After a small clinic’s worth of physicians showed up to testify in support of Gov. Dan McKee’s choice for the next director of the Rhode Island Department of Health, the Senate Committee on Health and Human Services affirmed its support for Dr. Jerome “Jerry” Larkin at a hearing Thursday.

The committee voted 5-1 in favor of Larkin’s nomination, with Sen. Elaine Morgan, a Hopkinton Republican, serving the only nay vote. 

Greg Paré, spokesperson for the Rhode Island Senate, said in an email Thursday that Larkin’s appointment will hit the Senate floor on Tuesday, May 19.

The clinicians, many of them colleagues and former protégés of Larkin, came to say nice things about the doctor who serves as medical director of inpatient infectious diseases consultation services at Rhode Island Hospital and teaches clinical medicine as a professor at Brown University. The committee’s mailbox had also been stuffed with written testimonies.    

“We got many, many letters,” said Sen. Joshua Miller, who chairs the committee. “I don’t remember seeing a letter that was not in support.”

But the most memorable affirmation may have been from Dr. Sabina Holland, medical director of the pediatric HIV clinic at Hasbro Children’s Hospital. 

“The highest compliment that a pediatrician can give another pediatrician is to entrust them with the care of their children,” Holland said. “He could have my children.” 

The crowd laughed. Chair Miller offered a playful retort. 

“He can’t have my children,” Miller said.

Jokes aside, Larkin’s competency with children was underlined in several testimonies — including those from members of the Tiverton School Committee, which Larkin has chaired since 2017. Larkin has served on the school committee since 2012 and was most recently reelected in 2020 with 31.1% of the vote.   

The afternoon’s first two testimonies came from school committee members, including Deborah Pallasch.

“I have known Dr. Larkin since he became involved in the anarchy that can be Tiveron politics,” Pallasch said. “In the middle of COVID, as the chair of our school committee — as you can imagine, quite a scary time for us, quite a scary time for our parents, quite a scary time for our children — he led us as a community through that so deftly and so patiently and so respectfully.”

Larkin, in his own words to the Senate, emphasized the at-time martial nature of municipal school politics. “As chair for the last seven years, I am the veteran of 12 hardball budget seasons — some of them scorched earth, some of them merely trench warfare,” Larkin said. “I believe if you can understand the budget of a small-to-medium-sized school district, you have a better-than-even chance of understanding the budget of the Pentagon.”

“The Pentagon might actually be easier, as it seems to be able to spend money unbudgeted, freely, without any apparent consequence.”

Priorities include stabilizing hospitals and nursing homes

The consistency of Larkin’s school board role contrasts the revolving door at the health department, a fixture of the McKee administration. The last permanent director, Dr. Nicole Alexander-Scott, worked under Gina Raimondo’s administration and led the department during the height of the COVID pandemic. Alexander-Scott was reappointed for another five years in 2020, but vacated the position in January 2022, less than a year into McKee’s governorship. 

That vacuum has been plugged by three interim directors since then: Dr. Jim McDonald, Dr. Utpala Bandy, and most recently Dr. Staci Fischer, who took over as acting director when Bandy retired on March 31. Statewide health directors are rare birds nationally, and regional directors are common in larger states. The compensation for such an encompassing job has been criticized for the turnover, although McKee recently and successfully raised the base salary to $250,000.  

Speaking to reporters, Larkin said that, if confirmed by the full Senate, his priorities would likely include the stabilization of hospitals and nursing homes, as well as responding to the opioid overdose crisis.

“But I’m still on the outside looking in,” Larkin said. 

Larkin was so far outside, in fact, that he was unsure how to assess the time demands of his possible new job. Would he continue serving on the school committee?

“I haven’t made a decision,” Larkin told a reporter. “Certainly, you know, the Department of Health is a full-time job but so is being a doctor.”

Judging by the afternoon’s testimonies, Larkin is a good clinician. His 1993 medical degree is from Robert Wood Johnson Medical School at the University of Medicine and Dentistry of New Jersey, and his research specialty is tick-related illnesses and Lyme disease in children and pregnant women.

Dr. Michael Koster pointed out Larkin’s talents as a “med-peds” physician, or someone who “understands pediatric issues as much as he understands adult medical issues.”

“You don’t get a showing of physicians like this,” Koster said, referring to the turnout for the hearing. “You have to earn it. It’s not something you can buy.”

While the public offered no opposition, the senate committee did have a few questions. Miller pointed out the statute that outlines the health director’s qualifications — a prescription which includes “a minimum of five (5) years full time experience in health administration.” Miller was curious how that requirement fit into Larkin’s experience.

“I think it depends,” Larkin began. “So, if you look at how much time do I spend seeing patients — so, everything I do is subsumed under the title of the director of infectious disease consults service. So in many regards, my clinical work is an administrative responsibility. I have to know how those services work.”

Larkin estimated that administrative duties probably comprise half his time currently. 

Sen. Linda Ujifusa, a Portsmouth Democrat, asked Larkin about the state’s shortage of primary care doctors as well as reimbursement rates. Could any initiatives from the health department help shape a more positive environment for Rhode Island’s doctors?

