One of the largest parts of the agreement is a $250,000 investment by the state to establish a jointly administered training and professional development fund. This program will help to improve the quality of care and early learning delivered by care providers. Those who are part of CCAP will also receive their first reimbursement rate increase since 2008.

“We have taken a big step forward in making it easier for working parents to find quality child care options in their communities that meet their work schedules,” SEIU District 1199NE Executive Vice President Patrick Quinn said. “All workers deserve a living wage and this historic agreement shows that Rhode Island is ready to recognize and live up to the value of the important work of our early educators.”

RI KIDS COUNT data shows that more than 70 percent of Rhode Island children under the age of six have parents who work, and are in child care at least part time. The Department of Human Services also reported that CCAP served approximately 5,800 families and 9,400 families in July 2015.

“Investing in our kids, and the systems that care of them, is essential to ensure everyone has an opportunity to make it in Rhode Island,” Governor Raimondo said. “Providing quality, affordable child care removes a critical barrier to getting and keeping a job for many of our hardworking families, improves the development of our kids and prepares them for success in the classroom. I am pleased that we have reach an agreement with SEIU to enhance our commitment to high quality child care and support working families.”

SEIU 1199

The press conference was part of a “Day of Action” at the State House, and was followed by SEIU members presenting their ideas to their state reps and senators ahead of the day’s legislative session.

“I love my residents like my own family, but at the end of the day, I don’t bring home enough money to take care of my two daughters,” said Nichole Ward, a certified nursing assistant (CNA) at Greenville Skilled Nursing and Rehab in Greenville, who spoke of the difficulty of not earning a living wage. “After working hard, being on our feet, taking care of people for 40 hours a week, I shouldn’t have to choose between my electric bill and school supplies for my kids. We deserve at least $15 an hour.”

Patrick Quinn, executive director of SEIU 1199 and a member of the Reinventing Medicaid working group, outlined the eight points of SEIU’s plan to both cut Medicaid costs and increase wages for frontline medical workers while improving health outcomes. The eight points are expanded upon in a white paper entitled From the Frontlines to the Bottom Line.

1. Create a value based purchasing program to improve care quality and staffing in nursing homes and reduce re-hospitalization.

2. Increase transparency of “related party” finances and reporting, in effort to reduce waste, fraud, and abuse.

3. Target any nursing home rate reductions toward costs unrelated to the provision of direct care, such as Fair Rental Value and “home office” charges.

4. Focus increased revenue and rate restoration initiatives on direct resident care and workforce stability.

5. Claw Back: Recoup Medicaid reimbursements that are not used for their intended purpose, especially in regards to direct labor.

6. Cap Medicaid reimbursement for executive compensation based on facility size.

7. Realize Medicaid savings though more energy efficiency initiatives.

8. Expand Rhode Island’s Paid Family Leave Program from 4 to 6 Weeks.

Speaking in support of the SEIU’s effort was Jenn Steinfeld of the Women’s Fund of Rhode Island, who sees this as both a social justice and gender equity issue.

It’s a gender issue on two fronts, says Steinfeld, because women live longer, and therefore make up 74 percent of the elderly patients in the Medicaid system and women make up 90 percent of the direct care workforce. Additionally, the over representation of minorities in the field makes this a racial justice issue, notes Steinfeld.

CNAs Dawn Auclair and Manoucheka Robert both spoke about the attachment they have to their patients, the importance of their work, and their difficulty in performing this valuable work for such low pay.

Sarah Nolan, who works for the SEIU International Policy Department in Washington DC, said that the white paper they have released focuses on both short and long term solutions to the problems in Medicaid quality and cost. She also stressed the importance of front line medical workers playing a role in these discussions.

Near the end of the press conference, CNA Nichole Ward explained that experience is key when dealing with patients. Cutting costs and worker turnover can raise the stress level of front line health care workers, and residents in nursing homes can sense that stress, even if healthcare workers think they are hiding it.

Such an environment cuts against the efforts to improve health care.

