Category Archives: Health.Care

Caregivers of disabled left in dark under Kansas’ private healthcare system

Source: Andy Marso, Kansas City Star, November 12, 2017

… The Star found other caregivers who were asked to sign off on plans of care without knowing if they included cuts — one of several concerns about transparency that have arisen since the state became the first in the country to privatize its entire Medicaid program by establishing KanCare in 2013. KanCare has made the Medicaid system in Kansas less collaborative and more secretive for people with disabilities, a group of independent case managers from Johnson County said in an August interview with The Star. When the system was run by the state and a network of disability non-profits, the case managers said, the focus was on figuring out what services could help and how to find them. Now it’s about justifying the services they’re getting. …

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Kansas proposes Medicaid work requirement
Source: Jonathan Shorman, Kansas City Star, October 27, 2017

The next version of Kansas’ privatized Medicaid program will require about 12,000 adults to work, a stipulation no state’s program currently includes. State officials unveiled their proposal for KanCare 2.0 on Friday. The program serves more than 400,000 residents but right now has no work requirement. The federal government must approve the proposal before implementation, a process expected to take months. …

Federal health officials approve one-year extension previously denied to KanCare program
Source: Allison Kite, Topeka Capital-Journal, October 17, 2017

The federal government has granted a one-year extension of Kansas’ privatized Medicaid program after denying the request and citing deficiencies in the program earlier this year. Following an on-site visit a year ago, the Centers for Medicare and Medicaid Services in January denied Kansas’ request for an extension and cited several concerns about the way the state ran its Medicaid program, KanCare, including limited oversight and coordination it argued posed a risk to recipients. The Kansas Department for Health and Environment, which runs KanCare with the Kansas Department for Aging and Disability Services, took issue with the January findings. In a letter dated Friday, CMS approved the request to extend the program through next year, as long as the state follows a list of directives, including continued compliance with a corrective action plan it submitted following the denial. The letter says the state has to apply for its full five-year reapplication by the end of the year. …

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Iowa Will Delay Plans to Add 3rd Company Back Into Medicaid

Source: Associated Press, November 7, 2017
 
An Iowa agency is delaying plans to add a third company back into the state’s privatized Medicaid program.  Iowa Department of Human Services Director Jerry Foxhoven says the agency will hire another company to offer Medicaid coverage in 2019. The agency originally said such a company would start next July.  Foxhoven says the agency will begin its search for a company soon, but the 2019 delay ensures adequate time.  Foxhoven provided the information Tuesday to a health care council. It comes one week after AmeriHealth Caritas announced it will drop Medicaid coverage in Iowa at the end of the month after failed contract negotiations with the state. Two other private insurance companies, Amerigroup and UnitedHealthcare, will continue Medicaid coverage. …

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DHS: Iowa Will Give $60M More to Companies for Medicaid
Source: Associated Press, November 2, 2017
 
An Iowa official says the state will spend an additional $60 million this budget year for private insurance companies to keep running the Medicaid program.  Iowa Department of Human Services spokesman Matt Highland said Thursday that additional costs announced this week as part of new state contracts with two companies will total $140.4 million. The state will pay $60.8 million of that. The federal government will pay about $80 million. …

Private insurance company to leave Iowa’s Medicaid program
Source: Barbara Rodriguez, Associated Press, October 31, 2017
 
An insurance company that helps run Iowa’s new privatized Medicaid program is withdrawing its participation after less than two years, state officials announced Tuesday, a move that highlights failed negotiations between the company and the state over future coverage expenses.  AmeriHealth Caritas will end its Medicaid coverage in Iowa at the end of November, the company confirmed in a press release. It offered no details on why a new contract with the state, through the Iowa Department of Human Services, could not be reached. DHS officials also declined specifics and focused attention to new contracts with the remaining companies, Amerigroup and UnitedHealthcare. …

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Two weeks in, Cedar Haven strikers are prepared for Christmas

