Wednesday, August 15, 2012
Later this month, I will assume administrative duties in the office of the Provost at UNLV, as Vice-Provost for Faculty, Policy and Institutional Research. In accordance with NFA state bylaws, I will become an associate member and step aside as board president. As of that date, Angela Brommel, our elected vice-president, will become NFA state board president. Angela and I have been working on a transition plan that will make her NFA president effective upon my resignation and culminate in the regularly scheduled state board meeting on September 14th. Those aspects of UNLV-NFA and NFA communications that have been my endeavor, including this blog, will be turned over to other officers or will cease to publish.
While logistically I will withdraw from the role of the president (and chair of the southern endorsement committee) at that time, and step aside from the state board after more than 5 years of service, my interest in and commitment to faculty advocacy and the work of NFA -- as well as my personal commitment to all of you, especially those I have worked so closely with for the past few years -- will not cease.
I remain available, at the request of NFA officers at the chapter or state board level, to provide any sort of guidance, information, or support that I can provide to the board -- especially for the important period of the 2013 legislature when we will be actively advocating for restoration of faculty compensation.
(Naturally any discussion of legal defense issues, especially concerning UNLV, must take place outside of my knowledge to avoid any conflict of interest.)
Upon the start of the university academic year, the NFA will communicate to its members and readers important developments over the summer in the governance of the organization and important steps the executive committee have taken to put the NFA on a sound financial and organizational footing, which has been our primary governance goal for several years. It is therefore a propitious moment for me to step aside, as well as a necessary one given my new position, which will still be one primarily of service to UNLV and NSHE faculty but which of course is incompatible with a formal leadership role in the NFA.
As I prepare to step aside, please allow me to close by thanking you -- colleagues, members, fellow officers, general readers, and especially those of you with whom I have worked closely for several years -- to express my heartfelt thanks, my respect and affection, and my continuing commitment to our shared values.
President, Nevada Faculty Alliance, 2011-2012
Vice-President, Nevada Faculty Alliance, 2009-2011
President, UNLV Faculty Alliance, 2009-2011
Secretary, Nevada Faculty Alliance, 2007-2009
Co-Chair, NFA PAC Endorsement Committee, 2006-2012
Thursday, June 28, 2012
According to UNLV Boyd School of Law professor Stacey Tovino, the one part of the law that the Court struck down was the provision penalizing states if they did not increase their Medicaid caseload by withdrawing all Medicaid funding. Instead, the Court made explicit that States may choose whether or not to expand Medicaid eligibility (and thus Medicaid caseload and budget obligations). From the decision
He said Nevada "will prepare to meet the serious financial implication of this decision.
An analysis by the state in 2010 found that the law would cost the state $574 million between 2014 and 2019, mostly through increased Medicaid costs.
"The implications for Medicaid costs are still unclear, but Nevada will prepare to meet the serious financial implications of this decision," Sandoval said.
As a practical matter, that means States may now choose to reject the expansion; that is the whole point.... Some States may indeed decline to participate, either because they are unsure they will be able to afford their share of the new funding obligations, or because they are unwilling to commit the administrative resources necessary to support the expansion. Other States, however, may voluntarily sign up, finding the idea of expanding Medicaid coverage attractive, particularly given the level of federal funding the Act offers at the outset.Now, to be clear, this is not to say that we in Nevada should not be concerned with the vexing issue of how to make health care affordable especially for those of the least means. It does not mean that the longstanding Sophie's Choice for states between human services for those in need and public investment in higher education is any less acute. Nor does it diminish the corresponding need for a broad-based source of adequate revenue for the state.
But the decision does give states like Nevada more short-term discretion in how to avoid further cuts to education and to restore competaitve compensation in highly competitive labor markets like academia and does lift what had been presented as an insurmountable burden for the 2013 legislature.
Tuesday, June 19, 2012
For this reason, the Nevada News Bureau covered the NSHE retirement plan as a "model pension" program over a year ago .
For those interested in some actual, empirically sound comparisons, we can turn to data from the 2011-2012 American Association of University Professors report on faculty compensation and benefits:
Tuesday, May 22, 2012
Saturday, April 21, 2012
On PEBP, some small but significant steps have been taken in the last few weeks. The PEBP Board at its rescheduled meeting on March 29 did allocate – as NSHE and UNLV representatives had sought – all its projected excess reserve to reduce out-of-pocket costs for faculty and staff and their families in 2012-2013, primarily by enhancing HSA/HRA employer contributions for next year.
While this will bring some monetary benefit for most faculty and staff for next year (though not, unfortunately, those enrolled in the HMO plan), it is heartening as well that the public discussion of PEBP's excess reserves highlights the point that many faculty and staff believe – and which the NSHE Task Force continues to study – that competitive health coverage can be made available to NSHE faculty and staff without additional cost to the state.
