Coffee Break 3-8-18: A Tale of Two Stories

A Tale of Two (News) Stories

QUOTE OF THE DAY

“Nearly a month ago, Rauner infamously declared that he ‘would not do anything different’ in the aftermath of a Legionnaires’ outbreak at the Quincy Veterans’ Home. Since then four residents have been diagnosed with Legionnaires’ and new reports keep raising questions about Rauner’s response to the crisis.

Yesterday, Rauner’s administration dodged a legislative committee who wanted to know why the state never acted on a recommendation to replace water pipes back in 2016. After a WBEZ investigative report into the home, which prompted a Rauner stay at the home, his team requested an updated report. And they asked for the plumbing replacement as an ‘emergency project’ since ‘frail, elderly residents at the home (are) still becoming sickened.’

Rauner told Crain’s Chicago this month, ‘We’ve handled it exceptionally well and we would not do anything different.’”

–DGA, quoted in Capitol Fax 2-21-18

There’s plenty of news circulating these days, but not all of it is making front-page headlines in the MSM—or at least, not until the stories themselves are played out.

Below the fold, we consider two stories we’re following, one out of West Virginia, and the other out of Illinois. The first was the West Virginia teachers and service personnel strike, the other is a mystery-tragedy in Quincy, Illinois.  Both serve to illustrate separate-but-related facets of the trend towards “small government”—small in terms of citizen services, that is.

The West Virginia Strike

The strike, which is now over (as of March 7), was slow to garner national attention and did not initially gain much support among coastal progressives, who are still angry that voters in the state went for Trump (by 68% no less) in November 2016.

West Virginia’s teachers are the 48th-lowest paid in the U.S., and the strike was presented by most outside reporters as being mostly about salaries; at an average of $44,000, those opposing the strike claimed that strikers were still making more than the West Virginia average of $39,000. Teachers can emigrate to nearby states and earn $5,000 to $20,000 more yearly, and this has resulted in a teacher shortage in the state—there were 727 vacant teaching positions when the strike started, and the likelihood of their being filled this late in the school year is zero.

However, the strike was about more than poor pay. It was also about changes to health insurance costs, which are slated to go up in the next few years (premiums, deductibles, and co-pays) and which would have eaten up a 1% or 2% pay raise and then some. This issue was not resolved (although costs have been “frozen” for 18 months), and will remain open until after the November election, when voters have a chance to reject lawmakers who have insisted on employees’ shouldering the burden of skyrocketing health insurance costs.

It is important to note that that 5% raise (about $2000-2500 yearly, or $200 a month) ultimately approved by lawmakers was not granted to teachers alone: it was given to all state employees, include the school service personnel who went out on strike with the teachers, and who swelled the number of strikers from just under 20,000 to around 33,000—a significant increase in a small state (1.8 million).

Also significant and  under-reported is the fact that the teachers got legislators to back down on other issues of importance, including charter schools, an anti-seniority bill (probably a segue to introducing “merit pay”, a favored ed “reform” measure), and preventing automatic payroll deductions of union dues.

There was considerable confusion over whether the strike was “illegal” or “unlawful”. Strikes are indeed forbidden for teachers in West Virginia, a right-to-work state with very limited union rights for the two national teachers’ unions with membership in the state, the AFT and the NEA. However, the fact that they were joined by school service personnel, which included bus drivers and school cafeteria workers, made the issue moot: West Virginia is a largely rural state, and without bus drivers to bring children to school, superintendents declared the equivalent of “snow days” and all schools in the entire state remained closed throughout the strike by force majeure. This also means that teachers will not be docked for the days they were out, and that the days lost will be made up without officially extending the school calendar.

Concerning the role of the two unions in the strike: the teachers’ unions are weak in the state and under-enrolled (although this seems to be changing in the wake of the strike – it will be worth following union membership numbers over the next several weeks and months). This was a grass-roots strike which spread rapidly from county to county and which eventually included the teachers in all of the state’s 55 counties—thus the now-famous Twitter hashtag, #55Strong, which was itself going strong throughout the strike.

The teachers made sure that parents and their communities were informed about the strike and its underlying causes in advance, and thereby gained the support of these important constituencies of fellow-citizens.

And they were pro-active about something else: food. Around 29% of West Virginia’s population lives in poverty, and many students depend upon their school to provide breakfast and the main meal throughout the school year. So teachers coordinated closely with local organizations like churches and food banks to ensure that students didn’t go hungry during the strike, and many helped to man distribution centers when they weren’t commuting to Charleston to be present during lawmakers’ deliberations.

The strike was noticed early on by labor organizers and progressive news sites, although not much of what was happening on the ground filtered through to mainstream sources. But it was also watched closely from the outset by teachers in other states with comparable, though not identical, grievances. Oklahoma teachers are paid even less than their colleagues in West Virginia; they can move a hundred miles or less into Texas and earn $20,000 more a year—and many have done just that. As of now, a preliminary announcement of the intent to strike in April (possibly as early as April 2) has gone out—interested readers can follow the latest developments on an almost-hourly basis at #77Strong.

