Rhode Island Risks Missing Its Moment to Advance Real Health Equity

Wednesday, October 22, 2025

Nicholas Oliver, Executive Director of the Rhode Island Partnership for Home Care

View Larger +

PHOTO: Hush Naidoo Jade, Unsplash

Rhode Island stands at a crossroads. The federal Rural Health Transformation Program (RHTP), a 10-year, $50 billion opportunity to reimagine healthcare delivery in rural and underserved areas, offers our state a once-in-a-generation chance to correct a long-standing inequity: the lack of meaningful access to care for residents in outlying communities. Yet, as state officials prepare their application, Rhode Island appears poised to overlook the most effective, most immediate and most sustainable solution to this problem, which is care delivered in the home.

From Tiverton to Burrillville and from Westerly to Foster, there are Rhode Islanders who live miles from the nearest clinic, hospital or bus stop. For these residents, many of them elderly, disabled or chronically ill, simply getting to a physician’s office can be a day-long ordeal or an impossible task. Our state’s health disparities are not just about income or insurance; they are geographic and structural. The only reliable bridge to those who are otherwise unreachable is the network of home care providers already serving on the front lines of our dilapidated health system.

GET THE LATEST BREAKING NEWS HERE — SIGN UP FOR GOLOCAL FREE DAILY EBLAST

Home care agencies bring skilled nurses, therapists, nurse assistants and homemakers directly to patients’ and client’s doorsteps. They operate where infrastructure ends, such as on narrow rural roads, in remote villages and in neighborhoods long forgotten by larger institutions. However, these services and their workforce faces its own challenges: travel distances, fuel costs, cloud-based technology limitations, unreimbursed time between visits and a lack of incentives to take on difficult-to-reach cases. The RHTP funding could change all of that if Rhode Island chooses to include meaningful reformations for home care services in its proposal.

Investing in home care is not a luxury; it is the simplest and most cost-effective path to health equity. Every dollar spent enabling home care professionals to reach isolated residents saves multiple dollars in avoided emergency visits, hospitalizations and long-term institutional care. More importantly, it allows Rhode Islanders to remain safely in their homes, close to their families and connected to their communities. Home is the place where Rhode Islanders most want to receive care.

Our state health and human service leadership must be willing to take measured risks and think beyond the traditional facility-based models that have defined and deteriorated our local healthcare infrastructure for decades. The Rural Health Transformation Program is not just another federal grant competition, it is a test of our state’s willingness to act on its promises about health equity.

If Rhode Island fails to dedicate meaningful attention and resources to home care in its RHTP proposal, it will once again be the most vulnerable who pay the price. Without real action, our leaders’ rhetoric about “moving the needle” toward health equity will remain just what it is — all talk.

Rhode Islanders deserve better. The people who cannot drive, cannot wait on a bus that never comes and cannot easily travel to a clinic deserve more than empty promises. We deserve healthcare that comes to us. It’s time for Rhode Island to prove that “health equity” is not a campaign slogan, but a commitment that begins at home.

Nicholas Oliver, MPA, CAE, is the Executive Director of the Rhode Island Partnership for Home Care.