Source: Daniel Walmer, Lebanon Daily News, November 3, 2017

A labor dispute at Cedar Haven shows no signs of abating two weeks after nurses went on strike. If you need proof, consider this: AFSCME Local 2732 President Penny Kleinfelter has placed an artificial Christmas tree along the Fifth Avenue picket line in preparation for the holiday season. Kleinfelter said she isn’t trying to send a message – she’s just decorating, since she usually puts up her Christmas tree at home at the beginning of November. But she hopes Cedar Haven ownership understands the strikers are “in it for the long haul.” … Some union members have applied for unemployment compensation, and the union is defending their claim on the basis that they went on strike to protest an unfair labor practice, said AFSCME council director Steve Mullen. The union has maintained that owner Stone Barn Holdings bargained in bad faith by implementing a new contract even though it was voted down by union members and while negotiations were still ongoing. …

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No end in sight as rally marks one week of Cedar Haven strike
Source: Daniel Walmer, Lebanon Daily News, October 27, 2017

Employees from other local unions joined Cedar Haven employees Friday for a rally to mark one week since the beginning of a nurses strike that has no sign of ending soon. Steve Mullen, council director for the American Federation of State, County and Municipal Employees, said there has been not yet been any movement by Cedar Haven ownership that would lead to a conclusion of the strike. “We reached out to them and asked them if they wanted to sit down and talk with us, and they said only if we’re willing to take (the contract) they’ve already given us,” Mullen said. Hundreds of protesters lined both sides of 5th Avenue at noon Friday, chanting “because we care,” and encouraging cars to honk their horns in solidarity. The rally featured heavy hitters like Elissa McBride, international secretary-treasurer of AFSCME, and Rick Bloomingdale, president of the Pennsylvania AFL-CIO. …

“It sucks in there”: Residents on conditions at Cedar Haven as strike continues
Source: Daniel Walmer, WITF, October 25, 2017

Cedar Haven residents expressed frustration Wednesday with the quality of care they are receiving as the nurses strike at the facility entered its sixth day. Marion Weiant has never had cause to complain about the quality of nursing care at Cedar Haven – until now, she said. Since the strike began, Weiant, a three-year resident at Cedar Haven, said she is often not properly wiped after being changed, causing her concern about getting sores. Nurses also haven’t gotten her out of bed until 11:30 a.m., more than two hours later than normal, she said. … The nursing home is currently being staffed with nurses from U.S. Nursing Corporation. Richard Boyer, another resident, said the temporary nurses “seem nice enough,” but “it’s not the same as the regular crew.” … The three residents were holding signs while attending the picket line in support of the nurses Wednesday afternoon. The nurses are protesting a contract implemented by Cedar Haven owner Stone Barn Holdings that reduces paid time off and substantially increases employee contributions to their health insurance. … To this point, Cedar Haven owner Chas Blalack has not agreed to sit down for additional negotiations, so the strike is expected to continue, said Steve Mullen, council director for the American Federation of State, County and Municipal Employees. …

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Incumbent Massena Town Supervisor issues last-minute debate challenge to Democratic opponent

Source: Abraham Kenmore, Watertown Daily Times, November 4, 2017
 
Town Supervisor Joseph D. Gray issued a challenge late Thursday to his opponent for a debate, four days before the election. In an interview with the Times on Thursday, Mr. Gray, the Republican incumbent, said he was challenging his Democratic opponent, Councilman Steven D. O’Shau­ghnessy, to a debate tonight in the Town Hall. He then issued a press release late Thursday night specifying that he had reserved Room 30 for 7 p.m. at the Town Hall to take community questions. … Mr. Gray has accused Mr. O’Shaughnessy of striking a deal to keep the hospital under town control in exchange for the endorsement of the Civil Service Employees Association Local 887, which represents over 200 workers at the Massena Memorial Hospital and opposes privatization. Mr. O’Shaughnessy has denied any such deal, and said Mr. Gray raised similar accusations that council members with state pensions would be under the control of Albany. …

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Gray accuses O’Shaughnessy of opposing hospital privatization
Source:Abraham Kenmore, Watertown Daily Times, November 3, 2017
 
