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Archive for the ‘OGB, Office of Group Benefits’ Category

OGB laying off 24 more; blow softened when CEO assures affected employees losing their jobs ‘not like losing a child’

Posted in Governor's Office, Health Care, Layoffs, OGB, Office of Group Benefits, ORM, Office of Risk Management, Privatization, State Agencies on July 26, 2014| 23 Comments »

The Jindal administration has announced plans to jettison 24 more positions at the Office of Group Benefits (OGB) as a cost cutting measure for the cash-strapped agency but is retaining the top two positions and an administrator hired only a month ago.

The effective date of the layoffs is Aug. 15.

The latest cuts will leave only 47 employees when the agency is relocated to the Claiborne Building basement to share office space with the Office of Risk Management. The Claiborne Building also houses the Civil Service Department, the Board of Regents, the Department of Education, the State Land Office and the Division of Administration.

The layoff plan submitted to the Department of Civil Service on June 14, said there was insufficient work to justify all 71 positions.

Affected by layoffs are eight Benefits Analyst positions, three Group Benefits Supervisory spots, one Group Benefits Administrator, seven Administrative Coordinators, an Administrative Assist, two Administrative Supervisors, one IT Application Programmer/Analyst and one Training Development Specialist.

OBG Chief Executive Officer Susan West, one of those being retained, will be making a physical move back into her old offices. She previously worked for ORM before that agency was gutted by Jindal’s grand privatization scheme and she moved over to OGB.

West, who makes $170,000, and Interim Chief Operating Officer Charles Guerra ($107,000) are not affected by the layoff nor is Elis Williams Cazes ($106,000)) was appointed as Group Benefits Administrator on June 23.

Cazes was previously employed by Blue Cross/Blue Shield of Louisiana which serves as the third party administrator of the OGB Preferred Provider Operation at a cost to the state of $5.50 per month per enrollee, which computes to an amount a little north of $70 million per year.

Her position was created—and the requirements reportedly written especially to her qualifications—as the Medical/Pharmacy Administrator responsible for benefit plan management and vendor performance with the primary responsibility to “continuously monitor medical and pharmacy benefit plans to seek out modification of plans or implementation of new plans that reduce claims costs and provide efficiencies for the state and plan participants,” according to the justification given for retaining her position.

Well, we can certainly see where her position is as indispensable as West’s and Guerra’s.

All this takes place at a time whe OGB’s reserve fund has dwindled from $500 million at the time of the agency’s privatization in January 2013 to about half that amount today. Even more significant, the reserve fund is expected to dip as low as $5 million by 2016, just about the time Jindal leaves town for good.

Completing the trifecta of good news, we also have learned that health benefits for some 200,000 state employees, retirees and dependents will be slashed this year even as premiums increase.

In June, West broke the news to the OGB employees. She erroneously said the 47 remaining employees would be reassigned other duties and some might see pay reductions and that those with seniority could bump junior employees in desired positions. The Civil Service Department, however, said salaries could not be cut and bumping is no longer allowed.

Isn’t it nice to know your agency director knows the procedures?

Employees were told that letters would go out between July 1 and July 15 to those who were being laid off. On July 7, they were told the letters would be delivered by hand on Friday, July 11. None came. On the following Monday (July 14) confusion of the order of the day as Deputy Commissioner of Administration Ruth Johnson sent emails to those affected and instructed them to attend a noon meeting in the OGB board room. Upon entering the board room, each person was handed a packet that informed them that Civil Service had not approved the layoffs.

During the meeting, according to one who was there, West kept repeating, “I get this. I’ve been where you are. I get this. However, there are worse things. It’s not like losing a child. I get this.”

Way to soften the blow, Susan. You might have reminded them that the fighting between Israel and Palestine isn’t so bad because there’s also an Ebola outbreak in Africa or that while you’re losing your home to a hurricane storm surge, some people are having to endure heavy wind damage. Or better yet, take them all to a showing of The Fault in Our Stars. That’ll cheer them up.