The PEBP Board also, at the urging particularly of NSHE faculty and staff, approved state subsidies for domestic partners of state public service workers enrolled in PEBP, on the same basis as spouses.
The PEBP Board, however, chose not to alter the basic plan design, as we had sought, to offer participants a "middle tier" (between HMO and the current high-deductible option) that would offer predictable and clearly comprehensible costs for office visits and prescription drugs. All faculty and stuff should continue to advocate for such an alternative for NSHE in the 2013-2015 biennium, either from PEBP or from another insurance pool.
Tuesday, March 13, 2012
2. Reduce premiums on all PEBP participants to reverse the alarming increase in the number of our colleagues declining coverage altogether.
3. Address the alarming increase in HMO premiums for southern Nevada.
Included in that one third are our colleagues among the classified state workforce on NSHE campuses. For these workers, a majority of whom earn less than $50,000 per year, the sharp increases in out of pocket up-front costs resulting from the conversion to a high deductible plan (an increase of several thousand dollars per year for some families) have forced a sharp increase in the number foregoing care, either by opting out of insurance altogether or by declining prescribed cure ,especially by reducing medical dosages below prescribed levels to cut costs.
The impact of the conversion of the PPO to a high-deductible plan, accompanied by a sharp increase in premiums and in co-insurance, and the sharp increase in premiums for HMO enrollees (especially in the south, where rates increased more sharply due to the blending of subsidies) has had a well-documented, negative effect on our workforce. The UNLV survey of faculty and staff conducted in November found that in addition to an unacceptably high 3.2% of workers who declined medical insurance entirely due to costs, over 60% of those who are covered reported either skipping prescribed medications or taking medications less frequently than doctor's orders to reduce out-of-pocket expense.
Lest one think this is merely a matter of faculty and staff cutting back on vanity care, our survey identified three instances of faculty or staff skipping prescribed insulin to control diabetes because they could not afford the cost of either the insulin pump or of the insulin itself at the end of the pay period.
We have therefore urged -- and continue to urge the Board -- to consider a "middle tier" plan, if not for FY13 than for the next biennium, that would allow participants to better anticipate (and budget for) the out-of-pocket cost of medical care through a separate prescription drug deductible and fixed co-pays for doctor's visits.
When an enhancement of coverage options was first suggested to the Board last fall, the response was that modifications to plan design would not be financially feasible or would come at such a high rate of participant premium as to be unviable. However, it appears from the program's last two quarterly financial reports that in actual cash terms, the program is accruing money to its reserve rapidly. Whereas last spring, during the 2011 legislative session, PEBP staff told a legislative committee that if the plan did not switch from a conventional PPO model to a high deductible plan, participant overutilization would drive the program to lose approximately $80m in the 2011-2013 biennium. However, it now appears that at the end of the 2010-2011 plan year, when we abandoned the conventional coverage paradigm, the plan had accrued between $20m and $43m in excess reserves -- above those necessary to meet the cost of care incumbered not but not yet claimed and of catastrophic claims. As of September 30, 2011, the plan had an excess reserve of $43, some $32m above that which PEBP had projected for the legislature in its work program.
And the most recent financial report reports that while the projected end-of-year excess reserve is down to $29.8m (due to the loss of an anticipated $12.5 in federal grants, not due to any increase in claims or coverage), the actual available reserve is up to $55 -- some $44m above what was projected in the budget submitted to the legislature. That is quite far to miss the mark and participants really do deserve an explanation.
Even more so, we deserve health coverage, which is the primary mission of the program, not the controlling of costs or the accrual of reserves. The state has allocated money for health coverage, participants have dutifully paid their premiums and deductibles, and the program appears to have netted at least $10m last quarter. Moreover, next year the program will receive a sharp increase in employer-side contributions, representing an increase in revenue of over 10% (over $30m statewide).
So between this excess reserve of over $40m currently and an increase in revenue of over $30m for FY13, we are urging the Board to lower premiums for all participants and enhance HSA contributions.
A final thought. We are aware that the staff is disposed not to alter the current plan design in order to see how it works out over the course of the 2 year biennium. From a scholarly standpoint, we understand this interest in carrying an experiment through to its conclusion. However, the mission of PEBP is not to show how to get us to use less care; it is to provide to the best of its ability and resources the care we actually do need.
That need is clear, the resources are available, and the time is now. We urge the board to commit to reducing out of pocket costs and enhancing coverage options for next year.
Monday, March 12, 2012
i. Amend the base subsidy allocation percentages paid by participants in the Consumer Driven PPO High Deductible Health Plan, the Southern HMO Plan and the Northern HMO Plan as provided in Appendix A of the Duties, Policies and Procedures and/or
c. Approving the rates, State subsidies and participant contributions to utilize Excess