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City Looks Different To Foley, Malloy

by Paul Bass | Aug 30, 2010 10:03 am

(12) Comments | Commenting has been closed | E-mail the Author

Posted to: Health Care, Politics, State, Campaign 2010

Paul Bass Photo When Tom Foley considers serving as governor for cities like New Haven, he sees new choices for nursing home patients and public-school parents, and a death penalty that works.

Foley hasn’t spoken much about cities yet. And New Haven hasn’t seen much of him. That’s because he spent most of this year running for the Republican nomination for governor. Republicans are as scarce as alligators in cities like New Haven, so Republican primary campaigns take place in the ‘burbs.

Now that he has won his party’s nomination and the general election campaign season approaches, Foley stopped by New Haven and offered his take on urban issues.

It turns out the Greenwich businessman has a starkly different take on some of those issues from that of his Democratic opponent, former Stamford Mayor Dan Malloy.

Just talking with the two candidates one-on-one can feel like taking a trip to different planets.

An interview with Malloy over coffee at New Haven’s Bru Cafe is a sprint. You’d think the one-time prosecutor has already mainlined his daily caffeine take before taking his first sip, ready to pounce into action. Before a question is completed, Malloy leaps into a bulleted five-point policy response, adorned with digs at his opponent and proactive spin to counter anticipated attacks. At times you have to wrestle to move to another question.

A chat with Foley the other day felt more like a stroll, or after-work G&Ts, than a campaign interview squeezed into a hectic schedule over coffee overlooking bustling Pitkin Plaza outside Bru’s window. Foley took maybe three sips of his brew in the course of an hour. He slipped his blue blazer off his white dress shirt with presidential-seal cuff links. The former U.S. Ambassador to Ireland listened to questions, shook them in his mind like ice cubes in a cocktail glass, offered calm, considered, confident responses, pausing to field feedback.

What he had to say about some of New Haven’s issues offered just as much of a contrast with Malloy, too.

About the death penalty, for instance.

A New Haven state legislator is hoping to revive a bill to abolish the state’s death penalty next year; the last time he got it passed, a Republican governor vetoed it. Malloy said Friday that if elected governor he’d sign the bill. He offered arguments similar to those of bill sponsor State Rep. Gary Holder-Winfield.

“I tried four homicide cases a prosecutor. I tried one as a defense attorney,” Malloy said. “I don’t support the death penalty because there is no data that indicates that it has anything to do with the homicide rate. If it did, Texas would have one of the lowest homicide rates as opposed to one of the highest homicide rates. My heart goes out to family members and friends of victims of homicides. But I also know it has been disparate in its application on racial lines, cultural lines, income lines. We put individuals to death wrongly.”

Foley said he’d veto the bill.

“The death penalty in Connecticut is very rarely imposed,” he argued, and has proved to affect people who were clearly guilty. “In some cases the death penalty is warranted. It does act as a deterrent.”

He said the penalty is especially important in prisons. Without it, prison guards have less protection against violence by life inmates who have no further consequences to fear.

New Haven has struggled lately to keep nursing homes open. Foley said the crisis in urban nursing care reflects the need for a dramatic change to programs that keep elders at home longer and in community-based alternative programs. Those programs cost less—and keep seniors alive longer through better care, he said.

Fewer than 50 percent of elderly Medicaid patients in Connecticut are in community-based alternatives rather than nursing homes, he said; in Oregon the figure is 75 percent. Foley said he’d aim to add 25 percent to Connecticut’s figure and save $600 million in the process.

Some of that money would go toward increasing state Medicaid reimbursements for those frail elderly patients who need to remain in homes. Right now Medicaid patients account for upwards of 80 to 90 percent of the patients in urban homes; the homes lose an estimated $18 or more per day on them because of low state reimbursements.

In a rare jab at Malloy, Foley argued that his Democratic opponent doesn’t share his determination because of his union support. “Guess what? Most of the nursing homes have unionized nursing home workers. The day of the [Democratic] primary, Dan Malloy was on the picket line with nursing home workers. No surprise,” Foley said.

“You can’t do both” boosting nursing homes and boosting community care, Foley said. “It’s one or the other.”

