JEFFERSON CITY, MO. — Missouri’s public employee retirement plans generally are in better financial shape than those nationwide, though there is cause for concern about some, according to a state audit released Tuesday.

Auditor Tom Schweich’s report examined 89 public pension systems that are set up to pay defined benefits to 546,000 people who worked for state or local governmental entities. It found a wide discrepancy in the systems’ financial health, with some in “very good financial condition” and others in a “very poor financial condition.”

“Our pensions, by and large, are better managed than those nationwide,” Schweich said. “They have fewer problems, but there are still definitely some land mines out there, as far as future pension benefits go.”

Schweich placed 15 pension plans on an auditor’s “watch list” because of their finances, including those for the state transportation department and Highway Patrol employees and retirement plans for some public employees in Columbia, Joplin, Kansas City, Springfield and St. Louis County. They could be subject to additional, in-depth audits, he said.

Statewide, Missouri’s pension plans had combined actuarial assets of $57 billion and accrued liabilities of $73 billion at the end of 2012, resulting in an unfunded liability of $16 billion, the audit said. The plans were funded at 78 percent of the present value of their future retirement payments — down from 83 percent in 2003 but several percentage points better than nationwide figures.

 

HUTCHINSON, Kan. (AP) — The Hutchinson School District is suing a Missouri-based group in a dispute over proceeds from a student fundraising effort.

The Hutchinson News reports  that the Kansas district has filed a lawsuit against Education Funding Group in Reno County District Court. The district claims it didn’t receive it share of proceeds from a fundraiser held during the last academic year. It’s estimating the loss between $11,000 and $15,000.

The Hutchinson district signed a contract with the business in October 2013 for a fundraiser in which students sold $10 discount cards with discounts to various local businesses and restaurants. Under the agreement, the district and company were to evenly split proceeds from the discount cards.

Education Funding Group disagrees that it failed to carry out its obligations under the contract.

JEFFERSON CITY, Mo. (AP) — Officials have selected the low bidder to undertake a renovation project involving the Missouri Senate chamber.
The state Office of Administration says work should begin in mid-to-late October on the project. It chose a $429,000 bid from Five Oaks Associates, of Centralia.

The project will remove staff offices that had been built in an open space overlooking the dais at the front of the chamber. The intent is to restore the chamber to its original appearance while also making the space available for Senate committee meetings.

The overall budget for the project is about $650,000 when design fees, hazardous materials testing and other costs are included.
It’s one of several projects going forward at the Capitol, although Gov. Jay Nixon has frozen hundreds of millions of dollars of other spending.

CDC Media Release

From mid-August to September 29, 2014, CDC or state public health laboratories have confirmed a total of 443 people from 40 states and the District of Columbia with respiratory illness caused by EV-D68. The 40 states include Kansas Nebraska, Iowa and Missouri.

CDC is prioritizing testing of specimens from children with severe respiratory illness. Of the specimens tested by CDC lab, about half have tested positive for EV-D68. About one third have tested positive for an enterovirus or rhinovirus other than EV-D68.

The Associated Press reports Colorado health officials have confirmed a 10th case of paralysis-like symptoms in a child.

Dr. Larry Wolk, director of the Department of Public Health and Environment, said Monday all 10 cases are being handled by Children’s Hospital Colorado in Aurora. Six of the 10 children have been discharged from the hospital.

The Denver Post reports most of them were ill before being stricken with a respiratory illness.

Eight of the nine children originally diagnosed with myelitis — an infection or inflammation of the spinal cord — were tested for viral outbreaks. Four tested positive for enterovirus 68, and the other four tested positive for rhinovirus or another enterovirus. No information was given for the 10th child.

The cases come amid an unusual wave of enterovirus 68, which can cause paralysis.

 

ST. LOUIS (AP) – The American Civil Liberties Union is seeking an end to the so-called “five-second rule” for Ferguson protesters.

The shooting death of Michael Brown by a Ferguson police officer on Aug. 9 led to volatile nights of looting and protests in the St. Louis County town. On Aug. 18, police began enforcing a rule to keep protesters moving along West Florissant Avenue, or face arrest.

The ACLU sued and the case went to court on Monday. Some testified they were told to keep moving for no apparent reason, sometimes during times when protests were peaceful.

By Dave Ranney
KHI News Service

SCRANTON — Karen Barezinsky is looking for an answer to what she says is a simple question: Are the people who run the state’s Medicaid program planning to cut the supports she and her husband use to keep her son, Ray Santin, who’s paralyzed from his neck down, out of a nursing home?

“I can’t find out anything,” said Karen, 62, who lives in Scranton with her husband and son. “I leave messages with Ray’s case manager, but nobody calls me back.”

Karen is worried because she’s read news stories about Gov. Sam Brownback and Kansas Department for Aging and Disability Services Secretary Kari Bruffett warning legislators that a recent ruling by the U.S. Department of Labor could cause reductions of in-home services for some people with disabilities and frail elders. That could send some of them to nursing homes, which typically are more expensive than community-based settings.

