“I don’t want to live beyond my means,” Sulham said. “I just want to be able to make a payment on time, to go grocery shopping and maybe luncheon meat would be nice … instead of peanut butter and jelly. I’d be able to live better if I could have $15.”

It can be too easy to forget that real Rhode Islanders have to live on the low wages that some of us only know about in abstract political terms. But Sulham now has a way to tell us about her plight.

SEIU 1199NE, the union that represents Sulham and about 4,000 other health care workers in Rhode Island, is producing video testimonials of local workers who are struggling to get by on their current incomes. Sulham’s is the first:

The videos coincide with state leaders considering making huge cuts to the state Medicaid program. “Our view is that Medicaid investments should be directed towards high-quality frontline care and towards ensuring that no health care worker is living in poverty,” said SEIU 1199NE Executive Vice-President Patrick J. Quinn. “It’s time that our society shows that we truly value the work that our caregivers do each day.”

“Lifespan executives have angered employees and the community by rejecting common-sense proposals, including a proposal to require the Hospital to “maintain sufficient staff and adequate supplies,” said the press release. “Lifespan even rejected a proposal that, “providing quality care to patients and their families is the top objective of the Hospital and that poor working conditions, inadequate staffing levels, inadequate supplies, and improper equipment undermine quality care.”

Rhode Island Hospital Senior Media Relations Officer Beth Bailey said, “We are committed to bargaining in good faith toward a fair labor agreement that reflects the positive contributions of our employees. Our proposals to date have included increases to wages for all three years of the contract and shift differentials, and a comprehensive plan to help union employees impacted by technology changes. We are confident in the quality of the care we provide and the investments we have made in technology, equipment and staff to support the delivery of quality care.”

Local 251 represents 2,200 employees at Rhode Island Hospital, including non-medical staff, such as secretaries, janitors and landscapers. “But they also represent the unit assistants, the folks who check on patients to make sure everything’s okay, and the CNAs,” said Strecker. He said he had no idea how many people would show up for the vote. “We hope lots!”

Tomorrow’s vote is one step in the process of calling for a labor strike, said Jess Strecker of Jobs With Justice.

“It’s an authorization vote,” he said in an email subsequent to sending the press release. “The contract negotiating committee will then make the final call about when or whether to strike. Then they would actually give a 10 day notice to Lifespan before going out on strike. The strike could last as long or as shortly as it has to.”

A FAQ sheet sent from Local 251 to the 2,200 members said, “Voting to authorize a strike notice does not mean we will issue a 10-day notice right away. We will continue to negotiate and try to reach a fair agreement. A strong Yes Vote will send a message of unity to the Hospital and give the Negotiating Committee more leverage to win a fair contract. A No Vote would send management the message that we are not united. Management would have very little reason to make a fair contract offer.”

The FAQ says, “The bottom line is there can be no strike without a second vote by members to go on strike.”

Kathy Ahlquist, says the press release, “blames understaffing for her father’s medical tragedy.” Kathy is the wife of RI Future contributor Steve Ahlquist, who has reported on some of the previous employee actions as a new contract was in negotiation.

• Picket at RI Hospital as contract negotiations stall
• RI Hospital employees and community allies speak out

“We’re here,” said Kelly Medieros, who has worked for BVCHC for ten years, “because we want fair wages and affordable health care.”

In a written statement, Anabel Garcia-Campos, an Administrative Medical Assistant, said, “many of us who work here can barely afford to live—some employees earn less than $25,000/year, and we have to pay $5,000 for family health care.”

BVCHC has been expanding recently, capitalizing on the increase in business the health care provider has received under Obamacare. The number of patients served by the company has increased to over 15,000.

“We’re bursting at the seams,” said BVCHC executive director Raymond Lavoie.

To meet demand the company has constructed of a new building in downtown Pawtucket for nearly $7 million and purchased another building for $1.4 million in late 2014.

“Management can definitely afford to pay us living wages,” says Anabel Garcia-Campos, “but while they’re getting richer, they’re leaving us behind!”

Christine Constant, a registered nurse, said in a statement that “low wages and high turnover take a toll on how we do our jobs” and says that a living wage and affordable health care will “stabilize our workforce so we can keep providing consistent, high-quality health care for our community.”

Just as working class taxpayers are casualties of economic disparity. Just as law enforcement has no interest in correcting their unjust actions and medical and psychological professions are interested in creating repeat offenders for monetary gains.

These are not new discoveries. But seeing how these entities work in conjunction with each other to fuel the disturbing medical-mental-prison construct has pushed the need for awareness to a new brink. Public services continue to serve the interests of private sectors grinding our dollars to the bone. The New Kennedy Plaza is evidence that we want the common person’s money, but not the common person.

