PROVIDENCE – Did you feel the Earth’s tectonic plates shift last week? Call it a dramatic rumble occurring beneath the Earth’s crust.

On Friday, Oct. 31, two federal district court justices, Judge Indira Talwani in Boston, Mass., and Judge John J.  McConnell in Providence, R.I., ruled against President Trump’s illegal attempts to shut down the federal funding for the Supplemental Nutrition Assistance Program [SNAP], which serves tens of millions of poor Americans.

The move by the Trump administration had been done not for lack of money but for calculated cruelty. There are some $6 billion in funds in the federal budget expressly targeted for this purpose – to pay for SNAP benefits in case of an extended federal shutdown.

Throughout the United States, a revolt is swelling. Call it a kind of prequel to the Nov. 16 release of “The American Revolution,” a new documentary by filmmaker Ken Burns, as community agencies, local public officials and ordinary citizens rallied to keep food on the tables for those Americans who are less fortunate and dependent upon SNAP benefits for survival.

Instead of dumping imported tea into coastal waters off Boston or sinking a British warship off the coast of Rhode Island, acts of defiance 200 years later after the initial spark of the American Revolution in 1775 involved finding the common ground to keep free access to nutritious food on the shelves of food pantries and food banks all across the nation. Call it massive display of civil disobedience by communities all across the United States.

What follows is reporting by ConvergenceRI on the public performances in Rhode Island that took place on three fronts:

•    The demand for accountability, fighting back against an outbreak of bullying and anti-Semitism by high school students in Smithfield by a coalition of community groups and local public elected officials.
•    The potential creation a single-payer health insurance plan in Rhode Island, led by AG Peter Neronha, where it is the needs of patients and not the greed of private-equity owners of hospitals and nursing homes that seek to drive prosperity forward for a new generation of caregivers.
•    A new narrative that has coalesced around the growing resistance to the illegal tyrannies of President Donald Trump, as Trump’s efforts to starve the nation’s poor, disadvantaged citizens by refusing to pay for SNAP benefits is a sign of his failing mental health and growing dementia.

First, here is an interview with Linda Hurley, president and CEO of CODAC, talking about the future health care challenges facing Rhode Island, as her agency focused on recovery pivots to address the growing needs of patients. CODAC was a sponsor and Hurley a panelist at the Providence Business News health summit held on Thursday, Oct. 30.

HURLEY: What were your questions relative to the Providence Business News health summit?

ConvergenceRI: You are a sponsor of these forums. It’s clear that you feel that it is important for your voice to be heard, as differentiated from what other panelists were saying.    
HURLEY: Correct.

ConvergenceRI: And, you’ve developed a new model of care delivery at CODAC that is inclusive, one that focuses on where the patient is coming from, rather than where the provider is coming from.    
HURLEY: That is exactly right.

That is what the whole mission of our shift in delivering care is about – being responsive to the community’s needs. You know, when people come to us for care, we ask them: What do you need? As opposed to the old conversation, where the primary purpose was to say: We know what you need; please let us help you.

And, our patients’ needs are so varied; and, many times, the needs are dire. [Switching voices.] It may have to do with not having a home – or not being able to feed my children. Sure, I may have other problems; of course, I am anxious and depressed. Maybe it happened before I was able to take care of my kids; maybe it happened after, I don’t know.

But right now, I need to feed them. This kind of approach is what we have been doing [at CODAC] for some time now [creating a patient-centered hub at our Royal Little Drive facility in Providence].

The Providence Business News “health care summit” is an event that we’ve sponsored for three years in a row.

The conversations occur at a much more macro level, at the 30,000-foot level: What we need to do to save our health care [delivery] system in Rhode Island? The last three years that I have participated, the same questions have been asked: How do you see each of the panelists? How do you see what the challenges are? What do you see as possible outcomes if we don’t do anything? And then: What are the opportunities to turn things around?

And, the answers are very different, [depending] if you are coming from the space of the CEO of an insurance company. Or, if you’re coming from a large [hospital] system. Or OHIC Commissioner Cory King.

Those perspectives are much different than if you are coming from a smaller, nonprofit provider system that sees what is happening to people daily.

So, when you are coming from this more global perspective: This is our five-year plan, this is how we can turn it around. My question is: “OK, this is the plan.” What is going to happen in eight months? What is going to happen in 12 months? In 24 months? In 36 months? How long is it going to take to heal, if things don’t change in the next election?

Those are the questions that I would ask people [to answer]. I am just rambling here. You usually take my words and make me sound smarter.

ConvergenceRI: Every time I have had a close encounter with a hospital system here in Rhode Island, it is an adventure. Thankfully, I encountered women doctors, and women nurses at Miriam Hospital, who listened.  

[Editor’s Note: I had been hospitalized for two days, because my blood pressure had fallen to extremely low, dangerous levels. Subsequently, I had been discharged on Friday afternoon, right before the telephone interview with Hurley took place.] 

HURLEY: Again, that listening piece is critical. It reverberates through the entire system. That is why a nonprofit that is actually quite poor would spend money to sponsor this event – because it is an audience that we are trying to get to listen to us.

Because, generally speaking, when providers are out there talking about what is happening, we are preaching to the choir; we’re preaching to each other. This [health summit] was an opportunity for others who have more influence – in terms of finances and in terms of politics [to hear what we are saying]. So, it was an opportunity.

There were two things that I stressed: one was that it was important to note, that although the fatal overdose rate has dropped by 26 percent [in Rhode Island], and 26 percent and change nationally, we still have to remember that, according to the Centers for Disease Control and Prevention, that, at a minimum, there were 15 nonfatal overdoses to every one fatal overdose  [emphasis added]. And, we have to say “Yay!” to that.

