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Lindenmuth

Lindenmuth

If there’s one news story about North Carolina state government that you don’t want to miss this morning it’s NC Policy Watch reporter Sarah Ovaska’s new investigative report on the McCrory administration’s “jobs czar,” Richard Lindenmuth. As Ovaska reports, the man charged with overseeing the privatization of the state’s business recruiting efforts (something that former Republican governor Jim Martin calleda “dumb and dangerous idea”) has some controversies and questions in his own background in private industry. This is from the report:

“N.C. Policy Watch investigation into Lindenmuth’s background uncovered federal court records showing that controversy has marred his career in recent years. He placed his Raleigh consulting company, Boulder International, into bankruptcy in 2010 and had his fiduciary abilities called into question by a federal bankruptcy judge in a separate incident.

U.S. Bankruptcy Judge Barbara Houser, the chief bankruptcy judge for the Northern District of Texas, found that Lindenmuth improperly overcharged expenses by nearly $117,000 while consulting for a home décor company undergoing bankruptcy, a situation she found ‘very, very troubling’ and potentially criminal.

‘[T]his appears to violate the criminal violations of the Bankruptcy Code, and I mean this is not right,’ Houser said, according to a hearing transcript.

Court records don’t show that law enforcement ever pursued the situation, and Lindenmuth denied any wrongdoing in court records and to N.C. Policy Watch. He did, however, agree to return $250,000, nearly half of what he was paid for seven months of work at the company.”

Click here to read the rest of the story including more of Judge Houser’s scathing characterization’s of Lindenmuth’s actions. It will be interesting to see if Gov. McCrory stands by the appointment given the numerous controversies already swirling around his administration’s economic development efforts.

Since assuming office Gov. McCrory has throttled the theme that Medicaid is broken and must be reformed. He began by offering a radical proposal of dismantling our current system and selling it off to private insurance plans. He has since backed away from that idea and now wants a more modest expansion of what currently works in Medicaid.

The House, in a bipartisan bill filed this session, clearly agrees with the Governor’s new approach. The legislation, spearheaded by Rep. Nelson Dollar, would build Accountable Care Organizations (or ACOs)  in Medicaid. These provider led ACOs would move us toward greater integration of care and away from fee-for-service medicine. Medicare is using the ACO model as are many private insurers. In fact, Medicaid is one of the only payers in the state not moving to this method of organizing care.

In its budget, the Senate flatly rejects this approach. That chamber wants Medicaid to move to full capitation. In other words, legislators want to provide a set budget to Medicaid. The insinuation is that the Senate prefers the Governor’s original plan to pay private insurers to care (or not care, as the case may be) for our most vulnerable citizens.

The Senate also engages in some fantasy by pulling Medicaid into a freestanding department that will engage the nation’s best health care minds in this ambitious reform effort. At least that’s how Sen. Louis Pate described the proposed process. The trouble, of course, is that the nation’s best health care minds consider North Carolina’s Medicaid program to be an important model and they aren’t interested in helping to dismember it. The nation’s best health care minds also aren’t interested in coming to our state and spending time tearing apart care for low-income people as the legislature reduces services, limits eligibility, and slashes the budget. We are, in short, engaged in the opposite of innovation.

Rep. Dollar is a smart chap and likely realizes that his ACO bill isn’t going anywhere as a piece of legislation. That means he will need to stick the proposal into the House budget to give it a fighting chance. Hence, the showdown mentioned in the title of this post.

Certainly the House is moving in a better direction. But it’s a good time to reflect that Virginia is having its own budget battle over Medicaid right now. Except instead of fighting over how to fiddle with (or blow up) a program that is working, Virginia’s leaders are having a serious discussion about using federal funds to expand Medicaid coverage to 400,000 people. If that happens it means that our tax dollars will help boost Virginia’s economy, bolster its rural hospitals, and support its citizens.

That will certainly be charitable of us, but not wise.

Pat McCrory 2It’s good to know that while things are going to hell in a handbasket during the busiest time of the year in the state capital, North Carolina’s fearless leader will be right in the mix doing what he almost always does on Friday — scheduling “official” events in Charlotte so that he can spend the weekend in his actual home. Today — and we’re not making this up — it’s a doggie photo shoot.

Here is the Guv’s official schedule for today: Read More

Last October Gov. McCrory caused a stir, and raised some eyebrows, when he said that the state may be forced to expand Medicaid due to a “new” regulation.

The policy to which he was referring is called presumptive eligibility. Presumptive eligibility allows states to give permission to hospitals and other providers to temporarily enroll certain people in Medicaid. North Carolina, for example, allows presumptive eligibility for pregnant women. That means if a hospital does an initial check and it looks like a pregnant woman is likely to qualify for Medicaid then the hospital can temporarily enroll her and get paid for the services it provides. Meanwhile, an application for full Medicaid can be processed without a disruption in care.

This policy is critical for ensuring that patients get care and providers get paid.

In states with efficient systems that can process Medicaid eligibility in real time, this temporary measure is not as important. In states where parents are having to ration medicine for their children due to a backlog in processing Medicaid applications, presumptive eligibility is a critical tool.

Health reform gave hospitals more latitude to presumptively enroll patients, even if the state has not granted the hospital permission to participate in the program. Other providers, notably Community Health Centers, however, are still not able to use presumptive eligibility to enroll children in Medicaid. The Community Health Centers are still limited to enrolling pregnant women.

Ultimately, the state needs to fix its computer system. In the meantime, we need to get care to children. We could start by granting Community Health Centers, and possibly other providers, the ability to temporarily enroll likely eligible kids in Medicaid while DHHS clears its application bottle neck.

And until the state expands Medicaid to all low-income people we will need every splint and bandage we can find to patch our broken system.

 

 

At a Tuesday morning roundtable sponsored by Dell, Intel and the N.C. Business Committee for Education, Gov. Pat McCrory spoke to educators and business leaders who were gathered at the N.C. Department of Public Instruction to strategize about ways to improve teacher effectiveness and next generation learning.

Using the opportunity to reiterate his education goals for the upcoming legislative session, which include paying all teachers more, McCrory hammered home his idea to create a “career pathway plan.”

“We want to ensure teachers have a career…and not a temporary stopover,” said McCrory, explaining that currently teachers have no way to move up in their profession unless they move into higher-paying administrative roles – a career move that not all practitioners are interested in making.

In addition to proposing a two percent average pay increase for all teachers and paying beginning teachers even more, McCrory proposed last week to create a long-term plan that would entice more teachers to stay in the profession by seeing salary increases that are linked to their work as teachers.

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