A seemingly innocuous proposal to let voters drop off their mail ballots earlier has divided Rhode Island elections administrators.
The Rhode Island Board of Elections (BOE) on Thursday narrowly backed a proposal to let voters deposit ballots in state-certified, secure drop boxes 35 days prior to Election Day. The 3-2 vote serves as a recommendation, requiring legislation and approval by the Rhode Island General Assembly, to amend existing law, which says drop boxes stationed outside city and town halls must stay locked until 20 days prior to an election.
The vote came after nearly an hour of discussion and debate, clouded with questions over logistics, and the specter of public doubt over election integrity.
Chair Jennie Johnson, along with members David Sholes and Marcela Betancur, supported the earlier opening. Board members Randy Jackvony and Michael Connors opposed the earlier opening date.
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Proponents including the Rhode Island Department of State, local boards of canvassers and the Rhode Island Town and City Clerks’ Association backed the change as a way to make voting easier and more convenient for voters eager to exercise their civic duty.
“Voters love to use the drop box,” said Kathy Placencia, elections director for the Department of State.
An earlier opening date also allows drop boxes to be used for voter registration forms, which are due 30 days before an election. Typically, city and town halls have to open their offices on the Sunday registration deadline to accept registration forms from stragglers.
But some BOE members hesitated, concerned about confusion created by combining registration forms and mail ballots in the same collection box. Not to be discounted: public trust in election safety and security, which has taken a hit nationwide.
“There is a lot of distrust in elections around mail ballots already,” said Michael Connors, a board member who also serves on the three-member legislative subcommittee. The subcommittee on Feb. 20 voted 2-1 not to support a change in drop box opening dates.
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Even Miguel Nunez, BOE deputy director (who will take the helm as executive director next week), acknowledged the solution was imperfect.
Identical legislation was submitted last year on behalf of the state elections board, and approved by both chambers, but was pulled at the eleventh hour due to conflicts with local special elections.
There is a lot of distrust in elections around mail ballots already.
– Michael Connors, a Board of Elections member who opposed to the earlier start for opening drop boxes
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Existing state law requires local boards of canvassers to lock drop boxes at 8 p.m. on Election Day, the same time polls closed. When a special election is held a month before a regular state or federal election, the earlier drop box opening might overlap with a time when the drop box has to be locked for a local election.
Nunez presented BOE members with a few options to minimize this conflict. They included getting rid of the requirement that local elections administrators lock the drop box when polls close. Or keeping the 8 p.m. locking time but reopening the drop box the next morning. A third option: opening drop boxes 30 or 32 days prior to the election, rather than 35.
Board member Sholes also suggested another hack to assuage concerns about ballot confusion: color-coded ballots to make it easier for local election workers to differentiate between special, local races and state or federal ones.
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Nick Lima, Cranston elections director, and Kathy Placencia, the elections director for the Rhode Island Department of State, address the Rhode Island Board of Elections at its meeting on Feb. 22, 2024. (Nancy Lavin/Rhode Island Current)
‘Can of worms’
But the multitude of Band-Aid fixes suggested to Jackvony that perhaps the best solution was no change at all.
“I think we’re opening up a can of worms,” Jackvony said. “We’re very concerned about giving people a positive sense of the integrity of elections. I think we’re going in the wrong direction with something like this.”
“Very few” mail ballot applications get sent out by the Secretary of State’s office 35 days before an election, Nunez said.
But the handful of voters who want to turn in mail ballots early would benefit by opening up the drop boxes, which are already paid for, under surveillance, and otherwise sitting empty, said Nick Lima, Cranston elections director and chairperson for the Rhode Island Town and City Clerks’ Association Elections Committee.
Lima has heard from a few Cranston voters who already received their mail ballots for the upcoming April 2 presidential preference primary but can’t drop off their ballots in the drop boxes until March 13, based on the 20-day opening date.
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“That voter will show up at City Hall at 4:35 p.m. today with that mail ballot in-hand and have nowhere to drop it,” Lima said.
Meanwhile, the city of Cranston is spending $2,000 across its four special elections this year to pay its staff to sit in City Hall on the Sunday when voter registration forms are due, Lima said. That cost could be eliminated if voters could drop their registration paperwork in a secure container.
“It’s a large expense for us, and it really isn’t a necessity,” said Lima, adding he “never” sees city voters dropping off registration forms on that final Sunday deadline.
The proposed changes in drop box openings was one of 25 election-related bills considered by the BOE Thursday, ranging from repealing constitutional requirements for 30-day residency prior to voting, to the maximum number of voters a single polling place can serve.
The drop box legislation has not been introduced yet, but must be submitted by Feb. 29 to be considered by the General Assembly.
