Opinion

1

I was diagnosed with mild high-frequency hearing loss as a child, probably related to early ear infections and fevers. I remember a specialist telling my parents, “He’ll be fine, but he should stay away from loud machinery.”

I went on to spend 24 years at the Vineyard Gazette, logging thousands of hours in the production room where the four-unit Goss Community press, once brought up to speed, shakes the building and sounds like a locomotive under throttle.

In June of 2006, I took a job in a quieter setting, at the Edgartown Library. That summer a parade of people came to the front desk and asked for help in their best library voices. My responses were variations on the theme of “Could you speak up, please?”

My library colleagues suggested, in the kindest terms, that I have my hearing checked — and soon I was fielding patrons’ questions more nimbly, thanks to a pair of hearing aids that set me back a month’s pay but have served me ably now for almost eight years.

Several of my Island friends, noticing the new wires and the tiny Oticons behind my ears — I will admit to being inordinately proud that they’re made in Denmark — have asked me about them, and have ended up being fitted for hearing aids themselves. And several of their spouses have made a point of thanking me. Because hearing is one of the most profoundly social senses, and when hearing is improved the benefits accrue to both the listeners and the people who speak to them.

Hearing aids have improved greatly over the past decade, but they still can’t do for hearing what eyeglasses can do for sight. You can enjoy 20/20 vision with the right optics, but even the best hearing aids don’t restore the acuity of human ears at their youthful, healthy best. I’ve become an aficionado of acoustic spaces, because one of the greatest challenges to my hearing is background noise. When we go out for dinner together, my wife and I pick restaurants as much for their quiet, which means we’ll be able to enjoy our conversation, as for their cuisine.

I’ve also become sensitized to the way hearing loss is treated as a poor stepchild in the family of disabilities. Medicare and most insurance plans generally don’t pay anything toward the considerable cost of hearing aids, which is one good reason why an estimated 80 percent of the more than 35 million Americans with hearing loss aren’t wearing them.

Across the Atlantic, the European Union has its own version of our Americans with Disabilities Act, and it requires that public spaces include a technology most Americans haven’t even heard of. It’s the hearing loop, also called the audio-frequency induction loop or AFIL, and it sends an audio signal into any pair of hearing aids fitted with a telecoil.

In a widely-circulated New York Times story three years ago, the composer Richard Einhorn described hearing a performance of the musical, “Wicked,” at the Kennedy Center in Washington after the center was fitted with a hearing loop system.

“There I was at ‘Wicked’ weeping uncontrollably — and I don’t even like musicals,” he said. “For the first time since I lost most of my hearing, live music was perfectly clear, perfectly clean and incredibly rich.”

Hearing loop systems are ubiquitous in Europe — every London taxi cab has one — and nearly all hearing aids sold there are equipped with the telecoil that receives their signals. But on this side of the water, we’re way behind the curve.

Massachusetts has just a handful of hearing loop systems in public spaces. They’re being used in half a dozen places of worship — the nearest are St. Peter’s Church in Harwich and the Cape Cod Synagogue in Hyannis. The meeting room of the Dennis Public Library uses a hearing loop; so do Logan Airport in Boston and the Coolidge Corner Theatre in Brookline.

On Martha’s Vineyard, any public space would be well served by the addition of a hearing loop. Church halls and performing arts spaces, selectmen’s meeting rooms, library program rooms, senior centers and our district court are among the prime candidates for a technology that promises to deliver clearer sound to the growing number of people with hearing aids. And as the loops become more common, hearing aids fitted with telecoils will become the standard, just as they already are in Europe.

Fortunately, the cost of this new technology is low. Most public spaces can be fitted with a hearing loop for about $10,000 — the price of two pairs of high-end hearing aids. Here’s hoping that someday soon, we’ll begin to see the hearing loop logo in the doorways of Vineyard spaces, promising help for hundreds of listeners in carving out meaning from the background of noise.

7

This winter found many of us trying to get inside from the cold, where the comforts of modern life awaited — warmth, lights, electronics, appliances, and a hot meal.

You may not have realized it, but the infrastructure that delivers energy to us, upon which all these comforts depend, was under great stress.

Massachusetts does not produce coal, oil or natural gas. We are at the end of the energy pipeline for all those fuels.  Over the past 30 years our region has shifted more of our energy use away from coal and oil toward natural gas.

Yet our demand for gas, both in the heating and electric sectors, has been increasing much faster than the supply of gas that pipelines deliver us. During this cold winter, we saw spot market prices for natural gas and electricity rise significantly. This not only made electricity generated by gas more expensive, it also meant that as the heating sector used more gas there was less available for power plants. There were times in this past, brutally cold January when our region’s electric grid manager, ISO-New England, needed to run old, inefficient and dirty “peaker” power units just to keep the lights on.

These cold periods that stress our energy infrastructure also tend to be quite windy. We have all seen the meteorologists on TV telling us about the “wind chill effect,” and winter is our windiest season. Massachusetts is not at the end of the wind pipeline. In elevated locations, along the shore and particularly offshore, we have our own vast supply of clean wind energy waiting to be tapped.

