Delivery of Care

What was said, who attended, and who was missing from the conversation

A recap of what happened in the conversation among elite stakeholders at the stealth Health Care Workforce Summit held on April 1

Photo by Richard Asinof, screen shot from the Facebook Live recording

Hannah Maxey, a presenter from Indiana, who urged the summit to include K-12 students in the pipeline for future health care workers. Maxey likened Rhode Island to a farm, raising talented students for other states to harvest.

By Richard Asinof
Posted 4/11/22
In PART Three, ConvergenceRI provides a brief overview of who attended the summit and what they said, providing a context to the content.
What would happen if the plan of action developed by the stakeholders attending the summit were to be given to front line workers to review the content? Will the R.I. General Assembly have the political courage to make budget investments in raising the low Medicaid reimbursements for providers? Which candidates running for Governor will step up to the plate and talk about health care workforce needs as a top campaign issue? When will CommerceRI recognize that the state’s nonprofit community agencies represent a key workforce component of the state’s small business enterprise?
All of the events related to the health care workforce summit, with the goal of creating an inter-agency, private-public partnership to create a new, unified health workforce board, occurred far, far under the radar screen. It was a major occurrence that went unreported by the Rhode Island news media, perhaps because there were so many distracting stories in the last two weeks. The 401 Gives campaign, sponsored by United Way of Rhode Island, also held on April 1, raised a phenomenal $3.1 million in support of more than 500 local nonprofit community agencies.
At the same time, the selection of a new license plate for Rhode Island drivers, which bears a remarkable resemblance to the old license plate, provided distraction, perhaps, from the ongoing war of terror unleashed against the civilian population of Ukraine by Russia, which has rightly been called war crimes and genocide.
Then there was the Senate confirmation of the first African-American woman, Ketanji Brown Jackson, to become a U.S. Supreme Court Justice. At the same time the Governor announced a transition team to guide R.I. EOHHS in seeking a replacement for Secretary Womazetta Jones, who departs on May 1. Under Gov. McKee, his administration has overseen the departure of two African American women from high-ranking positions in his cabinet. Will voters take notice?
The Governor named Kristin Sousa as the director of the R.I. Medicaid office, during a time of major upheaval – the re-procurement of Managed Care Organization insurance plans to deliver services roughly one-third of all Rhode Islanders. If and when the federal emergency from COVID-19 is lifted, those numbers will be downsized around financial eligibility considerations.

PART Three

PROVIDENCE – If his legs were stronger, the thought had briefly crossed ConvergenceRI’s mind about attempting to crash the health care work summit held on April 1 – to turn up unannounced in order to force the organizers to recognize that by inviting the Governor to attend, it was indeed a public event.

But the confrontational approach was quickly jettisoned, in favor of the shoe-leather approach – digging into the details and talking with sources that might have attended.

ConvergenceRI made some correct guesses – and spoke to a number of participants who had attended, off the record. Many others who had been queried were surprised to learn about the summit and that they had not been invited. One labor leader, for instance, said that he knew nothing about the summit – even though two major labor unions were invited. Similar situations had occurred at both a prominent trade organization and at a nursing school, where the top boss had received an invite to the summit but had not shared the information about the summit with other top colleagues.

When Neil Steinberg, president and CEO of the Rhode Island Foundation had tweeted during the summit about how “the right people were in the room,” and then praised Gov. Dan McKee for his “positive attitude,” it provoked a flash of anger. Particularly after being told by Beth Bailey, the press spokeswoman for the R.I. Office of Postsecondary Commisioner, that the sponsorship of the Rhode Island Foundation involved paying for breakfast and lunch. It made being excluded from participation in the conversation that much harder to swallow.

The question was: How was it possible to proclaim that “the right people were in the room” if the news media was excluded from the event? Without an attendance list, how could you reach such a conclusion?

Who was in attendance?
Not everyone was properly identified in the Facebook live presentation, and the transcription service used was not necessarily accurate. Gov. Dan McKee, for instance, was translated as “Gov. Pam Keith” on the screen. Chalk it up to the perils of machine learning and AI.

Here is a partial list, garnered from watching the nearly five-hour summit and reading the name cards of the participants when possible:

• Neil Steinberg, president and CEO of the Rhode Island Foundation.

• Elizabeth Roberts, director of URI’s Academic Health Collaborative, former secretary at R.I. EOHHS and former Lt. Governor.

• Jane Hayward, current self-employed health and human services consultant, former president and CEO of the Rhode Island Health Center Association, the trade group representing community health centers in Rhode Island, and co-chair of the Rhode Island Foundation stakeholder group developing a long-term health plan for Rhode Island.