Larkin replied that neighboring Massachusetts and Connecticut are well known to have superior reimbursement rates, but that “rectifying that ultimately is actually a federal issue.”

“Would you mask our kids again?”

Morgan asked Larkin about the state’s handling of the pandemic. Larkin suggested looking at a map, and that Rhode Island ultimately “dodged a bullet” given the severity of the pandemic in nearby Massachusetts and New York. 

Morgan then narrowed her focus. “Closing down the state: Would you do that again?” she asked.

“Do I think the decision was right to shut down in March of 2020 at that time? Yes,” Larkin said.  “Could we have reopened faster? Probably. There was certainly a loss in school districts, and there’s certainly an economic impact on this. So that’s my sort of armchair general retrospective perspective on it.”

“Would you mask our kids again?” Morgan continued.

“Yes. Yes,” Larkin said, and pointed to the measure as effective in reducing transmission, allowing kids to get back in school sooner.

At 4 p.m., bells started ringing.

“It’s not a fire alarm,” Sen. Pam Lauria said. “It’s just the bells for the Senate.”

Miller used the literal sounding of the alarm as a backdrop for one more comment.

“And with that bell from the Senate, I just would like to ask you to be aware of a couple of issues that we have discussed in committee this session,” Miller said, and pointed to recent discussions involving scope of practice. Should committees in the General Assembly be tasked with regulating scopes of practice, or should that be left entirely to medical boards and the health department?

But rather than discuss “going down a very slippery slope of having scope of practice legislated,” Miller filed the question away for another day, and the motion for a vote on Larkin’s advancement began. Sen. Alana DiMario seconded the motion. Only Morgan voted no.  

Larkin’s own words to the committee were punctuated with the occasional cough.

“Excuse my voice. My allergies decided to start today,” Larkin said after he sat down in front of the mic, following odes from his colleagues. “Yeah, I guess that was the easy part. It’s the fondest wish of every Irishman to attend their own wake, and I feel like that’s what I’ve been doing this afternoon.”

The 704-megawatt (M) Revolution Wind, Rhode Island and Connecticut’s first utility-scale offshore wind farm, just hit a major milestone.

Revolution Wind’s site is more than 15 miles south of Rhode Island and 32 miles southeast of Connecticut. The first multi-state offshore wind project is a 50/50 partnership between offshore wind giant Ørsted and New England energy provider Eversource.

“America’s offshore wind industry is scaling up, and the first steel in the water at Revolution Wind is a tremendous milestone for Rhode Island and Connecticut’s clean energy journey,” said David Hardy, group EVP and CEO Americas at Ørsted.

During the offshore construction phase, a variety of vessels will be active at the site, including construction and transport barges, cable installation vessels, tugboats, supply and support vessels, and protected species observer monitor vessels. Simultaneously, onshore construction is underway on Revolution Wind’s transmission system in North Kingstown, Rhode Island.

In New London, Connecticut, the first turbine components have started to arrive at State Pier, the project’s staging and marshaling port, where they will be assembled by local union labor.

In Rhode Island, crews in Providence are readying for loadout of advanced foundation components built by local union labor at Ørsted and Eversource’s construction hub at ProvPort. Revolution Wind’s crew helicopters and Rhode Island-built crew transfer vessels are based out of Quonset Point.

When it comes online in 2025, Revolution Wind will generate 400 MW of clean power for Rhode Island and 304 MW for Connecticut. Combined, that’s enough clean power for more than 350,000 homes across both states. It will displace nearly 1 million metric tons of carbon emissions annually, the equivalent of taking more than 200,000 cars off the road.

Last weekend, the US offshore wind supply chain marked another major milestone with the christening of the ECO EDISON, the first-ever American-built, owned, and crewed offshore wind service operations vessel. Constructed by over 600 workers across shipyards in Louisiana, Mississippi, and Florida, with components sourced from 34 states, the ECO EDISON will play a crucial role in operating and maintaining Ørsted and Eversource’s offshore wind projects in the Northeast, including Revolution Wind.

Rhode Island has set a goal of achieving 100% clean electricity by 2030, and Connecticut has set a goal of 100% clean electricity by 2040.

Read more: 2023 was a record year for wind power growth – in numbers

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What do you call someone who “who habitually lacks self-control as to the use of alcoholic beverages”? 

They’re an “alcoholic,” according to Rhode Island General Law.

But the state’s statutory language surrounding alcohol use and treatment could soon change thanks to the recent passage of bills in both chambers of the General Assembly. 

“We don’t talk that way anymore. We don’t think that way anymore. Yet it’s still codified into our statute,” said Rep. Jennifer Boylan, a Barrington Democrat, during a March 5 hearing of the House Committee on Health and Human Services. 

The bill she introduced that night, H7736, saw successful passage May 7 during a House floor vote. On Thursday, May 9, the Senate unanimously passed Bill S2087 by Sen. Joshua Miller, a Cranston Democrat. The twin bills allow revision of how state law defines alcohol disorders and their treatment. 

“These statutes have not been approached for revision in over 40 years,” Miller said on the Senate floor. “There are many flaws in it, including commitment to public hospitals where the actual commitment doesn’t exist, the beds do not exist. And the language is embarrassing to the departments and those involved as providers.”

