Rhode Island

Decades of inaction have wrought R.I.’s primary care crisis. We must address it right now, then nurse the state back to health. – The Boston Globe

Published

1 year ago

April 16, 2025

Decades of inaction have wrought R.I.’s primary care crisis. We must address it right now, then nurse the state back to health. – The Boston Globe

Yet, as a state, we have not properly maintained the health of our primary care environment, nor have we responded to the signs of its disintegration.

Now we must respond to a full-blown crisis.

Just as a person who suffers a heart attack receives emergency care and then is often advised to adopt lifestyle changes to restore their health, our state must deal with this crisis with emergency measures, as well as with medium- and long-term efforts to sustain and strengthen primary care.

While our Department of Health and Executive Office of Health and Human Services work to try to keep Anchor’s providers in Rhode Island, we and our Senate colleagues are working to enact legislation addressing Rhode Island’s shortage of primary care providers in the near and long term.

One root cause is clear: Primary care is reimbursed by health insurance at much lower rates than specialties, making it difficult for debt-burdened young providers to choose primary care when entering practice. Rhode Island is further disadvantaged in recruiting and keeping those who do go into primary care because our immediate neighbors are paying clinicians significantly more.

Senator Sosnowski has advocated for improved and equitable insurance payments to hospitals and providers for years. We must address reimbursement rates as an immediate step to maintain our current providers and recruit more to practice primary care here. That effort must include a Medicaid rate review for primary care providers now, not in 2027 as is proposed in the governor’s budget. It’s going to take continuing, coordinated effort to ensure our rates don’t force doctors to leave for surrounding states with higher rates, or choose other specialties.

Another immediate need is addressing the extra stressors on our primary care providers. Senator DiMario has focused on better supporting the incredibly under-resourced mental health system that would help PCPs and patients alike. We must also demand that insurers reduce the needless administrative burdens they place on primary care providers, and increase patients’ access to specialists to decrease time demands on PCPs. The R.I. Senate has focused on resolving these issues, and we currently have many bills under consideration to accomplish those goals.

Rhode Island must also make a concerted effort to encourage medical students to specialize in primary care, and to choose Rhode Island when they graduate. Senator Lauria has introduced bills that focus on those goals. One would fund four primary care residency positions annually at a community-based health care organization that provides primary care and support services to underserved populations, increasing our workforce and supporting these critical agencies. In addition, reducing student loan debt, scholarships for students entering medical school and studying to become nurse practitioners or physician’s assistants in exchange for a commitment to specialize in primary care and work in Rhode Island are all current proposals under consideration.

As we work to improve our primary care workforce, we must also build in a mechanism for accountability to consistently meet the health care needs of our communities. We need specific targets, action plans, and ongoing monitoring to first ensure every Rhode Islander has access to a primary care provider, and then to take earlier corrective action in the future, so we do not face this crisis again.

We are all members of the Senate’s commission exploring the education and retention of primary care providers in Rhode Island, whose charge, in part, is to consider the possibility of establishing a medical school at University of Rhode Island. While this commission’s work is ongoing, the possibility of a public educational pipeline graduating doctors right here in Rhode Island holds promise for sustainably addressing our shortage of primary care providers.

Our current primary care crisis is the product of decades of inaction. We urge our colleagues across state government to work collaboratively right now, and in the future, to nurse it back to health.

Senators Pamela J. Lauria (D-Dist. 32, Barrington, Bristol, East Providence), V. Susan Sosnowski (D-Dist. 37, South Kingstown) and Alana M. DiMario (D-Dist. 26, Narragansett, North Kingstown, New Shoreham) are members of a Senate commission studying the education and retention of primary care physicians and the feasibility of establishing a medical school at URI.

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Rhode Island

R.I. grandparents fighting for visits with 4-year-old granddaughter rest their case – The Boston Globe

Published

6 hours ago

April 23, 2026

Press Room

R.I. grandparents fighting for visits with 4-year-old granddaughter rest their case – The Boston Globe

Naso’s in-laws, Dr. Siavash Ghoreishi and Dr. Jila Khorsand, took him to Family Court in July 2024, three months after their daughter, Shahrzad “Sherry” Naso, died from metastasized breast cancer.

Naso had refused to let them see Laila, their only grandchild of their only daughter, saying he wasn’t comfortable with their behavior and was alarmed by their medical care of Sherry and Laila.

Scott Naso and his daughter, Laila, in their Portsmouth, R.I., home.Suzanne Kreiter/Globe Staff

The retired physicians used a little-known state law that allows grandparents whose children have died or divorced to petition the Family Court for the right to visit with their grandchildren.

It’s led to a bitter trial that began in October and has continued off and on over the last six months, with testimony about medical negligence, abuse, and control.

Naso, a Middletown narcotics detective, accuses his in-laws of prescribing dozens of medications and providing poor medical care, which he believes contributed to Sherry’s death and sickened Laila. Ghoreishi and Khorsand deny any wrongdoing.

“We love that child with every fabric of our beings and have never harmed her in any way or shape,” Khorsand testified in October. “I love that child to death and would never do anything to harm her. … Why would she be deprived of this love?”

Naso has argued that the expense of the trial and the state law allowing grandparents to sue parents for visitation violates his constitutional parental rights.

But Gill said on Monday that the state law was “narrowly tailored” to respect the constitutional rights of parents, and he denied Naso’s motions to dismiss or stay the ongoing trial.

