Why should Vermont implement equal pay certification?

Women in Vermont are experiencing an offensive level of gender inequity.  Change the Story VT‘s 2016 report on working women’s (full time) wages in Vermont found a 16% wage gap (14% among college-educated men and women and 23% for women with dependents). Yet today, nearly as many women have college degrees as men or are part of the labor force as men.  Why is there such a big difference in wages?

Employers can follow criteria such as seniority or merit in their compensation practices.  If women choose to take time off to raise children, they will have fewer years of experience than if they had not done that.  However, the experience required for a job is a common gatekeeper for better jobs and is a barrier for women re-entering the workforce.  Comparing people on the basis of length of experience in the first place is not entirely practical;  motherhood or fatherhood can involve complex skills that are transferable to many jobs  Furthermore, taking time off to take care of family is becoming an event that anyone having a family considers, whether the father or the mother, whether for children or other dependents or dealing with a personal medical illness; these occurrences are more common as non-traditional family structures become the norm and as large family networks of caregivers shrink. A companies try to give employees a better work-life balance and cater to employee satisfaction, they are looking for ways to provide families with tools to make them resilient.  The concept of treating employees right is not new; as Richard Branson famously said, “my philosophy has always been, if you can put staff first, your customer second and shareholders third, effectively, in the end, the shareholders do well, the customers do better, and yourself are happy.”  Unfortunately, allowing businesses to make processes that decide how much happiness (in the form of wages) an individual deserves and which use arbitrarily created individual-based criteria, has led to unfair outcomes.

There is a huge difference between de-valuing women’s positions because women have reduced hours of job experience if they have raised a family, and just devaluing all women’s work.  Egregious sex-discrimination is not uncommon. In times of economic downturn, managers may rationalize laying off a married woman because their husband has a “good job.”  Married women without children have been shown to earn less than their unmarried counterparts.  The same article, in the previous hyperlink, argues that the reason for that phenomenon is that women take on a greater share of domestic household work.  However, it is not outside the realm of possibilities that another cause is an unconscious bias working against women in multi-lateral ways. In her book, Life in Code, author Ellen Ullman expresses concern that women are being funneled toward “frontend” development that is becoming automated.  This is just one example how businesses use what is allowed under current laws by generating job descriptions that segregate women and men along financial lines.

Vermont Commission on Women currently runs the Equal Pay Compact as part of their commission work.  They explain the equal pay compact on their website.  But Iceland has taken it a step further. The Icelandic Standards (IST), a member of International Standards Organization (ISO) developed a certification that was voluntary in Iceland but now is mandated for business with more than 25 people.

Note This new standard called IST 85:2012.  You can read the equal pay law (Iceland) or reference the information sheet about the Equal Pay Management System in the links.



Vermont Legislature Considers Past-Compensation Question

Vermont’s equal pay law change proposal is a combination of the existing rules that prevent discrimination in the workplace with the addition of a provision to make employer inquiry into previous compensation rate illegal.  There is still a gap in the law that allows employers to consider compensation of current employers for a new position within the company.

Other states have made similar laws or are pursuing this law:  Oregon, Delaware, Massachusetts, and California and the cities of San Francisco, New York City, New Orleans, and Pittsburg (Adler, Bloomberg)

This bill landed in the Senate Economic Development, Housing and General Affairs committee and then appeared in the House Committee on General, Housing, and Military Affairs, but never went to the Senate floor for a vote.  A complementary bill around using past compensation on applications or in consideration for employment passed the house and is now in the Senate committee.



Vermont’s continued efforts to enhance quality of​ Primary Care through Patient-Centered Medical Home certification

History of Creation of Vermont’s Blueprint for Health for Prevention and Chronic Care Management

Blueprint Vermont started in 2003 as a public-private partnership (PPP) supported by the Vermont governor’s office (Besio, 2008, p.19) and later it became officially endorsed as part of the 2006 Health Care Reform Plan (Kaiser, 2013, p.2).  Its role is to act as a central resource and implementation manager for the rollout of quality and care coordination programs in Vermont.

Design of Primary Care Quality Program

To enhance quality and support payment reform in the Vermont health care system, Blueprint adopted the NCQA standards for Patient-Centered Medical Home starting in 2006.  The legislation tied a Primary Care Cast Managment (PCCM) payments to providers who participated.