Both bills direct the Rhode Island Department of Health and the Department of Behavioral Healthcare, Developmental Disabilities (BHDDH) and Hospitals to coordinate proposed revisions that would align the state’s law books with best practices by Jan. 1, 2025.

Miller previously worked on the Governor’s Overdose Commission and has sponsored other bills relating to substance use in the past. This is Boylan’s first bill relating to substance use. 

“I challenge you to find someone who doesn’t know anyone who has this problem (alcohol use disorder),” Boylan said in a recent phone interview. “It’s a problem that a lot of people struggle with, and I think our statutes should be updated to be more modernized.” 

Person-first language

Many doctors and advocates consider terms like “alcoholic” stigmatizing and loaded. Both the National Institute on Drug Abuse and Centers for Disease Control and Prevention suggest using “person with alcohol use disorder” in keeping with a person-first approach to language use.

The notion of self-control as the main motivating factor in one’s drinking is contrary to clinical understanding, which sees alcohol use disorder as a more complex pattern. 

“Yes, there is an element of choice when a person first starts drinking. For some people, however, a mix of genetic and environmental factors facilitates a transition, often without full recognition, to increasingly heavier drinking,” according to a core resource document from the National Institute on Alcohol Abuse and Alcoholism. 

Now the bills have to pass in opposite chambers, said Larry Berman, a House spokesperson, in an email: “In other words, the House now has to pass Sen. Miller’s bill and the Senate now has to pass Rep. Boylan’s bill. Once each bill passes in both chambers, they will be transmitted to the Governor.”

Boylan said on the phone that she’s “very hopeful” the bill will land on the governor’s desk this year. And on the Senate floor, Miller said the simultaneous OK is an improvement over previous years. In the 2023 legislative session, Miller’s bill secured Senate approval. But its momentum ended when it was referred to the House Committee on Health and Human Services.  

“I’ve had this bill for several years without any action on it on the House side,” Miller said. “The House passed it a few days ago, which will be a great relief to those involved in deciding in June what passes and doesn’t pass, [who] won’t have to hear from me about ‘Why didn’t this bill pass?’ Because it’s so simple and so important.”

The identical bills add only six sentences to existing statutes. Miller’s bill generated no discussion on the Senate floor. In the House, Minority Leader Mike Chippendale wondered if Boylan’s legislation would also change other instances of outdated language buried in state law.

“There are other sections in the law…where we use the term ‘habitual drunkard,’” Chippendale said. “I think obviously that sounds a little bit more offensive than ‘alcoholic.’” 

Laws on taverns, cookshops and oyster houses, for example, lump together “Drunkards, wastrels, and minors” as prohibited from entry into these businesses. Business owners face possible fines if they count among their customers “any common drunkard or person addicted to the intemperate use of spirituous or intoxicating liquors.” The section was first written in 1896 and most recently updated a century later in 1996. 

“Would this also change that or would that be something that we perhaps overlooked and will change later?” Chippendale asked Rep. Susan Donovan, who chairs the House Committee on Health and Human Services and presented Boylan’s bill.   

“I’d have to refer to counsel. I would hope that it would change all of those terms,” Donovan said.

Last year, Gov. Dan McKee signed into law legislation sponsored by Sen. Jonathan Acosta that replaced terms like “mentally retarded,” “alcoholic,” and “drug abuser” with less stigmatizing language. That legislation targeted different sections of state law, however. Boylan said her bill hones in on a very specific section of state law. 

Because circumstances can change

Beth Lamarre, executive director of the Rhode Island chapter of the National Alliance on Mental Illness, wrote via email how stigmatizing words like “alcoholic” can hold “a negative connotation, because of how alcoholism/alcohol use disorder has been viewed throughout time.”

“It also spotlights the issue, as though it is that person’s only characteristic,” Lamarre said. “Describing someone as having an alcohol use disorder, on the other hand, describes a circumstance or a situation, one that can be changed.”  

Other states have also begun to read the fine print surrounding spirits. “It’s hard to say how many states have replaced their language entirely, but we have noticed more states using AUD (alcohol use disorder) in current legislation,” said Karmen Hanson, a senior fellow in the National Conference of State Legislatures’ health program, via email.

Legislatures where similar legislation has been introduced include Connecticut, Maryland, Colorado, Massachusetts, New Jersey and the Virgin Islands, but Hanson noted “that’s not a reflection of everything that may be out there.”

Global opinions differ on people-first language, although what words are used also owes much to the disability being described. England’s national health agency, for example, prefers “disabled people” to “people with a disability” — a choice underlined by an argument that society makes barriers for people with disabilities, rather than the disabilities themselves. This alternative, known as identity-first language, is also common among autistic and deaf people in the United States, according to the National Institutes of Health.

Regardless of what language one uses, disability advocates seem to agree that the overall idea is ensuring people feel comfortable speaking up about their struggles.

“Words matter, and how we talk about someone’s health (including and especially behavioral health) can make the difference in whether they feel supported in getting the treatment and help they need,” Lamarre said.