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 Medicaid coverage
Advocates call for Governor to reject budget cuts they say would harm older adults
Published in RINewsToday on Oct. 28, 2024
As the state’s Office of Management and Budget (OMB) holds its Revenue & Caseload Estimate Conference to discuss the economic and revenue outlook for the upcoming legislative session, the Senior Agenda Coalition of RI (SACRI) warns of “onerous budget cuts” proposed by state agencies overseeing programs and services for Rhode Islanders. At press time, the state’s Medicaid and the Office of Healthy Aging offices proposed 7.5 percent budget cuts to be included in the upcoming fiscal year 2026 budget.
“It is unconscionable that at a time when our older population is growing – projected to reach one out of every four Rhode Islanders in a few years — to propose budget cuts for programs proven to keep them healthy and safe and that in the long term can save taxpayers money,” says SACRI Board Chair, Diane Santos.
According to Santos, the requests put forward by the Office of Healthy Aging (OHA) include a reduction in state funds for the Meals on Wheels home-delivered meals program projected to cause 13,000 fewer meals to be delivered to persons unable to shop and prepare meals; cuts in funding for local Senior Centers and programs for older adults; elimination of grants to provide security services in elderly housing; and decreased funding to support the Elderly Transportation program.
Santos warns that proposed changes in Medicaid eligibility guidelines are projected to cause hundreds of vulnerable older adults and persons with disabilities to lose state Medicaid coverage for their nursing home care and cause nursing homes, many of which are already struggling financially and face critical worker shortages, to lose millions of dollars if implemented. In addition, changes in the Medicaid CNOM (Costs Not Otherwise Matchable) program could reduce federal dollars that match state funding and impact hundreds of persons receiving home care and adult day services that help keep them living at home, the proposed cuts could result in greater spending in other areas.
For example, says Maureen Maigret, SACRI Policy Advisor, “Brown University researchers have shown that funds spent on home-delivered meals can delay or even prevent costly nursing home care.”
Over the years, Maigret noted that SACRI has worked to boost state funding to communities to assist them to operate local senior centers and programs. These serve hundreds of older adults and families across the state with a wide range of programs that keep older adults healthy, informed and connected to their communities, she noted.
SACRI has called for the state’s budget to provide ten dollars for each person aged 65 and over to Rhode Island’s 39 cities and towns, says Maigret, calculating that this amounts to about $20 per older adult. “The proposed cuts now being considered fail to recognize the increased need for these services due to the significant growth of our older population,” says Maigret.
Drawing a line in the sand
At press time, SACRI and its partners delivered a letter to Gov. McKee urging him to not balance the state budget on the back of Rhode Island’s older adults, stressing that the “potential ripple impact on families will be significant.
“Nonprofits and those who will be impacted need to know that SACRI and its partners are closely watching this process and are ready to advocate to protect programs and services which may impact our varied constituencies,” says Carol Anne Costa, SACRI Executive Director.
Costa continued, “The fastest growing demographic in RI is people over the age of 65. That is an obstinate fact. And cuts to the budget must be re-prioritized.” The Office of the State Ombudsman agreed, “If anything, OHA should be getting an increase, as they manage to complete all of their obligations on a shoestring budget. And kudos to Maria Cimini and her team at OHA for the outstanding work they do,” says Kathleen Heren, the RI Ombudsman.
Costa noted that OHA is Rhode Island’s designated state unit on aging. It serves as the chief advocate for older Rhode Islanders, adults living with disabilities, and family caregivers. “Prioritizing reductions in spending in areas not directly tied to OHA’s core mission or that would not harm vulnerable older adults and persons with disabilities dependent on Medicaid to meet their long-term care needs is clearly a place to start [in determining budget cuts]. Administrative expenses and the millions of dollars being paid out to consultants could be heavily scrutinized for budget reductions,” she says.
Adds Mirelle Sayaf, Executive Director of Ocean State Center for Independent Living (OSCIL), “The proposed budget cuts pose a serious threat to the mission of the OSCIL, which is dedicated to supporting individuals with disabilities. Reducing funding, along with changes to Medicaid eligibility and essential programs, will harm those we serve. These cuts jeopardize vital services such as home care, nutritional support, and community engagement initiatives that empower individuals to live independently and maintain their quality of life.”
“Cutting the budget for the OHA when its resources are already extremely stressed to fully meet the needs of a growing older population is unjustified,” charges SACRI’s Maigret, who is also a former Director of the Department of Elderly Affairs.”
Maigret also opposes changes to Medicaid eligibility after advocates have spent years to ensure persons in need of long term supports and services have access to a range of affordable options, and avoidance of long wait lists for service. She calls for increasing resources to the Rhode Island’s cities and towns to help them support local programs for older adults and increasing eligibility for the Medicare Savings Program so lower-income persons on Medicare can afford needed healthcare. But, Maigret also says that housing needs of older adults must be considered when allocating housing funds.
Food & Shelter important, too
Gerontologist Deb Burton, Executive Director of RI Elder Info also has some thoughts about the state’s proposed budget cuts.
“Cuts to Meals on Wheels that cause our most vulnerable, at-risk, elders to go hungry are simply unconscionable. Taking meals away from our elders cannot happen,” says Burton.
“We must bring back the housing stabilization unit for older adults. Older adult homelessness has increased more than 400% since COVID hit and rents skyrocketed. Rising housing costs, fixed incomes, and wait lists of 2-8 years for affordable elderly housing have all contributed to this crisis. In addition to these challenges, the application process for getting an apartment is onerous and nearly impossible if one does not have access to the internet,” adds Burton.
Eviction prevention is critical in addressing the elder homelessness issue, says Burton, noting that private sector partnerships and philanthropic donations can support a housing stability unit for older adults, ensuring sustainable funding for eviction prevention programs.
“We must find the strength and compassion to provide the funding necessary for food and shelter for our most vulnerable friends and neighbors. If we don’t, what does the future hold for ourselves?” asks Burton.
A Final Call
“The November Revenue and Caseload Estimating Conferences will provide updated projections to inform budget development which will help set priorities. However, RI’s most vulnerable and fastest growing demographic must be prioritized in finalizing the FY2026 budget,” urges Costa.
