Tag Archives: Morgan True

And now, the next phase of the “Get Rid of Norm” campaign begins

Yesterday, prosecutors and defense in the Senator Norm McAllister Incredibly Gross and Offensive Sexual Exploitation case got together and released the “discovery stipulation,” or in English, the projected timeline for a trial.

And as VTDigger’s Morgan True reports, it’s scheduled to take place “smack in the middle of the 2016 legislative session.”

Bwahahahahaha.

Wouldn’t that be fun? If McAllister remains determined to hold on to his seat, he’d have cameras following him everywhere he goes in the Statehouse, and following him back and forth to the courthouse, and reporters asking all sorts of embarrassing questions of fellow lawmakers (“Hey, Senator Mullin, got a minute? I want to ask about your old roomie.”), especially Republicans, and especially Franklin County Republicans.

Of course, legal experts say that delays are virtually inevitable, so the likely outcome is that the trial will happen sometime later next year. Buzzkill. Even so, the cameras and reporters will be swarming.

But with the legal schedule set, Republicans will redouble their efforts to convince McAllister to deliver the face-saving resignation they all desperately want. As Senate Minority Leader Joe Benning told me last month, once the discovery stipulation is revealed, “the process will be clear and Norm will have to face it.”

That is the hope, anyway.

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The downside of subcontracting human services

We had an unintended confluence on the Thursday edition of the Mark Johnson Show, hosted by Yours Truly. Back-to-back interviews with VTDigger’s Morgan True and State Auditor Doug Hoffer turned out to cover some common themes.

True had reported on problems at Rutland Mental Health Services, one of the state’s “designated agencies” for providing social services. Hoffer had just released a very critical performance audit of the Corrections Department’s transitional housing program. I was in the middle of the show when the light bulb went off. Both interviews were kind of about the same thing: Inadequate oversight of human services contractors.

In both cases, an Agency of Human Services program is contracted out to nonprofit agencies that get virtually all their funding from the state. In a way, it’s a mutually captive relationship: the agencies are completely dependent on the state, and the state effectively has no options for replacing a poorly-performing contractor.

In their own way, True and Hoffer found similar problems in different areas of AHS: lack of consistent oversight, gaps in service provision, and inadequate methods for tracking performance. (In the case of RMHS, the situation boiled over into scandal.) The result is a system that looks good from a distance, not so good up close. Its failures are partly due to lax oversight; but we should also consider whether poor contractor performance may also be due, at least in part, to bare-bones funding by the state.

After the show was over, I pondered another issue: What does the Rutland situation have to say, if anything, about the Shumlin administration’s community-based mental health care system? Because those designated agencies are the front-line troops in that effort.

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It’s not that simple

One of my readers posted a comment basically wondering why, if women were being routinely victimized by soon-to-be-former Sen. Norm McAllister, they didn’t go to the authorities? Why put up with the abuse? Why not stay away from the guy?

It’s an understandable reaction. I’ve never been in that situation, and it’s almost impossible to imagine being in that situation. But many people are — more than it’s comfortable to think about — and they feel powerless to resist, evade, or report.

For one great example of this phenomenon, see Morgan Trus’s fine piece on VTDigger regarding “survival sex” — in which victims feel their well-being is dependent on their abuser’s approval. It’s a surprisingly common occurrence, especially in a society where many women are financially dependent on a man.

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Vermont’s new mental health system will have more inpatient beds than the old one

I wouldn’t blame Jay Batra if he felt personally vindicated today. Maybe even a little bit smug. VTDigger’s Morgan True: 

The state wants to replace a temporary psychiatric facility in Middlesex with a permanent structure twice the size, officials told lawmakers last week.

… Last June Vermont opened the doors of the Vermont Psychiatric Care Hospital in Berlin, but the system still lacks the capacity to keep people with acute psychiatric needs out of emergency departments.

How about that. “…the system still lacks the capacity…”

Vermont’s new, decentralized, community-oriented system currently has 45 beds: 25 at VPCH, 14 at the struggling Brattleboro Retreat, and six at Rutland Regional Medical Center. If/when the Middlesex facility is built, the system will have 59 beds.

Before Tropical Storm Irene, the Vermont State Hospital had 54 beds. After Irene, the Shumlin administration insisted, repeatedly, that if we had a more robust community-based system, we wouldn’t need that many inpatient beds. In the process, it ignored the counsel of psychiatric professionals, who said that 50 was the bare minimum.

