2008 Annual Report - Community Health Network of Connecticut, Inc.

2 0 0 8 A n n u a l R e p o rt
A Year of
Transition
The Loss of a Leader
Community Health Network of Connecticut, Inc. (CHNCT) lost its most influential
and devoted supporter in 2008. Cornell Scott, known as “Scotty” to those close to
him, died August 25, 2008 after a long illness. He was 73 years old.
Cornell was the longtime Chief Executive Officer of Hill Health Center in New
Haven and also a founding member of CHNCT’s Board of Directors. He served as
the Board’s Chairman since its inception in 1995.
“In many ways, Scotty’s passing was such a sad time because he was a legend
in his own right, in his own being,” said Alfreda D. Turner, President and Chief
Executive Officer of Hartford’s Charter Oak Health Center and Cornell’s successor
as CHNCT’s Board Chairman. “However, his passing and the subsequent transition
afterward forced us to reassess where we were during that time and where we
were going. It was a time of reflection and it reaffirmed our commitment to this
organization.”
Cornell was described by CHNCT Board Member Carl A. Mikolowsky, D.D.S. as “an intensely dedicated man.” He
was instrumental in bringing all of the community health centers together in the mid-1990s when the state Department
of Social Services first announced its intention to oversee managed care, according to Gary Spinner, Chief Operating
Officer of the Hill Health Center and CHNCT Board Vice Chairman.
“Cornell’s vision was for the health centers to be in a position to use its expertise in managing Medicaid to control its
own destiny,” Spinner said. “Cornell saw this as an opportunity for those health centers, those that shared his vision of
bringing non-profit oversight of managed care, to come together in unity, to provide choices to patients and provide
choices to health centers. He wanted to create a model that brought to bear the same vision that health centers have in
bringing medical services to the underserviced people in the managed care arena.”
“For this, we will always be grateful to Scotty, grateful that he had the vision to incorporate the Connecticut Primary
Care Association, which then seized the opportunity to create CHNCT,” said Evelyn Barnum, Chief Executive Officer of
Community Health Center Association of Connecticut.
“He was one of the great pioneers in seeking high quality care for all people,” said Board Member Attilio V. Granata, M.D.
Cornell’s pioneering efforts in ensuring the success of the health centers he so
passionately supported continue to be widely recognized by those he worked with.
“Scotty was one of the patriarchs of the health center movement, as well as a mentor,
advisor and friend. He left indelible footprints and a model for all to emulate. I am
forever changed by knowing him,” said Katherine Yacavone, President and Chief
Executive Officer of Southwest Community Health Center
“He understood how important community health centers are and their essence in
the community. He was an invaluable ally for justice in health care, and thus was
a friend and advocate for every patient,” said Arvind Shaw, Executive Director of
Generations Family Health Center
“Scotty was a colleague and a friend, who was a champion not only for the
community health centers, but also for the patients whom we all served,” said Katrina
Clark, Executive Director of Fair Haven Health Center.
“My earliest memories of Scotty, when I joined the Staywell Health Center in 1985, were how welcoming to the
community health center family he was to me. He shared information willingly, was patient with my newness, and
over time became a friend and mentor. Scotty’s commitment to the people we served inspired all health center staff
to do the right thing. He is dearly missed,” said Don Thompson, President and Chief Executive Officer of StayWell
Health Care, Inc. and CHNCT Board Treasurer.
Many CHNCT board members acknowledged that CHNCT was tried and tested in the early years and episodically
thereafter. Outsiders always had concerns whether CHNCT had the ability to compete against the well-populated
and well-financed, for-profit companies, they said.
Due to the competitor’s caliber, the survival of CHNCT – a relatively small, not-for-profit organization – was always
in question; however Cornell never wavered in his vision and always remained its most vocal supporter.
“Scotty spent a great deal of this time making sure CHNCT would remain strong and continue to grow,” said Ludwig
Spinelli, Chief Executive Officer of Optimus Health Care, Inc.
“There is such great evidence that the community has recognized CHNCT for the jewel that it is. They were given
the choice of plans and they chose us,” Turner said. “Nothing is greater than being chosen. The actions of the
community have spoken louder than the words of anyone.”
Turner continued, “Some things you can purchase but some things you have to earn. We’re now reaping the harvest
of those seeds that were sown. I believe the sky is the limit for this organization.”