Representative David Cicilline hosted U.S. Secretary of Labor Tom Perez in Pawtucket Friday afternoon as part of “a roundtable discussion on paid leave.” Also on hand were Senator Jack Reed, Congressman Jim Langevin, State Senator Gayle Goldin, RI Department of Labor and Training Director Scott Jensen, Rhode Island AFL-CIO President George Nee and District 1199 SEIU Executive Vice President Patrick Quinn.

Before the discussion, held at Gold International Machinery and LNA Laser Technology, Company President Dan Gold gave a guided tour of his businesses and answered questions about the state of the local economy and his opinion about the future of his businesses. Gold was generally optimistic.

Secretary Perez was visiting Rhode Island as part of a “Lead on Leave” tour, in which “Perez and other Obama administration officials are currently traveling the country to meet with employers, workers, government officials, and other stakeholders to highlight the importance of paid leave.”

Noting the “regrettable gridlock” preventing smart policy from being implemented in Washington, Secretary Perez said that President Barrack Obama now defines success by, “how much work we can do with our state and local partners.” In this spirit, Rhode Island, along with California, Massachusetts and Washington State, is pioneering paid leave law. It is hoped that our experience will pave the way for a national system.

The United States, said Cicilline, is “one of only three countries today that does not offer paid maternity leave.” The other two are Oman, a totalitarian state, and Papua New Guinea, which has the highest levels of violence against women in the world.

Opponents say that a paid leave program will hold back business and slow economic growth, but Cicilline maintained that “nothing could be further from the truth.”

“Paid leave is good for business and employees,” said Cicilline, “Supporting programs like paid leave promotes [employee] retention, recruitment of employees and improves productivity.”

In California, 87 percent of businesses had no increased costs due to the implementation of paid leave and 9 percent of businesses, “reported that the paid leave program generated savings.” Women who receive paid leave are 39 percent less likely to receive public assistance and 40 percent less likely to be on food stamps, so paid leave can save taxpayer dollars as well.

According to figures presented by Director Jensen, about 4800 people have used the Rhode Island paid leave system in its first year after passage. 3600 used the system to care for children and 1200 to take care of family. $8.35 million was paid out, notes Jenson, so it’s a “popular program.”

State Senator Gayle Goldin was instrumental in getting Rhode Island’s version of paid leave through the General Assembly. Goldin noted that the room in Gold International Machinery where the roundtable was being held in was the same room where the Rhode Island coalition advocating for paid leave held their first press conference. She joked that the signing into law of a national paid leave act should take place in the same room.

Goldin also spoke of the many people who have told her their stories of being able to utilize paid leave under Rhode Island’s law, people who would have faced impossible financial, emotional or health related hardships had this law not been passed. Here are three such stories, from the press conference:

Company President Dan Gold spoke from the point of view of a successful business owner. “To me, there’s business, but there’s also community, and quality of life. I believe that the business community is critical for creating a quality of life for all workers.”

So often we in Rhode Island talk about how we are behind the curve in terms of business and social justice. On this issue, Rhode Island is a leader, paving the way for the rest of the country to follow.

The first is that excessive executive salaries at Care New England, (CNE) the Massachusetts based management company that runs Women & Infants, are negatively impacting patient satisfaction. The second concern is about “travel nurses,” out-of-state temps, being hired over qualified local nurses.

Regular readers may remember the travel nurses issue being raised back in June of last year. Travel nurses are temporary employees that allow hospital management to avoid new hires and promotion within the ranks. Travel nurses arrive from out-of-state and take most of their earnings out of state with them when they leave. Travel nurses miss out on the orientation regular staff receive, resulting in more mistakes for the regular staff to correct.

Patient satisfaction has been down since 2011, says 1199 SEIU citing Press Ganey, “an independent auditor that tracks patient satisfaction.” Perhaps not coincidentally 2011 is the near Care New England brought CEO Dennis Keefe on board. 1199 SEIU maintains that Keefe’s salary doubled after his first year and now tops $1 million. Meanwhile, funding for hospital staff and patient care is shrinking.

“These folks think that this is their personal piggy bank,” says Patrick Quinn, “management has embarked on a whole scheme of things to basically cut costs, reduce staffing, increase workloads and frankly, we’re sick of it.”

Care New England has not responded to a request for comment.