In the middle of a severe snowstorm free bus fare did not exist to ensure that travelers who may be caught in such conditions get to there destinations safe. That’s because public transportation is interested in collecting from the consumer and not perpetuating the producer. Fare should be free, along with our cities senior citizens. This shouldn’t be a request but a requirement. Just like heated bus shelters. Just like free produce. Instead our state spends our money on racial profiling and intimidation, mental conditioning, and ridding our societies of the trash and vagabonds as they’ve been defined.

Let us return to our fellow sister Tina for a moment. She was forced and coerced into going to the hospital, at the behest of the police despite voicing her right to refuse medical and psychological services. Her rights were blatantly ignored and infringed upon by Providence police and paramedics. The law enforcement system has already shown what they do when “criminals” don’t comply with their shoot-first-sign-paperwork-later tactics. If these entities aren’t too be trusted why do we put our faith in them?

Just as Tina needs an advocate, Eric Garner needed an advocate. Why can’t we the people be that advocate?

Let us build our own public service initiative so that we may be free of those who pull our strings and call it a service to our society. Our federal government has imposed sanctions on the working class if we do not comply to have health insurance. Businesses have complied to offer full benefits to workers employed for 30+ hours a week, but how many workers hours were cut to avoid such payout? For every drone that has been built, for every location service that is included in our apps, our federal government shows it is NOT in the business of ensuring our safety.

They want to know what we are doing and what attracts us for means of psychological stimulation and operant conditioning. To have a collective of Pavlov’s dogs ready to salivate at any glimpse of freedom and economic relief. Instead of SNAP benefits, pay our farmers so they can provide free produce. Give us back control over our lives, or we will take control.

I am calling out to all medical and mental professionals. High priced care does not equate to quality care. Ask the number of patients who have lost the fight to cancer but have truly won the fight for Freedom. A shaman has a duty that came with that title to ensure the health, guidance, and well being of its village. This duty shouldn’t be aligned with a monetary incentive.

Let us build our own public service initiative so that we may be free of those who pull our strings and call it a service to our society. Let us build solidarity, not wait for it to be handed down. We don’t need to be dependent to the hand that feeds us. You cannot put us all in Bellevue if we don’t comply. You cannot put us all in prison if we don’t comply. Your prisons and mental institutions are not big enough for everyone. You can’t kill us all.

I, for one, am tired of the intimidation tactics, the genocide. Anarchy is not as radical as extortion. We shun one because of its portrayal and accept the latter because we have been conditioned to accept it as norm. If you are unwilling to change your environment, then you are as lost as a hamster on the wheel. My people, step off and join me in liberation.

Corporate management decisions by Care New England are hurting quality care, patient satisfaction, and the Rhode Island economy – and damaging the stellar reputation that Women & Infants has built up over decades.

WHEN: Thursday, January 15^th, at 3:30 p.m.

WHERE:  Women& Infants Hospital, 101 Dudley Street, Providence, Rhode Island

More Background:  Management at Care New England, led by CEO Dennis Keefe, has focused their efforts on expanding the Care New England network by affiliating with and sinking money into new facilities.  However, patient satisfaction and staff morale at the hospital are down, due to a lack of investment in staff and quality care.

Since 2011, the hospital has consistently brought in out-of-state “Traveler Nurses” instead of hiring local nurses for permanent jobs.  These temporary travelers, who are unfamiliar with the hospital, have likely driven down patient satisfaction and quality outcomes.

According to the independent patient-satisfaction auditing agency Press Ganey, patient satisfaction has generally been down since Keefe took over in 2011.  Yet despite these worsening outcomes, CEO pay is up.  In 2012, the most recent year for which data is available, Keefe made $1,049,426 in total compensation.

Keefe’s decisions to sink money into expanding the network, refusal to hire more permanent local staff, and million dollar salary have all come at the cost of reinvesting in the hospital and achieving high quality outcomes for patients.

Lt. Governor Elizabeth Roberts, Rhode Island’s most prominent healthcare advocate, is slated to become the next director of the state Health and Human Services Department, according to a press release from Governor-elect Gina Raimondo on Sunday.

“Elizabeth Roberts is the right leader for HHS because she has the key combination of management skills and compassion for the thousands of people the agency serves. We will keep Rhode Island families healthy, while also cracking down on fraud and focusing on fiscal discipline in order to cut costs,” Raimondo said in the release. “The Lieutenant Governor’s years of experience working on various health and human services issues, coupled with her unwavering dedication to making our state stronger, makes her the best choice to lead this office.”

