Delivery of Care

How many millions?

The long-term cost of hiring high-priced corporate business firms as consultants to direct the state’s response to the COVID pandemic is still reverberating: the R.I. Department of Health now finds itself struggling with alleged persistent staffing issues – high attrition rates, high turnover, and a legal action alleging wage theft

Photo by Richard Asinof

R.I. Department of Health Interim Director Dr. James McDonald addresses a gaggle of news media at the press briefing on COVID held on Tuesday, Feb. 1, attended by, from left: Ernie Almonte, Lt. Gov. Sabina Matos, Gov. Dan Mc Kee, Dr. McDonald, Commerce RI Secretary Stefan Pryor, and the Rev. Chris Rev. Chris Abhulime, Gov. McKee's deputy chief of staff.

By Richard Asinof
Posted 2/7/22
Between 2020 and today, the Boston Consulting Group was paid $3.72 million in federal funds for its work on the COVID pandemic response, roughly 13.5 percent of the total amount spent by the state its “Public Health Response.” It remains unclear what the actual benefits of such a large expenditure were in terms of improving public health in Rhode Island.
How much of the ongoing problems with the state’s response to the COVID pandemic related to testing, vaccines, and resources were related to investing in high-priced, out-of-state corporate consultants who looked at the problems as one of managing behavioral economics, of managing good and services, rather than addressing structural barriers? Why was the state’s relationship with McKinsey & Company been kept on the hush-hush? Will the R.I. General Assembly be courageous enough to address the need to increase the low rates for Medicaid reimbursement, a primary cause for the shredding of the safety net for some many of Rhode Island’s most valuable residents? If Gov. Dan McKee were to lose the Democratic primary for Governor, would that spur an exodus of interim agency department heads?
The continuing controversy over the banning of Maus from the education curriculum in a school district in Tennessee – as well as the rumblings in many states about the alleged problems of teaching what some have called critical race theory in schools – amounts to a reactionary effort to control the free flow of ideas about our history and what really happened.
When I taught freshman English as an adjunct instructor at the University of Massachusetts Amherst, one of the books I included in my courses was This Way for the Gas, Ladies and Gentlemen, written by Taduesz Borowski, a Polish survivor of Auschwitz.
In his story from this slender collection, “The People Who Walked On,” Borowski wrote about his experiences as a worker responsible for unloading the people destined for the gas chambers. A train had just arrived, Borowski recounts; he was busy playing goalie in a soccer game. “Between two throw-ins in a soccer game, right behind my back, three thousand people had been put to death.”
There is nothing hyperbolic about the prose in his telling of the story; it is a factual account of the cruelty and destruction that he was a participant and observer to.
I think about Borowski’s stories every time I read about anti-mask and anti-vaccine protesters who have invoked wrong-headed Holocaust analogies to their situations, falsely comparing their situations to what happened in the concentration camps.
If nothing else, my students in the two sections I taught, I would like to believe, would be forever inoculated from the virulent contagion of hatred of the other, immune to the viruses spread by those who preach misinformation.

PART One

PROVIDENCE – For more than 11 months, ConvergenceRI has been attempting to follow the money, pushing to get a full public accounting of the millions of dollars spent on private consulting firms by the state in shaping its response to the COVID pandemic during the past two years.

ConvergenceRI had first posed the question to Gov. Dan McKee at a news briefing held on April 20, 2021, asking about what oversight plans the state had to look into millions of dollars being spent on private consultants to design and implement public health policy.

“We’re going to dig into that,” Gov. McKee had promised. The investigations will be “across the board. It’s not just on COVID, either.” [See link below to ConvergenceRI story, “Charting the rapid learning curve of Gov. Dan McKee.”]

Despite that promise by the Governor, no specific public report accounting for how the money spent by the state on private consulting firms was ever forthcoming, as best ConvergenceRI can determine.

Six months later, in October of 2021, after learning from numerous sources that an alleged “shadow government” had been created, utilizing Boston Consulting Group and McKinsey & Company, working as a top-level decision-making body that had superseded the public health operations at the R.I. Department of Health directing the state’s COVID response, ConvergenceRI persisted in seeking answers.

While Boston Consulting Group had a contract with the state of Rhode Island, no such contract apparently existed for McKinsey & Company, who were said to be operating under a pro bono arrangement coordinated by the Rhode Island Foundation, as first revealed by Stefan Pryor, Secretary of CommerceRI, in an interview with ConvergenceRI.

