Archive for the ‘Health Care’ Category

2Connecticut insurance exchange hired marketing company for ‘legislative communications strategy’

Access Health CT, the health-insurance exchange implementing Obamacare in Connecticut, paid a marketing firm millions in part to “engage key legislators” but contends the agreement does not violate a ban on lobbying by quasi-public state agencies.

The original $7.2 million agreement with marketing consultant Pappas MacDonnell included $59,900 for a “legislative communications strategy.”

“The quick answer is, NO they do NOT do any lobbing for us, they are a Marketing Firm only,” said Kathleen Tallarita, spokeswoman for Access Health and a former state representative.

State agencies, including quasi-publics, are not allowed to hire lobbyists.

The agreement describes the goal of legislative communications:

“To establish Access Health CT as the marketplace for quality, affordable health insurance in Connecticut, Pappas MacDonnell will immediately engage key legislators to ensure that they understand what Access Health CT is, how it functions, its impact on Connecticut’s health insurance marketplace, and the potential implications of legislative action (or inaction) in the upcoming sessions.”

Connecticut law defines lobbying, with a few exceptions, as:

“communicating directly or soliciting others to communicate with any official or his staff in the legislative or executive branch of government or in a quasi-public agency, for the purpose of influencing any legislative or administrative action.”

Pappas designated its subcontractor, public affairs and lobbying firm Grossman Heinz, to work on the legislative strategy listing three individuals – all billing $300 an hour – Andrew Grossman, Chris Heinz and Lynn Pincus.

The agreement lists “legislation” in a description of the duties of two project managers: Logan Kelly ($75 per hour) and Quynh Tran ($60 per hour).

“As a secondary objective Pappas MacDonnell will also seek out legislators’ input on consumer outreach and Navigator programs to get their buy-in to aid in the coordinated consumer outreach process,” the agreement says.

Access Health agreed to pay Pappas another $10.3 million under an October 2013 addendum that does not mention legislative communications for a total payment of $17.5 million. According to Tallarita, the payments to Pappas include the cost of advertisements purchased by the firm on behalf of Access Health.

Separately, Access Health hired Global Strategy Group to handle public relations.

The Connecticut Health Investigative Team reported earlier this year that Access Health, considered one of the more successful state-based exchanges, spent $156.3 million to start up.

Access Health also paid Pappas $1,650 each for two “CEO messages.” The contract originally called for 15 such messages – totaling $24,750 – but Tallarita said the exchange only sent out two.

Access Health also paid three artists $24,980 each to paint murals.

0Jackson Labs avoids local approvals as a ‘state project’

Construction on the Jackson Laboratory facility in Farmington is well on its way to completion thanks in part to unique treatment of the project: the lab didn’t need any local approvals.

The Jackson Laboratory for Genomic Medicine will receive a $297 million subsidy from the state. Gov. Dannel Malloy has touted the project for its economic-development potential.

If all goes according to plan, the time between legislative approval and grand opening will be almost exactly three years.

In addition to the monetary benefits from the state, treating the lab as a “state project” allowed to it to avoid the time-consuming and costly land-use process faced by other developers. Instead, the project received state approvals.

Mike Hyde, the nonprofit lab’s vice president of external affairs and strategic partnerships, said another developer “would follow the exact same process that we are” – if it was building on state property and had state financial support.

“I don’t know if one is more stringent than the other,” Hyde said. “I couldn’t say it was a privilege because I don’t know what the other experience is like.”

According to a March 2014 update on the project, JGM received about $9 million in state money for research, training and other reimbursable expenses.

By the end of 2013, JGM spent $64 million on construction out of $135 million budgeted. The state gave JGM a $192 million forgivable construction loan.

According to hiring projections, the subsidy amounts to about $42,000 per job per year.

The General Assembly approved Malloy’s incentives for JGM in October 2011. The new law designated Connecticut Innovations, the state’s venture capital fund, to manage the state’s relationship with JGM.

Connecticut Innovations signed an agreement with JGM in January 2012.

JGM awarded the contract to manage construction of the 183,500 square foot lab in January 2013.

Hyde said the lab plans an Oct. 7 grand opening.

