The last hurrah for RI retired pensioners

Published in RINewsToday on May 22, 2023

To this day, talk to any state worker or teacher who retired and they are not happy campers. To the contrary, they remain bitter as to how former Governor Gina Raimondo sold them out with her version of pension cuts in 2011 when state retirees, retired teachers, and many municipal retirees had their annual pension Cost of Living Adjustments (COLAs) suspended, and public workers had to trade in part of their defined-benefit pension plan for a 401 (k) style benefit, putting their retirement at risk. 

Four days ago, just like abortion and gun control legislation, pension change filled Room 35 to capacity with retired teachers and state workers calling for the Rhode Island General Assembly to bring back Cost of Living Adjustments (COLAs) to the retirees’ pensions.  The Clifford Group, Citizens for Pension Justice, and the Facebook Group, Advocates for COLA Restoration, successfully mobilized their retiree members to come to the House Finance Committee (HFC) held on May 18, 2023.

Putting the spotlight on three pension proposals

Currently there are at least 11 bills in the legislative hopper retgarding COLAs for state workers and teachers and the HFC heard testimony on many of these bills. These bills were held for further study in Committee. According to RI General Law Title 36-20-39 any proposed bills impacting the retirement system shall not be approved by the General Assembly unless a “pension impact note” is appended to the proposed legislation.  At press time this has not occurred.

Here are three of the pension bill fixes considered at last Thursday’s HFC:

Kicking off the over three-hour long hearing Rep. David A. Bennett (D-District 20, Warwick) called for HFC’s 15 members to pass H 5038, a bill that would restore the COLA to state employees and other RI pension system members  who retired prior to July 1, 2012.

Looking back when he was a freshman lawmaker in 2011, Bennett remembers voting to eliminate the retirees’ COLA because the administration told him that keeping the COLA would bankrupt the state and nullify all contracts.  “This is the only bill I have strong regrets voting for and it affected a lot of people, some of them already deceased,” he said. 

“It’s a shame and I wish I would never have voted yes to taking away the retirees’ COLA” says Bennett. With the cost of living continuing to increase, people need a COLA,” admits Bennett, noting that they had a contract ensuring a COLA when they retired. “When you retire your pension should be protected,” he says.  

Like Bennett, Rep. Patricia A. Serpa (D-District 27, Coventry, Warwick and West Warwick) expressed concerns about her vote to eliminate the retirees’ COLA over 12 years ago. Serpa told the HFC that “valuable actuarial information was withheld” and that she was “misled back in 2011” about the financial condition of the state’s pension system. 

Serpa acknowledged that many of her former colleagues are suffering because of her “terrible” vote. ”In all of my time it was the worse vote I ever, ever took.  I will never ever, ever, ever again take a vote like that against retired teachers or retired state employees,” she pledged.

“I have spoken to a number of people since that vote.  People I respect.  People with degrees in accounting and they have clearly indicated that the pension fund could easily have been amortized and left almost whole,” says Serpa. 

Serpa is the sponsor of H 6295 which provides a one-time stipend of 3 percent of retirees’ first $30,000 for all teacher and state retirement members, including many municipal systems retirees. This stipend, coming from the state’s General Fund, may be renewed annually by the General Assembly based on the state’s fiscal status. 

H 6295 would at least provide temporary relief to the retirees,” says Serpa, admitting that she is “not married to her bill” and has signed onto every pension bill that has come before her.  “I have been here long enough to know that if you have only one idea in the hopper you have no cards to play with”, she says. “We must put the ideas out there to start a conversation. and we have to take action soon,” notes Serpa. 

State Treasurer James Diossa  requested Rep. William O’Brien (D-District 54, North Providence) to introduce bill H 6006 that would provide a one-time allowance of $500 for eligible members of the employees retirement system of Rhode Island.

“H 6006 provides meaningful relief to those struggling to buy gas or groceries,” says Diossa, noting that over 30,000 retired teachers, state and municipal employees would benefit from passage. “This bill would not impact the pension system like other COLA restoration and stipend proposals would,” he said, stressing it would provide relief while maintaining the stability of the pension funds.  Diossa acknowledged that many might be frustrated knowing that it’s a stipend only and not a COLA.

To watch the May 18, 2023 hearing of the House Finance Committee, go to https://ritv.devosvideo.com/show?video=f66975520d59&apg=52ab780b.