Said CHNCT President and Chief Executive Officer Sylvia B. Kelly, “During the almost nine years I reported to
Cornell, he was truly the epitome of a great leader. He approached controversy and issues in a firm manner, but
never without his gentlemanly nature. When he spoke, his comments were thoughtful, insightful and commanded
everyone’s attention. He was passionate about his vision for his health center and
this company and personally was a great mentor to me.”
Operational Transition
CHNCT saw many operational changes in 2008, all of which greatly impacted us as an organization. CHNCT
was one of four risk-based managed care organizations administering the state’s HUSKY A and B programs in
November 2007 when Gov. M. Jodi Rell terminated the managed care contracts. This was done following two
competitors’ refusal to comply with the state’s Freedom of Information Act contract requirements.
As a result, CHNCT continued to arrange services for its HUSKY A and B members under a Prepaid Inpatient
Health Plan (PIHP) agreement with the state. As a PIHP, CHNCT was required to adhere to Medicaid fee-for-service
medical policies and it needed approval from the state to deny authorizations for services or negotiate provider
reimbursement rates. This meant implementing new policies and procedures and reconfiguring its claims processing
system in a very short period of time. “Regardless of the type of contract we had with the state, our main goal was to
ensure that our members continued to receive services and were not affected by the transition. We were committed
to working with the state to make this happen,” said Cory Ludington, Vice President of Government Affairs and
Compliance. With only one additional competitor agreeing to contract with the state as a PIHP, this provided CHNCT
the opportunity to grow as a company. In December of 2007, CHNCT’s membership was 61,421 and increased to
97,214 by October of 2008, which concluded CHNCT’s PIHP contract.
In 2008, the Governor sent out a Request for Proposal (RFP) with regard to the HUSKY A, HUSKY
B and Charter Oak programs. CHNCT signed a new contract with the state on July 1, 2008.
We began acting as a risk-based managed care organization on August 1, 2008 for
the Charter Oak program and on Sept. 1, 2008 when the first of several counties
began transitioning to the new HUSKY program. The re-procurement of the
HUSKY A, HUSKY B and Charter Oak programs resulted in CHNCT
transitioning from being a PIHP back to a risk-based managed
care organization. CHNCT’s three competitors chose not to renew their respective contracts with the state. Therefore CHNCT
remained the only organization in the program since its inception. Two new competitors joined CHNCT in administering the
HUSKY and Charter Oak programs. This turn of events proved very rewarding for CHNCT throughout 2008.
While CHNCT’s membership has been growing steadily over the last decade, even we were taken aback by the sheer
influx of new members seen during the latter part of 2008. Throughout the year, CHNCT nearly doubled its membership
since 1995. By the end of December 2008, CHNCT’s membership had grown to 137,379. In addition, CHNCT also
serves as the Administrative Services Organization (ASO) for the State-Administered General Assistance (SAGA)
program. During 2008, CHNCT saw an increase in its SAGA membership, which we believe was in
part because of the declining economy. In December of 2007, CHNCT’s SAGA membership was
33,581 and increased to 38,244 by December of 2008
2008
2007
HUSKY A
131,048
58,292
HUSKY B
5,412
3,129
38,244
33,581
919
n/a
175,623
95,002
SAGA
Charter Oak
Total
Member Services
The operational changes within the company tremendously affected CHNCT’s Member Services department. For one,
it created the need for additional training with regard to the switch from risk-based managed care to PIHP and the
addition of the new Charter Oak program.
The transition and membership growth resulted in a higher volume of communications to our CHNCT members to
ensure their understanding of program changes. In 2008, CHNCT experienced an overall 40 percent increase in call
volume from members.
• CHNCT Member Services Department completed 135,541 calls with HUSKY A and HUSKY B members.
• CHNCT Member Services Department completed 52,471 calls with SAGA members.
• CHNCT Member Services Department completed 5,448 calls with Charter Oak members.
New ID cards had to be issued and members had to be kept
informed of the organization’s changes. Significant changes
during this time included the carveout of dental and pharmacy
benefits and changes made to the HUSKY B billing process.
Health Services to Our Members
In our efforts to ensure that members continued to receive services and were not negatively impacted by the
transition, our Health Services and Medical Management departments worked diligently to handle the increased
volume in case reviews and of members participating in disease management programs.
