Pat McDonald and Ben Kinsley are co-hosts of the show “Vote for Vermont.” In a recent show they interviewed Al Gobeille, Secretary of the Agency of Natural Resources (AHS). He has quite the backstory, having graduated from Norwich University, served in the US Army, is a restauranteur, former Chair of the Green Mountain Care Board and now Secretary of AHS. Al said his secret to success is to surround himself with experts in their field who share his values.
Appointed as a member of the Green Mountain Care Board (GMCB) in 2011, Al was elected Chair in 2013. He said this assignment changed his life. He commented it is hard to grasp and explain the importance and complexity of health care to Vermonters and Vermont’s economy. What has been happening on a national stage has resulted in a tough debate about health care. Al said the health care system consists of three buckets: 1. Collect the money; 2. Pay for goods and services; and 3. Deliver services, with a focus on accessibility, high quality and coordination.
Al was particularly pleased with the leadership stance set by America’s Governor’s recently, which sent a strong message to the Senate that what they were proposing wouldn’t work. He is hoping going forward that the Administration and the Congress include Governors in their discussions. Al stepped down from the GMCB Chairmanship when he was appointed as Secretary of AHS.
As Secretary of AHS, Al is responsible for numerous areas providing services to Vermonters. A discussion of each Department and corresponding critical areas of concern/opportunity followed.
Administration: Vermont currently stands to lose $200M in Medicaid funding if the Affordable Care Act is repealed. Everyone is hoping that the close relationship between Vermont and the Feds, the Governor’s support, and the involvement of our congressional delegation will result in a much better outcome for Vermont.
Department of Children and Families: Al gave kudos to the Director of DCF and his ability to deal with the aftermath of the tragic shooting of a DCF worker. He praised DCF staff for their continued dedication, passion, and hard work on behalf of Vermont’s children and families. Al said his focus is on the security and safety of DCF staff as they do the work of angels.
Al talked about the impact of the opioid crisis not only on DCF but on every corner of AHS and the State. Through a lot of hard work, AHS has developed the “Hub and Spokes Health Homes” program which creates a coordinated, systematic response to the complex issues of opioid addition. White House Director Richard Baum pointed to this program as a model for the country.
Department of Disability, Aging and Independent Living: Vermont is now the second oldest state in the Union, right behind Maine. Because of this Al said that a primary challenge is to determine where aging Vermonters belong – in nursing homes or independent living. Are nursing homes a better option for Vermont’s Elderly or are there enough providers available to ensure safe in-home environments?
Al said that a primary focus of DAIL is the hiring of disabled workers while ensuring their benefits packages are supported throughout their work. The disabled have sometimes lost important benefits – similar to the welfare “cliff” we hear about – when they go to work.
Department of Mental Health: Al noted that mental health issues are found everywhere. Fortunately $8.lM was included in this year’s budget to support community based mental health treatment facilities. He admitted that we are not there yet in the implementation phase of the community model but they are working hard and will have some proposals ready for the next legislative session.
Department of Corrections: Al noted that Vermont is one of very few correctional systems in the country that provides treatment in prison for behavioral or mental health issues, and of course opioid abuse. Out-of-state housing continues to be an issue while the state seeks funding for new in-state facilities.
Miscellaneous: Issues such as transportation, early education and housing continue to be dealt with in collaboration with other agencies within state government.
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