Category Archives: Health.Care

County rejects Claremont privatization pitches

Source: Zack Hoopes, The Sentinel, April 25, 2016

The county’s quasi-controversial interest in further privatization at the Claremont Nursing and Rehabilitation Center appears to have come to a halt. The Cumberland County Commissioners voted unanimously yesterday to reject all offers received from vendors to completely take over the food, housekeeping, and laundry departments at the county-owned nursing home. After reviewing the bids received last month, county staff recommended to the commission that none of the offers were worth it. … In February, the commissioners had voted to issue a bid solicitation for vendors to run Claremont’s auxiliary functions. Currently, an outside management company – Sodexo – is responsible for the cash flow. But the 75 workers in the food, laundry, and housekeeping services are county employees. If the county were to go through with it, the proposal would have had those jobs become private-sector.

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County to get proposals on privatization of some nursing home functions
Source: Zack Hoopes, The Sentinel, February 1, 2016

Cumberland County has committed to at least testing the waters a bit when it comes to further outsourcing at the Claremont Nursing and Rehabilitation Center. The county’s’ Board of Commissioners voted two-to-one Monday to issue a request for proposals for an outside contractor to completely take over the food, housekeeping, and laundry departments at the county-owned nursing home. … Approximately 75 employees would be affected if the county were to move forward with such a proposal, which would not directly impact nurses or any other medical staff. Bids are due back March 10, with Sodexo or any other qualified company able to make a pitch. … The 65-page bid specification the county issued lays out, in detail, how the outside vendor would be required to maintain the current levels of quality and service. It also specifies that employees bound by collective bargaining agreements are to keep their jobs – the 75 employees in the food, housekeeping, and laundry operations are unionized.

Springfield Hospital workers ask Hogan to reconsider possible job cuts

Source: Jon Kelvey, Carroll County Times, March 31, 2016

A half-dozen food service workers from Springfield Hospital Center fanned out around a strip mall of small businesses in Eldersburg on Thursday afternoon, each clad in the bright green T-shirts of the American Federation of State, County and Municipal Employees, to protest potential job cuts on the horizon. Gov. Larry Hogan’s proposed fiscal year 2017 budget would eliminate 57 food service positions at the facility, and the workers were there to speak with local business owners and the community about their plight. … Hogan’s budget eliminates funding for the food service jobs at Springfield, presumably bringing in a private contractor to handle service, with a projected savings of $1 million, according to Jeff Pittman, a union spokesman. He and the food workers present Thursday afternoon are not so sure that’s as good a deal as it sounds.

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Springfield Hospital workers, local business leaders question Hogan over proposed job cuts
Source: Kevin Rector, The Baltimore Sun, February 27, 2016

The move, which the state health department has said would save $1 million, has been questioned by legislative leaders in Annapolis who cite the fact that the state is projected to have a $400 million surplus this year. … Matthew A. Clark, a Hogan spokesman, has said the administration is working to make sure employees who lose their jobs find new ones, in state government or elsewhere. He said Hogan is “focused on making sure every state agency runs as efficiently as possible while delivering the best service to taxpayers.”

Editorial: Hogan’s penny pinching
Source: The Baltimore Sun, January 28, 2016

… Thanks to a rebounding economy, Maryland now expects to finish the current fiscal year with about $420 million more in tax collections than analysts expected at this time last year. The budget for the current year, fiscal 2016, is in “structural balance,” meaning that ongoing revenues exceed ongoing expenditures … Despite the flush balance sheet, the governor has made a number of penurious decisions. He is funding step increases for state workers but not a general cost-of-living increase. He is eliminating a net of 553 positions in state government (though most of them are currently unfilled). … Moves like outsourcing food service at Springfield Hospital (and the Regional Institute for Children and Adolescents-Gildner) may result in greater efficiency, or they may result in worse service. Deciding not to give state workers a raise at a time when state revenues are coming in much higher than expected may help put the governor in a position to offer substantial tax cuts in the years ahead, but it may also contribute to low morale, high turnover and poor performance.

