Boys and Girls Home jobs up in the air - Grand Island Independent

“We had to try to do it as quickly as possible so we did it through e-mail. I would have much rather have done it in person, but we just have people all over the place so we just couldn’t see everybody at once,” Sheehan said.

Boys and Girls Home has offices in Columbus, Dakota City, South Sioux City, North Platte and Kearney.

The Boys and Girls Home struggle

Boys and Girls Home has provided services for the state for more than 30 years, Sheehan said. It is now the third of five private agencies to drop out of contracts signed in fall 2009.

When Visinet Inc. and Cedars Youth Services canceled their contracts with the state they blamed inadequate reimbursement.

Under the contracts, the agencies were to provide services, in-home and out of the home, for children and families in the child welfare and juvenile justice systems.

“Providing services in rural Nebraska has unique challenges,” Sheehan said in a press release. “We are proud of the services we offer children and families and plan to continue those services to all three areas. Administering all financial responsibility for all providers in the northern, central and western service areas was totally new to us. With all the struggles and complexities, we thought it best to stay focused on what we do well and have the state do what they do well.”

Todd Reckling, director of the HHS division of children and family services in Lincoln said the decision to end the contract with Boys and Girls Home was a mutual one.

“We both came to the realization that Boys and Girls’ strength is really in providing direct services,” he said. “So they’re going to go back and do what they do best.”

As the lead contractor for HHS in three out of five service areas in the state, Boys and Girls Home had to work with multiple subcontractors. In the last few weeks, Boys and Girls Home has been criticized for being behind in payments to its subcontractors, which has caused late payments to foster parents.

“Under the new lead contract, they had to do things they had not done before, including coordination with multiple subcontractors,” Reckling said.

“Boys and Girls Home will assist in the transition and will continue to provide direct services in Nebraska. We have and continue to say that this reform is needed if we are going to improve the way Nebraska serves children. Being able to keep kids in their own homes and communities is the right direction and results in better outcomes.

“We appreciate the long history of Boys and Girls Home and their continued commitment to Nebraska children and families,” Reckling added.

The state is divided into five service areas: northern, eastern, southeast, central and western. Boys and Girls Home provided services to about one-third, or 1,832 children who are state wards for the western, central and northern services areas.

At the end of August, 6,347 children statewide were wards of the state.

Smooth transition is goal

The Boys and Girls Home will continue to provide direct services to HHS, Reckling said. However, HHS will temporarily oversee the subcontractors until another lead contractor can be secured.

“Our priority right now is to have an absolutely smooth transition with as little interruption and disruption as possible,” Reckling said.

Within the next few days, HHS staff will contact all of the families and foster families and notify them of the changes. HHS will pay for services from Friday forward, while the Boys and Girls Home was responsible for payments for services before Friday.

Rebecca Gould, executive director of the Nebraska Appleseed Center for Law in Public Interest, released a statement responding to the split, saying the state welfare reform is flawed and unsustainable. She said the state failed to make necessary investments in child welfare.

“The state must seriously re-evaluate whether this privatization makes sense for Nebraska. Nebraska’s child welfare system has been failing for years. We cannot continue on this path. The well-being of thousands of children is at stake, and they cannot wait months and years for the state to truly reform the system and meet their obligation to children in care.”

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Boys and Girls Home changes rates - Grand Island Independent

"I don't know," Engel said. "But that's the way it's going to be."

Boys and Girls Home President and Chief Executive Officer Robert Sheehan said last week that 10 subcontractors have not been paid due to contract negotiations. He wouldn't specify the reason for the negotiations.

The new tier rate wasn't implemented when Boys and Girls Home initially landed one of Nebraska's child welfare system contracts because it didn't have real data on costs, Engel said.

"I think there's kind of a learning process here," he said. "It was being studied, and it took time to implement it."

Kathie Osterman, spokeswoman for the Nebraska Health and Human Services Department, said the state hasn't changed its rate. Nor is this the first contractor the state has had that has changed its rates after a contract began.