Over the past 13 years, our company has been developing America’s first offshore wind farm, Cape Wind, on Horseshoe Shoal. During that time Cape Wind would have provided significant energy, economic, and environmental benefits to Massachusetts and beyond.

During a severe three-day cold snap in January, 2004, ISO New England contemplated the need for rolling blackouts because of the shortage of natural gas for electricity generation.  The U.S. Department of Energy studied the region’s energy vulnerability and noted that during the entire three-day period winds over Nantucket Sound were strong and, had it been built, Cape Wind would have been operating at full capacity during most of that period and provided significant electric reliability benefits.

This past winter, Cape Wind would have eased the stress on the natural gas and electric spot markets and reduced price spikes. Had Cape Wind been operating, National Grid and NSTAR would have also saved millions of dollars this winter under their contracts with us compared with relying upon spot markets. Over time, Cape Wind’s impact in reducing electricity spot market prices will be significant, more than $7 billion over the life of the project, according to a study by Charles River Associates. Wind power consistently reduces electric spot market prices wherever it has already been installed on a significant scale, such as in Europe or in parts of the U.S.

Offshore wind is also particularly valuable during a less windy season, summer. One might think of the “dog days of August” when temperatures are high but winds are calm. Yet offshore, it’s a different story, where the sea breeze kicks in during hot summer afternoons. In fact, we have found that during the highest summer electric demand hours, Cape Wind would double its average hourly electric production.

There is a lot of interest in the direct bill impacts for electricity consumers from Cape Wind.  The Massachusetts Department of Public Utilities (MDPU) carried out lengthy adjudicatory proceedings and heard from energy experts and project supporters and opponents alike. The MDPU concluded that Massachusetts residential and business electric consumers will see an increase in the range of one to two percent on their monthly electric bills attributable to National Grid and NSTAR’s power purchase from Cape Wind. As with every other energy technology, the cost of harnessing offshore wind will fall as it is further built out and greater economies of scale are achieved.

Those who scoff at the energy contribution that offshore wind can play ignore key facts.  Denmark today gets 30 percent of its total electricity needs met by a combination of onshore and offshore wind power. Although Cape Wind’s electricity will be sold to electric consumers statewide, Cape Wind’s electricity supply will be consumed almost entirely on the Cape and Islands. Cape Wind’s turbines will produce power 88 percent of the time, and in average wind conditions will supply 75 percent of the average electricity demand of Cape Cod, Martha’s Vineyard, and Nantucket.

It has been a long road for Cape Wind, but we are now in our financing stage and preparing for project construction. Right now Europe is successfully operating 64 offshore wind farms that were built over the past 23 years, creating 58,000 offshore wind jobs in the process.  Massachusetts has some of the best offshore wind resources in the world and will soon have North America’s first offshore wind farm. Cape Wind will provide greater energy independence and electric reliability while also creating good jobs and contributing to a healthier, cleaner, and more sustainable energy future.

Mark Rodgers is the communications director of Cape Wind, based in Boston.

3

Let’s put aside — just briefly, because that’s the best we can hope for — the hubbub of broadly and furiously expressed but narrowly based opposition to the Stop & Shop expansion proposal. Instead, this page believes that Islanders will be better served by an earnest, common sense struggle to consider the good and the not so good of this undeniably substantial and highly visible project.

It seems grandly unrealistic to argue that the new Stop & Shop will alter the character of the Vineyard or of Vineyard Haven. Like the Roundabout, which was deplored in the years leading to its construction as a death blow to Island-ness, the new grocery store will look very different from what is there today. The building will be much bigger than the dilapidated market it will replace. It will stand out by virtue of its scope and height by comparison with the buildings it will replace. But, it is not designed as a big box store like Cronig’s State Road Market. Rather the architectural effort has been to mute the building’s visual impact, and the designers have generally succeeded. What Stop & Shop will build to replace the current market, the restaurant next door, and the house — a rundown apartment building that has been exalted in this debate to historic registry status — will be better looking than anything else that now exists along the short stretch of Water Street on which it fronts. And, Island-ness will survive the alteration.

A bigger, better market will attract more customers, and certainly most of those new customers will drive to the store. Still, traffic studies do not suggest that the added auto traffic will crush the circulation of traffic along that jammed road, whose congestion is primarily the responsibility of Steamship Authority service at one end of Water Street and the mess that is Five Corners at the other — neither the responsibility of Stop & Shop. Stop & Shop plans to add more than 40 parking spots beneath the grocery store, an important plus in a neighborhood where parking is miserably difficult and scarce. The removal of big truck deliveries from the north side of the building will be an important improvement, making possible walking paths along the side of the building and landscaping to improve the appearance. The revision of the town parking lot will make it better looking and more efficient, welcoming, and useful for drivers, walkers, and cyclists than it is now.

