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Making the local news media irrelevant; and they respond like well-trained pets
By Richard Asinof, ConvergenceRI.com – contributing writer
A trip to the Governor’s live news briefing at the Vet revealed how Raimondo has made the local news media largely irrelevant – and, in turn, how they have responded to the change like well-trained petsJust before I arrived at the Veterans Memorial Auditorium on Wednesday, July 1, to attend the scheduled live briefing and media scrum hosted by Gov. Gina Raimondo and her team, I had tuned in to listen to WPRO host Tara Granahan to “take the temperature” of talk radio in Rhode Island.A caller broke the news to Granahan that the Governor had just made Oprah magazine, highlighting Raimondo as one of the governors who “are helping Americans survive a global pandemic.”The Oprah news left Granahan momentarily stunned, at a loss for words; she quickly recovered, saying that Oprah herself had been apparently taken in by Raimondo’s aggressive marketing of herself.Granahan had been playing clips from CNBC’s “Mad Money” in which Jim Cramer had raved about Raimondo’s role in leading Rhode Island through the pandemic crisis. With fans like Oprah and Cramer, who could ask for anything more? The local news media, it seemed, was becoming a sideshow, much like Cambodia was to Vietnam, in Henry Kissinger’s opinion.In search of transparencyWhy was I attending the news briefing, against the advice of my primary care physician and my neurologist? In part, it was curiosity. In part, it was because of the failure of Gov. Raimondo and her communications team to respond to my repeated questioning about how much she was planning to invest in Rhode Island’s Health Equity Zones in the FY 2021 state budget.My question had not received any response, despite numerous inquiries. [See link below to ConvergenceRI story, “What happens to a question deferred?”] If I am honest, I had the delusion of self-importance that if I asked the question in person, I might get an answer.I did get to ask the question, toward the end of the news briefing, having to shout three times to be heard. The Governor refused to reveal or share what her plans were, saying it depended on what Congress did.Raimondo expressed exasperation at my question, as if her credentials for her support for Health Equity Zones should not be questioned. Twice before, in her proposed budgets, she had promised to commit $1 million to support sustainable funding for Health Equity Zones but reneged on that promise. Now, she was refusing to make her plans transparent.Not surprisingly, my question and the Governor’s refusal to answer were not included in any of the news summaries of the event provided by the other reporters covering the news briefing.But my takeaway from the gathering was that something far darker, much more ominous was occurring than refusing to answer questions. It was related to the way that the Governor had become adept in manipulating her messaging – and in how the local news media had become compliant, complicit, and complacent, particularly in their willingness to behave like well-trained pets in their response to the Governor’s announcement of a new initiative around re-imagining nursing home care, regurgitating what was said without providing any critical analysis.Setting the stageTwo potentially devastating news stories had lit up the social media universe in the day preceding the news briefing.• First, political reporter Kathy Gregg at The Providence Journal had broken the news that the Raimondo administration had contracted with the Boston Consulting Group to the tune of $1.85 million in a no-bid contract, paying a salary of $25,000 a week to the consulting group’s employees who became “embedded” at government agencies.In her response at the news briefing, Raimondo claimed the Boston Consulting Group had first approached the state and provided millions in “free” help before being offered a no-bid contract.What was not discussed, and has not yet been made transparent, is how McKinsey has apparently been contracted by the state to do similar work as the Boston Consulting Group, being paid for their efforts through a “philanthropic” contribution.Some folks on the Governor’s team apparently had found the work done by McKinsey to be far more “valuable” than the work done by the Boston Consulting Group. Until recently, Raimondo’s husband, Andy Moffitt, had been working with McKinsey.• Second, photographs of a badly bruised patient at a nursing home had been circulating, creating a storm of outrage. In apparent response, Raimondo chose the news briefing to announce a new initiative about “re-imagining” nursing home care, with an emphasis on providing more home health support.The new age of oblivionAs I slowly made my way down into the cavernous aisles at the Veterans Memorial Auditorium with my trekking poles in order to keep my balance, filled with mostly empty seats, a sudden insight occurred to me, influenced in large part by the news about Oprah and Cramer praising Raimondo: the audience of local news media had been made irrelevant by the Governor’s media savvy communications team, apparently led by Jon Duffy at Duffy and Shanley.The Governor now controlled a direct link to talk to Rhode Islanders, a video and radio feed, to get her messaging across. It was amplified by a daily email sent out by Constant Contact, often featuring an edited video of the news briefing.The reporters who attended and asked questions were never seen, only heard, with the video cameras focused on the Governor, Dr. Nicole-Alexander Scott, the director of the R.I. Department of Health, and Brett Smiley, the director of the R.I. Department of Administration.[Off-screen, Jennifer Bogdan Jones, who would soon be departing her position for a new job at Brown University, served as an official timekeeper.]Translated, the news reporters had been relegated to serving as unimportant, bit players, off-screen, a role that they seemed to have not yet fully understood, serving as willing conduits for the Governor’s messaging.The revolution will not be televisedI was early; the Governor, not surprisingly, was late. The running joke among news reporters who have regularly attended events held by the Governor was that she is always about 20 minutes late, operating by her own clock. On July 1, she was 15 minutes late.There were many of the usual suspects: Steve Ahlquist of Uprise RI, Michael Bilow from Motif Magazine, Bill Bartholomew from BTown podcasts [and soon to be RI PBS], Brian Crandall from NBC10, G. Wayne Miller from The Providence Journal, John DePetro from his own radio show, and the sole woman reporter on that day, Kim Kalunian, from WPRI.