The fact that such a pro bono arrangement existed between McKinsey & Company and the Rhode Island Foundation was confirmed by Chris Barnett, spokesman for the Rhode Island Foundation. [See link below to ConvergenceRI stories, “One on one with Stefan Pryor,” and “To become stuck – and then unstuck in time.”]

Following the money
At Gov. Dan McKee’s most recent press briefing on COVID, held on Tuesday afternoon, Feb. 1, in the second-floor conference room at the R.I. Department of Administration building, ConvergenceRI asked the following question of interim director Dr. James McDonald, who had replaced the former agency director, Dr. Nicole Alexander-Scott, who had resigned abruptly in January.

“Does the Health Department currently have enough resources and staff to do the job that it needs to do? Or does it need more staff and more money?” ConvergenceRI asked.

“And, do we know how much money was spent on consultants such as the Boston Consulting Group? How many millions of dollars were spent on them?” ConvergenceRI continued. “Might that have been better directed in investments in Department of Health to staff [the agency]?”

The context for ConvergenceRI’s question goes back to a Dec. 6, 2021, interview that ConvergenceRI had conducted with Dr. McDonald. He had responded to a question about the alleged budget plans by the McKee administration to cut some 25 percent from funds allocated toward the COVID response. “I have not heard that,” McDonald had responded at that time. “But I am not traditionally involved with the money side of the Department. Other people would have heard that before I would.”

At Gov. McKee’s news briefing on Dec. 9, 2021, ConvergenceRI had asked the Governor the same question: whether his administration had plans to cut agency’s budget for COVID-related activities by 25 percent, as had been reported by sources. As ConvergenceRI wrote, Gov. McKee sidestepped the question, but admitted to the fact that “his administration was seeking to return to the budget of pre-COVID days.” [See link below to ConvergenceRI story, “It is all about public health, not political health.”]

Fast forward to the Feb. 1, 2022, COVID briefing: McDonald said that, as interim director, he had only recently gotten his hands on the agency’s “checkbook.”

“You asked about Boston Consulting Group. I actually don’t know how much money we spent on Boston Consulting Group, because I only recently have gotten access to the checkbook,” McDonald said.

And then, McDonald deftly deflected the question with a red herring answer, saying: “And I promise that I will spend the taxpayers’ dollars extremely wisely, just so you know, because I pay taxes, too. By the way, I started doing my taxes last night; I am not happy.”

Following the press briefing, ConvergenceRI sent a request to Joseph Wendelken, the communications spokesperson at Department of Health, under the heading, “How many millions?” asking for details of how much money had been paid by the state to Boston Consulting Group and to McKinsey & Company. Wendleken, in turn, forwarded the request to his counterpart at the R.I. Department of Administration, Derek Gomes. An answer was received: “Since 2020, the State has paid the Boston Consulting Group $3.72 million. I did not find any records of payments to McKinsey & Co.,” Gomes wrote in an email to ConvergenceRI.

[Editor’s Note: One of the purposes of the Feb. 1 press briefing on COVID, according to Gov. McKee, was “to make sure the people of Rhode Island have confidence that the transition [to new leadership at the R.I. Department of Health] has been handled in a good way. Transitions can be destructive, or they can be very positive.” The Governor continued: “We are showing… today that the transition is going very smoothly, and people from the state of Rhode Island will benefit from that transition.”

Along with McDonald, the Governor introduced the transition team, which included: Ernie Almonte, chief of staff to Lt. Gov. Sabina Matos [on loan]; Ana Novais, assistant secretary deputy director at R.I. Executive Office of Health and Human Services [on loan], and the Rev. Chris Abhulime, Gov. McKee’s deputy chief of staff, who will be in charge of the search for a new director for the agency.

A detailed breakdown of the press briefing, including Dr. McDonald’s complete answer, as well as an annotated analysis of what was said – and the missing context of what was not said – can be found in PART Two, “All aboard: A never-ending dog and pony show of COVID briefings.”]

Show me the money
In addition to Boston Consulting Group’s initial work in the spring of 2020, when the firm’s employees were embedded into operations at the Department of Health [making roughly $25,000 per week per employee], Boston Consulting Group consultants were brought back in November of 2020 to help direct the state of Rhode Island’s public health response to what was known as the “surge.”

Translated, the $3.72 million paid to Boston Consulting Group since 2020 apparently represented a hefty chunk of the total amount of federal money spent by the state of Rhode Island under the CARES Act for its “Public Health Response” – approximately 13.5 percent of the total $27.5 million spent [emphasis added] by the state for that category, according to figures produced by the R.I. Department of Administration. [ConvergenceRI would welcome a more detailed breakdown of how the $3.72 million paid to Boston Consulting Group was actually spent.]

