INNOVATION ECOSYSTEM

Developer’s dream, or nursing students’ nightmare?

Forced marriage of URI, RIC nursing programs as part of $206 million development of Dynamo House may hinder, not help future nursing education

PHOTO BY Richard Asinof

The architectural renderings for the $206 million South Street Landing development, unveiled at an embargoed news briefing in the State Room at the State House. The nursing programs at RIC and URI are being forced into a marriage to use a shared space facility as part of the development.

By Richard Asinof
Posted 5/19/14
The forced marriage of the University of Rhode Island and Rhode Island College nursing programs, shoving them together in a shared-space facility to make the tax credits for a proposed development work, undercuts the education excellence of both programs. The planned facility will not provide additional resources to hire new faculty – the major barrier to increasing enrollment. It will not support building the talent pipeline for Rhode Islanders to address the need for more nurses – no conversation has yet happened with the R.I. Nurses Institute Middle College.
Who in the R.I. General Assembly will have the courage to stand up and challenge the development plans as a bad idea? Who will champion the excellence of the current model of nursing programs in Rhode Island? As the delivery of health care shifts away from in-patient care at hospitals to a primary care, patient-centric model, what are the most effective teaching models to support that transition? When was the most recent environmental survey of the site conducted for potential toxic hazards at the site?
The recent approval by Dr. Michael Fine, director of the R.I. Department of Health, of seven sites for CVS Minute Clinics, with detailed conditions spelling out the responsibilities to promote and protect primary care practices, is an important nodal point. So, too, is the effort by Dr. Lynn Taylor to support a comprehensive approach to treating Hepatitis C in Rhode Island. On Tuesday, the R.I. Chronic Care Sustainability Initiative is scheduled to announce expansion of its patient-centered medical homes network and the launch of CSI-Kids, aimed at addressing chronic conditions and preventive care for children. There are plans in the works for better coordination of primary health care through a neighborhood health station in Central Falls
The nursing profession is at the heart of these positive changes in health care delivery in Rhode Island.

PROVIDENCE – At the embargoed news briefing held on Monday, May 12, in the State Room at the State House, the rectangular architectural drawings on white poster board used to illustrate the proposed $206 million deal to develop the Dynamo House offered a sharp contrast to the room’s plush, ornate furnishings, celebrating Rhode Island’s legacy of political deal-making, wealth and scandal.

The precise lines of the pristine renderings, displayed on tripods against the largesse of the room’s decorous collection of objets d’art, seemed puny and out-of-scale against the dominion of Gilbert Stuart’s full-length portrait of George Washington. The contrast served as an apt backdrop for the comedy of manners that transpired next.

The Chafee administration, in friendly banter with a gaggle of reporters, portrayed the pending deal as a straight-ahead win-win-win for everyone in Rhode Island; in reality, the embargoed briefing bearded what appears to be a forced marriage between the nursing programs at the University of Rhode Island and Rhode Island College.

The vision of the two nursing schools sharing space in the proposed Nursing Education Center is not a new idea but a recycled retread of the failed $60 million facility proposed in 2010 by then Gov. Donald Carcieri, an idea that was rejected by the R.I. General Assembly. The plan for the nursing school, wrote Scott MacKay at that time, “was hatched by what Saul Bellow so famously called the Great Intentions Paving Company.”

This time around, it has provided the cover for the alleged public policy benefits needed to glue together the state and federal tax credits required to make the complex redevelopment deal for the South Street power station work, described as a project to transform the eyesore of the now vacant power station into a “jewel.”

Despite the premise that it will address the “shortage of qualified nurses” estimated to be between 3,000 and 6,500 by 2020, according to the material provided by state officials hyping the project as “advancing Rhode Island as a regional leader in nursing education,” the new facility comes with no additional resources pledged to hire new nursing faculty at either URI or RIC, the most pressing need if either school is to accommodate enrolling more students.

“We’re swamped,” said Lynn P. Blanchette, R.N., director of the B.S. nursing degree program at Rhode Island College, in an interview with ConvergenceRI in April 7 newsletter. [See link to story below.] “We admit 75 students each semester, spring and fall, and we have had to turn away 10 to 15 percent of the applicants because we can’t accommodate them. We don’t have the number of faculty or the resources in order to educate more nurses,” she said, either at Rhode Island College or at the University of Rhode Island.

“To increase enrollments, URI College of Nursing would need to hire additional faculty,” URI Dean of Nursing Mary Sullivan told ConvergenceRI. The school currently has about 800 undergraduate students and 125 graduate students, according to Sullivan.

The new shared-space facility, due to open in 2016, promises to exacerbate the situation, forcing the nursing programs to staff the shared space with existing faculty and resources.

Nursing leaders were not asked for their input in making the decision whether or not the shared nursing facility was a good use of resources; the idea was imposed on them by the state. Instead, the state told them to figure out how to make the shared space work; and no one wanted to look a gift horse in the mouth.

“We are the experts [about nursing education], not the people who are building buildings,” one source close to the negotiations told ConvergenceRI, exasperated by the state’s inability to listen.

Dance of the dealmakers
Details of the proposed deal to redevelop the Dynamo House were presented in a choreographed dance led by Gov. Richard Licht [as one reporter called the Director of Administration] and his sidekick, Lincoln Chafee, in advance of a R.I. Board of Education vote scheduled later that afternoon.