The financial contributions Tisbury officials negotiated with Stop & Shop will help the town better manage parking and traffic in the neighborhood, and although $2 million would be better than $1 million, the agreed upon contributions will do some good, and the project as a whole — market expansion and parking lot revision, taken together — ought to stimulate Tisbury planners to take a hard-eyed look at what their zoning regulation has wrought along the corridor from the Steamship Authority terminal to the Lagoon Pond Drawbridge. That strip of devastation is a creature of town and regional planning. If the Stop & Shop project spurs a rethinking of Water Street-Beach Road development rules, with an eye to attracting business investment and creating an environment that pleases Islanders and their visitors, it will have done the town a great service. And if the town and the Martha’s Vineyard Commission would only undertake the planning and political effort to get the Steamship Authority out of town — because Stop & Shop makes sense in downtown Vineyard Haven, but the ferry terminal does not — well, that would be a bit of God’s work.

In sum, this is a good plan — not perfect, not perfectly in tune with every Islander’s world view, not a solution to every existing problem in the Water Street neighborhood, and certainly not a solution to every imaginable problem — but it will do some good for shoppers who will benefit from competition and choice, for businesses in the neighborhood who will consider fresh investment in an area that is rejuvenated, and for a town that has tolerated, and even enforced an attitude of dilapidation, but may recognize an opportunity for healthy change.

2

This is the 807th and last weekly At Large column I will write. The series began in November of 1998, and I haven’t missed a deadline since. All by itself, that’s something to be proud of, I suppose. But actually, it was never my plan to begin the column, and I certainly never imagined I’d rumble on for more than 15 years. Figuring that I’d have to say something at least mildly interesting and certainly true in this final installment, I’ve been thinking lately about my lack of a plan, not just for the column, but for all the years I’ve logged as a newspaper writer, editor, columnist, and owner. I didn’t chart a course for any of it. It was all an accident — delightful, as it turned out, but unimagined and unplanned.

James Reston gave me a job as a feature writer at the Vineyard Gazette in 1972, after someone brought to his attention a story I’d written about living on my little boat with a big dog. A little while later, the woman I worked for left for a bigger, daily publication and a book writing career, and I became the managing editor. The learning curve was steep, but as luck would have it — and there is so much luck bearing on this tale — besides Reston, I worked under the guiding wisdom of Henry Beetle Hough, the Gazette’s hallowed editor, and Bill Caldwell, a Pulitzer Prize winner for commentary during his career as a columnist at the Record of Hackensack, New Jersey.

Henry’s reputation has over time parted ways with the workaday reality of this gentle but formidable man. He was not a summer visitor. His paper was not conceived as a postcard to summer folk who lived their lives elsewhere for most of the year, hankering all the while for their Vineyard vacation houses. He was a fully committed year-round Vineyarder, a member of the regional school committee, a bank director, the one who, with me, called the funeral directors — there were two in those days — early on Friday mornings to see if they had “anything for us” before the press began rumbling. And, he was the one who sat at the Linotype machine to set the late obituary in type. He meant his newspaper to be a tool for Islanders first, and then for others who loved the place and its land — and seascapes as he did.

Bill Caldwell taught originality and impeccable prose. His copy, which, in an odd and ironic twist, came to me for editing, though it needed none. No X-outs, no punctuation, spelling, or construction errors. Utterly perfect in every respect when he yanked it out of his typewriter and brought it to me.

Reston, the owner and publisher, whose archbishop-like presence led the great and powerful in the nation’s Capitol to genuflect, taught that beginning life as a sports writer and indulging a taste for flavorful sports metaphors and workmanlike, colloquial prose could make a columnist’s analysis of Washington politics and international diplomacy pleasurable and instructive to readers. He also taught newspaper office politics — a fervid, constant pastime in this business — at which he was clever and subtle.

In 1980, I left the Gazette, and it turned out that raising cattle, horses, pigs, chickens, hay, feed and sweet corn was next for me. But, six years later, I had a call from the founders of The Times and an offer. Five years after that, Molly and I bought the paper, and a few years after that, we met Barbara and Peter Oberfest, because our children went to the Vineyard Montessori School together. We and they formed a durable and successful two decades long partnership.

This column wasn’t my idea either. As I’ve told you on other occasions in this space, I began it at Molly’s suggestion. I had been writing a weekly editorial for several years before that — the one across the way on the Editorial page this morning is mine, another and final effort to get you to see things my way — but Molly said back in 1998 they often sounded bossy, and the subjects were boring. Well, no arguing with that. “Why don’t you write something more varied and occasionally fun,” she said. “You don’t want readers to think you’re a bossy, boring person.” (In the end, her hopes may have exceeded my grasp.)

But, as so much else over these many years has been, it was fun, and I enjoyed the unusual and enviable freedom to write what I liked on whatever topic I liked. Best of all, many of you were kind enough to say you enjoyed at least some of them. You stopped me in the market or the drug store or on the ferry to tell me so. On the other hand, some of you objected. A very nice Chilmark woman clipped a copy of one of the columns and mailed it to me with red pencil corrections to nearly every comma, capitalization, and word choice I had used. I’m sure she intended to be constructive, and she certainly was a diligent reader.

