CityState: Reporter
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benefit programs. In practice, UHIP nearly
cut off the flow of Medicaid, which supports
the majority of nursing home patients in the
United States. That was on top of the slow
starvation diet state leaders had imposed
on the homes by failing to provide the
required Medicaid Inflation Index increases
for eight years running.
Slim budgets have meant bottom-of-thescale
wages for workers, and it was common
for staffers to work in multiple homes to
try to make ends meet, says Scott Fraser,
president of the Rhode Island Health Care
Association. Controlling COVID added
operational costs as their workforce was
diminished by fear and an illness that could
be easily transmitted as staff moved among
different facilities.
“The state’s nursing homes have been
underfunded for years and still, we have
been able to provide high quality services,”
he says.
Hospital-based care suffered from a lack
of planning, says Linda McDonald, president
of United Nurses and Allied Professionals,
which represents 6,500 nurses, technologists,
therapists, support staff and other health
care workers in Rhode Island, Vermont and
Connecticut. Supply shortages forced
infectious disease control protocols — like
single-use personal protective equipment
— to be abandoned. Critical conversations
about screening incoming patients and
separating the COVID positive from others
were late. Hazard pay for the workers who
put themselves in harm’s way — including
the housekeeping staff — was another
after-thought.
“Never again will we allow ourselves to
be so unprepared for a crisis,” she says.
“I’m not convinced we are ready for the
next one. We have not had the conversation
about testing and screening. We need
policies already in place when the next
wave comes, when the next virus hits.”
In June, Governor Gina Raimondo began
talking about the pandemic as a catalyst
to make the health care system more
efficient and responsive. Dr. Michael
Fine, former director of the state health
department and currently Central Falls’
chief health strategist, believes that this
conversation is long overdue.
“It’s not a health care system,” he says.
“We do not have services we can deliver in
a systematic way to everyone who needs
them. We have people who sell the service
32 RHODE ISLAND MONTHLY l AUGUST 2020