To bolster primary care workforce, R.I. offers grants to train next generation of doctors
'Primary care is the backbone of the healthcare system in Rhode Island,' Dr. Jerry Larkin, the state's director of health, said in a statement. 'This program will encourage trainees in primary care to remain in Rhode Island after completing their education, and it will enhance Rhode Island's clinical training capacity.'
Get Rhode Island News Alerts
Sign up to get breaking news and interesting stories from Rhode Island in your inbox each weekday.
Enter Email
Sign Up
The nation's number of primary care providers has declined in recent years, as has the number of new physicians entering primary care, according to the Milbank Memorial Fund's 2025
Advertisement
In 2022, only 24.4 percent of new doctors began careers in primary care in the United States – or 19.8 percent when excluding hospitalists – the lowest rate in a decade. The decline in 2022 marked a steeper decline, year over year, compared to prior years.
'Right now, Rhode Island is on track to be short about 100 primary care providers by 2030. That's a shortage large enough to mean 1 in 5 Rhode Islanders will be unable to find a primary care provider,' state Senator, Pamela J. Lauria, a Barrington Democrat, said in a statement. 'As a state, we must recruit, train, retain, and sustain the number of primary care providers necessary to meet the health demands of all Rhode Islanders.'
According to officials, the grant program will expand 'interdisciplinary clinical training at advanced primary care sites' with an aim to boost the state's training capacity by 50 percent for physician assistant students, physician residents, and nurse practitioners.
Advertisement
Right now, the Care Transformation Collaborative of Rhode Island is working to develop the curriculum that will be used to train students, officials said.
'The Primary Care Training Sites Program is one of many steps we are taking across our administration to bolster primary care in Rhode Island,' Governor Dan McKee said in a statement. 'Accessible, quality primary care can lower rates of chronic conditions, lessen the burden on our hospital system, and bring down Rhode Island's overall healthcare costs in line with the goals of our RI 2030 plan.'
McKee is eyeing other measures to help bolster the state's primary care network through his budget proposal, including measures officials said will serve as 'a crucial step toward fostering a more competitive primary care job market in Rhode Island.'
Last month, the Rhode Island Senate also
Material from a previous Globe story was used in this report.
Christopher Gavin can be reached at
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
8 hours ago
- Yahoo
Biden's diagnosis shows two things. Cancer hits everyone and some forgot that
Earlier this week, former president Joe Biden announced that he'd been diagnosed with an aggressive form of prostate cancer. For the millions of us who've been told, 'You have cancer,' this kind of diagnosis is a deeply personal and painful moment that takes time to absorb. Then, we're faced with what seems like a zillion other questions, including whether to reveal the diagnosis and to whom. It was wrenching when I heard those three words when I was only 26. Days before Biden's announcement, a friend wrote to let me know that she'd been diagnosed with breast cancer, and that she had waited two weeks before telling anyone but her husband because she wanted her son's wedding to go off without a cloud in the sky. As she put it, 'Two weeks before the wedding, I heard, 'Yes, it is breast cancer and it's in the lymph nodes so we need to see if it's spread….'' She has a sense of humor, and so she continued, sharing her to-dos. 'All the scans and tests and MammaPrint—breast cancer crash course on staging, chemo, radiation, surgery, reconstructive surgery, wigs, side effects … oh, and don't forget to order the flowers for the rehearsal dinner.' There is no one-size-fits-all when it comes to cancer. We try to do the best we can. Upon hearing the news, most politicians—whether Republican or Democrat—issued heartfelt statements of condolence, similar to what Senator Susan Collins (R-Maine) posted on Facebook: 'I am saddened to hear of President Biden's cancer diagnosis and am wishing him and his family well as he begins treatment.' If you're taking notes, this is what you do when a friend, family member or colleague tells you they have a serious illness. You may even add in a hug. Opinion: Republicans keep clinging to Biden's health to ignore Trump's decline I couldn't help but notice that after some perfunctory condolences, others jumped in accusing Biden of a cover-up. As one commentator said on Fox News, 'That's a terrible thing for him and his family, so I hope he beats it. But look, I don't believe that they just found out Friday because they're not credible on anything they've done.' That turned into a drum roll, leading to bipartisan conspiracy theories about when Biden knew. 'I don't think it's coincidental that this was announced this week,' former Representative Dean Phillips (D-Minnesota) told the New York Times. 