Her fading rewrite, pinned to the wall in my office, reappeared the other day as I took down the photos and cards I’d saved over all these years, including the bumper sticker someone gave me that said “MVTimes: Hateful Journalism Every Thursday.”

My colleagues over all these years have been numerous and varied. A few came and stayed. One preceded me on The Times, and she and one or two others have been with me for almost a quarter of a century — excellent, committed people of integrity and, yes, durability. There were tough times as well as triumphs. The ones who came and went quickly left their indelible marks too — the young reporter who, in interviewing for the job, failed to mention that he was dyslexic; the theater reviewer who, inflamed with artistic integrity that brooked no clumsy amateur performances, lumbered the grade school kids acting in the school play; the giggling summer interns who found most of their stories at the beach; the section editor who never met a deadline she couldn’t miss; the other one whose only skill was meeting deadlines; the California website geniuses who built a site that drained our treasury, exhausted our patience, and vanished, leaving us face to face with the fact that we were fools and had been taken to the cleaners.

Today, this happy accident has run its course. Peter and Barbara will navigate the next leg of The Times trip. Molly and I wish them and all of The Times folk great fun, accidental or otherwise. Newspapers by nature are carried along daily in the bouillabaisse of human events: births, deaths, tragedies, triumphs, fire, flood, politics, arguments, crabbiness, euphoria. We are exposed to it all. It’s the job, and thanks to you — readers, customers, newsmakers, colleagues, neighbors, friends, critics — it has been a terrific job to have. There is always smiling promise and great opportunity for someone like me — especially in your neighborly, encouraging, indulgent, and enthusiastic company.

11

If you have been marveling at the other marathon, that is, the marathon, unanesthetized colonoscopy now being performed on the Stop & Shop project, history suggests that this is nothing new. When we fight, especially when we consider change, we insular types don’t flag, we don’t cave, we hold grudges, we fight on. Winston Churchill — “Never give in”  — would be proud. The fight over the Nantucket Sound Islands Trust legislation went on for years, followed by the fight over the Martha’s Vineyard Commission legislation, the fight over the creation of the Land Bank, the battle over the golf courses, the vicious and wearing conflict over the Ramsey-Counter land claim, and on and on, beyond remembering.

But, it may be that the fight over Cape Wind, still muttering on in the background, will one day be crowned the mother of all political wars. Cape Wind, more than a decade in the application-permitting-financing journey, has not erected a single turbine, not created a single volt of electrical power, and it’s better than even money that it never will.

If you are one of those who favor a clean, plentiful, growing, cheap supply of energy to support the growth of the American economy — and, naturally enough, its many subdivisions, including this tiny, remote (but not remote enough) outpost we call home — I urge you not to despair.

The state of Massachusetts, in its nutty devotion to wind-powered, ocean-based generating plants deployed, in cooperation with the federal government, in a strangling circle around the Vineyard, does not feel your pain. Indeed, the state’s aim is not only to conspire over the Cape Wind project, but to elbow aside valid economic and environmental concerns expressed by Islanders, to allow, no matter what local opinions may hold, wind factories to the east, west and north of us. It’s a plan whose benefits are immeasurably small and diminishing compared with new, less expensive land based technologies — especially solar, whose installation costs have plunged in the last few years. But, it’s a plan whose time, if it ever came, has now gone.

Among the drawbacks, and the Cape Wind deal with National Grid draws this out plainly, are the state’s policy determinations to allow the expansion of wind generation, no matter what the cost to residential and commercial customers and no matter whether the local targets agree to the intrusion. Wind-driven sea-based power will be significantly more expensive than energy produced by any other source, but the state endorses it, subsidizes it, and would protect its higher costs by attempting to block energy suppliers from buying less expensive power — even power from renewables — created out of state. Absent the politically forced premium to be paid for Cape Wind electricity, the development of that wind turbine factory could not be funded. Wind power needs such well-intentioned but foolishly conceived support, otherwise developers of wind-driven electricity would not find financing or a market. At this point, wind enthusiasts point to billions in subsidies extended to other energy producers, notably oil. But, although oil doesn’t create much electricity in the U.S., it is a vital, current transportation fuel, and for good reason. Oil produces powerful energy, and does it relatively cheaply. It’s been worth subsidizing.

The argument here is that the energy future of our economy will be built on electricity and transportation fuels. Oil, whether produced here or abroad, does not figure significantly in electricity generation now and will certainly figure only marginally in the equation as we move forward. But it predominates as a motor fuel and a raw material in too many manufacturing processes to count, and it will continue to do so until replacement technologies can be concocted or discovered that furnish the same dense, cheap power and hugely variable utility.

The keys to plentiful, growing, and inexpensive sources of electrical power are conservation (especially in homes and vehicles), natural gas, and nuclear power. Something better may come along, but it won’t be wind. And, political manipulation will not make ocean-based wind power more desirable, more economical to build, or more reasonably priced for consumers.

As is apparent after a decade of debate over Cape Wind, the industrialization of 25 square miles of Nantucket Sound and of the empty ocean southwest and northwest of the Vineyard will diminish valuable, wild, clean seascapes, in exchange for modest, intermittent supplies of high-priced electricity that will in the end depend on traditionally fueled, efficient, powerful, economically scalable electricity generators capable of reliably producing power when we need it. And, doing it less expensively on a much less profligate footprint.