What’s happened since then? The administration has slowly, quietly, built the system back up. And it has found that, yes indeed, those professionals knew what they were talking about.

Let’s take a trip in the Wayback Machine to Tuesday, December 13, 2011

Gov. Peter Shumlin announced on Tuesday that his administration plans to replace the Vermont State Hospital in Waterbury with a decentralized, “community-based” plan with 40 inpatient beds in four locations around the state. …

The unveiling of Shumlin’s proposal came on the same day a top mental health psychiatrist called for almost the exact opposite of what the governor proposed. Dr. Jay Batra, medical director of the state hospital since 2009 and a professor at UVM, told lawmakers at a hearing on Tuesday that the state should have one central mental health facility serving 48 to 50 patients in order to provide the best clinical treatment and best staffing model.

That, from a lengthy VTDigger account of Shumlin’s announcement, which was made in the conspicuous absence of Dr. Batra. At the time, Shumlin was planning on a central hospital with as few as 16 beds. It was a well-intentioned effort to avoid the serious problems that had plagued VSH in the past. But it was a misdirected effort, pursued against the advice of those actually in the field.

At the time, I wrote some highly critical stuff about the administration’s plan, and I got some active pushback from administration officials who basically accused the psychiatric community of professional puffery — overstating the need for their own expertise.

Now, it’s safe to say that the administration was wrong.

Assuming the Legislature approves the $11.4 million Middlesex facility, the mental health system will have more beds than before Irene, and those beds will cost more than a similar number at a single, central State Hospital. How much more, I don’t know. But the system has had persistent problems hiring and maintaining the staff it needs for the specialized care its patients require. Those problems are exacerbated when the beds are spread among four separate facilities.

Also unknown is how much money was [mis]spent on the long and winding road to get exactly where the experts thought we should go in the first place. Plus, we are left with a system that’s almost certainly more expensive to operate and harder to administer because of its geographic spread.

One of Governor Shumlin’s great strengths is his decisiveness. He can assess a situation quickly, make a decision, and carry it through. Well, it’s a strength when he’s right. When he’s wrong, and he stubbornly insists on staying the course, that same decisiveness is one of his great weaknesses.

Don’t expect the Vermont Workers’ Center to go away anytime soon

Those dirty hippies who made Joe Benning walk the gauntlet on Inauguration Day are most likely in this for the long haul. I say this because the Vermont Workers’ Center is a rapidly-growing organization with surprising financial muscle.

According to the nonprofit’s most recent IRS filing, VWC had revenue of nearly $680,000 in the year 2013. VWC head James Haslam told VTDigger’s Morgan True that this year, the figure will be around $800,000. As recently as 2009, its intake was less than $200,000; you do the math.

That’s pocket change in Koch World, but in Vermont it makes VWC a power to be reckoned with, beyond its ability to draw a crowd to the Statehouse.

Aside from money, it’s also tapped into a deep vein of dissatisfaction with/alienation from politics as usual. Its members are committed enough to turn out large numbers for a demonstration or flood the Statehouse hallways when needed. They are also willing to financially commit: VWC charges membership dues, and pulls in about 30% of its budget from members without much apparent effort.

My big question, when I saw VWC revenues in the high six figures, was: where is it all coming from?  Haslam:

That work is supported by a combination of foundations which, typically, is about half of our support or maybe a little bit more. The other half is from our base, which is individuals and trade unions. I think it’s something like 20% unions, 30% individuals. It fluctuates year to year, but that’s about right.

I didn’t ask him for a list of foundations; as a nonprofit, VWC is not obligated to release donor information. VTDigger’s Morgan True reports that the Ben & Jerry’s Foundation is its largest nonprofit donor, having given $50,000 this year and a total of $160,000 since 2010. True also reports that VWC has strong ties to a national network of progressive organizations; “We’re part of a broader people’s movement to turn things around for working people,” Haslam told him. Well, if its largest foundation gift was 50K and they’re pulling in 400K from foundations, then they’re drawing from a large donor pool.

One other note from Thursday’s protest. It’s been reported that five of the 29 people arrested that day were paid by VWC, which has raised some hackles. Haslam says the five are members of VWC’s ten-person staff. He says they did not receive any remuneration beyond their regular pay for taking part in the protest or for being arrested.