Some question Maryland layoffs given budget surplus
Source: Michael Dresser, Baltimore Sun, January 26, 2016

The jobs of dozens of low-level state workers at the Springfield Hospital Center in Sykesville are on the chopping block in Gov. Larry Hogan’s $42 billion proposed state budget. … Senate President Thomas V. Miller questioned Tuesday whether the job cuts are necessary when the state is projecting a surplus of more than $400 million this year. … Warren Deschenaux, the General Assembly’s chief fiscal analyst, said Tuesday that his agency had yet to receive a full accounting of the 553 state positions slated for abolition under Hogan’s budget proposal. He said his understanding is that about 100 positions would be contracted to private firms. … It was not clear how many of the abolished positions are vacant and how many would involve layoffs. Hogan administration officials declined to provide specific layoff figures Tuesday. …

Bump okays privatization of SEMass mental health services

Source: New Boston Post, March 31, 2016

In a win for the Baker administration, Auditor Suzanne Bump on Wednesday approved the privatization of government mental health services in southeastern Massachusetts, citing $7 million in savings and drawing a sharp rebuke from a union president who says the clearance threatens critical services. The Department of Mental Health’s privatization proposal affects emergency mental health services in a region covering Brockton, Fall River, the Taunton and Attleboro areas, and Cape Cod and the Islands. Under the proposal, the Massachusetts Behavioral Health Partnership (MBHP) will contract with Bay Cove Human Services Inc. and Community Counseling of Bristol County to provide services. … To assess the quality of services under a private contractor, Bump’s staff visited facilities and met with community members, department officials and MBHP officials. The auditor determined that all services currently provided will be provided under the MBHP model “but at a lower costs while maintaining the same quality.”

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Auditor OKs plan to privatize some mental health services
Source: Associated Press, March 30, 2016

State Auditor Suzanne Bump has approved a proposal from the state Department of Mental Health to privatize emergency mental health services in the department’s southeastern region. Bump said Wednesday the change could save $7 million over one year. … The area includes Brockton, Cape Cod and the Islands, Fall River, Taunton and Attleboro. Under the proposal, the Massachusetts Behavioral Health Partnership will contract with Bay Cove Human Services, Inc., a Boston Medical Center subcontractor, and Community Counseling of Bristol County to provide the services.

Senate passes disability bill, adds privatization provision

Source: Associated Press, March 18, 2016

The Kansas Senate has passed a bill intended to define and streamline the process for a shared living program for adults with mental illness and developmental disabilities. The Wichita Eagle reports that the bill passed by a vote of 31-5 after hours of debate Thursday. Before the bill was passed, a provision was added that would require the Kansas Department for Aging and Disability Services to seek legislative approval before privatizing facilities. The agency says the bill would enable it to re-establish a shared living program that allows adults with developmental disabilities or other disorders to be placed with a care provider. The agency temporarily suspended the program in October.

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Kansas Senate disability bill sparks privatization fears
Source: Bryan Lowry, Wichita Eagle, March 17, 2016

The Kansas Department for Aging and Disability Services says that a piece of legislation will enable the agency to re-establish a program for people with mental illness and developmental disabilities. However, some lawmakers say the bill would enable the agency to privatize facilities and avoid legislative oversight. SB 422 eventually passed by a vote of 31-5 Thursday after hours of debate, but only after it was amended to include a provision that would require the agency to seek legislative approval before privatizing facilities. … Several lawmakers alleged that the bill was actually meant to enable the agency to privatize facilities. Sen. Marci Francisco, D-Lawrence, scrutinized a clause in the bill that she argued would give the agency broad powers to privatize. Angela De Rocha, the agency’s spokeswoman, said that lawmakers were misreading the bill. She said the bill was meant to enable the agency to license subcontractors for the shared living program. She said the fact that the subcontractors weren’t licensed by the agency caused the moratorium to go into effect in the first place. Sen. Caryn Tyson, R-Parker, brought an amendment to restrict KDADS from privatizing without legislative approval, easing the minds of lawmakers who had concerns about the bill and allowing it to pass.