Roberts said in the press release: “I am honored to be joining the Raimondo administration and look forward to rolling up my sleeves to make sure Rhode Islanders of all ages have access to the quality services they deserve. Once confirmed, I will focus on how to improve our delivery systems across all agencies to make sure we are providing the best care, while reassessing our cost structures and contracts.  I look forward to serving on the team that will advance Governor-elect Raimondo’s vision for ensuring a healthy future for Rhode Islanders and a healthy economy for our state.”

The Providence Journal reports Roberts will focus on healthcare policy, about which Raimondo said Roberts is “one of the nation’s experts in this issue.” But the department has other responsibilities as well.

It’s $3 billion budget represents about 40 percent of state spending, according to the ProJo story. And Karen Ziner also reports, “the agency oversees the Department of Children, Youth and Families; the Department of Health; the Department of Human Services [including the divisions of Elderly Affairs and Veterans Affairs]; and the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals.”

Roberts was instrumental in HealthSourceRI, recognized as one of the most successful state-run health care exchanges in the nation. She chaired the commission tasked with creating the exchange and making health care more affordable in Rhode Island.

And according to the Raimondo press release:

Prior to taking office in 2007, Lt. Governor Roberts spent over a decade as one of Rhode Island’s most respected advocates for quality, affordable health care for families and small businesses and earned a statewide reputation for being a tireless leader on health and medical issues.

While serving in the Senate, Roberts was an acknowledged leader on healthcare reform issues.  She is credited with creating the Office of the Health Insurance Commissioner, an important mechanism for controlling health insurance costs and expanding primary care in Rhode Island.  She championed legislation to protect the safety of residents in nursing homes.  Then-Senator Roberts also led the effort to reform the corporate board structure at Blue Cross and Blue Shield of Rhode Island, providing for more transparency and public accountability.  As Lt. Governor and most recently as chair of the state’s Healthcare Reform Commission, Roberts has led the implementation of federal health reform in Rhode Island, a nationally recognized success in reducing the number of the uninsured and lowering the cost of health insurance.

According to her bio page: “Roberts has led the fight to ensure that all Rhode Islanders have access to high quality health care at a cost they can afford.”

Watch this video of her talking about healthcare in Rhode Island and HealthSourceRI to the League of Women Voters.

RI Lt. Gov. Elizabeth Roberts, Rhode Island’s Health Care Exchange from Videos LWVRI on Vimeo.

I’m a healthcare worker, Queer activist, and consider myself to be pretty well-informed and connected and yet if you had asked me about PrEP as recently as September, I would have wondered what you are talking about. I’m up here today because I feel that the word PrEP needs to be on the lips of every sexually active person and the people they love.

PrEP which stands for Pre-Exposure Prophylaxis is a once a day dose of an anti-retrovirus drug called, Truvada; which is also used for people who are HIV Positive to help keep viral loads low, but in people who are negative, if exposed to HIV, kills the virus before it has the chance to infect you. Numerous studies have shown it to be pretty darn effective.

Being newly single, and sexually active, this naturally piqued my interest; if a one a day pill can help prevent an unwanted condition, why wouldn’t I be on it?

But for good measure, I took to social media to see if anyone in my extended networks had any thoughts or experiences with it. The results were somewhat unsurprising, but worth breaking down:

Two people reached out to me privately to tell me their stories, which were well-received and appreciated, but I wondered why they didn’t feel safe to say publically they were PrEP users. Until I saw some of the other public responses (most of which were positive), but there were a strong current of people who were telling me that I weren’t being “sleazy” I wouldn’t have to worry about this or that they felt that this pill will encourage “bad” behavior.

This line of thought is nothing new…54 years after the Birth-control Pill hit the market and 41 years after safe and legal abortion was won, people are still saying that contraception will encourage “bad” behavior.

Well I’ve got news for them. “Bad” behavior does not need encouragement. At all. And furthermore, there is nothing bad, dirty, or shameful about sex. We owe it to ourselves, our partners, and the people we love to first and foremost, enjoy ourselves, but also to do everything we can to protect ourselves and other.

We as a society need to come to grips with the fact that sex-positive and queer-inclusive sex education not being a part of our public school curriculum is nothing short of a public health crisis; creating a layer of young people with lots of misinformation and questions who are afraid to seek out answers for fear of judgment. This is dangerous. Silence, in this case, literally equals death.