"We negotiate with the lead contractor for a payment that we pay them for both traditional foster care and then agency-based foster care," Osterman said. "Then they determine their rates with their providers, and we do not sign off on those rates."

Traditional foster care is the term for a lower-needs child. Agency-based is the term for a higher-needs child.

"As the lead contractors have gained experience, they have -- some of them -- made changes to some of their rates or rate structure," Osterman said.

Paul and Marty Harding of Aurora were owed nearly $8,500 last week and have been dipping into their own savings to pay for the care of their three teenage foster children as they awaited payment.

The couple did receive a payment from Boys and Girls Home for care they provided in July, and they received a payment on Monday from Mid-Plains Center for Behavioral Healthcare Services for foster care work they are now doing through Mid-Plains, which is a subcontractor for Boys and Girls Home.

Paul Harding said they are to receive $900 a month per child -- about $30 a day -- for care provided to higher-needs children.

That equates to $1.25 an hour for a high-needs foster child.

The difference in the $30 a day the Hardings receive and the $69 a day that Boys and Girls Home pays goes to Mid-Plains to provide oversight and support to the Hardings, Paul Harding said.

Scott Dugan, president and chief executive officer of Mid-Plains, said he has yet to have a personal meeting, phone call, letter or e-mail from Sheehan.

"I'm hopeful, if there are negotiations on contracts, they will actually contact me," Dugan said this week.

He said Mid-Plains has not yet received all the money it believes it is owed from Boys and Girls Home.

State Sen. Mike Gloor of Grand Island said he fears that the group that may end up shorted in this equation is the foster parents.

"My hope ultimately is that, when it comes to providing care to those kids, that we are appropriately reimbursing families what it costs to provide care for those kids," Gloor said. "I don't know what that number is."

Paul Harding said it takes the money from 1.5 kids just to cover the insurance costs for him and his wife to serve as foster parents. The care costs haven't gone down, and the payment rates haven't increased accordingly.

He said reimbursements have gone up just 11 percent in the past 14 years.

Under the tier system, those rates may actually drop.

"Everybody is short of money -- the state and everybody else," Engel said. "I think that (the tier system) is fair."

"Can you still provide adequate care with less money? That is the issue," said Gloor, a former hospital CEO who likened the foster care change to the health care industry's move to managed care.

Engel said he thinks the issue is less about pay and more about the timing of the payments.

The Boys and Girls Home contract gives 45 days to make a payment.

"What's upsetting a lot of people is the 45 days," Engel said.

"I still can't figure out why it takes 45 days to click a few keys on a computer," Paul Harding said. "We don't get checks. We get direct deposit.

"I can live with 45 days. Most of the past payments have been longer than that," he said.

Engel said the bill has to be a "validated bill" as to what was provided. If there's a discrepancy or inadequate documentation, then payment is held up, he said.

"There's a lot of hue and cry, but sometimes that just gets out of control -- out of proportion," Engel said. "When they get the facts, they may not like the facts, but that's what they really are."

According to calls he has received, Gloor said, the fact is that many families providing foster care are treading water quickly just to stay afloat.

"There are families who have been waiting a long time to be paid -- and have bills to pay. We've got to get those people paid as soon as we can, even if it's partial payment until records can be reconciled," Gloor said. "It's not a good situation."

"They've been paid up to Sept. 1 -- that was for July," Engel said of Boys and Girls Home's bills.

Engel said the financial hardship has been on everyone, including the Iowa-based Boys and Girls Home.

"They've been in their endowment fund to make sure this gets off the ground," he said. "They used about $6 million of their endowment funds to launch this thing, and the state put dollars in to launch this thing, also.

"It's just kind of a work in progress to get it to run efficiently and to make sure everyone comes out whole," Engel said. "The main purpose of the whole thing is the kids."

The kids are being taken care of, he said.

"As far as the families themselves, they are not complaining," Engel said. "The families themselves are satisfied with the care they are receiving.

"As long as the children are getting taken care of," he said. "At this point in time, I'm satisfied."