In order to maintain its incentives JGM needs to reach 300 employees within 10 years. Hyde said the building could fit up to 320 people. “We’ll hit the 300 employee mark sooner than we had imagined,” Hyde said.

Hyde said JGM has 79 employees in about 11,000 square feet of temporary space and is looking for about 35 new employees. “We’re adding people at a lively clip,” he said.

Some University of Connecticut employees count toward JGM’s hiring goals.

The legal principles that allow JGM to avoid local land-use regulations are the same that allow a contractor for the Department of Transportation to build a road for the state without local approval. These principles have expanded greatly. In 1959, Attorney General Albert Coles wrote an opinion giving the state the ability to give an airport hotel on state property a liquor license instead of following local regulations.

“Therefore, it is my opinion that the airport operation constitutes a governmental function serving the public need and by virtue of its nature is immune to the zoning power of the Town of Windsor Locks,” Coles wrote a half-century ago. “The hotel with a liquor permit would be in furtherance of, rather than a deviation from, the essential airport use and, therefore, exempt from the zoning regulations of the Town of Windsor Locks.”

Update: This  post was updated to clarify that JGM did obtain state-level approvals for construction in place of local approvals.

0Access Health CT CEO Recognized for Valiant Efforts

Last Saturday a group of local college students known as the Wesleyan Young Advocates teamed up with the Middletown Community Health Center to honor the CEO of Access Health CT, the state’s Affordable Care Act portal, Kevin Counihan.

Flyers distributed by the studenaca bruncht group (pictured left) espoused Counihan and his underlings at Access Health CT for their “valiant contributions toward CT enrollment.”

Apparently the standard for what would constitute a valorous act has been lowered or is at least being misinterpreted by the WYA, who since September has been working to get Middletonians enrolled in the state healthcare exchange. I mean c’mon, does enrolling people in crummy government experiment that only 40% of people agree with really constitute an act of valor?

What surely was left unmentioned at this Left Wing love fest was the valor and courage it took to spend $79,000 on three pieces of artwork. Last December Raising Hale reported that Access Health CT, who is entrusted with the responsible management of private information on every enrollee, very responsibly used taxpayer dollars to have artwork commissioned and installed at various offices. Don’t worry though; Lt. Gov. Nancy Wyman assures us that this is “a creative way for us to express that commitment to building healthier communities.”

Connecticut officials have boasted about the successes they have achieved enrolling people into the government controlled insurance marketplace in comparison with other state run exchanges. The Access Health CT exchange was also one of the first to reach completion, which of course is no surprise coming from a state that conceits to the President’s every wish.  

Meanwhile this week as millions instantly qualified for the Obamacare IRS penalty (supposedly), the President self-proclaimed the debate on repealing the healthcare law to be officially over. The achievement of the deadline enrollment goal of 7 million people apparently gives the president and the Left veto power over any argument concerning the successes or failures of Obamacare.

However what has not been reported by the administration is the amount of people that have actually paid for any of these healthcare purchases, the amount people who actually received healthcare for the first time or the amount of people that were forced off their existing coverage. Not to mention whether or not a sufficient amount of young “invincibles,” who are expected to shoulder the burden of healthcare costs, have enrolled to offset enrollees who will be totally subsidized.  

I guess when expectations for success are lowered to whether or not a multi-million dollar website actually functions one can easily be impressed.

Andrew is a Political Science Major at CCSU and a veteran of the USMC. 

0HealthBridge subpoenas Blumenthal, DeLauro, Jepsen and Malloy in RICO suit against union

The Connecticut nursing home company where striking workers became a political issue two years ago has subpoenaed several of the state’s top elected leaders, including Gov. Dannel Malloy and Attorney General George Jepsen.

HealthBridge, owner of eight Connecticut nursing homes, sued the unions striking at five of its locations in 2012 under the Racketeer Influenced and Corrupt Organizations Act, legislation originally intended to fight the mob.

Lawyers for the defendants in the suit – the New England Health Care Employers Union, also known as Service Employees International Union 1199NE, and United Healthcare Workers East, another SEIU affiliate – objected to the subpoenas in a Feb. 21 court filing.