Paul Bass File PhotoMalloy (pictured) countered that the state has to work on both, because the population is turning older and sicker. He said he supports continued efforts to move as many patients as possible into alternative care, which he said has been happening in the state. But especially in cities, nursing homes need more support to continue caring for a growing population that has nowhere else to turn. Otherwise, he said, the state will “destroy” nursing homes and eventually have to build them back up at higher cost.

“There is an aging tsunami. It is coming at us down the track,” he predicted. “We have downsized the number of nursing homes in our state over the last 16 years. We have closed a majority of the urban nursing homes so the people who rely on nursing homes who come from urban areas are unlikely to receive that treatment near where their families are.” Click here for more of Malloy’s thoughts on the topic at a recent visit to a city nursing home.

The two candidates split even more on SustiNet, the new state program created (over a gubernatorial veto) to insure more people, more fully, and to integrate President Obama’s new federal health care law into state programs.

Foley has little regard for Obamacare or for SustiNet. He said the law fails to address the core problem with the health care system: rising costs. It just adds new costs and mandates, he argued. He called SustiNet a costly program searching for a mission. It originally sought to provide universal health care coverage, he said. With 94 percent of the state covered, and many of the uninsured being young people uninterested in coverage, universal coverage is a moot concern, he claimed. He said he sees little reason to work with SustiNet as governor.

Malloy called SustiNet an important “vehicle” for making sure Connecticut benefits from “complicated” new federal health care programs and meet its obligations; SustiNet focuses in part on cutting costs through electronic records and reform of how people receive care (through concepts like “medical homes”). Malloy noted that much of its mission has been on helping the “underinsured”—small business people, middle-class families with inadequate coverage—as much as the uninsured. And he said it’s important to make sure all children eligible for Medicaid/HUSKY coverage receive it.

Foley said his concern is more with state government tracking down ineligible people who receive benefits. “I understand there are a lot of people who don’t technically qualify,” he said. The state government already focuses on making sure qualified people get benefits, but not enough on weeding out fraud, he argued.

Malloy agreed that the state needs to work harder to slim down a “bloated bureaucracy” and root out “dishonest practices by dishonest clinics or doctors or individuals.” But he argued that it’s costing the state more money when eligible children don’t receive Medicaid, the costs of which are reimbursed in part by the federal government. When those kids end up in hospital emergency rooms instead, the bill is higher, and entirely paid by the state, Malloy said.

Foley said he could also cut more than $100 million a year from the state budget by privatizing two psychiatric facilities, Riverview Hospital and the Southbury Training School.

Riverview spends over $900,000 a year per patient, compared to $400,000 spent in the private sector, he claimed. The training school spends $450,000 per resident compared to what Foley said is a private-industry norm of $350,000.

“Some people say the same services” can be had for as little as $140,000 to $150,000.

Malloy dismissed Foley’s math as dangerous “apples and oranges” comparisons. He said state mental facilities receive harder cases, people failed by the private sector. As it is, “the state has not kept its promise with respect to people who are mentally ill,” Malloy said. “They are not receiving appropriate services. This headlong drive into privatization would lead to a sicker population”—and more prison inmates, since inadequately treated patients are accounting for a growing percentage of the jail population.

On the number-one policy issue in New Haven these days, school reform, the candidates do share some ideas, but still speak differently.

Both oppose giving parents vouchers to send their children to private or parochial schools. Both emphasized the need to work with teachers on school reform rather than demonizing their unions.

Foley said the chance to improve urban schools ranks among “the most exciting” opportunities he sees in serving as governor. “It’s absolutely terrible we have the largest achievement gap in the country,” he said.

He emphasized offering parents more choices for their children—more magnet and charter schools, as well as in-district choice of which public schools in which to enroll. (He stopped short of embracing allowing urban students to attend suburban schools a la Hartford’s Project Choice.)

Foley spoke of his visits to the Amistad Academy charter school. It proves that alternate approaches to traditional public schooling can work, he said. He also praised New Haven Mayor John DeStefano’s embrace of an ambitious school reform plan, including a contract struck with teachers to allow for increased training for failing teachers and an easier route to dismissal if the training doesn’t take. He also emphasized performance pay for teachers and a longer school day.

Asked how he’d pay for that, he said the solutions don’t necessarily cost more money. He said he target administrative costs; he called public schools “top heavy.”