An element of Blueprint is the engagement of physicians in the sphere of quality improvement and reform.  Blueprint holds an annual conference and committees.  But more practically, it employes Blueprint facilitators across the state to support physicians in the PCMH certification process.

Today there are two backfill openings for facilitators, a contract-based position for individuals who work to coach practices through certification and continuous improvement processes.

Many independent physicians and practices groups, including Naturopathic Physicians, achieved the prestigious and extensive quality certification as a Patient-Centered Medical Home (and so qualified for Primary Care Care Management payments for their patients).


Besio, S. (February 2008).  Vermont Health Care Reform 2007 Annual Update to 2006 Five-Year Implementation Plan.  Retrieved from

Kaiser Commission. (2013). Vermont Health Care Reform Fact Sheet. Retrieved from




Enhanced Immunization Planning tools are not mandated yet by the CDC

The 2015 Office of the National Coordinator (ONC) certification requirements and test procedures tell software companies how to meet the Department of Health and Human Services Electronic Health Record (EHR) regulations. Included in its list is sending a patient’s immunization history to a public registry and then receiving immunization recommendations back from that registry and displaying that to the user of the EHR.  Immunization recommendations are generated by the public registries using a complex immunization engine (instructions for building such an engine are outlined in this 139-page document) that determines the right schedule for a patient’s age and history. The logic of the engine is based on the CDCs schedules (historically difficult material for medical students to memorize).

What ONC Certified EHRs are required to do, is be able to submit immunization data to a public registry,  pull immunization history and receive an immunization forecast for that record. After the forecast comes back, if the EHR has it’s own history or provides its own version of schedule estimates using manual reconciliation or alternative forecasting tools, that is fine. An example of how this reconciliation and forecast process would work in practice appears on the HIMSS website (paragraph 2).

I also know that there is also a growing contingent of parents who either shun immunizations or believe that receiving an entire panel of them at a single visit could pose harm to children. The anti-vaccine contingent in Vermont asks for the option to be able to not get vaccinated and question the relationship that drug companies have with the CDC.  In response to parents like these, one physician had a youtube video, marketing his own services as a physician who would work with you to stagger immunizations for your child to spread the injections out. He also suggests creating a separate vaccine appointment if your child’s provider doesn’t understand your concerns.

My view from a technology side creating software is that the technology doesn’t often support physicians or patient’s enough. Technology is inherently political. Its rules can serve to enhance current laws, such as those requiring public school-children to be immunized. For this reason, some groups like those against immunizations may find fault in these technology regulations too. But, my view is to not to consider what technology reinforces it, but how it does that by considering a usability and relationship-building potential perspective. Medical software is not currently a robust tool that can enhance the on-going relationships of trust and education between and physician and the patient. The immunizations forecasts may be a resource for physicians to validate against and to guide treatment right at the point of care, they are not that innovative because they don’t allow comprehensive planning. A tool that would, however, could serve to enhance the care and social relationship of trust between the patient and physician.


The Codes for Gender and Sex, in Healthcare and State databases

In 1990, when the V2.1 of HL7 was published there were four options for Administrative Sex for use in the healthcare setting.   The User-Defined Table 0001 from HL7 v2 designated administrative sex and required the following values:

  • F-Female
  • M-Male
  • O – Other
  • U – Unknown

Using HL7 V2.1 and above required a system to recognize these values and it also allowed local use expansion containing more values.  But since most systems stayed on V2.3 or V2.3.1 until the arrival of V3 and local expansions were not common, these four codes became the familiar values in coding patient sex through the early 2000s.

Conversations running up to 2015 led the Office of the National Coordinator to required certified EHRs to record and codify three separate fields: Gender Identity, Birth Sex, and Administrative Sex.  This data allows the federal government can collect data on how well healthcare systems meet the needs of those in sex or gender minorities. The utilization of 2015 Certified EHRs will be commonplace by January 2019.

