PROVIDENCE – Did you hear? While the health care CEOS have made their pronouncements about the future – Lifespan is now Brown Health, Steward Health Care is no more, and Prospect Health, owners of Roger Williams Medical Center and Our Lady of Fatima hospitals, have agreed to give up the remaining $45 million in an escrow account and “gift” it to the two hospitals.

In response, the worker bees – the nurses, the residents, and the doctors – are talking back, big time.

•    Some 950 Brown medical residents and fellows across four hospitals affiliated with Brown’s Warren Alpert School of Medicine – Rhode Island Hospital, Butler Hospital, Kent Hospital and Women & Infants Hospital – filed for union representation last week.

The health care workers have sought to join the Local 1957 chapter of the Service Employees International Union’s Committee of Interns and Residents, which currently represents more than 34,000 resident physicians, according to the Brown Daily Herald.

The bargaining units would represent the 721 Brown medical residents and fellows in programs affiliated with Brown University Health, and all 229 residents and fellows in programs affiliated with Care New England, the Brown Daily Herald reported.

•    In Boston, nearly 300 primary care physicians employed by Mass General Brigham have notified federal authorities that they want to join a union, citing “burnout” and the corporatization of medicine” at the state’s largest health system, wrote Boston Globe reporter Jonathan Saltzman in a story last week.

The physicians signed cards saying they wanted to join the Doctors Council of the Service Employees International Union, Local 10MD, petitioning to hold a union election, Saltzman reported.

“MGB has relentlessly become more and more corporate in the way that they manage their physicians,” Saltzman quoted a primary care physician. “We don’t have the autonomy and the ability to provide the kind of care that we signed up for,” the primary care doc said.

•    Meanwhile, back at the ranch at the Rhode Island’s EOHHS offices, a new report, the “RI Health Care System Planning Initiative” has been published, following a work group retreat held on Nov. 7.

The 191-page report contained the slides from seven working groups – Behavioral Health Sector, Data Recommendations, Health-Related Social Needs Service Sector, Healthcare Workforce Recommendations, Hospital Sector, Long-Term Care and Healthy Aging Sector, and Primary Care Sector.

Translated, the McKee Administration has begun to make public its recommendations for how it envisions transforming the health care delivery system in Rhode Island, under the direction of EOHHS, but the contents remain well under the radar screen, in somewhat stealth mode.  Stay tuned for a deeper dive by ConvergenceRI within the next two weeks.

More disruptions in the force?    
Given all these ongoing disruptions in the forces surrounding the delivery of health care, the recent decision made by the Department of Administration and the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals to award a peer recovery specialist training contract to a firm based in Lexington, Mass., C4 Innovations, is perplexing at best.

The training contract had been held by the Substance Use Mental Health Leadership Council for more than a decade, according to John J. Tassoni, Jr., the president and CEO of SUMHLC.

“We are very disappointed that after 14-15 years of having  the contract, they decide to go with a Massachusetts company that has no presence in Rhode Island,” Tassoni, Jr., told ConvergenceRI. “When you spend money in Rhode Island it goes around about seven times,” Tassoni, Jr., continued. “When you give a contract to a company outside of Rhode Island, it goes around zero. It does not help the state’s economy.”

As a result of losing the contract, SUMHLC had to lay off two of its long-standing employees – one who had been with the agency for 14 years, and the other for six years, according to Tassoni, Jr.

Tassoni, Jr., also voiced his disappointment in the way that the contract solicitation was handled. In a letter to Gov. McKee, Tassoni, Jr., wrote: “From initiation to submission of the proposal, the instructions, narrative and the uploading of the requested materials to the State’s website were filled with inconsistencies. Even with requests for assistance, personnel were uninformed and/or unable to respond in a manner that was helpful.”

A meeting is scheduled with Tassoni, Jr., at BHDDH offices on Friday, Dec. 13, to answer questions about the solicitation.

Attempts by ConvergenceRI to get answers from BHDDH regarding the rationale behind the decision not to rehire SUMHLC met with a somewhat puzzling response.

ConvergenceRI asked: “What was the process involved in contracting with 4c Innovations, a Lexington, MA, firm, to handle peer training in RI? Was the contract linked to RICARES in some manner?”

The response by BHDDH’s Randal Edgar: “I’m not aware of a connection to RICARES, but if you have a more specific question, I can check.”

