Tuesday, September 2, 2014

Vermonters for Health Care Freedom

Vermonters for Health Care Freedom
Health Care Reform Newsletter #39
Vermonters for Health Care Freedom continues our newsletter series on Vermont’s health care reform efforts. We aim to provide useful information to our client businesses and newsletter recipients; to inform our readers about Vermont’s efforts toward a “single payer” health care system and the problems inherent in such a system; and to address related health care matters at the federal and state levels.

More Evidence of State’s Failed Leadership
The Optum Report Is In
The state’s most recently hired health exchange contractor, Optum, has issued a highly critical report, citing a near total lack of leadership by the state as the cause of the failed health insurance exchange. The 116-page Optum report, issued last week, reads like a bad report card for the Shumlin administration.

From the Governor’s erroneous decision to use political appointees to build the exchange instead of hiring competent professionals, to the failure of those individuals to manage the project or hold the contractor CGI accountable, the picture painted by Optum is one of major incompetence by state officials and a runaway vendor CGI, that racked up millions of dollars in charges with little or no oversight by the Shumlin administration or the legislature.

The Optum report shows that essentially, prior to the release of last week’s report, no one in the Shumlin administration or the legislature knew who was running Vermont Health Connect, who was responsible or accountable, what had been done or not done, what the project budget was, how much VHC was really costing, what functionality had been delivered, when the missing functionality would be delivered, or what CGI was actually doing during the past year.

CGI repeatedly missed deadlines and failed to deliver critical functionality. Yet, as a parting gesture, the Shumlin administration signed a termination agreement with CGI, on behalf of Vermonters, promising not to sue or recoup any of the $67 million paid for missing system functionality, lack of work documentation, non-delivery of status reports, and lack of a project budget.

So after a year of misery and $67 million later, the state has agreed to waive all rights to sue CGI for any failures or any breaches of the system – and has agreed that neither party will assume fault for disastrous performance of Vermont Health Connect. In other words, the administration has struck a deal with a private contractor to withhold the details of its’ greatest management failure.

As you read Optum’s findings, consider whether you would have promised not to sue CGI.

Among the report’s findings:

• “Neither (the state) nor CGI believe they are accountable for project outcomes”, the report reads, nearly a year after the launch of the exchange. “The project’s program management structure and processes contributed to the State of Vermont’s (SOV) lack of project ownership and CGI’s lack of accountability”.

However, the project management plan (PMP) was “prepared by CGI and signed-off by SOV”.

• “Ownership of the project and its outcomes by SOV is limited at best. CGI took control of the project and the SOV ceded ownership”.

• “As CGI disregarded processes in the (PMP), the project’s lack of control and ownership impacted the ability of project teams to meet the project’s original and/or revised milestones”.

• “Key governance principals (sic) for establishing/maintaining SOV ownership and control…were not applied”.

• “The project’s aggressive schedule necessitated increased collaboration and rigorous processes. Instead, CGI proceeded with project activities without the appropriate SOV participation…”

• “A project-specific cost/budget management plan does not exist. Because of this, the overall costs are very difficult to define and manage”.

Optum also found that, “….nine months after the implementation of Vermont Health Connect (VHC), several critical functional requirements including Change of Circumstance, Renewals, and SHOP, and over 2,500 non-functional requirements specified in the (CGI) contract, have not been met.”

“Additionally, there is no agreed-upon plan for delivering the missing functional or non-functional requirements”.

“Each of the following Project Management processes….is a ‘High’ risk – Immediate corrective action is required”

• “Schedule Management - a current comprehensive program schedule does not exist. CGI has not fulfilled their contractual commitment with regard to this portion of the contract.

• Cost Management – A cost/budget management plan for the project does not exist.

• Quality Management – “Of 48 deliverables, 17 are ‘approved…..This highlights both a quality and process problem.

• Scope Management: A pproximately 130 (project) Change Requests (CR) are not approved, while 10 are approved. There’s no agreement on pricing with CGI, which does not allow for appropriate cost estimation for each CR”.

In addition:

• Staffing Management – “A detailed Staffing Management Plan is described in the (project management plan) yet not followed” “The staffing management plan does not include SOV resources”.
CGI was responsible for providing a staffing plan and updating its monthly for VHC. No updates have occurred since the end of 2013.