Birth Sex

The values for sex assigned at birth required by ONC are the following:

Per the University of Califonia San Francisco Center of Excellence for Transgender Health, this information could be collected using a questionnaire:

Example. What sex were you assigned at birth on your original birth certificate? (check one):  Male, Female, Decline to answer

The reasons for collecting birth sex are twofold. One is so the federal government can collect data on how well the health care system meets the needs of those in sex or gender minorities. The birth sex also plays a role in precision medicine (also known as personalized medicine) which uses genetic testing among other data to pre-determine the response and outcomes to treatment and medication.

Birth sex as transmitted to other systems can be entered as a finding under Social History section of a C-CDA document, but that is not uniform everywhere because it does not necessarily need to appear in that section.  The variability in location only adds minor inconvenience to programmatically reading this information, but could definitely add some reliability issues to the transfer of data by human interpretation.

Interplay with local law changes

More recently, the state of NY has allowed an intersex individual to have non-binary sex on a birth certificate. California is going one step further and considering a provision to allow non-binary and intersex people to request a new birth certificate with the third, nonbinary category as their birth sex. The individual could then go ahead and get a passport and drivers license with this designation which protects a person’s right to not identify a gender and the rights of intersex individuals to identify as non-binary. With the recent publication of books like Born Both that make the public more aware of intersex people and with recent litigation on intersex rights since 2015, it is likely that these provisions will continue to undergo iterative change to improve identification options. ONC and HL7 will probably need to revisit the birth sex codification and clarify the purpose and relation of it and administrative sex to a patient’s needs.

Administrative Sex

CCDA R2.1 HL7 allows three codes for “administrative gender.” Administrative sex is a field whose value is not meant to communicate a specific clinical finding. The field facilitates billing and other administrative decisions.  For example, billing a female patient for a prostate exam would flag the system to stop.  Historically, the administrative sex field is used in a hospital setting to choose shared room assignments. At an insurance company, it may determine whether they reimburse for certain treatments that are for a sex, such as a prostate exam.

The value set for Administrative Sex contains three allowed answers, as follows:

Administrative gender also supports all the Null Flavors. Null Flavors are what you can think of as “what to say when the field is blank,” because the flavors usually provide the reason the field is blank. For example, these are all acceptable codes:

  • Unknown  (nullFlavor UNK)
  • Asked but Unknown  (nullFlavor ASKU)
  • Not Asked  (nullFlavor NASK)
  • Masked (nullFlavor MSK)

Gender Identity

ONC’s 2015 updates also included a recommendation to gather the gender identity of patients. Again, this was to support studies for the betterment of healthcare among sexual and gender minorities. The values that can be selected from the dataset are:

  • Identifies as Male. SNOMED: 446151000124109
  • Identifies as Female. SNOMED: 446141000124107
  • Female-to-Male (FTM)/Transgender Male/Trans Man. SNOMED: 407377005
  • Male-to-Female (MTF)/Transgender Female/Trans Woman. SNOMED: 407376001
  • Genderqueer, neither exclusively male nor female. SNOMED: 446131000124102
  • Additional gender category or other, please specify. HL7: nullFlavor OTH
  • Choose not to disclose. HL7: nullFlavor ASKU


If you work in a medical setting, the new collection fields have different purposes behind each. The administrative sex field has been around the longest. Both the birth sex and gender identity fields have come forth to fill gaps that exist in public demographics.

Some states are becoming more accommodating of different gender identities on legal documents. Washington, D.C., Oregon, and California are three of multiple states that are allowing an X for non-binary sex on driver’s licenses without a doctor’s note. The State of Vermont has recently passed a bill to put X on the licenses. Canada already allows this designation and these laws may remove the legal requirement to obtain a physician’s note to be able to identify as something different than birth sex on a license.

Change the Story VT generates new energy around women’s economic well-being in the state

In August 2017, I had just been laid off my job at a tech company in Burlington, Vermont.  I was restless and bored.  But I also had been wanting to finally start my own business and pursue some of the dreams I had ignored for so long.  When the 21st Vermont Women’s Economic Development conference sponsored by Senator Leahy’s office came up (and actually only one of my facebook friends posted it), I immediately wanted to attend.  I wanted to learn about what was going on in Vermont to address the economic opportunities and development for women.  I also wanted to network with other people or groups who are working on health, social equality, and social justice issues in the state.  This conference seemed like a perfect start.

