July 10, 2014
Host: Ted Simons
AZ Giving and Leading: Dads 4 Special Kids
- An Arizona father searching for support as he raises a son with disabilities discovers he’s not alone. Ray Morris created a nonprofit group that offers monthly meetings, workshops and online help for fathers to ask questions, share experiences and learn from each other.
| Keywords: giving
Ted Simons: In tonight's edition of Arizona giving and leading, producer Christina Estes introduces us to an Arizona father who discovered he's not alone as he faces special challenges.
It’s 4-O’clock on Thursday afternoon.
Here we go.
And Zachary Morris is calling it a day.
Good job. How was the program today?
After spending eight hours at an adult day program, Zachary is ready to relax. That means the shoes, socks, and shirt come off and the TV comes on.
I don't know how you describe Zach. He is just -- I want to say perfect. Because he just wants to love. He wants to be loved.
Ray Morris's oldest son is 26. Cognitively he is about two years old. Zachary was born with hemimegalencephaly, a rare condition where one half of the brain is larger than the other.
Zach came home. I went into, I call it survival mode. I -- I took care of everything at home that needed to be done. I was the man, do what men do.
That left ray's wife Kelly to handle Zach's therapy and doctor's appointments.
After about three, five years, we were drifted apart. Because she is focused on him. I'm doing my thing over here, and I didn't know how to deal with my emotions.
He couldn't help me. He tried. He couldn't make my pain go away. I couldn't make his pain go away.
I had struggles dealing with my emotions. Allowing myself to grieve. Allowing myself to love again. Allowing Zachary to love me and loving Zachary because I didn't know is he going to have seizures. Is he going to die? Is he -- what's going to happen?
When ray began searching for ways to help himself and his marriage, he found resources for mothers, but nothing for fathers like him. So Ray formed a Nonprofit support group, called dads for special kids.
What are you thinking about Zachary?
I have a little model slogan that I live by, or try to live by. I'm the right dad for Zachary. He's the right son for me.
You are getting big, aren't you?
Greg Burgas believes the same thing about his daughter, Mia.
You already said hi. I know it is a camera.
For seven months, Greg and his wife experienced the joys of being first-time parents. Then a flatbed truck rear ended their car, spinning it so violently that Mia strapped into a baby seat suffered a traumatic brain injury.
The most difficult thing is emotionally, psychologically, is that she is never -- probably not going to live on her own ever. That is difficult just realizing that she will probably be a lot like her sister in understanding that she is never going to be able to do that sort of thing and it gets to you.
Are you happy now?
It is one of the feelings Greg can share with other dads when they get together each month.
Are you a big girl?
You're not a big girl? I think it has made me a better father and made me more aware of other people's problems.
Some of the kids are much worse off than Mia. I'm just -- I'm very thankful that she is as kind of engaged in the world as she is.
Back at the Morris house. Zach has moved upstairs to watch videos in his bedroom. It is a favorite spot for both his parents.
First thing in the morning, when he is awake and he doesn't have all of his seizure meds in him yet and so he's just happy. Rolling around on his bed. Pretending he can't get out of bed. I can't get up. He'll say that. Can't get up. That's the best. The best.
And I go in his room and he sits up and I lay on the foot of his bed sideways and he turns and looks at me and takes his head and leans right on my shoulder here and drives his head into my shoulder just back and forth. And he rolls and he just rests his head on my shoulder. I'm like, if that is not love, what is?
It took ray Morris years to reach this point. He hopes dads for special kids will help others get there sooner.
Ted Simons: Dads for special kids holds monthly meetings across the valley, along with special events and workshops. You can learn more at dads4specialkids.org.
- In a two-day event at the State Capitol, Cox Communications and the W. P. Carey School of Business at Arizona State University will gather about 40 executive MBA students to learn about policy-making and budget decisions from some of the state’s top lawmakers, staff and advocates. The students, acting as lawmakers and advocates, will then pass their own budget in a mock legislative session. It’s an exercise to help students learn how business and the political process intersect. Gerry Keim, professor of management at the W. P. Carey School of Business at ASU, and Michelle Bolton, director of public affairs for Cox Communications, will discuss the event and concepts used by the students.
- Gerry Keim - Professor of Management, W. P. Carey School of Business at Arizona State University
- Michelle Bolton - Director of Public Affairs, Cox Communications
| Keywords: government
In a two-day event at the state capitol, Cox communications and ASU's W.P. Carey school of business gathered about 40 executive MBA students to learn about policy making and budget decisions from some of the state's top lawmakers and advocates. The students then passed their own budget in a mock legislative session. The goal -- to show how business and the political process intersect. Here to talk about all that is Gerry Keim, professor of management at the W.P. Carey school of business, and Michelle bolton, director of public affairs for Cox communications. Good to have you both here.
