Governor Gina M. Raimondo today signed legislation (S 2734 and H 7803) at East Providence-based Goldsmith Manor establishing an Individual Provider model (IP) for home care in Rhode Island. The model will give seniors and people with disabilities another option to be cared for at home where they can continue to reside in their communities with families.
Under the IP model, which has been in place in Massachusetts since 2008, consumers would still be the direct employer who determines when to hire or fire an employee, but the state would take on responsibilities for maintaining a registry of qualified caregivers, and would set parameters such as rates, qualifications and hours.
Choosing the Right Independent Provider
“Rhode Islanders should be empowered to choose what model of care is right for them,” Raimondo said in a statement. “For a lot of people that might mean choosing an individual provider they know and trust. This bill ensures that kind of individual care that helps people lives more independent lives can be provided in a structured, consumer-friendly and transparent way.”
The bill allows the individual provider workforce to collectively bargain. The state will train, certify, set wages and qualification standards for the workforce. The state will also maintain a list of certified individual providers from which individuals and their families can choose.
“I enjoy caring for my clients and ensuring they can get good consistent care,” said Cindy Dennis, an East Providence home care worker for four years and mother of four, who spoke at the bill signing. “But at times, the clients do not get the quality of care they deserve due to the high turnover and low pay of our field. This bill will give clients another choice for how they receive home care, and help give workers like me a living wage and a voice that is heard.”
“Presently, Rhode Island ranks 42nd in the nation in terms of investment in home care. Ninety percent of older Americans prefer home care. Not only is it more comfortable for seniors, it’s more cost-effective, as we’ve seen in states like Massachusetts. High-quality home care is what people want, and it saves money. I’m proud to support this effort to help make excellent home care available to more Rhode Islanders,” said Senator Mary Ellen Goodwin (D-Dist. 1, Providence).
Said Rep. Christopher R. Blazejewski (D-Dist. 2, Providence), “There is little question that people prefer to stay in their homes as long as possible. Particularly now, as the over-65 population in our state is rapidly expanding, Rhode Island must shift more of our long-term care resources toward supporting home care. Our legislation will help provide more options for home-based services, enhance access to them and establish standards that assure high-quality care.”
Home Care Group Expresses Concerns
Although the new law is backed by the Rhode Island Campaign for Home Care Independence and Choice, a coalition that includes the Senior Agenda Coalition, RI Working Families Party, RI Organizing Project, District 1199 SEIU New England, RI AFL-CIO, Economic Progress Institute and the RI Chapter of the National Organization of Women, the Rhode Island Partnership for Home Care opposed the legislation when it came before the Rhode Island General Assembly.
While most who testified before the Senate and House panel hearings came to tout the benefits of bringing IP caregivers into the homes of older Rhode Islanders and persons with disabilities, Nicholas A. Oliver, Executive Director of the Rhode Island Partnership for Home Care, saw the legislation’s impact differently. He sees the new policy “duplicative and costly.”
Oliver warned that Rhode Island will be authorizing untrained and unsupervised paraprofessionals to deliver healthcare to the state’s most frail seniors without Department of Health oversight, without adherence to national accreditation standards for personal care attendant service delivery and without protections against fraud, waste and abuse.
With the Rhode Island General Assembly bringing IPs into the state’s health care delivery system, the state’s Executive Office of Health and Human Services, granted authority by the legislation to develop the program, might just consider establishing a Task Force of experts to closely monitor the progress of the new IP program’s implementation to ensure that quality of care is being provided and to make suggestions for legislative fixes next year if operational problems are identified.