Saratoga County cuts home care programs

Source: Paul Post, Troy Record, March 20, 2016

Saratoga County is terminating its home health and long-term home care programs Monday, a move that will save $400,000, but eliminate 12 jobs. CSEA Local 1000, which represents employees, criticized the cuts, saying workers and patients were given about 30 days’ notice – a decision made secretively without public input or review. But county Administrator Spencer Hellwig said home services are no longer needed because six other private agencies now provide the same type of care. … Eight full- and two part-time nurses lost jobs along with six clerical workers. Six others, both nurses and clerical workers, took jobs elsewhere within the Public Health Department. Some employees decided to retire. The home health agency program was caring for 25 local residents. However, most were short-term patients recovering from surgery or in similar circumstances. There was one long-term patient, Hellwig said. … The visiting nurse program’s elimination is the second major cut in county healthcare in the past year. In early 2015, the county completed sale of its nursing home, Maplewood Manor, to a private Long Island-based firm. The nursing facility had been costing the county more than $10 million annually, raising concerns from the state comptroller’s office about the county’s overall fiscal condition.

Connecticut Moves Away From Private Insurers to Administer Medicaid Program

Source: Melinda Beck, Wall Street Journal, March 18, 2016

In 2012, Connecticut fired the companies that were running Husky, as its Medicaid system is known, and returned to a more traditional “fee-for-service” arrangement where the state reimburses doctors and hospitals directly. State officials, physicians and patient advocates have welcomed the move: Average cost per patient, per month, is down from $718 in mid-2012 to $670 last year, according to state data. The number of doctors willing to treat Medicaid patients is up 7% and as a result fewer patients are using emergency rooms for routine care. … Once known as “the insurance capital of the world,” Connecticut had 11 companies offering Medicaid managed-care plans in 1995, each with different rules and reimbursement rates. Industry consolidation, battles over rates and other disputes whittled that down to four by 2000—near the minimum required by federal law—which some observers say limited the state’s ability to bargain and enforce rules. Patient advocates complained about denied services, delayed payments and inadequate provider networks. In a state-sponsored survey in 2006, only one in four callers posing as Husky patients was able to get an appointment with a network doctor; the others encountered erroneous listings or refusals to see Medicaid patients. State officials, meanwhile, were frustrated by the plans’ refusal to share data on costs and claims, prompting lengthy court battles.

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Conn. has big Medicaid change in works
Source: Mary E. O’Leary, New Haven Register, February 09, 2011

HARTFORD — Gov. Dannel P. Malloy’s administration, in a major break from the past, will drop the for-profit managed care organizations from running the state’s huge Medicaid program and also beef up a transition that takes seniors out of nursing homes and provides services to help them live in their own communities.

The state is projected to pay $3.96 billion for Medicaid services this year, one of its most costly commitments out of a $19.01 billion budget. Ellen Andrews, of the Connecticut Health Policy Organization, said its studies projected a savings of $40 million for switching HUSKY clients alone to the new model, but that adding the elderly, disabled and blind population could double that.

Wyman said under the new system, the state will assume the risk of paying medical claims, but it will now know what it is paying for and with 600,000 people in a network, there will be more predictability and accountability. The MCO contracts are costing the state $863.6 million this year.

Arkansas Legislators Concerned About Privatizing Home Health Care

Source: Valerie Van Booven, Home Care Daily, March 15, 2016

This move has some legislators worried that some services may no longer be available for those who need it, especially elderly and disabled who reside in rural areas of the state. The Department of Health sent out notice to more than 500 state employees and 1,800 contract workers who have some involvement in the in home care aspect of the state to inform them that this sale would occur sometime in the summer of 2016. Essentially, according to Department of Health Director Nathanial Smith, the program that’s currently in place is no longer sustainable. … Not all are happy with this decision, like Sen. Larry Teague, D-Nashville, who states that the state program is the only one in certain areas that provides these types of services and is concerned that those who rely on this level of care might not receive it when the entire program is privatized. …