'It's hard to comport otherwise.' It doesn't help the president's case that Original Sin, a book by Jake Tapper and Alex Thompson, had just been published, alleging Biden insiders papered over his cognitive decline. The current president weighed in, too, telling reporters: 'I'm surprised that ... the public wasn't notified a long time ago because to get to stage 9 [the stage of disease that Biden faces is] that's a long time." Trump added, '[S]omebody is not telling the facts. … It's a big problem.' By the way, Biden does not have 'stage 9' disease; there's no such thing. The nine refers to his Gleason score, which is a way of assessing how likely cancer cells are to grow and spread. Knowledge matters. Understanding, even more so. But yes, the former president has advanced and metastatic cancer. Medical experts agree that Biden had this cancer for some time, no doubt during his presidency. But 'having' it is not the same as 'knowing' it, which is also different than 'hiding' it. When my sister was diagnosed with advanced ovarian cancer in late 2017, it was clear to both of us that she'd had the disease for quite some time, likely years. But she only found that out after all the necessary tests, including a nine-hour 'debulking' surgery. Diagnosis, staging and developing a treatment plan take time, whether you're a former president or one of the 2 million Americans who will be diagnosed this year. Opinion: Republicans keep clinging to Biden's health to ignore Trump's decline Biden's critics have rushed to judgment, which is never wise, and even less so in frightening medical situations. Sometimes those of us with cancer get ahead of ourselves, too, finding ourselves going down rabbit holes. This is why I try to practice a philosophy of 'wait to worry'−or stay in the present. Patience, people. As the days go by, we're learning more. In fact, since the initial announcement, a Biden spokesperson disclosed that the president received his last known blood test, what's known as the PSA, to check for prostate cancer, in 2014, when he was 72. (He's now 82.) That's in line with the current guidelines from the U.S. Preventive Services Task Force, which 'recommends against PSA-screening for prostate cancer in men 70 years and older.' (According to its website, this recommendation is currently being updated.) More than 600,000 Americans will die from cancer this year, according to the National Cancer Institute; even with improved treatments and outcomes, this disease–'the emperor of all maladies'–is frightening. I think about my friends with this disease, not to mention my sister, and try to remember to think before I speak or tweet. And to lead from the heart because, as we all know, 'there but for the grace of God go I." Steven Petrow is a columnist who writes on civility and manners and the author of seven books, including 'The Joy You Make' and "Stupid Things I Won't Do When I Get Old." Follow him on Threads: @ You can read diverse opinions from our USA TODAY columnists and other writers on the Opinion front page, on X, formerly Twitter, @usatodayopinion and in our Opinion newsletter. This article originally appeared on USA TODAY: Biden's cancer diagnosis reminds we politicize everything | Opinion
Yahoo
10 hours ago
- Yahoo
US children struggle to catch up educationally while poverty further burdens Kentucky's kids
The Annie E. Casey Foundation's latest report on child wellbeing finds a decline in the share of Kentucky kids in preschool. (Photo by Getty Images) This story discusses suicide. If you or someone you know is contemplating suicide, please call or text the National Suicide Prevention Lifeline at 988. Kentucky's kids are struggling in school more than they did pre-pandemic, according to a new report on child wellbeing from the Annie E. Casey Foundation. While Kentucky children improved in the last few years on a few measures — more have health insurance, for example — every measure of education worsened, according to the KIDS COUNT County Data Book, released Monday. From 2019-2023, about 63% of Kentucky's children ages 3 and 4 were not in school, an increase from 58% from 2014-2018. In 2024, 67% of Kentucky's fourth graders were less than proficient in reading. That's up from 65% in 2019. That same year, most — 76% — of eighth graders in the state weren't proficient in math, up from 71% in 2019. From 2021-2022, 10% of high school students did not graduate on time, an increase from 9% in 2019, according to the report. Terry Brooks, the executive director of Kentucky Youth Advocates, told the Lantern that this new data is a 'very authentic litmus test for legislators and the governor to put up or shut up when it comes to a commitment to kids.' 'The child poverty level is really … the canary in the coal mine. It tells you not just where kids are today, but it tells you where kids are going,' Brooks said. Kentucky is the 44th worst in the nation for child poverty; one in five Kentucky children live in poverty. 'That flat out means that that is an unacceptable condition — if we care, at all, about kids,' Brooks said. Lisa M. Lawson, the president and CEO of The Annie E. Casey Foundation, wrote in the latest national report that 'while progress is uneven, the direction is clear.' 'We know what kids need to grow up healthy and connected: stable homes, strong schools, nutritious food, meaningful relationships and opportunities to learn, play and grow,' Lawson wrote. 