This event is where I learned about Change the Story VT (in fact they ran the entire afternoon session).  The event was inspiring but left me with a few questions about the group I wasn’t able to get answered during the whirlwind of conference activities, I decided to reach out to Tiffany Bluemle (pronounced “Bloom-lee”), the executive director of Change the Story VT to learn more.

CTSVT’s beginnings

Tiffany, who told me she will typically go by Tiff, was more than willing to talk with me about Change the Story VT’s upcoming plans.  First I asked her to provide some background about the initiative. Bush, Bottema, Midavaine, and Carter suggest that problem identification and opportunity identification are key pieces of social enterprise (2017, p.127)  So I was curious, as a researcher, if a social innovation type of project, such as the one represented here, would share any of the starting characteristics of other social entrepreneurial-like endeavors defined in the literature.

Change the Story VT is a multi-year initiative started in 2016 working as a catalyst for changing the system affecting women’s economic well-being in Vermont.  They are funded through a major grant from The Vermont Women’s Fund, the Serena Foundation and through the contributions of several individual donors.  The initiative is partnered with The Vermont Women’s Fund, Vermont Works for Women and with the Vermont Commission on Women.  All three groups have a shared common interest in the economic independence and security of women in Vermont. These relationships serve as a set of social contracts based on shared interest.   The groups’ alignment can serve as precursors to consolidated change, in this case, a formal show of shared recognition of an issue.  Tiffany describes the need to create system change.

Tiffany previously worked at Vermont Works for Women, whose focus is on changing women’s lives, such as through employment opportunities or life skills education. In talking with her, she described that program as effective at changing the lives of women engaged with their programs.  However, it has not operated with the top priority of changing a system that creates unequal outcomes for women, and so that need prompted the basis for this initiative coming together.

So similar to social entrepreneurship, an identified problem generates an initiative that looks to exploit the gaps represented by unequal experiences, and need for education and changed social outcomes.  However, as an initiative, Change the Story VT gains a level of formality through its relationships with its network.  It purposefully describes itself as a multi-year initiative, neither permanent nor necessarily long-living.  This is likely a characteristic of both dependence and the “in the wings” strategies exemplified by its activities (which I will discuss more in the next few sections).

Disseminating reports and developing stories

One of the first order of business of the initiative was to commission a number of reports on the state of economic inequality of women in the state[1].  In 2016 the group hired Burlington-based research firm Research Partners’ Laura Lind-Blum & Pat Heffernan to compile data for a status report titled “Women’s Business Ownership and the Vermont Economy”.  They also hired Vermont-based consulting firm Flint Springs Associates’ Joy Livingston & Vicki Hart to compile data for a status report on “Where Vermont Women Work..and Why it Matters” and “Women, Work, and Wages in Vermont.”

The result of these reports showed clearly on disparities affecting women’s pocketbooks, either through their business engagement or through their employment.  Then in 2017, a new status report[2] came out called “Vermont Women and Leadership.”  Statistics from this report have been cited recently in multiple media reports, bringing a certain level of public awareness to the differences in public or private leadership for women.  Even more concerning was the dearth of women represented in higher visibility or higher paid positions.

What happened in the remainder of 2017, came from both a desire to focus on the economic issues represented in the earlier reports as well as to reach new audiences. These renewed focuses were clear in the story-tellers spotlighted at the conference.  Not only were there two young women representing leadership in their community to provide their narratives, but there were also representatives on childcare, poverty and the male perspective.  People don’t want always want to look at and try to decode data, Tiffany says.  This is why the approach through the telling of stories has been so crucial to reaching a broader audience.

The strategy for knowledge production illustrated by Change the Story VT is overall as a resource for its partners and the community.  Due in part to the Change the Story VT initiative, Vermont non-profits, and community organizers are posed and ready with reports for legislative initiatives.[3]  It is unclear whether, due to its temporal nature, if Change the Story VT’s commitments change with stakeholder needs, initiative partner priorities.  It is evident that Tiffany demonstrates leadership skills showcasing the ability to weave together a mixture of work products designed to connect to new markets (stories) as well as creating material to support and sustain the initiative partners (reports).  This type of strategy pursuing concurrent growth patterns involving simultaneous investment pursuing sustainability and development is described in social innovation literature (Costanzo, 2017, pp. 101-123).  Another iteration of the dyad of sustainable activities and development seems to be a likely recurrence as Change the Story VT considers 2018.

