PART TWO

PROVIDENCE – One of the first orders of business when the R.I. Senate convened in January of this year was to pass legislation to enact the Good Samaritan Law in Rhode Island, which had lapsed in the throes of a dispute between legislative leaders when the R.I. General Assembly ended its session suddenly in 2015.

In turn, six months later, one of the last actions taken by the R.I. General Assembly in the 2016 session as part of the madcap rush to beat the final gavel was to give approval to seven bills targeted at helping to reduce the epidemic of drug overdose deaths and promoting recovery and prevention efforts.

The news release announcing that seven bills had been approved and forwarded to the governor’s desk for her signature was sent out early on Saturday morning, June 18, at 5:25 a.m.

However, recommended reforms to the criminal justice system targeting probation and parole practices, bills developed in partnership with Gov. Gina Raimondo’s 27-member working group on “justice reinvestment,” died on the vine, leaving R.I. Senate President M.Teresa Paiva Weed distraught at the defeat, as reported by The Providence Journal.

Why did the overdose prevention bills pass while the probation and parole reform bills failed?

Was the narrative what R.I House Speaker Nicholas Mattiello said it was: that changes made by the Senate to the parole and probation reforms were “a little soft on crime,” as reported by The Providence Journal?

Was the narrative of success that drove the overdose prevention bills a story of the governor’s leadership, as Elizabeth Roberts, secretary of the R.I Executive Office of Health and Human Services, tweeted, “RI budget passed by the House last night includes significant new funding to support @GinaRaimondo’s Overdose Prevention Plan?

Or was the narrative of success a direct result of the efforts of an engaged recovery community, a constituency of consequence?

And, was the demise of the probation and parole reforms a result of the failure to link it to the economic development initiatives being championed by CommerceRI, because those ensnared by the criminal justice system are not visible, have no political clout, and do not often make campaign contributions?

What emerges in attempting to find answers to these questions is a tale of competing narratives.

First, a brief history lesson
In a world where, in the words of the late Jack Newfield, many reporters are stenographers with amnesia, it is important to provide some context, history and nuance to explain why the passage of the Good Samaritan bill by the R.I. Senate became the first order of business this year.

As Convergence RI reported in its Jan. 11, 2016, newsletter: There are many untold stories as to why a bill never becomes a law – intricate dances that may begin with great hope and then end abruptly, without any public explanation, sinking beneath the weight of hidden agendas, egos, or lobbyists.

Such was the case in June of 2015, with the attempt to renew the Good Samaritan Law, scheduled to expire on July 1, 2015. The Senate had passed a reauthorization bill; there was a version pending in the House awaiting a vote when the R.I. General Assembly abruptly shut down.

The Good Sam law was left in the lurch, falling off the proverbial legislative cliff, despite a torrent of pleas by advocates. What exactly happened may never be known, save for the obvious: House Speaker Nicholas Mattiello and Senate President M. Teresa Paiva Weed had words.

The result: the Senate President adjourned the Senate, effectively ending the 2015 R.I. General Assembly session. Mattiello had no choice but to follow suit. And, despite frequent hints throughout the summer by the House Speaker that the unfinished business would be addressed in a special session in the fall, that special session never happened.

The fact that the state was in the midst of a continuing crisis, with hundreds of Rhode Islanders dying each year from accidental drug overdoses from heroin, fentanyl and prescription painkillers, and the Good Sam law sought to save lives by providing protections for those who called 911, did not seem to matter.

When the R.I. Senate reconvened for its 2016 session, one of the very first orders of business was passage of 2016-S 2002, “An Act Related To Food and Drugs – The Good Samaritan Overdose Prevention Act of 2016.”



The legislation was passed on Jan. 6 by a vote of 35-1, with only Sen. Frank Ciccone voting no.



Second, a bit of context
In the last year, there were a series of important nodal points in efforts to develop a more comprehensive approach to how the state responds to the ongoing crisis. The death toll from overdoses is expected to reach as high as 300 in 2016, an increase of some 40 deaths from 2015, according to physicians close to the efforts – threatening the overarching goal of the governor’s action plan: to reduce the number of deaths by one-third.

