Funds run low for health insurance in state ‘high-risk pools’ [Archive] - RetrieverTraining.Net - the RTF

: Funds run low for health insurance in state ‘high-risk pools’

Eric Johnson
02-16-2013, 08:54 AM
Why am I not surprised. No governmental program should ever be adopted on the basis of "it'll only cost...."


Tens of thousands of Americans who cannot get health insurance because of preexisting medical problems will be blocked from a program designed to help them because funding is running low.

Obama administration officials said Friday that the state-based “high-risk pools” set up under the 2010 health-care law will be closed to new applicants as soon as Saturday and no later than March 2, depending on the state.

But they stressed that coverage for about 100,000 people who are now enrolled in the high-risk pools will not be affected.

“We’re being very careful stewards of the money that has been appropriated to us and we wanted to balance our desire to maximize the number of people who can gain from this program while making sure people who are in the program have coverage,” said Gary Cohen, director of the Department of Health and Human Services’ Center for Consumer Information and Insurance Oversight. “This was the most prudent step for us to take at this point in time.”

The program, which was launched in summer 2010, was always intended as a temporary bridge for the uninsured. But it was supposed to last until 2014. At that point, the health-care law will bar insurers from rejecting or otherwise discriminating against people who are already sick, enabling such people to buy plans through the private market.

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Marvin S
02-16-2013, 01:54 PM
Why am I not surprised. No governmental program should ever be adopted on the basis of "it'll only cost...."


I believe there is a need for facilities of these types. I have never figured out who should manage them. Certainly not the government!

We have a facility for the mentally impaired about a mile from our place. It would be cheaper to send the residents (400) on a round the world cruise full time than it is to cover the costs (1350) staff including 9 shrinks (a gift from Jim McDermott when he was in the legislature & needed summer consulting contracts). Some of these folks cannot control their body functions & live full time in a diaper, but they have cut about 1/2 of these facilities along with all the mental health facilities years ago.

I would be interested in anything you have that discusses the eventual sale of the properties & how that came about.

Along with the school we had a WSU dairy facility which was closed down about 10 years ago, just after upgrading the facilities to the tune of $4.5 mil. It has a property & a facility that would make an outstanding regional park along with the ability to stage non shooting dog events.

Eric Johnson
02-17-2013, 11:00 AM
This message may be in the wrong thread but, here it goes.....

Your analogy of a world cruise is probably incorrect. While the cost of a single cruise for 400 people may be less than the costs of operating the facility, you need to factor in year round costs.....year after year after year.

Let's look at the costs. If 400 residents are treated by 1350 staff, that's about .3 manyears per patient. It takes about 5 manyears to cover one position year round. If residents are placed in group homes of just 6 or 7 residents, they'll need about 3 to 4 manyears to maintain the house plus contract help. Why do I say that? Out of the 1350 staff in the large facility there are some painters, carpenters, plumbers, and electricians. These positions are not included in the 3 to 4 direct care positions of a group home but the household maintenance has to be done. These folks place an incredible demand on a facility....flushing rolls of toilet paper, using 110 outlets to light cigarettes, etc, etc. So The idea of lower staff numbers with group homes is a pipe dream. There are people who can benefit from group homes but if a person can't benefit, s/he needs the state facility which takes advantage of economies of scale. The trick is to learn how to not just warehouse these folks but to actually treat them, even if that treatment will never yield a discharge from care.

People with MI/MR issues come from all financial classes. The vast majority of the residents of state run MI/MR facilities are from the group that couldn't afford to pay the high costs of this round the clock care.

As for land sales, I'm not certain that the Alabama situation will bear on the other 49 states. Alabama received almost 900,000 acres in land grants from the Federal government in the 1800's. The land utility ranged from potential forest and agricultural land, railroad right of ways, and a fair bit of land that was worth nothing then and nothing has changed....swamp land in the Mobile Bay region. Incredibly large grants were frittered away. By the 1940's, the Department was down to about 50,000 acres and the legislature created a Division within the Dept of Conservation and gave that Division the role of control of a large portion of the state lands. Under the law, there were two types of land. Lands controlled and managed by the State Lands Division (all our Swamp and Overflow lands) and lands managed by the various Departments but under the ultimate control of the Lands Division. These we can lease or utilize in any way we choose but we must get Lands Div permission to sell them. Even then there were some illegal actions taken. Before our Dept came into existence, each of our facility directors managed his facility including the land. One facility used to grant 40 acres of land to each senior staffer who retired. Clearly they couldn't do this per the Code of Alabama but they did it and when I discovered it had happened, it was too late to do anything.

Now, current day. One of our facilities was a former radar site (SAGE) that was built to watch Cuba. When that mission ended, the Feds gave it to use. We built a couple of buildings and used the 100 acres as a youth center. The problem was it was so isolated that eventually we downsized the population from 50 to 30, and moved the mission to Tuscaloosa into a new building that was purpose built...classrooms, dorms, etc. The site was then unused until we sold it to a farmer in the area. He's going to knock down most buildings and create a hunting lodge.

Another 2 sites were transferred to the Dept of Pardons and Paroles had have been converted to a "half-way house" sort of program. The key is that Jr Colleges have joined to teach technical skills to the parolees half days. Seems to be working.

One site, Bryce Hospital, has been sold to the University of Alabama. The Bryce campus was in the way of growth of the University so this was a good move for both as the University is building a new facility for Bryce on a portion of the nearby campus of Partlow Center (large MR facility which we had closed). The balance of the facility of Partlow was also sold to the University.

Greil Hospital was "given" to the Dept in the 1970's with a reversion clause in the deed. When we stopped using it, it reverted to the family. I knew about this as did my boss but the powers that be didn't listen to us. The facility was closed and senior management proceeded to move to sell it. That got stopped when the heirs came in and filed the papers needed to reclaim it. I'd still be laughing today except we'd just completed a $1.2 million energy savings upgrade. The Dept head gave up 100 beds with the intent of receiving about $10 million and got....nothing.

Another MR facility has been closed for 8 years and we've tried to sell it. No takers because of the way we are forced to price the buildings. Another MI facility just closed and has about 1400 acres. It won't sell either because the location is so remote that the only use is farm land and it appraises for more than a farmer will pay for it.

I sort of wandering. I hope that you've got a sort of general idea. Alabama law will be different from other states but all will have some measure of control on the sale of state land. In our case, to sell we must get the land appraised and then either auction it or take sealed bids but in either case, the minimum bid must be the appraised value. This is true whether the buyer is public or private except if it's a public agency the bid process is waived and we can sell it for whatever we can negotiate over the appraised value. Lots of humorous stories about local government trying get control of state lands.

I hope this at least partially responds to your questions.