Innovation Ecosystem

A matter of life and death in RI

A one-on-one interview with Deputy Attorney General Adi Goldsteiin, a key member of the legal team serving to protect Rhode Island’s public health

Photo by Richard Asinof

Adi Goldstein, RI Deputy Attorney General, is working with the Attorney General in preparation of a report of potential solutions to the current health care crisis in Rhode Island.

By Richard Asinof
Posted 10/30/23
The in-depth interview with Deputy Attorney General Adi Goldstein shines a bright line on the importance of raising Medicaid rates and the value of legal intervention in securing millions of dollars in settlements for corporate misbehavior in the opioid epidemic.
What is the connection between chronic absenteeism in schools and lead poisoning of children? When will CommerceRI make the investments in securing better economic data about the nonprofit sector in Rhode Island? Where will the public pressure come to raise Medicaid rates – from legislators, from businesses, from the news media? What is the connection between incidents of domestic violence and gun violence? What is the value of ConvergenceRI as a way to build engaged communities and neighborhoods in Rhode Island?
The rapid sequencing of news in our world makes it difficult to acknowledge the history each of us carries as our personal stories. The interview with Deputy Attorney General Adi Goldstein was an opportunity to find common ground around the legal advocacy she performs as part of her everyday job and the reporting that ConvergenceRI conducts in covering the complexities of health care and innovation in Rhode Island – about topics that Goldstein called “super wonky.” But they are a matter of life and death.
In the last 10 years, ConvergenceRI has been honored not once but twice for excellence in reporting on efforts to prevent childhood lead poisoning in Rhode Island, an extremely rare occurrence, according to CLAP’s Executive Director Laura Brion. And yet, there was no formal acknowledgement from the podium of ConvergenceRI’s presence. It was a fact that WPRI’s Kim Kalunian was unaware of. Neither did Attorney General Peter Neronha know about that history.
The question is: who will tell the story of the successful fights against corporate greed in health care?

WARWICK – The interview took place on Thursday evening, Oct. 26, in the noisy atrium at the Crowne Plaza, in the midst of the celebration of 30 years of protecting kids from lead poisoning, hosted by the Childhood Lead Action Project, at which R.I. Attorney General Peter Neronha was honored for his legal advocacy in taking delinquent landlords to court and suing them for their failure to follow the law and keep their properties free from lead.

The annual awards were also being given in 2023 to R.I. State Representative David Morales as “Legislator of the Year,” Elizabeth Gonzalez as “Community Activist,” and Jocelyne De Gouvernain, former Childhood Lead Action Project Board Chair, for her “Extraordinary Service.” [Editor’s Note: Twice in the past 10 years, in 2013 and again in 2019, ConvergenceRI has been honored by CLAP for his media coverage about protecting children from lead poisoning, an entirely preventable affliction.]

Instead of accepting the award by himself, Attorney General Neronha brought with him an entourage of his legal team, including Adi Goldstein, Deputy Attorney General, attempting to drive home the message about the ongoing teamwork involved in his efforts to serve as the public health advocate for Rhode Island.

Upon seeing ConvergenceRI, Neronha came over to say hello, after greeting the master of ceremonies for the awards ceremony, Kim Kalunian, the news anchor at WPRI. And, when ConvergenceRI inquired about his pending request to interview Goldstein, which had been first asked for five months ago in May, Neronha responded by bringing Goldstein over to the table.

Earlier that week, Goldstein’s name had been part of the front-page news story regarding the Attorney General’s finding that in the “use of force” report regarding the actions by the police in response to a shooting incident that had occurred on Denison Street in Providence, the police response had been justified. [See link below to ConvergenceRI story, “Is there a news credibility gap in RI?”]

Given the tragic mass shooting that had occurred in Lewiston, Maine, leaving some 18 dead, the ongoing work by the Attorney General’s office regarding the Urban Violent Crime Task Force, working to eradicate ghost guns, stolen guns, and large capacity magazines, took on new significance.

For Goldstein, the “use of force” report was all part of her ongoing job as Deputy Attorney General. For ConvergenceRI, it was curiosity about Goldstein’s critical but often unheralded role on the health care front.