[Ahlquist and Bartholomew were surprised to see me walking with my trekking poles, asking what had happened. I referred them to the July 4 column published last week. Bilow introduced himself.]My attendance was an apparent “aberration” – the last “live” news scrum conference I attended had been during the second week in March. As a result, I was “checked out” by one of the Governor’s aides who asked my identity and what news media outlet I represented. Really?It was much like the perfunctory health check done by the state police officers at the entrance to the concert hall when I walked in, asking if there had been any changes to my health. No temperature check was conducted, however.Nursing homes initiativeI could report on what the Governor said in announcing her new initiative about re-imagining nursing home care, but I am not a well-trained seal, and I do not bark on command. Arf, arf, arf. Some of the ideas floated were attractive, such as single rooms and single bathrooms. The problem, of course, is the cost: who is going to pay, how much, and how will those investments become part of the budget?I had previously reported on intimations made by the Governor about such plans. [See link below to ConvergenceRI story, “What nursing homes can teach us about future health care in a post-pandemic world.”] Much better than folks read that story, in particular, the details around the failings of the Reinvention of Medicaid, the signature initiative of Raimondo’s first term.A short synopsis, for those that no longer read, goes like this: The initiative, which became law in 2015, mandated that accountable entities be adopted for all Medicaid managed care programs. However, no accountable entity yet exists for long-term support and services under Medicaid. One physician told ConvergenceRI in 2019 that accountable entities “give clusterf**k a bad name.”In terms of the budget, Medicaid spending amounts to roughly one-third of the entire state budget; two-thirds of the state Medicaid budget goes to pay for long-term support and services. Worse, despite state law to the contrary, there were more than 800 Medicaid eligibility applications for care that were still pending for longer than 90 days in January of 2020, a delay directly linked to the UHIP snafu that has not be corrected since the Deloitte system’s launch in 2016.Translated, who is going to hold the Raimondo administration accountable for its past mistakes before it launches yet another new initiative?What struck me as strange was the timing of the launch announcement – it was the last regularly scheduled media briefing before July 4, without having yet lifted visiting restrictions on nursing homes [promised for the following week, but moved up to Friday, July 3, without consultation with the nursing home industry].Apparently, the Governor had failed to discuss her planned initiative with the nursing home industry trade association, leaving them in the dark.Scott Fraser, the president and CEO of the Rhode Island Health Care Association, issued a response on Friday morning, July 3, with some important “clarifications” around the issues raised by the Governor.“Because of the vulnerable nature of our nursing homes, RIHCA made it a priority to have a consistent communication to the state on our concerns and need for assistance at the onset of this virus. Many requests were answered, but some critical needs were slow in coming,” Fraser said.Fraser continued: “RIHCA sent a number of letters to the state on topics of concern. First, RIHCA requested the state test hospital patients for COVID-19 before they were transferred into nursing homes for their next stage of care. The state took weeks [emphasis added] to institute this testing policy. The insertion of untested hospital patients is what brought the first cases of COVID-19 into the nursing homes.”Further, Fraser said: “RIHCA also advocated for more testing and rapid results testing to be instituted into the homes. Isolating residents and workers is nearly impossible with a virus that is asymptomatic, and people are left untested. This critical testing of residents and workers was slow to be implemented [emphasis added]. Today, regular testing occurs, yet results can sometimes take between six and 10 days to come back, rendering many results unusable.”In initial two months of this virus, Fraser said, “Our calls for assistance were heard, but only slowly answered. These initial months had a big impact on how this virus played out in Rhode Island nursing homes.”Fraser cited statistics to back up his response to the Governor, saying that while, as of June 26, 73 percent of the state’s COVID-19 deaths had been “associated with” Rhode Island nursing homes, the percentages of deaths [627 out of 927], the numbers were on a par with what was occurring in neighboring states – 62 percent in Massachusetts and 75 percent in Connecticut. In fact, Fraser continued, “You don’t always hear the story that many residents survived COVID-19. In fact, nearly three-quarters of the 2,745 who have contracted this virus in RI’s nursing homes have recovered. Our homes are celebrating these recoveries week after week.”Fraser took on Raimondo’s challenge around “innovating around long-term care” head on, saying that the Governor had suggested that nursing homes should apply for grants for innovative solutions like single occupancy rooms and bathrooms and she also committed to investing in home care.“We are willing to be at the table to discuss how we move forward with a smart continuum of care for the people of RI, yet we want to remind Rhode Islanders that we are caring for the most frail elderly in our state who in most cases need 24-7 care,” Fraser said. “Medicaid patients account for two-thirds of nursing home residents. Since 2012, Rhode Island has cut the Medicaid budget nearly every year, forcing many homes to operate at the financial edge. If the Governor is willing to replenish the Medicaid budget after significant cuts and UHIP reimbursement issues, and provide more funding for single rooms and home care – this would be a welcome change.”At a time when the Governor will not reveal her budget hand about how much she is willing to invest in Health Equity Zones in Rhode Island, would she be willing to reveal how much she plans to invest in her nursing home initiative?While the idea of re-imagining care for residents of nursing homes strikes a resonant chord for many, particularly for those with family members currently in nursing homes, what her initiative does not yet address is how the Governor will change the current continuum of care relationship between hospitals and nursing homes. Where will patients go who are recovering from surgeries and need rehabilitative care?
Read the complete story, here, at ConvergenceRI:
Richard Asinof is the founder and editor of ConvergenceRI, an online subscription newsletter offering news and analysis at the convergence of health, science, technology and innovation in Rhode Island.