Innovation Ecosystem

When patience and persistence pay off

ConvergenceRI conducts a 15-minute, one-on-one phone interview with Gov. Dan McKee

Photo by Richard Asinof, file photo

Gov. Dan McKee at a news conference at the State House, underneath the portrait of George Washington.

By Richard Asinof
Posted 10/18/21
A one-on-one interview by ConvergenceRI with Gov. Dan McKee.
When will there be an audit conducted of the private contractors, the Managed Care Organizations, doing business with R.I. Medicaid? Are the plans being developed for an accountable entity for Medicaid long-term services and supports realistic? Despite the enthusiastic endorsement of Neighborhood Health Plan of RI by Gov. McKee, what is the best way to address reported problems related to shared savings, low reimbursement rates and bad data from Neighborhood Health Plan of RI?
The Rhode Island Council on Postsecondary Education approved a name change for the Rhode Island College School of Nursing, following a $3 million gift by local philanthropist Edward Avedisian, the largest individual gift in the college’s 167-year history. The School of Nursing will be officially renamed the Zvart Onanian School of Nursing, in honor of Mr. Avedisian’s sister, Zvart Avedisian Onanian.

PROVIDENCE – In six years, former Gov. Gina Raimondo had refused to do an interview with ConvergenceRI, despite having shaken hands and having agreed to do so in person, twice.

In turn, it only took six months – a relatively short time – for Gov. Dan McKee to agree to do a one-on-one interview with ConvergenceRI.

That anecdote captures the difference in leadershp between the two: McKee is genuine and likable; he is willing to engage on a personal level, and he keeps his word. After being ignored and kept away from decision-making when he was Lt. Governor, his partnership with Lt. Gov. Sabina Matos demonstrates many of these good qualities. 

The brief phone interview, which took place on Friday morning, Oct. 15, covered a lot of ground, despite the limited amount of time.

Shortly after the interview, the Governor made some breaking news, releasing a 55-page working draft of Rhode Island 2030, which articulated both short-term and long-term strategies for the best pathways toward prosperity for the state.

An in-depth analysis of the document will follow next week; ConvergenceRI will also publish an in-depth analysis of the 2021 Housing Fact Book, which was released on Oct. 15. The story will include an interview with Brenda Clement, the director of HousingWorks RI.

The chief business
The release of the working paper, Rhode Island 2030, which Gov. McKee spoke about during the interview, provided a framework for the conversation with the Governor. In the interview, he voiced his frustration about the difficulty of getting his messaging heard, particularly his desire to talk about the metrics around the success in vaccinations, in controlling the rate of infections and hospitalizations from the continued COVID contagion, and in reporting on the improved economic recovery of the state.

The chief business of the American people is business, said former U.S. President Calvin Coolidge, in a talk before the trade group, the American Society of Newspaper Editors in Washington, D.C. on Jan. 17, 1925. “They are profoundly concerned with producing, buying, selling, investing and prospering in the world.”

Nearly a century later, the strategic approach toward prosperity outlined by Gov. Dan McKee, in the recently released “Rhode Island 2030: Charting a Course for the Future of the Ocean State, seems to reflect a similar emphasis on the connection between business and prosperity – in this case, small businesses in Rhode Island.

The opening section of the 55-page “working draft,” released on Friday, Oct. 15, under the heading, “RI 2030 Priority: Supporting Small Businesses,” begins with the following paragraph: “Rhode Island has been called the quintessential small business state. Small businesses in Rhode Island make up 98.9 percent of all businesses in the state beings and employ more than half [52.2 percent] of all workers [compared with 46.8 percent nationally].”

The opening paragraph continued: “These firms range from small, family-owned retail and restaurant businesses to larger professional services, construction, and advanced manufacturing businesses. Some of our small businesses started small and want to remain that way, while others have their sights set on rapid growth.”

Further, the opening paragraph said: “Not only are small businesses a crucial part of Rhode Island’s economy, but entrepreneurship represents an important opportunity for job creation, wealth building, and economic growth.”

In the interview, ConvergenceRI posed questions about health, housing, and the recovery community, but began with a question asking the Governor about what were the most important lessons he had learned during his first six months on the job.

Here is the ConvergenceRI interview with Gov. Dan McKee, hopefully the first of several one-on-one interviews that will take place in the months to come.

ConvergenceRI: What are the most important lessons that you have learned in your first six months as Governor?
McKEE: I would say that… I don’t know if it is lessons as much as the experience is intense. I guess that would be an observation.

It has been an intense experience, and it is also one that I embrace.