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Board members Diane Mederos and Louis DeSimone did not attend the meeting.
Four Rhode Island hospitals — Newport, Miriam, South County and Westerly — received top marks in the fall report from Leapfrog Group, a nonprofit that grades hospitals on safety.
The Washington, D.C.-based Leapfrog assigns hospitals letter grades based on data from the Centers for Medicare & Medicaid Services (CMS) as well as Leapfrog’s own surveys. Rhode Island’s hospitals didn’t perform much differently than they did in spring 2024 (The Miriam and Newport have consistently earned A’s the past two years), with two notable exceptions. Westerly’s A is its first since 2022. Landmark Medical Center in Woonsocket, which has received nine consecutive A grades, dropped to a B.
Kent Hospital and Rhode Island Hospital also received B grades. The embattled Our Lady of Fatima Hospital and Roger Williams Medical Center both earned C grades.
South County Hospital’s good report card was a boon to Dr. Kevin Charpentier, the vice president and chief medical officer at South County Health, the hospital’s parent company.
“It’s more than a score — it’s a promise to our community of prioritizing the highest level of patient care,” Charpentier wrote in an email.
The score was also a bit of good news amid an ongoing dispute between the hospital’s administration and its staff. A September letter sent by doctors and nurses to the South County Health’s board of trustees detailed escalating tensions between providers and management, with doctor resignations, service cuts and growing patient backlogs among the signatories’ concerns.
Landmark’s B left its CEO Mike Souza disappointed.
“We take quality very seriously and our team has already put plans in place to address the areas needing improvement,” Souza said in an emailed response to Rhode Island Current. “Our community will continue to receive great care and our expectation is that we will return to an ‘A’ grade in the near future.”
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Leapfrog aggregates 30 metrics to assess how well hospitals care for patients as well as prevent bad outcomes, like infections and falls. The grades are given to roughly 3,000 hospitals, not including VA hospitals or children’s hospitals. Hospitals that lack enough data for multiple metrics are also excluded.
Lisa P. Tomasso, senior vice president of the Hospital Association of Rhode Island, said via email that the trade group was pleased with the state’s performance. But she added that the grades, while insightful, are “not comprehensive, as they exclude factors like social determinants of health, community-level health challenges, and systemic issues like Medicaid reimbursement rates.”
But grades still hold value. Robert Hackey, a professor of health sciences at Providence College, said that “hospitals that don’t do well tend to poke holes in whatever rating methodology that’s used.”
“If you look at the hospitals in Rhode Island, for the most part, we’re performing very well,” Hackey said. “Yeah, we obviously have two low performers. It’s Fatima and Roger Williams. And there’s a common thread there. They’re both owned by Prospect and they’re both for-profit institutions, yeah. And they both struggle.”
A representative for CharterCARE Health Partners, the Rhode Island subsidiary for Prospect Medical Holdings, which owns Roger Williams Medical Center and Our Lady of Fatima Hospital, did not respond to requests for comment. Facing growing debt, Prospect has sought to unload many of the hospitals in its portfolio, including the two safety net hospitals in Rhode Island. A proposal to sell Roger Williams and Fatima to a new, nonprofit owner, received conditional approval from state regulators in June, but the status of financing required to complete the transaction is unclear.
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Hackey said it’s a bad sign when hospitals ignore questions on Leapfrog’s survey — something both Fatima and Roger Williams Medical Center did when it came to inquiries about nursing and leadership. Our Lady of Fatima Hospital’s ‘C’ grade is indicative of ongoing quality issues at Prospect Medical Holdings’ hospitals in Rhode Island, says Providence College Professor Robert Hackey. (Michael Salerno/Rhode Island Current)
Meanwhile hospitals owned by the state’s largest health care system — Brown University Health, formerly Lifespan Corporation — all performed well. Rhode Island Hospital, the state’s flagship hospital, received a B grade despite demonstrating below-average prevention rates of blood and urinary tract infections and falls causing broken hips, as well as less-than-stellar marks for hospital leadership and communication about medicines with patients.
Since 2021, Rhode Island Hospital has received C grades more often than not. The B is evidence that things are improving, said Dr. Dean Roye, senior vice president for medical affairs and chief medical officer at the hospital. The Leapfrog grades “help us pinpoint areas” to work on, Roye said. He added that a reorganization of quality and safety departments across Brown Health’s properties was another factor in Rhode Island Hospital’s improved grade.
But Hackey is eyeing another Brown property, the A-graded Miriam, for a surgery he has scheduled for December. He explained with a laugh that checking the Leapfrog ratings was one of the first things he did when deciding where to have his surgery.