'These are shared needs across communities — and meeting them is a shared responsibility.' In several ways, Kentucky's data is similar to the national trends. In both, the education category fared the worst — 'consistent with the pandemic's well-documented toll on student learning and school experiences' — while family and community improved. Democrat Beshear renews push for universal preschool in Kentucky Trends for Kentucky, revealed in the report, include: One in five children live in poverty, ranking them 44th on this measure. From 2019-2023, 63% of young children were not in school. That number was 58% in 2014-2018. Kentucky Youth Advocates says this shows 'a continued need for a robust early childhood education infrastructure that prioritizes early learning and care for our youngest learners.' Last week, Gov. Andy Beshear signed an executive order to establish an advisory committee that will explore support for universal pre-kindergarten programs in Kentucky. There is an 'unprecedented learning loss following the pandemic and the toll of chronic absenteeism on academic performance' resulting in 67% of fourth graders scoring below proficient in reading and 76% of eighth graders not proficient in math. Kentucky has the third highest rate among the states of children who are covered by health insurance; in 2023, 3% of Kentucky children were without coverage. The death rate for children and teenagers ages 1-19 increased by 28% in 2023 from 2019. There are fewer kids living in homes with a household head who doesn't have a high school diploma — the number dropped from 11% in 2019 to 9% in 2023. There were fewer teen births in 2023, with a rate of 21 per 1,000 ages 15-19. Despite the drop, Kentucky Youth Advocates says, 'this remains the Commonwealth's worst-ranked measure relative to other states at 46th in the nation.' In 2023, there were more Kentucky babies born below optimal weight, which can lead to health problems, than in 2019 — an increase from 8.7% to 8.8%. 'This moment calls for focus, creativity and commitment,' Lawson wrote in the national report. 'It calls on leaders at every level to act boldly where improvement is needed and rely on what we know works.' The COVID-19 pandemic, which shuttered school buildings and sent kids home to learn remotely, certainly played a role in delaying youth, Brooks said. But, he added, 'to blame it on COVID is a cop-out.' 'I don't think we can continue to blame a virus for low academic achievement,' he said. 'It may have (been) exacerbated under COVID, but it wasn't created by COVID.' In the 2017-18 and 2018-19 school years, about 17% of Kentucky children were chronically absent, the Lantern previously reported, meaning they missed more than 10% of their enrolled time at school. During the 2022-23 school year, nearly 30% of Kentucky's students were chronically absent. During the 2023-4 year, it was down to 28%. Meanwhile, the Kentucky General Assembly is too focused on 'every hot button social issue there is,' Brooks said. They need to spend more time thinking about deep policy work that can improve education marks, he said. 'It's easy to criticize schools, but it takes some imagination to improve schools,' Brooks said. A retired educator and longtime advocate for children, Brooks said the poor education outcomes Kentucky is seeing now come from multiple factors, including children's poor mental health and an inadequate teaching workforce. Other items could use lawmaker attention, Brooks said, such as the SEEK formula for funding public schools, 'both in terms of adequacy and equity,' and assessment protocols. These aren't trendy policies to work on, Brooks acknowledged: 'The assessment system is deep policy work. It's not a way to grab attention.' 'In a lot of ways, forces around education are playing chicken with one another and seeing who blinks first,' Brooks said. 'And that's not the landscape for positive change.' There are some immediate policies Brooks would like to see Kentucky lawmakers consider in 2026, which is a budget year. Those include a state earned income tax credit and also a dependent child care tax credit to address childhood poverty. 'The '26 budget is probably being crafted in the General Assembly right now. I want to see if there's any dedicated effort to address childhood poverty in this budget, as well as what the governor presents,' Brooks said. 'If there is such an attempt, then kudos go to whoever is proposing that. If not, frankly, Frankfort leaders just need to be quiet about childhood poverty because they don't really care.' Not every issue facing Kentucky's kids can be fixed with a 'magic wand' from Frankfort, Brooks said, including the high mortality rate among children. The death rate for Kentucky youth 1-19 increased by 28% in 2023 from 2019. In 2023, there were 395 deaths per 100,000, the data shows, which includes suicides, accidents and homicides. There were 22,841 deaths nationally per 100,000. The pandemic hit kids hard, leading to high rates of depression and anxiety in those separated from peers and support networks. In addition, as the Lantern has reported, access to guns and medications kill kids. 'What we see is an alarming rise in children dying either because of access to medication — and I'm not talking illicit drugs, I'm talking (about) what they get out of the medicine cabinet in their parents' bathroom — and also unsafe storage of guns,' Brooks said. A variety of medications — including over the counter pain relievers like Tylenol — can hurt kids if not taken according to directions. Experts recommend securing all medications where children cannot access them, keeping bullets separate from guns and using gun locks. 'While there's certainly an abundance of responsibility that (goes) to lawmakers and the governor, there's also an abundance of responsibility to go to moms and dads and grandmas and grandpas,' Brooks said. 'Be diligent. Use common sense when it comes to making sure that little boy or little girl can't get to your gun and shoot themselves, and they can't get to your medication and overdose.' SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
