Healthcare Advocate Raises Red Flag
A key healthcare advocate is raising concerns about possible conflicts of interest in the Healthcare Innovation Steering Committee, whose members oversee the $45 million State Innovation Model grant and were appointed by Lt. Gov. Nancy Wyman.
The committee has been vetting ideas, issuing RFPs, and then awarding smaller, project-specific grants to spur changes in the state’s healthcare industry.
But the committee’s recent activity is raising some eyebrows. Healthcare advocate Ellen Andrews of the Connecticut Health Policy Project asked the Citizen’s Ethics Advisory Board for a ruling on whether the state’s code of ethics applies to members of the Steering Committee or its subcommittees. The short answer from the ruling, released last week, is that they are not subject to the state’s code of ethics. More on that later.
Last week, Andrews said she asked the ethics board for a ruling because the Steering Committee has not voluntarily adopted its own code of ethics. And without adherence to any such code, board members are theoretically in the clear to apply for the funds they are overseeing, Andrews said.
In her request to the Citizen’s Ethics Advisory Board, Andrews cited an application from St. Vincent’s Health Partners for a yet-to-be-awarded $650,000 grant. A spokeswoman for St. Vincent’s confirmed Tuesday that some of the medical practices in St. Vincent’s network had applied for the “patient-centered medical home” grant.
But Andrews is concerned about the St. Vincent’s application because the company’s CEO, Thomas Raskaukas, is a member of the Steering Committee.
Calls to the Office of Healthcare Reform, of which the Steering Committee is a part, were not returned Tuesday, so it is not clear when the Steering Committee plans to award the grant, or how many companies have applied for it, or if Raskaukas had any influence over the development of the committee’s RFP for the grant. It’s also unclear whether other Steering Committee members or their various companies have applied for grants.
Andrews pointed out that adopting the state’s code of ethics would help the Steering Committee and its subcommittees avoid any appearance of a conflict.
But why aren’t they subject to the state’s ethics code?
According to a decision issued last week by the Citizen’s Ethics Advisory Board, the committee’s members are not considered state employees or public officials. And the same goes for the members of its subcommittees and the Consumer Advisory Board, according to the decision.
Peter Lewandowski, assistant general counsel for the Office of State Ethics, said the background of the question Andrews raised was complex, but the legal analysis was pretty straightforward.
Lewandowski said the state’s definition of a public official specifically excludes any appointments by or appointees of the lieutenant governor.
“Because of this omission in the definition, the declaratory ruling concludes that members of these various bodies are not public officials, and therefore they are not subject to the code of ethics,” Lewandowski said.
Since they aren’t subject to the code of ethics, the Citizen’s Ethics Advisory Board declined to comment further on the whether the Steering Committee or its subcommittees are prohibited from realizing any financial or other gains from committee activity. However, Lewandowski said the Healthcare Innovation Steering Committee and the various subcommittees should consider adopting “internal guidelines concerning conflicts of interest, and the issues concerning financial gain.”
Charles Chiusano, chairman of the Citizen’s Ethics Advisory Board, said they should make sure lawmakers are aware of this loophole and strongly encourage the Healthcare Innovation Steering Committee to adopt conflict-of-interest language as part of its bylaws.
State Ethics Director Carol Carson said she would communicate with the lieutenant governor’s office and explain the board’s concerns. She said it’s unlikely they would be able to pass legislation this year, but would look to get something raised in the next legislative session.
Andrews told the Citizen’s Ethics Advisory Board that she tried to be proactive in February by asking the steering committee and its various subcommittees to voluntarily adopt the state’s code of ethics, but she received no response.
Mark Schaefer, the director of the state’s Healthcare Innovation office, provided a statement Friday: “We received and are reviewing the declaratory ruling approved by the Citizen’s Ethics Advisory Board. We have not yet discussed the ruling with the Healthcare Innovation Steering Committee.”
Andrews said she believes the board should halt any procurement decisions until they look at adopting conflict of interest language. Schaefer declined to respond to several emails and phone calls regarding the ruling or the grant award process.
The Healthcare Innovation Steering Committee’s next meeting is June 11.
Editor’s note: Karen O’Driscoll, a spokeswoman for St. Vincent’s Health Partners, called Friday to clarify that their practices applied for a portion of the $650,000 grant. Dr. Mark Schaefer, director of the Office of Health Reform, has not responded to repeated requests for details about the grant and its applicants.