Cook rice as directed on package. Add sausage to a skillet and cook over medium; cook until browned and no longer pink. Set aside.

In a large saucepan, melt butter over medium heat. Whisk in flour until smooth and then gradually add milk, half-n-half, and pumpkin puree. Continue to whisk until smooth again. Once sauce bubbles, reduce heat to a simmer and allow to thicken.

Remove from heat and stir in nutmeg, sage, Parmesan, salt, and pepper. Add cooked rice and sausage; mix until combined.

Garnish with fresh cilantro and serve with grapes on the side.