• Communications Management – CGI’s “report communicates project activity, but not the status in context to the plan. There are risk indicators flagged “red” without corrective actions noted”.

• Risk Management: “Risk management does not appear to be effective”.

• Performance Management: “A deliverable tracking process is described in the Plan but not followed. A Performance Management plan is specified but not followed”.

• “Examples of CGI commitments not met include:” (monthly progress tracking reports); (performance of tasks against the schedule); (task progress reported to SOV through weekly updates).
“Each week CGI will update the percent complete on tasks”. “Review of these commitments with CGI’s leadership team indicated that they were not familiar with them”.

Optum found that the project’s management plan, prepared by CGI, does not provide a sufficient method for controlling the project. It does not distinguish CGI’s accountability for performing activities, from the state’s project ownership responsibility. The project lacks the appropriate state oversight. Yet VHC signed off on those contract terms.

The report states, “The majority of the required documents to be produced by CGI are incomplete or not approved by SOV”. “KPIs (key performance indicators) have not been defined nor reported by CGI. Without these KPIs the real status of VHC is not fully known”.

The Optum report shows that either VHC was totally unaware of CGI’s many performance failures throughout the entire work period, or worse yet, they were not telling anyone. If VHC management was telling the Governor, then the Governor significantly mislead both Vermonters and the legislature over a long period of time. It has become clear that the Vermont legislature was kept out of the loop.

If VHC management was not disclosing CGI’s failures because they did not know, which appears to be the case, then they have failed miserably to do their jobs, and should be replaced immediately.

Adverse Impact on Vermonters

The Optum report says that the “change of circumstance” (CoC) functionality of VHC has yet to be enabled. These circumstances include a job/salary change, marriage, a new baby, or divorce. Any of those situations can lead to a change in the premium tax credit that Vermonters receive though VHC. Most Vermonters using the exchange have qualified for a premium tax credit or subsidy. This in turn can mean that a person receives too much of a tax credit and will have to pay it back come tax filing time. The lack of a functional CoC system makes it difficult, if not impossible for Vermonters to report alterations in their circumstances that would help them avoid getting too much or too little in tax credits.

Right now change reporting has to be done manually on the phone with VHC staff. It has been widely reported that many Vermonters are spending hours on the phone, getting incorrect premium statements or double premium statements, not getting an insurance card, getting duplicate insurance cards, showing up at the doctor’s office and finding they have no insurance, and on and on.

By contrast, here is how it works for states that use the federal exchange. On the HealthCare.gov website you log into your account, click on the link for your existing application, and choose “Report income or life changes”, and make the change. That is how simple it is for our neighbors in New Hampshire who chose the federal exchange.

The Shumlin administration now says that much of the CoC backlog has been cleared up by Optum. But what happens to Vermonters whose change of circumstance happened months ago? The IRS says that when you file your income taxes next year, you will have to subtract any advance payments you received during 2014 from the amount of the credit calculated on your tax return. If you received more than you were eligible for because of an inability to make a change of circumstance timely, it will result in an increase in the taxes you owe. There were approximately 13,000 CoC’s just in the backlog as of June 2014. Clearly there were more to start with.

The change of circumstance issue won’t be fixed even by year-end, according to VHC Chief Lawrence Miller. That means Vermonters will still be unable to update their policies online to avoid an unpleasant tax surprise that could come early next year. None of the remaining website functions will be fixed before the end of the open enrollment in February 2015, either, says Miller. These include automated coverage renewals, and allowing small businesses and their employees to enroll through the website.

The Optum report found that, “The SOV’s decision to communicate (premium assistance amounts) as the member portion of the premium…results in scenarios where carriers will interpret an incremental payment as a partial payment and mark the consumer as delinquent”. “Missing enrollment reconciliation is not occurring”.

Miller also said that the exchange when completed will meet federal standards, but might not end up with all the design and automated features that Vermonters would like. That, after two years and $171 million dollars spent, is a travesty.

In Closing

While the Shumlin administration was woefully unprepared to take on the creation of Vermont Health Connect, it bears remembering that the Governor refused to consider the simpler alternative of joining the federal exchange, which would have saved taxpayers nearly $171m.