HealthBridge subpoenaed Jepsen and Malloy’s office, plus both of their campaign committees, Sen. Richard Blumenthal, Rep. Rosa DeLauro, state Sen. John Fonfara and state Rep. Russ Morin.

All of the subpoenaed officials are Democrats.

“We have received the subpoenas and are reviewing them,” said Jaclyn Falkowski, a spokeswoman for Jepsen. “We have no further comment at this time.”

Leon Dayan of Bredhoff & Kaiser said in his objection the subpoenas are too broad especially for “this early phase of discovery, which is required to be limited in nature.”

According to Dayan’s objection, HealthBridge issued 92 document requests and 25 interrogatories.

“The depositions’ sole purpose appears to be the improper one of sending the message that if a union or other organization dares to exercise its First Amendment right to petition government officials in a manner that displeases Plaintiffs or their owner, not only will that organization be subject to a harassing lawsuit, but all the organization’s perceived political and other allies can expect to be harassed and have their costs driven up as well,” Dayan wrote.

“Absent intervention by this Court, sitting elected officials and their staffs will be forced to take time away from working for their constituents.”

Dayan also objected to HealthBridge’s efforts not to disclose the name of the former union organizer upon whose testimony the company is relying to make some of its claims.

The Blumenthal subpoena, included in Dayan’s objection, requests documents related to:

– HealthBridge’s application to close a Wethersfield nursing home,

alleged sabotage by striking workers,

– efforts to put HealthBridge nursing homes into receivership.

Jepsen recused himself from any investigations into union sabotage after joining strikers on the picket line.

Company contributions to union pension funds have long been part of the labor dispute at the five nursing homes, which declared bankruptcy last year.

Update: Now with link to objection.

0Bridgeport Housing Authority faulted for ‘Cadillac’ employee health plan

Federal watchdogs faulted the Bridgeport Housing Authority Tuesday for improperly charging $1.7 million to Washington and for giving employees a “Cadillac” health plan.

The U.S. Department of Housing and Urban Development Office of the Inspector General raised the issues in a report.

HUD identified $895,000 of federal money used for ineligible purposes and $790,000 of improperly documented expenses. The federal agency will seek to get the money refunded.

A Cadillac health plan costs more than $10,200 each year for individuals or $27,500 for families. Starting in 2018, insurance companies will include a 40 percent excise tax on such plans as a result of the Affordable Care Act, also known as Obamacare.

“Paying the additional tax would result in fewer funds for housing,” the report said.

Investigators found the housing authority had limited itself “to one vendor and a specific plan” through its collective-bargaining agreements. Authority officials told HUD its health care plan “was generous compared with those of other authorities and private businesses.”

Authority officials are trying to remove the restriction or join the state health care plan, according to the report.

The report also found ”a prior executive director promoted all of the janitors to maintenance aides without ensuring they had the skills to perform their new duties.”

10Other facilities rival costs of Southbury Training School

Connecticut’s agency for serving people with intellectual and developmental disabilities runs five campus-style centers that on average cost more than Southbury Training School and twice as much as privately-run alternatives.

The Department of Developmental Services regional centers – located in Meriden, Newington, Norwalk, Stratford and Torrington – care for people with greater needs. The federal government designates the facilities “intermediate care facilities for individuals with intellectual disabilities” or ICF/IID so the state is reimbursed for half its expenses.

“One has to be cautious in engaging in general comparisons,” said DDS spokeswoman Joan Barnish. “They are a very diverse group of residential settings. Some have significant nursing and behavioral supports with high staff ratios and others have lower staff ratios and far less clinical supports.”

“While there are some differences there is no question that private community settings cost far less than residential settings operated by DDS for people with similar needs,” Barnish said.

“Regional centers have nursing available all the time; this is true of some but not most community settings,” she said. “A small number of the individualized campus units serve people with very special needs that are not typical of the community settings.”

The Southbury Training School has received extensive media attention for its high costs and legal battles. A 2012 report issued by the Program Review and Investigation Committee found that, adjusting for need, Southbury does cost more than regional centers. The report found Southbury costs twice as much as a private alternative for the same level of need, while the regional centers cost 1.8 times as much as private providers.

