Name: Christine C. Ferguson
Age: 40
Position: Director, Rhode Island Department of Human Services
Backround: Former counsel and chief of staff under U.S. Sen. John H. Chafee; Ferguson was the principal architect for the Republican alternative to President Clinton’s health care reform bill and led the cause for negotiations and passage of a bipartisan health reform package; Named one of the 100 Most Influential Attorneys in the United States by the National Law Journal in 1994.
Education: University of Michigan (BA, 1980); Washington College of Law, American University (1986)
Family: Married, one son
Residence: Jamestown
CHRISTINE C. FERGUSON: ‘We’re moving in (the right) direction.’
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PBN: You grew up in Jamestown and attended The Lincoln School in Providence. How have you been able to connect so closely to the impoverished?
FERGUSON: I believe everyone has something that can be drawn out of them. No matter where they come from, or what their background. I have a vivid imagination. I can imagine what it would be likeand I can imagine that trying to live that way for a week wouldn’t give you any more of the flavor of what reality is. The other thing is, when I went to Washington, D.C., I had $500 in my pocket. My car was totally unreliable – going to a city where I knew one person. My family was not politically connected. I went there because I had interned at the Action Agency in D.C. I lived in a moldy basement. I ate baked potatoes and chicken thighs because they were the cheapest things at the market. I lived on minimum wage. I now have a child. I can’t in my wildest dreams imagine trying to raise a child and work like that with no support. It’s something I have lived, but in a different way. The neighborhoods were not great. It was not the best of situations. But I knew that if anything happened or I got into trouble, I could always call home. A lot of these folks don’t have that option. Understanding that is critical. The other piece is that when you are in D.C., you are never very far from poverty. It’s different from here. The poverty there is much more intense, more vicious. You see it every single day. You cannot avoid it. To see kids on 14th Street who are 13, 14 and 15 and are hookersand to see young men, 13, 14 or 15, running drugs. It’s not quite the same here. I have a fierce desire to protect all of us from that. I don’t mean that in a paternalistic way. I mean using the resources – and that’s not always money – and figuring out the right decisions at the right time. I guess it’s just the power of having a vivid imagination and having been frightened by the depth of violence in D.C. And knowing that the only thing standing between us and that is each and every family in each of our core cities feeling like they have a voice and an opportunity. If they have that feeling, sure you are going to lose some, but you aren’t going to lose as many.
You were a top aide to U.S. Sen. John Chafee and spent 12 years in Washington, D.C. Why return to Rhode Island?
The job itself is fascinating because of the breadth of things it touches. I knew it was going to give me the opportunity to look at health reform at a local level. From a career perspective, it was a chance to do some hands-on stuff. I came here at the end of January in 1995. People were still bitter about the banking crisis. There was a real negative, anti-Rhode Island feeling. But I can tell you, the difference between Rhode Island and other places is just night and day. Our natural resources, the people. When I talk to people who have transplanted into Rhode Island or have left like I did for an extended period and come backwe all say the same thing. We’ll never leave again. It would have to be a real bad economy where you felt like you could not support yourself. The quality of life here is amazing. The interaction you have with other people from all walks of life is amazing. That’s not true in other places. This is also a chance to be back with my family. My parents live in Jamestown; so do my brothe
rs. If we all talked about Rhode Island like this, about it being the jewel it isI can’t imagine relocating a company someplace else when you have the option of being here.
You have been credited for your work to enhance RIte Care and improve health care for needy children in Rhode Island. What enabled you to make progress on that front?
The most important thing for me in coming back was making the health insurance programs for kids work. And then test out a number of things. We’ve tested out different benefit structures. We’ve tested out a different medical necessity definition. We’ve looked at the fiscal implications over time. The motivating factor is to ultimately have a situation where everyone can have insurance at a reasonable price. We’re slowly moving in that direction.
A year ago, I attended a forum at the Providence Children’s Museum sponsored by Health & Education Leadership for Providence (HELP) and Rhode Island KIDS COUNT. The audience was made up of educators, health care leaders, politicians and social service professionals. There was talk that more of an effort must be made to lobby at the General Assembly for programs that benefit children. That morning you said lobbying efforts in the past have been missing a critical element. You added; “If groups of suits would accompany the groups of skirts at the legislature” Have you seen any progress?
No, but in fairness, we haven’t really asked. Between the governor and Tony Pires and some of the folks who have been supportive of kids’ issues, we haven’t really engaged the business community and the university community. Having said all of that, one of the difficulties is that in good times we don’t always use that time to exchange information so that when there is a crisis we can call on folks. I think we haven’t yet made the case that these investments in kids really pay off in terms of workforce that is capable. That’s going to take a few years for the data to come back.
You speak your mind. Does this help you to accomplish your goals?