New Hampshire has spent a mere $8m with none of the headaches that thousands of Vermonters have had to endure. New Hampshire has also increased the number of carriers who are selling insurance though their exchange, enhancing competition and leading to lower premiums, while Vermont’s choices have dwindled down from 18 to 2, due to VHC’s incompetence.
The Governor and the Vermont legislature insisted on building a state exchange so they could turn it into a theoretical single payer system in 2017. It does not appear that in making this decision, they placed the interests of Vermonters ahead of their own political ambitions.

It should also be noted that while the administration did release the Optum report, many areas were blacked out by the state prior to the release. Most notably, under “Security Review and Assessment”, the first “High risk” finding by Optum is blacked out. This is of great concern. What is the risk? Why is it blacked out?

Thursday, August 28, 2014

Mount Holly Select Board

The next regular meeting of the Selectboard will be on September 09, 2014.  Items for the agenda are due at the Town Office by Noon, Thursday, September 04.  If you have an agenda item, please DO NOT ‘REPLY’ to this Newsflash. Contact the Town Office (259-2391) or email the Selectboard mthollysb@gmail.com.

While agenda items may be added or deleted at the beginning of the meeting, the Select Board must give the public adequate notice and an opportunity to be heard.  Therefore, an item brought to the Board after the agenda is posted might not be considered until a later meeting.

The completed Agenda will be posted inside and outside the Town Office and at the Mount Holly and Belmont post offices.

NOTE:  There will be two meetings on September 09, both held at the School Gym (not the Town Office).

6:30 pm – Special Selectboard meeting:  VTrans public information meeting about rumble stripes on Route 103.  No other agenda items or decisions at this meeting.

7:30 pm – Regular Selectboard meeting

Thursday, August 21, 2014


Saturday, September 6 at 7 pm
Claudine Langille and Victor Paul
In Concert at Mount Holly Library
Celebrate the Release of Their New Album
" You Are My Flower”
Songs of the Original Carter Family 

