Rhode Island: In a Year After a Big Win, Four Major Priorities for 2019

Last year was Rhode Island’s first year with a full-time Government Affairs Office (GAO) program—And what a year it was. Together with our Rhode Island office staff, field staff, clients, and families, we were able to band our voices together in advocacy to achieve monumental increases on behalf of our staff and clients.

As a result of our efforts, the State increased Medicaid rates for certified nursing assitants (CNAs), and to the State’s private duty nursing (PDN) program. These increases allow BAYADA to raise field workers’ wages and better compete for a larger segment of the workforce. As a result, BAYADA is in a better position to recruit and retain the staff necessary to keep up with demand, and Rhode Islanders are poised to see increased access to reliable, consistent care.

Our work is far from done. BAYADA’s GAO, along with the continued advocacy of so many of you, is focusing on four key issues at this time:

Priority #1: Continued COLa Adjustments

GAO Director for RI and NY, Ashley Sadlier, testifies in support of COLa adjustments for home care workers

The 2018 increases also included a first-in-the-nation Cost of Living adjustment (COLa), which will provide additional increases to Medicaid rates every year based on the Bureau of Labor Statistics’ Cost of Medical Services annual adjustment. Our first majority priority for 2019 is to ensure that the state keeps its commitment to COLa and includes it in the state budget each year. If passed, this year’s COLa will add an additional 1.9% to current rates to ensure they remain consistent with actual, determined cost of living increases. In March, GAO director Ashley Sadlier testified in support of this important adjustment in front of the House and Senate Finance Committees alongside other supporters. At this time, we see no opposition and continue to monitor COLa through the state’s budget process.

Priority #2: High Acuity Skilled Nursing Rate Modifier

RI representatives Patricia Serpa (left) and Mia Ackerman (right) introduce bill to increase home care rates for high acuity skilled nursing services

One major issue that Rhode Island’s skilled nursing offices often face is recruiting the specialty-trained nurses necessary for more complex, high acuity clients. Luckily, home care supporters in the House agree. Recently, representatives Patricia Serpa and Mia Ackerman introduced House Bill 5621, which calls for a 10% increase to Medicaid reimbursement rates for nursing services provided to clients with tracheostomies and/or ventilators. The bill has taken the next step in the legislative process by being referred to the House Finance Committee. Currently, GAO is awaiting a date for the bill to be heard. If you, a loved one, or your staff or clients would benefit from such a bill, please reach out to asadlier@bayada.com! We hope to have a strong showing of support at the state house when the bill moves forward and we would love your help.

Priority #3: Helping Pediatric Clients Transition to Adult Clients

BAYADA is working with the State of RI to streamline processes for medically complex Rhode Islanders transitioning from pediatric to adult home care

BAYADA has collaborated with the Rhode Island Partnership for Home Care (RIPHC) to advocate for additional resources for pediatric clients currently receiving home nursing services who are transitioning to adult services. Currently, clients that are transitioning face many challenges navigating the system, especially when determining what programs and services they are eligible for. BAYADA and the Partnership have met with the Executive Office of Health and Human Services (EOHHS), the Department of Behavioral Healthcare, and Developmental Disabilities and Hospitals (BHDDH) and Managed Medicaid, to create plans on how to streamline the process for this population and expand eligibility options for families. To date, several BAYADA clients have transitioned to a more appropriate program for the level of care that they require. GAO looks forward to continuing to help our partners at the State to develop plans to ensure parents, caregivers, caseworkers, schools, and agencies are equipped with the resources necessary to assist families in navigating the challenges of transitioning from pediatric to adult home care services.

Priority #4: Continued relationship-building

BAYADA and the RI Partnership for Home Care meet with Rep. Joseph McNamara

While 2018 brought success to Rhode Island’s home care front, GAO continues to build relationships to ensure that legislators and regulators understand the importance of home care to so many of Rhode Island’s families, and support policies that ensure its accesibility. Recently, alongside the Partnership, GAO director Ashley Sadlier met with Rep. Joseph McNamara, the Chairman of the Rhode Island House of Representatives Committee on Health, Education and Welfare. Rep. McNamara is in a key role to influence legislation, and BAYADA looks forward to continuing to be a valuable partner to Chairman McNamara—and many other key legislators and regulators—on issues such as employee training and supervision, access to care, and challenges that providers, employees, and families see within the home care industry.

Strategically Utilizing Media to Advocate for Nursing Rate Increases Proves Effective in Rhode Island

Mitzi Page and her son, Kyle, both of East Providence, are one of the several families that were covered in the media in an effort to increase Rhode Island’s reimbursement rates for in-home skilled nursing services.

BAYADA’s Government Affairs Office (GAO) always seeks new ways to accomplish BAYADA’s legislative goals. In the past two years, GAO solidified a grassroots advocacy team to engage staff, clients, and families in advocating for better home care rates and policies. Even more recently, GAO has begun to see how much media attention on home care issues can further our message and help us reach our legislative goals.

Earlier this year, BAYADA contracted with Regan Communications to bring attention to the need for a state Medicaid reimbursement rate increase. Regan helped BAYADA gain the media coverage necessary to reveal Rhode Island families’ access to care issues and the bleed-out of in-home nurses, who are better paid to do similar work in other settings and neighboring states. Regan was able to assist BAYADA in gaining the momentum necessary to successfully bring the increase across the finish line! 