“It was the ‘I get this’ and comparison of losing a job to losing a child that infuriated the OGB state employees,” the employee said. “This is the worst thing in their lives right  now, some are battling cancer and working; some have children and grandchildren to feed; some live paycheck to paycheck; some are taking care of the elderly and family; all have bills, rents/mortgages, school tuition, etc.”

But you really can’t blame Susan. She previously worked for ORM and was among those present when ORM Director Bud Thompson broke the privatization news to his employees by standing before them, grinning, as he said, “I still have my job.”

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Here’s how Jindal’s privatization works: OGB fund balance to be broke by fiscal year ’15 after $500M balance in 2012

Posted in Audit Reports, Budget, Governor's Office, House, Senate, Legislature, Legislators, OGB, Office of Group Benefits, Privatization, State Agencies, Transparency on July 17, 2014| 29 Comments »

To probably no one’s surprise except a clueless Gov. Bobby Jindal, the takeover of the Louisiana Office of Group Benefits (OGB) by Blue Cross Blue Shield of Louisiana 18 months ago has failed to produce the $20 million per year in savings to the state.

Quite the contrary, in fact. The OGB fund balance, which was a robust $500 million when BCBS took over as third party administrators (TPA) of the Preferred Provider Organization (PPO) in January of 2013, only 18 months later stands at slightly less than half that amount and could plummet as low as an anemic $5 million a year from now, according to figures provided by the Legislative Fiscal Office.

OGB is one of the main topics to be taken up at today’s meeting of the Joint Legislative Committee on the Budget (JLCB) when it convenes at 9 a.m. at the State Capitol.

OGB is currently spending about $16 million per month more than it is collecting in revenue, said Legislative Fiscal Officer John Carpenter.

The drastic turnaround is predicated on two factors which LouisianaVoice warned about two years ago when the privatization plan was being considered by the administration:

  • Jindal lowered premiums for state employees and retirees. That move was nothing more than a smokescreen, we said at the time, to ease the state’s share of the premium burden as a method to help Jindal balance the state budget. Because the state pays a percentage of the employee/retiree premiums, a rate reduction would also reduce the amount owed by the state, thus freeing up the savings to patch gaping holes in the budget.
  • Because BCBS is a private company, it must return a profit whereas when OGB claims were processed by state employees, profits were not a factor. To realize that profit, premiums must increase or benefits decrease. Since Jindal had already decreased premiums, BCBS necessarily found it necessary to reduce benefits.

That, however, still was not enough and the negative income eroded the fund balance to its present level and now legislators are facing a severe fiscal crisis at OGB.

And make no mistake: this is a man-made crisis and the man is Bobby Jindal.

In a span of only 18 months we have watched his grandiose plans for OGB and the agency’s fund balance dissolve into a sea of red ink like those $250 million sand berms washing away in the Gulf of Mexico in the wake of the disastrous BP spill.

There is no tactful way to say it. This Jindal’s baby; he’s married to it. He was hell bent on privatizing OGB and putting 144 employees on the street for the sake of some hair-brained scheme that managed to go south before he could leave town for whatever future he has planned for himself that almost surely does not, thank goodness, include Louisiana.

So ill-advised and so uninformed was Jindal that he rushed into his privatization plan and now has found it necessary to have the consulting firm Alvarez and Marcel, as part of their $5 million contract to find state savings, to poke around OGB to try and pull the governor’s hand out of the fiscal fire. We can only speculate as to why that was necessary; Jindal, after all, had assured us up front that the privatization would save $20 million a year but now cannot make good on that promise.

In the real world, the elected officials are supposed to be the pros who know that they’re talking about while those of us on the sidelines are mere amateurs who can only complain and criticize. Well, we may be the political novices here, but the results at OGB pretty much speak for themselves and we can rightfully say, “We told you so.”

