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justme
Advanced Member
1428 Posts |
 Posted - 01/23/2009 : 12:10:19 PM
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| OutaHere............ Why don't you stay outa here? You're extremely annoying and add nothing tho the forum. |
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Paul
Senior Member
158 Posts |
Posted - 01/23/2009 : 12:18:00 PM
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How serious is item #34?
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massdee
Moderator
5299 Posts |
Posted - 01/23/2009 : 12:34:13 PM
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| From what I am hearing there is a very good possibility of the Whidden closing if the state does not pay them the millions of dollars they are owed from the state. So, I would say it could be very serious. |
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Tails
Administrator
2682 Posts |
Posted - 01/23/2009 : 1:50:04 PM
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The hospital situation is sad. It's seems like it's been going on for a while. It's the government payments that have stopped to the state too. Maybe President Obama will do something about the million and millions of people that do not have health insurance. I’d rather hear about those things that infrastructure.
Health provider predicts big loss
Hospital alliance cites impact of reform law; Could cut 300 jobs, suffer $25m shortfall
By Jeffrey Krasner, Globe Staff
Cambridge Health Alliance, a key part of the Boston area's healthcare network, is facing a potentially "catastrophic" loss this year and is looking to eliminate up to 300 jobs, or about 9 percent of its workforce, in an effort to stabilize finances.
The alliance, which includes Cambridge Hospital, Somerville Hospital, and Whidden Hospital in Everett, says it is being hit hard by the state's new healthcare reform law, which has left it responsible for providing free care for those without insurance while reducing the hospitals' compensation for such services.
"A significant downturn in our volume and the transition to the new free care pool reimbursement system created a perfect storm for us," said Dennis D. Keefe, chief executive of the alliance.
Before healthcare reform took effect last year, Keefe said, Cambridge Health Alliance was reimbursed by the state for the full cost of providing services to the uninsured. Under the new system, "we only get 60 to 70 percent," he said. The reduction is particularly significant for the alliance because its hospitals serve a high percentage of uninsured patients. Despite the state's efforts to enroll all low-income residents in free or subsidized insurance programs, many still do not have coverage.
Keefe said the hospital was especially bruised in its second fiscal quarter, which ended Dec. 31, when the new payment system for uninsured patients took effect. Government payments for free care to the uninsured fell by nearly $14 million compared with the previous quarter, he said.
At the same time, the number of patients admitted to the alliance's hospitals dropped by about 3 percent, while patients kept overnight for observation - a category for which insurance companies do not pay as well - grew by 48 percent. Additionally, the number of walk-in patients, which do not generate as much revenue as inpatients, also grew substantially in the six months that ended Dec. 31, Keefe said.
During a department meeting last month, the chief administrative officer of the health system's physicians' group predicted a potential loss of $25 million to $35 million for the year.
"This would be catastrophic," Dave Porell told members of the Department of Psychiatry, according to the approved minutes of the meeting, which were obtained by the Globe.
On Friday, Gordon H. Boudrow Jr., chief financial officer of the system, met with bargaining representatives for nurses at Cambridge Hospital, who have worked without a contract since last summer. He said the system lost $13.2 million in the first six months of the fiscal year, and is on track to lose about $26 million for the year.
Cambridge Health Alliance is the last publicly funded healthcare system in the state. In addition to the three hospitals, the system includes 20 community health centers. It is the largest provider of mental health and addiction treatment services in the state. Of 348 beds in use, 45 percent are devoted to mental health and addiction treatment, an unusually high proportion.
Keefe said he has met several times with Dr. JudyAnn Bigby, state secretary of health and human services, to discuss the alliance's finances. Bigby, in an interview, said Cambridge Health Alliance posted a surplus of $1.6 million in fiscal 2007 and is receiving "substantially" more public funding this year than last year.
She acknowledged that the healthcare system is burdened because mental health services don't pay as well as complex medical procedures like heart surgery and cancer treatment. But she also said the state had compensated the alliance for payments that were delayed by the federal government.
"The Commonwealth will continue to support Cambridge Health Alliance with public funding as much as we can," Bigby said.
Keefe said the alliance is indeed receiving more money from the government this year, but that it is because of increased reimbursement for treating low-income patients, not additional funds to help the system stay afloat.
"It's accurate for her to say that payments have gone up, but you have to deduct the expenses for providing medical services," he said.
To stem losses, the health system has put in place a hiring freeze and eliminated discretionary spending, such as for travel and conferences. It is seeking to eliminate the use of contract nurses and other outside care providers, which cost more than using staff.