First, there was a “roundtable” convened by Sen. Jack Reed on June 22; inexplicably left out of that conversation had been Traci Green, who had been scheduled to testify as a national expert before the FDA about Rhode Island’s experiences with Narcan. Two days later, the R.I. General Assembly shut down its session abruptly, leaving the Good Samaritan Law as unfinished business, despite the fact that it would sunset on July 1. [See link to ConvergenceRI story below.]

Then, a new working group was organized by executive order by Gov. Gina Raimondo, in a ceremony at Anchor Recovery Community Center on Aug. 4, with Traci Green and Dr. Josiah Rich as key expert consultants, and with Maria Montanaro, director of the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, and Dr. Nicole Alexander-Scott, director of the R.I. Department of Health, as co-chairs. [See link to ConvergenceRI story below.]

In late October, the draft of “Rhode Island’s Strategic Plan on Addiction and Overdose: Four strategies to alter the course of an epidemic,” was released. [See link to ConvergenceRI story below, with a link to the Strategic Plan.]

In January, the R.I. General Assembly enacted the Good Samaritan Law.

In February, Dr. Nicole Alexander-Scott led a citizens’ effort to petition the FDA to change the labeling around anti-anxiety and painkillers, because of the dangerous results if they are mixed. [See link to ConvergenceRI story below.]

On May 11, at the Overdose Prevention and Intervention Task Force meeting, Raimondo publicly unveiled the latest update version of the Task Force’s plan of action. [See link to ConvergenceRI story below.]

There were competing narratives about the new document that emerged. The plan of action, according to numerous members of the task force, had been developed through an iterative, ongoing process, building upon the initial strategy. It was viewed by these task force members as still being very much a work in progress.

Mike Raia, communications spokesman for R.I. Executive Office of Health and Human Services, took exception to the idea that the latest version of the plan, first released in October of 2015, had been revised.

“Saw your coverage of the Overdose Prevention Action Plan,” Raia wrote to ConvergenceRI. “Wanted to make one thing clear: this is not a revised action plan. This is a detailed, policy-oriented plan with specific metrics and action items based on the strategic vision that was released late last year.”

One builds on the other, Raia continued. “The strategic vision laid out the Task Force’s recommendations and articulated specific strategies the state should develop. The Action Plan is the Governor’s comprehensive directive to BHDDH, RIDOH, EOHHS and others of what specific policies, investments and initiatives need to be developed, implemented and tracked.”

Do the semantics matter? Is it an important distinction about content, accountability and ownership? Perhaps.

But then, why did the criminal justice system reforms fail to become law?

The role of an engaged community
One narrative not told by the news media were the efforts behind the scenes by the community-led groups such as RICARES, the Rhode Island Communities for Addiction Recovery Efforts, which included a last-minute push in support of the legislation, in coordination with Anchor Recovery Community Center.

RICARES sent letters to 52 state representatives, including the chairs of each committee where the pending legislation was awaiting a vote, as well as the majority leader, the minority leader and the speaker.

The three separate letters sent by RICARES were written by Brandon Marshall, an assistant professor of Epidemiology in the School of Public Health at Brown University, who wrote to members of the House Finance Committee and its chair in one letter: “I have studied overdose, HIV, and other harms associated with addiction for over a decade. I have specific expertise in the drug use and overdose among young adults. I am writing you today to seek your support in hearing and voting on two pieces of life-saving legislation.”

In addition to the RICARES letters, other concerned community members and organizations who sent letters to legislators included: Anchor Recovery, Parent Support Network, Brown University, CODAC, Welcome House, Project Weber, Protect Families First, AIDS Care Ocean State, PONI, and NOPE-RI.

RICARES also posted an online petition in support the legislation, entitled: “Nicholas Mattiello pass legislation to prevent opiate overdoses in Rhode Island.”

Did the advocacy prove to be effective? It’s often hard to tell which axe blow felled the tree, but RICARES was there, swinging away.

Ironically, RICARES had had its legislative grant of $50,000 pulled by legislative leaders in the aftermath of the scandal involving Rep. Raymond E. Gallison, Jr., with no apparent reason given.

The nonprofit is a well-managed, fiscally responsible group, according to Michelle McKenzie, chair of the RICARES board.