Are we happy or smug? Hell, no. We have to continue to live here and raise our children here while Jindal will be taking a job with some conservative think tank somewhere inside the D.C. Beltway (he certainly will not be the Republican candidate for president; he isn’t even a blip on the radar and one former state official now residing in Colorado recently said, “No one out here has ever even heard of him.”)

In a five-page letter to JLCB Chairman Rep. Jim Fannin (R-Jonesboro), Carpenter illustrated the rate history of OGB going back to Fiscal Year 2008 when premiums were increased by 6 percent. The increase the following year was 3.7 percent and the remained flat in FY-10. In FY-11, premiums increased 5.6 percent, then 8.1 percent in FY-12 when the system switched from a fiscal year to calendar year. but in FY-13, the year BCBS assumed administrative duties, premiums dropped 7 percent as Jindal attempted to save money from the state’s contributions to plug budget holes. For the current year, premiums decreased 1.8 percent and in FY-15 are scheduled to increase by 5 percent.

OGB Report_July 2014 FOR JLCB

Carpenter said that since FY 13, when BCBS took over the administration of OGB PPO claims, OGB’s administrative costs began to shift to more third party administrator (TPA) costs as the state began paying BCBS $23.50 per OGB member per month. That rate today is $24.50 and will increase to $25.50 in January of 2015, the last year of the BCBS contract.

That computes to more than $60 million per year that the state is paying BCBS to run the agency more efficiently than state employees who were largely responsible for the half-billion-dollar fund balance.

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Alvarez & Marsal’s $5 million eyewash is released by Jindal administration only minutes before legislative adjournment

Posted in Contract, Contracts, DHH, DOA, Finances, Governor's Office, Legislature, Legislators, OGB, Office of Group Benefits, ORM, Office of Risk Management, State Police on June 3, 2014| 18 Comments »

The $500 million savings report by Alvarez & Marsal (A&M) was finally released on Monday only minutes before adjournment of the 2014 legislative session—and, conveniently for the administration, too late for critical feedback from lawmakers.

http://doa.louisiana.gov/doa/PressReleases/LA_GEMS_FINAL_REPORT.pdf

So, what makes this one any different than the others, given the fact that the A&M report acknowledges that Louisiana “has a long history of performance reviews, dating back to one performed by the Treen administration in the early 1980s?” Well, for one, the punctuation, spelling and grammatical errors contained in the report indicate that it was thrown together rather hastily to satisfy a state-imposed deadline for completion.

Of course the report was cranked out by “experts,” and as an old friend so accurately reminded us, an expert is someone with a briefcase from out of town.

The 425-page report, produced under a $5 million contract, while projecting a savings of $2.7 billion over five years (an average of $540 million a year), the substance of the report was sufficiently ambiguous to render the document as just so much:

(a)    Useless trendy jargon and snappy catch phrases like synergy, stakeholders, and core analytics to give the report the appearance of a pseudo-academic tome;

(b)   Eyewash;

(c)    Window dressing;

(d)   Regurgitation of previous studies by previous administrations that are now gathering dust on a shelf somewhere;

(e)    All of the above.

Three things were immediately evident with only a cursory review of the report:

  • Two offices that have been privatized by the administration as a means of savings and efficiency—the Office of Risk Management and the Office of Group Benefits—were subjected to rather close scrutiny by A&M which identified a host of ideas to make both offices more cost efficient. And we thought all along the administration had assured us of great cost savings and efficiency as its reasons for privatization in the first place. Yet A&M, in its report, claims its recommendations can save OGB another $1.05 billion while ORM can save an additional $128 million through implementation of recommendations contained in the report.
  • While A&M met extensively with and took suggestions from state employees who were tasked by the administration with coming up with savings ideas as far back as last September, not one word of acknowledgement is given to those employees in the report, prompting one employee to wonder, “Why the hell can these New Yorkers take my ideas and work and resell them to the state?” Of course the report did give a tip of the hat to Commissioner of Administration Kristy Nichols for her assistance in overseeing “all aspects of the state’s participation.” We suppose that will have to suffice.
  • Though virtually every office operating under the auspices of the Division of Administration came under the watchful eye of the A&M suits, not a single recommendation for increased efficiency and/or cost savings was offered up for the Governor’s Office itself. The closest A&M got to the governor’s office was the Office of General Counsel, the legal office of the Division of Administration. The obvious conclusion to be drawn from that is that the Governor’s Office is already operating at peak efficiency and minimum waste.