Gerry Keim: Thank you.
Ted Simons: This thing just wrapped up.
Gerry Keim: It did.
Ted Simons: Wrapped up today.
Gerry Keim: Finished about an hour ago.
Ted Simons: Talk about this. Give me a better definition of what happened down there.
Gerry Keim: We had sessions where we met legislators, we met advocates, we met representatives of governor's office and then we played the simulation, where everyone of our exec MBS students had a role. Some were lobbyists, some were members of the house, some were members of the Senate, one was the governor. We went through a number of rounds where each one had goals they were trying to advance. They got a really good hands-on understanding of how the public policy process actually works.
Ted Simons: Cox communications is involved in this because?
Michelle Bolton: We think it’s really important for business and non-profit leaders to be involved in the process and know how easy it is to be involved in the process. Arizona has one of the most accessible legislatures in the country, and, so, why not take that opportunity to influence public policy matters that impact our business, or non-profit.
Ted Simons: These were MBA students, they went down there and learned about policy, learned about -- was it initially a classroom setting or was it feet on the ground and go from there?
Gerry Keim: Initially it’s a classroom setting. We started at the campus in Tempe. They do some reading, they write -- do analysis on their own, teach them tools for thinking about how the public policy process works. And then we come down here. This is a course we've had for a long time, but it exclusively focused on the federal level process. Cox came to us around 2004 and said could we help you develop a state analog for this course? I said wonderful, we would love to do that. They have connected us with all of our speakers. They get access to the Senate for us. We couldn't do it without Cox. It is a great partnership.
Ted Simons: How do you get access to all of those folks? How do you get them to say ok, I will do this for a couple of days in the summer?
Michelle Bolton: Long time relationships with us being down at the capital. We have been lobbying for decades down at the state legislature, we built great relationships with republicans, democrats, regulators, other lobbyists and they, too, want folks to be involved at the capitol. There is a fantastic enthusiasm by our lawmakers and our lobbyists, our advocates to say we'll show you how it's done because people do want to hear from you.
Ted Simons: Describe the atmosphere down there. I guess once the budget game starts, even before and after the budget game, what is it like down there? Is it a lot of running around? What does it look like?
Michelle Bolton: It is a little chaotic, of course. Most of the students haven't really done this before. So this is brand new to them. You know, we're lifting the veil of mystery, so to speak. They're learning that process. We help them dip the toe in the pool and gradually get them involved. Once they get that taste and they get that knowledge, they're hitting the ground running. In fact, we started to really hit the ground running last night with the elections. They elected their leaders last night.
Ted Simons: Oh, my goodness.
Michelle Bolton: Yeah.
Ted Simons: When you see these students, obviously you go from a classroom setting to down there at the capitol to electing leadership and such. Do you see things changing? Does it start clicking or is there a little bit of intimidation involved?
Gerry Keim: A little of both. It definitely clicks. These are executive MBAs, these are 35 to 55 years of age and it is about learning to think strategically. The point we try to make a lot of threats and opportunities come from the public policy process, our tag line for the course is democracy should not be a spectator sport. Democracy works better when more people are involved. These folks develop the understanding and the capability then to help their organizations become more involved in the public policy process. I think that's good for our state and quite frankly at the federal level for our country.
Ted Simons: When the budget game begins and then folks are trying to pass this and trying to lobby for that, I mean, are they -- are they getting the gist of what really needs to be done? I know it is a mock setting. But do they understand just how sensitive and -- the political -- this -- a lot of politics going on with this.
Gerry Keim: Well, the game is structured thanks to the Cox team, structured in a way that they have very specific goals. Some of them win or lose points if they can get funding for body armor, for DPS officers. Others focusing on the high-tech industry. Others focusing on poor families and children. And they win or lose basically on how effective they are at pushing for their programs. Most of these folks are type A. They're pretty excited.
Ted Simons: I would imagine so. I want to get response from them, but what is the response from lawmakers and lobbyists? It is done now. What did you hear from them?
Michelle Bolton: First off, it is interesting how art imitates life. We had a very tenuous budget session. A vetoed budget as well. We had a Senate president that was rolled. So, it was quite interesting. No one could have anticipated any of that. That's just how it worked. But, you know, the key things I think they learned out of this is relationships are important. They mean everything. Your current seat at the capitol is your word, your reputation, and if you don't have that, then you start to get isolated. So, everything that we have in the real world they saw it there in the game. And tried to be very strategic in how they moved things through the process.
