewsToday on June 17, 2024 

With a 35-2 vote in the Senate early on Friday the Senate gave its approval for a $13.963 billion budget for the 2025 fiscal year, comprising 13 articles that direct additional funding toward education and children, raises Medicaid reimbursement rates, health care support, and includes a $120 million affordable housing bond. The 300-page budget bill – read here, 2024-H 7225Aaa has now gone to Gov. Dan McKee, who is scheduled to sign it at an event Monday, June 17, at 11:15 a.m. in the State Room on the second floor of the State House.

Rhode Island’s FY 2025 Budget and Seniors

House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick) reeled off specifics as to how this year’s budget proposal impacts senior programs and services, noting that it aims to lower the rising housing and health care costs that impact the quality of life of older Rhode Islanders. “We have asked the voters to approve an additional $120 million in funds to increase affordable housing production. The budget accelerates a commitment to raising Medicaid reimbursement rates for services to care for our most vulnerable seniors and people living with disabilities to stabilize our health care and human service provider networks,” noted Shekarchi. 

Under the budget proposal tax relief is provided to seniors who rely on retirement income, raising the exemption to $50,000 for qualified single filers and $100,000 for joint filers. It also repeals the suspension of annual cost of living (COLA) adjustments for retirees in the state pension system who retired before 2012 and moves up the timeline for resumption of COLA for other state retirees. 

Lawmakers changed the calculation for pension benefits to base it on the highest three consecutive years of earning instead of five. Finally, the House Speaker noted that this budget fully funds Medicaid rate increases for home care and other services that help seniors age with dignity in the community and stay in their homes if they so desire, and also increases support for services provided in nursing or assisted living settings. 

Adds Senate President Dominick J. Ruggerio(D-Dist. 4, North Providence, Providence), “I am pleased that the budget will invest in many Senate priorities, particularly in the areas of health care, child care, education and providing some needed relief to retirees,” says Ruggerio. “Specifically, the budget incorporates $2.7 million for primary care provider training sites, as well as $500,000 for tuition assistance for students who enter the primary care field and remain in Rhode Island. The budget also includes funding for purchasing medical debt for pennies on the dollar,” he says. 

But how does the aging network view this spending plan? 

According to Maureen Maigret, Policy Advisor with the Senior Agenda Coalition of RI (SACRI), under the spending plan approved by the Assembly $103.2 Million in all funds was added to the Governor’s proposed budget to fully fund the social and human service provider rate increases as recommended by the state’s Office Health of Insurance Commissioner (OHIC) based on the comprehensive legislatively mandated Rate Review Study performed in 2023. According to Maigret, who served as a member of the Advisory Task Force for the Rate Study, the full funding was especially important for those older adults and persons with disabilities seeking access to home and community services. 

“Too many persons on Medicaid have been waiting three months or longer to access needed home care supports which can cause health to deteriorate or to consider nursing home placement at far more expense to the state,” Maigret said. Maigret noted the increases would raise rates for providers of home care, assisted living, shared living and adult day services – all critical to helping persons with support needs to be able to stay at home where most persons with care needs prefer to live. 

Senior Agenda Coalition has worked for many years to promote better access to home and community-based services and to advocate for better wages for the direct care workers who provide this care,” she added, noting that these individuals are usually women, mostly women of color, and for too long have been undervalued and underpaid she noted. In 2022 the SACRI advocated with the legislature to set a minimum wage of at least $17/hour; however, the budget only called for a minimum of $15/hour. With full funding for the recommended home and community care provider rates, we would like to see these essential workers get a minimum starting wage of at least $25/hour in order to recruit and retain the necessary workers. 

SACRI also successfully pushed along with other housing advocates for the addition of $20 Million more to the Housing Bond to go on the November ballot for a total of $120 Million, Maigret added, noting that the coalition continues to advocate for paying adequate attention to the housing needs of older adults in the allocation of the bond funds. “Increasing affordable housing options for this population is critical,” says Maigret, stressing that census data shows that 53% of older RI renters pay more than 30% of their income on housing and studies show that 43% of extremely low-income RI renters are seniors. In the housing space, passage of bills to streamline development of Accessory Dwelling Units (ADUs) advanced by House Speaker Shekarchi along with most of his housing package was also a major win for expanding housing options and development. 

The legislature also addressed SACRI and its advocacy partners push to increase income eligibility for the Medicare Savings Program (MSP) that helps lower-income Medicare enrollees not on Medicaid afford needed healthcare and save dollars for other needed basic needs by covering Part B premiums ($176/month in 2024) as well as required co-payments for some with very low-incomes. “The budget includes a provision requiring the state to seek federal approval to increase the eligibility for the Medicare Savings Program for “qualified individuals” (currently persons with annual income between $18,312 and $20,331) up to 185% of the federal poverty level ($27,861),” says Maigret, adding that the Coalition plans to monitor the approval process and to seek additional legislation, if needed, next Legislative session to further expand the program. Maigret says that lawmakers expanded the Temporary Caregiver Insurance Program up to 8 weeks but SACRI was disappointed that siblings and grandchildren were not added to the list of persons for whom a worker could get paid leave.

