Tag Archives for Office of Healthy Aging

House Finance Committee’s FY 26 Budget boosts support for older Rhode Islanders

Published in RiNewsToday on June 16, 2025

Last Wednesday evening, the House Finance Committee voted 11–3 to approve a balanced $14.33 billion budget for fiscal year 2026—approximately $500 million less than the current year’s budget.

Lawmakers were tasked with closing a $250 million deficit without resorting to broad tax hikes or cuts to essential services. Faced with a slowing state economy and looming federal funding reductions, they focused squarely on bridging the budget gap while improving access to health care, increasing reimbursement rates for primary care providers, nursing homes, and hospitals, and addressing the state’s housing crisis.

The budget proposal also boosts funding for housing and homelessness services, supports municipalities through increased revenue sharing, expands Rhode Island Public Transit Authority (a.k.a. RIPTA) funding, invests in education, imposes new EV registration fees, restores highway tolls, and extends childcare subsidies while setting distinct rates for toddlers and infants.

“Despite the very significant challenges we face in this fiscal year, this budget reflects our commitment to our priorities: not only protecting, but strengthening the vital Medicaid programs that provide health and safety to Rhode Island’s seniors, children, individuals with disabilities, and working families; supporting our health care system, particularly the hard-working primary care providers and frontline caregivers; and addressing our housing crisis,” said House Speaker K. Joseph Shekarchi (D-Dist. 23, Warwick), in a statement announcing the budget’s passage by the House Finance Committee.

Vote Set

According to House Communications Director Larry Berman, the 435-page budget proposal (2025-H 5076A) now moves to the full House for a vote scheduled for Tuesday, June 17, at 3:30 p.m. If passed, the budget will be sent to the Senate, where action is expected by the end of next week as the legislative session concludes.

If the Senate makes no changes, the bill will go directly to Governor Dan McKee for his signature. However, if revisions are made, it must return to the House for final approval before being sent to the Governor.

Berman and his Senate counterpart, Greg Paré, Director of Senate Communications, do not anticipate any major issues—but note that nothing is ever guaranteed.

Funding Aging Programs and Services

The Senior Agenda Coalition of Rhode Island (SACRI) and its allied aging advocacy groups didn’t get everything they lobbied for —but they made progress, according to SACRI Executive Director Carol Anne Costa, who praised the proposal as a “moral budget.”

“This budget represents a moral compass pointing toward a healthier, more equitable Rhode Island,” said Costa, crediting the group’s advocacy efforts, particularly those of SACRI Policy Advisor Maureen Maigret.

Costa highlighted new language in Article 8 that expands the Medicare Savings Programs, enhancing healthcare access for vulnerable older adults and individuals with disabilities. The House Finance Committee recommended adding $7.1 million—$700,000 of that from general revenues—for this critical expansion.

Unlike a narrower 2024 Assembly proposal that faced implementation barriers, the FY 2026 budget expands eligibility to 125% of the federal poverty level for the Qualified Medicare Beneficiary (QMB) group and up to 168% for the Qualified Individuals (QI) group.

“This crucial change is estimated to assist thousands of Medicare enrollees, helping them cover burdensome co-payments and deductibles, and potentially saving them at least the $185 monthly Part B premium—which can now go toward food and other essentials. For many, this means the difference between delaying care and receiving timely treatment,” Costa noted.

Strengthening Primary Care Access

“The state’s primary care system is at a crisis point. We’ve heard that our reimbursement rates are low, and that’s the main cause of the health care shortage. We wanted to address that immediately,” said Speaker Shekarchi.

SACRI applauded the Speaker’s efforts to address both the shortage of primary care physicians and the funding shortfall for direct-care staff in nursing homes. “This budget recognizes the critical importance of primary care—especially for older adults and those managing chronic conditions—and addresses provider rate increases through several key initiatives,” said Costa.

The proposal includes over $40 million—$15 million from the state and the rest from federal funds—to increase Medicaid reimbursement rates for primary care providers, currently lower than in neighboring states.

