From the Winter 2025 Newsletter
Advocating for Home Care: More than just Preserving Medicaid Funding
The fight to secure the Medicaid cost inflation factor (CIF) for home care in the State Fiscal Year 2026 (SFY26) budget is not just about numbers on a balance sheet—it’s about the future of Rhode Island’s home care industry. The stakes are high and the impact of these decisions reaches far beyond Medicaid reimbursement rates. It influences commercial and private pay rates for both skilled and personal care services, affects the sustainability of home and community-based services and ultimately determines the quality of care our clients and patients receive.
Governor Daniel McKee (D-RI) and the Rhode Island General Assembly (state legislature) face a daunting road ahead to balance the state’s next budget without significant cuts. Home and community-based services, including home care, are at risk of losing essential funding and the rates newly implemented in the current state budget. For those of us in the industry, this is not the time to stand by—it’s the time to act!
Why the Medicaid CIF Matters
The Medicaid CIF is more than a line-item in the state budget. It ensures that home care providers can adjust their reimbursement rates to account for annual cost increases, such as rising wages, fuel costs and supplies. Without it, providers are left absorbing these costs, threatening their financial viability and ability to deliver quality care.
But the impact doesn’t stop there. Medicaid rates often serve as a benchmark for commercial and private pay rates. If the CIF is cut, it creates a ripple effect, driving down rates across the board. This makes it harder to attract and retain skilled staff, jeopardizes care quality and places additional financial strain on families relying on private pay services. Plus, in recent years, fluctuations in Medicaid rates, especially proposed cuts, never mind implemented cuts, in each state have been discussed and factored for Medicare-contracted home health and hospice cuts recommended to the U.S. Centers for Medicare and Medicaid Services (CMS) by the Medicare Payment Advisory Commission (MedPAC).
The Road Ahead
Governor McKee and state legislators are navigating a challenging fiscal landscape. While the economic climate demands tough choices, it’s critical to remind them that cutting funding for home and community-based services is short-sighted. These services keep people out of expensive institutional care settings, saving the state money in the long-run and supporting the dignity and independence of Rhode Islanders.
Collective Advocacy Is Essential
Securing the CIF in SFY26 and protecting home care funding will not happen without a united front. We need collective advocacy at every level—from direct care and operations staff to administrators. Here’s how we can make our voices heard:
Engaging Direct Care and Operational Staff: The stories of our caregivers and operational staff are powerful. They are the ones providing or ensuring critical services to clients every day. Their firsthand accounts can highlight the real-world impact of budget decisions. Encourage staff to share their experiences and participate in advocacy efforts.
Administrator Participation: Administrators must take an active role in meetings set by the association with key legislators. By demonstrating the financial and operational challenges providers face without adequate funding, we can make a compelling case for preserving the CIF.
Storming the State House: There is strength in numbers. We must mobilize our workforce, clients and families to attend hearings and advocate for home care funding. A strong presence at the State House sends a clear message to decision-makers: home care is essential and cuts, including pinning one or more community-based program or service such as home-delivered meals or senior centers against home care, is unacceptable.
A Call to Action
The path ahead will not be easy, but the stakes are too high to back down. By coming together as an industry, we can fight to preserve the Medicaid CIF and protect the future of home care and other vital community-based services that help keep vulnerable Rhode Islanders safe and supported in their home.
Let’s make our voices heard! Engage your staff, participate in advocacy efforts and join us in storming the State House this legislative session. Together, we can ensure that Rhode Islanders will continue to have access to the quality home care services that they deserve.