Tag Archives: Harry Chen

Shumlin on vaccine exemption bill: No, but maybe, but yes, or possibly N/A

Today, State Health Commissioner Dr. Harry Chen testified before the House Health Care Committee on H.98, a bill that would do a number of things but most famously end the philosophical exemption to childhood vaccines.

I’ll be writing about that hearing in a while, but first… After the hearing, Chen spoke with a small pack of reporters: Dave Gram, Paris Achen, me. Most of the conversation was about Gov. Shumlin’s position on H.98. And as Gram and Achen have reported, Chen characterized the Governor as “neutral” on the bill.

Which in itself was news, because in 2012 Shumlin blocked a bill to end the philosophical exemption. Instead, he supported a bill to improve data collection and educational efforts on vaccination.

Since then, he has said he wanted to allow time to let that law work before reopening the question. But this year he hasn’t closed the door to ending the philosophical exemption; he’s just expressed a desire not to have the debate.

So here’s what Chen said today, and it goes beyond mere neutrality.

I think the Governor’s position is that he’s neutral; he understands that the Legislature has decided to take this up, and will support whatever comes out of this Legislature. And if there are other things, you should ask him, not me.

I read that as an affirmation that Shumlin will sign the bill if it reaches his desk.

Of course, it was only yesterday that Shumlin told reporters “I don’t expect the vaccination bill to get to me.” Profiles in courage?

Right now, the House is considering whether to concur with the Senate amendment that would eliminate the philosophical exemption. After three days of testimony, the Health Care Committee has scheduled a public hearing Monday at 5:30. The Legislature is scheduled to adjourn on Saturday the 16th. House leaders could hold a vote on H.98 next week; they could also decide to kick the can down the road and save the Governor the trouble of deciding where he stands.

Advertisements

Shunned by the vaxxers

Was it something I said? Yes, I’m sure it was.

Sometime today, the Twitter voice of Vermont Coalition for Vaccine Choice cut me off. They blocked me from reading their Tweets.

Let me mark the occasion by reproducing the last Tweet I ever got from them.

Stay classy, folks. As your lobbyist Keith (my mistake, his name is Kevin, I know that, I’ve spoken with him often and have a lot of respect for him) Ellis is probably trying to tell you, you’ll attract more flies with honey than vinegar. Or as I Tweeted in response to the above:

And that’s when they cut me off.

Methinks the vaxxers are feeling the heat. The last rounds of the vaccine saga are playing out at the Statehouse this week and next. There’s one more day of testimony before the House Health Care Committee — including a long-awaited appearance by Dr. Harry Chen, Vermont’s Health Commissioner. After that, it remains to be seen whether H.98, a bill that would remove the philosophical exemption, will be heard on the House floor.

From what I hear, the votes could be had; but House leadership might decide to put it on ice for the year. They have the always-plausible “out of time” excuse in their back pockets, and Governor Shumlin has reportedly said he doesn’t expect the bill to reach his desk.

In which case, we’d wait till next year. Between now and then, either of two events would absolutely tip the balance against the philosophical exemption: a breakout of a vaccine-preventable illness, or a continuing decline in childhood vaccination rates. We’ll hope it’s the latter, not the former.

Bureaucracy to the rescue

It’s a story languishing in the shade of Governor Shumlin’s single-payer surrender, but on Thursday the Department for Children and Families released a third report on its effectiveness. This report pretty much echoed the first two, as VTDigger’s Laura Krantz reports:

The new report grouped its findings into five categories. The key items include better training, more social workers, more transparency and a stronger focus on opiate addiction’s impact on family dynamics.

DCF head Ken Schatz said the similar conclusions of the three reports was an affirmation that “We have a good road map now to go forward.”

Well, that’s nice, but is that sufficient justification for three separate reports plus a legislative review that’s still pending? How much money did we spend on all this investigation? Why didn’t we just commission one really good and thorough report instead of a bunch? Were DCF investigations on sale at Costco?

Beyond that, two things in Krantz’ account jumped out at me. First was the fact that the DCF news conference was “attended by only three reporters.”

That’s sad, and bad. DCF was one of the year’s highest-profile issues in state government. And, to be callous about it, the story was more clickbaity than most because it involved the deaths of two toddlers. Also, the presser was held not in Montpelier, but in Williston — a hop and a skip away for Burlington-based media outlets. Like the Free Press, which I’ve been told was not in attendance. (So far, its website does not provide any coverage of the event.)