Additionally, the budget proposes a new healthcare assessment similar to the state’s immunization program assessments. This broad-based assessment, applied per member per month to all covered lives (including self-insured plans), is expected to raise $30 million annually to support primary care and related services. The estimated state cost is $1.4 million, including $800,000 in general revenues.

The committee also recommended $26.4 million ($8.3 million in general revenue) to raise Medicaid primary care rates to 100% of Medicare rates beginning Oct. 1, 2025. This significant increase aims to incentivize providers to serve more Medicaid patients and improve access to foundational care.

Furthermore, the Office of the Health Insurance Commissioner (OHIC) must submit a one-time report by September 2026 to recommend further adjustments to primary care reimbursement rates.

“To address fiscal challenges facing our community health centers, the budget also includes $10.5 million—$4 million of that from general revenues,” Costa added.

Attacking Persistent Staffing Issues in Rhode Island’s Nursing Homes

SACRI, the Rhode Island Health Care Association (RIHCA), SEIU 1199NE, and the state’s Long-Term Care Ombudsman praised the House Finance Committee’s decision to allocate funds aimed at addressing persistent staffing issues in Rhode Island’s 73 nursing homes. The committee approved a $12 million funding package—including $5 million from general revenues—for a base rate staffing adjustment to improve compensation, wages, benefits, and employer costs for direct-care staff. These investments are designed to enhance the quality of resident care and improve workforce stability.

According to John E. Gage, President and CEO of RIHCA, following months of negotiations, RIHCA and SEIU 1199NE reached a compromise to amend the 2021 nursing home staffing law. The revised agreement establishes a more achievable staffing target of 3.58 hours of care per resident per day and adjusts penalties to support facilities in reaching consistent compliance. It also introduces flexibility for high-performing facilities and those with site-specific challenges. “The state budget passed by the House Finance Committee invests $5 million, which unlocks an additional $7 million in federal matching funds,” noted Gage.

“On behalf of RIHCA and its members, we are pleased that the Speaker and House Finance Committee members recognized the dire conditions facing the industry,” Gage added. “We are encouraged that their actions will help stabilize Rhode Island’s nursing facilities and ensure access to high-quality care and services.”

Rhode Island currently ranks second in the nation for “Immediate Jeopardy” violations—the most serious federal nursing home deficiencies. Both SEIU 1199NE and RIHCA believe the budget provisions will help reverse this alarming trend.

SEIU 1199NE’s Patrick Quinn and SACRI’s Costa praised the inclusion of the $12 million investment in the FY 2026 budget, viewing it as a crucial step in helping nursing homes recruit and retain essential staff.

Lori Light, Rhode Island’s State Long-Term Care Ombudsman, also commended House lawmakers for allocating new funding to improve pay and staffing levels—critical measures for enhancing care quality and creating safer, more stable environments for vulnerable residents. “These are issues our office has consistently advocated for, and we’re encouraged to see real movement in the right direction,” she said.

Finally, the budget proposal also includes an increase of $1.86 million for the Office of Healthy Aging, raising its funding from $37,091,920 to $38,948,518. This includes:

  • A $200,000 boost for Senior Services Support (from $1.4 million to $1.6 million)
  • A $50,000 increase for Meals on Wheels (from $630,000 to $680,000)
  • $325,000 to provide elder services, including respite care, through the Diocese of Providence
  • $40,000 to fund ombudsman services provided by the Alliance for Long Term Care

The Missing Millionaire’s Tax

SACRI and progressive advocacy groups had hoped the budget would include HB 5473, introduced by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls) on Feb. 12, 2025 and S329 introduced on by Sen. Melissa Murray (D-Dist. 24, Woonsocket, North Smithfield, on February 21, 2025. The bill proposed a 3% surtax on taxable income above $625,000—on top of the existing 5.99% rate—targeting the top 1% of Rhode Island filers. The tax was projected to raise roughly $190 million annually and impact only 5,700 of the state’s 500,000 taxpayers.

But the surtax didn’t make it into the final budget.