“We will continue to advocate for these additions and to increase the number of weeks of leave up to 12 which is provided by most states that have such a program,” she says. And finally, SACRI will continue to advocate for additional funding for the Office of Healthy Aging to provide each of our communities with at least $10/per person age 65 and over to help support local senior centers and programs for older adults, says Maigret, as well as increasing the income cap to $50,000 for eligibility for the state Property Tax Relief Program (called the Circuit Breaker program) that provides a tax credit or refund for older homeowners and renters and those on Social Security Disability. 

FY 2025 Budget Helps State’s Nursing Homes  

James Nyberg, Executive Director  of LeadingAgeRI is pleased with the infusion of much-needed funds in the FY 2025 Budget to help support financially-distressed nursing homes as they continue to provide quality care in a very difficult environment.  “The providers are clearly in distress and we need to avoid any further closures to ensure access to care, resident choice and well-being, and support for the workforce,” he says.  “We also are grateful that the OHIC-recommended rate increases for various programs, including assisted living and adult day services, were expedited with full implementation this October.  Assisted living providers are scheduled for a 10.8% rate increase and adult day a 19.8% increase.  This will help support our home and community-based providers and those for whom they care, says Nyberg, who serves on the Advisory Task Force for the Rate Study. Lastly,

LeadingAgeRI supports the FY 25 Budget’s increase in the housing bond to $120 million, and calls for a portion of it to be used to expand safe and affordable senior housing, the lack of which is well-documented, including a recent report by the Long-Term Care Coordinating Council. According to Nyberg, one legislative priority that remains is to establish a Medicaid rate add-on for private rooms in nursing homes, since Medicaid is the primary payer for nursing home care.  “This would be an important step in helping to support a more homelike environment and resident privacy and dignity,” he says.

“RI nursing homes have been chronically underfunded since the implementation of the reimbursement methodology over thirteen (13) years ago,” charges John E. Gage, President & CEO of the Rhode Island Health Care Association, representing 62 nursing home providers. “Cuts to the annual inflation index, failure to re-base rates every three years since, and skyrocketing costs since the beginning of the pandemic have put RI nursing facilities at significant financial risk,” he says.

“The FY ’25 Budget passed the Rhode Island General Assembly includes funding for the first-ever rebase of Medicaid Rates since the inception of the Priced Based Reimbursement System back in 2013,” says Gage, noting that this increase represents a 14.5% increase with an estimated increase in revenue of $66 million beginning October 1, 2024, based on actual expenses from the most recent Medicaid Cost Reports from 2022. 

Additionally, Gage says that the budget as passed includes $10 million in State Fiscal Recovery Fund Grants to stabilize RI’s nursing facilities from July 1, 2024, through the implementation of the new rates on October 1. 

Pension changes initiated 

“Our primary task during this past General Assembly session has been to strongly support Bill H-8193, introduced by Rep. Pat Serpa, which would see the return of the COLA which was so ruthlessly slashed away in 2011. It applied to all current and future retirees, including teachers, state workers, and some municipal employees, says Sandra Paquette, representing Advocates for COLA Restoration and Pension Reform, a non-profit representing 4,700 retirees.

However, the actual pension provision in this year’s budget provides for the restoring of a compounded COLA to those who retired prior to July 1, 2012, notes Paquette. “Initially, this was a disappointment to our organization, as we had hoped for much needed relief for all who have been so detrimentally affected by Rhode Island Retirement Security Act — creating a financial crisis in the lives of so many lifetime workers. But further thought and consideration caused us to realize that the pension benefits in this year’s budget represent a huge step in a 13 year’s duration of no progress whatsoever in alleviating the injustice, she adds.

“And we are delighted that after so many years, older persons in the state retirement system who retired prior to 2012 will finally see a COLA,” says Maigret, “This is especially important for those who do not receive Social Security benefits.”

Editor’s Note: Added comments

Union thoughts…

Jesse Martin, Executive Vice President of SEIU 1199 NE and President of Rhode Island SEIU State Council said, “For months, union members of Rhode Island SEIU State Council have been working to raise awareness of issues that matter most to working Rhode Island families and, as a result, made great strides in healthcare, wages, funding, retirement, career training and more to the benefit of all. This year’s budget contains emergency funding to keep Linn Health open until August, provides funding to paraprofessional healthcare workers to help them advance in their careers, streamlines the hiring process at DHS and DCYF in order to attract new qualified candidates and finally enables domestic workers to earn the minimum wage. We thank all our elected leaders who offered their steadfast support and prioritized the needs of working Rhode Islanders.” 

The Rhode Island SEIU State Council, which is representative of all four SEIU affiliate locals, represents a variety of workers across the state, including healthcare, Department of Children and Families, Janitorial, Family Child Care, Department of Labor and Training, Security, Workforce Development and more. Nationwide, the Service Employees International Union represents over two million members.

Kathleen Gerard, Advocates for Better Care in Rhode Island, added, “”We were very glad to see the passage of the full Medicaid reimbursement increases recommended by the OHIC this session, and will continue to advocate for measures that ensure that our public funds are put towards the public good of improved wages for direct care staff and improved care for residents.”