Now that Michael Ahn, the lawyer for Ghoreishi and Khorsand, has rested his case, Naso’s lawyer will argue that the grandparents haven’t met their burden under the law and the case should be dismissed.

Veronica Assalone told the judge that she will argue for the dismissal on Thursday.

If her motion is denied, and the Supreme Court justices reject the emergency motion, the trial proceedings will resume, with at least a dozen witnesses expected to testify on Naso’s behalf.

On Wednesday, the court heard more testimony from Cheryl Allspach, the former longtime office manager for Ghoreishi’s pediatric practice and a close friend of the family. She had testified glowingly on Tuesday about Ghoreishi and Khorsand’s relationship with Laila.

She also testified about Ghoreishi’s recordkeeping at his practice and his medical treatment of Scott, Sherry, and Laila Naso, and explained the process for billing and filing for insurance claims.

Assalone questioned her about Blue Cross Blue Shield of Rhode Island’s payment policy, since 2009, regarding self-treatment and treatment of immediate family members. The insurer’s policy follows the American Medical Association code of ethics, which warns physicians not to treat or prescribe medications for themselves and close family members, and does not cover those services.

Allspach read the two-page policy aloud for the court. “Why did you bill?” the judge asked when she concluded.

“I just did it as part of normal billing, and truly I didn’t realize that,” Allspach said. “If I realized, I would have said to [Ghoreishi], ‘you cannot treat your family members.’”

The judge quickly stopped more detailed questions about billing practices, chart-keeping, and whether Allspach was aware that it was a felony for physicians to prescribe narcotics to relatives.

“It’s a grandparent visitation case, not a medical malpractice case,” Gill snapped at Assalone. He added that she should take her claims about illegal prescriptions to the state police, “not here.”

Julie Emmer, the owner of Strengthening Family Foundations, testified that Naso had alleged “serious things” about his in-law’s medical care when she was handling the supervised visits between Laila and Ghoreishi and Khorsand.

Emmer testified that Naso told her “there were prescriptions in different names for his late wife” and that his in-laws were being investigated by the US Drug Enforcement Administration and the state police.

“He thought they shouldn’t have visits,” Emmer said. “He thought they were responsible for what happened to his wife.”

Emmer began supervising visits in September 2024, after then-Family Court Judge Debra DiSegna temporarily ordered one-hour supervised visits every other week. The visits continued until late January 2025 and were suspended after Naso filed a complaint with the Department of Children, Youth, and Families. The investigation was closed, but Naso has refused to resume visits.

Emmer supervised nine visits, all at public places, and performed a home inspection at the grandparents’ condo in Jamestown at Ahn’s request in December 2023. They wanted to visit with Laila at their home, but Naso refused, Emmer said, and he is the custodial parent.

Emmer testified that the grandparents abided by the court order not to give Laila any gifts or medication.

Khorsand played with the little girl, while Ghoreishi stayed in the background, filming them or taking pictures, Emmer said. (Some of the photos and videos have been entered as evidence in the trial.)

Emmer said she noticed over time that Laila was anxious at the start of the visits and said she didn’t want to go. During one visit, she said, Laila whispered to her over and over “they are bad people.” At another visit, Laila was late because she vomited on the way over, she said.

She told the court that Laila would eventually warm up to her grandparents.

Emmer said she saw Naso crying and shaking, but that he was careful to compose himself so Laila didn’t see him becoming emotional. She testified that she didn’t hear him make any derogatory comments about his in-laws in Laila’s presence.

She said that Laila was reluctant to leave her father during the visits, but he encouraged her to go. “He often made comments, ‘Go have fun with Miss Julie. You’ll be safe,’” she said.

Amanda Milkovits can be reached at amanda.milkovits@globe.com. Follow her @AmandaMilkovits.

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Rhode Island

Rhode Island shifts its primary to Wednesday, Sept. 9, easing a Labor Day poll setup crunch

Published

18 hours ago

April 22, 2026

Press Room

Rhode Island shifts its primary to Wednesday, Sept. 9, easing a Labor Day poll setup crunch

PROVIDENCE, R.I. – Rhode Island’s primary elections will now be held on Wednesday, Sept. 9, moving it back from the typical Tuesday election day because it fell too close to Labor Day.

Gov. Dan McKee, a Democrat, signed off on the change earlier this week. The primary election had been scheduled for Sept. 8, which is the day after the holiday weekend.

State and local officials had requested the change after raising concerns about having enough time to set up polls for voters. However, under the legislation enacted, the filing deadlines will remain the same.

“We have to set up over 400 polling places around the state on the day before the election,” Nick Lima, the registrar and director of elections for the city of Cranston, told lawmakers at a hearing in January. “That’s very difficult to do on a holiday because many of our polls are schools, social halls and churches.”

It’s not unusual for states to change their election day. Lawmakers in neighboring Massachusetts changed the state’s 2026 primary election day from Sept. 15 to Sept. 1, arguing that doing so will help improve voter turnout.

Only four states hold their primary elections in September: Rhode Island, Massachusetts, New Hampshire and Delaware, which has the latest primary date in the U.S., taking place this year on Sept. 15.

Legislation seeking to move up Delaware’s primary election by several months has been introduced in the statehouse, but previous attempts to do so have stalled.

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