Malloy called Foley’s schools position “ideologically driven.” He too decried the achievement gap and said he’d too focus on how money’s spent, creating a “matrix” to track what percentage of district spending goes toward administration, what percentage to the classroom.

The centerpiece of his program does involve money: Guaranteeing universal pre-kindergarten education for all Connecticut kids within eight years. Malloy did that in Stamford. Advocates emphasize pre-K in cities because of the rapid development of children’s brains at that age, determining in part how well they can fare later on in school. Click here to read the rest of Malloy’s education plan.

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Comments

posted by: andi on August 30, 2010  11:44am

This is a really great article.  As far as the candidates go- Foley’s idea on privatization is simply naive.  While it may seem like a good idea for people who dislike unions- the fact is the state is not looking to sell stock or make a profit for the training school.  A private company would want that profit- so there will either be hidden costs or cuts made to the care of those least able to speak out.
I keep hearing all about how many want this privatization but I happen to know that there are way to many hidden costs.  A good example of this is that in some state agencies when they privatized it has been discovered that in addition to the contractor doing that private work, there are numerous sub-contractors hired as well and each one of these is a separate item in the budget.  In other words- you pay the contractor and you also pay the sub-contractor.
OK- I admit I am a long time supporter of Dan Malloy and if he can do half the job as governor that he did as mayor of Stamford then Connecticut finally has a real chance- improving education and creating jobs.  Even if I did not support him - I still know that this privatization is intended to be profitable for the owners of the company doing the work and that means there will be a consequence.  I would not want one of my family members to find out exactly what that cost is- would you?

posted by: Tessa Marquis on August 30, 2010  2:39pm

Foley: Hasn’t “Been There”, and hasn’t “Done That”. Is sounds suspiciously like he has the GOP talking points but no substance.

posted by: Frank DeCrescenzo Jr. on August 30, 2010  2:51pm

Privatization leads to increased competition and better results. History provides undisputable proof of this basic fact. Foley’s plan is the only one that works to build Connecticut’s future instead of rewarding campaign donors today.

posted by: Jonathan Hopkins on August 30, 2010  4:36pm

Health care costs are rising because we are becoming sicker as a populace, and because of superfluous medication handed out by doctor’s offices that get money from pharmaceutical companies. We are collectively getting sicker because of a tremendous lack of daily routine exercise and because of atrocious diets that consist of too much hormone filled meat that is produced in enormous facilities by unskilled butchers in filthy conditions, and because we eat too many processed corn products and produce that is sprayed with petroleum-based herbicides and pesticides. We also feed cows corn feed instead of grains, which is what cows evolved to digest and the change has resulted in previously non-existent strains of mutated e coli.
We must stop rendering our growing soil useless by spraying nutrients-killing chemicals on it. In order to get rid of the need for these products, we need smaller, more diverse crops instead of monocultures, which do not self regulate rodents and insects naturally. We also need to stop raising cows in cramped pens where their feces are knee-deep and therefore the ground cannot grow grass and grains for them to eat. Chickens probably should also be kept in open air cages in less cramped conditions if not for a moral reason, at least as a deterrent to the spread of disease. Re-establishing smaller and local or regional farms requires a complete re-organizing of federal farm subsidies (perhaps more state and local control of the allocation of those subsidies) and a retrofitting of suburban sprawl to reclaim prime agricultural land across the country, which could be wisely done by selecting particularly hard hit foreclosure areas and dismantling the houses and re-using in vacant urban lots. There is a proliferation of “ghost town” suburban housing subdivisions, shopping malls, strip malls, and office parks across the country that could be land re-purposed for growing food closer to where the demand is, which would cut down on transportation costs in both the public and private sector.
Retirement facilities should be available only to the people who really need special accommodations and professional care like Alzheimer’s patients, the physically disabled, the blind, etc, which is actually a minority of the elderly population. We must allow those who are able-bodied, which is the majority of seniors, to age in a dignified way in desirable housing that is within easy walking distance of daily needs and affordable (hopefully free after 65) and efficient transit. This means building more walkable neighborhoods where people can simply retire in their homes, and providing affordable housing in apartment buildings and ground floor apartments for those who cannot retire in their homes because of lack of accessibility. We need to stop designing everything around wealthy young and middle-aged adults who can drive. About half the country is either too young, too old, or too poor to afford a car and they need to be represented and provided the same opportunities for civic involvement as everyone else.
As for schools, we need fewer magnets and no charter schools. Every child should be within walking distance of their elementary and middle school, a park, a jungle gym, and some kind of ball field and this is a matter of civil right. High schools should be centrally located in the city with no neighborhood ties and should be chosen based solely on what the student wants to study. There should be a trade school, a commercial school and an arts school each offering basic courses but with focuses on various professions, which should be increasingly integrated into the curriculum as the student ascends grades with ample opportunities to change minds and switch schools. The existing and hopefully an improved version of the city bus system should be used instead of the elaborate, unnecessary and expensive private yellow busing system. The problem does not fundamentally lie with our schools, which now have the nicest facilities in the state, or teachers, who for the most part could be effective with better at home prepared students; the problem lies with income segregated (defacto racial segregation) neighborhoods. Neighborhood stabilization is expensive and hard, but it would resolve the issues to crime, under preforming students, blight, overpriced nearby neighborhoods, affordable housing deficiency, suburban sprawl, midwestern industrial scale produce and meat manufacturing, a dwindling middle class, car dependency, national debt accumulation, increased financialization of the economy as a replacement for manufacturing and assembly jobs, etc. It will take a large public and private sector investment and input from the citizenry instead of consolidated decision-making in the hands of elite specialists.

