Raimondo: Virus illustrates need for big changes in state’s health care system

Though the numbers are trending down, Covid-19 is still very much present in Rhode Island, Gov. Gina Raimondo said during her daily briefing Thursday. 

Since Wednesday, 14 more Rhode Islanders have succumbed to the virus, bringing the state’s total to 756 deaths since the start of the crisis. On Wednesday, 3,226 residents were tested across the state and about 3 percent tested positive. There are currently 185 Covid-19 positive patients being treated in Rhode Island hospitals, down four from Wednesday.

For those residents and all other Rhode Islanders, access to quality and affordable health insurance is a major issue, and Gov. Raimondo talked Thursday about the need to do a better job delivering affordable and quality services to all, not just during this crisis, but permanently: 

“In many ways the virus has brought many Rhode Islanders away from the health care system,” she said. “We’ve seen a real drop in primary care office visits; we’ve seen vey concerning drops in immunizations in our kids.”

The virus “has highlighted the pressing need of rooting out inequities in our health care system. We need to invest in our health care system, particularly for the most vulnerable among us, and in a way that is fair and equal and equitable across the board.”

Long-term vision

Addressing the inequities in the state’s health care system will take place on many fronts, she said, and the system “will not look the same a year from now as it does now.”

To get to a better place, she said, the state needs to:

1. Invest in primary care;

2. Invest in community-based health care services;

3. Invest in prevention;

4. Invest in tele-medicine and tele-health, in which patients can see doctors remotely, from the privacy of their homes.

“We have to reduce duplication, excess (and) inefficiency so that the money we’re spending goes to the point of care.”

Luckily, she said, the state has long been committed to health care reform, and efforts on that front predate the crisis. Last year, Gov. Raimondo said, the Rhode Island Foundation put together a group to “really double down” and think about Rhode Island health care. Thursday afternoon, she said, she will sign an executive order affirming the state’s commitment to that group’s efforts so that over the long run, we can “make sure that (the state has) a long-term health care plan.”

She said she would have more information later in the week on steps the state will take to dress health care inequities and inefficiencies in the long term.

Hospital relief fund

Other steps are already underway, she said. Last week, Rhode Island launched a hospital relief fund, and will invest up to $150 million of the state’s federal stimulus funds to help hospitals offset immediate costs and prepare for the future.

“We asked hospitals to cut down on the services they were delivering,” she said.  As a result, “they saw massive losses in their revenue, and at the same time their costs were increasing. So we need to be there for them.”

The $150 million is not the end, she said; there will be more to come.

Pediatric advisory council

Another new initiative is a pediatric advisory council that will be led by Department of Health Director Dr. Nicole Alexander-Scott. Pediatric practices have been hit hard by the crisis, and there are reports that childhood immunizations have dropped 35 to 50 percent since it began.

“That’s a disaster waiting to happen,” she said. “If we don’t fix that now, next winter that’s going to result in potentially devastating health care issues.”

Gov. Raimondo said she understands that parents have been concerned about bringing their children to medical centers to get their important immunizations. But she said facilities are safe, and they should go ahead and make those important appointments for their children.

“Call the doctor, schedule an appointment and get those immunizations,” she said.

Tele-health

The state is taking other immediate steps to reduce health care inequities and roadblocks, including promoting the use of tele-health and tele-medicine for those who don’t have cars or otherwise can’t get to doctors’ offices. The governor recently signed an executive order to direct insurers to cover visits conducted over the phone or by video conference at the same reimbursement rate that in-person visits are covered. She announced Thursday that she will extend that executive order until July 5, and hopes to make it permanent by statute.

“In certain specialties it’s an excellent substitute,” she said. “I want to continue to break down barriers for access to health care.”

Nursing homes and congregate care settings

More than a month ago, the governor pledged to supplement the pay of all congregate care institution employees who earn less than $20 per hour. These are employees in group homes, nursing homes, the Rhode Island Veterans’ Home - all places where large groups of residents co-habitate.

On Thursday, she announced that the supplemental income for those workers will continue through Monday, June 15.

“These are people who are working in very very difficult, scary situations,” she said, adding that there are currently staffing shortages at many nursing homes. 

“We are doing this in order to make sure that our nursing homes have the staff they need.”

Lay of the land

Apart from talk of health care, the governor said Thursday that, overall, she is pleased to continue to see the numbers of infections and hospitalizations trend downwards. Restaurant and other restrictions started easing up two weeks ago and, if it had led to increased cases, “we would have seen that now.”

But that hasn’t happened, she said.

“It’s all good, it’s really good, and it’s what we want to do,” she said. “We want to continue to get back to business.

But the virus isn’t gone, Gov. Raimondo warned.

“It isn’t going to be gone. It’s still here, it’s still dangerous. We’ve just learned how to deal with it. Even though we are leaving our homes ... please follow the rules. Social gatherings are limited to 15. If you can work from home, work from home. Wash your hands, wear your mask, do not go out if you feel sick.”

“If we double down on the rules we will continue to re-open the economy and continue to be safe.”

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