Asked why, Speaker Shekarchi explained: “There is still a great deal of uncertainty at the federal level. We don’t know what changes are going to be made in the federal tax code. We felt comfortable enough to move forward with the non-owner-occupied property tax on homes valued at over $1 million, and we will revisit the millionaire’s tax when we have more clarity from Washington.”

While Costa wished the surtax had been included to fund additional initiatives, she said, “The bottom line is the budget is balanced and people-focused. In particular, older adult concerns were seriously considered.” As the session winds down, SACRI will continue to monitor remaining legislative proposals that affect Rhode Island’s older residents.

Senior Agenda Coalition of RI pushes wealth tax to fund programs for older residents

Published in RINewsToday on June 2, 2025

With the recent passage of the House Republican budget—which cuts some programs and services for seniors, veterans, people with disabilities, and families with children—Sulma Arias, Executive Director of Chicago-based People’s Action (PA), is calling on billionaires and large corporations to finally pay their fair share of taxes.

Senator Bernie Sanders has echoed similar sentiments on the national stage, urging lawmakers to ensure that ultra-wealthy individuals and powerful corporations contribute more equitably to the nation’s economic well-being, rather than shifting the burden to everyday Americans by cutting essential services.

In Rhode Island, Democratic lawmakers are advancing legislation this session that would increase taxes on the state’s highest earners to generate vital revenue for public programs and services.

Proposed Legislation Targets Top Earners

HB 5473, introduced on February 12, 2025, by Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls), was referred to the House Finance Committee. The bill proposes a 3% surtax on taxable income above $625,000—on top of the existing 5.99% rate—targeting the top 1% of Rhode Island tax filers. The surtax is projected to raise approximately $190 million annually and would affect about 5,700 of the state’s more than 500,000 filers. If enacted, the tax would apply to income earned in tax years beginning in 2026 and would not be retroactive.

As of the May 6 House Finance Committee hearing, about 140 pieces of written testimony had been submitted on HB 5473. The committee held the bill for further study, with no additional action yet taken. The proposal remains under consideration as part of ongoing budget negotiations.

A companion bill, S. 329, was introduced in the Senate by Sen. Melissa Murray (D-Dist. 24, Woonsocket, North Smithfield) and referred to the Senate Finance Committee. A hearing on the measure was held last Thursday, and the bill was also held for further study.

As the volume of testimony indicates, the battle lines are clearly drawn. Progressive groups and unions support the legislation, while businesses and business organizations, such as the Greater Providence Chamber of Commerce and the Northern Rhode Island Chamber of Commerce, have voiced strong opposition. Governor Dan McKee has not yet taken a public position on the bills.

The Pros and Cons

Supporters argue that with Rhode Island facing a $220 million budget deficit, HB 5473 and S. 329 could raise nearly $190 million annually to fund critical services, including: K-12 and higher education; health care; housing; public transportation; affordable child care; infrastructure, and programs for older adults

They contend that the proposals would bolster the state’s safety net, particularly in light of uncertain federal funding. A more progressive tax structure, they argue, would make the system fairer by reducing the burden on middle- and lower-income residents. Currently, the top 1% of Rhode Island taxpayers control a disproportionate share of the state’s wealth but, when accounting for sales and property taxes, pay a smaller share of their income than lower-income households.

Opponents, however, warn of unintended consequences. They claim the bills would drive wealthy residents and businesses out of the state, eroding the tax base.Supporters dispute this, pointing to IRS and Stanford University studies indicating that wealthy individuals typically relocate for family or climate-related reasons—not for tax considerations. States like California and New Jersey, they note, have implemented similar surtaxes without experiencing significant outmigration.

Morally, proponents argue, those with more resources have a responsibility to help those with less—especially in a post-COVID era when many low-income families continue to struggle.

Yet critics, including the Rhode Island Public Expenditure Council (RIPEC) along with the Greater Providence Chamber of Commerce, Northern Rhode Island Chamber of Commerce and businesses, warn that such a tax could signal to entrepreneurs and investors that Rhode Island is “business unfriendly.” They contend that higher income taxes might discourage business investment and hiring, harming the state’s long-term economic prospects.