At a planning meeting before the protest, Haslam told me, people were asked whether they would be willing to be arrested if necessary. “We were hoping that nobody would be arrested,” he said, “but our members felt that it was important for us to take a bold stand.”

Those who volunteered for arrest, he said, “were all people who had had first-hand experience with the health care crisis.” Five of them happened to be VWC staff. “That was a voluntary act for sure,” he says. “We have a number of staff people who didn’t do it.” Including, as it happens, Haslam himself.

With a committed membership and a growing financial base, VWC shows no signs of being a flash in the pan, or some sort of Occupy movement that will burn brightly for a brief time and then flame out. They look to be in this for the long haul, on a broad variety of issues. Whether or not they continue to declare themselves at big political events, they’ll be around, promoting their causes and making it harder to ignore their issues.

Our still-broken inpatient psychiatric system

One of journalism’s highest purposes is to lance the boils of society — to expose unpleasant truths that everybody is doing their best to ignore.

A prime example appears on VTDigger today: a story by Morgan True about the continuing problems in the state’s psychiatric care system, and particularly the brand shiny new state hospital in Berlin.

Among the key points:

— Even after the facility’s opening, some psychiatric patients have found themselves parked in emergency rooms for days or even weeks.

— There have been 59 documented attacks by patients on hospital staff, some resulting in significant injuries.

— The hospital houses a couple dozen of the most severely ill people in Vermont. Many have been convicted of violent felonies. One doctor told True that the hospital is “one of the most dangerous workplaces in Vermont.”

— State law strictly limits the restraint or medication of patients against their will. Even the most violent.

— In part because of this dangerous work environment, the hospital has been consistently understaffed since its opening. As a result, it has yet to operate at full capacity.

Which brings us back to point one: several months after the hospital’s opening, severely mentally ill people are still being warehoused in ERs.

This is a whole lotta bad stuff. It shows a mental health care system that’s still functioning poorly even after the Shumlin Administration’s entire plan has been put in place.

The Department of Mental Health, for its part, seems to be taking a remarkably lax and unforthcoming attitude toward the situation. DMH knows the total number of attacks on staff, but it won’t release any information on staff injuries.

And according to DMH Deputy Commissioner Frank Reed, the department “has not tried to compare the number of violent incidents at VPCH to other psychiatric hospitals.”

Well, why the hell not? I’d think you’d want to know whether our problems are unique, or simply the natural consequence of caring for the most severely mentally ill.

Reed also flunks the transparency test when it comes to waiting times in hospital emergency rooms. He says average wait times have decreased, but…

Reed was unable to provide documentation of average wait times, saying those figures are still being “pulled together.” The numbers will be presented to a legislative oversight committee in January.

Perhaps Mr. True should apologize for inquiring at an inopportune time. But it shouldn’t be that hard to assemble those numbers. Indeed, I’d expect a Department that’s doing its job to compile those figures on an ongoing basis.

In fact, I’d be very surprised if DMH doesn’t have the numbers already. It’s Management 101, isn’t it? Keep track of your most important statistical markers?

True’s report raises all kinds of questions about state law, the Shumlin Administration’s concept of a mental health care system, and how many resources were spent trying to develop a system that was undersized from the start. DMH officials are talking about supplementing the system with a new 14-bed secure residential facility, but acknowledge that it’ll be a tough sell when lawmakers are under the gun to cut the budget. DMH may have already squandered its best opportunity to create a good system.

And please don’t insult me with the “No one could have foreseen” excuse. The people responsible for inpatient care were all saying the same thing after Irene: the Shumlin Administration’s plan was so bare-bones that it was almost doomed to fail. While their advice was ignored, how many millions did the Administration spend on inadequate plans, patchwork facilities, and extra costs? (One example: according to True, the state has paid more than $1 million since 2012 for sheriff’s deputies to monitor psychiatric patients in hospital ERs.)

And it turns out, to the surprise of no one who works in the field, that a 24-bed hospital costs nearly as much to run as the old 50-bed facility, and costs more on a per-bed basis because the foundational staffing needs are so high.

And, given that the new hospital has some of the same kinds of problems as the old one, I have to ask if our laws are out of whack. I mean, look: We’re talking about the two dozen  sickest people in Vermont, many of them violently, dangerously sick. The restrictions on restraint or medication without patient approval may be the best thing for the vast majority of patients; I believe different standards should apply to the very sickest. They are the ones least capable of exercising sound judgment, and most capable of inflicting harm on staff or fellow patients.