It seems sometimes that I am just spouting off, but usually I have at least thought about it in advance. I mean what I’m saying. You’d have to ask other people. On the whole, there have been times when I wish I could have put a sock in my mouth. But as a general rule I don’t find that it has been harmful. I think it’s important that people not screen themselves so well that what comes out doesn’t mean anything.
Political pundits are already speculating as to who will make a bid to succeed Gov. Lincoln Almond in 2002. As for Democrats, Charles Fogarty, Sheldon Whitehouse and Myrth York have all been mentioned. On the Republican side, the names of Ron Machtley, Bernard Jackvony, James Bennett and Christine Ferguson have been bandied about. Would you consider running for governor?
Right now all I am considering is getting out of this job with my skin intact.
Have you heard that talk?
People always ask me I think people are always interested in what women are going to do. That’s three years away, though. That’s a long time in politics. A lot of things can happen.
Are you flattered by the talk?
How could you help not to be? It’s always nice to think that people think highly enough of you to put your name out there. But there is a lot that still needs to be done here. If I did do something like that, the reason would be to move state government further along in terms of really using its resources more effectively. That’s a hard message to get out.
What is your opinion of HMOs?
They are part of an evolution of health care. There are two aspects of HMOs that people get confused. One is the taking on of risk, the insurance capacity – the capitated payments (one rate per head). Whether that person costs more or less, they still get that dollar amount. The other side of the coin is actually the managed health care. On that side, HMOs have moved us to a much better place. In terms of the concept of looking at a patient as a whole and determining what mix of things is going to help improve the health of that patient. The problem is when they begin to look at that role as also related to the financial world. With RIte Care we have pushed them on the issue of managing care. We have an advantage though, because we have 80,000 people. But each individual employer in the state has far fewer people – and no power to negotiate with an HMO about how all this gets done. That’s the element that is missing. Rhode Island skipped a lot of steps in this because of the prominence of Blue Cross.
Gov. Almond has asked you to develop a program that will allow any individual or small business unable to access or afford comprehensive health coverage, to purchase insurance through the state. Where are you with that?
Not only has the governor done so, but so has the legislature. We’re on track. We’re hoping to be able to get a grant to help with some of the planning and evaluating. We’re going to put together an advisory group. We’ll have some things on paper that we can talk to people about soon. I’m hopeful that by sometime next year we will have a plan that people will be able to buy into.
What is your message to Rhode Island’s business leaders in terms of bettering the lives of Rhode Island’s neediest residents?
If you look at the demographics, in terms of who is having children, what the ethnic background and income level is and you look at what the workforce is going to look like in 10 to 15 years, the reality is that unless we invest in early education and make an effort in K through 12, we are going to see a workforce in Rhode Island not capable of technological advances. If we had a goal in Rhode Island – as crazy as this sounds – mine would be that 20 years from now, if any child in Rhode Island was trying to find a job and they had on their resume that they were raised in Rhode Island, and went to school in Rhode Island, that an employer would automatically put them at the top of their interviews. Because they would know that a child from this state was heavily invested in from the time they were born. That they were looked at during all of their development stages to make sure they were up to speed, and if they weren’t, actions were taken to intervene. That a clear emphasis was placed on emotional competence, as well as intellectual school competence. And that these were people you would want in a team environment because they knew how to mediate and deal with a disparity and diversity of views. I don’t think that is an unreasonable thing for us to go for – at all. If we all put our minds to it, we could get to that point. It’s not impossible that we could have all of our children out of poverty in this employment market. In this employment market today, there is no reason that any child has to be in poverty. Unless their parents are totally incompetent – and that’s a different set of issues. These are not pie in the sky goals for a state like this. We need to suspend disbelief for awhile and make an effort. The reason business people need to be concerned is that you cannot isolate from people who are different. It doesn’t matter where you live, you will be touched by someone who is poor. You will be touched by someone who has a disability. You will be touched by someone who is older.
Much has been made of our booming economy – both nationally and on the local level. Have your constituents benefited from this prosperity?
When you talk about my constituents, I want to be clear. There are about 130,000 people at any given time who get health insurance through us. That’s the aged, families and folks with disabilities. There are probably about 18,000 families who get cash services from us. So the bulk of our folks are getting health care. Then, we buy from all the hospitals and health insurers – a whole spectrum of people. So when I look at the economy and the things I deal withI think for families that have been on cash assistance, the combination of the economy and changes in policy is definitely leading to a good outcome. Hopefully, in the next year or two, we’ll go farther with that. On the health care side, the economy being good has enabled us to get the legislature and the governor to give us the time we needed to get our health insurance programs in place in work. Not having a crisis has allowed us to get four good years of data on health outcomes. It has made a huge difference. For the elderly, it hasn’t really had an impact yet. We’ve done some improvements in health care for seniors, but nowhere near what needs to be done. On the other hand, every health care provider is screaming. Health insurers are into their reserves.