The system is also trying to keep more patients under its care for longer periods. It wants doctors to limit referrals to specialists or other physicians outside the alliance - something hospitals refers to as "leakage."
"All staff needs to continue to focus on keeping patients within our system, as appropriate, and to continue to focus on improving our inpatient volume in particular by increasing admissions on each campus each day," Keefe wrote in a Jan. 16 memo to staff. "We must also refer our patients for necessary services within our ambulatory care system whenever possible."
Keefe said the hospital is also exploring ways to combine services among its three hospitals to minimize duplication. Cambridge Hospital and Somerville Hospital are ripe for consolidation of specific services, he said, because they are close to each other.
The Massachusetts Nurses Association, in an update to its 400 members at Cambridge Hospital, said the alliance's financial problems are the result of poor management.
"The introduction of the new health reform law was years in coming, and the changes in reimbursement rates and other factors have been well known and should have been anticipated," the union said in a newsletter. "Our management built a budget that anticipated unachievable growth and set up this hospital for the failed situation it now faces."
"blatantly, gone are the days" |
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tetris
Moderator
2040 Posts |
Posted - 01/25/2009 : 09:25:03 AM
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1.
Since the deadline for the Common Council comments isn't until Tuesday, I doubt that we'll see anything new on the consent order from the administration Monday night. However, might we see some reaction from the BOA to some of things that the Mayor said about them at last week's CC meeting? I guess that we'll have to tune in and see.
2.
Does the city have more than one contract with Local 25? Is that why there were two separate agenda items for Local 25 contract settlements? I guess that the reason why these transfers were introduced in two separate weeks could be attributed to the time that it takes to calculate the amounts needed to fund the raises for each employee. Just guessing though.
7.
It seems as if that this item for raises in the solicitor's office has been around for a long time but, unless you were at the last Finance Committee meeting, you have no idea what any of the BOA members think of it. I'm guessing that it will pass but I'm almost certain that it won't be unanimously.
25.
I guess it's been explained that the School Committee actually approves its own bills and that if the Bills and Accounts Committee does anything with these, it's only as a rubber stamp.
26.
I haven't heard that the city has been overrun with lots of applications for fortune teller licenses as was predicted after the first one showed up. I just don't see it. But, if the council feels that it is necessary to control them under zoning laws, let them do what they need to do to see if everyone agrees. On a side note, I thought that I saw at least one neon in the windows of the fortune teller's place on the Parkway. I thought no neons was one of the conditions that was placed on the business after the BOA was forced to give them a license.
28./29./30./31./32.
Since the License Committee won't meet until just before the BOA meeting, it's hard to know if any of these licenses might be in jeopardy.
33.
Wasn't this item tabled so the fee schedule could be adjusted? I don't believe that we've seen anything on that front yet. Maybe we'll get it as a part of this discussion.
34.
Thanks for posting that article Tails. From the information presented in it, I agree with the union position. It doesn't seem that the Cambridge Health Alliance was prepared for the changes that were coming their way even though they knew that they were coming. Maybe it was hard to anticipate everything that happened to them but it doesn't seems that they did enough to be ready for it. After reading that article, it doesn't seem that the reality of the situation matches up exactly with the situation described in the Alderman's piece. Why am I not surprised?
35.
The funding for the first set of Local 25 raises just got approved last Tuesday. I don't know when the contracts were actually settled but it probably wouldn't have been a wise move for the administration to start making the payments until the funding for them was secured. Admittedly, it was very unlikely that the funding wouldn't have be approved though. Probably another issue that Alderman Marcus doesn't need to get involved in unless there has been a significant delay in the implementation of the contract.
36.
Although, I understand Alderman Matewsky's frustration over this issue (people who block intersections happens to be one of my own personal pet peeves), does he really feel that this will happen on any type of a regular basis?
37.
According to the article in yesterday's Globe, Everett faces a cut of $860,000; I think that I'll throw up if I hear Alderman Marcus asking for promises not to make any cuts in the city...again! Although I hate to see people lose their jobs, the option can't be taken off the table. No cuts to Chapter 70 money this time around, so the city won't have that headache at least. I fear that the approach that city will take to address the issue will be to raid free cash or money from the sale of surplus property (City Yards, Devens School, if that ever happens). While I may not have a problem with that being some part of the solution, I don't think that it should be the only part. We still don't know for certain what's going happen in the future; we can't even be sure that there won't be further cuts this fiscal year as far as I know. Part of what got the state into trouble was using a billion dollars from the rainy day fund to balance their FY09 budget. Let's not repeat that mistake on the city level. From the looks of it, things are only going to get worse in the near term. The time to take appropriate, prudent actions is now.
