New Haven-based American Medical Response employees rallied on the Green Tuesday afternoon in the hopes that AMR will address safety concerns that first responders say affect them and the patients they serve. … IAEP union, Local 999, held the rally and listed the following claims: potentially hazardous working conditions at AMR stations; staffing issues that lead to paramedics and EMTs working extra-long shifts without warning; and complaints of an operations manager who is now often out of state, after his job was expanded to a regional role. … AMR Regional Director Chuck Babson said in a statement that the rally is taking place in the context of a union contract negotiation. Babson wrote that twice in recent months, AMR and union officials have agreed on “generous” pay and benefit packages but were rejected by union members. They will continue to negotiate in the hopes of reaching an agreement soon, he wrote. … Michael Montanaro, president of Local 999 and 21-year veteran, said contract negotiations with AMR have hit a stalemate and the longer hours have “overwhelmed” local first responders. AMR first responders handle a high call volume, he said, responding to between 85,000 and 100,000 calls each year.
Two legislative committees agreed Monday to allow the Department of Social Services to outsource case management work for about 500 people with acquired brain injuries, after defeating a similar proposal about four months ago. Officials from the Department of Social Services told the two committee that if they didn’t outsource these services they would have to move forward with hiring an additional 17 social workers, which is impossible to do now that the state has implemented a hiring freeze. … The state is projected to save about $353,515 in the first year of the contract, $542,171 in the second year, and $584,000 in the third year, according to an analysis by the Department of Social Services. … Brian Anderson, a lobbyist for AFSCME Council 4, the union that represents social workers in the department, urged lawmakers to reject the proposal. He called the outsourcing of case management work the “privatization” of state services.
… I used to work for the state Department of Transportation, in the construction division, so I know a little about this from personal experience. Engineers in DOT are now required to do a cost-benefit analysis on construction work that may be outsourced by DOT to for-profit consultant engineering firms, which perform inspection oversight work on highway construction projects. This is the same work that I used to do and that the DOT does with state employees on a regular basis. A current cost-benefit analysis provided by the Connecticut State Employees Association showed that in 2013-14, DOT in just this one unit could have saved the state $160 million to $180 million over two years. That is at least $80 million in savings each year — and the next, and the next, etc. When I worked for the DOT, the reason given for using consultant firms was that the work was of a special nature and of short duration. However, the work keeps on coming, and state employees could do it — and save taxpayer dollars — if the administration would hire more state employees. …
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.
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.
This past week, the Boston nonprofit Social Finance announced it helped design PFS projects launching in Connecticut and South Carolina.
The Connecticut project focuses on an in-home intervention for families where one or both parents struggle with substance abuse. The project will pay for new treatment teams to visit a client’s home several times a week to help parents end their addictions and provide better care for their children. It wasn’t immediately clear how much the program will cost, but it’s scheduled to serve 500 families over more than four years. Connecticut estimates that it spends more than $600 million a year on child abuse and neglect. If the new program is successful, it would ultimately save money by keeping kids with their parents and out of foster care, while also keeping parents productive and out of the judicial system.
South Carolina’s PFS project aims to improve health outcomes for mothers and children living in poverty. The new program is a so-called nurse-family partnership that pairs vulnerable first-time mothers with specially trained nurses to support healthy pregnancies and positive child development. About 27 percent of South Carolina’s children live in families struggling with poverty, according to the governor’s office. The project is being funded by $17 million from a handful of philanthropic organizations and about $13 million from Medicaid. The state will pay back up to $7.5 million to keep the program going if evaluators find it’s helping moms and kids stay healthy.
‘Government only pays for the positive outcomes.’ A strikingly new approach to social problems.