Between 2007 and 2008, CHNCT experienced a 61 percent increase in members receiving case management. In
particular, those involved in the Charter Oak program had a myriad of health issues and problems that needed to
be addressed. “This was expected in that individuals enrolling in the Charter Oak program had many unmet needs,”
said Lynn Childs, Vice President of Health Services.
The number of members participating in CHNCT’s three Disease Management programs – Healthy Airways
(asthma), Healthy Beginnings (pregnancy) and Healthy Cells (sickle cell disease) – increased 55 percent as a result
of the organization’s transition in 2008. In 2008, 4,888 cases were closed compared to 3,158 cases in 2007. That
represents an increase of 55 percent.
The program most affected by the transition was Healthy Beginnings. For this program, case management numbers
increased not only in numbers, but also in acuity. Therefore it became necessary to add two additional nurses to
work with those identified as having high-risk pregnancies. Future plans for the Healthy Beginnings program include
hiring several licensed practical nurses, who will contact low-risk members, triage cases and perform assessments.
“We obviously have a larger membership than we expected at this time and this has certainly presented challenges
to all of us. Thus far, we are quite pleased with the results and the level of services our members are receiving,” said
Senior Vice President and Chief Medical Officer John V. Federico, M.D.
Provider Network
With the increase of membership in the HUSKY program and the recently implemented Charter Oak Health Plan
came the need for a larger Provider Network to accommodate the organization’s growth. By year-end, CHNCT had
the most robust Provider Network of all three managed care organizations administering the state’s HUSKY and
Charter Oak programs.
CHNCT’s Provider Network increased by more than one thousand participants
from 2007 to 2008. The Provider Network grew from 6,591 Primary
Care Physicians and Specialists in 2007 to 7,693 Primary Care
Physicians and Specialists in 2008.
“From the outside looking in, I don’t
think anyone thought we could do this.
And we did.”
– Gail DiGioia
Vice President of Operations
Claims
Due to the influx of new members, the number of claims processed also skyrocketed. In 2008, CHNCT staff
processed roughly 2.3 million claims, up from approximately 1.2 million claims in 2007. That is an increase of
roughly 92 percent.
There were also many changes within the Claims department in 2008. It began scanning paper claims in
CHNCT’s document management effort to go paperless, which was completed in December.
It also created new workflows to utilize its system to the highest capacity.
IT System Conversions and Infrastructure Enhancement
Responding to the organization’s transition to PIHP and its subsequent changeover back to a risk-based managed
care organization, CHNCT’s IT department implemented a number of system and configuration changes in 2008.
These changes were also needed in part due to the implementation of the Charter Oak Health Plan and the enhanced
coordination of benefits with regard to claims processed.
CHNCT recognized the need to strengthen our technical and data
infrastructure in 2008 to handle the sheer volume of new
members. Most importantly, however, we moved to a
virtual server environment along with implementation
of thin client technology, which has allowed us to
expand to accommodate the organization’s
growth. We also began focusing further on
core system business process efficiencies
along with data analytics and business
intelligence reporting.
“2008 has been a landmark year for CHNCT’s IT department. We have been challenged with the implementation
of a new line of business, extensive system reconfiguration of our existing business lines, support of the expansion
of new members and employees along with redesign of internal business processes and infrastructure to meet the
needs of our complex and high volume environment. It will be vitally important that we continue to carry forward
our efforts to provide high quality and cost effective IT services/solutions for the organization in support of the
delivery of critical services to our members, providers and business partners.”
– John Kaukas, Vice President and Chief Information Officer
The Team
At CHNCT, we pride ourselves on the ability to give personal, one-on-one contact to each and every one of our
members. In order to fulfill the increase in needs, CHNCT staff grew from 119 in 2007 to 172 in 2008. That figure
includes temporary staff that helped us during the transition. “One of the lessons of this transition period is that
when this organization is faced with a major challenge that’s felt and understood by everyone, we can
get very agile and we surprise each other about how much we can accomplish in a short
period of time,” said Jim Karl, Vice President of Human Resources.
Celebrating CHNCT’s Long-Term Members
CHNCT celebrated its members who had been with the plan for ten or more years.
To mark this important milestone, we asked our members to share their stories as
part of a contest called “Hear My Story.” We wanted to know how CHNCT had
helped them to manage their health care needs.
