Care denied and bills not paid among problems plaguing Clark County teachers

LAS VEGAS (KTNV) - The people we count on to teach and care for our children every day cannot care for themselves. So say many Clark County School District teachers who are caught in what they call a health care crisis.

And they tell Contact 13 Chief Investigator Darcy Spears it's brewing to a boiling point. 

Substandard and inaccessible. 

That's how Paul Feaker and Sheri Tapani DeBartolo describe their healthcare plan. 

The two Clark County School District teachers are taking the rare step of speaking out about something they can no longer tolerate.

"I have three young children," said Sheri. "I currently work all day and I tutor students six days a week after school, three to four hours a night, and my husband works a full-time job as well in order to pay for the medications."

Sheri's son, Dominic, was born with an immune deficiency. 

Her family paid nearly $22,000 out of pocket in medical bills just last year.

"Medication is not affordable and access to care is not available. My son was turned down by multiple doctors because of the Health Trust."

Special Education Facilitator Paul Feaker, who's been with CCSD for 32 years, is in a similar boat.

"Because my spouse has a degenerative nerve disease and Teachers Health Trust and WellHealth and WellDyne are not cooperating on providing that medication unless I'm willing to pay the $3,600 per dose co-pay."

The concerns raised by Sheri and Paul are echoed in this internal memo Contact 13 obtained about the Teachers Health Trust. 

The self-funded plan covers more than 40,000 participants including teachers and their families. It's managed by a company called WellHealth. 

Sheri says the insurance provider has questioned the weekly blood infusions that keep her son alive.

"And when I met with WellHealth, they asked me if there was a generic alternative to human blood."

The internal letter from the school district to Clark County Education Association Executive Director John Vellardita details numerous accounts from teachers who've been denied health care or sent to collections for bills the Trust isn't paying.

"I know a lot of teachers who are not taking medications for heart problems, for diabetes, they are not taking care of themselves, they are not taking care of their families. If we can't take care of ourselves and our families, how can we help the children that live in Clark County?"

The District's letter, written by Chief Negotiator Edward Goldman, says CCSD provided a $9 million bailout to the Health Trust in 2016, but the Trust paid 100,000 fewer claims in 2016 than in 2015. 

Plus, teachers' co-pays skyrocketed. 

For Sheri, it went from $35 a month in 2015 to $2,513 per month the next year.

Based on the number of outstanding and unpaid claims, the district believes the trust is about to implode.

Vellardita would not go on camera to answer questions, but sent a statement pointing a finger at the school district for inadequate contributions. 

Teachers say everyone will end up paying dearly.

"I certainly would never recommend to anybody I know that they come work for Clark County School District," said Paul Feaker. "Why would you want to come and subject your family to this kind of healthcare?"

CCSD wants teachers to move to a different plan that the district provides to support staff and school police. 

Teachers are planning a healthcare rally Wednesday at 4 p.m. at the Edward Greer Education building before the Board of Trustees meeting.

FULL STATEMENT FROM CCEA DIRECTOR JOHN VELLARDITA:

"THT is a non-profit self-funded plan controlled by teachers to provide health insurance to over 40,000 participants (teachers and their dependents). Over the past year and a half THT has had to implement a new health plan based on the current health premium contributions from the School District. CCEA understands that during this period there has been educators who have experienced problems with their care and that THT has been dealing with those problems as they come up. THT is not able to discuss individual issues of participants due to HIPPA regulations. THT is not alone in this country dealing with the changes in the health care industry and the growing costs of care and how it affects health plans like THT. THT is continuously finding ways to improve its health care delivery system within the financial means it operates with.  Finally, in reference to the letter from CCSD’s Edward Goldman you cite, CCEA has filed an unfair labor practice charge against CCSD for bad faith bargaining on the health insurance issue in an effort to force all educators on a for profit insurance plan operated by an insurance company in Southern Nevada that controls 75% of the market."

CCSD response:
 
"We will not be commenting on this matter publicly except to say the following:
 
Update on the Clark County School District’s Proposal to
Provide an Alternate Health Care Plan for Teachers

The health and safety of our employees is the top priority for the Clark County School District Board of Trustees. CCSD has made a proposal in contract negotiations with the CCEA to include all teachers in the CCSD Health and Welfare Insurance Program. We would like to correct several inaccurate statements that the Clark County Education Association (CCEA) has distributed:

“Yesterday in contract negotiations, CCSD made a proposal to the CCEA Negotiations Team to eliminate the Teachers Health Trust and replace it with the Support Staff Union’s healthcare plan, United HealthCare. This is a substandard plan that has fewer benefits and with less premium contributions to teachers than what it currently gives to support staff and administrators.”

CCSD currently provides comprehensive coverage to support staff and School Police as part of the CCSD Health and Welfare Insurance Program. The current plan offered to CCSD support staff employees and School Police is not substandard – it is a significantly improved plan from the Teachers Health Trust (THT).

The proposed offer to the CCEA for teachers provides the same five quality options that are currently provided to support staff and School Police.

CCSD has not yet proposed a premium contribution for the plan. Like teacher salaries, the district’s contribution toward teachers’ health care coverage is part of the negotiations CCSD conducts with the CCEA.

Other associations have chosen to direct new funds toward health care costs, which is why CCSD provides more money toward their health care contributions. The CCEA has chosen to allocate most of the new funds provided through negotiations into teacher salaries, instead of contributions toward health care coverage for teachers.

“Last year THT received the first increased contribution from CCSD in over 8 years.”

When CCSD and CCEA negotiated a contract for 2015-2017, CCEA bargained that almost all of the $135.5 million increase go toward teacher salaries – not for additional health care costs.

Subsequently, CCEA requested another $10 million for the THT. The Board agreed to that request as a one-time bailout for the THT from Jan 1, 2016 – Dec 31, 2016. Fifteen months later, the THT appears to be in even worse financial shape than it was before the bailout.

“This is CCSD's efforts to destroy the Trust and turn over control to a private carrier.”

The CCSD has never tried to destroy the THT. In fact, in an attempt to save the THT, in 2015, the Board agreed to provide an additional, one-time-only $10 million bailout to the THT from Jan 1, 2016 – Dec 31, 2016. This was a one-time payment designed to help the Trust regain financial footing as it transitioned to a new management system. One of the stipulations to this increase was that the THT would become financially stable and provide reliable coverage to its beneficiaries. The Trustees are unwilling to provide additional bailout money to the THT given its ongoing financial instability and the concerns we are hearing from employees about the unreliable health care coverage they are receiving.

Trustees made CCSD’s latest health insurance proposal to the CCEA not in an effort to destroy the THT but rather because the district has received many complaints from teachers who say the THT is providing substandard care. Our Trustees believe that teachers deserve to seek medical care without having to worry about being turned over to bill collectors, or having major tests turned down by their health insurance, as some teachers have told us is happening to them. Our only goal is to provide reliable, affordable health care to teachers and their dependents without having to keep bailing out the increasingly expensive and financially challenged THT. We cannot continue to bail out the THT every time it encounters a financial crisis.

The CCEA falsely claims that the THT is better because it is non-profit.  But the THT currently uses a for-profit corporation to manage its insurance, WellHealth Quality Care."
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