If true, that’s pretty shameful, especially for a media outlet that has beaten the drum for greater transparency at DCF. They want transparency, but they’re not going to advance the cause by, oh, sending a reporter to a significant event. Nice.

The other thing that jumped out at me was this. The “road map” that Schatz referred to included a call for “more front-line workers [and] lower case loads.”

In response, Schatz and his boss, interim Human Services Secretary Harry Chen announced that DCF would hire ten more staffers.

Social workers, right? New troops to bring down the case loads, yes?

Er, no.

They include five management positions in the economic services division, two assistant attorneys general to help district offices with child protection cases and the family services division: an assistant district director in St. Albans, a assistant for the centralized call intake unit and a policy specialist.

By my count, that’s six middle management types, two prosecutors to help with cases that have gotten so far out of hand they’re headed for the courts, and two other functionaries, neither of which are on the front lines.

Bureaucracy to the rescue! Our troops are having trouble in the trenches, but never fear — we’re beefing up the staff at headquarters.

Maybe there are excellent reasons for these particular hires, but at a time when AHS is under heavy pressure to make deep cuts, it kinda leaves me scratching my head a little.

Speaking of tight budgets, you might wonder where they’re getting the money for these positions. The not entirely convincing answer is “through anticipated savings from the state’s Reach Up program, which helps poor families.”

Hmm. At the presser, DCF officials released some downright scary numbers on how their case loads have increased over the past year. And we’ve all been told over and over again that the sluggish economic recovery, with almost all its bounty going to the top one percent, is putting the squeeze on working Vermonters. But they’re confident they can save money on Reach Up?

They’re certainly more knowledgeable than me, but I have trouble seeing it.

About those rescissions, pt. 2: The poor will always be with you

It seems as though the Shumlin Administration’s cowardly pre-Thanksgiving newsdump was successful: our political media dutifully reported the topline — $17 million in cuts, including $6.7 million to be implemented without legislative approval.

But nobody, at least not yet, has reported any of the details. And there are some noteworthy details. Some entire agencies seem to be getting off scot-free, while others are taking it in the shorts.

Well, one in particular. And if you guessed “Agency of Human Services,” you’d be a cynical observer of Vermont politics.

And you’d be correct.

Human Services is expected to provide almost two-thirds of the total rescissions — more than $10 million.

It must be noted that Human Services is the single biggest agency, so it could be expected to take a hit. But it’s not anywhere near that big. This seems to be a rerun of past Administration efforts to cut human-services spending; I’m reminded in particular of its ill-fated effort to slash the Earned Income Tax Credit. This time, instead of calling for specific (and politically unpopular) cuts, the Administration is dumping the mess into AHS Interim Secretary Harry Chen’s lap.

Gee. Supposedly Shumlin thinks Chen is doing a bang-up job, and would love to have him stay in the post. This is a damn funny way of showing his appreciation.

Most other state agencies come in for some cuts, but nothing close to AHS scale. And there are a couple of agencies that seem to have avoided the budget ax altogether.

Number-one on that list is the Agency of Transportation. It’s one of the bigger state agencies, and it won’t be getting any smaller; it’s being held harmless.

At the same time, the Governor’s hit list gets awfully picayune in spots. The Vermont Humanities Council is being docked $9,000. The Lieutenant Governor’s office is getting nicked by $2,900. And the Vermont Symphony Orchestra is in line to lose $2,000.

I find it hard to believe that Human Services can slash $10 million but Transportation can’t spare a dime. I also find it hard to believe that a process so fine-grained that it could find two grand in savings from classical music couldn’t identify any cuts at all in concrete and asphalt.

My own budgetary chops are pretty limited, so I can’t assess each and every cut. These are a few highlights, obvious even to the untrained eye. It is to be hoped that someone in the media is taking a closer look at the rescission list. There’s definitely some funny stuff going on.

One final note. It’s been widely reported that there’s a potential conflict between Administration and Legislature over the former’s claim that it can cut $6.7 million without lawmakers’ approval. What hasn’t been reported is that the Administration wants the other cuts — the ones requiring legislative approval — to go into effect before the new session begins.