The Cape Wind deal to sell the electric power that the planned Nantucket Sound wind farm would one day produce will cost electricity end-users billions more than conventionally produced power. That’s not because wind-driven electricity is better electricity, or more dependable, or more easily scaled up to meet growing demand, or less demanding of the natural environment — consider the marine acreage to be consumed — but it’s because the political climate insists on it, no matter the costs.

For someone with a native fondness for New Bedford, the Whaling City, I’m happy to report that the only valuable spinoff from the failing Cape Wind project is the rehabilitation of a portion of the New Bedford waterfront.

Gov. Deval Patrick selected a portion of New Bedford’s waterfront that will be resurrected to serve Cape Wind’s construction and maintenance needs as the staging area for its turbine factory at Horseshoe Shoals. It’s about $35 million in investments, now underway in the form of dredging and dock building. We’re likely never to feel a single jolt from electricity produced by Cape Wind, but at least a community that needs investment and jobs is getting a lift from the project, now in hospice care.

24

For the umpteenth time in recent history, the Dukes County commissioners have demonstrated their latent but persistent determination to get their mitts on county airport management.

The commissioners declined the reappointment of two airport commissioners, using the fireworks over the dismissal of an airport employee as the pretext.

Airport management and its union employees have been feuding, and the airport commissioners and the Dukes County commissioners have a decades-old history of feuding. Here was an imagined opportunity for the county commissioners to enlarge their influence over the airport, which after all is the largest, indeed the only significant county asset.  So, the county commissioners spurned the re-appointment request from two of their former appointments to the airport commission. They did so against a backdrop of repeated chastisements – federal, state, and judicial – over attempts by the county to exercise authority over the airport, apart from the strictly limited authority to appoint airport commission members.

The county commissioners tossed two airport commissioners, one of them a county commissioner himself, and replaced them with a fresh county commissioner, perhaps unacquainted with the knotty history of airport-county relations, and with a former airport employee, a frequent and vocal critic of airport management, now on disability retirement and an organizer of airport employees to form a bargaining unit. He also served as shop steward.

You name the landmark county attributes — the criminal, civil, and probate courts, the registry of deeds, the sheriff’s department, the county-owned beaches, the airport — and none of them falls to the county to manage. Sometimes, toward Dukes County voters, God is good.

The Martha’s Vineyard Airport, which by statute is under the control of the appointed airport commission and its professional airport manager, accounts for more than half of the county budget. The county commissioners slaver over that solid financial enterprise, and they’d like to have a piece of it.

The sheriff’s office is now under state control. The registry of deeds and the office of the county treasurer are county departments headed by elected county officials who do not answer to the county manager. Each has direct control over their employees.

In terms of day-to-day supervision and responsibilities, the county manager oversees a total of just two people in three departments — her office, veterans affairs, and a fragment of  integrated pest management.

Until 1993, three elected, paid county commissioners presided over county government. In 1994, voters created a new form of county government that delegated general legislative powers to a seven-member board of unpaid commissioners and gave a county manager full control over the county administration. This enlargement of county administration anticipated an enlargement of the appetites of the six Island towns for more and better county government.

As it happened, what actually occurred was the amputation of county responsibilities, in part because of the county’s demonstrated inability to get things done rationally — the airport expansion fiasco, for example — and the state’s need to streamline its own budget relationship with county governments that were crumbling across the state — the sheriff’s department, for another. Plus, the towns, in their clear-eyed wisdom, asked for nothing from the county. Indeed, over time the county has shifted more and more of the costs of some of the shards of its legacy responsibilities to the towns.

Here is the latest moment offered to the towns and the voters to take steps to sunset this government charade and not to countenance county’s ham-handed intrusion in the business of the only dependably functioning and financially successful county enterprise.

1

You may remember an Essay by Dr. Henry Nieder, [Medical marijuana, mostly a fiction, November 14, 2013] discussing the issues presented to physicians by the law allowing marijuana dispensaries in Massachusetts.

“I had hoped,” he wrote, “that when medical marijuana was approved in Massachusetts the provisions of the law would have allowed only limited prescribing of the drug. Unfortunately the Massachusetts law, after naming the serious diseases such as advanced cancer and multiple sclerosis, in which a marijuana prescription could be considered, then says but also may be prescribed for ‘other conditions as determined in writing by a qualified patient’s physician.’”

Dr. Nieder, skeptical about the new state law and about its implementation and particularly the role of physicians in certifying use by patients, added, “If other states that have legalized medical marijuana are examples, then the majority of prescriptions for marijuana will not be for patients who have grave medical diseases but for patients with diagnoses such as anxiety, chronic insomnia, and chronic pain. These patients will for the most part be requesting prescriptions because using marijuana makes them feel better.