ConvergenceRI: You just had a big case that was out in the press about all the gunfire and the police.
GOLDSTEIN: The use of force report on Denison Street.

ConvergenceRI: What is it that you don’t do at the Attorney General’s office?
GOLDSTEIN: I hope nobody ever asks me to write a job description, because I don’t know what I would write. I go where I am needed. And I do what’s needed.

In all seriousness, I think that there are certain projects, there are certain responsibilities that we have at the Attorney General’s office that require a lot of time, frankly – a lot of time, a lot of work. Our line attorneys, they are hard pressed to find that time, with caseloads in the hundreds.

It’s very hard to find the time to spend hours and hours, pouring over thousands of pages, or hundreds of pages, of reports and recordings and body-worn camera videos, do the legal research, and then do the writing that’s required to produce the report. That’s just one example in the use of force report.

ConvergenceRI: What I see is that the Attorney General is often the last bastion of protecting the health of Rhode Islanders at this point.

ConvergenceRI: Because no one else has stepped up to the plate.
GOLDSTEIN: Right. We are definitely trying.

ConvergenceRI: You have all these incredible opportunities to make the world better when it comes to health care, the environment, gun safety…
GOLDSTEIN: One of the best experiences I’ve had in the office so far is that I as on the Prospect team at the very end, leading the negotiations, with Prospect Medical Holdings, when the time came to decide on whether we are going to let the ownership change go forward, and the Attorney General was very clear in his guidance: “I’m not going to take their word on it. They extracted hundreds of millions of dollars out of these hospitals and they’re not just going to walk away. You can’t let that happen.”

That’s literally what he said to me. I, myself, and Miriam Weizenbaum, who I know you know, we were locked in a room, the two of us, with the Prospect management and their lawyers, trying to hammer out the deal [See links below to ConvergenceRI stories, “You cannot be risk averse,” and “A good day for the state of Rhode Island.”]

And, you know, I’m not in the civil division, I don’t do all of the cases, there are phenomenal lawyers there right now, but at the end of the day, you need to have someone go in a room, and carry out the mandate that the attorney general has laid out for us, very clearly for us.

ConvergenceRI: So, there is a plan, somewhere in the works, to create a solution for what the attorney general says he is going to do about health care in Rhode Island. Have you been involved in that? [See link below to ConvergenceRI story, “AG Neronha offer bold prescription to solve RI health care crisis.”]

GOLDSTEIN: Yes. You know, again, I think the Attorney General’s vision has been really clear. Which has been to task the health care advocate and the folks in the public protection bureau in our office to identify the greatest challenges to our health care landscape in Rhode Island, and to provide solutions, to prescribe solutions.

And, the way we have been doing that, [the team] has literally been doing the research; we’ve been talking to stakeholders. We meet regularly, I would say maybe monthly, if not more frequently, where the [team] presents to Peter, to myself, to Miriam, this is what we are seeing, this is what we think needs to happen.

It can be super wonky. It can be things about Medicaid, Medicare, Medicaid waivers. And, rate increases. And, capacity-building. What we do is we sit in that room, and we pressure test some of these ideas.

We ask questions: What does this mean? What are you basing this on? How do we really sell this?

That’s been great. But again, that takes an awful lot of work. And, at the same time, these attorneys are handling significant cases, significant transactions that come before our office.

ConvergenceRI: My concern is… I assume that Brian Hodge [the communication’s officer for the Attorney General] shares ConvergenceRI with you; I hope that he does.

ConvergenceRI: You have seen how I have tried my best to stay on top of the issues, with everything that is going on in the health care landscape. I am frustrated at this point that there do not seem to be more, better health care reporters in the state. That’s my opinion. They are not really following what is going on. Things like Optum and their bad [behavior]. And, what’s going on with Medicaid is astonishingly bad. But unless the Legislature can raise the rates for providers…
GOLDSTEIN: I think that is really the biggest challenge for the state. I mean that is inevitable. They are going to have to raise the rates. It is just going to have to happen. It is. Everybody knows it. It is painful. We have among the lowest reimbursement rates in the country. It is a direct impediment to our workforce.

