Category Archives: Home.Health

US government failing millions by paying below $15 an hour, study finds

Source: Mike Elk, The Guardian, August 10, 2018
The federal government employs more workers making less than $15 an hour than any other employer in the US, a new report has revealed.  The study, compiled by pro-union group Good Jobs Nation, analyzed federal data and showed that the government spends more than $1.6tn on federal contractors employing more than 12.5 million people with 4.5 million of those workers making below $15 an hour.  Many of these workers are employed by contractors as janitors, cafeteria workers, call center workers, administrative assistants and healthcare aides, and union campaigners say they are being kept on poverty wages. …

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Home care registry bill on Gov. Charlie Baker’s desk could lead to lawsuit

Source: Shira Schoenberg, MassLive, November 15, 2017
A bill creating a registry for home care workers is back on Gov. Charlie Baker’s desk, to the dismay of home care workers who are considering a court challenge.  “This legislation exposes these essential frontline direct care workers to enormous privacy and due process violations,” wrote advocates for the home care workers in a statement.  The bill, H.3821, would require home care workers who work for state-contracted agencies to include in a database their name, home and mailing addresses, gender, job title, and training or certifications. The information could be reported to labor unions, home care worker agencies and private organizations that have state contracts to connect people with elder services. …

State Contractor Accused of Denying Overtime Pay to Thousands of Pennsylvania Home Care Workers

Source: Business Wire, May 12, 2017
A major state contractor has been accused of systematically failing to pay overtime wages to thousands of home care workers in Pennsylvania in a lawsuit filed Thursday in federal court. The suit alleges Public Partnerships, LLC, a subsidiary of the nationwide management consulting firm Public Consulting Group, knowingly refused to pay workers for overtime despite its active role in hiring employees, administering services and issuing paychecks, a violation of federal and state laws governing wages and labor conditions. The issues raised in the case mirror those at the forefront of ongoing litigation throughout the country on joint employers and their responsibilities to their workers. …


Performance Audit: Department of Public Welfare’s Oversight of Financial Management Services providers
Source: Commonwealth of Pennsylvania, Department of the Auditor General, November 2013

From the press release:
Auditor General Eugene DePasquale today said an audit of a Department of Public Welfare shows long-term mismanagement of home care worker payroll providers caused undue financial and emotional strain on tens of thousands of people. Thousands of workers had paychecks delayed for up to four months. … Beginning in December 2008, DPW had agreements with 36 different providers for payroll services of home care workers across the state. However, from 2009 through 2012, auditors found that DPW did not adequately monitor these providers resulting in numerous instances of noncompliance with applicable state and federal laws, regulations, and financial services standards by some of the providers. … DPW issued a request for applications in January 2012, and in August 2012 selected the Boston, Mass.-based vendor, Public Partnerships Limited, to provide payroll service statewide. In the short time frame that DPW had to transition 20,000 care recipient files to Public Partnerships Limited, DPW ignored many red flags — including concerns expressed by the vendor — that the new vendor was not fully prepared to pay all direct care workers by the DPW-imposed Jan. 1, 2013 deadline. The audit also found significant flaws in the procurement process used to select Public Partnerships Limited. …
Audit Summary

Lawmakers Hear Testimony Concerning Privatizing DDS Care

Source: Todd Piro, NBC Connecticut, March 8, 2017

Beverly Laporte of East Hartford worries about what will happen to her son Robbie if he is moved from his group home in South Windsor to private care. Laporte joined others at the Legislative Office Building in Hartford on Tuesday, testifying in front of the Public Health Committee against privatizing Department of Developmental Services care for their relatives. … At issue, of course, is money. Non-profit providers, through The Alliance, which provides a voice for community non-profits, say they can provide the highest quality of care at a fraction of the cost, saving the cash-strapped state $150 million dollars per year in residential care alone. … Some like Laporte are not convinced, arguing that because many private employees in the caregiving field are paid less than their public counterparts, there is a high turnover rate that hurts continuity of care. … Wednesday’s testimony was just one part of the larger battle that will be going on throughout the session.