Retirees weigh in

According to W. David Shallcross, a former Cranston teacher and retired Lincoln school principal, many Rhode Island state workers and teachers do not receive Social Security coverage. The state pension system was established in 1936 as an alternate Social Security plan. The state required by Rhode Island law that every teacher and state worker must participate and that the employer, the state, like all employers, must contribute.

Shallcross stressed that to teachers and state workers “this is not free money, it is money they ‘banked by RI law’ to sustain them when they retire. They contributed a significant portion of their wage as long as they were employed.

“Today’s dollar is only worth 68 cents compared to the 2012 dollar. Yearly, Social Security adjusts benefits based on the cost of living in the preceding year. Rhode Island has done nothing in this regard for retirees in the last 10 years. Yet our legislators continue to enjoy the COLA first awarded them in 1995,” he charged.

Retired State Employee Santa Priviter strongly supported the passage of H 5038, opposing any retirement bills [considered by the HFC] which offer a one-time stipend and/or distribution schedules for pension benefits. “Those other bills would still maintain the RI Retirement Security Act formula which effectively eliminates retirees’ inflation protection,” she says.

“A one-time taxable stipend worth about $1.00 per day for one year – or 25 cents per day for 4 years – is not a COLA because it doesn’t offer continuing, real relief against inflation.  H 5038 does,” notes Priviter.

“Our newly elected treasurer has offered a $500 onetime stipend.  How utterly insulting.  What can $500 buy?”  asks Lorraine Savard, a teacher who retired in 2004.  “The millions in this years’ financial state surplus can be used to give teachers and state workers a much needed financial boost. If not the return of our COLAs, then other creative compensations, for example a reduction in state income tax on state pensioners,” she urges.

“As you know, since 2012 the value of our pension benefits has decreased by 30%”, said Brian Kennedy, a former state worker employed for over 30 years at Rhode Island’s Division of Personnel at the Office of Human Resources.  “In the same time period, the State Budget has increased from $7.7 billion  to $13.7 billion,” he says.

Kennedy acknowledged that it is highly unrealistic to consider being reimbursed all the COLA monies owed, as some other bills provide, but he urged the HFC to consider adjusting the 2012 base for computation of the go-forward COLAs.  That base should be increased by the inflation rate from 2012 to the current time in order to reflect 2023 dollars.

According to Kennedy, in dollar amounts, the average individual “increase” over the last ten years is roughly $10/month. “Our pensions reflect 2012 benefits paid with 2023 dollars, a windfall for the state, but an insult to the retirees,” he says.

“Is there anything more sinister than mandating a “reform” program with a twenty year finish line to elderly retirees with a twenty year mortality rate?  Coincidence?” he quips.

Patricia E. Giammarco, from Citizens for Pension Justice, agrees with Kennedy’s assessment that it is now or never. “It’s abundantly clear that the state will be spending less and less on COLAs until it reaches the illusory 80% funding, when most pre-2012 retirees will be dead.  To ask us to continue to subsist on virtually nothing, only to receive that virtually nothing once a year or once every four years, is not only highly suspect, I feel it is downright treacherous,” she says.

Giammarco ends her testimony by stating: “You can disguise a pig and bring it to market trying to sell it as a cow, but in the end, it’s still a pig.  I would ask this body to absolutely reject the offerings of any false prophets and to do the only thing that is ethically, morally, and legally acceptable when viewed in the totality of the circumstances.  Support H 5038 and return to the retirees who retired prior to July 1, 2012, that which should never have been taken away – their contractually guaranteed 3% compounded COLAS.”

Susan Sweet, a former state associate director of the Department of Elderly Affairs and an advocate for seniors facing hardships and low-income difficulties, remembers being part of the original group opposing the pension cuts and the broken retiree contract and being told by the state arbiters that the pension cuts were entirely political, not financial.  Members of the General Assembly were deceived regarding the need and impact of the cuts.  No other state has taken benefits away from already retired workers who have fulfilled their side of the contract. Two tried but were struck down by their courts.

“A Rhode Island Superior Court ruling states that a COLA and a pension are “one and the same” and ‘not gratuities’, Sweet quotes, “and the General Assembly was advised otherwise even though the state’s actuary advised against this. How long will this injustice continue? House bill H 5038 and the companion bill in the Senate which is identical, S 0564, are the most reasonable and responsible pieces of legislation being considered.  I urge all Representatives and Senators to pass this legislation before it is too late to benefit the retirees who were dealt this terrible blow to their later years.”