10 hours ago
- Yahoo
Oversight hearing probes failure to prevent youth deaths, substance use in R.I. child welfare system
Richard Leclerc, foreground, director of the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, searches through his slide presentation during a May 21, 2025, House Committee on Oversight hearing. At left is Department of Children Youth and Families Director Ashley Deckert. (Photo by Alexander Castro/Rhode Island Current) It's not unusual for a government agency report to anger lawmakers. It's less common a report nearly brings them to tears. This year's child fatality report from the Office of Child Advocate did both at a May 21 meeting of the Rhode Island House Committee on Oversight. 'This, by far, is the worst oversight hearing I've ever had to sit through,' Rep. Julie Casimiro, a North Kingstown Democrat, said at the afternoon meeting, a flat and gray sky visible through the committee room's windows. Casimiro choked up as she addressed Child Advocate Katelyn Medeiros after Medeiros finished giving a presentation on the May 13 report, the first public documentation of child fatalities released in six years. The report, subtitled 'A Review of Seven Fatalities and Twenty-Three Near Fatalities,' details dark and sometimes final chapters in the too-short lives of these young Rhode Islanders from 2019 through 2024. The 30 incidents all involved substances, including a 1-year-old who almost died from taking suboxone that had been left next to candy atop a nightstand. All of the youths had past or present involvement with the Department of Children Youth and Families (DCYF). The report was the first public documentation of child fatalities released in six years. Half of the report's 118 pages are devoted to case-by-case narratives. Infants and toddlers accidentally exposed to substances comprise 14 of the cases, and teenagers who knowingly took drugs made up the remainder. Incidents involving younger children were more likely to occur when living with parents or relatives. The opposite was true for older kids, who often used drugs while in DCYF placements like foster homes or treatment centers, or while on the run from home. The remainder of the report includes 19 pages of discussion plus 56 formal recommendations — some new, some old but unaccomplished, according to the child advocate. The Office of Child Advocate produced the report as part of its statutory responsibility to oversee DCYF. The hearing was attended by DCYF Director Ashley Deckert and Richard Leclerc, director of the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH), which handles substance use prevention for young adults. The week of the hearing marked Deckert's second anniversary on the job; Leclerc assumed his role in March 2024. Medeiros became the permanent child advocate two months later, although she has worked in the office since 2012, with two of those years as interim director. But Committee Chair Patricia Serpa, a West Warwick Democrat, was unconvinced that much has changed even as agency leadership shuffled. 'This is the smallest state in the union,' Serpa said during the hearing. 'And I just don't know why we can't get it together. This isn't California. This isn't Texas. The same things keep happening and happening and happening.' The DCYF budget for fiscal year 2025 was over $399 million. Deckert testified that DCYF currently has 43 vacancies out of 714 budgeted positions. That included 13 openings for child protective services investigators. The agency's collection of social caseworkers is more complete, with only three vacancies out of 213 positions. 'Our staff do this work because they care deeply,' Deckert testified. 'They carry the weight of every case and every outcome, even when the public doesn't see it.' DCYF became the first state child welfare agency in New England to receive accreditation from the nationwide nonprofit Council on Accreditation on Feb. 14. Accreditation guidelines suggest a maximum of 15 cases for one investigator, Deckert said, noting that maximum caseloads in Rhode Island range from 11 to 13. 'This report shows that the vast majority of what is being asked of us is already in process or has been done, and yet these tragedies still happen,' Deckert said. 'Child safety is not the sole responsibility of DCYF, it is the shared responsibility of every system that touches a child.' At the hearing, Casimiro asked Medeiros what she would do with the child welfare agency if she had 'a magic wand.' 