The same report found private providers paid direct-care workers an average of $15.53 an hour, while DDS paid an average of $24.24 and offered benefits worth about $40,000.

According to department cost estimates submitted to the General Assembly for fiscal year 2012, the average cost per client at Southbury Training School was $329,614 while the cost per client at the regional centers averaged just over $400,000.

DDS pays a privately-run ICF/IID $159,788 on average per resident, about half the cost of a Southbury resident and 40 percent the cost of a regional center.

Unlike the PRI report, these costs do not adjust for level of need.

Barnish said the agency is primarily serving people with at home or in the community, so “the state is not pursuing expansion of public or private ICF-IID settings.”

DDS has a list of more than 1,000 people seeking services, although only a portion are seeking the level of care available at ICF/IIDs.

For every regional center resident transitioned to a private provider, the agency could afford to serve another person with a high level of need or multiple people with lesser needs.

A 2008 report by the Program Review and Investigation Committee found costs at Southbury and the regional centers to be very close at the time, with costs per client per day of about $800 in 2007, up from less than $600 in 2002.

Over the same time period, private provider rates per client per day rose from about $350 to more than $400.

In 2012, the per diem rates were $1,096 for the regional centers, $903 for Southbury and $437 for private providers, according to the DDS estimates.

The 2012 PRI report provides a more detailed look at daily costs over recent years. It found Southbury’s costs fell by 1 percent between fiscal years 2009 and 2011. The West region’s costs rose 5.6 percent, but were the lowest of the regions at $779 per day. The North region went up a similar amount, 5.3 percent, to $1,000 a day.

The South region’s costs went up 11.5 percent, reaching $1,362 per day.

None of these cost estimates adjust for levels of need.

According to the 2012 cost estimates, 414 people lived at Southbury Training School, 211 at the regional centers and 407 at private ICF/MRs.

“The trend of services in Connecticut over the past 25 years has been an increasing reliance on private providers. Over the last 10 years there has also been funding of supports to assist people to live with their families or more individualized person centered settings,” Barnish said. “There has been a corresponding trend of decreased reliance on DDS operated residential settings.”

1Brookfield breaks the law and violates charter by accounting like the state

The Brookfield Board of Finance reviewed a draft audit Wednesday showing the town’s schools used improper accounting to hide overspending in the past two fiscal years amounting to $1.1 million.

The town’s auditors from Mahoney Sabol & Company said the schools are in the process of undoing $471,000 in excess spending from the 2013 fiscal year by obtaining a credit from Cigna for that amount.

More than $700,000 in excess spending from the previous year remains. The board will have to decide whether to raise taxes or spend down its fund balance to pay for the unbudgeted expenses.

The auditors, new to the town, found school officials had pushed expenses out of the current fiscal year and into the next.

For example, in 2012 and 2013 the board of education paid for 11.5 months of health insurance instead of a full 12 months, according to the auditors. Since the board only accounted for paying for 23 months of insurance during a 24-month period, it underreported spending. This allowed the board of education to spend more than its appropriation.

“The material noncompliance appears to be due to the board of education’s business office operating under the past practice that any excess costs over budget pertaining to the prior fiscal year could be paid from the subsequent fiscal year appropriation,” the auditors wrote in a draft report. “As such, the need for an additional appropriation was never considered by the business office.”

Board of finance chairman Phillip Kurtz said the town’s boards would need to work together to resolve the problems. “It comes down to one bottom line,” he said.

The practice of pushing expenses into future periods is something many families do at home since they use cash accounting instead of accrual accounting. Cash accounting considers money spent when it changes hands. Under accrual accounting money is spent when goods and services are provided. That is why it is impossible under accrual accounting to pay for less than one year of health insurance each year.

“This is like operating a mom and pop,” said Ernie Nepomuceno, board of finance vice chairman. “This is pretty serious from my perspective.”

The state requires municipalities to use accrual accounting, but uses a different system for itself, modified cash accounting.

For years, governors and the General Assembly used accounting gimmicks to make Connecticut’s budget appear balanced. They made the fiscal year longer when it came to collecting taxes and shorter when it came to paying bills.