Select Board Meeting - Draft= Aug.12

AUGUST 12, 2014
The meeting was called to order at 7:30pm by Jim Heald. Raymond Tarbell and Tim Martin were
present. All stood and recited the Pledge of Allegiance. Jim welcomed everyone and requested that
speakers raise their hand to be recognized, state their name and keep remarks civil and short.
1. Additions/Deletions to the Agenda: There were five additions to the agenda:
 VTrans Grant review letter
 Route 103 rumble strip meeting
 RRPC Town Plan approval process
 Star Lake Dam Inspection report
 VLCT PACIF property surveys
2. GMP Pole locations on Russellville Rd. This item was tabled from last meeting. The Town received
a petition from residents of Russellville Road regarding GMP’s plans for relocating electric lines
along the road, instead of the current line which runs through the interior of several properties. Tim
Upton (environmental dept.) and Carl Ojala (distribution director) from GMP were present. They
outlined the history of the project going back as far as 2010, from gathering easements from property
owners, site visits and reviews by ANR and the Act 250 permit approval in Dec. 2012. GMP changed
the new line running from an existing pole on the Shaw property to a new pole location across the
road on another property, as the Shaws did not grant the easement for theirs. GMP has all necessary
easements and permits to proceed with the project as is. Erin and Heather Shaw are asking that the
Selectboard find that the new pole location is not appropriate and that GMP keep the line where it is.
The Shaws believe that the proposed location in the highway ROW will be unstable in another flood
event such as Irene, and that the location does not meet the Act 250 requirements. After some
discussion between the parties, Jim Heald asked both parties to meet and try to come to a
compromise, which they agreed to do.
3. The minutes of the regular meeting of July 08 and the special meeting of May 27 were sent
out before the meeting for review. (The May 27 minutes should have been approved at the
June meeting, but were inadvertently missed.) There were no corrections or additions. Upon
motions made and seconded it was
VOTED: To approve the July 08 and May 27 minutes. (3-0)
4. Highways
 Winter Sand: Jeff reported that Casella’s bid was $1.00 more than Pike’s. As Casella has not
provided a sand sample, he preferred to stick with the relatively coarse sand from Pike. The
Board all agreed. Eithier Trucking will deliver the sand.
 Tarbellville Culvert
1) Jeff first reported on the proposal to move the streambed above the culvert, which could
eliminate the other two culverts above the one being replaced. If feasible, this could
eliminate up to $400,000 for replacement culverts in the future. There are some legal issues
with this, and a survey by Otter Creek will cost about $5,000. The Board agreed to the cost.
2) The bids for the culvert being replaced were made assuming a round culvert, and there is
some question about ledge. A design of a 6’X14’ 3-sided (open bottom) culvert would allow
for a shallower placement, but still requires footings 6 feet down. A test drilling for ledge
was inconclusive. The Board agreed that a better auger drilling should be done for ledge and
that the bids would need to be redone for the open bottom design.
 Route 155 status – Dennis Devereux reported that he had written a letter to Secretary Searls of the
Agency of Transportation regarding the poor condition of Route 155 From East Wallingford to Weston. While the Agency agreed that the road needs work, budgetary issues mean there are no
plans for substantial work other than patching as needed along VT155. Dennis mentioned that he
will contact other legislative members from the area to push for paving, and suggested that a
citizen’s petition might be effective. The Board agreed to write a letter to the Agency.
 Hortonville/Shunpike Roads: A resident complained about potholes on these two roads. This
year’s paving project is planned for Hortonville, which should take care of most of the problem
area. Jeff reported that Shunpike has been regraded and he will look at the pavement change
areas for possible improvements.
 New Garage.
Jim Heald read a report from Jerry Hansen, providing a project progress thru the end of July (a
copy will be available at the town office). Mr. Hansen also approved the third payment request
from Josselyn Bros. The structural steel has been erected and the installation of banding and
fabric for roof insulation and roof panels in is progress. This phase of construction can be
affected by wind and rain conditions. Jeff noted that electricity to the building was installed
 VTrans had a Grant Review team look at documentation for the July 2013 storm damage grant for
Old Turnpike Road and the Town received a letter with the results of the visit. While they
suggested that the Town adopt a procurement policy, the Town was commended for our readiness
for a FEMA audit, if one should happen.
5. Report of Treasurer
 David Johnson presented an income and expense statement dated July 31, 2014 showing cash
balances of $1,194,429. Property taxes have started coming in. The State Adjustments are down
about $58,000 from last year, but that may change with late tax filers. The first quarter State
highway aid has been received. No notable expenses with only one month in the fiscal year. The
new garage bills are about ½ of total project.
 Advances to U39 and MH Elementary – David requested that the Board authorize advances to
both schools, as the exact school payment schedules will not be known until mid-September
(usual timeframe) and the schools will have expenses before then. Upon motion made and
seconded it was
VOTED: To authorize David to advance $100,000 to each school until the exact payment
schedule can be determined. (3-0)
 External Audit – David asked if the Board wished to continue with Jeff Bradley for an external
auditor or look for other bids. David would hope to begin the audit in September unless other
bids were needed. Upon motion made and seconded it was
VOTED: To continue with Jeff Bradley as external auditor. (3-0)
6. Primary Election – August 26th
Susan Covalla, Town Clerk, reported that the primary election will be held on Tuesday, August 26th
at the Town Office with voting from 10am – 7pm. Voters will receive four ballots (one for each
party), choose which party’s ballot they wish to vote on, and the others are thrown away.
7. Planning Commission
 Hazard Mitigation Plan – The committee met on July 31st with Laura Keir from RRPC to
continue the updating of the Town’s plan. She will finalize the plan and send to committee
members for review. The process for the plan’s adoption and approval includes a 15-day public
comment period, review and approval by the Northwest RPC, the State Hazard Mitigation Officer
and then FEMA Region 1.
 VTrans is planning to hold a public information meeting on the installation of rumble stripes
along the length of Route 103. Susan Schreibman is coordinating a meeting for the Rutland
County towns involved and requested Mount Holly host it. The Board agreed to hold the meeting
on September 09 at 6:30pm at the school gym. The regular Selectboard meeting will follow at
the school.  RRPC sent a letter to clarify and simplify the process RRPC will be using to approve town plans
and the planning process. This information was forwarded on to the Planning Commission.
8. Star Lake Dam Reconstruction – Update
 The Town received the Star Lake Dam Inspection Report from the State. Ron Unterman noted
it’s pretty much the same as previous years and the State is glad we are moving on.
 Ron Unterman reported on conversations with Dubois and King, State engineers and other parties
to relook at an option for the dam (overtopping dam design). This design would consider the
1000 year flood time period over 48 hours rather than 24 hours. The resulting change in design
means not raising the dam level as high, no parapet wall, (lower costs) and probably no need to
get easements from the property owners. The lake will still be raised to the historical level (18
inches higher).
9. Other Business
 VLCT PACIF performed property surveys on the old garage and the town office. As a result, the
replacement values for both buildings were raised, and the town’s premium will increase for the
2015 calendar year.
 ATV committee update – Don Patch presented a proposed ordinance regarding ATV use on town
roads. (A copy of the proposal is available at the Town Office.) The committee felt that ATV’s
are used on town roads now (illegally) and an ordinance would provide a structure for allowing
legal use of approved town highways while protecting the health and safety of all vehicle
operators, residents and property. They recommended opening a couple of non-paved roads on a
trial basis for one year.
Comments from those attending (including one non-resident) covered numerous topics including
but not limited to: accidents have already occurred with illegal use; ATV’s are not designed for
use on roads; 27 towns and clubs covering multiple towns allow it; would allow handicapped
people to move around (state law allows handicapped hunters to use them); possible liability
issues for the town; education issues of both residents and riders; handling of complaints or
enforcement issues not resolved; concerns that ATV’s will begin to use VAST trails.
Upon motion made and seconded, it was
VOTED: To table the proposed ATV ordinance to a future meeting (2-1, T. Martin
 New England Clean power Link Project (NECPL), a proposed 1000 MW electrical transmission
line to run along Route 103, has scheduled a public open house meeting on Thursday August 21
at the Town Office from 6:00pm to 8:00pm.
 Okemo Act 250 Application Amendment – Okemo has filed an amendment to the Act 250 permit
to allow construction of the chair storage building for the new lift.
 VT ANR – announced planned stewardship activities in Okemo State Forest, to include relocation
of two sections of the Healdville Trail, trailhead maintenance, and two culvert replacements on
Mountain Road.
 The Town’s DUNS# number registration was updated on July 10 (required annually). Don Patch
noted that the NIMS compliance will also be required for FEMA grants (requires certain town
officials to have completed various levels of NIMS certification courses).
10. Executive Session – None needed.
11. The Board reviewed and signed the July orders for payment.
There being no further business, the meeting was adjourned at 9:32 pm.Respectfully submitted,
Rhonda Rivers
Minutes are DRAFT until approved at a Select Board meeting. Approved on: _______________