Ted Simons: What kind of response did you get from the students now that it is done? It’s not really done. You’ve got a federal thing back in D.C.
Gerry Keim: Exactly. And they're chomping at the bit to go. They're very enthusiastic. Nothing quite like an experience like this. Also, the fact that we can be in the Senate, something about smelling it, tasting the environment, we couldn't do this on campus.
Ted Simons: So the response that you’ve gotten so far?
Gerry Keim: Universally positive.
Ted Simons: Students as well.
Michelle Bolton: Yes.
Michelle Bolton: And we may even have recruits to run for office. There certainly were three or four students that said I might be interested in taking a whack at that. I love it.
Ted Simons: As far as the intersection of business and politics, is the message getting across?
Gerry Keim: Oh, absolutely. Absolutely. They clearly understand. What -- and most people in business understand that the political process is important, but a lot of them just don't know what to do about it. Our students after this experience, they know how to participate.
Ted Simons: Is that what you're seeing as well?
Michelle Bolton: Oh, absolutely. And the comments back after we finished our session was, wow, this was an eye-opening experience. It's tough. I have a greater respect for our lawmakers. I didn't realize it was this tough. How to actually build coalition and, you know, there are all kinds of outside forces that can change dynamics. You think you're on one track but then a curve ball is thrown and now there is something new.
Ted Simons: It sounds like a lot of fun if nothing else and it sounds like a lot of things were learned as well. Good to have you both here.
Gerry Keim: Thanks very much. Appreciate it.
Uncompensated Hospital Care
- A new survey by the Arizona Hospital and Healthcare Association shows that care given to those unable to pay their bill has fallen 31 percent for the first four months of this year as compared to the same time period last year. Jim Haynes, senior vice president and chief operating officer for the association, will talk about the new survey.
- Jim Haynes - Senior Vice President and Chief Operating Officer, Arizona Hospital and Healthcare Association
| Keywords: medical
Ted Simons: A new survey by the Arizona hospital and health care association shows that uncompensated care has fallen in the first four months of this year as compared to the same time last year. Jim Haynes is senior vice president and chief operating officer for the association. He joins us now. Good to have you here. Thank you for joining us.
Jim Haynes: You're welcome.
Ted Simons: This survey was done by the association, correct?
Jim Haynes: It certainly was.
Ted Simons: What were you looking for?
Jim Haynes: Back in July 2011, when the state was having real budgetary problems, they put a freeze on the childless adult population. When that happened, our hospitals were really concerned about what is that going to do to our uncompensated care and we started to survey members at that point. The first survey we completed was in October, and it showed that uncompensated care went from 3.5% of charges to 6%, it almost doubled overnight. We have been tracking that every month since then and it had gone up to 8%. It is a large number. We continue to track that. See what the results are. Since January 1st, it has gone down a lot.
Ted Simons: Some of the numbers are amazing. Uncompensated care down 31% in the first four months.
Jim Haynes: Absolutely. We kind of expected that it would go down quickly. Typically what happens is someone comes in the hospital, doesn't have insurance, and you try to see if you can find insurance for them and see if they qualify for the access program. And since January 1st, the number of people that are covered, childless adult population, has gone from 68,000 in December of 2013, to 235,000. So it has been a big increase, a huge increase and that is the reason why the uncompensated care has dropped.
Ted Simons: Before we get too much further, define uncompensated care. What are the parameters here?
Jim Haynes: What it is, is somebody comes in the hospital and they don't have the ability to pay. They just don't have the dollars. They don't have the money. That's called charity care. That is part of uncompensated care. The other portion of it is people who choose not to pay. They have other responsibilities. They choose not to pay their hospital bill. They call that bad debt. Uncompensated care is a combination of those two items.
Ted Simons: Again, with 31% down, judging from what I saw, 170 million written off versus maybe 240, $250 million written off last year.
Jim Haynes: Those are the numbers. Pretty significant.
Ted Simons: What does that do to operating margins for hospitals?
Jim Haynes: It has helped a lot. It almost goes dollar for dollar, so hospitals’ operating margins have gone up about one percent which doesn't sound like a lot but it is a big number. That is a good thing. It gives an ability to put money back into the operations, finance capital, all of those kinds of things that are important to provide care to residents of Arizona.
Ted Simons: You mentioned January 1st, as being the time when it seemed like things changed. Obviously we saw expansion of access. Is this a direct correlation to expanding access?
Jim Haynes: No question in my mind at all. As I said before, when the population was frozen, it went up immediately. And now that the population, people do qualify, can be added to the access insurance again, it started to go down directly. I don't think there is any question that has had a direct correlation.
Ted Simons: Is there any way in the future or now you can get a specific metric that can be more specific or you can say it seems pretty obvious as opposed to there it is right there.