Some opponents cite Connecticut’s experience in the early 2010s, when a handful of wealthy taxpayers reportedly relocated after tax hikes, resulting in noticeable revenue loss. Given that a small number of high earners contribute a significant share of state income tax revenue, even limited outmigration could have an outsized fiscal impact, critics argue.

Skeptics also question whether new revenue will be reliably dedicated to education, infrastructure, and social programs. They point out that in the past, even funds placed in restricted accounts were sometimes redirected to fill budget shortfalls.

Aging Programs and Services at a Crossroads

“Rhode Island stands at a crossroads,” warns Carol Anne Costa, Executive Director of the Senior Agenda Coalition of Rhode Island (SACRI). With a projected $220 million deficit and potential federal cuts to programs such as Medicaid, SNAP, and services provided by the Office of Healthy Aging, Costa insists that passing HB 5473 and S. 329 is essential to preserve and expand supports for older adults and people with disabilities.

“Most of our state’s older residents are not wealthy,” Costa notes, citing Census data showing that one in four older households earns less than $25,000 annually, and 45% earn less than $50,000. Only about 8% of older households earn more than $200,000.

In FY 2023, 27,535 Rhode Islanders aged 65 and older were enrolled in Medicaid, which funds the majority of long-term services not covered by Medicare. In addition, 14% of older adults in the state relied on SNAP benefits to help cover food costs.

Costa argues that revenue from the proposed surtax could ensure continued funding for these essential programs and expand the Medicare Savings Program. Such an expansion could save low-income seniors and adults with disabilities up to $185 per month in Medicare Part B premiums—money they need for food, housing, and transportation.

While critics warn of wealthy residents fleeing Rhode Island if taxes increase, Costa cites a comprehensive report by the Economic Progress Institute refuting this claim. “In fact, the data suggests the opposite,” she says. “Higher-income tax filers are moving into Rhode Island more than they are leaving.”

Costa also points to Massachusetts as a real-world example. After voters approved a 4% surtax on income over $1 million in 2022, the number of Massachusetts residents with a net worth over $1 million increased from 441,610 to 612,109 by 2024, according to an April report from the Institute for Policy Studies and the State Revenue Alliance.

Business Community Pushes Back

At the House Finance Committee hearing, Laurie White, President of the Greater Providence Chamber of Commerce, voiced strong opposition to the proposed tax.

“Our views reflect those of thousands of local businesses statewide,” she said. “Rhode Island is already in fierce competition with neighboring states to attract and retain businesses, residents, and talent.”

White warned that the surtax would send the wrong message, particularly as Rhode Island invests in high-wage sectors like life sciences and technology. “Tax burden is a key factor in business decisions, and an increase in personal income tax would significantly reduce Rhode Island’s appeal,” she stated.

House GOP Minority Leader Michael W. Chippendale (R-Dist. 40, Coventry, Foster, Gloucester) echoed White’s sentiments: “Taxing people who have worked hard and become prosperous is an insult to the American dream. We shouldn’t be punishing success—we should be creating an economic environment where everyone can thrive. Driving away high-income residents with more taxes is backward thinking.”

Chief of Staff Sue Stenhouse confirmed that the entire 10-member House Republican caucus stands united in opposition to the surtax.

The Washington, DC-based Tax Foundation also weighed in. In written testimony on S. 329, Senior Policy & Research Manager Katherine Loughead stated that if the surtax were enacted, Rhode Island would move from having the 14th-highest to the 8th-highest top marginal state income tax rate in the nation—excluding the District of Columbia. She warned that this could make Rhode Island less attractive to high-income earners than even Massachusetts.

So What’s Next?

Costa maintains that taxing the wealthiest residents may be both a necessary and viable solution to protect the state’s safety net amid budget shortfalls and looming federal cuts.

However, with HB 5473 and S. 329 still being held for further study, it remains unclear whether they will be included in the final state budget.

“As we approach the final weeks of the session, there is no shortage of meritorious proposals that affect state resources,” said House Speaker Joseph Shekarchi (D-Dist. 23, Warwick). “The uncertainty of the federal funding picture and the numerous holes in the Governor’s proposed budget complicate both balancing this year’s budget and planning for the unknown. I continue to keep many options on the table for this challenging task.”