posted by: Anderson Scooper on August 30, 2010  5:32pm

What a great Republican ticket this year. Two Greenwich mega-millionaires who hope to cut government because they think their own personal taxes are too high!

posted by: James D on August 30, 2010  7:11pm

...  94% health coverage in the state?  Not according to the US Census Bureau. And a good percentage of those with so-called “coverage” in CT pay through the nose for inadequate care that they could lose in a heartbeat.  Hey, Tom: Most young people “choose” not to have coverage for one simple reason: they - can - not - afford- it.  Little reason to work for SustiNet as governor?  How about, “It’s the law.”

Dude, weren’t you Speaker of the House?  You should know better.

posted by: Threefifths on August 30, 2010  7:45pm

One is like king bloomberg and the Other Like King John. Again the bird is the same Left wing,Right wing take your pick, Red or Blue pill.

posted by: Jeremy Engdahl-Johnson on August 30, 2010  9:29pm

Medical homes face a public awareness problem. The solution?  Scenarios that work.  http://www.healthcaretownhall.com/?p=2880

posted by: Townie on August 31, 2010  7:48am

Foley’s views on the death penalty are something to pay attention to and, to me, are disturbing. Also, I used to be against universal health care because of the cost, but now I think that the cost is worth it. We could cut costs in other areas, like the prison system, DCF, DOT, etc. and establish a doctor managed, publicly funded health care system. If we are willing to fund wars we should be more than willing to fund a program that ensures quality health care for all citizens. It would be nice to hear a candidate advocate such a program or to just promote a progressive socialistic agenda. When that happens I might just vote.

posted by: Threefifths on August 31, 2010  9:02am

posted by: Townie on August 31, 2010 8:48am

Also, I used to be against universal health care because of the cost, but now I think that the cost is worth it.

Watch it.You will be called a socialist.

posted by: Clifford Wallace Thornton, Jr. on August 31, 2010  5:32pm

Good luck Charlie, I hear and understand why you are doing this.

posted by: Steve McPherson on September 3, 2010  10:27am

I read the recent article in the New Haven Independent, “City Looks Different to Foley, Malloy.” I take exception to Mr. Foley’s comment that community-based alternative programs keep seniors alive longer through better care. While Masonicare has an entire affiliate devoted to care in the community, individuals receiving care in our two nursing homes simply would not be safe at home. Our care giving staff certainly would take exception to a comment that implies their care is inferior to what is delivered in the home.

Masonicare embraces the philosophy of caring for seniors in the setting of their choice. Our continuum includes independent living, home care, assisted living, skilled nursing and many other services that seniors may want or need. Sweeping generalizations make headlines. If you are advocating that our system needs a fresh look, I agree wholeheartedly. It is an important subject. Unfortunately, the state and federal reimbursement systems force decisions that may not be the first choice of seniors and their families. The system is broken and needs to be changed, but please separate this issue from quality care being provided.

Stephen B. McPherson
President & CEO
Masonicare
22 Masonic Avenue
Wallingford, CT.  06492

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