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In-home care in ’16 to go private
Source: Shea Stewart, Arkansas Democrat-Gazette, August 11, 2015

The Arkansas Department of Health on Monday alerted about 500 state employees and 1,800 contract workers that the department’s in-home services program will move to a private-sector provider sometime in 2016. The notification came via a letter from Dr. Nathaniel Smith, department director. The program, started in 1981, offers hospice, home health care, personal care and other services to about 13,000 patients … Department officials don’t expect a disruption in services while transferring the program from the state to one or more private vendors, Smith said in an interview Monday. The transition is expected to take about six months.

Arkansas ending out home health program, affecting more than 2,300 workers and contractors
Source: Andrew DeMillo, Associated Press, August 10, 2015

Arkansas health officials announced Monday that the state is ending a home health care program that serves thousands of people, a move that could leave 2,300 workers and contractors seeking new jobs. … About 13,000 people are served by the program, which provides in-home services such as health care and hospice. Smith said in the letter that the department would help those served by the program move to a private provider over the next several months. About 500 Health Department employees work on the program, along with another 1,800 who contract with the state. A spokeswoman for the department said the agency didn’t have a definite end date for the program, and Smith wrote the process would take at least six months. Smith said the state would assist workers as they try to find jobs with a private provider or elsewhere in state government.

Superbugs vs. Outsourced Cleaners: Employment Arrangements and the Spread of Healthcare-Associated Infections

Source: Adam Seth Litwin, Ariel C. Avgar, Edmund R. Becker, Industrial and Labor Relations Review, Forthcoming, February 24, 2016

Abstract:

On any given day, about one in 25 hospital patients in the U.S. has a healthcare-associated infection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately, the spread of most HAIs can be halted through proper disinfection of surfaces and equipment. Consequently, cleaners — “environmental services” (EVS) in hospital parlance — must take on the important task of defending hospital patients (as well as employees and the broader community) from the spread of HAIs. Nevertheless, despite the importance of this task, hospitals frequently outsource this function, increasing the likelihood that these workers are under-rewarded, undertrained, and detached from the organization and the rest of the care team. As a result, the outsourcing of EVS workers could have the unintended consequence of increasing the incidence of HAIs. We demonstrate this relationship empirically, finding support for our theory by using a self-constructed dataset that marries infection data to structural, organizational, and workforce features of California’s general acute care hospitals. The study thus advances the literature on nonstandard work arrangements — outsourcing, in particular — while sounding a cautionary note to hospital administrators and healthcare policymakers.

Chicago Teachers Union says outsourcing nurses bad for students

Source: Juan Perez, Chicago Tribune, February 23, 2016

The Chicago Teachers Union wants the district to scrap a multimillion-dollar deal for outsourced school nurses, saying in a newly released report that hiring nonunion nurses puts the system’s 400,000 students at risk. The union-produced report says “privatizing the nursing department will create a health disaster in Chicago,” and calls on Chicago Public Schools to hire a full-time registered nurse for each school, as well as additional support staff. … CPS has turned to private contractors to supply nurses before, but the union report argues the latest deal is intended to “eventually eliminate the union nursing positions” and replace them with temporary staffers who don’t receive employment benefits that include pensions.

Read full Report.

Editorial: Fix formula for privatization

Source: Lansing State Journal, February 19, 2017

The State of Michigan has nearly 1,700 privatization contracts. Undoubtedly, many of them are beneficial for taxpayers and for government. But not all privatization makes sense, which is why there is a process by which the Civil Service Commission determines whether privatization will result in significant savings. What happens, however, if the state’s system of vetting privatization opportunities relies on faulty math? In the case of several Michigan contracts, the projected savings don’t even come close to the actual realized savings. A Lansing State Journal analysis of 23 privatization deals approved last year showed the state saved nearly $61 million less than projected. That’s because the current formula is flawed, allowing agencies to include savings on retirement debt. The catch, however, is that debt must be paid whether the jobs remain with the state or move to a contractor. … The cost of the state’s pension and health care liabilities is a problem independent of privatization of services. But the fact that current calculations tip the scales in favor of privatization is troubling. The state, and Civil Service Commission by proxy, must make decisions in the best interests of taxpayers on the issue of privatization. That review must begin with a formula that makes sense – one that acknowledges long-term retirement costs don’t go away when state jobs do.  Privatization is not bad. Neither are state-worker jobs. It’s incumbent on the state to use clear, defensible metrics to determine which option is best in each circumstance.  The current formula is broken. Michigan must fix it.