Stay tuned—SACRI and other aging advocacy groups are watching closely to see what options will be considered by the House Speaker when he releases FY 2026 state budget to address funding for programs and services that support Rhode Island’s growing older population in this difficult fiscal year.

To read submitted emails and testimony on S. 329, go to https://www.rilegislature.gov/senators/SenateComDocs/Pages/Finance%202025.aspx.

To read written testimony submitted on HB 5473, go to https://www.rilegislature.gov/Special/comdoc/Pages/House%20Finance%202025.aspx.

New Detailed Aging Report Will Help Officials, Policymakers

Published in RINewsToday on May 17,2025


By Herb Weiss

In an era of tightening budgets and shrinking federal and state resources for aging programs, legislators, service providers, and advocates now have access to vital data that can help identify and address the unmet needs of older adults in their communities.

Just over a week ago, the Gerontology Institute at the University of Massachusetts Boston released the latest Healthy Aging Data Reports (HADR), funded by the Point32Health Foundation. These reports offer a comprehensive, neighborhood-level view of aging in America—insights often unavailable from other sources.

Rhode Island’s updated report, released on May 1, 2025, follows previous editions published in 2016 and 2020. This year’s release also includes updates for Connecticut, Massachusetts, and New Hampshire, and introduces a first-time report for Maine. The HADR team is now expanding its reach to additional regions, including parts of the Deep South (such as Mississippi) and the West (including Wyoming).

“This is what’s magical about our report: we provide data at very local levels,” says Dr. Elizabeth Dugan, principal investigator and associate professor of gerontology at UMass Boston. “That empowers local advocates, helps policymakers make smarter investments, and allows philanthropists to assess the impact of their contributions,” she says.

The Rhode Island report features 41 community profiles—covering each city and town, along with two neighborhoods in Providence. Drawing on data from the U.S. Census Bureau, Medicare Summary Beneficiary Files, the CDC’s Behavioral Risk Factor Surveillance System, and state health departments, the report highlights disparities that may be hidden in broader state- or county-level statistics.

“What’s powerful about this approach is that we can observe health outcomes that vary dramatically even within a 10-minute walk in the same city,” adds Dugan.

Spotlight on Rhode Island

Several key findings emerged from the 2025 Rhode Island report:

  • Health: Rhode Island ranks highest in New England for rates of high cholesterol, diabetes, hypertension, ischemic heart disease and peripheral hearth disease, stroke, multiple chronic conditions (four or more), and anxiety disorders.
  • Gender Disparities: Women experience anxiety and depression at rates 15% higher than men and are also more likely to suffer from Alzheimer’s disease, schizophrenia, and PTSD.
  • Housing: Roughly 39% of older renters spend more than 35% of their income on housing. Additionally, 46% of Rhode Islanders aged 65 and older report annual incomes under $50,000.

“The Rhode Island Healthy Aging Data Reports are invaluable,” says Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of Rhode Island and a member of several state aging commissions. “They provide essential data down to the ZIP code level, which is useful for legislative testimony, policy recommendations, program planning, and grant writing.”

With Rhode Island’s older adult population rising from 16.5% in 2020 to 18% in 2025, this data is more critical than ever. “The report shows how age and racial diversity vary widely across communities,” Maigret says, noting that in some smaller towns, older adults now make up over 30% of the population.

Maigret notes that availability of localized data helps municipalities develop comprehensive plans and adopt age-friendly strategies. Interactive maps within the report allow comparisons with state averages, making it easier to target resources where they are most needed.

The report also reveals demographic shifts, including a rise in the Hispanic older adult population—from 4.9% in 2020 to 5.9% in 2025. “There are significant racial and ethnic disparities in health outcomes,” says Maigret. “Black and Hispanic older adults are more likely to be dually eligible for Medicare and Medicaid and to be enrolled in Medicare managed care,” she says.

As lawmakers navigate complex budget negotiations and potential changes to federal programs such as the Administration for Community Living, Medicaid, and the CDC, Maigret stresses the importance of leveraging this data in decision-making.