Most of the projected cost savings were based on assumptions for which A&M offered little or no supporting data other than arbitrary estimates and suppositions that could have been produced at a fraction of the report’s $11,760 per-page cost.

The report acknowledged that Louisiana already has the highest Medicaid recovery rate in the nation with $124 million in improper payments recovered but nevertheless listed as one of its recommendations that the Department of Health and Hospitals (DHH) “reduce improper payment in the Medicaid program.”

Seriously? Who would’ve thought that might be a way to save money?

Other suggestions included in the study by agency and projected savings (in parentheses):

DHH ($234.1 million)

  • Establish more cost-effective pediatric day health care programs and services;
  • Maximize intermediate care facility (ICF) bed occupancy rates;
  • Shift the administrative management of uninsured population from state management organization to local governing entities (Municipal and parish governments better take a long, hard look at that recommendation);
  • Improve the process and rate of transition of individuals with age-related and developmental disabilities from nursing facilities and hospitals. (So just where are those age-related and those with developmental disabled individuals being transitioned to? Are they to be removed from state facilities as a cost-saving move? And they accused Obama of creating death panels with the Affordable Care Act?)

Department of Transportation and Development (DOTD) ($99 million)

  • Expand advertising revenue for roads, bridges and rest stops;
  • Reduce the construction equipment fleet;
  • Convert some of vehicle fleet to natural gas (for this we needed a consultant?)
  • Reduce cost overruns with quality assurance/quality control engineering firm (another consulting contract);
  • Utilize one-inch thin asphalt overlay (and after reducing the construction equipment fleet we can change the names of our state routes from highways to obstacle courses).

Department of Corrections: ($105.3 million)

  • Expand certified treatment and rehabilitation program;
  • Expand re-entry program;
  • Increase use of self-reporting.

Department of Revenue and Taxation ($333.4 million)

  • Re-build audit staff positions depleted because of retirements and hiring freezes;
  • Increase compliance efficiency and reduce backlog of litigated cases

Department of Public Safety ($45.4 million)

  • Centralize state police patrol communications
  • Consolidate state police patrol command position;
  • Optimize state police patrol shifts
  • Expand Department of Public Safety span of control.

Office of Juvenile Justice ($44.2 million)

  • Increase probation and parole officers’ caseloads (Seriously? Do these clowns have even a remote idea of what these officers’ job is like? The caseloads have increased steadily and there have been no pay raises for what, five years now? For even suggesting that, those A&M suits should be horse whipped with a horse.);
  • Relocate youth from Jetson Center to other Office of Juvenile Justice (OJJ) facilities (so, just how out of touch was A&M to have not known the Jetson Center was closed in January?);
  • Increase OJJ span of control.

Department of Children and Family Services ($2 million)

  • Continue to implement innovative strategies intended to reduce;
  • Safely decrease the time children spend in state custody.

Louisiana Economic Development ($142.9 million);

  • Adjust fees for inflation;
  • Enhance review process for Motion Picture Tax Credits;
  • Enterprise Zone benefits and audit review process;
  • Consolidate Louisiana Economic Development (LED) offices into one government-owned facility (What? No privatization?).

Human Capital Management ($65.9 million)

  • Creation of agency workforce and succession plans;
  • Redesign of job families through creation of a competency model;
  • Improve the administration of Family and Medical Leave (FMLA) across agencies;
  • Review overtime policies;
  • Increase span of control for agency supervisors.

