Archive for the ‘Health Care’ Category

1SCOTUS ruling strikes blow to CT’s forced unionization scheme

As millions anxiously awaited the Supreme Court’s decision in Hobby Lobby v Sebelius (regarding the Affordable Care Act’s mandate that all employers provide contraception coverage despite religious objections) the Justices released their decision in another case that has quietly dealt a huge blow to public unions and to decisions made by Governor Malloy and the General Assembly.

In Harris v Quinn the Court ruled that home healthcare workers providing services to individuals who receive state or federal funding should not be required to pay dues to a union that represents public employees (mainly the SEIU and AFSCME). This precedent sends shots across the bow of public union advocates seeking to add to their political coffers by forcing anyone who operates near government money to pay some sort of union fee.

The details of this case should sound familiar to folks here in Connecticut. In 2011 Governor Malloy, via two Executive Orders, effectively forced individuals providing home daycare and home health care services similar to those in Harris to pay union dues, regardless of whether or not they wished to unionize. The logic behind this fiat being that since these employees, mainly mothers running daycare out of their homes and healthcare workers contracted by persons needing in-home care, often provide services for individuals who receive public money through Medicare, Medicaid etc. they should therefore be considered public employees.

Unions have tried this in numerous states claiming that these private employees are “free riding” on the collective bargaining efforts of local unions who are of course only seeking to ostensibly improve things for workers, society and the human condition. In reality anyone who follows the money can see that this is a strong arm tactic that enables unions swing the political pendulum in their favor by getting and keeping Democrats in office by expanding their donor base by force.

In response to Malloy’s Executive Orders a slew of lawsuits were filed against him in 2012. Among them was a suit filed by the Yankee Institute on behalf of Cathy Ludlum. Ms. Ludlum, who suffers from Spinal Muscle Atrophy, wished to prevent the twelve people she employed, who helped her with everything from running her business to eating, from being forced unwillingly into the SEIU.

At a personal level it was argued that this forced unionization scheme effectively changes the relationship between employer and employee. When a union attempts to inorganically force its way into this relationship the people who get pushed to the side are the ones that actually need care. Loyalty for the service providers is diverted from their employers, such as Ms. Ludlum, to their union bosses. It was also argued that Malloy’s actions intruded upon a constitutional authority reserved for the Legislature.

Unfortunately for Ms. Ludlum and her peers in 2012 the CT General Assembly, who could not pass up the opportunity for increased campaign support, passed a bill that concurred with Malloy’s executive actions. In late 2012 the State Superior Court ruled that the lawsuits against the actions were rendered moot by the passage of legislation.

Fast forward to Monday June 30, 2014 and it appears as if the suits filed against the Governor may have not been all in vain.

The SCOTUS ruling on the Harris case is extremely narrow and pertains to only home healthcare workers, preventing them from being considered state employees and therefore subject to forced unionization. However, it signals victory for those types of workers in CT like those employed by Cathy Ludlum who do not wish to pay union dues and will now be able to opt out.

While unions will react to this decision by saying it is anti-worker, anti-poor, anti-(insert sacred cow of the left here) those who truly understand the underbelly of union politics should take solace in the fact devious tactics used to expand union influence have been put on hold; for now. For every freedom loving individual the holding in Harris (and Hobby Lobby) represents just a little bit more decision making power returned to the hands of individuals. Such a nice Independence Day gift from SCOTUS!

Andrew is a Tax Consultant at Alternate Tax Solutions and a Summa Cum Laude graduate of CCSU.  

0State awards another $10 million in stem-cell grants to the usual suspects

The state awarded another $10 million in stem-cell research grants Tuesday, but not a single private company benefited.

Like the $80 million awarded in the previous seven years, most of the money this year went to the University of Connecticut Health Center or Yale University.

The Jackson Laboratory for Genomic Medicine, already the recipient of $291 million in taxpayer largess, secured $1.1 million from this batch of stem-cell research funding.

In the history taxpayer funding of stem-cell research in Connecticut, only two private companies received grants totaling $2.4 million out of about $90 million, or less than 3 percent.

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.

2Jackson 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. 

1HealthBridge 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.