38.
It's probably way past time that we got some official word about what is going on with the MIS Department. |
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Tails
Administrator
2682 Posts |
Posted - 01/25/2009 : 2:47:09 PM
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You explained 37 very well...of course I hate to see anyone, regardless of who they are, loose a job, but the time is now to take appropriate, prudent action. We are already being told that worse cuts are on the way. It's a painful decision but we have to face reality.
"blatantly, gone are the days" |
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massdee
Moderator
5299 Posts |
Posted - 01/26/2009 : 7:24:25 PM
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Is it just me, or does Colleen Mejia comes off as totally incompetent?
How does the attorney working on the consent agreement not know if there has been any resident complaints to our Health Department about the odor and dust down at Wood Waste. |
Edited by - massdee on 01/26/2009 7:42:19 PM |
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charm
Senior Member
264 Posts |
Posted - 01/26/2009 : 8:38:08 PM
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| she needs to go everyone I talk to says she does not know the city law |
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massdee
Moderator
5299 Posts |
Posted - 01/26/2009 : 8:54:16 PM
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| I don't know how they justify her salary. |
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charm
Senior Member
264 Posts |
Posted - 01/26/2009 : 8:58:28 PM
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| by us taxpayers |
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justme
Advanced Member
1428 Posts |
Posted - 01/26/2009 : 9:05:51 PM
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quote:
Originally posted by massdee
Is it just me, or does Colleen Mejia comes off as totally incompetent?
How does the attorney working on the consent agreement not know if there has been any resident complaints to our Health Department about the odor and dust down at Wood Waste.
Unfortunately, Colleen makes John Kruzevik(sp?) look good! The woman doesn't seem to have a clue and is never prepared! Carlo really needs to do something with that department........ |
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massdee
Moderator
5299 Posts |
Posted - 01/26/2009 : 9:06:20 PM
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| Isn't it sad? We have to pay for that! Someone has compared her to, "a deer in a headlight" I couldn't agree more. |
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Tails
Administrator
2682 Posts |
Posted - 01/26/2009 : 9:50:30 PM
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This whole situation is sickening. How many hours and hours did we have to listen to the Mayor advocate for Thibeault with the "Enclosed facility" "Tucked away" Blah, Blah, Blah! Even just last Tuesday night and something changed since then and he doesn't have the go-nads to contact the city council and keep them in the loop?? More than half are on e-mail. Would that have been too much to ask to drop a quick e-mail and say this happened......and I will explain the rest at the BOA meeting.
As for the glorified Kruzevik, one of the dumbest comments was the last common council meeting. Rosa asked specifically about the piles, and if we had an ordinance on the books, and she had that stupid look and said "About buildings??"...........like a total space shot.
She is never NEVER prepared. She never has a clue as to what is going on. She has not once stood up there and represented the people. She does exactly as she's told like a puppet.
Lets not forget, she was not the first pick and NO WAY is her salary justified. Although, I would rather have her, than a blatant liar.
"blatantly, gone are the days" |
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Tails
Administrator
2682 Posts |
Posted - 01/26/2009 : 10:51:45 PM
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I forgot to mention I thought Jason Marcus was a pompous jerk, putting RVC on the spot......... and asking his salary.
Who exactly does Jason think he is? That had NOTHING to do with RVC, it's about the Everett taxpayers that are loosing their jobs and loosing their homes, and the council is supposed to be there for the people.
Not Marcus favors.
Any one of the Alderman can outsmart him day or night. I agreed 100% that this is not the time. Entertain it during the budget hearings, not now.
Jason should be keeping his mouth shut and not starting more trouble. Obviously he never learns.
"blatantly, gone are the days" |
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tetris
Moderator
2040 Posts |
Posted - 01/27/2009 : 01:13:24 AM
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I was tied up earlier with something else and couldn't match the meeting live. I read some of the posted comments with some interest but, after watching the replay of the meeting (better late than never ECTV), I found much more that I wanted to comment on.
1.
A lot more to talk about on this issue that I thought there would be tonight.
So, as of tomorrow, the consent order will become the sole responsibility of the mayor and his administration, or more specifically the Board of Health. From the way that this had been talked about all along, I thought that the final version of the consent order would be presented to the city council for their support before signing it. I'm not sure if that was a misunderstanding on my part but I actually think that it works out better this way for the city council. The mayor allowed them a chance to have some input to the process even though he didn't have to. However, the council has to take no responsibility for the agreement. It probably works out for the mayor too in the sense that it was likely that the final consent order would not have been supported by the BOA, at least. However, now the mayor will have to live or die on the consent order on his own. Let's hope that it is airtight in protecting the city as he has been warned that it needs to be; otherwise, the entire city may join in the pain.
