PROVIDENCE – During a nearly five-hour hearing Thursday evening, clients, legislators, advocates and leaders of unions, health centers, hospitals, nursing homes and social-service organizations testified in favor of a cluster of Senate bills that together would implement long-overdue increases in Medicaid reimbursements and adopt other measures aimed at improving access and the quality of health care services for needy Rhode Island babies, children and adults.
The picture they presented was of a system long neglected by the state and in deepening crisis.
“We were once in top-10 in the country and now we’re in the bottom 10 and slowly sinking into the quicksand. The system is broken and broken badly. We need to fix it,” said former state Sen. John J. Tassoni Jr., now the vice president of operations for the Substance Use Mental Health Leadership Council of RI.
“I now have waiting lists where I never had waiting lists before,” said Daniel J. Kubas-Meyer, president and CEO of Thrive, which is headquartered in Warwick. “Right now we are in a crisis situation.”
“It is unconscionable to have people waiting for services for months or in some cases for our children being denied services. We just cannot tolerate that as a state,” said Maureen Maigret, chair of the Long Term Care Coordinating Council, in a reference to the difficulties youngsters and elders experience in finding behavioral health services.
‘Find the levers of power within the system’
Patrick Crowley, secretary and treasurer of the Rhode Island AFL-CIO, spoke of how persistently low Medicaid reimbursement rates have made it difficult for nonprofit organizations to attract and retain employees when many of them, already struggling to meet payroll, cannot afford to pay competitive wages.
“It is harder and harder and harder to attract people into this work,” Crowley said. “Not just because of the long hours, not just because of the personal sacrifices that members make on a daily basis, but because [health care jobs] don’t pay well enough. And it’s about time that we find the levers of power within the system to change that and the reimbursement rates.”
Two bills sponsored by state Sen. Louis P. DiPalma, who with Rep. Julie A. Casimiro is spearheading the campaign for change, would raise those rates. Both bills have been signed by all 38 of Rhode Island’s state senators, an unusual example of bipartisan support of major proposed legislation.
Thursday’s hearing drew a crowd that packed the Senate Lounge, where testimony was heard, spilled into a corridor and filled two other rooms at the State House.
Christina Battista, who lives with a disability and is employed by the nonprofit Skills for Rhode Island’s Future, spoke of the personal-care assistants, paid through Medicaid, who help her live a fulfilling life. The thought of worker shortages leaving her or others without them is disturbing, Battista said.
“Imagine not being able to start your day because your personal-care assistant doesn’t show up for work. Imagine one day that you may need a personal-care assistant because you unfortunately cannot dress yourself, feed yourself or do any activity of daily living independently,” Battista said.
The long fight for better wages
“We have been fighting for so long to have better wages for our personal-care assistants and support staff for those that help individuals with disabilities … My personal-care assistants are my family, my friends. And without them, I wouldn’t be able to be here before all of you today.”
“The state’s nonprofit behavioral health and social services infrastructure is in the worst condition it has been since the 1980s,” said Ben Lessing, president and CEO of northern Rhode Island-based Community Care Alliance.
“One of the consequences of the depletion of the nonprofit sector is that we have now unprecedented numbers of children that are being boarded in hospital emergency rooms because there are basically no services in the community. And the waiting lists for inpatient care for children’s behavioral-health services are off the charts.
“In addition to that,” Lessing said, “what we’re hearing is that kids are stuck now in hospitals and can’t get out because there are no follow-up services both in terms of child psychiatry as well as other clinical and case-management services and so forth.”
“We need to get this over the goal line,” said DiPalma. “We need to get this done.”