The clock is ticking… with the state’s now-estimated surplus of $500 million plus and millions received from the Wells Fargo settlement, it’s time to act now.  The General Assembly must not continue to kick the can down the road until the can is destroyed and the retirees are all dead.

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RI Seniors, aging advocates call for an “age friendly” budget

Published in RINewsToday on March 27, 2023

Over two months ago, Gov. Dan McKee unveiled a sweeping $13.7 billion budget for the upcoming fiscal year.  After its release, the Senior Agenda Coalition of RI (SACRI), representing 21 organizations, called this budget “unfriendly to seniors,” charging that it “short-changed” seniors.  In an e-blast that was sent to 1,800 seniors and aging advocates SACRI urged them to contact their lawmakers asking that they put more funding into the delivery of aging programs and services.  

As the House Finance Committee continues to hold hearings on bills that might ultimately be rolled into the upcoming FY 2024 Budget, last week the SACRI brought 220 seniors, aging advocates and professionals in the aging network to the Warwick Crown Plaza to personally urge House Speaker Joe Shekarchi (D-Warwick) and Senate President Dominick Ruggerio (D-Providence, North Providence to hammer out an “age-friendly” budget.

SACRI Board Chair George Neubauer began this year’s Legislative Leaders Forum by quoting President Joe Biden’s call to Congressional lawmakers at the annual State of the Union Address to maintain Medicare and Medicaid. The President urged lawmakers to “stand up for seniors”.  Setting the stage for why this event was organized, Neubauer told the packed room: “Today, we are here to speak up for ourselves.”

Painting a Portrait of Rhode Island Seniors

“Effective advocacy includes good data and good stories,” said Maureen Maigret, a SACRI Board member and policy advisor for the group setting the stage for the speakers. She presented demographic data on the state’s graying population, discussed the increased needs of state’s aging programs and services to keep people at home, and detailed SACRI’s budget policy fixes.

“We speak up for 200,000 seniors and our numbers are growing,” says Maigret, also a former State  Representative and Director of the RI Department of Elderly Affairs. By 2030, 1 in 5 Rhode Islanders will be aged 65 and over,” she says.

While many think that seniors are a drain on the economy, they are not. According to Maigret, $3 billion dollars in Social Security benefits are pumped into the state’s economy. Twenty percent of seniors are still working and paying taxes and employers are very aware that seniors have extensive job experience skills and are usually very reliable employees.

“Additionally, seniors are part of an invisible workforce of unpaid caregivers who take care of family members and friends, also,” says Maigret, noting that AARP Rhode Island recently released a study reporting that there are 121,000 unpaid caregivers, with the value of their unpaid care estimated to be $2.1 billion dollars (just under $19 per hour).

“Seniors also contribute thousands of hours of volunteer work to their local communities, lending a helpful hand to senior centers, friendly visitor programs, Meals on Wheels, and to the Village Common of RI at four Village communities and multiple other agencies,” adds Maigret.  

“An overwhelming 70% of Rhode Island seniors want to age in place and remain in their communities,” says Maigret, noting that “after age 65, 3 out of 5 of these individuals will need some support to stay in their homes.”

SACRI survey on areas of concern for seniors

With Rhode Island’s top House and Senate leadership listening, Maigret touched on the findings of a SACRI survey that identified an array of concerns expressed by their older constituents.  Health and care issues came up on the top of this list, followed by isolation and loneliness, lack of knowledge of community support services, the need for transportation, loss of mobility, high housing costs, and lack of income.

The survey findings indicate that needed information is not reaching older adults to navigate the long term care system, says Maigret. Forty percent do not know about programs and services offered by Rhode Island’s Office of Healthy Aging (OHA) and The Point, the state’s aging and disability resource center.  She noted that the Governor’s FY 2024 budget didn’t allocate any state dollars to operate The Point, whose mission is to direct seniors to needed programs and services.

“Even with Social Security, a large number of seniors have low incomes,” says Maigret, with 50% of older households living on less than $50,000 a year, another 27% living on less than $25,000. “The cost of long-term care is staggering and unaffordable with semi-private rooms in nursing facilities going for $94,900 a year,” she pointed out. “Assisted living facilities is out of reach for many, too, costing about $54,000 a year. Bringing a home care aide 40 hours per week into a person’s home costs a whopping $56,160,” she adds.