I don’t think that there have been many real surprises [on the job], other than the fact that the workload is important. And, I take it very seriously, Richard.

I clearly came in, in terms of transition, in a way that no other Lt. Governor has ever transitioned in the country, into a Governor’s spot, in a pandemic of extraordinary proportions, a 100-year type of pandemic, a health crisis.

We stepped into a economic crisis as well; it is one of the areas that I have been very focused on. I know that we also stepped into an education crisis, relative to educating our kids.

So, I would say that the experience has been intense, like I said, but it is one that I embrace.

And, I think that the outcomes have been really good – knowing that our municipalities could play a real legitimate role in the vaccination rates, and understanding and learning how important the National Guard was, FEMA was, as [well as] all the volunteers, [such as] first responders, and school nurses.

We took [the state] from last place in [the rate of] vaccinations, to right now, where we are third in the country. And, as a result, now we are the second-lowest infected [state] in the country.

I think that, all in all, the partnerships that we have been able to bring to the table, and, the partnerships that were in place when I got here – continually embracing those partnerships has been important.

[Rhode Island is] first in the country [on vaccinations]; we are first in the Northeast on the economic recovery. You hear me keep saying this, over and over again, because I don’t hear it very often out in the media, expressing this.

I mean, this is an extraordinary outcome so far, and we want to keep that going – fourth in the country on recovery. Now we are getting to the education piece, and particularly in Providence schools, settling a contract that no one thought you could settle, but that was part of the experience and the expertise I brought to the table. Now we have a really big opportunity in Providence to help get better outcomes in the schools.

So, you do that across the board, to keep people healthy; you continue with the [high] vaccination rate, and lower infection rates, we have some of the lowest hospitalization rates in the country. We’ve been anywhere from 45 to 50 on the lowest entry [rates] in the country since Delta [variant] hit.

It was good that we were positioned the way we were to push back on Delta. Other states have not been able to say the same.

ConvergenceRI: Well, you will be able to read about what you say in next week’s ConvergenceRI, for sure, about the outcomes you cite.
McKEE: Great.

ConvergenceRI: Much of the focus recently has been on affordable housing development in Rhode Island. I know that you have made that a priority for some of your initial recommendations for how to spend the federal Rescue Plan funds. I was wondering if you could define “affordable” for me?
McKEE: We got a jumpstart on this, right, because we put into the [FY 2021] budget a sustainable funding stream, right, for affordable housing.

I think that [the meaning of] “affordable” really runs the gamut.

It is in low-income, which is defined by federal statutes. I think that right now the money that we are putting into this plan, what we are calling Rhode Island Rebounds [proposals for how to spend a 10 percent investment of the state’s yet unspent $1.13 billion American Rescue Plan Act funds], which you are familiar with, we addressed a couple of those definitions.

For instance, I think we have about $15 million to incentivize the development of affordable housing – the term [is defined] as being for individuals whose income is below 80 percent of the median income.

And, I think we have $12 million plus that is in there for property acquisition, a grant program.

We are putting a [substantial] effort in this down payment, and we realize that it is only a down payment. I think we will be putting millions of dollars more toward this effort.

One of the things that I think is lacking, Richard, is that we have a lot of estimates about what the need is, but I have not really seen a plan in terms of how to address that.

That is why we are coming out with this Rhode Island 2030, a draft of a working document that should be out within the next 48 hours, either later today or early next week.

We need to be looking at this as a short-term effort, but we also have to be thinking about long-term planning. And, really establishing a plan, working with people in the unfortunate situation of being homeless, all the way up to fair-market housing – and everything in between.

We need a plan, and that is what we are going to do through Rhode Island 2030.

We will have a plan that will address where the need is and how you can actually leverage these dollars. Remember, these dollars can be leveraged, Richard, right? If we are talking about a program to incentivize the development of affordable housing, when we are talking about property acquisition, we can use those dollars to leverage greater investments.

So, $12 million for property acquisition, that could become $50 million in acquisition, that could be $80 million in acquisition, right, if you do it right, and leverage the dollars.

I think that defining what is affordable really is a great objective question.

The needs [range] from the extreme, from those who are, a relatively low percentage of people, in a homeless situation, compared to the larger percentage of people who are in the working family/fair market area.

The needs all have to be addressed, because if we are going to have a real strong economy, we are going to need housing.

Also, we have to be focused on the other side of the coin on this issue – it is really about creating an economy where people earn more money, at all levels of that ecosphere.