One commonality between the old hospital and the new is our strongly patient-centric laws. It seems clear to me that those laws are on point for the vast majority of patients, but that there should be a different standard for patients in the state hospital.

Shumlin waves the white flag

The governor’s number-one public policy goal is no more.

At a news conference today, Governor Shumlin pulled single payer health care off the table, saying the numbers simply don’t add up. Instead, he promised a continued effort to improve access to, and lower the cost of, health care in Vermont.

“This is the greatest disappointment of my political life,” he said, and that nails it. Single payer was one of the foundations of his initial run for governor in 2010. His promise to push for single payer set him apart in a crowded Democratic field and helped overcome doubts about his liberal bona fides.  That promise kept the Progressive Party on the sidelines in 2012 and 2014.

And now, it’s not gonna happen.

Oh, he promised a continued fight for a fairer and more accessible system, starting with the 2015 legislative session. But single payer is out until further notice. When asked, “If not in 2017, when?” he only answered in generalities.

As for the timing of the announcement, only six weeks after the election, Shumlin claimed that his team had just finished working the numbers last Friday and confirmed the bad news on Monday.

The numbers were unacceptably bad. Morgan True of VTDigger had reported that the financing mechanism would be based on an 8% payroll tax and a consumer premium imposed on a sliding scale. But the way the numbers shook out, the actual payroll tax would have to be more like 11.5%, and the premiums would have to be higher than expected. The result could punish the economy and leave many Vermonters with higher health care costs.

He cited several factors that moved single payer out of reach. Federal subsidies were not going to be as generous as hoped. The sluggish economic recovery meant fewer dollars coming into the treasury. That had led to state cuts in Medicaid payments that reduced federal support.

Also, the administration had decided a three-year phase-in for small businesses that don’t currently provide insurance was necessary to cushion the shock of a payroll tax. That phase-in meant substantially lower payroll tax revenue for the first three years.

Shumlin was clearly sensitive to the concerns of the business community. That, and his woodshedding in the November election. He saw single payer as a huge gamble that he was unlikely to win, and now is not the time to stick his neck out.

He also acknowledged that the troubled rollout of Vermont Health Connect cost him credibility on building a new health care system. “We must show we can deliver,” he said. “Vermonters have reason to question us, given the troubles with Vermont Health Connect.”

He emphasized all the hard work that’s been done to create Vermont Health Connect, bend down the cost curve, and lay the groundwork for a better system. And he promised a continued, all-out effort to improve the system. But single payer was his signature deal, and now he’s had to forego it.

Even if the delay is relatively brief — say, two years — single payer is almost certainly unattainable during his tenure in office.  The failure of single payer will be a big part of his legacy, and will significantly hamstring his ability to win back liberal and Progressive voters who’ve been skeptical of him.

Fair or not, today’s announcement confirms that skepticism. Let’s accept that the numbers are honest and the timing was just the way things worked out. Even so, the optics are bad.

There are many liberals who never believed Shumlin was serious about single payer. They will see their cynicism as confirmed.

This retreat will also lend great comfort to the foes of health care reform. A determined Democratic governor, with all the resources he could want, spent three years researching single payer, only to conclude that it wouldn’t work. The revised cost estimate for single payer — $2.6 billion a year — is almost exactly what Wendy Wilton, then-Republican candidate for Treasurer, estimated two years ago.

And the abandonment of single payer strips the governor of his signature issue. Aside from Tropical Storm Irene, his administration has been marked by incremental gains on a number of issues and blocking tax hikes. There haven’t been any high-profile accomplishments — which is why one of Shumlin’s re-election ads focused on GMO labeling, an issue he didn’t support until the last minute. And why a recurring theme in other ads was Irene recovery, something that happened in his first term.

Now we can now look forward to more incremental gains and belt-tightening. His downsized proposals for the 2015 legislature on health care were purely incremental in nature. None will generate headlines or fuel a grassroots movement.

The governor’s gonna have to pull a rabbit out of a hat somewhere to restart his political career. And his biggest hat is now empty.

Now that I have their attention

Funny thing happened Thursday, unprecedented in my three-plus years of political blogging.

My sources. Not exactly as illustrated.

My sources. Not exactly as illustrated.

