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.
Tag Archives for long-term care continuum
National Report: Brain Health Matters to Most, But Understanding Falls Short
Published in RINewsToday on April 27, 2026
As with the findings detailed in previous reports, the numbers in the Alzheimer’s Association’s recently released 2026 Alzheimer’s Disease Facts and Figures report are jarring.
In 2026, about 7.4 million Americans aged 65 and older, or roughly 1 in 9, are living with Alzheimer’s disease. Nearly three-quarters are 75 or older, and almost two-thirds are women.
As these numbers continue to rise, the challenges ahead grow even more daunting. We see the graying of the U.S. population, which has resulted in the number of people living with Alzheimer’s rising sharply, says the report. By 2030, all baby boomers, those born between 1946 and 1964, will be in higher-risk age groups for developing devastating cognitive disorders. By 2060, Americans with Alzheimer’s could reach 13.8 million.
Over the years, the Facts and Figures reports have become the nation’s primary source of statistics and analysis on Alzheimer’s and other dementias. The report has been published every year since 2007, and this year’s edition also appears in the April 2026 issue of Alzheimer’s & Dementia®, the Association’s journal.
The 142-page report, released last week, provides updated national and state-level data. Its findings suggest that Alzheimer’s has become more common and challenging for caregivers. The report remains a guiding roadmap for state and federal officials and researchers to combat this serious cognitive disorder. It also includes a special survey about how Americans aged 40 and older think about and manage brain health.
“The latest data show Alzheimer’s is still a growing challenge for families in Rhode Island,” said Laura Hoffman, executive director of the Alzheimer’s Association’s Connecticut and Rhode Island chapters, in a statement announcing the report’s release on April 21, 2026. “That’s why it’s critical to keep progressing research and developing treatments that can improve outcomes and support everyone facing the disease,” she says.
Hoffman stressed that the nationwide crisis demands urgent action now, given the mounting financial burden on caregivers. This year, professional care for people with Alzheimer’s and other dementias is expected to cost $409 billion. By 2050, Hoffman warns, this figure could reach nearly $1 trillion.
Caregiving is still mostly handled by family and friends, the report notes. Nearly 13 million relatives and friends provided more than 19 billion hours of unpaid care last year. The value of their efforts is estimated to be a whopping $446 billion.
The report noted that Alzheimer’s is also a growing cause of death. Since 2000, deaths from the progressive g cognitive disorder have surged by 134%. In the same period, deaths from heart disease have risen by only 3.8%. Today, Alzheimer’s takes more lives than breast and prostate cancers combined.
Rhode Island: By the Numbers
According to the report’s Rhode Island-specific data, about 22,000 Rhode Islanders aged 65 and older are living with Alzheimer’s disease. That’s 11.4% of this population group. Another 37,000 people serve as caregivers — many are unpaid family members or friends. So roughly 1 in every 30 Rhode Islanders is caring for someone with the cognitive condition. Together, they provide 53 million hours of unpaid care, valued at $1.5 billion.
In 2025, the State’s Medicaid costs of caring for persons with Alzheimer’s and other Dementias totaled around $ 640 million. Per-capita Medicare spending for these individuals was $33,705, according to the report.
Recently, Rhode Island’s care network relied on just 32 geriatricians and about 8,070 home health and personal care aides to support persons with Alzheimer’s and dementia. To keep up with rising demand for dementia care, Rhode Island’s workforce must expand. The state requires a 23.9% increase in home health aide roles by 2032 and an 18.8% increase in specialist geriatricians by 2050, according to the report.
When comparing national and Ocean State-specific data, Hoffman, who heads the Alzheimer’s Association’s Connecticut and Rhode Island chapters, notes that the nation’s smallest state has the same rising trend in Alzheimer’s prevalence, increasing caregiver burden, and growing strain on health systems. “As a smaller, aging state, these trends will be felt even more. The impact on families, providers, and community resources is both visible and immediate,” she says.
