Boston Globe. March 4, 2024.

Editorial: All eyes on the state’s next move on prison health care

With private equity firms dominating the field, the lawsuits just keep piling up.

Rarely has there been a brighter spotlight on prison health care in Massachusetts — and rarely has there been a greater need for it.

The Department of Correction remains under a four-year settlement agreement with the Justice Department to provide “adequate mental health care and supervision” to those in “mental health crisis,” following a scathing 2020 report for failing to provide “constitutionally adequate” care. An aging prison population poses new challenges for addressing both the physical frailties of the incarcerated and the cognitive issues the system has not adequately planned for. And complaints about the existing levels of care and staffing of prison medical facilities by the current provider, Wellpath, have been all too common.

Today a contract worth well over $100 million a year to provide health care services to all of the state’s prison facilities (except Bridgewater State Hospital, which is under a separate contract with Wellpath) is out to bid. DOC officials, who have not made public the names of bidders or the final number of firms vying for the contract, which includes care for some 6,000 men and women in state custody, are expected to select the winning bid at the end of March for a contract that will begin July 1.

Adding to the drama has been the recent involvement of Massachusetts Senators Elizabeth Warren and Ed Markey, who zeroed in on the current contractor, Wellpath, and YesCare (previously known as Corizon), both of which are among seven vendors known to have filed bid intent forms, according to a public records request by Prisoners’ Legal Services of Massachusetts, a nonprofit advocacy group. The two giant for-profit corporations have attracted a fair amount of congressional attention — and not in a good way.

“We hope you will carefully consider the congressional oversight findings as you move forward with your decision and we trust that you will implement robust measures to monitor the performance of the contract that you select,” the two senators said in a letter to Massachusetts Correction Commissioner Carol Mici.

Wellpath, owned by a private equity firm, has been accused of delaying needed care to its incarcerated patients and failing to adequately staff the state’s facilities.

In response to the congressional inquiry, Wellpath executive vice president and chief legal officer Marc Goldstone acknowledged that, “Like every health care provider, whether public, non-profit, or for-profit, we are constantly working to address the impact of the nursing shortage that was exacerbated by the COVID-19 pandemic, as well as the effect of an overall aging patient population and the resulting increased need for healthcare resources.”

YesCare, according to the congressional report, was accused of manipulating “bankruptcy law with the aim of skirting accountability for the harms that incarcerated individuals have endured under Corizon’s care.” As of late 2021, the firm had been named as a defendant in more than 1,000 lawsuits alleging substandard care in the prisons it serves, according to a 2023 report by the Private Equity Stakeholder Project. The congressional oversight report noted that, “as a result of Corizon’s failures, many local agencies that hold contracts with Corizon have chosen not to renew those agreements.”

As of 2019, Correct Care Solutions — one of the two companies that were combined to form Wellpath — had amassed some 1,395 federal lawsuits brought by prisoners or their families, according to a report in The Atlantic. Locally some 30 federal lawsuits have been filed involving Wellpath as a defendant by prisoners or their families in the past several years.

Those lawsuits run the gamut from ignored “sick slips” and untreated skin rashes to the horrific — a case brought on behalf of two women incarcerated at MCI-Framingham, who alleged they were repeatedly raped by a prison guard over a period of five months and each time they “suffered a mental health crisis” Wellpath and prison personnel confined them “in solitary cells for prolonged periods of time” with “little to no human contact, no therapeutic treatment, no opioid use treatment.”

The medical care Wellpath provided “largely consisted of a 4-5 minute daily ‘wellness’ checklist completed by a Wellpath employee through a small opening in the cell door,” the suit said.

So, yes, when Warren and Markey say they are hoping for more oversight, adequate staffing, appropriate mental health care, and more opportunities for incarcerated patients to access outside care when needed, they couldn’t be more on target.

The next contract will include some modest improvements, such as specific performance measures, “pay-for-performance” incentives, and a provision for geriatric care.

But, the senators noted, it’s also important that incarcerated individuals have “meaningful channels” to “report problems with the contractor without facing retribution” and that the contractor should face penalties for noncompliance.

More oversight within the system would be a better — and faster — route than lawsuits.

There are more eyes on the state’s prisons than ever. Last week Attorney General Andrea Campbell, in a newly released Strategic Plan for her office, vowed to hold accountable “prisons, jails, and their vendors that deny access to basic rights such as constitutionally adequate medical care.”

But as one lawyer familiar with the congressional probe of prison health care noted, a provision for an independent outside monitor — someone who could enter any of the state’s prisons without advance notice and observe how health care is being delivered in real time — “certainly would be the gold standard.”