Source: Lenny Bernstein, Washington Post, February 16, 2016
Two states announced Tuesday that they would experiment with an unusual method of financing human service programs that allows governments to pay nothing unless the programs are successful. The approach recruits private companies and philanthropies to provide millions of dollars up front for efforts aimed at difficult social problems. If they meet a series of measurable goals over a number of years, the states will pay them back — with interest. …
Connecticut Gov. Dannel Malloy (D) announced Tuesday that his state would begin a $12 million, four-year initiative to help keep the children of 500 families out of foster care. Social workers from the Yale Child Study Center will work intensively to keep the children in their homes, focusing on parents with substance abuse problems. … No funder has yet been named for the initiative, but officials said several are interested. …
In South Carolina, Gov. Nikki Haley (R) announced a $30 million, four-year program that will send registered nurses who specialize in maternal and child health into the homes of low-income pregnant women. The nurses will help mothers learn parenting skills and how to keep their children healthy. The nurses will follow the families until the children turn 2. The program, expanding on an existing state effort, will be funded by organizations that include the BlueCross BlueShield of South Carolina Foundation, the Duke Endowment and the Boeing Co. It will be evaluated by a research group at the Massachusetts Institute of Technology, which will determine whether the program meets goals such as fewer pre-term births, fewer hospitalizations and emergency room visits, and longer intervals between births.
Gov. Dannel P. Malloy’s budget includes millions of dollars in savings through the privatization of living arrangements for dozens of developmentally disabled Connecticut residents, Hearst Connecticut Media has learned. Sources familiar with the governor’s budget plans, which will be unveiled Wednesday as the General Assembly begins to craft budget revisions to take effect July 1, said Tuesday that Southbury Training School would remain in operation for the state’s most profoundly disabled residents. But as many as 60 training school residents, as well as those from other long-term care facilitities, would be relocated to private providers. At least 30 developmentally disabled residents living in individual state-operated units would be shifted to privately owned homes to save about $6.2 million a year. It’s an effort to downsize the state’s operating capacity. …
A group of union and health care advocates are warning that allowing the Yale New Haven Health System to affiliate with Lawrence and Memorial Health will exponentially increase its market share and put upward pressure on prices. Vincent Petrini, senior vice president for public affairs at Yale-New Haven Hospital, took issue with the market concentration figures in the report, as well as speculation on price increases, the relative size of the Yale New Haven Hospital System and the methodology of groups analyzing quality care. … The proposal for L+M is one of five major hospital affiliations pending for action by OCHA. The report points out that if the five requests are approved, more than 80 percent of patients in the state will get their care at hospitals “owned by large, powerful multi-hospital systems.”
Critics seek hard look at Yale–L+M deal, hospital market power
group of unions and advocacy organizations are calling for state regulators to take a hard look at the growth in power and market concentration of large health systems in Connecticut – and what that means for patients – when they review the Yale New Haven Health System’s proposed acquisition of New London’s Lawrence + Memorial Hospital. “The acquisition of Lawrence + Memorial health by the Yale-New Haven Health Services Corporation is a pivotal opportunity for stemming the growth of monopoly in Connecticut’s health care market and limiting the ill effects of consolidation,” they said in a report issued Tuesday by seven groups: the unions AFSCME Council 4, AFT Connecticut, UNITE HERE! Connecticut, and New England Health Care Employees Union, District 1199, SEIU; the Connecticut Citizen Action Group; the Connecticut Health Policy Project; and United Action Connecticut.
This is a list of pending and recent significant federal and state law enforcement investigations of, and actions against, for-profit colleges. It also includes some major investigations and disciplinary actions by the U.S. Department of Education and Department of Defense. It does not include investigations or disciplinary actions by state education oversight boards. It also does not include lawsuits prosecuted only by private parties — students, staff, etc. To date, 37 state attorneys general are participating in a joint working group examining for-profit colleges, according to the office of Kentucky Attorney General Jack Conway. Many of those are actively investigating specific for-profit colleges in their states.