This seems like a pretty devious way to undermine the legislature’s budget-writing authority. It’s yet another potential flashpoint between the two branches of government. And yet another sign that the Governor has already stopped his post-election “listening and learning.” He’s back to taking pre-emptive action and trying to box the legislature into a corner.

 

Dear Shumlin Administration: Please heed the words of Uncle Barack

President Obama got in a brief tick of turmoil a while back when his approach to foreign policy was summarized as “Don’t do stupid shit.” Which, as the political equivalent of the Hippocratic Oath, makes a world of sense to me.

And I wish our leaders in Montpelier would frame it and hang it over their desks, because it sure would come in handy when dealing with Vermont Health Connect. The latest, ICYMI:

Thousands of Vermont Health Connect customers who signed up to pay health care premiums online recently received email notices directing them to pay through a website that is offline.

Vermont took down its health exchange Web portal Sept. 14…  But the state and its contractors apparently forgot during the intervening three weeks to cancel an automated email blast that directed roughly 6,500 people who signed up to make payments online. Those people, about 20 percent of the website’s commercial customers, were directed to visit vermonthealthconnect.gov to view their premium invoice.

(ahem.)

NNNNNOOOOOOOOOOOOO!!!! 

Stop it! Just stop it!

Stop doing stupid shit!

“Apparently forgot,” eh? Maybe some of you should come to work tomorrow and find that your keys no longer work because your bosses “apparently forgot” to let you know about your change in employment status.

This bout of apparent forgetfulness happened under the new contractor, Optum, and under the revamped administrative team of Harry Chen and Lawrence Miller, so we can’t blame this on the dearly departed (CGI, Doug Racine) and the recently rendered invisible (Mark Larson).

I’m a strong supporter of the current iteration of health care reform, and I have high hopes for single-payer. As a result, I’ve too readily accepted Administration assurances that they’ve learned their lessons, they’re working hard, they’ve got a handle on it, and they’ll fix it.

This time, as Bullwinkle T. Moose used to say, for sure.

But I am getting tired of defending the Governor and getting the ground cut out from under me. Maybe that’s why a new poll shows him with a 45% favorable rating against 41% unfavorable. In spite of the fact that he’s running for re-election against the legendary comedy team of Mr. Blandy and Mr. Fringey.

So, Shumlin team, please tell me there won’t be any more screwups, revelations of past blunders, delays, or embarrassing emails to the very constituents who (a) were in line to benefit from Vermont Health Connect and would love to see it work, and (b) now have every reason to be royally pissed off at the authors of this reform.

A protest vote for Doug Racine is startin’ to look awfully tempting.

Two ships that pass in the night

Today, via Neal Goswami of the Mitchell Family Organ:

A report released Wednesday based on an internal review of the Department for Children and Families does not recommend restructuring the agency, but does seek immediate boosts to staffing, additional staff training and better collaboration between the department and its partners.

Yesterday, via them damn commies at the Public Assets Institute:

A month after announcing a 2 percent cut to the current year’s budget, the Shumlin Administration is signaling its intention to make additional cuts of as much as 5 percent and possibly more next year (fiscal 2016).

Well, that looks like a conundrum in the making.

Human Services Secretary Harry Chen, the presumably more loyal and/or pliable replacement for the cashiered Doug Racine, now has a report that says his agency needs more resources. Which probably induces a rueful chuckle from Mr. Racine.

And now this report will duke it out with the Administration’s budget instructions reportedly given to its top managers:

The administration laid out two scenarios for fiscal 2016:

— Level funding—the same amount appropriated for this fiscal year after the cuts adopted in August.

— Five percent cut from fiscal 2015 levels—again after the August cuts.

As PAI notes, the best-case scenario — level funding — would mean cutbacks, since there are built-in cost increases: “cost of living increases for state employees, caseload increases, contractual increases, loss of federal funding, inflation, and other new demands…”

The AHS/DCF review was initiated by then-Secretary Racine. Will Dr. Chen back up the report’s conclusions? Or will he bend to the apparent belt-tightening mandate from above? According to the PAI report, he’s got about two weeks to turn in his budget recommendations.