“Prescribing medications is complicated. To do it as safely as possible, doctors must know effective doses and duration of effect so that they can determine the correct initial dose and frequency of use with the original prescription and then can adjust in a logical fashion if the dose requires adjustment. Prescribed marijuana has no reliable dosage. In states with legal medical marijuana, patients are generally advised to adjust the amount of marijuana they purchase to obtain the desired result and to repeat the dose as needed. That is no different than buying marijuana on the street and being told to stop smoking when you feel the way that you want to feel.”

Massachusetts, mired in the throes of permitting dispensaries across the state —  and, as the process continues in fits and starts, curiously reminiscent of the disappointing complications attached to the permitting of casino gambling in the state, also pursuant to new law — has made a wise move. The state has become the first in the nation to require physicians to take a course — at least two hours of instruction — before being allowed to certify or recommend marijuana use to their patients. Certification is the mechanism that state law employs to govern the interaction between patients and physicians when marijuana is at issue, because prescriptions may only be written for Federal Drug Administration approved medications by physicians following appropriate guidelines for diagnosis and prescribing. Not every physician will participate in certifying patients for marijuana purchase and use, but at least those who choose to do so will have the opportunity to learn whatever there is to be learned about how it might be wisely done.

 

1

What is the paramount requirement for navigating the information age in which we live today? What is the irreducible minimum skill that our children must learn and that we and they must practice all our lives long, in this media-mad life of personal and commercial promotion?

A while ago, a young woman speaking from the audience at a discussion of the changing news media, said she utterly mistrusted what the news and information services — all of them, including print newspapers, online information and news sites, broadcast and cable, and social media of all sorts — do. She did not, I learned later, mistrust James Cameron’s film version of the Titanic’s sinking. That was history, she thought. Go figure.

The discussion topic considered what media consumers could rely upon in the overwhelming stream of incoming stuff.

What’s worrisome is that it is easier to accept what one hears and reads as fact or truth without troubling to discriminate. And, in this single context, discrimination on the part of the reader or listener, is not only desirable, it is critical. This is particularly problematic for parents and teachers who must guard young, inexperienced, beginning thinkers among the web sites, the docu-dramas, the hype, the bombast, and the hyper-opinion that flood our lives.

Most journalists share the young woman’s skepticism. We do not, however, share her gullibility, and we do not despair, as she did.

Information. Data. News. Truth. Opinion. There is so much of it, so many outlets for it, so much need for high quality and reliable examples of it, that it’s a crying shame there is no easy way to distinguish the good and useful from the bad and worthless, or at rock bottom, to recognize the point of view or the promotional attributes of any sort of communication. Eric E. Schmidt, former chief of Google, distributor of much of the nonsense, referred to the online universe his successful company exploits as a “cesspool.”

What passes for news these days arrives interlarded with promotion, Facebook likes, Twitter observations, and sponsored posts, even on the print pages and web sites of responsible publications desperate to keep their heads above water. Smart people yearn for trustworthy intermediaries to sort through the mess.

But, that sort of guide to what one hears and sees becomes more illusory as each day passes and each new digital innovation strives for monetization. Ultimately — and exhaustingly — the responsibility for picking and choosing lies with you, the consumers. Critical watching, reading, hearing, thinking and a discriminating approach to the information age — these are the indispensable tools. And it is difficult work, distinguishing between truth and untruth.

Discovering reliable information and journalism is not so terribly different from the familiar process of shopping for, say, a used car. Cruising the Internet, cruising the newsstand, surfing the channels: but imagine for a moment that you are cruising the Auto Mile. A red car catches your eye. It’s on a dealer’s lot. There are pennants snapping in the breeze. There are big smiles on the salesman’s face. You stop. He talks. You get out your checkbook and you buy.

No, of course you don’t. You don’t stop just anywhere. Mostly you go to dealers whose good reputations you know about. You go because someone recommended the place, or because you had a good experience with that dealer or that model. You know quite a bit about what you want and what it’s worth. And, even in these apparently reliable venues, you discriminate.

You need to shop for news and information, data and opinion, even truth, the same way. You go to trustworthy outlets, and not necessarily to the Comment section of the newspaper’s website. You discriminate. This makes sense, that doesn’t.

What helps you, the information consumers, to sift through all this and all the rest on TV, in national and international publications, and on the web?

Be on your toes. Know what you are looking for — news, information, data, opinion — know what distinguishes one from the other, and know what it is you have found when you find it. Training kids to shop critically for information is a key part of life’s curriculum, as taught by parents.

Shop for sources of information critically. There are signs that mark responsible media outlets. Do they declare themselves? Do they tell you who they are, with bylines and mastheads listing ownership and editorial responsibility? Do they distinguish news from opinion in their pages and identify sources of data? Are they significant businesses, in your community, or in the community of web sites — much harder to get your arms around, of course? Or is it a one-man or one-woman show? A blog? Do they spend money to find and deliver information, data, or opinion? Gathering and publishing information takes money, lots of it. Financially successful organizations and web media spend money to create their information products, and that makes their products better. They hire thinkers, writers with judgment and curiosity, and they give them license to get at information and pass it along. They do not pay by the click. Google earns that way.