That’s due in part to the remarkable proliferation of naloxone. It’s a wonderful thing. But there has  been another outcome: every time you injure the brain by an overdose, every time that the brain gets injured by a lack of oxygen, what [occurs] is that there is an Alzheimer’s-like dementia, a memory issue that occurs. And, executive function gets impaired.

So, if I have had five overdoses in the last three years, which is not uncommon, and my brain has an injury of two, three, or four minutes without oxygen, I am starting to function at a different, [lower] level.

And, if I have had a four- or a five-minute incident of a lack of oxygen to the brain, I could very well become paralyzed. It could be a complete, life-changing [event] to me as an individual but also to my loved ones and to my family. We’re looking at horrendous medical bills; we’re looking at an absolute, catastrophic, life-changing event [as a result of] those injuries that [occurred because] of the absence of oxygen supply to the brain.

As a result, it’s harder for those people to remain in recovery. You know, the [lack of] impulse control, the building frustration – not remembering to do certain things needed to do for a job. All that starts to erode someone’s sense of self-worth. And, it makes it all the more difficult for people to be in recovery.

These folks, over time, are going to start costing taxpayers more and more and more. More trips to the emergency room, more people on Medicaid, and more people that, frankly, can no longer support themselves in the community. And, they become the responsibility [emphasis added] of the community.

I recently looked at data from three different studies. It’s very real; it’s happening across the country. And, we are looking at what is going to happen when these individuals that are being supported by Medicaid are required to be credentialed, two times a year. Or, when they are being required to document their volunteer work; they are now being required to document work.

All of these examples of “cognitive decline” occur over time. I believe we are looking at some catastrophic problems when you combine what’s happening in the population with opioid use disorder – and then you look at what’s happening with the support for them from the federal government.

History is history; it never goes away.    
ConvergenceRI conducted a telephone interview with John J. Tassoni, Jr., President of the Town Council in Smithfield, who recently was honored by Mothers Against Drunk Driving for his work in media focused on recovery, including serving as the producer of Recovery TV.

Tassoni, Jr., has been outspoken regarding the need for accountability, following an incident of anti-Semitism, where five football players physically attacked a Jewish football player. Tassoni, Jr., has publicly called for the resignation of the football coach, the school superintendent, and the athletic director. Tassoni, Jr., has also participated in a number of news conferences, focusing attention on the issue of anti-Semitism.

TASSONI, Jr.: The health care end, I’m sure you saw it today; they want more money to bail CharterCARE out. How much more? Why doesn’t someone say to them: OK, we can give you money, but everyone at the top is going to take a pay cut.

ConvergenceRI: Right. How much are their salaries and how much of their salary are they willing to match to get the money?      TASSONI, Jr.: 100 percent.

ConvergenceRI: I was going to ask you, and you’ve made it very clear: When I contacted you two weeks ago, to talk about what was going on with hazing. I wanted to talk with you about accountability. What message are we sending if we don’t hold kids and teachers and administrators accountable for their actions.    
TASSONI, Jr. It sets a bad precedent if we don’t hold people accountable.

The only jurisdiction I have is their budget. And that’s it. I have already called for the resignation of the superintendent, the football coach, and the athletic director.

ConvergenceRI: Does that put you on the hot seat? Tell me what you want in terms of accountability?    
TASSONI, Jr.: Number one: those three have to go. And, we have to start over.

I think the town of Smithfield, and I have had this discussion with the town manager. He is going to call the Jewish Alliance next week, and have them schedule classes for all municipal employees in the town of Smithfield. And, we will offer the same thing to the schools. If they accept, that’s great. If they don’t accept, well, there is a problem.

ConvergenceRI: Tell me what you mean by accountability?    
TASSONI, Jr. Accountability means they need to get terminated. That’s accountability. We need to get new people in that know the rules and the regulations. And, how to treat people.

You cannot leave adolescents alone in a locker room and not know what is going on, if you are a coach or an athletic director. And, as far as the superintendent goes, when she made that first announcement, that these kids were going to be suspended for the rest of the year and not play, that was OK with the family, from what I was told. Enough punishment.

When she reversed her decision, and never told the family, and this young boy then went to practice, and these five individuals were at practice, suited up, and they played the next night.

ConvergenceRI: Why, in this particular time and moment, given what is happening nationally, why is it so important to stress accountability?    
TASSONI, Jr.: I think it is two-fold. One, as we heard at the press conference yesterday [Thursday, Oct. 30], these types of [anti-Semitic] actions are up 54 percent for the Jewish community, because of what is happening over in Gaza and Palestine; 54 percent in the last six months.

And, if you don’t do anything, pertaining to this particular issue, it’s going to fuel the fire. That means that no one is going to be accountable for their actions going forward. And, that is a problem.

ConvergenceRI: When you were growing up, John, did you ever experience hazing yourself?    
TASSONI, Jr.: No, I never did.

ConvergenceRI: Were you aware of any hazing that went on with your classmates?     TASSONI, JR.: No, not that I was aware of. I graduated in 1976.  Were there pranks? Yes, there were pranks, but nothing to this magnitude.

ConvergenceRI: I wish I could say that I was as lucky as you were. There was hazing; I got beat up in the baseball locker room one year.      
TASSONI, Jr.: They need to bring this stuff, the training and the classroom stuff, back in.

I can almost guarantee you. Most of these kids have no idea about the Holocaust. History never goes away. I blame part of that on the education system. History is history; it never goes away.