VHC and the NFL

The National Football League, the unstoppable beast of modern sports, is having a bad time of it. Commissioner Roger Goodell, team owners, and players are under scrutiny for what appears to be an epidemic of bad behavior toward women and children, and a casual attitude toward violent offenders.

In actual fact, there are no more or fewer incidents than there have ever been. The problem is the league’s hypocrisy, backtracking, dishonesty, and double-dealing. Or, as we learned from the Watergate scandal — well, we should have learned it — it’s not the crime that gets you, it’s the cover-up. If the NFL had gotten out in front and taken plausibly strong action, its current PR crisis would never have happened.

Which brings me to Vermont Health Connect, our long-troubled and (temporarily?) sidelined health care exchange. And particularly the need for a heavy dose of the best disinfectant: sunshine.

To begin with the takeaway: Please, let there be no more surprises. If there are unrevealed problems, call a news conference ASAP and get all the bad stuff out in the open at once. No more dribs and drabs, no more Friday afternoon newsdumps; just a public accounting for everything. Take heed of the NFL’s tribulations, made worse every time new information comes out or a prominent figure sticks his foot in his mouth.

Maybe there’s no bad news left. Maybe we know it all. That would be great, if true. But the Administration’s recent track record doesn’t fill me with confidence.

Go back, first of all, to the Friday afternoon newsdump to end all Friday afternoon newsdumps: the release of the Optum report detailing serious problems with the state’s oversight of the VHC website’s construction. Not problems with the technology or software; but serious management shortcomings by Shumlin Administration officials. The report was released the Friday before Labor Day, so maybe you missed it.

At the time, the words of responsible officials were not reassuring. Health care reform chief Lawurence Miller said the Optum report would help chart “the best way forward,” which seemed to preclude any accounting for past maladministration. And Health Access Commissioner Mark Larson, who has since been sidelined from VHC oversight, allowed as to how his takeaway from the report was that “we have worked hard with our vendor partners.”

Well, yeah, hard. But not effectively.

On September 15 came the temporary VHC shutdown. It was first announced as a way to streamline repairs and upgrades in advance of the next open enrollment period. It made sense, and I praised it at the time: stop futzing around, get it fixed, and set the stage for the single-payer debate.

Since then, a couple things have happened that cast doubt on my sunny interpretation. A few days later, VTDigger’s Morgan True reported that the VHC shutdown had as much to do with a site-security crisis as with a sudden onset of managerial diligence.

Over the summer the federal government provided a timeline for reducing security risks, which expired 10 days ago…

Miller and Harry Chen, the secretary of the Agency of Human Services, decided to take down the website last weekend because the state was unable to meet a Sept. 8 federal deadline for security controls; the determination was not the result of a security breach or a specific threat.

“Rather than asking for more time, we decided to disconnect from the federal hub,” Miller said.

Miller could not rule out the possibility that the feds might have ordered a VHC shutdown if the state had failed to act.

Which puts quite a different complexion on the shutdown. And Miller didn’t reassure much when, speaking about security issues, he had trouble with verb tenses:

… it needs to be a high priority; it needed to be a higher priority than it was.

A curiously passive tone, methinks.

The very next day, we learned that top state lawmakers were displeased that they learned of the VHC shutdown through the media. Sen. Ginny Lyons, chair of the Senate Health Care Oversight Committee, said “We’re legislators, so we need to know.” Miller’s response? Officials kept it quiet for security reasons.

“The nature of the announcement was also an abundance of caution. Security advisers say when you’re going to do something for security reasons you do not telegraph that ahead of time.”

Uh, sorry, but no.

The federal government has crafted ways to share top-secret information about things like war, terrorism, and intelligence with appropriate members of Congress. I think Shumlin’s people could have passed a quiet word to, say, legislative leadership and the chairs of the health care committees. I think those people could have been trusted to keep a secret, for a couple of days, for good reason.

Miller’s explanation, of course, implies that lawmakers cannot be trusted. I think if I were Ginny Lyons or Mike Fisher, I’d be insulted by that.

And next winter, when Shumlin starts the push for single-payer, he’s going to need the support, good will, and trust of those leaders. Well, Miller as much as said he didn’t trust them.

I sincerely hope we’ve emptied out the Pandora’s Box of VHC. If there are still some dark, unexamined corners and crevices, then I implore the Administration to throw open the lid and let the sun shine in.