Wednesday, August 20, 2014

Mount Holly Select Board

Mount Holly Select Board

Reminder that the New England Clean Power Link Project (NECPL) open public meeting is Thursday evening, 08/21 at the Town Office from 6-8pm.  NECPL has publicized these meetings in several papers.  See the attached for more information.

Saturday, August 16, 2014



September 9, 2014 @ 6:30 pm – 8:00 pm
Mount Holly Town Office, 150 School St, Mt Holly, VT
 Kevin Marshia
The Vermont Agency of Transportation (VTrans) will hold two public meetings examining the potential to add centerline rumble stripes to sections of VT-103 between Rockingham and Mount Holly, including Chester, Cavendish and Ludlow.  If the installation is to move forward, it would occur as part of the current paving project in the Fall of 2014. The meetings are open to all and will be:
  • Thursday 8/28 at 6pm – Town of Rockingham/ Village of Bellows Falls Town Office (7 Square, Bellows Falls, VT)
  • Tuesday 9/9 at 6:30pm (during regular Selectboard meeting) – Mount Holly Town Office (150 School St, Mt Holly, VT)
Click here for a newly revised factsheet about how VTrans decides why and where to install centerline rumble stripes on roadways across Vermont.  For more information about the meetings please contact Kevin Marshia, Deputy Chief Engineer Highway Division  from VTrans (kevin.marshia@state.vt.us , 802-828-2932).

Annual Silent Movie Festival in Ludlow August 16