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Attorney Floyd Dugas has been investigating complaints.
Amid “very real concerns about our financial future,” the Cornell Scott Hill Health Center is instituting pay cuts and company-wide furloughs and canceling plans to open a clinic in Hamden, according to a confidential internal memo.
Those decisions are laid out in a confidential memo distributed recently to staff. The memo paints a dire portrait of the organization, which has about 450 employees and runs 16 community health centers in and around New Haven.
The memo states that Hill Health is in a difficult financial position compounded by a shortage of providers and problems with bill collection. Click here to read the memo.
Meanwhile, Hill Health has hired local attorney Floyd Dugas to conduct an investigation into “a personnel matter.” Dugas said his probe stems from a lengthy letter of complaint about mismanagement submitted to the board of directors in August by Chief Operating Officer Stewart Joslin.
Melissa Bailey Photo
Hill Health laid off 25 workers in February, after 30 layoffs last May.
Rob Rioux, Hill Health’s director of community relations and corporate development, said he didn’t know anything about Dugas’ investigation. He described the current financial difficulties as “temporary cash flow issues” and said that he hopes more layoffs can be avoided.
The center also currently faces several lawsuits from former employees for wrongful termination, workers compensation retaliation, and intentional infliction of emotional distress. One woman has accused Hill Health of “the unlawful receipt of millions of dollars in federal grants and reimbursements from Medicare and Medicaid.”
Rioux said he had no information about these lawsuits but added, “I assure you it’s highly unlikely those things would be proven.”
Jamesina Henderson took over as CEO at Hill Health three years ago amid a turbulent period following the death of founder Cornell Scott.
Corrective & Specific
The confidential memo, distributed to senior staff last week, consists of a bullet-point list of problems and proposed solutions.
“These are critical times,” the memo begins. “We have very real concerns about our financial future.”
The subsequent bulleted points include problems about “Access to Care”: “We continue to have a shortage of providers. We struggle to ensure people can be seen in a timely manner.”
The memo also lists problems related to billing: “We’ve discovered issues with our internal controls and collections processes. We are struggling to collect what is owed to us and to correct rejected claims.”
While the organization is looking for “continuity of care,” the memo states that less than half of the center’s over 900 new patients every month return for a visit within two years.
The memo then lists a number of “Corrective Actions” followed by a set of “Specific Actions.”
The corrective actions include general intentions regarding things like completing documentation “in a timely fashion” and findings ways to “improve customer service.”
Among the specific actions:
“• Our plan is designed to cut costs and increase revenues within the next 90 days.
• First, the senior leadership team is taking a substantial reduction in pay.
• Our plans to open the Hamden care site have been cancelled.
• We will have a company-wide furlough of five days to be taken before December 20th. We will be asking all departments to reduce operational expenses by 15%
• Our vacation payout program where you can exchange vacation days for cash is no longer an available option.”
Rioux declined to say how big the pay cuts are. He said they are affecting 12 people in “senior leadership.”
“All of us are taking sizable reductions,” he said. “Our promise” is to not even consider bringing the pay back up until Hill Health is on a better financial trajectory, he said.
The furlough will affect all staff. Workers can take the unpaid days of leave non-consecutively, he said.
As for the Hamden expansion cancellation, Rioux said that plan has been “on the drafting board for a number of years.” Hill Health didn’t get the federal money it was hoping for to pay for it, and the organization is now taking it off the table entirely, he said.
Asked if more layoffs are likely, Rioux said, “We certainly hope not. But we won’t know until we get there.” He said he hopes the new plan will help Hill Health avoid laying people off.
Threefold
“Three things are driving this,” Rioux said of Hill Health’s “temporary cash flow issues.”
First: “We still have a shortage of primary care providers, specifically in internal medicine,” he said. “We’re down about three providers.”
The absences are part of a nationwide shortage of providers, he said. It’s difficult for Hill Health to attract primary care doctors and nurses. When the conversation turns to salary, “we’re at a disadvantage.”
Without those staff members, Hill Health can’t see as many patients and collect the corresponding reimbursements.
Second: Grant dollars have dried up. Grants are harder to get and pay for less and less, he said. Funders will pay for a position for a year and then pull the money, he said.
Third: Hill Health is still struggling to implement an electronic health records system. That’s been a “major project” since last year, he said.
“We haven’t gotten it right every single day,” he said. That has meant delays in claims collection, as mentioned in the memo.
Take those factors together and “things are getting tight,” Rioux said.
Asked about morale at the organization, Rioux compared it to the Hospital of St. Raphael as it struggled with financial problems before being acquired by Yale-New Haven Hospital.
“It’s a tough industry,” Rioux said. “But the fact of the matter is all these issues can be solved and they will be solved. We’ve been here 44 years and we’ll be here another 44. We may not look the same. … But nothing stays the same.”