Sending a S.O.S. to the Governor During Nurses Week

May 6, 2020 — Sending a S.O.S. to the Governor During Nurses Week
By: Nicholas Oliver, Executive Director

Happy Nurses Week to every nurse throughout Rhode Island, especially those of you that work in home care. You have my gratitude and continuous support. Thank you for your bravery and professionalism as you continue to provide optimal care during the COVID-19 public health emergency.

One week ago, I sent a letter to Governor Gina Raimondo requesting her support for Rhode Island’s home care providers as she prepares to lead our state through its first phase of the reopening process. One week seems like a lifetime ago during this public health emergency, but this weekend is only a couple of days away. As our state economy reopens and the public restrictions loosen, our state’s public health experts are advising us of a surge in COVID-19 positive cases in the community. Some of these patients will require sub-acute and post-acute care from a home care provider. However, without the adequate resources needed to deliver optimal care, home care providers will not be able to support the surge of community cases. 

Vincent Ward, President of the Board of Directors for the Rhode Island Partnership for Home Care, was interviewed by Tara Granahan on her NewsTalk 99.7 FM & AM 630 WPRO radio show on Friday, May 1, 2020. The conversation that aired between Vinnie and Tara provided the public with an exceptional overview of our plight and the need for an immediate response from our Governor to support home care at this stage of the public health emergency. I am encouraging everyone to listen to this interview at Thank you Doug MacGunnigle, Program Director at NewsTalk 99.7 FM & AM 630 WPRO, for sharing this link with us.

It is my hope that Governor Raimondo will respond to this letter before beginning to open the economy this weekend. Rhode Island’s next wave of COVID-19 positive patients in the community, along with their home care nurses, nurse assistants and therapists need the support of their Governor more than ever. 

April 29, 2020 

The Honorable Gina Raimondo
Office of the Governor
Rhode Island State House
82 Smith Street
Providence, RI 02903 

Dear Governor Raimondo,

As Rhode Island embarks on your “Reopening” Initiative, home care will become the next primary healthcare setting for our state’s battle against COVID-19. We are already experiencing demand for our services as some patients have been and will continue to be discharged from hospitals and nursing homes to home care and others strive to avoid hospitalization by seeking admissions to home care directly. Because home and community-based healthcare providers are currently in desperate need of access to resources, many of Rhode Island’s home care providers are not ready to tackle the incoming surge for our healthcare services. Prior to entering Phase I or the “Testing the Water” portion of your state reopening plan, the Rhode Island Partnership for Home Care (“The Partnership”) would like to work with you and your administration to ensure that Rhode Island has adequate resources to deliver optimal sub-acute and post-acute healthcare at home for COVID-19 patients. 

The Partnership is seeking the following accommodations to support “Reopening” and prepare for the increased need for sub-acute and post-acute healthcare services in the homes of COVID-19 patients:

  1. Access to an adequate supply of personal protective equipment (“PPE”): Home care providers have not received the necessary supply of PPE during  this public health emergency (“PHE”) to date. Because The Partnership and its providers have not been able to compete in the marketplace against the federal government, state government, hospitals and nursing home conglomerates, nor have received the necessary minimum PPE from the state stockpile, The Partnership issued guidance on April 6, 2020 to state government representatives and community referral sources restricting COVID-19 related admissions from hospitals and skilled nursing facilities to home care. Once all of the home care providers can access an adequate supply of PPE, these providers can lift their admissions restrictions.
  1. Inclusion in the “Congregate Care Workforce Stabilization Fund” or the development of a similar fund for the home care workforce: While those that work in nursing homes and assisted living facilities need wage increases and resources to continue to provide care, so do those that work in home care. Home care nurses, therapists and nurse assistants work in congregate settings as well. We are continuing to provide hospice care in nursing homes, rehabilitative and personal care in assisted living and elder high-rises and all of these services in every zip code of the state to over 20,000 Rhode Islanders. With a workforce of approximately 7,800 clinicians and paraprofessionals, our services are larger than any hospital, nursing home, assisted living, group home, high-rise or any other congregate setting within Rhode Island’s borders. We experienced enough difficulty competing with wages in these settings prior to the PHE. Certainly, we cannot retain and expand our workforce to treat COVID-19 patients with the additional pressure for higher wages without opportunities to provide wage parity as our congregate setting peers.
  1. Support to conduct mobile testing for our patients and the homebound community: Within a week of your PHE declaration, dozens of home care nurses offered to conduct testing for the homebound that are unable to ambulate to a testing site because of their complex health issues and already compromised immune systems. Unfortunately, we are still awaiting a response from your administration on reimbursing these nurses for their time and travel and offering protection for these nurses that would be transporting viral specimens. Because many of these homebound Rhode Islanders are already home care patients, it would be comforting to have nurse that they already know come into their home and conduct that test over the current concept that has been proposed to you for having strangers in military uniform and donned with full PPE entering into the homes of our already frightened elderly and disabled patients that are viewing the daily statistics of people sick and dying of COVID-19. Because of our training and experience with delivering compassionate care in the home daily, it would be a better experience for our patients and other homebound people that cannot ambulate to a testing site versus utilizing the Rhode Island National Guard to enter into these homes for this purpose.

With your support to ensure that home care providers have the proper protective equipment, adequate financial resources and ability to continue to support our patients during the remainder of the immediate PHE and throughout the reopening process for our state, we can meet the upcoming challenges together to reduce the spread of community infection and enhance outcomes for those Rhode Islanders impacted by COVID-19. 

I am looking forward to receiving your response to this request to partner on this next phase of the emergency.

Nicholas Oliver, MPA, CAE
Executive Director
Rhode Island Partnership for Home Care

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