Office of General Counsel ($3.825 million)

A&M noted that the Office of the General Counsel (that would be the in-house legal counsel—they hate being called that—for the Division of Administration) “is responsible for ensuring that the commissioner’s statutory duty to respond to public record requests in a timely and legal manner is carried out.”

This was a favorite part of the entire report for us. The DOA Office of the General Counsel has historically delayed responding to public record requests of LouisianaVoice far beyond any reasonable—or legal—time limits. Louisiana’s public records statutes require an immediate access to public records unless they are unavailable in which case the custodian of the record must, according to law, respond in writing as to when they will be available within three working days. It is not at all unusual for the Office of the General Counsel to drag his feet for weeks on end before producing requested records.

But A&M has solved that knotty little problem by pointing out that as the custodian of the DOA’s public records, “it is the commissioner’s (Kristy Nichols) responsibility to receive and process public records.”

A&M’s recommendation that the Office of the General Counsel can generate its five-year cost savings simply by:

Increasing the organization efficiency of the office, ($1.975 million) and

Increasing the efficiency of document review process and reducing internal and external attorney costs ($1.85 million).

That, of course, raises the burning question of what will happen to Jimmy Faircloth?

Other suggested savings came under:

  • Procurement ($234.8 million);
  • Facilities Management and Real Estate ($70.9 million), and
  • Provider Management ($2.2 million).

“I am so proud of this report,” gushed Nichols. “These are real, common sense solutions that will not only save money for the people of Louisiana, but will improve the way we operate.”

Question, Kristy: If they are such “real, common sense solutions,” why has this administration in six-plus years experienced this epiphany before now?

Another question: If these suggestions, which you say were “thoroughly vetted,” are going to save money for us and make our lives better through better operations, where has Jindal, his cabinet secretaries, undersecretaries, deputy secretaries department heads, managers and great legal minds been all this time? Wasn’t it their job to give us the biggest bang for the buck? (Oops, that’s three questions.)

Oh, well, let’s go for broke here. Fourth question: Who “vetted” these wonderful ideas? If the vetting was done by those already on the state payroll, why didn’t those employees perform the task in the first place instead of blowing $5 million on this report that a second year economic major at LSU could have written?

Fifth question: Does the administration—and by extension, A&M—hold employee morale in such low regard that it was not considered as a factor in facilitating more efficient job performance across the board? Improved employee morale would seem to be conducive to cost savings, yet it was never addressed even once in the entire 425-page document. That omission speaks volumes.

And finally, if you are “so proud of this report,” why was it that you reportedly tossed an A&M representative out of your office with the admonishment that he’d better find something after he initially reported to you that his consulting firm was having trouble coming up the $500 million savings?

Could this explain why some of the “savings” appear to have been plucked out of thin air?

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Alvarez & Marsal bills $2M thus far on $5 million contract; state has little to show for expenditure to save $500 million

Posted in Audit Reports, Budget, Contract, Contracts, Governor's Office, Legislature, Legislators, OGB, Office of Group Benefits on May 27, 2014| 12 Comments »

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Alvarez & Marsal, Gov. Bobby Jindal’s favorite consulting firm, has submitted invoices totaling more than $2.1 million thus far, accounting for a tad more than the firm’s $5 million contract to ferret out $500 million in savings to the state, according to documents provided by the Division of Administration.

And so far, all taxpayers have to show for that is a 2 ½ page preliminary report provided to legislators earlier this month recommended $74 million in spending cuts, some of which have already been rejected by the administration.

A&M’s invoices included an $80,000 charge for an assessment of the Office of Group Benefits (OGB) conducted in December at the specific request of Commissioner of Administration Kristy Nichols.

But…but…but didn’t the administration conduct a full blown assessment of OGB before it made that decision to privatize the agency a couple of years ago? Is this administration determined to study and consult this state into financial oblivion?