Maigret urged Shekarchi and Ruggerio to reallocate more state dollars to home care services.  While other states, on average, spend 45% of Medicaid long-term care dollars on home care, Rhode Island only spends 22% with hundreds of seniors having to wait over 3 months to get home care services.

Maigret says that SACRI supports a legislative agenda that calls on the Rhode Island General Assembly to craft a “Better Budget for Better Care,” which will result in a permanent investment to improve the care provided to seniors.  SACRI also urges that lawmakers raise direct workers pay to $20 per hour to attract workers into home care agencies and nursing facilities. To assist seniors to access needed programs and services, $500,000 must be allocated into the House budget to better market available information and referral services offered by The Point.  

“Meanwhile, SACRI also is pushing to add five new positions at the OHA, with two being assigned to its Adult Protective Services Unit to increase increased caseloads,” says Maigret.  By allocating funding to help more lower income Medicare beneficiaries pay their Medicare Part B premiums, seniors will have more money to pay their bills.     

Telling Powerful Stories

SACRI pulled together a few “real life” stories to illustrate why Rhode Island lawmakers must craft an “Age Friendly” FY 2024 Budget.

Jeanne Gattegno, working in the elder abuse sector, shared her thoughts as to why OHA’s Adult Protective Service Unit (APSU) is underfunded.  “Elder abuse is a crime and anyone suspecting abuse must report it.  When its reported it must be investigated by the APSU,” she says.

According to Gattegno, in 2021, there were over 6,200 calls to OHA, over 1,400 calls were elder abuse complaints, and 2,800 were investigated as self-neglect. “There are five workers in the APSU. Just do the math. It’s an incredibly difficult job and it’s life and death and there are not enough people to help,” warns Gattegno.

Allyson Manning, an overworked Registered Nurse at a local nursing facility, highlighted her typical day working with two Certified Nursing Assistants to take care of 26 residents.  Due to low wages, the facility can’t fill the third CNA position to assist the other two CNAs on the shift. 

Serving as Team Leader, Manning says that there is not enough time to take care of her 26 residents.  During this shift her chief responsibility is to pass medications, perform treatments and assessments.  She often finds that her primary functions as an RN are late or difficult to carry out, due to the need to assist the CNAs with their tasks of toileting, washing, dressing and feeding residents.

“We are not attracting the people we need to these [CNA] positions.  They are low paid jobs, but it is really rewarding work but it is hard work., she says.  When hired, CNA’s are not staying long, turnover is high says Manning. While initially working full-time, she now only works two days a week.  

Giving Their Thoughts…

RI Speaker of the House, Joe Shekarchi remarked that he clearly understood the very powerful stories shared by Gattegno, Manning and others. “I didn’t need to hear those stories because I live those stories every day.  When his 97-year-old father recently fell at home and broke his pelvis, he was admitted to the Bethany House.

“I see how hard they work and the limited staff they have,” says the House Speaker, understanding the labor shortage’s impact on nursing facilities. “I see when my father hits the call button and it takes a long time [to answer] not because they are slow, but because they are doing three or four things at the same time,” he says.

“It’s important that seniors have options so they can choose what’s best for them,” says Shekarchi. “We need to provide supports for seniors to age in place and remain in their homes living independently,” he added, acknowledging that it is not always easy to do.

Shekarchi also recognized his effort with the Senate President made historic investments to require minimum staffing last year. Unfortunately, it hasn’t happened because the nursing facilities are now facing labor shortages, he says. 

According to Shekarchi, last year the General Assembly also provided more funding to make home care more accessible for seniors.  Lawmakers also provided tax relief on pensions for older taxpayers and military veterans, strengthened laws to protect seniors from financial exploitation, and made it easier to apply for SNAP benefits and expanded property tax relief for seniors. He expects to continue his efforts this legislative session.

Shekarchi also reported that he has introduced a bill, supported by AARP RI, to allow zoning for constructing Accessory Dwelling Units (ADUs) in garages or basements. He called on seniors and aging organizations to support his housing bill.

The House Speaker also discussed proposed legislation by Rep. Lauren Carson (D-District 75, Newport) proposed legislation that would create a House Study Commission to coordinate Rhode Island’s programs and services for seniors, expressing the need for such a study commission.  