The ongoing Steward Health Care debacle has shown what the wonderful world of private equity has done to health care here generally. The same thing has been happening for years in prison health care — an industry dominated by two private equity-backed firms — Wellpath and YesCare — both possible bidders for the state prison contract.

Is this really the best Massachusetts can do?

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Rutland Herald. March 2, 2024.

Editorial: Know your vote

Tuesday is Town Meeting Day. The New England tradition carries with it certain expectations aimed at governance and community building.

Just a few years ago, the rite was tested when the pandemic made it all but impossible to assemble safely. Some communities acknowledged they missed not being able to come together; a few others took it as a sign that perhaps there are other ways to govern that incorporates more voters than the 10% to 15% who have come to be the average number of attendees statewide.

This year feels different in another way. A coronavirus has not cast its pall on the process as it did in 2021. It has been replaced with something else. Whether we want to admit it or not, we are at a tipping point — both as a statewide community and in our individual communities.

When the municipal and school budget season began late last year, it seemed obvious that the struggle to make ends meet was going to be real. Federal dollars associated with COVID had mostly been assigned, and the deficits created during the height of the pandemic were starting to pile up. Inflation was driving up costs, especially for supplies. Fuel costs were higher than ever, and so was health insurance. While boards urged budget-builders to stay below the customary 3% growth cap (based on previous years of inflation), the starting point was already around 7% higher than normal because of high inflation.

Then certain realities really started to settle in.

The annual “December 1 Letter” was published by the state Department of Taxes. The letter landed with a bang, as Tax Commissioner Craig Bolio predicted that Vermonters might see an average 18.5% increase in their property tax bill. That should have put pressure on school districts to put forth budget proposals that would assuage the tax burden scare that Bolio had put forth.

For sure, school districts were facing unprecedented challenges this budget season. In what was hoped to be legislation designed to reduce inequities across Vermont’s school systems, Act 127 proved to be problematic: a contradiction.

Act 127, an act meant to promote equity in our educational funding formula, became the scapegoat for school budgetary pressures. Act 127 was a necessary step to bridge the gap between the “haves” and “have-nots.” Every child deserves equal educational opportunities. As we know, this was not being practiced before Act 127, as wealthy towns were better positioned to provide children with a better education than high-poverty, rural and more diverse districts.

Act 127 was designed to help districts deal with an increased need for services for disadvantaged students. And yet a provision in the act made it inequitable by allowing for school officials to pad budgets — sometimes by millions of dollars — because a cap of 5% would be passed on to local taxpayers. Statewide, the Education Fund would pay the difference. That oversight simply passed overspending (when reasonable spending was urged) on to every taxpayer in Vermont. It was an opportunity some school districts took brazenly.

Crafted after weeks of discussion within the House of Representatives Committee on Ways and Means, H.850 resolved that unintended consequences of Act 127. H.850 repeals that protective provision — Section 7 — and replaces it with “a cent discount transition mechanism” that provides pre-Common Level of Appraisal tax rate discounts to districts that have lost tax capacity under the new weights.

It was passed by both chambers and signed by Republican Gov. Phil Scott — who has been aggressively calling out affordability challenges facing Vermonters.

School districts across Vermont then had to decide: Do we take our chances on March 5 and see if voters will give us all that we want? Or do we go back to square one and produce a budget that is within the means of the community and the state?

To be clear, not every school district “played” the Act 127 loophole. But many did.

The budgetary pressures building in the school districts were (or should have been) on the minds of boards and councils as they created their operating budgets. Again, in some cases, municipal officers acted independently, ignoring a potential — unaffordable — tax increase for local voters.

That is all to say that it is imperative this Town Meeting Day to know what you are voting for, and what the potential consequences of approving the municipal and school budgets will have on your tax bill.

Some communities have opted to wait a few weeks before finalizing the budget and holding the vote. They are letting the budgetary dust settle.

That is potentially a smart approach, since we are expecting that a lot of voters — either spooked by this budget process or unsure what actually was settled upon — are going to reject budgets.

As they should, by the way.

Because if budgets are approved without all factors considered, and if we are truly at a tipping point in our communities and as a state, then this is only the beginning of some hard times ahead.

Know what you are voting for.

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Barre-Montpelier Times Argus. March 6, 2024.

Editorial: Surprise, surprise

When we first heard that Gov. Phil Scott had encouraged all Vermonters to take a Republican presidential primary ballot and cast a vote for Nikki Haley, we were surprised.