Another cool thing about the initiative is the spillover effects that they have seen which encourage different ways of dealing with barriers and provides insight into strategies that work to overcome barriers (you’ll see this theme recurs in the discussion about the business peer network later).   Following-up with Tiffany via email provided me more insight into the chain-reaction she has seen following the publication of reports and events with the following examples:

  • Middlebury College students read one of their reports and investigated the gender ratios in various academic programs and the wage gap between its male and female graduates.
  • Parents and teachers tell them that they have shared the reports with their children to expand their ideas about the work they might pursue.
  • Data has affirmed the experience of many women and prompted many of them to share their stories with Change the Story VT and in their circles.

The spillover effects are difficult to measure for many reasons, and in some cases, Change the Story VT is not even aware of discussions because they are happening without involvement or the knowledge of the initiative.  But Tiffany describes this effect as exciting.  Despite being difficult to measure, the initiative has demonstrated that the narratives are reaching those with change or ethical orientations to the issues and providing an avenue for those with activist self-identifies to see new opportunities or to make changes within their current organizations.

Avoiding the mistakes of the past

Like a true story-teller, casting a character who faces a crisis and then must transform, Tiffany describes the women’s movement in terms of its mistakes.  She describes what happened in the past with the women’s movement:  it excluded groups from participating if it seemed they would possibly compromising the movement.  Gains, then often went not to all equally, but to those who were represented.  bell hooks describes the exclusion of working-class women, and especially black women from the women’s liberation movement in her essay “Rethinking the Nature of Work” (hooks, 1984, pp. 96-107).  Tiffany and I also talked about the #Metoo movement as an illustration of the prominence of gender issues in the recent news.  I wanted to know if she thought that on a serious discussion about sexual harassment has been long overdue since only now that women are coming forth and accusing prominent men are these issues becoming more important to the general public.[4] What Tiffany stressed to me was the need to be vigilant and careful not to repeat the exclusion of groups or factions of women.  The issues to address are those that affect us all.

Tiffany’s leadership demonstrates a commitment using various sociological lens when discussing gender-issues such as salary negotiation and sexual harassment.   Approaches to diversity should always include to an extent, other sociological lenses.  An openness to ideas for the future, such as Tiffany’s openness as a leader to hearing stories from women and to their input for Change the Story VT’s 2018 agenda, continued work with the business peer network which I discuss in the next section to reach stakeholders in the community. And continued investment in developing narratives to demonstrate the personal experience, and reach broad audiences, clearly relate to others and engage a diversity of voices.    The next section discusses the business peer network developed by Change the Story VT, another place where it is important to have a dialog around diversity through the various lens to recognize its benefits in the workplace.

On-going projects

So far, Change the Story VT has generated valuable reports & narratives,  organized and facilitated events, as well as taking the position as an embedded partner for women through philanthropic, non-profit and business networks all interested in examining the work and economic issues in Vermont.  As important as it is to study how organizations start, is the current context they work within and attempts toward social and institutional consolidation.  Change the Story VT has been careful to avoid defining themselves as an organization that grows in the traditional sense.  They are instead a multi-year initiative (with no defined end date, but also explicitly endings),  But as they gain more publicity through involvement in conferences such as the one I went to they gain a sustainable presence.  It is the second year in which they have made efforts to work with businesses (see more below) and participation is expanding.  It will be interesting to continue to see Change the Story VT evolve and perhaps become an important voice in government affairs in the next few years.

Business Community engagement

Another approach to knowledge production is through the sharing of experience, tools, and knowledge in a year-long cohort program called the Business Peer Network.  The challenge is to engage with businesses to talk about gender in new ways.  For example, discussions about the different approaches to risk by those with diverse backgrounds, links the financial-orientation of businesses to equality issues. The conversations with businesses and employers have started with the current partners including companies such as Vt Energy Investment Corp, SunCommon and Seventh Generation (a larger list appears on the website).  There were 12 partners in the first year and now there are 20.  They meet once a month to discuss workplace issues through a gender lens.