Hoffman calls for more dementia care professionals across the long-term care continuum. “There is also a need for more respite care, adult day programs, and long-term options that are equipped to treat complex Alzheimer’s or dementia cases,” suggests Hoffman, to fill gaps in providing services, supports, or workforce capacity to care for Alzheimer’s and dementia patients.
With the General Assembly now in session, Hoffman is urging lawmakers to pass HB 7542 or SB 2874, which establishes a Dementia Services Coordinator position within the Department of Health. “This state agency position will support the work of the Advisory Council on Alzheimer’s Disease Research and Treatment, oversee implementation of the state Alzheimer’s plan, and serve as a liaison between state agencies, the governor, the legislature, and external stakeholders,” she says.
Understanding and Sustaining Cognitive Health
The Alzheimer’s Association’s 2026 Alzheimer’s Disease Facts and Figures report comes with a special report, Brain Health in America: Comprehending and Supporting Lifelong Cognitive Health. It is based on a survey of more than 3,800 U.S. adults aged 40 and older.
The special report’s findings show a clear disconnect: most Americans see brain health as a top priority, equal to or even more important than physical health, yet many are unsure how to protect it.
“Americans care deeply about their brain health and recognize that midlife is a critical time to take action,” said Heather M. Snyder, Ph.D., the Association’s senior vice president of Medical and Scientific Relations. “But many don’t know where to start and are looking for clear, practical guidance,” she says.
Almost all respondents said keeping their brains healthy is important, but only 9% feel well informed about it. Many know that sleep, diet, and exercise matter, but fewer people clearly understand how these habits might lower the risk of dementia.
Many respondents expressed concern about their potential declining cognitive health. More than two-thirds of those surveyed admit they worry about their brain health and the chance of developing Alzheimer’s or another dementia. Still, fewer than half of these individuals strongly link healthy lifestyle habits with lowering that risk.
The special report’s findings also reveal that interest in prevention programs is high, but barriers to participation remain. About 73% would consider joining brain health programs, such as cognitive exercises, health monitoring, nutrition advice, or physical activity. However, the program’s cost, location, motivation, and insurance coverage are major obstacles to participation.
Respondents also said they want flexible options. About 40% prefer self-guided programs at home, while 38% like blended formats that mix independent and in-person participation. Only 8% prefer fully in-person programs.
Many say midlife, ages 35 to 64, is a key time for them to act. Nearly two in five respondents think people should start focusing on brain health during these years. Almost half believe formal programs should begin then. About one-third also said brain health should be a lifelong pursuit.
Even with a strong interest, many people say they do not talk often with health care providers about brain health. Two-thirds of respondents said they would like to discuss brain health with their physician. Most would welcome these talks during regular office visits. Most would welcome these conversations during routine office visits. Still, only a small percentage say they have actually had them.
“These outcomes show a real opportunity to better integrate brain health into routine care,” Snyder said. People are motivated to protect their brain health, but they need clear, effective guidance, she says.
Snyder sees a wider, clear message in the report: Brain health is a lifelong priority, not just a concern in older age, she says. “By connecting efforts across individuals, communities, workplaces, and health care systems, we could support cognitive health and help reduce dementia risk,” she adds.
A Final Note…
With this year’s Alzheimer’s Facts and Figures report released, Hoffman also sees a clear takeaway for Rhode Islanders: “Brain health matters at every stage of life. Take steps now—stay active, eat well, get enough sleep, remain socially engaged, and talk to your healthcare provider about memory concerns,” she adds.
The Alzheimer’s Association is expanding efforts with community and research partners to deliver evidence-based information and programs. These projects are informed in part by the landmark U.S. POINTER study, which continues to explore how lifestyle interventions may help protect cognitive function.
If you have any questions about Alzheimer’s or any other form of dementia, contact the Alzheimer’s Association 24-7 Helpline at 1/ 800-272-3900.
For a copy of the Alzheimer’s Association’s 2026 Facts and Figures Report, go to Alzheimer’s Disease Facts and Figures
For a copy of this year’s Brain Health in America special report, go to Brain Health in America: Understanding and Supporting Lifelong Cognitive Health.