DeedSpeakOut has spent many hours reading about the strike and listening to on-the-ground reporting and labor organizers’ podcasts over the past two weeks. A few things we’ve garnered along the way:

–prepare well in advance: this strike did not happen overnight despite appearances
–include as many workers as possible: teachers were joined by service personnel
–demand relief for as many fellow-workers as possible: all public employees got 5%
–gain the support of those whose support matters: students, parents, wider community
–stay the course: the teachers rejected the initial offer of 2%, despite the fact that their union leaders announced a settlement a week ago
–acknowledge when an issue can’t be solved: a resolution to the spiraling-out-of-control costs of health insurance and health care requires a different approach, TBD

Another lesson: pundits don’t have a full grasp of events. Strikes are organic.

General conclusion: Solidarity, forever.

Legionnaires’ disease at the Illinois Veterans Home in Quincy

The other story we’ve been following is that of a tragedy and perhaps, a major scandal-in-the-making, at Illinois’s largest veterans’ home, located in Quincy (IVHQ).

First, some background:

Legionnaires’ disease broke out at the IVHQ in late summer 2015. The outbreak, which probably began in late July, was not confirmed by the Illinois Department of Public Health (IDPH) until August 21. There then followed a six-day gap in information provision to the residents and their families; an announcement of the outbreak came on August 27. By August 29, 39 people had become ill and there were 4 confirmed deaths of persons who had not been appropriately treated for the disease (it is bacterial, and is treated by a course of antibiotics).

In 2016, another three (possibly six – the exact numbers vary according to date/source) residents became ill; and as of late 2017-early 2018, another four confirmed cases have been announced to the public.

The total number of those who have contracted the disease to date is (probably) 67. Thirteen residents (twelve veterans, one spouse) have died. [Note: at least one staff member became ill early on before confirmation of Legionnaires.]

This story broke in late August 2015, and the state responded by installing a new $6.4 million water treatment plant at the aging facility (built in 1886) and by putting $150 water filters on faucets, shower heads, etc. – the disease is air-and-water-borne, so any distribution point where water is aerosolized was particularly suspect.

The Centers for Disease Control were called in and advised the IDPH on controlling the disease’s spread. The Illinois Department of Veterans Affairs (IDVA), which has direct oversight of the Quincy home (together with Illinois’s other three veterans’ homes in Anna, Mantena, and LaSalle), was involved as equal partner in managing the crisis.

An assessment of the plant’s residential homes (“dorms”) at a cost of $20,000 was ordered to propose remediation plans; a revised plan (extra $$$) has also been presented. The report includes a plan/estimate for replacing the entire plumbing system.

Fast forward to December 2017, when Chicago reporter Dave McKinney (WBEZ) began publishing a series of investigative reports on the outbreak, which has yet to be brought under control—we estimate that about 15% of residents have now contracted the disease—and for which the IDPH/IDVA/Governor of Illinois have yet to present a plan for protecting Illinois veterans from further outbreaks. (Note: the four confirmed cases from late November 2017 – February 2018 are particularly worrying, given that Legionnaires’ disease is rare in winter).

The facility is a sprawling one – it occupies a 220-acre “campus” in the city of Quincy (pop. approximately 40,600 [2010]), and has numerous residential facilities (we have seen eight buildings listed as residential in the reporting; the residence where the outbreak has proven most severe is the Elmore Building) where its 350 current residents are housed (total capacity = +/-500). Its plumbing system, which extends over many miles over/under the grounds and buildings, has not been replaced since construction, and its old metal pipes are considered prime breeding grounds for the bacteria legionella).

From the original outbreak in summer 2015, there have emerged two major issues:

  • Why was there a six-day delay in notifying the families of residents about the outbreak?
  • Why has the governor not acted?

Yesterday, Nirav Shah, Director of the IDPH, was interviewed on The 21st (an Illinois radio program) by Niala Boodhoo. In the course of polite-but-not-friendly discussion, it became clear that there’s going to be a whole lot of buck-passing going on at IDPH/IDVA (which are apparently trying to present a united front here), and that the home’s personnel will be taking the brunt of the blame. It sounded to us like Shah and his colleague in IDVA, Erica Jeffries, are setting the PR stage for future lawsuits (eleven of the thirteen families whose veterans died are already involved in civil suits  against the state).

From the published report on the interview:

Shah said his agency’s role during an outbreak is to figure out who’s at risk, identify the source, and make recommendations to facilities on how to keep people safe. Within 27 minutes of learning of the second Legionnaire’s death at the Quincy veterans home in 2015, Shah said ‘we were on the phone with the facility to let them know of what was going on and giving them recommendations that they could put into place.’ After that point, he said it was the responsibility of the facility—not his agency—to notify staff and families.”

