Man in custody after hours-long standoff with police ends peacefully

1. In normal times, the resignation of a state Health Department director would not be major breaking news. But these are not normal times, and Dr. Nicole Alexander-Scott was not a normal health director. Alexander-Scott has been a constant presence at the sides of two governors as Rhode Island navigated the pandemic over the last two years, giving her a high profile and winning many admirers (and some critics). “Dr. Nicole Alexander-Scott is one of the smartest, most capable public health leaders I have met,” Dr. Ashish Jha said Thursday, one of many laudatory statements that came in after the news. In the months since Gina Raimondo left for Washington, it became increasingly evident that Alexander-Scott and Governor McKee had clashing views about how to handle the current phase of the pandemic — and the tension between them was hard to miss, even if they smiled for the cameras. The coolness was reflected in Alexander-Scott’s resignation letter, which included a lawyerly rundown of her unused comp time and said nothing about McKee. Lt. Gov. Sabina Matos downplayed the rift Thursday, saying it was natural for any governor to balance health officials’ advice against the counsel of other experts, and that Raimondo did the same thing. Policy-wise, McKee’s team faces an immediate challenge in locating a credible candidate for a tough job in the middle of a crisis, since Alexander-Scott is only staying on for two weeks. With daily case counts trending lower at the moment, there are hopes the omicron wave could be waning and the state could be back out of pandemic emergency mode before long. But the state’s hospital system is still under enormous strain, and the Health Department also faces a major looming decision about the Lifespan-Care New England hospital merger. Then there’s the political fallout: McKee’s primary opponents seized on Alexander-Scott’s departure to renew their criticism of him over the pandemic, with Nellie Gorbea warning of “a real vacuum in leadership.” McKee’s choice of a new health director could turn out to be one of his most important personnel decisions.

2. Brown University President Christina Paxson is putting more of her institution’s political capital behind the Lifespan-Care New England hospital merger. This week Brown released a study it commissioned making the case for the benefits of the proposal, suggesting it would boost the economic impact of academic medicine in Rhode Island by over $3 billion, though the report drew pushback from some health experts. Appearing on this week’s Newsmakers, Paxson was adamant that the merger will benefit not just Brown and the hospitals but Rhode Island as a whole. “I think the arguments for it coming together are so compelling — and maybe it’s the optimist in me — at the end I think the right things will prevail,” she said. For skeptics of the Brown-commissioned study, Paxson points to a new Journal of the American Medical Association article that found NYU Langone Health’s acquisition of a safety-net hospital led to improved quality and safety outcomes. Brown is not a legal party to the actual merger transaction, but it is still playing a crucial role due to its medical school and a promised investment of $125 million in the new system. Paxson declined to lay odds on how likely it is the FTC will allow the merger to go forward (a decision is expected by late February), but she acknowledged Brown’s plans to grow its commitment to academic medicine “will be much harder if the merger doesn’t go through.”

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