“Despite the growth in our older population and increasing reports of elder abuse, neglect, and substandard nursing home care, the Office of Healthy Aging’s budget has remained relatively flat,” she warns. “With half of its funding coming from the federal government, proposed cuts could seriously undermine vital programs such as the Long-Term Care Ombudsman,” she adds.

The report also shines a light on mental health, showing high rates of depression and anxiety—especially among older women. Maigret believes this supports increased investment in the 988 mental health crisis line and other behavioral health services.

Another notable trend is the continued shift toward Medicare managed care, now covering more than half of Rhode Islanders aged 65 and older. While rates of arthritis and depression have increased, the report also notes a decline in nursing home stays, inpatient admissions, emergency room visits, and several chronic conditions such as diabetes, COPD, hypertension, and heart disease.

Since the 2020 report, communities have taken meaningful steps to support aging in place. “The Village Common of RI has built age-friendly communities that enable older adults to live independently with the care and resources needed to promote health and well-being,” says Maigret. “There are now 11 local villages across 14 communities, supported by trained volunteers who help members stay connected and independent.”

Data Driving Policy and Innovation

Marie E. Cimini, MSW, Director of the Rhode Island Office of Healthy Aging, says the HADR report has broad implications. “As a state agency, we must lead with policies that prioritize inclusion, access, and dignity throughout the aging journey.”

“The report reinforces our commitment to advancing the goals outlined in the RI 2030 Plan, especially around expanding in-home care, supporting workforce development, and strengthening behavioral health services,” Cimini continues. “But it also challenges us to go further—to integrate aging into every aspect of public life and ensure that the voices of older adults inform policy at every level.”

For Meghan Grady, Executive Director of Meals on Wheels of Rhode Island (MOWRI), one of the most important takeaways is the persistence of health disparities, particularly in managing chronic conditions. Grady supports legislation introduced by Sen. Victoria Gu (D-Dist. 38) and Rep. Justine Caldwell (D-Dist. 30) to integrate medically tailored meals into healthcare delivery. “This report validates our advocacy,” she says. “Food is a fundamental part of care, especially for aging populations facing health disparities.”

The HADR report is also proving instrumental for nonprofit organizations. “We use the data in community presentations, grant proposals, and to guide our work in promoting health equity,” says Debra Burton, Executive Director of RI Elder Info. “With so much uncertainty around policy and funding for programs that impact older adults and caregivers, this data helps us identify where changes will have the greatest impact,” she says.

James Connell, Executive Director of Age-Friendly RI, agrees. “The Healthy Aging Data Report is extraordinarily helpful for nonprofits across sectors. I used it to support funding for a home-share program that pairs older homeowners with individuals facing housing insecurity—a creative approach to our state’s housing crisis,” he says.

“The ’25 Healthy Aging Report provides vital indicators of older adult well-being that are essential for policymaking, intentional planning, and program development,” says Connell. “The data highlight serious concerns about the mental and emotional health of our community, with one in three Rhode Islanders experiencing anxiety and/or depression.” Connell also emphasizes the report’s finding that women are disproportionately affected, calling it “a clear call to action for improved screening and more accessible treatment options.”

Greg Shell, Chair of the Point32Health Foundation Board of Directors, emphasizes the value of data in shaping policy. “When we use data to guide our work, we can change policies and practices, engage communities, and highlight what truly matters,” he says. “These reports are essential tools in making New England a better place to grow up and grow old.”

The research team behind the Healthy Aging Data Reports includes: Principal Investigator Elizabeth Dugan, PhD, along with Nina Silverstein, PhD; Qian Song, PhD; Taylor Jansen, PhD; Jay Lee, PhD; Yan-Jhu Su, PhD; Han Lin, PhD; Shan Qu, MS; Tiffany Tang, BS; Jeannine Johnson, PhD; Amanda Cox, MS; and Mengshi Liu.

To access the 2025 Rhode Island Healthy Aging Data Report, visit https://healthyagingdatareports.org/ri/rhode-island-healthy-aging-data-report.