I, along with my Doctor, Dr, Chan, did decide that going on PrEP was the right decision for the type of life I lead. I was very fortunate to thus far not experience and of the side effects (nausea, vomiting etc.). And if you’re wondering, it didn’t encourage and more or less “bad” behavior.

To conclude, I would be remiss if I didn’t discuss how equally important access to this drug is to it’s availability. I am lucky in that I have a good job with good health insurance, so access to PrEP was no issue for me. But there are so many people in vulnerable demographics (I think of sex-workers and IV drug users especially) may not be as lucky and cannot afford to pay the over $1500 out-of-pocket cost of a monthly supply of Truvada. PrEP has the potential to make new HIV infections a thing of the past, but it cannot do that if no one’s heard of it and people who need it the most cannot access it.

These are the facts, but our challenge as healthcare providers, law-makers, activists, and people who want to see a world without HIV/AIDS is to overcome them. We have come so far already; research in tandem with activism has taken HIV for a death sentence to a chronic, but mostly manageable condition, and now we have the capability to prevent it in the first place. We need to be screaming about this from rooftops, flyering every gay bar, I also liked Dr. Nunn’s idea about using sites like grindr and scruff as tools for outreach, and also making the phrase “ask your doctor about PrEP” as recognizable a slogan as “get tested” and “know your status” is now!

The controversial SCOTUS decision sent ripples through progressive Rhode Island today. Senator Sheldon Whitehouse also released a statement critical of the high court.

Here is Cicilline’s full statement:

Women, not their bosses, should be in charge of their own personal health care choices. While much work remains, we have made tremendous progress in affording women full equality over many years and this decision rolls back that progress by limiting women’s access to contraceptive health care services.

The Affordable Care Act is designed to ensure women have access to quality, affordable health care, including contraception and family planning — services that are critical to a woman’s health care needs. In fact, an overwhelming majority of women use birth control or contraceptives at some point in their lives and the idea that they should be denied access to these basic health care services because their boss finds it religiously objectionable is ridiculous. While today’s ruling will not undo all the benefits under the Affordable Care Act that allow millions of women to access birth control, it wrongly dictates that a CEO’s religious beliefs outweigh a woman’s right to access affordable contraception. This unfair discrimination contradicts the values of a majority of Americans and has no place in the 21st century. Importantly, today’s decision also sets a bad precedent encouraging other for-profit corporations to deny health care coverage to their employees based on their owners’ religious beliefs.

I am deeply disappointed with the Supreme Court’s ruling and will continue working to stop attacks on women’s access to complete health care services and to advance women’s basic rights. This fight is not over.

The Supreme Court dealt a blow to Obamacare today when it ruled the government can’t force companies to pay for contraceptive coverage if it violates the owners religious sensibilities.

Rhode Island Senator Sheldon Whitehouse said the so-called Hobby Lobby decision is another in a long line of pro-corporate rulings from the high court.

In a statement, he said:

This is just the latest example of the activist Roberts Court siding with the narrow interests of corporations over those of the American people.  Ignoring the clear will of Congress, the Court’s five conservative justices today ruled that corporations have religious beliefs that they can put ahead of the medical well-being of the women who work for them.  The decision sets a dangerous precedent by allowing for-profit corporations to meddle in decisions that should be left between a woman and her doctor, and I’m deeply disappointed in the Court’s ruling.  It follows an increasingly predictable pattern of five activist, conservative Supreme Court justices deciding in 5-4 decisions that the Constitution and our laws mean whatever the Republican Party and big corporations want them to mean

According to the Bureau of Justice Statistics, between 2001 and 2011, cancer and heart disease were the leading causes of over 3,000 annual deaths in state prisons. Another 1000 people die every year in local jails, often with little or no health care.

I met Edgar Barens in 2009, when he had 300 hours of footage from the Iowa State Penitentiary’s hospice unit, shot over six months in 2006-2007.  Prison administrators invited him to do a story after seeing his previous documentary Angola Prison Hospice.  This latest product is a 40-minute film nominated for an Academy Award. Coincidentally, Prison Terminal is about the death of Jack Hall, a World War II POW survivor, while the winning film was about the last survivor of the Holocaust.

Jack Hall is proud of his military service, yet remains haunted by the hundreds of farm boys, tradesmen, and regular folks he killed while wearing the uniform.  It is interesting that the government awarded medals for these killings, but sentenced him to die in prison for killing the man who sold drugs to his son. The latter was probably the only time he had a genuine motivation to end someone’s life, but Jack’s story here is not about that homicide.  The story is deeper, taking us to a crossroad of multiple dilemmas in America’s criminal justice system.

