Vermont’s former human services secretary and chief hospital regulator has taken a job with the state’s largest health care provider.
The University of Vermont Health Network announced Tuesday that Al Gobeille will serve in the newly created role of executive vice president for operations, starting in September. In that position, he will work to align the systems, culture and services of the sprawling organization, which now includes six hospitals in Vermont and New York.
“If you think about the network as a coming together of hospitals and home health and nursing homes and clinics, the role of this position is to make that coming together smoother, better, faster and stronger,” Gobeille said.
The Shelburne resident and Burlington restaurateur chaired the regulatory Green Mountain Care Board under Democratic governor Peter Shumlin and led the Agency of Human Services under Republican Gov. Phil Scott. He resigned as secretary in June.
In a written statement, UVM Health Network president and CEO John Brumsted credited Gobeille with “an uncanny ability to quickly understand and master some of the most complex health care challenges we face.”
Gobeille’s hiring will likely raise questions about the revolving door between government regulators and those they regulate.
“The optics of this are not good,” said Mike Fisher, chief health care advocate for Vermont Legal Aid. “When things like this happen, I think a lot of people wonder — and I understand that.”
The Green Mountain Care Board regulates the state’s hospitals and must approve their budgets. Divisions of the Agency of Human Services license hospitals and control Medicaid payments to them.
During both the Shumlin and Scott administrations, Gobeille was a champion of the all-payer model, which compensates providers for health outcomes instead of individual procedures. That work enabled OneCare Vermont, an affiliate of the UVM Health Network and Dartmouth-Hitchcock Medical Center, to launch a pilot accountable care organization that now includes 110,000 Vermonters.
While Gobeille said he had “quite a bit” of contact with his future employer when he chaired the Green Mountain Care Board, he said he “didn’t have that much personal contact” with UVM Health Network officials as AHS secretary. Asked whether he thought his hiring represented a conflict of interest, he said he viewed it “in a more positive light.”
“I think it’s sort of a progression of going from a regulator to human services … and then moving into the private sector to work on the place where all those things intersect,” he said.
Gobeille isn’t the first former regulator to leave the Scott administration for a job with an entity he once regulated. In May, then-tax commissioner Kaj Samsom disclosed that he had accepted a job in February with the National Life Group. Samsom had previously led the state Department of Financial Regulation’s insurance division, which oversees National Life.
Gobeille said Tuesday that he had applied for the UVM job mid-May — after he had informed the governor he would resign, but before he announced the decision and before he left the agency on June 28. He said his decision to leave state government was not prompted by the possibility of working for UVM. “I wasn’t sure what I really wanted to do,” he said.
As a cabinet official, Gobeille was required to sign the Governor’s Code of Ethics. That prohibits former appointees from lobbying the legislature and other public bodies, such as the Green Mountain Care Board, on matters they were involved with for a year after leaving office. Said Scott spokesperson Rebecca Kelley, “Members of the administration are expected to adhere to the law at all times, and we are confident both former Secretary Gobeille and the UVM Health Network will honor both the spirit and the letter of the law.”
According to Gobeille and UVM Health Network spokesperson Michael Carrese, the job will not require its occupant to run afoul of state ethics regulations.
“[H]is job is focused on improving internal operations among the members of the UVM Health Network,” Carrese said. “He is a person of the highest integrity and we have no doubt he will follow the letter and spirit of the code of ethics.”
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We are doomed. This is Vermont at its worst. Al Gobeille is a good man, but this is just representative of the problem. Way too much bureaucracy and crazy spending instead of investing in nurses and doctors. The entire healthcare system is going to crater. The ACO has failed to fix the problem so far, and Gobeille is now making likely at least $700,000 in this new role. Shaking my head.
Carrese said, “He is a person of the highest integrity and we have no doubt he will follow the letter and spirit of the code of ethics.”
Shortly before resigning from state government, former Secretary Gobeille was notified along with state and federal law enforcement of stunning new losses to employees of the Brattleboro Retreat as the hospital had terminated their Benefit Manager in January of this year. Despite being the key person overseeing the Retreat and the State of Vermont’s “Memorandum of Understanding” related to the completed criminal fraud probe he was responsible for seeing to it the psychiatric hospital was engaging in lawful best practices.
The former Benefit Manager spoke with a current employee of the Retreat last week who is owed over $2,000 and the hospital has taken no action to acknowledge or return what she describes as “hundreds of thousands” in employee losses stemming from the Retreat taking fraudulent payroll deductions on employee benefits that had expired a decade earlier. Gobeille & Co. and many across state government and law enforcement are covering up massive fraud to protect the reputational risk of the hospital given the importance of the Retreat to provide needed care, and as a result of the state’s huge financial investment in the hospital. Gobeille’s silence and inaction as it relates to recent employee losses should speak for itself.