Do you know the people behind the information source, or do you know their reputations? Can you approach the web, or broadcast, or print publishers of the information you find? Can you call them, or email them, or write them with questions about the provenance of the information? Will they reply? Do they care about their record?

You want media types to care about the record, and their records in particular. If such news and opinion sources are the ones on which you depend, there is little reason to despair, but every reason to be vigilant.

 

17

The ownership claim made by Ben Ramsey and Nisa Counter to a portion of Chilmark property owned by Sheriff’s Meadow Foundation is meritless. The state Land Court decided the matter this month. The court found no substance at all to the Ramsey-Counter position. Not on any grounds.

The judge examined the long, complicated history of ownership of the disputed land and concluded that Ramsey-Counter had no record ownership of the Sheriff’s Meadow land they claimed, or even to a portion of it. Sheriff’s Meadow, the plaintiff in the case, which dates to 2010, offered a “persuasive and correct interpretation of the boundary and chain of title” to its property.

The judge, considering the Ramsey-Counter secondary argument that even if they did not have record title to the property they might legally claim it by adverse possession, said no. Ramsey-Counter had not possessed the land, had not made actual, normal, open, notorious, and adverse use of the property for 20 years, the judge found.

In the news report of the Land Court decision on mvtimes.com, readers will find a link to the complete text of the Land Court’s decision. It is pretty dense, and too few will read it. And anyhow, while the substance of this long, vicious battle was never in doubt, the collateral damage — perpetuated by social media commentators — continues. Superficially, the attacks by Ramsey-Counter partisans appear to be intended to do damage to Sheriff’s Meadow Foundation and sunder the organization from its principles. Really, the vile and baseless criticisms do far greater harm to their authors.

If the issue was, Do Ramsey-Counter have a legitimate claim on the land?, the matter is settled. If the issue was, Sheriff’s Meadow ought to have acquiesced before an attempt to extort real estate from a nonprofit conservation organization, whose obligation is to protect the property it has acquired through purchase or gift, and to do it though sub rosa vilification and misrepresentation, then there never was an issue. No right-thinking person, never mind a responsible, historic, nonprofit conservation organization, would sign on to that sort of behavior.

0

By Michael A. Goldsmith, chairman; Patti Young, secretary; Jack Law, vice president; Mort Fearey, treasurer; and members Allan Keith, Karen Kennedy, Ursula Kreskey, Diane Nordin, Joan Coles Potter, Edie Radley, and Robert Tonti, the chief executive of the board, of the Visiting Nursing Association.

On March 27, The Martha’s Vineyard Times published an editorial posing “unanswered” questions to the Vineyard Nursing Association’s (“VNA”) volunteer board. The board welcomes the opportunity to provide details regarding the events of the past 18 months, and we believe our experience will provide insight as to why the VNA’s plight is representative of the rapidly evolving changes in patient medical care — specifically homecare.

On March 11, 2014, we closed our doors after 30 years of service on Martha’s Vineyard, and three years of serving Nantucket. Cape Cod Health Care (“CCHC”) is now treating all of our patients who qualified for and desired continuing care. Our patients have not witnessed a change in personnel — CCHC hired all clinical staff who applied for jobs, as well as some administrative employees.

The end of VNA’s 30-year run is a sad reality. But the board’s sole focus during the last 18 months has been on finding a viable alternative. Specifically, we looked for an organization to: (a) provide for the safe transfer and care of existing and new patients; (b) assume our moral and financial obligations to a capable staff who have remained loyal throughout this arduous period; and (c) bring to bear the expertise and the financial stability to withstand the vicissitudes of future Medicare reimbursement.

Since 2010, when the Affordable Care Act (“ACA”) became the law, homecare agencies have been the target of progressive reductions in reimbursement rates. In November 2013, Centers for Medicare Services (CMS) outlined its plan to reduce homecare reimbursements by 14 percent by 2017. CMS acknowledged that its planned reductions would force net losses affecting about 75 percent of homecare agencies, primarily smaller agencies.

We were aware of these changes, but the ACA initially included some temporary safeguards to help small nonprofits weather the financial storm. Unfortunately, as reimbursement reductions progressively took hold, our losses mounted more rapidly than anticipated.

Between 2010 and 2012, management and the board identified several specific strategies to mitigate the impact of future losses. These measures included:

  • Increasing fundraising efforts;
  • Seeking new board members;
  • Implementing cost-cutting measures; and
  • Reducing facility costs by acquiring our own building.

Additionally, we diversified our business by offering private care, partnering with HopeHealth Hospice, opening an office on Nantucket, and seeking more grant funding. We constantly walked the line between controlling costs and meeting the needs of the growing senior population.

In the fall of 2012, we retained a nationally renowned homecare consultant to review our alternatives. Our efforts to define a strategy came none too soon: in the first quarter of 2013, revenue fell 17 percent below expectations, a clear indication of the severe impact of the ACA cost-saving measures. The precipitous revenue decline can be traced to a decrease in Medicare patients (20 percent), a reduction in reimbursement rates (4 percent), and stricter application of Medicare regulations governing who qualified for homecare services.