Connecticut unions say state needs to negotiate privatization
Source: Christine Stuart, New Haven Register, October 13, 2016

Two state unions representing workers at the Department of Developmental Services filed a lawsuit Thursday alleging the state can’t move forward with privatizing group homes without negotiating first with the unions. The Connecticut State Employees Association, SEIU Local 2011 and New England Health Care Employees Union District 1199 sought an injunction in Hartford Superior Court to stop the privatization from moving forward until negotiations are completed. Department of Development Services Commission Morna Murray announced in August that the state was moving forward with a plan to convert 30 group homes to private operation by Jan. 1, 2017. The agency also closed two regional centers in Meriden and Stratford. The plan is expected to save the agency $42 million in 2017 and $70 million in 2018. …

State employee unions suing to block group home privatization
Source: Arielle Levin Becker and Keith Phaneuf, CT Mirror, October 13, 2016

State employee unions plan to ask a judge to block the privatization of group homes for people with intellectual or developmental disabilities, saying the layoffs caused by those changes violate Connecticut law and will eventually be blocked by the state labor board. If that happens, the unions say in their request for an injunction, clients would have their lives upended twice – first by having to go through a change in staff in state-run group homes where they have developed relationships with caregivers, and then again if the labor board orders the laid-off state employees to be reinstated. … The unions, CSEA-SEIU Local 2001 and SEIU 1199, New England, represent nearly 500 workers who are expected to be laid off because of the Department of Developmental Services’ plans to privatize the services they provide. The workers include staff at state-run group homes and institutions, and those who provide job support, education, physical and speech therapy, health care and other services to people with intellectual or developmental disabilities. Both unions filed a complaint with the state Board of Labor Relations earlier this week, alleging that DDS broke the law by failing to bargain with them over the decision to outsource the work. … The Malloy administration plans to privatize 40 group homes, as well as services for people with intellectual or developmental disabilities – moves aimed at saving the state nearly $70 million per year by next fiscal year. Overall, the plan is expected to eliminate 605 state jobs. In an August memo detailing the plans, budget director Benjamin Barnes wrote that the state was requesting that the private providers give hiring preferences, when possible, to state employees who lose their jobs because of the changes. …

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Public Sector Unions and Privatization: Evidence From the Eldercare Sector in Danish Municipalities

Source: Søren Kjær Foged and Lasse Aaskoven, Journal of Public Administration and Research Theory, June 22, 2016

Privatization varies considerably among local governments. One of the oft-listed explanations is the ability of public employees to block privatization. However, many studies on the influence of public employees on privatization do not use very precise measures of the influence of public employees, they have been unable to isolate a one-way effect, and the studies have not been attentive to whether the effect varies for different market forms. In this article, we focus on privatization in Denmark through a voucher market without price competition for eldercare services. Using new data for all 98 Danish municipalities in 2012, we are able to measure the strength of the public eldercare union as well as the number of the public eldercare workers relative to the number of local voters. We find that the increased union strength measured in terms of union density at the municipal level leads to substantially and significantly less privatization through the voucher market. By comparison, the estimated relationship between the relative number of public workers and privatization does not reach statistical significance. Features of the voucher market and qualitative evidence suggest that the union influence primarily goes through a direct user channel, that is through union influence directed at the service users, whereas a minor effect possibly runs through a political channel, that is lobbying directed at the local politicians.

Kindred wins bid to privatize Arkansas home health business

Source: Dave Barkholz, Modern Healthcare, June 21, 2016

Kindred Healthcare has agreed to purchase the State of Arkansas’ home health operations in a privatization move that would put the company’s facilities in 70 counties across the state, compared with the four it currently covers. The investor-owned giant was the winning bidder for the Arkansas Department of Health’s in-home healthcare operations, the two sides announced Monday. Kindred agreed to pay $39 million for the business. As part of the privatization, Kindred agreed to retain all employees and serve all current patients upon consent. … In the transaction, Kindred is buying the agency’s 74 home health locations serving 69 counties, seven offices providing hospice services in 42 counties and its personal care services business that assists patients with their daily living. Today, Louisville, Ky.-based Kindred has six offices providing home health and hospice in four of the state’s counties. Altogether, the company will have a presence in 70 of Arkansas’ 75 counties after the deal closes. …


State sells its in-home care setup to firm; services go to $39M bidder
Source: Chris Bahn & Michael Wickline, Arkansas Online, June 21, 2016

Kindred Healthcare Inc. is under contract to purchase the Arkansas Department of Health’s in-home health care services for $39 million, the company and state announced Monday. … After figuring costs associated with the sale and transition, including retention bonuses for about 1,880 employees and contract workers, Hutchinson said, the state will net about $24 million from the transaction. Hutchinson said the state was losing money providing in-home health services and called the decision to sell “a unique solution” that allowed the state to preserve the jobs of about 280 state employees and an additional 1,600 contract employees for up to a year. The arrangement also allows for 3,380 patients to continue coverage for at least a year. Kindred will acquire the Department of Health’s 74 home health locations providing services in 69 counties, seven offices providing hospice services in 42 counties and a personal-care services business. …

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.