Like Shekarchi, Senate President Dominick Ruggerio outlined a number of legislative successes last year.  He recognized passage of Sen. Josh Miller’s legislation authoring the creation and implementation of a pharmaceutical redistribution program. Former Sen. Cindy Coyne’s legislation became law, too, lowering the age at which a victim can be considered an elder under the state’s financial exploitation law from 65 to 60.

With the state’s growing number of seniors, Senate President Ruggerio stated that senior issues are more important than ever.

“We need to do everything we can to ensure seniors and retirees can enjoy their older years with dignity and security,” he said. “Because after a lifetime of hard work and contributing to our communities… older Rhode Islanders deserve nothing less.”

“The Senior Agenda Coalition is a powerful tool in its work.  At the Statehouse we rely on your voices to help guide us as leaders,” says Ruggerio, noting “we don’t have all the answers and appreciate your input.”

To watch SACRI’s 2023 Legislative Leaders Forum, go to  https://ritv.devosvideo.com/show?video=7cd34a907d29&apg=c7e3a6c7.

Nursing home workforce crisis deepens with minimum staffing standards

Published in RINewsToday on February 13, 2023

“The long-term care industry is enduring the worst workforce crisis in its history, in Rhode Island, and across the country. Although providers are committed to recruiting and retaining staff to provide quality care for residents, despite our best efforts, many nursing homes have fallen short of the staffing ratio set by the RI Department of Health,” notes James Nyberg, Executive Director of the East Providence-based Leading Age Rhode Island (LARI), representing nonprofit providers of aging services.

“We are extremely  concerned about the impending fines that will be imposed on nursing homes here in Rhode Island as a result of our state’s existing nursing home minimum staffing ratio statute,” said Nyberg. Because of staffing ratio mandates, “the industry would have faced fines of over $11 million, in just one sample quarter (April – June 2022), since over 70% of nursing homes are not in compliance,” he said.  

“While April-June was a sample, the fines go into effect for July-September and we will receive a similar notice in just a few weeks, with only 10 days to pay the fine,” says Nyberg, stressing that these fines will only increase going forward if nursing homes are unable to meet the minimum staffing ratio.

Nyberg calls on the Rhode Island General Assembly to rescue Rhode Island’s nursing homes and provide relief from these penalties by delaying them and exploring an alternative approach to support the efforts of nursing homes to meet the ratio.  He warns that the current fine-based approach is excessive and counterproductive and will lead to reduced access to care and threaten the survival of the state’s nursing homes.

Nyberg points out that the current workforce shortages are already preventing nursing homes from filling open positions, limiting new admissions, and forcing organization closures (five nursing homes have already closed since the COVID pandemic began).  These challenges are also resulting in backlogs at hospitals, which are unable to discharge patients due to reduced capacity in nursing homes.  

“We are working with numerous stakeholders on various initiatives to develop a pipeline of workers, but the simple fact is that it will take time.  In addition, as you know, the industry has faced years of underfunding from Medicaid, which pays for the majority of nursing home care.  This has made recruiting and retaining workers more difficult than ever,” says Nyberg. 

John Gage, President of the Rhode Island Health Care Association (RIHCA) agrees with Nyberg’s assessment of the nursing home workforce.  “Nursing homes across the nation are facing an historic labor shortage as the direct result of chronic Medicaid underfunding and the devastating impact of the Covid-19 pandemic on the workforce, he says, noting that the state’s nursing home workforce is down 20% since the start of the pandemic, with 2,000 workers lost from Jan. 2020 to June 2022.  Nationwide, the nursing home workforce is down 210,000 workers.

According to Gage, Rhode Island’s staffing mandate, while well-intentioned, will siphon tens of millions of dollars from resident care. In the first year of full implementation of the state’s minimum staffing mandate, RIHCA estimates that facilities will be fined upwards of $60 million. “These fines will imperil care, not bolster it,” he warns.  

Without legislative action, Rhode Island nursing homes will be fined an estimated $11 million on or about February 28, 2023, because of their inability to attract workers to meet the mandate from July 1, 2022, through September 30, 2022, Gage charges. “There are simply not enough available workers to fill the open staff positions, and resources are scarce.  Nursing homes will be devastated by these fines.  Facilities will reduce admissions, backing up hospital referrals and clogging hospital beds.  More nursing facilities will close – five have already closed since the beginning of the pandemic,” he predicts.  