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For details about the U.S. POINTER study, to https://www.alz.org/us-pointer/study-results
2025: A Year on the “Age Beat” in Rhode Island
Published in RINewsToday on December 29, 2025
Throughout 2025, this “Age Beat” columnist published a weekly commentary covering an extensive list of aging, healthcare, and medical issues. During this year, this columnist followed Congressional debates inside the Beltway involving Medicare, Medicaid, reauthorization of the Older Americans Act, and Social Security, reporting on how these federal policy proposals would affect older Rhode Islanders. During the latest legislative session of the Rhode Island General Assembly, policy debates on Smith Hill were also covered in my weekly commentaries, examining how the proposed bills or enacted laws would impact state programs and services serving Rhode Island’s growing older population.
After reviewing the latest U.S. Census Data, it becomes very clear that the state’s aging population continues to grow. For more than twenty-five years, I have tracked and continue to follow the graying of Rhode Island’s population. Through more than 50 articles published in 2025 in Blackstone Valley Call & times and its sister publications, RINewstoday, Senior Digest and other statewide outlets, these stories have decoded complicated public policy debates, and demographic trends to shed light as to how they affect the daily lives of older adults, their caregivers, and nonprofit organizations that serve them.
Some might interpret my weekly reporting as a way that specifically looks at older adults as one group of people. However, others might see them on how aging impacts our own family members and our neighbors, and how we all deal with real-life challenges as we get older.
Themes from Past Year’s Coverage
Over the past year, several themes have become clear: the economics of growing older and financially surviving retirement; staying safe from increasing sophisticated scams, public health issues surrounding loneliness and food insecurity; limited public transportation, finding a primary care physician, and managing multiple chronic illnesses. Many of these commentaries also looked closely at state and federal policies that led to cuts in Medicare and Medicaid; the pressure points placed on Rhode Island’s safety net; and the ongoing policy questions the Rhode Island General Assembly is asking about how to help older adults stay independent at home—not just to live longer, but live better.
You learn very quickly that national policy debates don’t go the same way here,, if you’ve lived in the Ocean State for a while. A change in federal requirements of the Supplemental Nutrition Assistance Program (SNAP) or changing eligibility requirements and cuts to Medicaid funding are not distant Washington stories reported by the Washington Post or New York Times especially if they affect food, meal deliveries and health care provided in Providence, Pawtucket, Woonsocket, or Westerly. A change in Medicare drug pricing is not an abstract concept if it determines whether your older neighbor can fill a lifesaving prescription—or whether your spouse’s non-drug compliance stretches pills just to make them last.
Many of these articles were tied to timely triggers—AARP reports detailing findings of national surveys and polls, a Senate Aging Committee or Congressional hearing putting a spotlight on an aging issue, a proposed legislative proposal being considered by Congress or the Rhode Island General Assembly. But the reporting doesn’t just give a concise summary of a policy issue. The point of these commentaries is to shed light on the issues by asking: “So what does this mean for older Rhode Islanders?” Where are the funding gaps?” “Who is being left out? “What can be done now while larger reforms slowly grind their way forward, only to be enacted years later?”
Many of the commentaries published this year focused on out-of- pocket costs that increase with one’s aging —especially skyrocketing medical expenses. Even when Medicare covers a significant portion of one’s care, many older adults still face overwhelming costs, from premiums and co-pays to dental and vision needs, to uncovered services and especially costly prescription drugs and nursing home care. The reporting also examined pending questions about Medicare’s financial future, including whether the program will be able to pay beneficiaries full benefits beyond 2033, or face potential benefit cuts. Even the Washington, DC-based National Committee to Preserve Social Security and Medicare’s call for expanding the retirement program, along with raising the cap to enable Social Security to pay its bills made it into these commentaries.