Jim Haynes: I don't think there is any question. There it is right there.
Ted Simons: So obvious you don't need anymore metrics.
Jim Haynes: I don't think so.
Ted Simons: The impact of the Affordable Care Act, just generally speaking, more people insured. Making a difference?
Jim Haynes: It's too early to tell at this point for that. We certainly expect it will. It is hard to imagine it won't. But at this point in time it is too early to tell.
Ted Simons: As far as ERs, are they seeing fewer patients?
Jim Haynes: No, ED volumes are still -- I don't expect it to be a huge change there at least immediately. Over time, you think it will. You think people will be able to go to the physicians’ offices as opposed to ED. And hopefully that’ll be the case, but it’s too early to tell on that one.
Ted Simons: Why are you not surprised or didn't expect to see a change on that because I think most people would.
Jim Haynes: We expected to see a change on that several years ago when we first went into HMOs. It didn't happen at that point in time. So, it's -- people need care, want care right away. And EDs are very convenient for that.
Ted Simons: Regardless of the insurance situation.
Jim Haynes: That's correct.
Ted Simons: In a -- I know that assessments are now supposed to be helping pay for the access expansion. What are we seeing as far as what hospitals are paying in those assessments?
Jim Haynes: For the first six months, it was about $75 million that hospitals paid. And for 2015, the amount to $235 million. It is a lot of money. The key question there though is there -- two parts to it. One is by providing this, people get coverage. That's a great thing. Uncompensated care is down. That is a great thing. But there’s also another part to that assessment, that is we're supposed to start seeing additional patients. It’s still too early to evaluate that at this point in time. We think that is going to be the case, but we don't know. If it turns out that we don't see an increase, or hospitals don't see an increase in volume, we will address that, assessment will go down, if that's the case. It does tie directly to what the cost of caring for those patients are.
Ted Simons: And compare that now, if you can, to how much the feds are paying as far as expanding access. Obviously there is a formula here and cooperation here and a couple of different avenues. What are you seeing out there?
Jim Haynes: A great program for the state. The way it works is -- in Arizona, almost a two for one, if we put up $1,000, the fed puts up $2,000. So it is a great return on investment. Bringing Arizona dollars back to Arizona. It is a great program. It is a good thing.
Ted Simons: Okay. As far as what we're seeing from the feds, whatever we're seeing, you're saying is a good thing.
Jim Haynes: Absolutely.
Ted Simons: Okay. Critics are saying things are going well for the hospitals. Things are turning around for the hospitals. Are hospitals lowering their costs to patients?
Jim Haynes: Two things on that. First I will say when we do our survey, 30% of the hospitals were still reporting that they were losing money on operations. That is a lot of hospitals losing money on operations.
Ted Simons: Stop there. Why?
Jim Haynes: Just a lot of things going on as far as first we haven't had rate increases from the access program for years. Right now we're not getting paid full costs from the access program for taking care of patients. In addition, Affordable Care Act has a couple of components to it. They're reducing some of the payments that they're making to hospitals. And the whole part of that was they're reducing those payments to hospitals, but hospitals were getting that back by seeing additional patients. And that is when we still have to see if that is going to happen. Not only additional payments, but lower uncompensated care, and we just have to play that out and see how that plays out.
Ted Simons: And was there a second point you were going to make or did you get that one in there?
Jim Haynes: I think I got that one in there.
Ted Simons: Okay. So, the impact of the expansion and I know Affordable Care Act is still early, and, as you mentioned, moving parts still on that. But the impact on hospital bottom lines in general, you got some folks still losing money out there. What -- what do you see in the future?
Jim Haynes: I think what we will see is hospitals really working hard to decrease their costs. They have been working hard to do that. Maintaining high quality, or improving quality, but also reducing costs, that is the name of the game in the future. Hospitals are going to have to do that.
Ted Simons: Do you see as far as any other states, can you compare and contrast -- I thought Colorado had something interesting you can compare to. Seeing anything out there?
Jim Haynes: The states that did expand are seeing reduction uncompensated care. Exactly what you would expect. Those that didn't, are still seeing the same uncompensated care levels they had before.
Ted Simons: And the next survey will be…??
Jim Haynes: We do it on a monthly basis. The next big survey where we look and see what is the impact -- what additional patient are we seeing? We will see that probably towards the end of the summer.
Ted Simons: Who's who exactly is showing up now in other words.
Jim Haynes: Absolutely.
Ted Simons: Along with how many.
Jim Haynes: Yes.
Ted Simons: Good information. It’s good to have you here. Thanks for joining us.
Jim Haynes: Thank you.