“It was gratifying to find out we had almost 3,600 members who had been
part of the CHNCT family for ten or more years. At the end of every day, I
know we have impacted the lives of vulnerable individuals, particularly
children,” said President and Chief Executive Officer Sylvia B. Kelly.
The winners of the contest were Lina Salazar and Brendalee Heredia.
The following are a few excerpts from their stories in their own words:
Brendalee Heredia
“I’ve been a member of the CHNCT program since I was 10 years old and I am now a
student at Housatonic Community College. I feel CHNCT has always been there for me
even when I had gotten pregnant with my son Phillip. I felt important when CHNCT called
to see if my pregnancy was going well. And they even sent me a free JC Penney’s portrait
package so that I can take pictures.
“CHNCT is also a good program that keeps me up-to-date with everything. I feel this
program has helped my keep myself healthy enough to keep moving forward. I really do
appreciate CHNCT for providing me and my child with the proper care and attention. Every
time some change occurred, CHNCT has notified me by letter or phone.”
Lina Salazar
“My relationship with CHNCT goes back 15 years. I had left my home to be with the
young man of my dreams, only to be left with neither home nor dreams. I was only 15
years old. I was alone, scared and very pregnant. CHNCT not only provided excellent
prenatal care, they were behind me all the way when I had to face surgery during my
fourth month of pregnancy. But they also went above and beyond to connect me to other
much needed services.
“Having a baby at 15 was scary, but with CHNCT I was not alone. Even after the birth of my
baby, I was not alone. I was not alone when my child got his first cold or ear infection. And I
always knew if I had any questions or concerns about my child’s health growth needs or coverage,
I could always ask any one of the CHNCT team members. Due to all the help my CHNCT team provided, I
knew that with a little of my own effort, my child and I would be Ok.”
Community Connections
While we experienced changes in 2008, many things still remained the same.
Our efforts to support the community never wavered.
Adopt-a-Shelter
CHNCT adopts a shelter several times annually in locations across Connecticut.
In doing so, CHNCT identifies each shelter’s individual needs and then works
to replenish those items. Through its Adopt-a-Shelter program, CHNCT also
provides residents with nutritional workshops, including “Cooking on a
Budget,” one of our most popular workshops that teaches families how to calculate what they should use in a month
for groceries and how to stretch those dollars using a combination of food stamps, food pantries and their own
money. CHNCT also provides information on the state’s SAGA (State-Administered General Assistance) program.
Beginning in 2008, CHNCT expanded its Adopt-a-Shelter program to include
community partners. Norton Elementary School in Cheshire was the first
community organization to team up with CHNCT for the benefit of Meriden’s
Shelter N.O.W. CHNCT would like to thank the staff, students and families of
Norton Elementary School for far exceeding expectations and setting the bar for
future undertakings.
In 2008, CHNCT “adopted” the following shelters:
• Norwalk Emergency Shelter, Norwalk
• East Hartford Community Shelter, East Hartford
• Shelter N.O.W., Meriden
Coat Drive – New Haven area
The 2008 Coat Drive was CHNCT’s largest success yet!
Crowds of people lined up at the New Haven Field House to
pick out one of roughly 1,700 new and gently used coats.
The coats were either purchased or collected by CHNCT and
Easter Seals Goodwill Industries.
The Coat Drive is a collaborative event between CHNCT, the
New Haven Firebird Society, 94.3 FM WYBC, Easter Seals
Goodwill Industries and Metro Taxi. Besides giving away all of
the coats, thousands of dollars of toys are also given away at
this event. The event serves as a kickoff to the holiday season.
Hundreds of children waited patiently to meet the man from
the North Pole himself – Santa Claus! Santa Claus met with
each child. He also gave away countless toys. The children
also enjoyed playing video games. Some left with their faces
painted. Others left with custom holiday crafts, which they
made at the Coat Drive.
CHNCT’s How CAN You Help? Food Drive – Hartford area
Throughout the month of November, CHNCT held its annual food drive, in which it collected food for four Hartford
area shelters. CHNCT staff members, as well as members of the public donated countless food and personal care
items. The collection was a collaborative event between CHNCT, the Hartford Fire Department, KISS 95.7, the Boys
& Girls Club of Hartford and Price Chopper.
