Connecting the Dots: Leadership, Vision & Courage

It helps to understand emergency rooms and prisons as the end-game of bad policy decisions.

Vermonters can’t afford to keep spending money patching up the accelerating dysfunction absent a clear vision for what’s unfixable and what must instead be re-imagined more cost-effectively and cost-efficiently.

The solutions are not all monetary but rather systemic and must be based on a shared vision realized by courageous leaders.

Each broken element  ̶  housing, hunger, transportation, physical and mental health, addiction, the environment, childcare, criminal justice, and public education  ̶  has their advocates. But who’s connecting the dots and seeing how they are all related, and how fixing one without addressing the whole gets us nowhere except further in debt?

The three essential drivers of Vermonters’ well-being are:

• Public Education: (DOE) community schools and colleges
• Health/Wellness: (AHS) community health centers, parent-child family centers, medical professionals, hospitals, and other institutional providers of health services
• Social and Environmental Justice: (AHS) the criminal justice system, corrections & the Dept. of Children and Families(DCF)

If we understand these three essential drivers of community well-being as interdependent, we can begin to form a consensus around needed changes and begin the work of reinvention that takes us from an expensive patchwork of legislative and agency-driven repairs to much more cost-efficient upstream redesign investments in education, intervention, and prevention of downstream crises.

Public Education: It’s time to reimagine and redesign Vermont’s public education system to one that enables learning. Merely patching up a system that’s failing us in equity, access, infrastructure, and quality will bankrupt us with no change in outcomes. At $19,340 per student we spend more per pupil on public education than all but four other states, even as our public school student population has shrunk by 21,000 since 1997.

There is a move afoot to fund an analysis of the environmental safety of Vermont schools. New scientific understanding of safe levels of PCB, PFA, lead, microplastics, urea formaldehyde off-gassing, and radon in air and water handling systems have prompted concerns. If school buildings are found deficient, how much will we spend mitigating the toxins or, as in the case of Burlington High School, building a whole new school for $320M without assessing what a modern school should be from an infrastructure standpoint? Will we just replicate the dozens of square classrooms and desks, a book-library, and a few labs or does modern pedagogy, remote learning, and internships point the way to newer, more cost-efficient and effective learning spaces perhaps integrated with other civic spaces?

Also, try to imagine that public education begins at six months after a paid family leave to allow for the critical bonding of a newborn with its parents. It then becomes mandatory at age three or four, but is available from six months on to working parents as “learning centers,” not “childcare.”

These learning centers would be staffed by appropriately-compensated professional early-educators with specialized pediatric and child-development knowledge and with trauma-informed counselors to identify adverse childhood experiences(ACES). Family-support services would be available to work with children and families to address and remediate problems that, when undetected and unaddressed, often regress into special ed, the criminal justice system, and even incarceration. The hungry child living in the back seat of their mother’s car does not come to school with learning as their top priority.

To invest in early learning, we must retire our current, arcane educational architecture – pre-school / nursery, kindergarten, grade school, middle school, junior high, high school, and college – and see education as a continuum that focuses on the individual learner. The old and arbitrary divisions defy what we know about childhood development and distract us from the individual learner’s needs and abilities.

We’re at an inflection point in public education. We must come together to reimagine it as a cost-efficient institution that fulfills our Constitutional obligation in a democracy to provide free and effective learning for our youngest citizens. And we must focus those investments on the ages where research in human development tells us our children and young people are most receptive to learning.

Public Healthcare: any future vision must be viewed through the eyes of those who need it, use it, and provide it, not solely through the eyes of those who administer it or profit from it. We must find the will and leadership to derive a consensus on patient-centered, community-based healthcare delivery systems with primary care as the point of entry except in emergencies.

Community health centers, primary-care practices, and parent-child family centers are uniquely skilled at identifying and treating not only incipient illness, but, equally important, sources of trauma and toxic stress induced by ACEs. Treating them in a local setting supports family as well as patient. Community-based centers are best able to connect the dots of inadequate housing and nutrition, the toll of abuse, addiction or an incarcerated family member, and so provide the best and simplest way to initiate measures to begin and sustain recovery.

Dr. Paul Farmer understood this intuitively and his work today in the Navaho Nation, Rwanda, and Haiti among the poor is widely regarded as embracing a new understanding of population health. “A mother cannot undergo cancer care and lose work without receiving economic support. A tuberculosis patient cannot endure strong medications on an empty stomach. And a patient showing symptoms of covid-19 cannot take public transportation to her local testing site.”

Social and Environmental Justice: Finally, we must understand our failures in healthcare and education as principal drivers of costs in our criminal justice system. If we were to reinvest a quarter of the $160M a year we spend keeping people in jail in prevention, we could reduce the number of Vermont children  ̶  6000 at present  ̶ who either have an incarcerated parent or a parent under correctional oversight. And Vermont might lower its dubious rank as the fifth most frequent terminator of parental rights that remove children from their families. And we are supposed to be one of the best states to have and raise children?

I am both grateful for and sympathetic to the daunting task of legislating truly revolutionary reform, reform that both saves taxpayer money, improves outcomes, and enhances economic growth.

Healthcare, public education, and social and environmental justice have each become systemic behemoths laden with incomprehensible language, impenetrable processes  ̶  all defended by the powerful status quo bias of the many feeding of these ageing systems. But if there was ever a time to re-envision these bulky systems, it’s now. Try to understand emergency rooms and prisons as the end-game of bad policy.

We need a strategic vision and courage from the executive branch and its leaders, the courage to change and face-down those for whom change poses risk to their privilege and position to come from the legislature – all back-stopped by a watchful and apolitical judiciary.

Failure is no longer an option. Taxing capacity is nearing its zenith for the middle and lower tax tiers. The federal spigot will close next year, and inflation will continue.

Connecting the dots between learning, well-being, and justice is the basis for a vision that truly improves the lives of Vermonters. It interrupts the continuum of intergenerational failure, lowers costs (taxes), and is the best economic development strategy any state could have.

States with superior public learning and healthcare services, shaped by social and environmental justice, will have the strategic advantage in attracting and retaining their future workforce. That could be us.