Edgar continued: “Here is a link that provides details on the solicitation that led to the existing contract with C4 Innovations. [See link below.]

Edgar seemed unaware that RICARES Executive Director Sandy Valentine had very publicly been soliciting for the new peer recovery specialist training in her newsletters and on her website, beginning on Thursday, Oct. 24, saying that registration process was now open.

“We are pleased to share that Anchor Recovery and RI Community for Addiction Recovery Efforts [RICARES] are partnering to deliver the new Peer Recovery Specialist Training that the state of Rhode Island’s Department of Behavioral Health, Developmental Disabilities and Hospitals designed in conjunction with C4 Innovations,” Valentine wrote in an Oct. 24 email advertising the training sessions.

From the wording of the email, it appears that Valentine was a full partner in the new training program “designed in conjunction with C4 Innovations.”

The question is: Who in the McKee administration was involved in the decision-making to select an out-of state firm for the contract? And, are there more contracts in the works for C4 Innovations that will blow up existing contracts with Rhode Island providers?

Editor's Note:

Editor’s Note: Sandy Valentine, thanks for providing the clarification on RICARES role with the training. I am happy to publish your clarification, as you requested. Your original email to me was sent to the wrong email address, causing a delay in my response.  

ConvergenceRI regrets publishing any information that may have been inaccurate, misleading or confusing about the training contracts.

In her response, Valentine wrote:

• “RICARES was blocked from applying for the delivery contract for BHDDH’s bid request because they only allowed vendors with a Master Price Agreement to apply. RICARES did not have one.” 

• “C4 Innovations on behalf of BHDDH invited providers to attend a Training of Trainers (ToT) session on August 26 and 27.”

• “If you attended the session, you were beginning a process to be approved to deliver the program at your own cost and initiative.”
• “I and a staff member attended the session. Following the session, on Sept. 27, C4 Innovations sent another email: ‘If you would like to be on the approved list of State trainers, please work with fellow ToT participants to co-facilitate the 46-hour training. The State will be observing this training to make sure you are facilitating to fidelity before you are certified to train via the State’s Certification Board.’ ”

Valentine further explained:  

“Anchor had two staff members at the ToT, and both our agencies had insight into the number of individuals who had been waiting for many months to secure this training to fulfill all their requirements for CPRS in Rhode Island.  

We agreed that we would partner and offer the training in November without receiving any funding for it (BHDDH paid for the training manuals) to achieve the required observation from BHDDH/C4 and solve a workforce need for the recovery community that both our organizations are dedicated to serving. 

We filled the spots first come, first serve. No tuition was charged. Anchor graciously provided the space and refreshments, and RICARES provided the administration/coordination. 

We hope to hear soon that RICARES has met the requirements to be able to provide the training independently so we can continue to help those in recovery and their allies become equipped to help others on their recovery journey.”

The description Valentine offered today of the proposed training, seems a bit different from the description in your Oct. 24 email, which was quoted at length in ConvergenceRI story, which read: 

“We are pleased to share that Anchor Recovery and RI Community for Addiction Recovery Efforts [RICARES] are partnering to deliver the new Peer Recovery Specialist Training that the state of Rhode Island’s Department of Behavioral Health, Developmental Disabilities and Hospitals designed in conjunction with C4 Innovations,” Valentine wrote in an Oct. 24 email advertising the training sessions.

Source of confusion.  
What appears to be most confusing is that there have historically been two separate behavioral health-related contracts from BHDDH involving peer recovery specialist training, one reader wrote.

“For years, the training contract intended for the education requirements for certification and recertification of alcohol and drug counselors, prevention professionals, etc., has been delivered by SUMHLC [and by old DATA of RI before the merger of DATA and the community mental health advocacy organization that became SUMHLC].”

The reader continued: “SUMHLC also offered multiple courses that peer recovery specialists could take to satisfy re-certification CEU requirements. The specific PRS certification training was delivered, thru the BHDDH contract, by Parent Support Network-RI, and subsequently the contract was given to Anchor.”

Another reader offered a further clarification: “FYI. Drug and alcohol counselors, prevention professionals, and peer recovery specialists are all certified by the RI Certification Board, a long-standing independent entity that is a member of the (independent) International Certification and Reciprocity Consortium - they set the certification standards. Certification is the pre-requisite for the licensure by the RI Department of Health of alcohol/drug counselors.”