Another common theme in this year’s published commentaries is the recognition that aging affects not only our bodies and wallets, but also our emotions and relationships as well. The past year’s reporting on the role of loneliness and isolation serves as a reminder of how harmful they can be, especially when they lead to worse health outcomes. In these writings, the goal is not to romanticize “community” but to show how social connection and networks in a “community” can be a good way to improve one’s health.
The commentaries on loneliness do not regard the negative emotional response as a personal deficiency but rather as a significant policy concern influenced by the persistent scarcity of affordable housing, inadequate public transportation, mobility limitations, the loss of spouses and friends, and communities designed around the use of cars rather than their pedestrian walkability or accessibility. How we view this matters because it is the framing that shifts the discussion away from “Why don’t older adults get out more?” to “What community barriers make connections harder to make—and what public supports are needed to make community connections possible?”
Taking a New Look at Being Age-Friendly
The commentary on “age-friendly” thinking shows how Rhode Island’s 39 cities and towns can change their programs, services, and public spaces to keep older adults engaged in their community instead of primarily isolated. The announcement that the City of Pawtucket had joined Newport, Cranston, Providence, Westerly, and Bristol to become one of Rhode Island’s Age-Friendly Network Communities is an example. We hope to report on more communities doing the same.
Over the past year, coverage of food insecurity, and a profile on the Meals on Wheels of Rhode Island, have helped to answer bigger policy questions: What happens when demand goes up but and payments don’t? How do people get on waiting lists? “What does “service disruption” mean for someone living at home? And how much does it cost—both in money and in people, when these programs have to be cut back?
One of the most important things we’ve reported on this year is consumer protection, especially when it comes to scams that target older people, because they are often the ones that more easily fall for scams because they have savings and are concerned about them, aren’t as familiar with digital manipulation, or have cognitive impairment. There are many reasons why this topic is important right now, especially with new technology being used to spread scams. And the Rhode Island General Assembly has been quick to act. One commentary informed readers that Rhode Island has passed a new law to crack down on Crypto ATM fraud, making it the 12th state to do so.
The best reporting on scams doesn’t just explain the tricks and why people fall for them – it also keeps the reader updated as to how scams keep changing. Plus, it gives you practical tips as to how to avoid them, like pausing before you respond, double-checking what you’re told, and turning to someone you trust if something feels off, verifying, and seeking trusted help before acting. I wrote about these tips in great detail.
These consumer protection commentaries didn’t blame the victims, rather by framing scams as a systemic program caused by new technology and weak verification standards. And it makes this point clear. Scams are not just seen as financial crimes; they can also cause shame, isolation, and stress that can harm your health.
Caregiving is also another common topic in this year’s published commentaries. Aging advocates will tell you that caregivers are the hidden backbone of providing care to those in need. They will tell you that family members, friends, and neighbors help out in ways that would otherwise need paid services or institutional care. An AARP report says that about 121,000 in Rhode Islanders provided unpaid care to others in 2021 – estimated to be valued monetarily at over $2.1 billion.
These commentaries on caregiving don’t talk about it in terms of sentiment, but in terms of policy, taking a look at time costs, impact on jobs, burnout, and the lack of enough respite support. The reporting also helps to shed light on common caregiver stress, and that needing help is not a personal failure but a normal result of demographics and underfunded state programs and services.
When National Policy Hits Close to Home
In Rhode Island, where community-based services are important to “aging in place,” the weekly coverage has helped readers to understand the whole long-term care continuum—from home care to day care to senior centers to assisted living to nursing home care, if needed.
At best, access to health care is uneven; transportation is a barrier to many; affordable, accessible housing is limited; and the Medicaid-funded workforce that helps people stay at home is overworked and underpaid. Older adults are dealing with rising costs for food, utilities, and rent or home upkeep, as well as the effects of inflation.
Although many of this year’s commentaries put the spotlight on policy issues that need to be fixed, they also provide state policy makers ideas to solve these issues. These are advocacy groups age-friendly planning; stronger protections for consumers; smarter use of technology; and increased state funding that treats community-based supports as cost-effective interventions rather than optional add-ons.