Our consultant made a presentation to the full board in April 2013. In brief, he advised us that the days of the small health care organizations were numbered, and he recommended that the VNA look for a partner to ensure the future of homecare on the Islands.

In June of 2013, we approached Partners Healthcare as the most logical affiliate. For the next five months, we responded to endless requests for information, held conference calls with a cadre of Partners professionals and underwent on-site reviews. Partners’ stated objective was the need to be satisfied that they could operate our businesses in accordance with its financial model. Since we were not asking for any remuneration or imposing any conditions, we believed a favorable outcome was most probable. In communications as late as November 4, Partners stated that “things were moving in a positive direction.” Throughout this period, we continuously updated Partners’ decision-makers of our impending negative cash flow predictions.

Our continued optimism was a mistake.

On November 26, 2013, Partners advised us that no alliance would be forthcoming. Partners offered to assist us by ushering the VNA through a “structured bankruptcy,” but was non-specific as to which liabilities would be assumed, which employees would be hired, or which assets would be taken over.

Through the press we alerted the community to our financial needs and consequently received approximately $100,000 from the general public. The board contributed $100,000, with a commitment for more, if required. Cottage Hospital (Nantucket) gave us a generous five-figure amount. The MV Hospital did not respond to our request for financial support.

We quickly mobilized to find other potential partners and opened dialogues with CCHC, Martha’s Vineyard Community Services, and HopeHealth. We decided to focus on CCHC (Cape Cod) because of its size, diverse programs, and financial stability. We firmly believed that CCHC had the financial wherewithal to withstand the impact of further reimbursement reductions, and we found CCHC’s management to be of the highest caliber and capable of making timely decisions. Senior management, including the chief executive officer of Cape Cod Healthcare, travelled to the Island to express their interest in an association and advised us that they intended to take over all of our assets and assume all of our liabilities, pending due diligence. These discussions took place in early January of 2014.

We embraced the VNA of Cape Cod’s interest as the best option for providing this community with a comprehensive array of homecare services. Ultimately, CCHC decided, at the 11th hour, not to acquire our assets, including the building (or directly assume our liabilities).  CCHC’s stated reason was that it was unwilling to accept the normal successor liability associated with acquiring any VNA, citing a change in CMS Region I management, which CCHC appears to have understood would sanction its proposed acquisition of our assets without successor liability, given our impaired financial condition.

In the end, CCHC established the infrastructure necessary to serve our patients; made arrangements to take control of our patient records; and hired all clinicians who wanted a job.  CCHC’s affiliated charitable foundation made a significant contribution, which we used to satisfy accrued employee wages and our financial responsibility to the Commonwealth for unemployment liability. While we wish the deal had turned out differently, CCHS stepped into the void.

In summary, after closing:

  • All patients on both Islands are being cared for;
  • 85 percent of the VNA staff are now employed by Cape Cod VNA;
  • 100 percent of our former employees received their full pay, including accrued vacation;
  • We are working to sell the building and to collect all outstanding receivables, to satisfy our financial responsibilities.

Our closure is a regrettable consequence of changes in the Medicare landscape and is unfortunate in that it marks the end of a community agency. However, the transfer of critical health care services to a large, well-financed agency was forced on us by external events and, ultimately, was the right decision. It is the health care system, nationwide, that is the “mess.”

We wish to make a few other points:

We reject the idea that the board failed to move in a timely or decisive manner. We acted immediately as events required. Beginning as early as June of 2013, cost reduction plans were implemented, which included pay cuts, reduced hours, and hiring freezes.

We reject the inference that we suffered from “inexperienced, informal, casual and self referential governance.” Like most Island nonprofits, the board had representation from the Island’s medical, fundraising, business, legal, and financial communities. Board support included the contributions of  approximately $1 million in personal funds since 2010. We have never shirked “our responsibility.” In fact, most board members have remained involved despite the risk of personal liability. The VNA board, like any nonprofit board, faced the real possibility of personal liability if the organization was unable to meet the payroll obligations.

We reject the notion that acquiring “an expensive new headquarters” was instrumental in causing our closure. The rationale for a new home was (a) to respond to growth in existing operations and planned future programs, and (b) to seek improved financial stability. Our plan called for purchasing a building and paying it off within five years, through donations, thus saving $100,000 a year in operations. At no time did we expect, nor did we incur, higher operating expenses in our new building.

For obvious reasons, we were constrained from commenting publicly prior to the transfer of patients/staff. To the extent legally permitted, we shared information with both papers to keep our community apprised of the rapidly deteriorating financial situation.

And, for other privacy and legal reasons, we are not free to comment on “personnel” issues, which some have whispered contributed to our demise. To be sure, like any business that grows from 40 to more than 100 employees in a brief span, changes in staff are likely to be necessary, but we can say, with certainty, that no employee issue drove us to look for a more financially sound partner.

To our donors: We are grateful to all who supported the VNA during the past 30 years. With the exception of the capital campaign, which we stopped last spring when our future became uncertain, all donated funds were applied to patient care. We returned all donations that came in after we knew the organization was going to close.