At other times, we have speculated those kinds of voting tactics were being promoted, but not openly as the Republican governor did earlier this week, less than a day before a Haley rally in Vermont.

We were equally surprised that Haley did so well in Vermont. Having the presidential primary on Town Meeting Day is sometimes a crap shoot. But voter turnout was decent.

We are not fans of the term “referendum” for an action, it would appear that Vermont voters of all stripes either heard Scott or had simply decided on their own that they did not want Donald Trump to get the Super Tuesday sweep he so badly wanted.

That Haley won the Republican primary in Vermont is another sign that voters here did want to send a message. It was clear before Super Tuesday that Haley did not have the momentum to knock Trump’s rise to be the nominee off kilter. But maybe she made a dent, showing the rest of the country (and U.S. territories) that no planned ascension is necessarily full-proof. (She also won the District of Columbia.)

For his part in the vote totals, the governor took another risk in sticking his thumb in Trump’s eye. Scott, who is considered a moderate Republican (and admitted he voted for President Biden in the last election after challenging some of Trump’s pandemic policies), has to decide a) whether he wants to seek a final two-year term (potentially under another Trump presidency) and b) does he have the confidence that he has the state’s votes now that he has further upset the far right of his GOP base. Fortunately, as we have seen with this latest tactic of throwing support — Republican and Democrat — against Trump, Scott does not seem to mind the heat.

One commenter on Tuesday, a Vermonter, responded to a neighbor online (a Democrat) who was touting that the Green Mountain State’s voters on Super Tuesday had shown they could stand up for “what needs to happen to move the country forward.”

The response: “America is not ready for a woman President.”

That short-sighted, misogynistic, outdated remark really caught us off-guard. We were not just surprised but incensed. While Haley may not have the politics that everyone can get behind, that argument carries no water any longer. Haley sensed this when she bowed out on Wednesday, having made her run — and depriving Trump of his precious sweep.

Without endorsing Trump, she withdrew with a shoutout to the women and girls who supported her, and by quoting a woman who did make it to the top in a democracy — Margaret Thatcher, Britain’s first female prime minister. “Never just follow the crowd,” Haley said, suggesting she’ll become a private citizen, for now. “Always make up your own mind.”

Women have run for president since before they won the legal right to vote in 1920. In 1872, Ohioan Virginia Woodhull was the first. Since 2000, five Republican women, including Haley, have launched campaigns for major party nominations. A dozen Democrats, including Harris, have done the same.

Polls show most Americans do not necessarily oppose electing a woman president. According to some political watchers and political scientists, Haley made some history with her primary wins. Supporters and analysts say she may have developed a playbook for confronting Trump and his cult-like following in the Republican Party. Vermont voters saw the opportunity, too. They cast votes knowing full well that — once again — there will be no woman at the top of either party’s ticket. Perhaps throughout the next four years, as a nation, we can allow ourselves to mature enough to see the potential in the candidate. In all other jobs out there, we are not allowed to discriminate. Hire the best person for the job.

Scott showed backbone, and some voters — including Democrats — followed his lead. Those kinds of steps continue to provide hope that while extremists in both parties are sucking up all the air, there are more practical, reasoned individuals waiting for their chance to restore the election process back to the people’s choice.

The prospect of electing a woman president for the first time seems another four years off, but the chance to use strength in numbers — even with a gag-worthy rematch of 2020 — to have sway seems very possible now.

We will keep hope alive, and continue to be surprised.

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Bangor Daily News. March 7, 2024.

Editorial: Maine needs constitutional protections for reproductive autonomy

Nearly two years ago, the U.S. Supreme Court ruled that there is no federal constitutional right to abortion. The decision upended the nearly 50-year-old Roe v. Wade ruling, and it opened the floodgates to numerous state laws around the country further limiting or nearly outright banning abortion.

Several states have responded by passing amendments to their constitutions protecting reproductive rights. Similar amendments are under consideration in more than a dozen states, including Maine.

Although Maine currently has strong laws to protect reproductive autonomy, there are efforts every year to chip away at these protections, which could be eroded or eliminated in the future.

To protect these rights, Sen. Eloise Vitelli, D-Arrowsic, has proposed an amendment to the state constitution to stipulate that every person has a right to reproductive autonomy.

To be clear, Maine’s proposed amendment is not just about abortion. It would cover other reproductive rights, such as access to contraception, sterilization and in vitro fertilization.