Town Supervisor Joseph D. Gray issued a news release Monday questioning the endorsement of councilman Steven D. O’Shau­ghnessy, his Democratic opponent, by Civil Service Employees Association Local 887, which represents over 200 workers at the Massena Memorial Hospital. The CSEA has organized protests against the privatization of the hospital, which Mr. Gray says is necessary to keep the debt-ridden hospital open. …

Massena Memorial Hospital privatization process stalled until transfer agreement settled
Source: Andy Gardner, North Country Now, September 28, 2017
 
The Massena Memorial Hospital privatization process is at a standstill until the hospital and town can come to terms on an asset transfer agreement, the MMH CEO told the Board of Managers on Monday.  “We are still talking to the town and we hope to have a town proposal that we can discuss in the very near future,” MMH CEO Robert Wolleben told the board, adding that the proposal needs to “model the financial impact” privatization would have on the hospital.  “Everything is teed up and hopefully we can move pretty quickly,” he said. Talks with two larger health networks they may affiliate with can’t move until that part is done. …

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UCLA student groups advocate for medical center valet workers

Source: Sharon (Yu Chun) Zhen, Daily Bruin, October 24, 2017 
UCLA labor- and immigration-justice groups held a town hall meeting Monday night to urge UCLA to create more insourced positions for contract valet workers at the Ronald Reagan UCLA Medical Center.  … Victoria Salgado, a union organizer at the American Federation of State, County and Municipal Employees Local 3299, the UC’s largest union, said many workers are concerned for their job security because they received unclear notifications in July and September about their employment dates. … Owen Li, a senior researcher for AFSCME Local 3299, said the UC has been increasing executive pay while cutting benefits for workers.  “The University of California literally wastes billions of dollars on hedge funds, management bloats and on these crazy executive perks,” he said.  The UC has 67 percent more overall staff than in 1993, and the number of senior managers has increased by 327 percent since 1993, Li added.  Li said most of the jobs UCLA is offering to current valet workers are part-time jobs, which he he thinks do not offer enough pay to live on. …

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Valet workers transferred from UCLA fear insourcing, loss of benefits
Source: Sharon (Yu Chun) Zhen, Daily Bruin, October 8, 2017
 
Edwin Cifuentes, a contracted valet worker at the Ronald Reagan UCLA Medical Center, said many valet workers who are being transferred away from UCLA are worried their new jobs will not offer them the same wages or benefits UCLA provided. … In August, UCLA ended its contract with ABM, a facility management company that employed valet workers like Cifuentes at the Ronald Reagan UCLA Medical Center. Although ABM had employed about 80 valet workers at the hospital, the university created about 35 in-house positions and has also hired part-time student workers.  Workers UCLA did not rehire are set to leave by Oct. 30, said Victoria Salgado, union organizer at American Federation of State, County and Municipal Employees Local 3299, the UC’s largest union. … Throughout the summer, ABM workers have protested the insourcing alongside AFSCME, including at the medical center in July and at the inaugural UC public law conference in September.  John de los Angeles, communications director for AFSCME, said when workers interviewed for the inhouse positions at UCLA, UCLA management discouraged workers from participating in union activities. In return, AFSCME issued a cease and desist letter in July. …

UC employees, students protest in support of contracted valet workers
Source: Sharon (Yu Chun) Zhen, Daily Bruin, July 31, 2017
 
About 500 University of California workers and students protested the Ronald Reagan UCLA Medical Center’s treatment of contracted valet service workers outside the medical center Friday.  Valet service workers, who help park visitor and guest vehicles at the medical center, are contracted through ABM, a facility management company. Beginning in August, however, the hospital will lay off many valet workers because it will no longer be contracting out valet services, said hospital spokesperson Tami Dennis. Instead, it will offer in-sourced full-time, part-time and student positions. … John de los Angeles, communications director of American Federation of State, County and Municipal Employees 3299, the UC’s largest union, said the medical center would only offer 30 positions for the in-sourced program, even though the program currently employs 80 workers.  Several students and workers said they think the hospital will carry out the layoffs because the contract workers received a pay raise. …

