Engaging State Legislative Leadership on Critical Budget and Policy Proposals

Bethany Skinner, President

The Rhode Island Partnership for Home Care recently met with several leaders within the General Assembly, including House Finance Chairman Marvin Abney, to advocate for essential policy provisions affecting Medicaid home care, as the General Assembly deliberates on the 2026 state budget. The meeting and subsequent committee hearings underscored the urgency of safeguarding access to quality home-based care while stabilizing the direct care workforce.

Medicaid Rate Floor Legislation

At the top of The Partnership’s agenda is the inclusion of House Bill 5774 and Senate Bill 255 in the 2026 budget. Sponsored by Representative Patricia Serpa and Senator Mark McKenney, these companion bills would establish a Medicaid home care rate floor, ensuring that managed care organizations (MCOs), such as Neighborhood Health Plan of Rhode Island, United Healthcare, Tufts Health Plan and Blue Cross Blue Shield of Rhode Island, cannot undercut rates set by the General Assembly. This protection is vital for maintaining provider financial viability and supporting frontline workforce wages.

The bills also preserve a $1.56 per hour rate enhancement for providers that meet a 30% workforce threshold of CNAs and homemakers who complete a 30-hour behavioral health training program through Rhode Island College. Without these provisions included in the budget, providers that have made significant workforce investments risk being forced to cut wages on July 1, 2025. Cutting wages will jeopardize both care quality and staff retention.

Preserving the Cost Inflation Factor (CIF)

The Partnership also urged the removal of language within Article 8, Sections 5 and 9 of the Governor’s budget proposal that would sunset the Medicaid Home Care Cost Inflation Factor (CIF). This year’s CIF was recently calculated by the Rhode Island Executive Office of Health and Human Services (EOHHS), which houses the Medicaid Program, at 7.61%. The CIF is a critical policy that offsets the inadequacies in wage benchmarking used by the Office of the Health Insurance Commissioner (OHIC), whose biennial rate review compares Rhode Island’s wages to a broad New England average, rather than more accurate comparisons like Massachusetts and Connecticut.

Eliminating the CIF would severely impact home care providers’ ability to offer competitive wages, risking further workforce attrition, pushing more residents into institutional settings and ultimately increasing costs to the state. Receiving a 7.61% rate increase at this time would help bring in and retain more staff.

Concerns Over Eliminating the Certificate of Need (CoN)

A third concern discussed was the proposed elimination of the Certificate of Need (CoN) requirement for home care, home nursing care, and hospice provider licensure under Article 10, Section 1. Rhode Island is experiencing rapid and unprecedented growth in home care licensure applications, including 33 last quarter and 16 more this quarter, raising concerns about the Rhode Island Department of Health’s oversight capacity.

History has shown that removing CoN without adequate safeguards leads to unchecked growth and declining care quality. The Partnership recommended establishing a study commission to evaluate the impact of CoN and the Governor’s rationale, rather than repeating past policy mistakes when CoN was eliminated in 1998 and subsequently restored in 2011.

Eliminating Obsolete Reporting Requirements

Finally, The Partnership advocated for eliminating outdated 2021 P.L. 162 reporting requirements for Medicaid-contracted home care providers. The wage pass-through reporting, initially implemented to track CNA and homemaker shift differentials, is now obsolete following rate increases in 2025 that absorbed this wage enhancement.

Maintaining this reporting requirement creates unnecessary administrative burdens for both providers and the EOHHS, with no added benefit to state oversight or policy.

As budget negotiations continue, The Partnership will remain fully engaged with legislative leaders and state agencies to ensure Rhode Island’s home care sector is funded and regulated in ways that protect patients, support the workforce and ensure long-term sustainability.

We encourage every home care provider to become informed and engaged as these actions impact your company’s cash flow and the stability of your employees. Contact The Partnership at (401) 351-1010 to learn how.