The town’s proposal to create a combined dispatch center with Cheshire and North Haven is similar to a 2012 project in Danbury and a more recent proposal in Montville that ultimately failed because of union contract negotiations and questioning of the potential benefits…Mayor William W. Dickinson Jr. said Monday he was aware of a variety of factors behind other municipalities’ failing to create a combined dispatch center, but emphasized the town was in the preliminary stages of the project. “It’s not simple, but I know that the state is very — from what I’ve been told — very interested in encouraging the regionalization of this dispatch (center),” Dickinson said…Dickinson has said state officials are encouraging municipalities to consolidate dispatch centers…In Wallingford, dispatchers at the police and fire departments are members of Council 4 of the American Federation of State, County and Municipal Employees. Larry Dorman, a spokesman for Council 4, said Monday that he couldn’t comment on the project in Wallingford because the union has not been approached by the town…“I don’t want to sound like we’re against it, but there are a lot of drawbacks and you just have to make sure workers are a part of discussions and see if the rewards outweigh the risks,” he said. “When talking about public safety, it’s not a good idea to compromise public safety.”
After nearly 74 years of service, Griswold Ambulance is no longer serving the town of Griswold. American Ambulance officially became the ambulance provider for the town Friday after Griswold Ambulance relinquished its primary service area agreement, or PSA, to the state. The state Department of Public Health hearing originally scheduled for Tuesday has been cancelled now that Griswold Ambulance has returned its PSA. The state reissued the PSA to American Ambulance Friday. First Selectman Kevin Skulczyck said he’s looking forward to a long relationship with American Ambulance. Currently, the company has a set term of 10 years. “Griswold is joining a growing group of towns being served by American Ambulance,” Skulczyck said. “I want to express my appreciation for Griswold Ambulance’s years of service.” Griswold Ambulance was founded by the American Legion in 1941. On June 30, Griswold Ambulance ceased operation after the company’s worker’s insurance compensation ran out. By law, Griswold Ambulance had to provide worker’s compensation insurance or have its licenses suspended. American Ambulance has been filling in since July 1 per an agreement with the town and Griswold Ambulance.
American Ambulance to fill in for Griswold Ambulance at midnight
Source: Jaclyn Diaz, Norwich Bulletin, June 30, 2015
American Ambulance will provide ambulance services for Griswold starting Wednesday because Griswold Ambulance worker’s compensation insurance ran out at midnight and it must cease operating….By law, Griswold Ambulance must provide workers compensation insurance or have its licenses suspended…[First Selectman Kevin Skulczyck] said a representative from Griswold Ambulance approached him two weeks ago requesting money to pay for the workers compensation insurance. Skulczyck said he denied it because there was no allocation in this year’s budget…“I would assume those who have only counted on public funding know that you need to apply or at least put in a request for money,” he said. “We can’t just stroke a check for twenty grand to cover your workers’ comp.”
Griswold ambulance saga set for state hearing July 21
Source: Jaclyn Diaz, Norwich Bulletin, June 28, 2015
The final chapter in the American Ambulance saga is set to begin July 21. That’s when town representatives, American Ambulance and Griswold Ambulance will meet for a Department of Public Health hearing that will decide the fate of the town’s application to use American Ambulance as the Griswold’s emergency services provider. Voters overwhelmingly decided in January to act on contracting with American Ambulance. If accepted, a new contract will terminate the town’s relationship with Griswold Ambulance that began in 1941.
Griswold residents to vote on ambulance service decision Jan. 20
Source: Elizabeth Regan, Norwich Bulletin, January, 11, 2015
A decision by Griswold’s Board of Selectmen to authorize American Ambulance Service Inc. as the town’s ambulance provider will be put to its first test Jan. 20. That’s when voters will be given the opportunity to say yes or no at a town meeting at Griswold High School…The exact wording of the question being put to a vote will be available pending approval by the town’s counsel, according to the office of First Selectman Kevin Skulczyck…Selectmen have expressed support for the option in the company’s bid proposal that said it would operate one in-town basic life support ambulance 24 hours a day at no cost to the town, with backup and paramedic service available through its Norwich headquarters…. Griswold Ambulance consultant Bob Holdsworth said voting on a provider before a contract has been established will leave voters unsure what they’re actually deciding…“What’s the actual, contractual promise? That’s not been identified,” Holdsworth said. “Until it’s signed, it doesn’t exist.”