Consultant: BRF lacks cash, experience to adequately manage hospitals

Source: KTBS, October 10, 2017
 
Biomedical Research Foundation’s lack of cash could cause the state to lose funding for free and low-cost health care at the former public hospitals the foundation operates in Shreveport and Monroe.  Documents obtained by KTBS through an open records request show state officials are concerned the hospitals could lose Medicaid funding. That federal money helps cover the cost of treating poor people without insurance at the hospitals BRF operates as University Health through a wholly-owned subsidiary.  In September, state officials put BRF on notice it had breached its contract to operate the hospitals, in part because BRF has failed to pay doctors at LSU Medical School in Shreveport for treating patients. BRF also owes the state for a lease on the hospital property. …

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$135M boost going to LSU hospital managers under new deals
Source: Melinda Deslatte, Associated Press, October 27, 2016

The private operators of LSU’s charity hospitals and clinics are in line for a $135 million boost in their payments as part of new deals struck by Gov. John Bel Edwards’ administration, and the university’s medical schools will benefit from some of the new money. State lawmakers are being asked Friday to increase financing for the privatization deals to nearly $1.3 billion in the current budget year, only four months after lawmakers were told the previous level of funding was sufficient. … The money for the hospital and clinic operators is part of a larger budget adjustment requested by the Louisiana Department of Health at Friday’s meeting of the joint House and Senate budget committee. Jeff Reynolds, chief financial officer for the health department, said $135 million is a financing increase for the private managers that have taken over LSU’s hospitals, clinics and patient services. He said the additional payments are part of the renegotiated deals recently worked out by the Edwards administration. … The renegotiated privatization deals crafted by the Edwards administration included provisions in which some of the hospitals will be paying more money for the services of LSU’s doctors who work at the hospitals. … Henry said he wanted to know why the dollars weren’t available when lawmakers were crafting the budget in June, when they were told the previous level of agreed-upon financing was sufficient for the privatization agreements. …

Negotiating over, Edwards makes offers on LSU hospital deals
Source: Melinda Deslatte, Associated Press, September 7, 2016

Gov. John Bel Edwards’ administration will make its offer Thursday to the operator of LSU’s hospitals in Shreveport and Monroe for a renegotiated contract with the state, as the governor pushes to rewrite all the LSU hospital privatization deals. Edwards’ lead negotiator on the contracts, Commissioner of Administration Jay Dardenne, said Thursday’s presentation to the Biomedical Research Foundation of Northwest Louisiana is the last offer to be made. … Dardenne wouldn’t provide details about what changes are being sought in the north Louisiana hospitals’ deal — or any others. But he said negotiations are over and hospital operators can either take or leave the reworked arrangements offered. … Former Gov. Bobby Jindal privatized nine LSU-run hospitals and their clinics through no-bid contracts, with the earliest deal starting in April 2013. In most instances, the management company of a nearby hospital took over operations. Three contracts closed an LSU hospital — in Baton Rouge, Lake Charles and Pineville — and shifted its services to private hospitals. The Edwards administration says the deals were too hastily slapped together, with terms that aren’t favorable to the state. … LSU System President F. King Alexander described the arrangement to have the foundation, known as BRF, run the Monroe and Shreveport hospitals as dysfunctional from its start in October 2013. Alexander said the research foundation, which runs the two hospitals as the University Health System, doesn’t have the resources or experience, isn’t paying bills on time and isn’t providing enough support to the LSU medical school in Shreveport. BRF and University Health leaders say Alexander’s accusations are untrue and LSU’s Shreveport medical school has financial problems of its own making. They say the research foundation’s hospital management has improved health care. …

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Council urges Univ. of Memphis to decline state outsourcing contract

Source: Michelle Corbet, Memphis Business Journal, September 20, 2017

With the University of Memphis’ next Board of Trustees meeting set for early October, members of the Memphis City Council are asking that the group think twice before opting into the state’s facilities management contract. It’s no secret the University of Memphis plans to opt into the state’s property management contract, said Councilman Martavius Jones, who sponsored a resolution Sept. 19 urging local universities and their administrators to do the opposite. In May, the State of Tennessee entered into a contract with Chicago-based JLL to privatize maintenance, security, janitorial and landscaping services for state-owned public colleges and universities. “Based on my experience on the school board, the quality of the service, the cleanliness and the general morale suffered [when outsourced],” said Jones, who served on the Memphis City Schools Board from 2006 to 2013. …