You know, I spent two hours this afternoon at the Opioid Settlement Advisory Committee meeting. I attended on behalf the AG, because again, the Opioid Settlement, that was my baby. I worked on that almost full time until right before we arrived at the settlements.

I wanted to know how is this money is being spent, that I worked personally, along with some of my colleagues Kate Sabatini, other folks in the office, Dan Sutton, who is no longer there, but, and now Julia Harvey [Special Assistant Attorney General, Health Care Advocate], who is outstanding. We worked so hard to get that money to the state. [I wanted to know:] How are we going to use it?

And look, it’s amazing to be in these meetings. Because I think there is a lot of good use being made of this money.

ConvergenceRI: I’m glad to hear it, because I have been worried that the bureaucracy hasn’t broken free of the silos. And, worried whether they are investing in programs that didn’t seem to work in the past…

GOLDSTEIN: I know. I understand. It’s good to be doubters. But I also think, in fairness, we need to give things time. People are always very impatient for results.

But we’re one of the first states to get out of the gate and to have programs and spend money. And that’s a fact: We are really at the forefront of the work we are doing. Seventy treatment beds added because of opioid settlement dollars. A ton of more work being done on data gathering and mapping of overdoses, just because of the settlement dollars.

Why am I raising these facts? Because of the impediment; you have the beds; that’s great. We need to have people to work those beds. The staffers. And, until we get our Medicaid rates up, that is always going to be a challenge.

[Some of] these treatment providers are closed, because they can’t attract staff. It’s a real problem; it’s a challenge. And the settlement money can’t be used for rent.

ConvergencceRI: In the best of all possible words, you are a mensch.
GOLDSTEIN: [laughing] I appreciate that. Thank you.

ConvergenceRI: If I sound as if I am frustrated, I am.
GOLDSTEIN: You should be. I am frustrated. I just had a meeting; I called a meeting with the folks at EOHHS. I think they are wonderful people over there. They work very hard.

And DOA. To ask, what can we do to move the procurement faster? Let’s get the procurement out faster. You know, there are millions of dollars that are ready to go out the door for Fiscal Year 2023-24.

There’s $18 million of those dollars that have been encumbered – already allocated to projects, granted out. It takes time, right, for all these providers to ramp up and to start spending. But only about $5 million of the money has actually been spent.

That’s why I am saying: it’s frustrating. You want to move things [more quickly], because people are dying.

But I think we are trending in the right direction. At least I hope so.

ConvergenceRI: What haven’t I asked you, should I have asked you? Whenever you have a story that you want to get out there, please let me know. Reach out so I can do what I do best, which is to create the impetus for stories to be told – and to be heard.
GOLDSTEIN: You are one of those rare birds I think right now, in the media, that is interested in reporting on substance. And that is interested in spending the time to understand stories.

And, it’s sad. You know, we always hear about the Fourth Estate and how crucial it is for our democracy. But, you know, frankly it is demoralizing – talk about being frustrated and demoralized, when you get the sense the media is now becoming [ignored].

I love Alex Kufner [a reporter for The Providence Journal]. He does fantastic reporting on the environment. His stories are lengthy… How many people read through those stories?

These things really matter to people’s lives. Particularly about the quality of life.. You do that kind of reporting in health. I don’t know if it is really being done in a lot of other places in Rhode Island. What is more fundamental than the hospitals? Than the lack of primary care providers? About access issues, about equity issues?

We have a challenge; we have a real challenge [to get the stories right].
ConvergenceRI: Do you know the master of ceremonies? Kim Kalunian?


The interview concludes with ConvergenceRI inviting Kalunian to come over and talk with Goldstein, introducing them.

For all the times that Kalunian has interviewed Attorney General Neronha on air, this is the first time that she had talked with Goldstein. Hopefully, ConvergenceRI thought, the introduction would serve as a way to open the door for WPRI to do a better job of reporting on health care issues in Rhode Island, garnering a broader understanding of the legal team hard at work serving as the state’s public health advocate.

© | subscribe | contact us | report problem | About | Advertise

powered by creative circle media solutions

Join the conversation

Want to get ConvergenceRI
in your inbox every Monday?

Type of subscription (choose one):

We will contact you with subscription details.

Thank you for subscribing!

We will contact you shortly with subscription details.