Not that I don't believe the mayor but I find it strange that first time we hear about an effort by the Board of Health in Newburyport to reopen the landfill without the support of their selectmen comes from the mayor of Everett? I wonder what our friends from Newburyport will have to say about that?
Why/how do Wood Waste's plans change every week? Now, we're back to Boston Street only. I don't get it.
While I share some of the criticisms that everyone else has with Mrs. Mejia, I believe that part of the problem with her is that she does exactly what she is told to do.
7.
Once again, an incorrect prediction. Who woulda thunk it? While I was pretty sure that Aldermen Van Campen and DiPerri would be against this piece, I wasn't sure that Alderman Marchese would vote against it. I knew that the only other possible "no" vote could come from Alderman Matewsky; but, trying to predict his vote is always a losing proposition. And that's what happened to me.
I'm sure that the mayor wasn't happy with this vote but he has no one to blame but himself. Paying assistant city solicitors what they should be paid is something that his administration should have addressed as part of the budget process. I guess that they felt that they would be taking too much heat on the amounts that would be paid to the two top people in the department (at that time anyways) to deal with these two positions appropriately.
15. + 19.
So, for years, there has been a problem with this place on Cabot Street and they haven't had the appropriate license to fix all of the cars that they work on. How does this stuff happen? It sounds as if the actions that the Board took tonight were appropriate. I go by that area quite often and it seems that things have improved since the last time that the business received a tongue lashing about their operation. Hopefully, this will help to alleviate the remainder of their issues. I guess that the issue of the car sales office and the beauty salon sharing that building have gone away though.
22./28./29./32./42.
So, at least some of the problems caused at one rooming house can be attributed to another rooming house even though the two of them are separated by two businesses, a street and a house. More problems are caused by two bus stop shelters being right outside the rooming house in question. Whatever. I might be more inclined to actually believe it if there wasn't so much signaling going on between the members of the Board and the petitioners in the audience during the discussion of the pieces. I hope that this doesn't come back to bite them in the butt.
33.
If there is going to be change in the fee for the Certificate of Habitability Ordinance, it needs to show up on next week's Common Council agenda in order to be in place for the implementation of the process since it will take a minimum of four readings to get the ordinance changed. Probably a good idea to allow some time to educate the public before beginning to enforce this ordinance. Yes, it should have been done long ago but it wasn't.
34.
I'll reserve the right to rag on Alderman Marcus some more about this one the next time that piece comes up.
35.
Typical piece from Alderman Marcus. Pick-up the phone and ask a question instead.
36.
Let's see if the State Police actually do anything with this request.
37.
Alderman Marcus didn't actual say it but others did it for him; so, I only threw up in my mouth. All kidding aside, I'd like to know some of the specifics of the $530,000 that the administration found to cut in the budget. It shows that there was some fat in the budget; that's probably a good thing now, at least as far as city employees are concerned. It was good to hear that the administration will pay particular attention to health care costs. That will probably be the area where the city can save the most money.
38.
OK, so maybe there were some reasons why house was cleaned in the MIS department. And yes, they seemed to get by their e-mail issues. And money is being saved by not filing the positions. But, it appears that the city still has MIS issues that need someone to be there on a regular basis to address them. And the mayor wants to do something about by brining someone in house. The department has been without staff for almost 6 months. Why do these things take so long? And too many times, the answer seems to be "I have a plan and I'll be coming before you soon". But the "soon" never seems to happen. Yes, money is being saved but how much is lost in productivity because of the outages? It could be argued that lost productivity is a "soft" cost, but once any staff cutbacks start, those costs will become very real. Let's hope that this issue gets addressed soon.
39.
In the prior storms this year, the city might have been a little to aggressive in declaring snow emergencies, too early at least; the last time they got burned by not declaring one. As long as they are aware of the issues and are trying to do their best with it, I guess that we shouldn't complain too much.
41.
Why wasn't there more advance notice of this meeting? I think that I'll probably wait until February 2 and catch the presentation at the joint convention.
I was surprised to see so many items added under suspension. I'm glad that Alderman DiPerri let his feelings be known on that issue. |
Edited by - tetris on 01/27/2009 01:19:37 AM |
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BOA 2009