This approach engages people to look reflectively at working within existing structural realities.  Businesses have reported having revamped job descriptions and websites to attract more women applicants after exposure to the reports published by Change the Story VT (evidence of the spillover effects mentioned earlier).  The network also builds social relationships because it serves to engage and educate those that may feel interested in the issue but not sure how to get involved, for example, men.  It also empowers employers through inclusion as they work to implement and understand ways to make the workplace family friendly, for example.

Vermont is, in some ways, well-poised for equal-pay certification being a requirement like it has begun in Iceland.  In addition to the status reports, the stories, a network of stakeholders with business interest can serve as a source of valuable testimony in government debate.  Equal pay programs or (more recently debated) raising the minimum wage are issues that affect women.  Change the Story VT’s website points to the Vermont Commission on Women’s equal pay compacts and their experience working with businesses may provide useful evidence and experience in event of opportunities for growth in response to legal requirements.

Not forgetting poverty.

While at the women’s conference, I got to hear Prudence Pease speak about poverty and its impact on women, through her personal story.  She described the huge difference in completing basic tasks such as grocery shopping.  Something which may take a middle-class person who can afford a car and easily move their children around may take a disadvantaged mother many hours longer to complete.  Tiffany described similar observations she made while working on issues around recidivism in the state.  As part of that work, it was necessary to understand the challenges of women.  For example, a woman released from prison has a number of responsibilities required by law.  To complete those requirements, such as going across town to do a urine screen and going to another bus stop to get to programming that only occurs during the day, required time and resources.  Often, the probationer was also required to hold down a job.  Talking about poverty, Tiffany says, is difficult because it is such a difficult issue to get your arms around.  Change the Story VT has not stopped recognizing the need to deal with those at the margins, those, for example, looking to meet basic needs such clothes for children and healthcare.  Without solving some of the more basic economic needs of women in the state, we would be ignoring those in greatest need.

Website information for reader’s further research

The “More questions we can ask” section at the end of each previously-mentioned reports contain a list of phenomenal questions for individuals who are voters, leaders, teachers, parents, decision-makers and anyone being active or intrapreneurial within their spheres.  They are exactly the type that you can ask yourself as a professional to test your reasoning, or to use in a discussion group, or to facilitate training.  (Those community and group facilitators in my readership, pay attention here!)

Here are some of my favorites:

  • When exploring opportunities for work, education or training with women: Do we support them in considering business ownership as a viable option?
  • When investing state dollars in contracted services or products: Do we intentionally invite women-owned businesses to bid on state contracts?
  • When crafting major state policy decisions, priorities, and program evaluations that relate to business development: Are we sufficiently focusing on reducing barriers that particularly affect female entrepreneurs, such as access to child care, after-school programming, and options for elder care? (Change the Story VT, 2016, “Women’s Business Ownership and the Vermont Economy”)
  • As employers:  Who do we retain?  Who do we lose? Do we know why individuals leave?
  • As employers:  How diverse are the candidates who appear on the shortlists for internal promotions?
  • As policymakers:  What are the long-term implications of continuing to pay low wages to so many Vermont workers, particularly those in female-dominated fields? (Change the Story VT, 2016, “Where Vermont Women Work…and Why It Matters”)
  • In the public sector:  What are the unspoken “rules” about how to pursue higher office?  How do we encourage women to better position themselves to reach those offices?  (Change the Story VT, 2017, “Vermont Women and Leadership”)

I like how these questions ask us how we allow or take part in constructing the systems that offer economic gain.  When these systems are historically male-created, there are high chances that they do not offer friendly avenues to women. Can we challenge ourselves to think empathetically about the needs of both genders?  I would love to even start questioning the term “barriers” and try to see the value in the experiences of mothers or women.  I also love the focus on sustainability and long-term needs of stakeholders represented by the question about continuing to pay low wages to so many Vermont workers.  The questions also serve as a way to understand how broadly and deeply gender issues appear in society (and in Vermont).

Articles linking to great resources from the Change the Story VT website

There are a number of articles referenced on the website that point to freely available articles from places like the Harvard Kennedy Women and Public Policy Program’s Gender Action Portal.  There were a few articles that interested me:

I definitely would continue to check back here to find resources on gender’s connection to economic development and security in the future.