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Does Outsourcing Some State Jobs Save TN Taxpayers Money?
Source: Local Memphis, August 31, 2017
 
Many Tennessee lawmakers hope to see if outsourcing some state jobs actually saves taxpayers money. It’s been a controversial topic since Governor Bill Haslam began implementing the idea a few years ago.  Questions about outsourcing are always the same. Does it save money and is there accountability?  “There’s… people concerned about state jobs all over Tennessee,” said one protester.  Many state lawmakers have heard and seen the protests about the ongoing outsourcing of state jobs. That’s why a majority of legislators from both parties signed a letter of concern earlier this year to Governor Haslam. The Governor has defended outsourcing state jobs in some areas, especially on state college campuses. …

UT campus workers protest Gov. Haslam’s outsourcing plan
Source: WBIR, August 28, 2017

University of Tennessee Knoxville staff, faculty and students joined local business leaders, state representatives and faith leaders in a demonstration Monday to call on university officials to “opt-out” of Gov. Bill Haslam’s outsourcing plan. The demonstration was organized by United Campus Workers. Last week, a bill to introduce oversight in outsourcing was heard in summer study in the General Assembly. If the university were to “opt-in”, United Campus Workers believe as many as 10,000 facilities jobs, including hundreds in Knoxville, would be outsourced. Those who oppose the plan fear it will result in job loss, loss of oversight and accountability, reduced services and negative consequences for local businesses which provide services to campuses. …

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WV officials unsure PEIA would benefit from privatization

Source: Phil Kabler, Charleston Gazette-Mail, September 19, 2017
 
Privatization of West Virginia’s Workers’ Compensation insurance was successful, particularly in lowering employer premiums and increasing competition, Brickstreet Insurance CEO Greg Burton told legislators Tuesday.  Whether those successes would apply to privatization of the state Public Employees Insurance Agency health insurance remains to be seen, he said.  “I’m not sure all the successes that happened with Workers’ Comp privatization, particularly with the decreases in rates…would translate over to PEIA,” he told a legislative interim committee studying PEIA. … According to a report on state employee health benefits published by the National Conference of State Legislatures on April 2, only two states exclusively use private insurers to provide health insurance to public employees, Idaho and North Dakota. According to the NCSL, 29 states, including West Virginia, have fully self-funded health insurance plans, while the remaining 19 states provide employees with coverage options, including self-funded plans. …

KDADS Secretary makes pitch to privatize Osawatomie

Source: Melissa Brunner, WIBW, August 30, 2017
 
The Kansas Dept. for Aging and Disability services is making the case to privatize the Osawatomie State Hospital.   Secretary Tim Keck presented information Wednesday to state lawmakers and community leaders. Over nearly two hours, Keck detailed the history Osawatomie, the issues it has experienced in recent years and steps the state has taken to address the problems.  Looking to the future, Keck detailed a bid from Correct Care Recovery Solutions to rebuild and run Osawatomie, which lost federal certification in 2015. Correct Care runs mental health facilities around the country. …

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State officials hope to replace, privatize Osawatomie State Hospital
Source: Peter Hancock, Lawrence Journal-World, August 30, 2017

State officials in Kansas began laying out their case Wednesday for why they think the state should replace the aging and troubled Osawatomie State Hospital with a new facility and hand over management of the facility to a for-profit, out-of-state corporation. Tim Keck, secretary of the Kansas Department for Aging and Disability Services, which manages the psychiatric hospital, said the hospital has become too challenging for the state to manage, and it is time for the state to make a decision. …

Kansas Lawmaker Leary Of Plans To Privatize Osawatomie
Source: Celia Llopis-Jepsen, KMUW, August 23, 2017