I got calls from not one, not two, but three different top Democrats seeking to gently upbraid me for stuff I’d written this week, and offer some guidance toward alternative views. Their own views, of course.

Which is nice for the ego. They read, and they care.

Also, their messages were valuable. They did offer some good information. But I’m not completely convinced.

The callers offered some pushback on the subject of newsdumps. They insisted that what appear to be newsdumps — the offloading of bad news when people are least likely to see it — were not newsdumps at all, but simply cases of the calendar conspiring against them.

There was a second message: the upcoming round of budget rescissions do not single out Human Services. They don’t deny that AHS is going to feel the pain, but the problem, as they explain it, is that vast areas of the budget are off-limits for rescissions, which makes AHS the only real target of substantial size.

They made some good points. The problem is this: the Shumlin administration has a well-earned reputation for (1) deviousness, (2) political gamesmanship, (3) newsdumps, and (4) targeting Human Services. Their own track record colors my views of recent events. In other words, if I was overly cynical, I put much of the blame on their doorstep.

I’m sure those inside the administration don’t see it that way. For the most part, they honestly believe they’re trying their best to move the state forward through tough times. But the 2014 election should have been a wake-up call: their view of things is often at odds with others’ views. Say, the voters’ views.

Let’s take their points, shall we?

First, on Human Services having to make almost two-thirds of the cuts in the upcoming rescissions. It’s true, but the reason is that AHS takes the lion’s share of general fund money. And only general-fund programs are open to rescission. Schools and transportation don’t get much money from the general fund, for instance.

According to outgoing Administration Secretary Jeb Spaulding, appearing on VPR’s Vermont Edition Friday, AHS accounts for 40% of the total budget — but 75% of General Fund spending.

Which sounds reasonable to me. But…

1. This wouldn’t be the first time the administration targeted AHS. The most notorious case is Shumlin’s ill-fated effort to slash the Earned Income Tax Credit, one of our best bulwarks against the rising tide of income inequality.

2. The rescissions list was released on the Thursday before Thanksgiving. This may or may not have been a newsdump (see below), but it gave little or no opportunity for journalists and bloggers to seek clarification of the raw numbers. When I saw the raw numbers, they looked really, really bad for AHS.

And now, on to newsdumps. I had identified three: the rescissions release, the deadline for submitting rescissions, and the Governor’s release of his single-payer financing plan at the end of this month.

The rescissions release on Thanksgiving Eve wasn’t a newsdump, my callers insist. They had put together the list and informed agency officials earlier that week. Many agencies wanted to tackle the budget-cutting immediately — over the holiday weekend. That meant releasing the list on Wednesday, so the process could begin.

The deadline, Friday Dec. 5, they say, wasn’t a newsdump because they hadn’t planned to release anything on Friday. It was an internal deadline only.

I can accept that. But once again, history informed my cynicism. When I see something bad happening on a Friday or a holiday eve, my Weaselometer begins to howl.

Finally, the long-awaited and catastrophically overdue reveal of the single-payer funding plan (which VTDigger’s Morgan True appears to have uncovered the substance of already) on either Monday December 29 or Tuesday December 30. Many voters will be out of town or otherwise occupied during that time; media outlets will have bare-bones staffing. So of course it looked like a newsdump. 

Not so, insist my callers. They blame the calendar, mostly. You see, the 29th and 30th are on Monday and Tuesday. They couldn’t release it on Friday the 26th, and New Year’s Eve would be universally viewed as a newsdump.

The week before is problematic as well. The 24th, 25th, and 26th are out. Monday the 22nd or Tuesday the 23rd would hardly be any better than the 29th or 30th. And the week before that is too early; the plan may not be completely done by then.

Okay, spin it ahead. New Year’s Day is a Thursday; Jan. 2 is not only the day after a holiday, it’s a Friday, so that’s no good.

Which brings us to Monday the 5th — only two days before the Legislature convenes. That week is likely to be a circus, what with Scott Milne’s Dance of the Seven Veils, various ceremonial activities, and other hard news. (Such as the RAND Corp. report on marijuana legalization.)

The fear, so I’m told, is that a single-payer unveil on Jan. 5 could get lost in a blizzard of news. It would also give lawmakers less time to look it over. And, I’m told, lawmakers wanted to get their hands on it as quickly as possible. Hence, a pre-New Year’s release.