'That'd be a big magic wand,' Medeiros began, then went on to describe 'a full continuum of care that can meet all levels of need here in Rhode Island' for children whose wellbeing is entrusted to the state. In 2024, there were over 2,300 children who had some contact with DCYF services, whether foster care, behavioral health referrals, or child protective services. Among the report's guidance is fortifying the state's treatment options for adolescent substance use by forging a stronger connection between DCYF and BHDDH. Medeiros noted that 14 of the 30 incidents occurred in just the last two years, which she credited partially to 'a fractured behavioral health system and a non-existent adolescent SUD [substance use disorder] continuum.' Other mistakes included delays in coordinating care across agencies, the use of residential treatment as a first rather than last resort, and the exclusion of youth from decisions about their own care. Sometimes, DCYF referrals to care providers failed to include diagnostic information or insights into the youth's history, Medeiros said. 'We're seeing a net cast so wide that sometimes the providers that are receiving the referrals are not even specifically addressing, or do not address, the specific needs of that youth,' Medeiros told the House panel. In a phone interview, Medeiros acknowledged structural quirks in how the state handles youth with both substance use and behavioral health needs. Other states may sweep behavioral and substance use treatment for youth under the same umbrella of governance. But years ago, Medeiros said, the state carved out substance use as the sole responsibility to BHDDH, regardless of age group. That means every adolescent in the fatality review had both substance and behavioral issues and needed to access services from two different state agencies — not an ideal model for planning treatment. 'We don't want kids to have to tell their story multiple times,' Medeiros said. Deckert told lawmakers she found the Child Advocate's report timing problematic. 'The decision to release multiple years of reports simultaneously, though rooted in a desire for transparency, does present a significant emotional and practical burden,' Deckert said. She said DCYF has already done much of the work the report suggests. 'It is also troubling that the Office of the Child Advocate made numerous recommendations without first acknowledging that DCYF is already implementing many of them,' Deckert told the Oversight Committee. 'This omission not only misrepresents the current state of our work, but it also undermines the efforts.' DCYF spokesperson Barb Francella confirmed in an email to Rhode Island Current that of the advocate's 56 recommendations, 22 were already underway or completed. Only three recommendations require funding: expanding DCYF's runaway investigations unit, adding a substance use coordinator position and establishing a referral policy for caseworkers whose clients need substance use treatment. Eight recommendations did not apply to the agency, Deckert said at the hearing. This report shows that the vast majority of what is being asked of us is already in process or has been done, and yet these tragedies still happen. – Ashley Deckert, director, Department of Children Youth and Families Francella's email highlighted recent efforts that address some of the report's concerns, including joining a national child safety partnership to improve fatality reviews, launching an interagency collaboration to prevent child fatalities, and expanding its slate of community-based programs by 82% to 62 partners overall. The agency is also prioritizing family-centered care as part of its 2025-2030 strategic plan. Rhode Island Current shared the email reviewing DCYF responses with Casimiro. She replied in a followup phone interview that she was 'happy with most of them' and that her communication with Deckert, which she said began strong, has improved recently. 'I believe she is making changes,' Casimiro said. She later added, 'I think Ashley is doing a great job. I mean, in these responses that you sent me, there was a little bit of fluff.' Casimiro thought Deckert 'needs to push back harder' to accomplish more profound change, but she also acknowledged the intense demands placed on Deckert's role. That was made tangible at the hearing, as Deckert, like Casimiro, had to pause and gather herself as she began to broach the serious topic at hand. The question of why the report took so long to emerge came up during the hearing. Medeiros told the House committee that for nearly two years, from 2022 to 2024, the office only had six people. 'We were kind of frozen in place with hiring,' Medeiros said. 'I was in limbo, serving as both the child advocate and the assistant child advocate.' Also taking place in that timeframe was the office's 2023 investigation and report on abuses and neglect at the now-shuttered St. Mary's Home for Children in North Providence. That report had made Medeiros a protagonist in a January 2024 oversight hearing. The child advocate's office reviews all fatalities and near-fatalities of youth who have or had a DCYF connection. Medeiros said her office is now working on another fatality report with 40 additional cases from 2019 to 2025 under review. 'Wait. Forty more?' Serpa replied. 'Yes, Madam Chair,' Medeiros said. 'That's … unbelievable,' Serpa said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