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Michigan’s privatization savings overstated
Source: Justin A. Hinkley, Lansing State Journal, February 17, 2017

State guidelines on privatization allow agencies to count savings on retirement debt that has to be paid whether or not the jobs are outsourced. If that debt were not factored in, a State Journal analysis showed three contracts OK’d by the state Civil Service Commission last year — worth more than $92 million — would never have been approved because they didn’t actually save enough money to meet the commission’s threshold for privatization. Those contracts affected 265 state-worker jobs. The State Journal analysis was based on what Roland Zullo, a University of Michigan researcher working with state-employee unions on this issue, said is the more accurate calculation.

Using Zullo’s method, the State Journal analysis showed the 23 privatization deals approved last year saved nearly $61 million less than what state officials reported, though most contracts still would have saved enough taxpayer money to be approved. No state employees were laid off through privatization last year; many of the 23 deals approved last year were re-analyses of previously approved outsourcing. That’s because, when Civil Service compares the cost of state employees against the cost of a potential contract, it includes on the state employees’ tab what the government pays into its employee pension system, which was closed to new hires starting in 1997. However, as the Senate Fiscal Agency explicitly warned in a 2013 white paper, the debt to that system “must be funded regardless of whether employees remain directly hired by State or local government, or privatization occurs.” Currently, Civil Service guidelines claim privatization saves departments about 50 cents of retirement costs for every $1 in state employee wages. Zullo says the true savings is only 9 cents on the dollar, the amount the state chips in to employees’ 401(k) plans and retiree health care. Only one employee affected by the 23 deals approved in 2016 was on a pension plan. …

Opinion: Privatization does not Work
Source: Ron Bieber, Michigan AFL-CIO President, Detroit News, March 9, 2016

Six years ago, Republicans swept into Lansing after promising to “make government run like a business.” It was a catchy slogan. The trouble is, we as voters didn’t do such a great job asking hard questions about what running government like a business actually meant. For Gov. Rick Snyder and the Republican-controlled Legislature, it meant privatizing vital public services in our schools, prisons and a state-run home for veterans. The goal of privatization, we were told, was to save taxpayers’ money. The truth is the state’s two biggest experiments with privatization have been huge failures.

First came the prison food contract with Aramark. The trouble started when the Legislature rigged the bidding process by giving Aramark a do-over after its initial bid came in too high, allowing it to low-ball competitors. The state approved Aramark’s contract even though it had a terrible track record — including a prison riot in Kentucky and rampant contract violations in Florida. Then came a steady stream of horrible news. There were persistent food shortages, maggots repeatedly found in food, drug smuggling, sexual contact with inmates and even a murder-for-hire plot. …

What happened at the Grand Rapids Home for Veterans was even worse. In 2011, the governor and Legislature privatized 150 nursing assistant jobs and awarded the contract to J2S, a company founded by two brothers — Tim and Chris Frain — who had no background in health care. The complaints of chronic staff shortages started immediately. One former J2S employee told a local TV station “there definitely were times where a member would sit in their urine or feces for extended periods of time because we were shorthanded.” A scathing report from the auditor general last month found employees routinely failed to respond to alarm checks, and J2S failed to investigate complaints of abuse and neglect. …

Unfortunately, Lansing Republicans might not have learned their lesson yet. Right now lawmakers are considering legislation to privatize mental health services, making it harder for people to get access to needed treatments and medications. This would be a big handout to insurance companies, and it’s another privatization disaster waiting to happen.