Again, it all makes sense. And again, given the administration’s iffy history, you can understand why an outsider would look at a late-December release and scream “Newsdump!”

This all illustrates how much the administration will have to do, to repair its tattered and battered public image. Much of those batterings were self-inflicted, as the administration acted out of unwarranted hubris and, sometimes, arrogance.

They may not believe they acted badly in the past. But a lot of Vermonters, including a whole lot of liberals, are convinced that they did. That’s why Shumlin’s pre-election approval numbers were so dismal, and why his very expensive campaign hardly moved the numbers at all.

And that’s why I’ve said the Governor should avoid newsdumps or anything that looks like a newsdump, or anything that looks like a political maneuver or a transparently bogus explanation. He’d be better served by standing up in broad daylight and owning the bad news, instead of reinforcing his reputation.

Of course, he’d be far better off by having an administration that didn’t produce so much bad news. But that’s another matter.

Callers, thanks for reading theVPO and taking it seriously. And thanks for calling.

Signs of hubris in the VTGOP

Vermont Republicans gained significant ground in last week’s election. But when you get right down to it, they’ve still got a long, long way to go. They didn’t field serious candidates for most of the statewide offices; they made nice gains in the legislature, but remain on the short end of big Dem/Prog majorities. They made progress on the back-office stuff, but they remain heavily out-organized and out-fundraised by the Dems.

And whatever made Scott Milne a serious contender in spite of a deeply flawed campaign with virtually no resources, well, can you bottle it and spray it on the next guy? Nope. I don’t think anyone really knows why Milne made such a strong showing, and I doubt it’s replicable.

My point is, the Republicans still have serious work to do. The VTGOP is not yet a serious contender — not statewide, not in the legislature. And already, there are signs that this whiff of success is going to their heads.

The most obvious sign is their eager acceptance of Milne’s reasoning for continuing the campaign into the legislature. Or should I say “Milne’s reasonings,” since he has a number of them on offer.

There’s the “ideological majority” notion, that lumps all of Dan Feliciano’s votes in with Milne’s, plus (I guess) most of Emily Peyton’s and Cris Ericson’s and Peter Diamondstone’s to, somehow, get Milne to 50% plus 1.

There’s the “incumbent rejection” idea: since most voters rejected the incumbent, that means the second-place finisher really won. In spite of the fact that more voters rejected Milne than rejected Governor Shumlin.

Then there’s the “legislative district” argument, which says that Milne won more districts than Shumlin and therefore demonstrated broader support. Which is obvious nonsense because many of Milne’s wins came in districts heavy on real estate and light on population.

And finally, we have the “there really isn’t a precedent” argument, in which Milne cites the handful of counter-precedents he can find — all of them emitting a fishy odor. The problem is, there really is a precedent, a very solid one; and when it hasn’t been honored, things have gone haywire.

In football, they say if you have two quarterbacks, you really have none. Well, Scott Milne has four arguments, but really has none. He’s throwing a whole bunch of stuff against the wall and hoping something sticks.

Among the people seeing through this are the two most popular Republicans in Vermont: Lt. Gov. Phil Scott and former Gov. Jim Douglas. Both have said that if it comes to the legislature, the top vote-getter should be elected. Here’s Douglas on VPR:

“It would seem to me unlikely that that would be a useful strategy and perhaps he should consider what Doug Racine and others have done historically which is to acknowledge the result and come back and fight another day,” said Douglas.

In 2002, Racine lost to Douglas by about 5,800 votes but since neither candidate won a majority, the vote went to the Legislature. Racine told lawmakers to vote for Douglas because he was the top vote getter.

… “It would seem to me that the good will that he’s accrued during the last several days ought to be preserved,” said Douglas.

I can kinda understand why Milne is sowing seeds of doubt; he came incredibly close to winning, which, in a way, must be harder to accept than losing decisively. (Gollum!) What’s harder to accept is that top Republicans like Don Turner and Joe Benning are grabbing at this logical apparition. Do they not, in Jim Douglas’ words, risk losing “the good will that [has been] accrued”? I think they do.

As they also do with their immediate call for repeal of Vermont Health Connect in favor of the federal exchange. They offer this as a serious proposal, but as VTDigger’s Morgan True reports, they haven’t worked out any of the details. Like how we’d make good all the premium assistance the working poor and middle class receive thanks to Vermont having its own exchange. Turner’s got a kinda-sorta plan for that, but he clearly hasn’t thought it through.