The latter is especially important after the Alabama Supreme Court ruled that frozen embryos, which are used in IVF, can be considered children, with the rights of children. Several fertility clinics in Alabama have suspended IVF services, leaving families in the midst of treatment in limbo. This prompted Alabama lawmakers to quickly consider legislation to shield IVF clinics from the impacts of the ruling and to protect would-be parents’ access to IVF treatments.

A constitutional amendment protecting reproductive autonomy could help Maine avoid this type of turmoil and uncertainty around all types of family planning, including contraception, which is also under threat from court rulings and legislation in some states.

This amendment is about protecting the rights of individuals to make their own decisions about family planning. These decisions include whether to have children, when to have them, how many to have. These decisions are fundamental for any family and people in Maine (and elsewhere) should be able to make these decisions without interference from politicians, judges and others.

A few states, including nearby Vermont, have amended their constitutions to protect these rights. More than a dozen others may have such amendments on their ballots this November.

The language of Maine’s proposed amendment mirrors some of the successful amendments in other states, notably Ohio and Vermont.

Under Vitelli’s bill, the proposed constitutional amendment would read: “Every person has a right to personal reproductive autonomy, which is central to dignity and the liberty to determine one’s own life course. The State may not deny or infringe on the right to personal reproductive autonomy unless the denial or infringement is justified by a compelling state interest and is accomplished using the means that least denies or infringes on the right.”

Passage of LD 780 would not be the final word on the matter. If approved by lawmakers, the question would then go to voters in November. The proposed ballot question reads: “Do you favor amending the Constitution of Maine to declare that every person has a right to personal reproductive autonomy?”

Polls generally show strong support among Mainers for abortion rights, one aspect of reproductive autonomy.

For decades, the federal guarantee of a right to abortion was tempered by standards for restrictions, which were set in the Roe decision and further defined in Planned Parenthood v. Casey.

Adding this proposed amendment to the Maine Constitution would ensure those types of protections, for many types of reproductive health services, for now and for future generations.

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Portland Press Herald. March 3, 2024.

Editorial: Ban on ‘unauthorized’ paramilitary groups simply should not be a hard sell

By waffling over a sensible proposal for which there is ample precedent nationally, legislators are letting Maine down.

A photograph of a group of men in balaclavas outside the Maine State Capitol last summer, hands raised in a Nazi salute, holding a large banner that read “KEEP NEW ENGLAND WHITE” accompanied our reporting this past week on the fate of a bill that undertakes to do something one would think uncontroversial: to ban paramilitary training camps intended to create civil disorder.

Let us be clear: There is absolutely nothing wrong with the spirit or intent of this bill.

By Thursday evening, however, it was floating in space. A vote was postponed at the last minute by House Democrats who had legitimate concerns that the bill did not have enough support to pass.

House Republicans almost unanimously oppose the proposal, citing concerns to do with the right to free speech, free association and the right to bear arms. They have suggested the legislation would be wrongly applied, resulting in misplaced Class D misdemeanors for those leading camping troops, Scouting, outdoor survival courses, self-defense training, the activities of veterans’ groups or other endeavors.

Spurious concerns about the law’s application should be quieted by its very wording, which features a reassuring definition of “civil disorder” as “any public disturbance involving an act of violence by a group of two or more persons that causes an immediate danger of injury to another person or damage to the property of another person or results in injury to another person or damage to the property of another person.”

The outside risk of infringement of certain constitutional liberties, if present, is a risk that can be mitigated by more cautious, tighter drafting of the provisions to do with intent, reasonable knowledge and the bearing of arms. If other states have successfully done it – and, by one expert analysis, a majority of states (26) has – why can’t we?

So long as Maine’s opponents of L.D. 2130 are satisfied that its aims are sound, they should be advocating for appropriate changes to precise wording of the bill as drafted, allowing it to be faithful to those aims. So far, we haven’t heard much in the line of suggestions for its strengthening. That opposed legislators’ preferred course is, apparently, to walk away, to abandon the bill in its entirety, should come as a serious disappointment to all Mainers.

The aims of the bill are sound. The bill is proportionate. And there’s a clear reason it’s being introduced now; hate groups, like the one represented in Augusta last August – aggrieved groups of white nationalists, neo-Nazis and other extremists – are organizing and becoming more visible in our state. Ignoring this dark reality is not an option. One leading extremist for a time had a plan to establish a paramilitary group “headquarters” in Springfield, which came to light last year.

As it stands, such a base could legally be established in Maine. That’s a live risk, and it’s abysmal that – out of conservative stubbornness, a lack of will or reckless disregard for the public interest – many of our state lawmakers would have us run it.

END