PROVIDENCE – Gov. Dan McKee has named a new housing secretary: Deborah J. Goddard.

Who is she? Goddard, the former managing director for policy and program development at MassHousing, currently leads the Massachusetts-based DJ Goddard Consulting, which has done consulting work for the Rhode Island Department of Housing among other public, quasi-public and nonprofit agencies, according to a press release from the McKee administration.

Prior to this role, Goddard served at the executive vice president for capital projects at the New York City Housing Authority from 2016 to 2019, where she oversaw $3 billion of construction builds and helped advance the agency’s energy and sustainability programs, the press release said.

She is scheduled to start her new $238,597 job on Dec. 2. In the interim, her name has been submitted to the Rhode Island Senate, which is in recess, for advice and consent after the legislature convenes in January.

“Deborah Goddard is a deeply committed and accomplished housing professional whose work has benefitted people from all backgrounds,” said McKee. “Housing affordability and availability in Rhode Island have never been more important than they are right now. I am confident Deborah’s knowledge and experience will guide the department to achieving our housing goals.”

Senate President Dominick Ruggerio said he “look[s] forward to the Senate’s thorough review of Ms. Goddard’s appointment through the advice and consent process.”

House Speaker K. Joseph Shekarchi said he met with Goddard for the first time a day earlier “and she was very impressive.”

In her own turn, Goddard said her career has been “dedicated to creating and preserving housing opportunities … for the unhoused, for renters and homeowners, alike, with attention to equity.” As such, she said, “I am very aware of the persistent headwinds that we face in this arena, but they are not unique to Rhode Island nor are they new.”

The Rhode Island Department of Housing has been run by an interim chief – former Senate Majority Leader Daniel Connors – since Housing Secretary Stefan Pryor’s last day in July in one of the state’s most critical jobs.

A former Senate majority leader, Connors – who quit a job as a top aide in the Raimondo administration after his arrest for driving under the influence – had most recently been chief of staff in the state Executive Office of Health and Human Services, making $184,000 annually.

On the day of his interim appointment, the governor’s office said: “He is not being considered for the permanent position and will return to his role at EOHHS at the end of this process.”

Pryor is now a partner in Palm Venture Studios, which “works to rescue and build companies that positively impact human and planetary health,” according to his LinkedIn profile..

How did we get here?

Spokesman Andrea Palagi told The Journal at that time that McKee’s office would interview local candidates for the permanent position over the coming weeks, and a national search would only be initiated if a qualified candidate could not be found. As it turned out, there was no national search.

Pryor announced that he was leaving in late June after close to a decade leading Rhode Island’s economic development efforts as its first commerce secretary and, for a year-and-a-half as head of its Department of Housing,

The hunt for his replacement stretched out over several months, amid significant jockeying between the many arms of Rhode Island’s housing community for advantage − and appointment.

The Department of Housing is responsible for managing hundreds of millions of previously dedicated state dollars and the newly approved $120-million housing bond.

But the picture that has emerged in the wake of Pryor’s departure was of an agency beset by employee infighting, leaks about end-runs in the award of contracts, and complaints to the governor’s office about the management styles of both Pryor and Assistant Secretary Hannah Moore, whom Pryor brought into the department with him.

More recently, Rhode Island’s deputy housing secretary, Deborah Flannery, resigned to take a job with the Vermont Housing Finance Agency. Her last day is imminent.

The Department of Housing was unable to pinpoint the amount Goddard and her firm have been paid as a consultant or promised. As for her role, spokeswoman Emily Marshall listed non-specific duties, such as: “drafting regulations for internal review, and co-authoring  multiple grant applications, among other responsibilities.”

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. 

Rhode Island’s hospitals collectively ranked seventh nationwide.

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.”

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. 

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.   

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.

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.

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.