The new rule, due to take effect Jan. 1, 2015, requires state Medicaid programs to pay home care workers minimum wage and overtime. That reverses policies in place since the mid-1970s that considered them “elder sitters,” a term for paid companions whose primary responsibility involved staying with someone who is elderly or disabled.

Medicaid provides health coverage for about 420,000 low-income and disabled Kansas adults and children. Approximately 11,000 Kansans – primarily disabled adults and frail elders – receive Medicaid-funded in-home services.

In Kansas, complying with the new rule is expected to cost the state an additional $13 million to $16 million annually. Bruffett and Brownback both have said KDADS doesn’t have that money in its budget. Neither of them has yet announced plans to ask the Legislature to come up with it.
nstead, administration officials have asked the Department of Labor to exempt Kansas from the ruling or delay its implementation. All six members of the state’s congressional delegation have signed a letter in support of both requests.

Several national associations – including the National Association of Medicaid Directors, National Council on Independent Living, National Disability Rights Network and National Association of States United for Aging and Disabilities – also have asked for a delay.

“Everyone is supportive of people getting minimum wage and being paid overtime,” said Martha A. Roherty, executive director at the National Association of States United for Aging and Disabilities, a group that represents state departments that administer programs for the aged and disabled populations.
“That’s not the issue; the issue is timing,” Roherty said. “There simply isn’t enough time for states to implement the kinds of structural changes that this requires by Jan. 1 – things like changing state statutes, having to rewrite state Medicaid plans, getting those changes approved, acquiring funding, coming up with the technology for keeping track of all the hours worked. I mean, it’s virtually impossible, especially since most states’ legislatures won’t be in session until after Jan. 1.”

Others disagree. “This is not a sea change,” said Deane Beebe, a spokesperson for Paraprofessional Healthcare Institute, a national organization that advocates for home health aides, nurse aides and personal care attendants.

“This is a change that back on Dec. 11, 2011, President Obama said he was going to make happen,” Beebe said. “It’s not new; it’s been in the works a long time. People can’t say they’re surprised. This wasn’t thrust upon anyone overnight.”

Beebe said the ruling was driven by long-standing concerns that “we can’t build a long-term care system that’s going to meet the needs of an aging population and help people with disabilities live independently and not pay workers minimum wage, not pay them overtime and offer them zero benefits.”

According to a Department of Labor report on the ruling, at least 15 states already have laws that require government-funded home care programs to pay workers minimum wage and overtime.

Losing sleep support?

Medicaid pays Karen Barezinsky and her husband, Richard, $9.64 an hour to care for Santin, who was a star athlete at Sterling College before suffering a broken neck in an automobile accident in 1995. He’s been quadriplegic since.

“He’s paralyzed from the neck down,” Karen said. “He can shrug his shoulders, but that’s pretty much it.”
Neither of the Barezinskys is paid overtime. Instead, Karen’s care hours are capped at 40 hours for a seven-day week, while Richard is paid for up to 30 hours a week.

“(Richard) takes over for me when he gets home from work,” Karen said, adding that her husband is a pavement engineer with the Kansas Department of Transportation. Before Ray’s accident, Karen was Scranton city clerk.

Medicaid also pays Karen’s 47-year-old daughter, Tracy, $25 a night, seven nights a week, to provide what’s called “sleep cycle support.”

“Basically, she gives us relief at night. She lives just a couple blocks away,” Karen said. “She’ll brush his teeth, give him his medicine, turn him so that he’s not in one spot too long, massage him if he gets a knot, empty his night catheter bag. If he needs anything, she’s there to get it for him.”

Typically, Karen said, Tracy spends at least six hours a night with Ray. Tracy, who works as an orthodontist’s assistant by day, helps care for Ray seven nights a week.

The Department of Labor ruling isn’t expected to affect Karen or Richard, because they each are paid more than minimum wage and neither puts more than 40 hours on their weekly time cards.

“That’s not what I’m worried about,” Karen said. “I worry about sleep support, because it looks like that’s what they’ll end up cutting.”
The ruling requires that Tracy be paid at least minimum wage, which is $7.25 an hour. So if she puts in six hours a night, she would be paid $43.50 a night. And if by week’s end she’d worked more than 40 hours, she would need to be paid overtime.

KDADS officials have said they expect the ruling to increase the state’s share of night support costs by $6 million a year, almost half of the projected $13 million to $16 million state cost increases due to the ruling.

Currently in Kansas, about 1,400 people receive Medicaid-funded night support services.

“I’m not saying that if we lost night support, Ray would have to go to a nursing home,” Karen said. “We’re family, and we’re not going to let that happen. But I will say that I’m getting close to 65, and I don’t know how much longer I can keep going like I have. If we lost that sleep support, it’d be just that much harder on us and on Tracy.

“And what about all the disabled people out there who are like Ray but don’t have family like he does?” she said. “What’s going to happen to them?”

According to KDADS records, about 14,600 full- and part-time workers provide Medicaid-funded in-home services. The department does not track the number of workers who are caring for family members.