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94-yr-old man killed at OC nursing home - abc7.com

William McDougall, 81, was arrested in connection with the beating death of his 94-year-old roommate, Manh Ban Nguyen, at the Palm Terrace Healthcare Center in Laguna Hills. (KABC Photo)

  LAGUNA HILLS, Calif. (KABC) -- An 81-year-old man was arrested for allegedly murdering his 94-year-old roommate at an Orange County nursing home on Saturday.

Orange County Sheriff's Department spokesman Jim Amormino said that William McDougall allegedly beat his roommate, Manh Ban Nguyen, to death with a bar used to hang clothes.

The murder took place at Palm Terrace Healthcare Center in Laguna Hills.

Amormino said detectives are still trying to figure out a motive for the killing.

The Associated Press contributed to this report.

Do you want the Eyewitness News team to call you? Get a FREE Morning Wake-up Call and personalized weather report at abc7.com/wakeup

(Copyright ©2010 KABC-TV/DT. All Rights Reserved.) Get more Orange County News »

murder, arrest, orange county news

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Faxton St. Luke's focuses on future of seniors - Utica Observer Dispatch

Faxton St. Luke’s Healthcare has received a $31.3 million state grant to improve its long-term-care services with a focus on keeping more seniors in the community and out of nursing homes.

The state grant is the largest in the hospital’s history, officials said. It is the second largest of the $150 million in grants announced by the state last week.

The grant will be used to:

ä Renovate St. Luke’s Home so that the inpatient acute rehabilitation unit can be moved from the hospital’s Faxton campus to the nursing home. This will make the Faxton campus a strictly outpatient facility.

ä Construct a new building on the St. Luke’s Home site to house Faxton’s community-based long-term-care services, including an expanded adult day health program, the Visiting Nurse Association and Senior Network Health, which provide medical services and case management to seniors in their homes. The new building will be connected to the nursing home.

ä Add an eight-station outpatient dialysis unit to the new building for use by patients in the nursing home and community members, alleviating a countywide shortage of dialysis units.

These projects will expand care options for area seniors and their families, said Lori Calabrese, Faxton’s grant writer.

“It’s really finding alternatives to having a senior citizen in an adult facility such as a nursing home,” she said. “It’s trying to keep seniors in their homes and let them age in place with all these different services. We’re changing the face of long-term care.”

Project planning started Friday, the day after the grant was announced, and construction should be completed within two years, officials said.

Seniors age 85 and older are the fastest growing group in the state, increasing by 25.5 percent between 1990 and 2000, according to Calabrese. The number of seniors age 75 and older rose 15.4 percent during the same period, she said. In Oneida County, seniors make up 16.3 percent of the population, according to Calabrese.

“We are very excited about the opportunity that this grant provides our community,” said Steven J. Brown, Faxton’s senior vice president and chief operating officer. “With a growing number of people age 65 and older in Oneida County, in the near future we will see a greater need for health care services. Through this transformational (grant), we will make efficient and effective changes to our system to meet their needs.”

Currently, patients at St. Luke’s Home have to be transported to another facility for dialysis, but that will change once the new building is built. “Just imagine a frail elderly individual in the dead of winter having to be loaded into a van to be taken somewhere else for dialysis treatment. So this is huge,” Calabrese said.

The new building also will allow Faxton’s adult day health program -- which provides a safe and social daytime environment for frail seniors, often while a caregiver works -- to expand by at least 10 slots, Calabrese said.

The other services in the new building — Visiting Nurses and Senior Network Health – provide seniors with health-care services, such as registered nurses, home health aides and physical therapists, in their homes.

And Senior Network Health provides clients in Oneida and Herkimer counties with a care plan and lines up services, including ones Faxton does not provide, such as eye exams, housekeeping services, durable medical equipment and nonemergency transportation.

The grant was awarded by the state Department of Health and the Dormitory Authority of New York State through Phase 20 of the Health Care Efficiency and Affordability Law of New York State, or HEAL NY, and the Federal-State Reform Partnership.

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