The Disposable Heroes

Incarcerated veterans are vastly growing in number, as they historically do after every war, with estimates ranging from 140,000 to 250,000 currently behind bars.  It should come as no surprise that Jack Hall’s experience of killing, seeing friends die, and being held in an enemy prison might leave more than a few scars. It is understandable that any such person might seek to suppress their thoughts with alcohol or drugs, and may also have a hard time holding down a regular job.  This PTSD and effects, and effects of effects, helps explain the record high disposable heroes currently locked up in prison after their Iraq and/or Afghanistan tours.  It is only amplified by America’s shortcomings in soldier reentry and rehabilitation (words typically used for prisoners returning home, but soldiers’ experiences can be frighteningly similar).

At the heart of Prison Terminal is a hospice program, where fellow inmates are serving as the volunteers and providing end-of-life care.  In another twist on presumptions, Jack is a former Segregationist who found himself living in the most intense racial experiment throughout history. The viewer doesn’t experience Jack’s evolution over the previous years, but what we see is the shared love and humility of two primary caretakers in action: “Herky,” and “Love,” both Black men.  Both also convicted of killing someone and will apparently also die behind bars. As they see it, what they do for Jack will hopefully be done for them when the time comes.

Many members of the general public develop their views of prisons through television shows such as Oz, Orange Is The New Black, and LockUp.  Furthermore, most documentaries focus on a wronged situation, such as exonerations, drug war casualties, and political prisoners. Prison Terminal defies stereotypes and presents a familiar world to those who have been incarcerated, and their families. Herky and Love are like hundreds of people I know: just waiting for a burning car on the side of the road so they can save some kids. It will never erase the terrible things that gets someone into prison, but will at least make looking in the mirror a little easier by creating a counter-narrative, about helping humanity rather than hurting.  Not to imply that everyone in prison is an angel, nor even that the majority are there for something terrible, but the number of lifelong malicious and selfish people in prisons is a far smaller than most would ever imagine.

It should not come as a massive surprise that the majority of hospice workers in Iowa are Black.  As examined in the book, “Mothering in Prison,” some communities unfortunately have learned to expect travesties. Coming up out of slavery and through a challenging American history, Black people have had to adapt to survive, and take care of their wounded family.  Here, Jack Hall is part of this family regardless of his color. And to Jack’s credit, healing his previously-strained relationship with the son who turned him in is a core part of the dying process.

Prisoner health care: an oxymoron

Prison health care in America primarily consists of popping pills, and scant staffs struggling with sparse budgets. If they are going to take control of someone’s body, the government has a legal and moral duty to take care of it.  However, not every person enters prison with a clean bill of health.  They go in with cancer, diabetes, HIV, and every other ailment afflicting the general public.  Perhaps on the outside they had a job, insurance, or even coverage under the Affordable Care Act. And then they are sent into this jungle. The diet is terrible and, at times, the exercise non-existent.  Leave someone in prison long enough and they will certainly contract any ailment one would expect on the outside.

There are only 75 hospices in the thousands of American jails and prisons, and only 20 are staffed with prisoner volunteers. People should die with their families, especially the ones closest to their hearts.  Iowa’s hospice program struggled since the film was made, as a new director was not as passionate about the program. This signals the need for specific policies to be in place, to survive turnover and attitude. The program costs absolutely nothing, with everything donated (including hospital beds) or made by prisoners. Hospice actually saves money by weaning people off costly medications and treatments in their final days.

Some states have responded to the medical crisis by building multi-million dollar medical facilities that will need to be staffed and maintained over the years.  This also creates more overall beds in the system; beds to be filled. Every prison should instead convert space already in place, and consider Medical Parole whenever possible. Not everyone has somewhere to go in the final years, and granting homelessness to sick people is not providing dignified deaths.

Edgar Barens is taking Prison Terminal on a tour that will include dozens of prisons throughout the nation.  This film should be seen. A five-minute version should be screened for politicians.  Hopefully they, like Iowa, will recognize that it is possible to do better. They can respect families and religions, and make a considerable reform within this terrible phenomenon of mass incarceration.  Furthermore, the Veterans Affairs administrators can watch this film and reconsider the final crime in Jack’s case: the VA would not allow him to be buried with honors due to the “Timothy McVeigh” rule, barring people convicted of capital crimes from a final acknowledgment of their service.  Jack’s final respite, despite fears his service would send him to Hell, was to be buried as a soldier.  Instead, the prison fingerprinted and disposed of him, his life, and death.

Pvt. Jack Hall escaped from a POW camp, yet could not escape that one moment of rage as an unwilling soldier in the War on Drugs.

Find out more at www.prisonterminal.com.