The Kansas Department for Aging and Disability Services has unveiled a proposal to build a new mental hospital at Osawatomie, which a Tennessee company would run. But Kansas House Minority Leader Jim Ward says the agency should be exploring in-house options. “This administration has a terrible history of privatization. Whether it be child support collection, DCF, KanCare,” Ward says. KDADS Secretary Tim Keck says the private operator would bring expertise and the ability to recruit mental health professionals. But, he says, his department is keeping an open mind. …

Kansas agency may privatize state psychiatric hospital working to regain federal funds
Source: Allison Kite, Topeka Capital-Journal, August 16, 2017
 
The Kansas Department for Aging and Disability Services is considering privatization for a troubled state psychiatric hospital that has now passed an initial step toward regaining some federal funding. KDADS Secretary Tim Keck said the department was considering a bid from Correct Care Recovery Solutions, which runs other mental health facilities across the country, to rebuild and privately run Osawatomie State Hospital.  The department also announced in a press release Wednesday that the acute care unit at the state psychiatric hospital had passed an initial survey required to get that part of the hospital re-certified by the federal Centers for Medicare and Medicaid. …

Kansas Official To Outline Privatization Plan For Osawatomie State Hospital
Source: Jim McLean, KCUR, August 14, 2017
 
One way or another, Tim Keck wants to replace the state’s aging Osawatomie State Hospital with a new mental health treatment facility.  Though he is meeting with some resistance, the secretary of the Kansas Department for Aging and Disability Services is pushing lawmakers to consider privatizing the state-run psychiatric hospital, which in recent years has been beset by operational problems.  On Tuesday Keck will outline a privatization plan submitted by a Tennessee-based company to stakeholders and legislators during a 1 p.m. meeting at hospital’s administration building. …

Osawatomie Contract Bidder Has History Of Safety Issues At Its Florida Psychiatric Facilities
Source: Meg Wingerter, KMUW, February 23, 2017

Correct Care Solutions, a Tennessee-based company that is the sole bidder for a contract to operate Osawatomie State Hospital, has a history of safety problems at the state psychiatric facilities it runs in Florida. Officials with the Kansas Department for Aging and Disability Services (KDADS) declined to provide details this week on Correct Care’s bid to operate Osawatomie State Hospital, one of two state facilities for people deemed a danger to themselves or others. The department is evaluating the proposal and hasn’t given a timeline for whether or when it would bring it before the Legislature. Under a law they approved last year, lawmakers must approve the contract before KDADS can move forward. …

‘Tough’ Budget: New Funding Unlikely For Kan. Mental Health System
Source: Meg Wingerter, Hays Post, February 12, 2017

A key Kansas lawmaker says the state doesn’t have the money to fix problems in its mental health system, which a new report says are getting steadily worse. The report, the second from a task force created in 2015 to advise the Kansas Department for Aging and Disability Services, says the system has continued to deteriorate. The task force’s first report, issued about 18 months ago, concluded the system was “stretched beyond its ability to provide the right care at the right time in the right place.” Rep. Brenda Landwehr, who chairs the House Social Services Budget Committee, agreed there are substantial gaps in the system but said lawmakers are virtually powerless to respond because of the depth of the state’s budget problems. … Given the amount of projected red ink, Landwehr said the state can’t afford to implement task force recommendations that would require significant new spending. Specifically, she said, it can’t afford to add psychiatric residential services for people covered by KanCare, the state’s privatized Medicaid program. … In the updated report, task force members also signaled their opposition to privatizing Osawatomie State Hospital, citing concerns about the quality of care delivered by for-profit contractors in other states. … More than 60 [House members] have signed on to a bill that would prohibit the privatization of either of the state’s mental health hospitals unless authorized by the Legislature. …

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Privatization considered at Osawatomie State Hospital
Source: Charity Keitel, Miami County Republic, November 23, 2016