“The goal of this is to have a more educated healthcare consumer,” he said.
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Above average results
Leapfrog uses the percentage of A grade hospitals in a state to determine a state’s national ranking. Almost 61% of Utah’s hospitals received A grades, giving it the top slot nationwide. The top 10 states all sported at least 40% A grade hospitals.
An A grade indicates hospitals that prioritize safety, said Alex Campione, program analyst for the Leapfrog Group, who noted that about 32% of hospitals nationwide achieved this grade. Rhode Island was over the national average with 44% of its hospitals receiving an A grade.
“Each year more than 250,000 people will die in hospitals due to preventable errors, injuries, accidents, and infections,” Campione said. “We estimate that, at the very least, 50,000 of those lives could be saved if all hospitals performed like A hospitals.”
Rhode Island placed fourth nationwide in Leapfrog’s spring 2024 scores, also with 44% at an A grade, but it was pushed out of the top five this time around by three states that rose with higher grades: California, North Carolina and Connecticut. Connecticut was the only other New England state to crack the top 10. Vermont fared worst of all, and was ranked 48th nationwide, tying for last place with North Dakota, South Dakota and Iowa. There was not a single A grade hospital in any of these states.
Grading the graders
But a bad report card might not be the final word on a hospital’s quality. A 2019 article in New England Journal of Medicine Catalyst graded the graders, and gave Leapfrog a C-, the second lowest of the four systems reviewed. The study noted that Leapfrog had a detailed framework for measurement, with a unique focus on the hospitals’ “culture of safety.” But it also relied on its proprietary survey for a good chunk of its data — a problem, the authors thought, since Leapfrog grades hospitals the same regardless of whether they complete the survey.
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Dr. Karl Bilimoria of the Indiana University School of Medicine, who chairs the school’s surgery department and leads its Surgical Outcomes and Quality Improvement Center, led the 2019 study. He wrote in an email Tuesday to Rhode Island Current that Leapfrog’s efforts still leave something to be desired.
“Leapfrog has many issues with their methodology and their general approach that persist and they have been the least receptive to improvement suggestions and the least adaptive to changes in the science of quality measurement,” Bilimoria wrote.
Asked about Bilimoria’s idea that Leapfrog is not responsive to suggestions, spokesperson Lula Hailesilassie said by email that the public is regularly invited to submit feedback on proposed changes to its surveys. Comments on the 2025 survey are open through Dec. 13, 2024.
PROVIDENCE — The application period for Rhode Island’s charter schools opened this week, giving families a shot at roughly 3,000 seats projected to be available at charter schools next year.
A blind lottery for available seats will be held on April 1. Charter schools are in high demand in Rhode Island, with roughly 11,000 families submitting 30,000 applications for 2,500 seats lasts year. (Families can apply for more than one school.)
There are about 13,000 Rhode Island public school students currently enrolled in 25 charters, some of which are larger networks with multiple schools.
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Despite the demand, teachers unions and other public school advocates have sought to block the expansion of charter schools, concerned they are financially hurting the traditional public school system. School funding follows each child from their home school district to the charter school.
In this week’s episode of the Rhode Island Report, Chiara Deltito-Sharrott from the Rhode Island League of Charter Schools talks about the future of charter schools in Rhode Island, and provides a rebuttal to comments made by Maribeth Calabro, the head of Rhode Island’s largest teachers union, in an episode earlier this month.
Steph Machado can be reached at steph.machado@globe.com. Follow her @StephMachado.
United Way of Rhode Island accepts initial donations from the Fund’s sponsoring energy companies. (courtesy: United Way of Rhode Island)
PROVIDENCE, R.I. (WLNE) — United Way of Rhode Island announced the Rhode Island Good Neighbor Energy Fund has begun for the 2024 through 2025 season.
The fund helps families that need assistance paying their home heating bills but are not eligible for federal or state assistance.
Since it was founded, the Good Neighbor Energy Fund has aided over 48,250 Rhode Island homes.
United RI says any local households in the state that are in need of funding assistance for energy are encouraged to contact a local Community Action Program agency, or to call the 211 helpline for help locating a CAP agency.
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GNEF eligibility is determined on total income not exceeding 300% of the federal poverty level, and provides up to $825 per household each heating season depending on eligibility, fuel type, and need.
United RI said in addition to sponsors, the fund relies on Rhode Islanders who donate through the “Warm Thy Neighbor” campaign.
Donations can be made through the yellow donation envelope enclosed with monthly energy bills, or by scanning the QR code on the envelope.
Additionally, donations can be given through phone by texting “WARM” to 91999.
For more information, visit United Way of Rhode Island’s website here.
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