The information received from Gomes also appeared to confirm that the state apparently had not made any payments directly to McKinsey & Company for their work on behalf of the state – work that had never been shared publicly in any news releases. Which, in turn, has raised more questions about the nature of the apparent pro bono relationship coordinated with the Rhode Island Foundation.

Questions: If the state did not pay McKinsey & Company for their work, who paid them, and how much were they paid? Was such an arrangement legal under the state contracting rules? Given that McKinsey & Company may have been privy to potential confidential information they obtained as part of their work for the state, did they turn around and apply any of that information for use with their other clients, including other states in the U.S. and other countries? Did the Raimondo administration ever ask the R.I. Attorney General’s office for a legal opinion regarding the ethics and legalities of such an arrangement?

Curiouser and curiouser, to use a phrase coined by Lewis Carroll, author of Alice in Wonderland, to describe the strange circumstances that Alice found herself in, having fallen down a rabbit hole.

Further, Boston Consulting Group was not the only private consulting firm that was involved in working on behalf of the state of Rhode Island on the public health response as part of the apparent shadow bureaucracy – those firms playing a prominent role in directing the state’s response to COVID included Alvarez & Marsal, IBM, and KPMG, among others, according to sources.

Question: What was the total amount of CARES Act money spent by the state of Rhode Island on private business consultants under the category, “Public Health Response?”

How many millions?
The question, “How many millions?” carries with it a new connotation regarding Gov. McKee’s relationship with government contracts with consulting firms.

New revelations have been unearthed by investigative reporters Tim White, Ted Nesi,and Eli Sherman at WPRI-TV, which have raised questions about the behind-the-scenes maneuvering by the McKee administration to shepherd through a $5.2 million award to ILO, a nonprofit incorporated just two days after Gov. McKee was sworn in as governor.

In the WPRI story published on Monday, Jan. 31, a day before the Feb. 1 press briefing, it reported: New records obtained by Target 12 how ILO managing partner Julia Rafal-Baer worked with a close confidant of Democratic Gov. Dan McKee, Michael Magee Jr., on the outline of a potential state contract in the days before Magee encouraged state officials to consider hiring her firm.

The WPRI story continued: Magee – who was Rafal-Baer’s boss at a nonprofit at the time [Chiefs for Change] – also outlined how she would lead the work, according to emails obtained through a public records request. “Julia Rafal-Baer and I worked on this scope over the weekend,” Magee wrote to the then lieutenant governor and his top aides in an email on Feb. 28, [2021], two days before McKee was sworn in as governor.

The WPRI story continued: “Julia would play the lead role in this personally,” Magee added, estimating that the consulting work would likely cost million of dollars because “none of this is cheap.”

“How many millions?” [emphasis added] McKee responded the following morning.

According to WPRI, “ILO is no longer working for the state, effectively ending the contract just six months into the deal. The state has paid an initial ILO invoice for $763,000, but the governor’s office has refused to release ILO’s second invoice, saying the billing is still under review.”

In comparison, Boston Consulting Group was paid $3.72 million for its work as a consultant beginning in 2020, $1.48 million less than the $5.2 million contract awarded to ILO in 2021.

ConvergenceRI had responded to the posting of the story by WPRI on Twitter with the following questions on Twitter: “What was the relationship between Infante-Green [the R.I. Commissioner of Education] and Chiefs for Change? Did you ask about or pursue emails involving Infante-Green? And, what McKinsey contract is Magee referencing; was the reference to a specific contract? Or was it a generic reference?

Magee had written in his Sunday, Feb. 28, 2021, email to then Lt. Gov. McKee, Anthony Silva, and Christopher Farrell: “I want to point out now that s with a BCG [Boston Consulting Group] or McKinsey contract, or the Alvarez [Alvarez and Marsal] contract, none of this is cheap. It would be a contract in the many millions of dollars to support a large staff of consultants. What I can promise is that it would give you the very best team in the country to do this work. My only goal is to put Dan in a position to say he led the nation in fully reopening schools and accelerating learning.”

Translated, the goal of this contract was not about protecting and ensuring public health but about leading the nation in fully reopening schools.

One source took a cynical view of the machinations behind the awarding of the ILO contract by the McKee administration. “They are so incompetent. The current administration is really trying to do what [former Gov.] Raimondo did with her friends. And, their incompetence is almost laughable.”

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