A challenging job

Angela de Rocha, a KDADS spokesperson, said the agency has no intention of offsetting the ruling’s costs by shaving hours off case plans that define how many hours of service a person needs to live in a community-based setting rather than a nursing home.

But in an effort to avoid paying overtime, she said, beneficiaries may be pressed to find additional workers if the ones they rely on now are logging more than 40 hours a week caring for one or more people.
n Kansas, Medicaid beneficiaries who receive in-home services are allowed – and encouraged – to choose their care workers.

Kansans with disabilities say finding reputable people who are willing to do the often-stressful work is not as easy as it sounds. Job turnover is high.

“When I advertise to find to somebody for night support, I get emails back that say, ‘Are you sure that’s right? That can’t be right, that’s not even minimum wage. Who’d want to do that for that price? It’s not even minimum wage,’” said Jason Gallagher, who has limb-girdle muscular dystrophy and lives in a federally subsidized apartment in Overland Park.
He relies on five day and night workers – one full-time, four part-time – for assistance in getting in and out of bed, using the bathroom, preparing meals and running errands.

“The last time I had to find somebody, it took me three or four months,” he said. “It’s extremely difficult. It’s like, when I’m in my (motorized) wheelchair, I can get to my cell phone or I can get out the front door. But when I’m in bed, I can’t do anything. So it’s really important that you get good, responsible people who you can absolutely trust, because that’s what you’re doing. You’re trusting them with your life and with all your stuff.”

Gallagher, 34, said he dreaded the prospect of his having to find more workers but welcomed the likelihood of a pay increase for them.

“The ruling will be good for me if the state pays it, because I think it would make it easier for me to find people,” he said. “But if the state it doesn’t have the money, and to make it work they’re going to reduce my hours – that would cause major problems for me. I don’t know what I would do.”

KDADS is aware of this and other “unintended consequences” tied to the ruling, de Rocha said. It’s why, she said, the agency’s “focus right now is on DOL to come to a resolution that protects workers and our self-directed consumers.”

Department of Labor officials have not said if or when they might respond to the requests for delaying the ruling.

“Over the last few months, the Department has received letters urging the Department to implement the rule on time, and has also received letters requesting additional time for compliance,” Tania Mejia, a spokesperson for the Department of Labor, wrote in an email to KHI News Service. “The Department is carefully considering these requests. Should the Department have any relevant announcements concerning the rule, a notice will be published in the Federal Register.”

Bill Dombi, vice president for law at the National Association for Home Care and Hospice, said he doubted that the department will agree to exempt Kansas from the ruling.

“I don’t know of any legal basis for them to treat one state, in this case Kansas, differently than all the other states,” said Dombi, an expert on health care wage-and-hour laws. “But there is a basis for their delaying it or, for that matter, pulling it all together.”

He declined to predict whether federal officials would agree to a delay.

“I know this isn’t what Kansas wants to hear from an outsider in Washington, but if I were you, I’d plan on this rule taking effect on Jan. 1, 2015,” Dombi said. “And the best way to deal with it, frankly, is to finance it. Because the alternatives are going to trigger higher rates of turnover, less job satisfaction and reduced quality of care.”

JEFFERSON CITY (AP) – Missouri community colleges are getting $19.7 million from the federal government to train more students and collect data about them.

The Missouri funding was included in $450 million of job-training grants announced Monday by the White House and federal education and labor departments.

A little less than $15 million will be used to hire instructors and purchase equipment to teach an additional 1,900 students in science, technology, engineering and math fields. About $4.7 million will be used to collect data on Missouri community college students who are enrolled short-term certificate programs, similar to data already collected on students in courses that award credit hours.

The federal grants are similar to ones received by Missouri 2011 and 2012. That $35 million went toward community colleges programs in health and manufacturing.

RICARDO ALONSO-ZALDIVAR, Associated Press

WASHINGTON (AP) — The Obama administration is planning to release data Tuesday on drug and medical device company payments to tens of thousands of individual doctors.

The goal is to shine a light on potential ethical conflicts in medicine. Consumer groups say it’s overdue, but doctors’ groups fear consumers will jump to the wrong conclusions.

President Barack Obama’s health care law calls for companies to report payments of $10 or more to physicians. It’s a provision that has bipartisan support.

The goal is to allow patients to look up their own doctors online. That functionality won’t be ready yet. But the preliminary data being released Tuesday is expected to be useful for researchers.

TOPEKA, Kan. (AP) — The owner of a no-kill rescue organization has been found guilty of violating Topeka’s dangerous dogs ordinance after a German shepherd fatally mauled a teacup poodle at this year’s St. Patrick’s Day parade.

The Topeka Capital-Journal reports Jan Price, leader of Saving Death Row Dogs, was fined $250 and ordered to pay $500 in restitution to the poodle’s owners.

Judge Vic Miller also ordered the release of a dog that has been kept in custody since the attack because the city couldn’t convince him it was the dog that killed the poodle. If he had been sure the dog was the attacker, it would have been put down.

Miller said he thought the dog was worth more than the $500 its owners had requested.