• Elena Nicollella, the current president and CEO of the Rhode Island Health Center Association, and a member of the Senate legislative commission looking at the future organization of R.I. EOHHS.

• John Gage, president and CEO of the Rhode Island Health Care Association, a nursing home trade association.

• Rick Brooks, director of the Healthcare Workforce Transformation Initiative Team at R.I. EOHHS.

• Marianne Raimondo, associate professor and director of the Health Care Administration program at Rhode Island College [and sister of U.S. Commerce Department Secretary Gina Raimondo].

• Lynn Blais, RN, president of the United Nurses & Allied Professionals

• Elizabeth Lange, MD, pediatirician, president of the Rhode Island Medical Association

• Tina Spears, executive director of the Community Provider Network of Rhode Island, and a member of the Senate legislative commission looking at the future organization of R.I. EOHHS.

• Patrick Quinn, executive vice president of SEIU 1199

• Sandra Powell, associate director of health, Division of Policy, Information and Communications

• Maggie Thomas, vice president, Human Resources, South County Health

• Laurie-Marie Pisciotta, executive director, Mental Health Association of Rhode Island

• Marti Rosenberg, director of Policy, Planning and Research at RI EOHHS.

In total, the named participants represented approximately 25 percent of the people who attended the summit, but the group captures the flaovr of who was represented, as best ConvergenceRI could determine. One missing participant, who was invited but did not apparently attend, was Peter Marino, president and CEO of Neighborhood Health Plan of Rhode Island.

What was said
Here is a brief collection of comments made during the nearly five-hour summit that stood out when ConvergenceRI watched the Facebook Live recording. [Editor’s Note: If the quotes appear to be choppy in their content,  they are; it was difficult to capture what was being said, because the audio quality was often poor, and the real-time transcription inaccurate.]

Lynn Blais talking about the labor market in health care: “I have grave concerns about where we are and where we are going.”

Marianne Raimondo, talking about the fate of students entering the workforce: “They get hired, and then we throw them to the wolves, with heavy case load, and a lack of supervision and mentoring. They don’t have leaders that they can talk to.”

Dana Brandt, presenter from DataSpark, sharing data about the health care workforce related to educational attainment: “Of all those who graduated college with a health care major, only 26 percent have entered the health care workforce in Rhode Island.”

Sandra Powell, talking about the need to expand the vision of the workforce to older adults: “We need to look at adult learners who enter the workforce.”

Maggie Thomas, talking about the changing demographics in Rhode Island among older health care workers: “Many workers are retiring, selling their homes, taking their experience with them, so there is not the same support for new health care workers from experienced health care workers.”

Marti Rosenberg, talking about missing information about the workforce: “What data are we missing?”

Elizabeth Roberts, talking about the need to move forward with the new public-private group being proposed to work on workforce issues: “We need to create a planning council where we have a place to engage, a place to bring us together.” Roberts added that “bureaucratic recovery, it’s a path.”

Neil Steinberg, talking about outcomes from the summit: “We need to present the top ten bullet points and present them to legislative leaders.”

Tina Spears, talking about the underlying issues with workforce development – and the desire by workers to have a fulfilling life. “We need to create the pathways to a living wage; without a pathway to a living wage, workers will leave our state. Having the hard conversation about wages is paramount if we get the opportunity to keep [workers here in Rhode Island].”

Laurie-Marie Pisciotta, talking about the connection to the need to raise Medicaid reimbursement rates and to look not just at costs but at longer-term savings: “Our leaders need to invest in Medicaid reimbursement rates. It is not about costs; it is about savings down the line. We need to modernize how we look at costs, using dynamic modeling and cost savings, which are more accurate, even if those savings are a year or two down the line.”

Ana Novais, summing up the summit: “We knew, coming in, we had a health care workforce crisis. The pandemic exacerbated it, but it didn’t create it; it highlighted the deep rooted disparities in our health care system and in our society.”

Novais continued: “We have the expertise in this state to come up with solutions. The summit reminded us that we have data needs that are important.”

Further, Novais said: “Seventy percent of the health care workforce is white. We know we have issues of access, we know we need to learn how to train the workforce, and how to retrain the workforce. We need to address the leadership not just in education, but in providing a livable wage that fulfills workers.”

In conclusion, Novais said: “When equity and environment depend on health, we are saying education, employment, health, it requires a collaborative action, our collective commitment and staying power, developing an action plan, challenging our leadership and ourselves to act.”

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