[Smiling, Licht said that he was very confident about the vote’s outcome – which turned out to be unanimous in endorsing the project.] The project still needs to be approved by the State Properties Committee and the R.I. General Assembly.

The embargoed briefing was much like watching a rehearsal for a professional wrestling bout, where the outcome is never really in doubt. The news media performed its role not so much as critical questioners but more as well-trained regurgitators at the ongoing development circus that is Rhode Island.

[Ironically, many of the same reporters are busy covering the R.I. House oversight hearings now underway on the failed investment in 38 Studios – filled with righteous indignation, years after the fact. Yet no one asked a single question about the nursing programs.]

A TV station blogger, who had been chatting with Licht before the briefing, sharing stories about their families, asked Licht during the briefing what he thought the headline should be for the story.

Chafee’s chief spokeswoman came into the room late and planted a big kiss on the cheek of former colleague Providence Journal reporter Paul Grimaldi.

Another reporter asked, in response to Licht using flowery language to describe the development project: “Can we say that you waxed poetic in describing the project?”

When Chafee said: “If everything falls apart, we’re in for only a $1 million; the risk is on the developer,” another reporter responded: “Are you sure that’s the best way to phrase it?”

Who benefits from the deal?
From the developer’s view and the state’s view, the deal is good business – a continuation of Chafee’s mantra of meds and eds, following the pathway of medical centers built in Houston and Pittsburgh.

[No one questioned Chafee about the ongoing labor strife at the University of Pittsburgh Medical Center in Pittsburgh, where the $10 billion enterprise had actually denied that it had any employees and that its facilities were not subject to civil rights standards for federal contractors, when he waved his book about the project at the embargoed briefing to the news media as proof of the validity of the concept.]

The deal is good business for Brown University, one of the cornerstone tenants, which will get 135,000 square feet – about 51 percent of the building – in which it plans to relocate its administrative staff, freeing up space in the increasingly cramped facilities on the College Hill campus.

The new development at the former Dynamo House at the South Street Power Station will also benefit the developer, Commonwealth Ventures Properties LLC, the Connecticut-based developer of Davol Square. Richard Galvin is the president and founder of the firm – as well as a board member of The Rhode Island Foundation.

Galvin will be able to use both state and federal tax credits to develop the property – including a six-story, 220-bed housing development that will “service the student needs of area universities,” with retail shops and a restaurant, and a 650-space parking garage, privately financed and owned. The state, in turn, will lease about 200 parking spaces in the garage.

In turn, the former developer of the site, Patrick T. Conley, president of the Heritage Harbor Museum Corporation, also benefits. He will be paid $4.5 million by Commonwealth Ventures in exchange for relinquishing easements and rights to $2.3 million in state historic tax credits.

The power station property had been donated by Narragansett Electric, now part of National Grid, to the Heritage Harbor Museum.

The city of Providence will also benefit from the deal, having reached a property tax stabilization deals with Commonwealth Ventures that will generate about $9.9 million in tax revenue over the next 15 years – the length of the initial leases. The agreements include payments that will come from both Brown and the state of Rhode Island.

When asked if lawyer Michael D. Corso, now under investigation for his role in the 38 Studios scandal, was involved in the development, Licht said no. A representative of Commonwealth Ventures at the briefing also said that Corso was not involved.

Licht also said that there were no problems that he knew of related to the environmental remediation of the site, which had been a coal-burning power station beginning in 1912. Any environmental remediation, Licht continued, would be the responsibility of the developer, Commonwealth Ventures, not the state.

Departing from the current model of nursing education
The new, shared-space facility will introduce a new model of education for nurses in Rhode Island – where students will spend the first two years on campus and the next two years at the shared facility. It’s a model that is practiced by other nursing schools that operate in direct partnership with medical schools – something that does not exist, nor is such an arrangement planned – with the Warren Alpert Medical School at Brown University.

Whether that’s the best model for nursing education in Rhode Island was never addressed by the state.

While Brown medical school and the new Johnson & Wales physician assistant’s program, which is scheduled to open in June, will be “across the street,” and proximity will come into play, there is no formal affiliation other than serendipity. “It’s not educators [but administrators] from Brown who are coming to that building,” another source told ConvergenceRI.

Students from both RIC in North Providence and URI in Kingston will be forced to commute, according to Blanchette and Sullivan.

“The details of transportation and costs have not been discussed,” Sullivan said.

“Who’s going to shuttle our students from North Providence to downtown Providence?” Blanchette asked, expressing concern. “Our students can’t afford to pay $20 to park.”

Students will also be isolated from resources and supports at their main campuses.

Further, there has been no coordination or discussion regarding the new facility with the Rhode Island Nurses Institute Middle College Charter High School in Providence, the first charter school in the United States that is dedicated to the nursing profession.

The school, which will graduate its first 59 students this year, is building a local talent pipeline for nurses in a patient-centric world. [See link to ConvergenceRI story below.]

Sullivan said that URI has not had any discussion with the Nurses Institute Middle College regarding coordination at the new facility. “We are open to coordination,” she said. “We do not have any current plans regarding the current facility,” saying that Associate Dean Lynne Dunphy sits on the RINI Middle College board.

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