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.

Who Rules Home Care? The Impact of Privatization on Profitability, Cost, and Quality

Source: William Cabin, Home Health Care Management Practice February 2016 Vol. 28 No. 1 28-34

This article explores the literature, including two recent studies, on whether home health agency (HHA) ownership type plays a significant role in agency quality, cost, and profitability. The literature is limited, except for the two recent studies that use a merged database created from the Medicare Home Health Compare and the 2010 Medicare home health cost reports databases. One study found statistically significant differences between proprietary and non-profit HHAs: Proprietary agencies have lower overall quality, higher profitability, higher costs per patient, and more visits per patient, with therapy visits accounting for a larger share of the total. However, the second study found that the explanatory value of ownership is limited, with the number of HHAs in the state and therapy visits as a percentage of total visits having a significant influence on cost and quality when combined with ownership compared with ownership alone. Policy, practice, and research implications are discussed.

State explores privatizing care for aged and disabled

Source: Warren Vieth, Moore American, October 28, 2015

…the Oklahoma Health Care Authority is exploring cost-saving options that could lead to partial privatization of the state’s $2.4 billion Medicaid program for aged, blind and disabled people.  The state tried that once before, and it didn’t work out. Costs escalated, companies dropped out, and the state pulled the plug. Supporters of the new effort predicted it might turn out better because of improvements in managed-care practices. Even if it does, however, advocates of the aged, blind and disabled said a new managed-care program could be highly disruptive for thousands of impaired Oklahomans who might be forced to switch doctors and adapt to new care regimens. … The 178,025 aged, blind and disabled Oklahomans who received health services in fiscal year 2014 accounted for 16 percent of Medicaid membership, but 47 percent of spending. … The current initiative was launched after the Legislature passed Mulready’s House Bill 1566 earlier this year. The bill directed the authority to request proposals from independent vendors who could coordinate health care for aged, blind or disabled people currently enrolled in SoonerCare, the state’s version of Medicaid. The bill was backed by three influential health care groups: Blue Cross Blue Shield of Oklahoma, the Oklahoma Hospital Association and the Oklahoma Association of Heath Care Providers, which represents for-profit nursing homes. …


Worries Build As State Moves To Privatize Care For The Aged, Blind And Disabled
Source: Oklahoma Watch & Warren Vieth, KGOU, September 28, 2015

Even if it does, however, advocates of the aged, blind and disabled said a new managed-care program could be highly disruptive for thousands of impaired Oklahomans who might be forced to switch doctors and adapt to new care regimens. … The 178,025 aged, blind and disabled Oklahomans who received health services in fiscal year 2014 accounted for 16 percent of Medicaid membership, but 47 percent of spending. The state pays about a third of the cost. The federal government pays the rest.

OHCA looking into privatized, coordinated care
Source: Sally Asher, Enid News, September 24, 2015

Oklahoma Health Care Authority held a stakeholder meeting in Enid Wednesday night to gather thoughts, opinions and information on privatizing health care for aged, blind or disabled Medicaid consumers.  In the most recent session, the Legislature passed House Bill 1566, which directs OHCA to explore care coordination models for those individuals. Currently, the state contracts with providers through OHCA for their care, but under the new program, OCHA would work with third-party care providers. … Cohen said some things will not change with privatized care: eligibility for Medicaid and Medicare programs and services covered by those programs will stay the same. Some things that could change include an increase in care availability, service providers, the way payments are made and who authorizes such services.

MAXIMUS Awarded $23.5 Million Customer Relationship Management Contract for Oklahoma’s SoonerCare and Insure Oklahoma Programs
Source: BusinessWire, September 27, 2012

MAXIMUS (NYS: MMS) , a leading provider of government services worldwide, announced that it has signed a new contract with the Oklahoma Health Care Authority (OHCA) to operate a Customer Relationship Management (CRM) solution for the SoonerCare and Insure Oklahoma programs. The one-year contract includes five one-year renewal periods, for a total contract value of $23.5 million if all renewal periods are exercised. The contract was awarded on September 17, 2012 and the first contract term ends on June 30, 2013.

SoonerCare, the state’s Medicaid program, provides medical benefits to qualified individuals who have inadequate or no health insurance coverage. Insure Oklahoma provides employers with premium subsidies to help buy private market health insurance for low- to moderate-income employees. The program’s individual plan provides health benefits to employees whose workplace does not offer health insurance.