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 nursing assistants
Fed’s Proposal to Confronting Nursing Shortage is Not Enough
Published in Pawtucket Times on April 1, 2002
Responding to the nation’s serious nurse staffing shortage, a new Federal proposal gives states flexibility to allow nursing facilities to use paid feeding assistants to supplement the services of certified nurse aides (CNAs). The specialty trained staff would help residents eat and drink.
With a growing number of frail elderly resident in the nation’s nursing facilities, today’s nursing staff must take care of residents who require a higher level of medical care. This leaves less time to ensure that residents eat their meals and drink enough fluids on a daily basis.
Oftentimes, both physical and psychological changes will interfere with a resident’s ability to eat and consumer a meal. Some residents may only need encouragement or minimal assistance with eating.
On the other hand, frail residents may require staff assistance with feeding . Assistance would be needed for residents with cognitive impairment, impaired swallowing due to muscular weakness or paralysis, a tendency to aspirate or choke, poor teeth, ill-fitting dentures or partial plates, poor muscular or neurological control of their arms or hands, as with Parkinson’s disease.
Under the Centers for Medicare & Medicaid Services (CMS) proposal, trained feeding assistants are allowed to help residents eat and drink, especially at meal times.
The workers would be required to complete a state-approved course to quality to be hired for the new position. Currently nursing facilities rely primarily on CNAs, registered or licensed practical nurses to assist residents with eating and drinking. However, volunteers and family members also may assist with these tasks.
At this time, there is no provision in federal regulations for the employment of nursing facility workers to perform only a single task without competing 75 hours of nurse aide training.
The proposed rule change published in the March 29 issue of the Federal Register would allow facilities to hire workers to perform a single task with training on feeding techniques and some basic information that is currently part of CNA training requirements.
“Meal times can often be the busiest time in nursing facilities,” says CMS Administrator Tom Scully.
“Feeding residents is often a slow process and competes with m ore complex tasks, such as bathing, toileting and dressing changes, as well as urgent medical care,” he added.
“Trained feeding assistants will free nurses and nurse aides to focus on residents’ other health care needs. The result will be that residents will receive better nutrition and care,” Scully noted.
The American Health Care Association (AHCA), a Washington, D.C.-based trade group, that represents both profit and non-profit nursing facilities, gives the new federal rules a thumbs up.
‘Simple common-sense dictates that when our nation’s health care system is being undermined by a chronic nursing staffing shortage, and the greater needs of increasing sicker patients, we should do everything conceivable to better the lives of our patients,” stated Dr. Charles H. Roadman II, president and CEO of AHCA. “The rule will also help the overextended nurses and nursing aides already on the job cope with competing important tasks.”
Hugh Hall, executive director of the Johnston-based Cherry Hall Manor Nursing and Rehabilitation Center, supports the federal government’s approval of the single task workers who feeds nursing facility residents.
“The prior regulation was not logical or practical when prohibiting other nursing home workers other than registered nurses, licensed practical nurses and CNAs from feeding, but allowing volunteers and families to participate in the feeding process with little training,” he said.
Hall, the former president of the Rhode Island chapter of AHCA, said the health care community would prefer that the federal government develop long-term care programs to recruit fully trained certified nursing assistants and to financially support those initiatives.
Roberta Hawkins, who serves as the state’s nursing facility ombudsman and executive director of the Alliance for Better Long-Term Care agrees.
“The federal proposal is only a Band-Aid fix.” Hawkins says, calling on the federal government to put more funds into the nursing facility reimbursement system to enable facilities to pay better wages to hire permanent full-time staff and to create career ladders.
“Even though you may teach an aide to just feed residents, they are not trained to spot medical changes in the resident, Hawkins told Everything About Seniors. More important, she said, “they will not be familiar with the specific needs of the residents.”
Hawkins believes that the Bush administration’s proposal can become an obstacle in providing continuity of care in nursing facilities.
A state commission, chaired by Human Services Director Jane Haywood, is currently looking at Rhode Island’s staffing shortage and how the existing Medicaid reimbursement system can be improved.
Recommendations for a new and improved system coming from Haywood’s group might just fix a long-time systemic problem, enabling nursing facilities to better recruit and retain CNAs.
Hopefully, Haywood’s long-awaited proposals will be seriously considered by the administration and General Assembly and won’t end up on a dusty shelf or a circular file.
While allowing the use of single-tax workers, proposed by the Bush administration, it is a step in the right direction. Gov. Lincoln Almond, state lawmakers and state policymakers must not lose sight of the real issue – inadequate Medicaid payments- which fuels an ongoing CNA shortage in many of the state’s nursing facilities.
Almond and the General Assembly are currently at odds over subsidized gambling in the Ocean State.
During this year’s budget debates, overshadowed by a projected $70 million plus budget deficit, let us not forget about Rhode Island’s 10,000 nursing facility residents or the growing elderly population who may ultimately require that level of care or community-based long-term care services.
If the General Assembly can easily find $ 15 million next year to keep the greyhound racing industry afloat, lawmakers might dedicate some time and a little energy and effort in finding state dollars to increase funding to Rhode Island’s long-term care delivery system.
For older constituents and the state’s aging baby boomers it is the right thing to do.