The following shelters were recipients of CHNCT’s How CAN You Help? food drive:
• East Hartford Community Shelter, 385 Main St., East Hartford
• Hockanum Valley Community Council, Inc., 155 W. Main St., Vernon
• Immaculate Conception Shelter, 560 Park St., Hartford
• Hartford Interval House for Battered Women, Hartford
Community Health Network of Connecticut, Inc. presents:
How CAN You Help?
2008 Hartford Food Drive
LIVE RADIO
PROMOTION
Nov. 15, 2008
1-3 pm
Asylum Hill
Boys & Girls Club
170 Sigourney St.
Hartford, CT 06105
For more information call
203.949.4053
Items to Donate:
100% Fruit Juice (cans/bottles/boxes)
Canned Vegetables and Fruit
Chunky Soups and Beef Stew
Macaroni and Cheese
Peanut Butter
Powdered Milk
Rice/Dry and Canned Beans
Spaghetti and Sauce
“Sugar Free” “Low Sodium” and “No Salt” items
Tuna and Other Canned Meat
ALSO:
Personal Care Items: Shampoo, Toothpaste and
Toothbrushes, Diapers, Detergent, Deodorant,
Shaving Cream, Razors and Hairbrushes
Serving food pantries in Hartford County
Food donations may be dropped off at one of
the following Hartford Fire House locations:
• 197 Main St.
• 1515 Main St.
• 275 Pearl St.
• 129 Sigourney St.
• 181 Clark St.
• 721 Park St.
• 655 New Britain Ave.
• 510 Franklin Ave.
• 150 Sisson Ave.
• 25 Blue Hills Ave.
• 8 Fairfield Ave.
• 636 Blue Hills Ave.
Food donations may be dropped off at one
of the following Price Chopper locations:
• Newington: 2985 Berlin Turnpike
• Vernon: 35 Talcottville Road, Tri City Shopping Plaza
• Windsor: 675 Poquonock Ave
Food donations may also be dropped off at:
• The Boys & Girls Club of Hartford at 170 Sigourney St.
PLEASE NO
FRESH FRUIT,
VEGETABLES or
OTHER
PERISHABLE
ITEMS
Please visit www.chnct.org for more details
Financial Information for CHNCT’s 2008 Annual Report
Current Assets
$41,302,669
Other Assets
$12,701,744
Total Assets
$54,004,413
Current Liabilities
$37,308,103
Total Liabilities
$37,308,103
Total Net Assets
$16,696,310
Total Liabilities and Net Assets
$54,004,413
Risk Program Husky A, Husky B & Charter Oak:
Revenue
$58,134,600
Medical Expense
$50,903,232
Administrative Expense
$5,636,084
Net Income
$1,595,284
ASO Program Fees:
SAGA
$2,670,148
PIHP
$15,913,349
“Last year was a very challenging time for the Finance Department. The transition out of the original risk program
into an interim non-risk program and then back again into a risk program required us to maintain distinct
classifications of company spending for the three separate programs.”
– Anthony Bruno, Senior Vice President and Chief Financial Officer
Board of Directors
Alfreda D. Turner, President and Chief Executive Officer
Charter Oak Health Center, Hartford
Chairman
Gary Spinner, Chief Operating Officer
Hill Health Center, New Haven
Vice Chairman
Katrina H. Clark, Executive Director
Fair Haven Community Health Center, New Haven
Secretary
Don Thompson, President and Chief Executive Officer
StayWell Health Care, Inc., Waterbury
Treasurer
Ludwig M. Spinelli, Chief Executive Officer
Optimus Health Care, Inc., Bridgeport
Arvind Shaw, Executive Director
Generations Family Health Center, Willimantic
Katherine Yacavone, President and Chief Executive Officer
Southwest Community Health Center, Bridgeport
Attilio V. Granata, M.D.
Associate Clinical Professor of Internal Medicine
Yale University School of Medicine, New Haven
Carl A. Mikolowsky, D.D.S (Retired)
Manchester
Evelyn Barnum, Chief Executive Officer
Community Health Center Association of Connecticut, Newington
Sylvia B. Kelly, President and Chief Executive Officer
Community Health Network of Connecticut, Inc., Wallingford
11 Fairfield Blvd., Suite 1 • Wallingford, CT 06492