    • Bush, S., Bottema, M., Midavaine, J. & Carter, E. (2017). Sustainable entrepreneurship in marine protected areas. From K. Nicolopoulou, M. Karatas-Ozkan, F. Janssen & J. Jermier (Eds.) Sustainable entrepreneurship and social innovation. New York, New York: Routledge. pp. 124-139.
    • Change the Story VT. (2017).  Vermont Women and Leadership. Retrieved from
    • Change the Story VT. (2016).  Where Vermont Women Work…and Why It Matters. Retrieved from
    • Change the Story VT. (2016). Women’s Business Ownership and the Vermont Economy. Retrieved from
    • Change the Story VT. (2016). Women, Work, and Wages in Vermont. Retrieved from
    • Costanzo, L. (2017). The application of the ‘ambidexterity’ theoretical perspective to sustainable entrepreneurship: Balancing the sustainability-development equilibrium over time. From K. Nicolopoulou, M. Karatas-Ozkan, F. Janssen & J. Jermier (Eds.) Sustainable entrepreneurship and social innovation. New York, New York: Routledge. pp. 101-123.
    • Freire, P. (1970). Pedagogy of the oppressed. New York, New York: Bloomsbury Publishing Inc.
    • hooks, b. (1984). Feminist theory: from margin to center. New York, New York:  Routledge.
    • Smucker, B. (1991). The nonprofit lobbying guide: advocating your cause – and getting results. San Francisco, California: Jossey-Bass Limited.


I want to extend a special thank you to Tiffany Bluemle for taking her time to speak with me and making it possible to write this article.


I was able to frankly talk to Tiffany about women my age and my experiences.  For instance, I told her that the perceptions I had of the real world turned out to be very different than I thought. As barriers came up for me, they shaped my direction significantly and that impacted the results and outcomes I experienced.  For example, one of the questions I had for Tiffany was whether there is too much focus on STEM fields for women and not enough on the civic and public realm, where many of these positions live.

Tiffany graduated college in 1983 and had seen women such as Sallie Ride, Sandra Day O’Connor, and Geraldine Ferraro.  (Did I mention that one of Tiffany’s earliest civic activities was campaigning for W. Mondale in 1984?). The other mistake of the 80s feminist movement was seeing some of the women breaking barriers and thinking that we had accomplished so much when for every woman that did accomplish a great feat, many were struggling.
Tiffany felt an urge to do the same thing my aunt did when I brought up this topic with her: apologize. I felt very touched by the empathy I received in this moment.   I do think there is certainly agreement that the outcomes we have today are better than they were then and there is a lot more opportunity, even when they are lacking a comprehensive equality that is expected by young ambitious women.  However, it is important for us, young ambition women, to remember that those gaps are today’s opportunity to do more.


      1. When I first learned about Change the Story, I had just finished reading Pedagogy of the Oppressed by Paulo Freire.  I wondered how data gathering itself could have been done using an alternative methodology from hiring research firms. Of instead of solely contracting to gather data and generate reports, a community-based, dialog-based effort to gather information and stories locally, would also serve to provide valuable skills and participation to stakeholders (Freire, 1970).
      2. The 2017 status report was generated by Change the Story team using publically available data, surveys, telephone interviews, email correspondence as well as research conducted by Common Good Vermont and compiled reports by Emerge VT and The Vermont Higher Education Council.
      3. It is important to note here that per The nonprofit lobbying guide, research costs do not need to be treated as costs of lobbying if published results were later used in lobbying (Smucker, 1991, p.74).  (And accordingly the materials cannot refer to a view on specific legislation, nor funded within the last 6 months, nor prevented from substantial distribution, and another cooperating organization is not using them for lobbying purposes.). Due to the dissemination of these reports, “spread them far and wide,” the lack of linkage to specific legislation, it is clear that these serve as valuable assets to the organization upon the pursuit of any legislative change.
      4. Consider listening to an excellent segment on NPR’s CodeSwitch about Rape on the Nightshift, which was also made into a Frontline documentary, about sexual assault allegations brought forth by undocumented workers and janitors in the early 2000s.
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