Gage asks, “Who will care for Rhode Island’s frailest elders?” To recreate a minimum staffing mandate in nursing homes on the federal level would be a huge mistake, especially given the historic workforce crisis here in Rhode Island and nationwide,” he says.  

Gage’s comments echo concerns expressed by another group of US Senators in Jan. 20 correspondence (https://www.tester.senate.gov/wp-content/uploads/1-20-23-Nursing-Home-Staffing-Mandate-Letter-FINAL.pdf) sent to CMS by Senators John Bourasso, Jon Tester, and eleven other US Senators.  They caution the agency that a one-size fits all mandate would undermine access to care for patients, and they encouraged CMS to work with Congress on tailored solutions that address the workforce challenges facing nursing facilities.

At the federal level

Just days ago, U.S. Senators Bob Casey (D-PA), Chairman of the Senate Committee on Aging, and Ron Wyden (D-OR), Chairman of the Senate Finance Committee, called on the Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to encourage the federal agency to establish minimum staffing standards in nursing homes to ensure high-quality care for nursing home residents. In Feb. 10 correspondence, Casey and Wyden, along with Senators Sherrod Brown (D-OH), Kirsten Gillibrand (D-NY), Richard Blumenthal (D-CT), Cory Booker (D-NJ), and Elizabeth Warren (D-MA) urged CMS to advance the agency’s ongoing study to determine adequate staffing requirements in nursing homes.

“We appreciate the work that CMS has undertaken to promote safety and quality in nursing homes and applaud the Biden-Harris Administration’s commitment to protecting our nation’s seniors,” said the senators in Feb. 10 correspondence, urging CMS to “bring this work to completion.” 

“In our view, that means continuing the agency’s ongoing study to determine the level of staffing that is necessary to ensure safe and high-quality care for nursing home residents, developing an evidence-based and actionable proposal for mandatory minimum staffing levels, and a robust and transparent process—including direct stakeholder engagement— that will allow for further discussion and fine-tuning of requirements before the proposal is finalized,” wrote the senators.

The senators noted that studies have shown a correlation between inadequate staffing levels and lower quality of care. More recent studies have demonstrated that higher nurse staffing ratios mitigated the effect of COVID-19 outbreaks in nursing homes and resulted in fewer deaths. A recent Department of Health and Human Services Office of Inspector General report examining the high level of COVID-19 infections in nursing homes also pointed to the need for the establishment of minimum staffing requirements.  

In the correspondence, the senators cite the Social Security Act, which requires skilled nursing facilities to “provide 24-hour licensed nursing service which is sufficient to meet nursing needs of its residents,” including the services of a registered nurse at least 8 consecutive hours per day, 7 days a week. The letter commends CMS for working to update this vague standard that has led to substantial variation in staffing levels and quality of patient care across facilities.

“Achieving the shared goal of ensuring quality care in nursing homes nationwide is a complex undertaking, says LeadingAge’s Ruth Katz, senior vice president, policy. LeadingAge is an association of nonprofit providers of aging services, including nursing homes.

“As our Get Real on Ratios proposal highlights, a number of conditions must be met in advance of any mandate implementation,” suggests Katz. “The senators correspondence to CMS is a promising development; it covers many of the same points as our Get Real on Ratios proposal – a recognition of the critical need for adequate reimbursement; that one size does not fit all, and that workforce shortages will need to be addressed with additional support. Without addressing these, staffing mandates are impossible. We look forward to continuing our discussions with Congressional leaders on this critical issue so that older adults and families can access much-needed care and services,” she says.

“The Senior Agenda Coalition of RI fully supports the need to develop national staffing standards to ensure quality care is provided to nursing home residents across our nation. It is important to note that Rhode Island has been a leader in this area. For many years our state has required 24/7 RN coverage in nursing homes and in 2021 the legislature passed the Nursing Home Staffing and Quality Care Act that includes staffing standards,” says Maureen Maigret, Policy Advisor to Senior Agenda Coalition of RI. “Now we must work to address workforce shortage issues and ensure that adequate government resources are provided especially through Medicaid payments so the standards can be met, and our critical direct care workers receive competitive living wages in order to keep them working in long term care,” she adds.

As the House Leadership hammers out the FY 2024 budget, it is crucial that adequate Medicaid funding is allocated to allow nursing homes to attract the necessary staff to meet the state’s minimum nursing standards that it codified into law. We must address this policy problem now rather than just kick the can down the road.