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Hot Topic: New strategy to ease bike backlash
BY NANCY LAVIN | Lavin@PBN.com
HOPING TO CURB some of the resistance to bike lanes, street safety and cycling advocates are trying a different approach by offering a preview of what is to come in a busy commercial district on the East Side.
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But so far, the 1-mile stretch along Hope Street is the only area that will get temporary “demonstration” bike lanes next spring, even though the city is forging ahead with plans to add another 20 miles of permanent “urban trails” in 2022.
Property owners affected by the ongoing and upcoming bike infrastructure projects – along Manton Avenue, Broad Street and several sections of downtown, for example – were given notice primarily through city mailers, online documents and community forums.
That was the same outreach the city used for the controversial bike lanes along South Water Street, which many businesses, two colleges and even state transportation officials claimed had caught them off guard.
Along Hope Street, even skeptics seem to appreciate the chance to see how the urban trail project would work long before it is scheduled to be installed permanently.
In fact, while the Hope Street lanes are included in Mayor Jorge O. Elorza’s 2020 Great Streets Initiative, there are no immediate plans to build it or money to pay for it. The city only has enough funding to cover the projects planned through the end of 2022, and Hope Street is not on that list, according to Martina Haggerty, director of special projects for the city planning department.
Should the city be doing more to avoid backlash against the bike lanes before they are installed?
“There’s always more we can be doing in terms of community engagement,” Haggerty said.
Elorza pointed to door-to-door conversations with Broad Street businesses, including the food trucks that frequent the area, as an example of nontraditional engagement.
But realistically, city officials say, they don’t have the funds or the manpower to put on a demonstration project in every neighborhood where it wants to add a bike lane.
Even the Hope Street project, which is being organized by Providence Streets Coalition, not the city, using funding from e-scooter company Spin, will take months of planning and volunteers, said Liza Burkin, coalition organizer.
And no matter how many test projects are done, there will always be detractors.
“Regardless of how much outreach you do, right before any major project launches, there are always folks who come out and say they’ve never heard of it,” Elorza said. “At some point you
NIRVA LAFORTUNE, Providence city councilwoman
just have to balance outreach with getting the work done.”
Still, there could be ways to win over the business community more effectively. Asher Schofield, co-owner of Frog & Toad LLC on Hope Street, said he thought more emphasis on the many studies showing how bikefriendly cities boost area businesses would help.
A better argument might be the economic growth that a walkable, cycle-friendly city can create, Schofield said.
“For me, the potential for increased economic activity stemming from a fluid bike corridor on the East Side is very appealing,” he said. “At the end of the day, I have to ask, ‘Is my business offering a product that my customer might park and walk an extra block for?’ If the answer is no, I have much bigger problems than a bike lane.”
City Councilwoman Nirva LaFortune, a mayoral candidate, stressed the strategy is not a one-size-fits-all approach. Not everybody can attend a weeknight meeting, or they might miss a mailer sent to their business.
“The important thing is to make sure we’re hearing all voices,” she said. “They’re not all going to agree. But at least then, no one can say we didn’t engage.” n
DENTAL CARE
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in 1992, the roughly 25% of dental fees covered through the program is proving to be insufficient, even as the nonprofit continues to serve more clients than ever, Gadbois said.
And the impact of inflation and other new costs – including COVID-19-related expenditures – have made the financial situation even worse for Carelink’s mobile dentistry clinic, Gadbois said. It’s now becoming tough to make ends meet, while still providing adequate pay to retain its skilled team of dental professionals, she said.
“Demand is outpacing our ability to serve everyone who needs mobile dental care right now,” Gadbois said. “The issue becomes one of access for our most vulnerable citizens. It’s a problem for all adults dependent on Medicaid for their dental coverage.”
There’s now a $135.69 gap between the costs incurred for each Medicaid patient seen by the CareLink mobile clinic and the amount that’s reimbursed through Medicaid, marking the largest deficit for dental visits that the nonprofit has ever seen, Gadbois said. This comes as the CareLink mobile clinic caseload has hit a peak, with more than 14,000 visits per year serving 3,000 patients at 53 nursing homes.
Concerns over the compensation rates have been long-standing, causing most dentists in private practice to refuse or severely limit the amount of Medicaid patients they see. And the amount of private practice dentists submitting Medicaid claims has dropped in recent years, with less than 18% of dentists seeing any adults covered by the state’s Medicaid program, down from 29% of all Rhode Island-licensed dentists in 2012, according to R.I. Department of Health records.
The burden has shifted to busy nonprofit dental clinics and federally qualified health centers that are seeing a disproportionately large number of these clients, according to an October 2017 report from the state health department.
“I think it’s just come to a crisis point, where the access has just become more limited,” Gadbois said.
CareLink officials warned that a failure to meet the dental health needs of Medicaid patients could be a much bigger health problem in the future, due to the association between poor oral health and chronic diseases such as diabetes and heart disease. Preventative dental care pays for itself, warding off more costly Medicaid-covered emergency room visits, CareLink says.
“The rate that was established in 1992 doesn’t reflect the 2021 operation costs of our efficient organization,” said Dr. Jeffrey Dodge, lead dentist with CareLink’s Mobile Dentistry Program. “Investing in this program will save the state money in future health care costs.”
State Sen. Louis P. DiPalma, D-Middletown, had pledged to file legislation supporting in-
CRUCIAL CHECKUP: Margaret Vargas, right, a dental hygienist with nonprofit CareLink Inc.’s mobile dental clinic, conducts an examination of Sister Anne Kelly at The Villa at Saint Antoine in North Smithfield. The clinic serves 3,000 patients at 53 Rhode Island nursing homes.
PBN PHOTO/MICHAEL SALERNO
creased funding for mobile dentistry programs. The senator said he also learned of a new proposal by the state Medicaid program that offers greater compensation and covers more dental services. DiPalma said he is going to support that plan and will still file a bill in the upcoming legislative session urging Gov. Daniel J. McKee to adopt recommended changes.
“We need to address the health and welfare of Rhode Island’s most needy folks,” DiPalma said. “If we’re not looking out for them, nobody is.”
McKee’s office and the Department of Health did not immediately respond to requests for comment.
The fiscal year 2023 budget request from the
R.I. Executive Office of Health and Human Services
proposes an injection of $9.2 million to enhance Medicaid-covered dental care, with roughly $3.2 million of that from the state’s general revenue and $5.9 million from federal funds.
Of that, $7.2 million is proposed to boost reimbursement rates. And $746,979 is specifically set aside in the proposal to boost the state’s mobile dental services offered by CareLink, increasing the baseline reimbursement from $102 per encounter to $180 per encounter, enabling mobile dentistry to reach 1,500 additional Rhode Islanders per year.
The funding request states that increasing the rate to compensate providers for at least 60% of the costs of providing service to Medicaid patients, rather than the roughly 25% offered now, will lead to better participation among private dental practices and alleviate problems with access to care. Department of Health data provided shows that African Americans and Latinos are three times more likely to visit a hospital emergency room for tooth-related pain or infections.
However, Martha Dellapenna, director of the Center for Quality, Policy and Financing at the Washington, D.C.-based Medicaid/Medicare-CHIP State Dental Association, said she’s skeptical about seeing significant changes in compensation. Dellapenna, a Warwick resident who previously served as Rhode Island’s dental program manager at the Office of Health and Human Services, said she’s seen failed attempts before.
The sheer amount of state funding required has been a roadblock, she said.
“The rates are so low that it’s going to take a lot [of state funding],” Dellapenna said. “Dental health is considered the bottom of the totem pole. So, there’s not a lot of time and energy spent to solve the problem.” n
