Monday the Lieutenant
Governor’s office announced the award of SIM’s first grants from federal
funds; two of the four recipients are represented on the
SIM Steering Committee. The members represent Northeast
Medical Group (Yale-New Haven affiliate) and St. Vincent’s
Health Partners. This would have been prohibited under the state’s Code
of Ethics but for a loophole in the law.
Totaling $650,000, the grants are to large provider networks
to develop patient-centered medical homes. The standards for the grant were set
by a SIM committee and initially
rejected by the Steering Committee. With others, both conflicted Steering
Committee members then met
with the subcommittee arguing to reduce one specific standard to allow at
least one to apply for the grant. The committee agreed and the Steering
Committee subsequently
approved the new, lower standards.
In May, CT’s state ethics board released
an opinion that the SIM Steering Committee (and Consumer Advisory Board)
both have substantial roles in setting state policies and funding, but there is
a loophole. SIM committee members are not subject to the state’s Code
of Ethics for Public Officials because members are appointed by the
Lieutenant Governor. The law defining Public Officials subject to the Code only
identifies appointees of the Governor and General Assembly; it does not address
the very new practice of very significant policy and funding decision-making by
appointees of the Lieutenant Governor. Two amendments
were offered in the last days of the session to include SIM in the Code of
Ethics.
This
problem allows situations, as happened at the AccessHealthCT Board, where
a member argued and voted for weak standards for insurers to join the exchange
and opposed active purchasing. He then resigned from the Board, and
subsequently went to work for an insurer that intends to participate in the exchange under
the weak standards and without facing negotiation with the state to keep rates
affordable.
This
issue was first raised with SIM’s Consumer Advisory Board in November,
with no action taken, and in a February sign on letter from advocates to the
Lieutenant Governor, with no response.