So why pull a half-baked cake out of the oven? The obvious answer is, to try to capitalize on the election results. And because the hubris is strong in the VTGOP right now.

Turner goes so far as to insist that VHC might need repeal even if it’s up and running when the legislature reconvenes.

Hmm, yeah, kill something that’s finally working after all the investment of money, time, and toil? Don’t think so.

The Republicans would do well to consider the letter and the spirit of Jim Douglas’ advice. Don’t get over your skis. Don’t, in the words of Gov. Shumlin, get too far out in front of the troops.

In renewing the war against health care reform, and in promoting the idea that the legislature should elect the second-place candidate, the Republicans show early signs of turning into the balls-to-the-wall ideologues we all love to hate in the national GOP. By now they should know that’s a recipe for disaster in Vermont. And it’s the opposite of Phil Scott’s alleged vision for a broader, more inclusive party.

A little diplomacy, a little statesmanship, might seem like a step backward right now. But it’s the best thing for the longer-term prosperity of the Vermont Republican Party.

$20,000,000 is the least of our problems

Big scoop came out Friday. As first reported by VPR’s Peter Hirschfeld, the still-troubled Vermont Health Connect could cost the state as much as $20 million extra this fiscal year — for expenses that the federal government might decide not to cover.

The story got some legs, although it came out in the journalistic dead zone of Friday afternoon. It was picked up by other outlets and became kind of a big deal.

And it was the best possible thing that could have happened to the Shumlin Administration. 

Why do I say that? Because it sucked the oxygen out of that particular room, leaving a much bigger VHC story flailing in its wake. (Mixed metaphor? Sorry.)

The story, by VTDigger’s Morgan True, included the $20 million bit, but also revealed a host of other problems with VHC. The story paints a bleak picture of a system still in disarray, and facing big new challenges in less than two weeks.

The problems, in rough order of appearance in True’s narrative:

— The VHC website will be up and running in time for the new open enrollment period, which starts on Nov. 15. But previously insured customers seeking to renew will be asked to stay away from the website and instead fill out a paper form and submit it by mail. The reason: More of this year’s “customer service frustration” is expected by health care reform chief Lawrence Miller. Great.

— As open enrollment looms, there’s still “a mountain of old problems” that will be impossible to resolve by the 15th. So the masters of health care have come up with a kludge: they’ll keep the old cases active with tricks like fake zip codes, even as they’re working on new cases.

Gee, that sounds like a sure-fire plan. Nothing can go wrong with loading fake zip codes into an already wonky system, can it?

— The state’s contract with its new contractor, Optum, hasn’t been renewed yet. If it’s not by the end of business Monday, the company won’t continue to work and “‘Vermonters will not be renewed and will lose coverage,’ according to a document obtained by VTDigger.”

— The state has failed to keep up with required income verifications for “thousands of Medicaid beneficiaries,” which is “a growing concern of the feds.” If some recipients turn out to be ineligible, the state could be on the hook for their medical bills.

— This is more of a problem than you might think because “during the past year, people were hastily added to the state’s Medicaid rolls in order to close out their cases and get them off the hands of overworked employees,” according to the anonymous VHC worker.

— One anonymous VHC worker reported internal problems with Optum employees making mistakes, being poorly trained, being shuttled in and out of state frequently, and “a lack of ownership on the part of mid- to lower-level state employees,” who believe that if the system fails, Optum will take the heat.

— The motives of Optum and other contractors are being questioned by a top VHC official, who pointed out in an Oct. 15 memo that the contractors “have financial motivation to protract their term of employment… to generate profit.” He says the state needs to find a path forward that gives contractors a reasonable profit but ensures that Vermont doesn’t pay too much.

— “Many of the state employees… are temporary workers.” Some have been working on VHC for over a year, which is far longer than is allowed for temp staff. Unlike regular, unionized state employees, the temps don’t get any benefits, just a straight hourly rate.

— Because some coverage has tax implications and VHC staff are not trained in that area, there’s a fear that thousands of VHC customers could find themselves with an unexpected tax bill come April.

This is all on top of the potential $20,000,000 shortfall. Which is bad enough, but now you know why I say the Shumlin Administration should thank its lucky stars that it was Hirschfeld’s story that got spread around and not Morgan True’s far more detailed, far more damaging one.