And speaking of OGB, that $500 million reserve fund it had when Jindal came up with the bright idea of privatization—an economy move, he said; it would save the state gazillions—has shrunk like hemorrhoids in a Preparation H commercial and both the Legislative Fiscal office and the Legislative Auditor’s office are projecting an end of year balance of only $55 million or so.

And Jindal’s ploy of reducing premiums—the by-product of that action being that it would also reduce the state’s portion of premiums by 9 percent, freeing up money Jindal would use to patch yet another state budget—has now done a 180 with the word going out this week that premiums for state employees and retirees and their dependents will be increased by 5 percent, effective July 1.

Talk about your voodoo economics…

So why blow $80,000 to conduct the OGB “assessment when the Legislative Fiscal office and/or the Legislative Auditor’s office would probably have performed the same service for free.

Wait…they did already.

Yep, both conducted their own separate assessment and came up with remarkably similar numbers for the anticipated reserve fund reduction by the end of 2014. The picture isn’t pretty and no consultant’s study is going to change that.

Legislative Auditor Daryl Purpera said the reserve fund is currently being reduced by about $17 million a month and even with the 5 percent premium increased announced by the administration, the drawdown will be reduced by less than half—$7 million, leaving the monthly deficit at $10 million a month.

Nichols, in typical fashion, continues to spout the party line, assuring us that everything is peachy and the fund is in no danger of going broke. So now with this prediction coupled with previous pronouncements, we now know her to be a legal authority, an economist, an actuary and a wellness expert. Given her track record, we should be worried, very worried.

But we digress. Back to those A&M invoices and the firm’s recommendations.

In case there may be those whose memories are short, A&M is the same firm that Jindal hired last year to come up with his brainstorm of eliminating state income taxes, a plan that crashed and burned before ever lifting off.

It’s also the same firm that advised the Orleans Parish School Board to fire 7,500 teachers after Hurricane Katrina, an action that prompted a class action lawsuit which in return produced a judgment in favor of the teachers that could end up costing the state $1.5 billion.

So, what did that 2 ½ page preliminary report contain? Oh, great things, like requiring women on Medicaid to use midwives or doulas for delivery (these would be women who often go without prenatal care), finding jobs for prison inmates, cutting the thickness of asphalt in future highway overlays, and cutting back hours of operation for the Cameron Parish ferry.

It didn’t take Jindal long to cave to pressure to keep the ferry open.

Scratch that big savings.

Then Jindal decided against a plan not part of the A&M recommendations, that of closing 18 motor vehicle offices throughout Louisiana.

Out with that savings plan.

Now, having already been paid 40 percent of its contract amount, A&M still has not submitted the overall plan for saving $500 million—a plan originally given the deadline of April 30 but extended to the end of May.

That gives A&M three days to come up with an additional $426 million in savings.

Could it be that the one-month extension was timed to have A&M submit its savings plan only hours before the legislature adjourns on Monday, thus giving lawmakers no opportunity to review the plan or to offer any input of their own?

With this governor, stranger things have happened.

 

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Notable Quotables (in their own words)

Posted in Health Care, OGB, Office of Group Benefits on February 10, 2014| Leave a Comment »

“In no event will coverage be provided to any subscribers, as of March 1, 2014, unless the premiums are paid by the subscriber (or a relative) unless otherwise required by law.”

—Blue Cross Blue Shield of Louisiana spokesman John Maginnis, explaining why BCBS of Louisiana will no longer comply with terms of the federal Ryan White Program.

Ryan White grantees “may use funds to pay for premiums on behalf of eligible enrollees in Marketplace plans, when it is cost-effective for the Ryan White program. The third-party payer guidance CMS released (in November) does not apply to” Ryan White programs.

—CMS spokesperson Tasha Bradley, refuting BCBS’s interpretation of a CMS anti-fraud directive issued in November.

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