Shah went on to claim that within 27 minutes of the second confirmed death from the disease on August 21, 2015, his agency had notified the IVHQ of the situation.

But the home didn’t notify families. When pressed on this by Boodhoo, Shah digs the hole a little deeper, but not so deep the home can’t squirm out if it tries:

Well, there are no set standards in any statute, or rule, or regulation as to when families need to be notified. Again, we trust facilities to do that on the schedule that they have set forth. And again, Director Jeffries can discuss the nuances at the mechanics of those notifications. But in this situation, we did immediately alert the facility of what was going on, we provided them—”

The home, for now, isn’t talking—it will have its day in court, apparently.

The second issue which is emerging in 2018 concerns steps to remediate the outbreak by the governor. At present, it does not appear that Mr. Rauner has any plans to address the IVHQ Legionnaires’ disease outbreak beyond appointing a coordinator of efforts by the two primary agencies involved, IDPH and IDVA, the Adams County Health Department (the home is located in Adams County) and, perhaps, the CDC and the VA itself—and who else? The coordinator, Michael Hoffmann (former directory of Illinois’s Central Management Services, the most powerful agency in the state), has not yet appeared in public hearings to speak to the nuts and bolts of coordination.

Speaking of public hearings, a joint Illinois House-Senate Veterans Affairs Committee met in Chicago on Tuesday to hear testimony by Shah and Erica Jeffries of IDVA. At this meeting it was announced that replacing the old plumbing in the complex was not considered practical and there is the prospect of building new residences.

Jeffries, we recall, had in the past claimed that “replacing the pipes” was too expensive, although her various estimates, provided at different times and in different contexts during the course of this nearly three-year-old crisis had varied, ranging from $8 to $30 to $500 million.  (No one, including Jeffries, has accounted for these wildly-disparate figures.)

The governor moved to the home in January and spent a week there, apparently in a PR gesture to show residents, families, veterans and citizens of the state that he is a caring, compassionate individual. He said he had a swell time, and even invited one of the veterans he’d met to attend his “State of the State” address in Springfield. That veteran later came down with Legionnaires’ disease.

The question is “But what is to be done?”

The governor doesn’t want to spend a nickel on veterans—or on anyone, really, who is in need of any social service provided by the state. His philosophy is one of “negative rule” – for more than two-and-a-half years, he held the legislature and state hostage to his refusal to sign a budget, which resulted in billions of dollars of additional debt and a downgrading by the bond raters of the state’s bonds to one grade above junk. He seems  to believe that his policy of “starving the beast” (anti-worker, anti-union, anti-social services) will solve Illinois’s budget woes. Instead, they have only become more severe.

But we need to realize that even had Rauner gotten the budgets he demanded, the situation at the IVHQ would have been just as bad as it is today—perhaps more so.

At this moment, the options for the home involve (a) replacing all the plumbing at a cost of –x; (b) replacing the entire plant at a cost of –x+y.

Senator Cullerton has an appropriations bill ready to go—all they need is a number, and it’ll pass. But Rauner has now appointed a coordinator, who will coordinate with a task force or working group for a couple of months, and around the end of May we may have a figure on the cost of whatever they decide they’re going to propose be done.

In the meantime, the Director of Public Health feels “mournful” (is this the new iteration of “thoughts and prayers”?) about those 13 deaths, and the governor thinks he’s done a terrific job of addressing the crisis and wouldn’t have done anything differently. And Erica Jeffries is now telling us that a “resolution” will take between three and five years.

The governor doesn’t have a blameless past with nursing homes. The private equity firm he owned, GCTR (the “R” is for “Rauner”) had invested in a string of nursing homes in the late nineties which were subsequently involved in multiple personal injury lawsuits. The legal wreckage left by these cases, however, is a complex one, as often in cases involving PE:

“At issue are lawsuit awards in a half-dozen wrongful death and patient-neglect cases that at one point totaled more than $2.3 billion, as well as allegations by personal injury attorneys that GTCR and other nursing home investors failed to provide proper funding for care and later moved to shield assets to avoid paying damage claims. …

“In one 2012 case, a jury awarded $900 million in damages for neglect involving a man who had been in a Gainesville, Fla., nursing home. But in December, a Florida state appeals court overturned the award and sent it back to the trial court, saying the trial judge had erred by preventing the defense from making its case. Last July, another $1.1 billion judgment was handed down in a 2007 wrongful death of a Florida woman, but that award was put on hold as part of the bankruptcy proceedings, court documents show.”

This is what happens when a fiscal ideologue gets elected governor of the country’s fifth-largest state. The beast is starved, by hook and by crook. People—people who fought in World War II, and the Korean War, and in Vietnam—die.

 

 

 

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