As both Brookfield and the state have learned, this works in the short term, but has long-term consequences. An expense pushed into next year makes the next budget that much more out of balance.

The state’s current gap is $1.1 billion. That’s the price tag for adopting accrual accounting and Generally Accepted Accounting Principles as Gov. Dannel Malloy has promised to do.

According to the board of education’s comments in the draft audit, unexpected costs in three areas led to the overspending.

For the two-year period, special education costs exceeded the budget by $427,840, substitute staff costs by $424,925 and health insurance premiums by $340,486.

To alleviate the overspending, the board of education negotiated a one-time credit from its health insurer, Cigna, for $471,262 or the equivalent of the June 2013 monthly premium. The credit is “based on a strong and positive business relationship,” according to the board of education comments in the draft audit.

2Health insurance exchange buys three murals for $24,980 each

Access Health CT, the quasi-public state agency that sells insurance under Obamacare, spent nearly $75,000 to commission three murals, plus nearly $4,000 to have one of them installed.

Contracts with the three artists – Adam Niklewicz, Katro Storm and Rafael Cornier Jr. – show they were each paid $24,980 to produce a mural eight feet tall and 32 feet long.

The agency paid AdamsAhern Sign Solutions $3,945.51 to install the Niklewicz mural in at the Hispanic Health Council in Hartford.

Just before Thanksgiving, state officials gathered at Optimus Health Care in Bridgeport to unveil the Cornier mural.

“Healthcare reform isn’t just about getting people insurance for unexpected medical emergencies, it’s also about providing access to the preventative care and wellness programs that will help people become and stay healthier,” said Lt. Gov. Nancy Wyman, a co-chairwoman of the Access Health CT board. “This mural is a creative way for us to express that commitment to building healthier communities.”

Storm’s mural is at the Stetson Branch Library in New Haven.

The contracts are publicly available on the exchange’s website.

0Invasion of privacy or needed transparency? Days remain to comment on healthcare database

Connecticut’s all-encompassing healthcare database is moving forward and looking for feedback.

Residents have until Sept. 12 to submit comment on the proposed policies and procedures for the database that will collect information about every person who receives healthcare in Connecticut, including social security number, date of birth, zip code and medical condition, plus the amount paid for all treatments.

Access Health CT, the quasi-public agency charged with implementing the Affordable Care Act, also known as Obamacare, will run the project, known as the All-Payer Claims Database. The agency just hired Tamim Ahmed, who has a doctorate and MBA, to run the database.

Experts have criticized Connecticut’s lack of price transparency in the healthcare market. One report gave the state an F. However, some critics of the database approach fear it will collect too much information, beyond what is needed for consumers to compare prices.

To comment, email Margo Lachowicz at margo.lachowicz@ct.gov with “Public Comment” in the subject line by Thursday.

0Conn. stem cell grants mostly help UConn and Yale

Connecticut has distributed nearly $80 million in stem cell research grants but only two private companies received funding in the program’s seven years, with most of the money going to the University of Connecticut Health Center and Yale University.

In 2011 Chondgrogenics received $1.3 million and this year ImStem received $1.1 million, but they are the only companies to receive state money. Both companies are based in Farmington and emerged out of UConn.

Yale researchers received nearly half of the grant money, $35.7 million. Yale’s endowment – worth $19.3 billion – generates that much money for the university every two weeks.

The UConn Health Center received more than a third of the funding, or about $29.5 million. Researchers at the Storrs campus and Wesleyan University also received state money.

Only $2.4 million or 3 percent of the money went to private companies. The state offered a $900,000 grant to a third private company in 2008, but the company failed to meet certain criteria and never received the money.

As of 2011, the program had funded 151 jobs at Yale, 40 at UConn and seven at Wesleyan.

Gov. M. Jodi Rell started the plan to fund stem cell research with state money in 2006 with a plan to spend $100 million over the next decade. After a $20 million initial infusion from the state budget, money from the state’s settlement with tobacco companies would supply $10 million a year going forward.

Rell’s successor, Dannel Malloy, altered the plan. He plans to use the $10 million in tobacco money to balance the budget and instead borrowed money to pay for stem cell research.