After more than a year of improvements, renovations and the pursuit of recertification, the Osawatomie State Hospital’s (OSH) future continues to remain in a state of flux. Kansas Department for Aging and Disability Services (KDADS) Interim Secretary Tim Keck recently announced that a request for proposal (RFP) for privatization of the operation of OSH has been put into effect. The RFP entails several specifications and could allow for a partial privatization of the hospital or a full bid for the entire operation. The RFP states that the state may award one contract to assume responsibility for providing at least 206 inpatient beds within the state of Kansas, but a minimum of only 94 inpatient beds would be required to be maintained at the current Osawatomie State Hospital campus. The remaining beds could be maintained at the OSH campus or at another KDADS-approved facility within the state hospital’s 45-county catchment area. Despite the RFP, Keck said it in no way means that privatization is a certainty in OSH’s future. He said he believes it is worthwhile to consider all the options even those that may not come to fruition. The RFP can be rescinded at any time for any reason at the state’s discretion. … Jones went on to say that he does not agree with an RFP that plans to move beds away from OSH and not increase functions there. He said the RFP seems to allow for a move of beds away from the state hospital as an option, which he does not favor. … It’s his belief that the legislators need to push back and make sure the RFP does not make it through the legislature. …

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More funding, accountability for VA Choice program proposed, now what?

Source: Steff Thomas, Federal News Radio, August 7, 2017

Veterans Affairs Secretary David Shulkin received his wish last week as the House passed a bill that will add an additional $2.1 billion for the Veterans Choice Program. The bill, also known as the Choice Act, was introduced just weeks before the current Choice program funding was set to expire, and passed as a last-minute decision before Congress left for the August recess. One question that still lingers is, if passed into law, how will that money be spent? In an interview on the Federal Drive with Tom Temin, Shulkin outlined in detail some of the ways the Veteran Affairs Department would use the extra funds in a system of modernization projects, construction of new facilities and comprehensive public-private sector partnerships.

… These private-public partnerships would allow veterans to get best-in-class care at VA facilities and, when they needed to, take advantage of the services from community providers. It would alleviate some waiting times and give veterans more options for health care. Shulkin strongly urged that this idea was not an attempt to privatize VA operations, but to create a stronger and more modern system. He said even President Donald Trump’s budget proposal was supportive of improving more services within the VA, and not at all representative of someone supporting privatization. …

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How VA Reform Turned Into a Fight Over Privatization
Source: Russell Berman, The Atlantic, July 17, 2017

In 2014, the Department of Veterans Affairs was mired in a scandal. An inspector general’s report had found “systemic” manipulation by government officials to hide lengthy and growing wait times at its medical centers. … Spurred to action, Congress created a program aimed at temporarily alleviating the strain on the VA: Veterans who lived more than 40 miles from a health-care facility or who had to wait more than 30 days for an appointment could take their benefits outside the system and seek treatment from private doctors. …The Choice Program, as it was called, would allow veterans to get the care they needed while giving policy-makers time to make broader fixes at the Department of Veterans Affairs, which suffered from mismanagement and insufficient resources. Three years later, attempts by Republicans in Congress and the Trump administration to extend and significantly expand the Choice Program have given these groups and leading Democrats a new worry: a creeping privatization of the VA. …

Senate Easily Confirms Trump Pick of Shulkin as VA Secretary
Source: Hope Yen, Associated Press, February 13, 2017

The Senate on Monday easily confirmed physician David Shulkin to be secretary of Veterans Affairs, charged with delivering on President Donald Trump’s campaign promises to fix long-standing problems at the department.  Senators voted 100-0 to approve the former Obama administration official, who was the VA’s top health official since 2015, in a rare show of bipartisanship amid partisan rancor over Trump’s other nominees. Shulkin secured the backing of Senate Democrats after pledging at his confirmation hearing to always protect veterans’ interests, even if it meant disagreeing at times with Trump. … The 57-year old physician has ruled out fully privatizing the agency and says wide-scale firings of VA employees are unnecessary, describing the VA workforce as “the best in health care.” … The immediate challenge includes revamping scheduling and access for VA medical appointments following a 2014 wait-time scandal. Shulkin is urging a more integrated VA network where veterans could seek outside private care only in coordination with the VA. He has not sketched out full details. “We’ve yet to hear from him how he’ll pursue President Trump’s vision for a public-private partnership at the VA,” said Dan Caldwell, policy director for the conservative group Concerned Veterans for America. …

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