GAO is pleased to announce that BAYADA has extended our contract with Regan through the end of the year. Additionally, GAO is exploring a more extensive contract with Regan across our major media markets, and has expanded our in-house public affairs program with Public Affairs Manager Alisa Borovik.

Below, please find the media coverage that Regan Communications helped BAYADA earn throughout our campaign for increased reimbursement rates for in-home skilled nursing services

4/11/18 – Channel 10, NBC 10 I-Team, Home care pay gap hurting vulnerable families.

5/2/18 – Channel 12, Bill aims to increase pay for RI’s home care nurses.

5/16/18 – Cranston Herald, Cranston family lobbies for in-home nurses’ pay increases.

5/22/18 – The Valley Breeze, Lack of home nurses spells trouble for families.

6/12/18 – Newport Daily News, Rhode Island dealing with shortage of home health-care nurses.

Successful Rate Increase in Rhode Island!

GAO Director Ashley Sadlier and home care staff and clients advocate in support of a bill before a hearing in the Rhode Island state house

GAO is excited to announce its first legislative accomplishment in Rhode Island: A Medicaid rate increase for personal care and skilled care services! The 10 percent increase to CNA services and 20 percent increase to nursing services are effective as of July 1, 2018. The State of Rhode Island intends to implement these rates by October 2018 and payments to services will be made retroactive. This increase will allow for BAYADA’s Rhode Island service offices to recruit and retain more quality caregivers and care for more Rhode Islanders that want to remain independent and healthy at home with their families.

We couldn’t have done it without you. BAYADA staff, clients, and families were instrumental in this win. Advocates submitted nearly 25 testimonies to legislators, spoke at hearings, and participated in online action alerts. While BAYADA’s Government Affairs Office (GAO) and our state partners supplemented your messages media coverage and direct lobbying to ensure continued pressure on legislators and governor, the quick and efficient mobilization of our office staff, field staff, was our secret sauce! It was inspiring to watch our advocates take initiative and transform their passion into action.

In addition to this monumental increase, the legislation included a Cost of Living adjustment (COLa), which is unprecedented. A COLa ensures that the governor and legislature must include yearly increases for these home care services in each budget going forward. The COLa will be dictated by a national database, specific to health care costs.

But our work isn’t done yet. Rhode Island’s reimbursement rates remain approximately 20-30 percent less than Massachusetts’s rates. Without additional increases, we will continue to face challenges with recruiting, training, and retaining high quality caregivers because they can make a higher wage in other settings.

This legislative session, we are continuing to educate our elected officials about why it is imperative that the state support and invest in home care services to keep our medically fragile Rhode Islanders at home. GAO has scheduled meetings with legislators, coordinated home visits and roundtable discussions with elected officials and regulators, and have developed the tools and resources necessary for our in-office and client advocates to take action.

Thank you to all our advocates – the progress Rhode Island has made is a direct reflection of your engagement and your willingness to share your stories! To learn about how you can get involved in advocacy, email advocacy@bayada.com.

Supporting Home Care at the Rhode Island State House

Submitted by Rick Hynick, Director of Client and Family Advocacy

On Tuesday, April 11, a crowd of people gathered at the state room in the Rhode Island State House to thank those in our state government who support the many children, adults, and their families who rely on home care. The gathering was part of an event planned on behalf of BAYADA and the Rhode Island Partnership for Home Care.

“We’re here today to thank those legislators who have listened to your conversations and heard your challenges, and have become steadfast supporters to make your lives and the lives of your children better,” said BAYADA Chief Government Affairs Officer Dave Totaro. Dave and other representatives from GAO partnered with Rhode Island Skilled (RIS) pediatrics Director Ashley Sadlier and her staff to make the event a success.

State Representative Gregg Amore was presented with a 2017 Legislative Advocacy Award for his tireless work to back the needs of his constituents and the many other residents of the state who use home care services on a daily basis. Senator Hannah Gallo was also recognized but could not be present. Additionally, Lieutenant Governor Daniel Mckee spoke about the important role home care plays in the lives of many Rhode Island residents.

Mr. Mckee and Rep. Amore continued to discuss the positive impact of home care, to the great interest of our clients and their families who were present in the audience. These families—the very people who rely on having nurses to provide clinical care to their loved ones—can offer firsthand testimony as to why home care is so vital.

Eric Olson—the father of client Liam and a long-time home care advocate—explained that the nurses who work with his son have such a connection with him. They understand that many of Liam’s movements are actually the way he communicates what kind of care he needs from moment to moment. He went on to explain that, without the close connection that the nurses have with his son, Liam would not be where he is today. With their help, he has thrived, despite his dependence on many mechanical devices. Eric went on to underscore how important it is that the families work with the elected officials, as they have the ability to make positive change.

“Our goal today was to bring enough of these voices together so we can start to make a difference.  Not just for families in this room, but for all families who want to keep their loved ones at home,” Dave said.  Side by side, BAYADA and the Rhode Island Partnership for Home Care provide significant support to the goals of legislators and families who depend on home care. We are working together for a better tomorrow for all home care services in Rhode Island.