ConvergenceRI: Let me make the transition from housing to health care. My question is: Where does housing overlap with health care in terms of priorities? Some have said that safe, affordable housing is health care. Do you agree?
McKEE: I think it is a little more complicated than that. I think that is certainly a piece of it, for sure.

People who are housed in warm and safe environments are going to be healthier than those who are in the extremes of not having that ability, right?

People want to have homes that they call home. They want a home, they want to have a stable housing situation.

But health care, and the health environment is multi-faceted. So it is about economy, it is about earning a living. That’s just that.

A Lt. Governor whom I knew when I chaired the Lt. Governor’s Association, he was a medical doctor He shared his [beliefs] with other Lt. Governors from around the country about the relationships between housing and health care costs, that safe, affordable housing will reduce health care costs.

From that respect, what you are talking about, I agree; it is definitely a piece of it. I do believe that good, safe housing will reduce our health care costs, so, in that respect, they are definitely aligned.

ConvergenceRI: Have you been briefed recently about potential problems emerging with Rhode Island Medicaid? I have reported about the potential entrance of Blue Cross and Blue Shield of RI into the market for managed care organizations, along with Molina Healthcare, and whether they may supplant the current three MCOs.
McKEE: Richard, I am familiar with that. There was a recommendation that we should go to a competitive procurement process, which I think is healthy. So, we are going out.

I was just at Neighborhood Health Plan of RI. I met with their team over there; they do a fantastic job, and I am very supportive of them. We are going to open it up, through a procurement process. What we are doing is that we are going to make sure that if there is any change, we are going to put that into effect come July 2023.

So, while you are asking about Medicaid , we do have an issue, which is that we have about 335,000 [Rhode Islanders] on Medicaid right now.

We need to figure out ways, that’s what the Rhode Island 2030 plan is about: how do we increase people’s income. It is not how do we get people off Medicaid.

Right now, Neighborhood Health [Plan of RI] has 235,000 people on Medicaid. We have to figure out a way where we are transitioning them by increased income. I think that is one of our most important things we can do in the state, which is to raise per capita income. We need to be focused on that.

ConvergenceRI: If and when the 2030 plan becomes available for distribution, feel free to send that along to me. I’d love to get a look at it. You can embargo it to whenever it is being released.
McKEE: We are going to release it as a working document. Then we are going to have public sessions around the state, for public input. It is a draft plan, so what we hear from people about what might be missing can be added, as well as what might be enhanced. It will cover some of the things that you just talked about – certainly more of the economic issues that we need to make sure we are paying attention to. We’ll get you a copy.

ConvergenceRI: The recovery community recently challenged BHDDH Director Richard Charest around proposed funding cuts to recovery programs – and won, because the cuts were rescinded. What was your takeaway from that episode?
McKEE: First, I think it is important to know that they weren’t cuts; they weren’t state cuts. The federal dollars that were allocated to that program ran out.

I thought that Director Charest did a really good job in restoring [the money] so, there was never an intention not to fund those programs.

It certainly shed a light on the programs. We are going to [create] public awareness about how much money is actually being appropriated, and then, we are also going to measure outcomes.

I think I answered this question a few weeks back with you. That was not a cut, it was the result of a federal program funding that ended.

[Editor’s Note: Despite the Governor’s claims, as detailed by ConvergenceRI’s reporting and by the public testimony from recovery community members at the Task Force on Sept. 8, there were more than $2 million in funding cuts. The problem, it appears, was that Charest and the agency had not been transparent about how and where federal funds were being spent. Legislative leaders, including Sen. Josh Miller, chair of the Senate Health and Human Services Committee, had never been consulted or briefed about the proposed cuts. Just because the Governor claimed they were not “cuts” does not make it so. See link below to ConvergenceRI story, “Hard of hearing? BHDDH’s Charest and Gov. McKee seem to be tone deaf.” ]

I think Director Charest was doing what he was going to do anyway, whether there was pressure or not. I don’t think that you have to put pressure on to get the right things done.

I thought that was a little over the top, with the walkout by the people who are on that committee, especially after the discussion got going.

I think Director Charest is doing a remarkable job, in terms of taking us from where we were on Eleanor Slater Hospital when I showed up to where we are right now, with accreditation, and with Medicaid. He put us in a position where we are going to recover tens of millions of dollars on past billing that we were told was not allowable when we walked in, and Richard has been able to lead the way.

ConvergenceRI: What is the best way to continue to have this kind of conversation in the future, outside of the media scrum at news conferences?
McKEE: This is an intense job, with an intense schedule. I am happy we were able to do this today. I have instructed our staff that this is the way we are going to handle it going forward.

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