The measure would also empower the state — through eminent domain — to assume control of hospitals that are at risk of closure because of financial instability.

Sen. Saud Anwar, a South Windsor Democrat who is co-chair of the Public Health Committee, said he raised the proposal after researching what authority other states had to intervene in dire situations.

CT officials vow 3 hospitals in bankruptcy won’t close

Rhode Island has a policy that permits hospital receivership, and state officials in Massachusetts can seize hospitals through eminent domain, as was recently done in the case of St. Elizabeth Medical Center, a Steward Health Care-operated facility. Steward has also filed for bankruptcy.

Earlier this month, Prospect Medical sought Chapter 11 protection in U.S. Bankruptcy Court in Northern Texas. The chief executive officer of Prospect’s three Connecticut hospitals — Manchester, Rockville and Waterbury — said payroll continues to be met and Gov. Ned Lamont vowed that the hospitals would remain open.

But it’s unclear what the filing will mean for the pending agreement Prospect signed in 2022 to sell its three Connecticut hospitals to Yale New Haven Health.

Attorney General William Tong recently commented on the need for stronger state authority to intervene when hospitals confront financial hardship.

“We need stronger power and authority to step in when situations like this happen,” Tong said at a press conference last week. “The Rhode Island Attorney General, for example, has receivership power that I don’t have, and he exercised that power in Rhode Island. … As I look at the legislators over here, we’re going to have the conversation about what we need to do in Connecticut.”

New wrinkle in sale of three struggling CT hospitals. ‘We are watching this closely’: state official

The language of Anwar’s bill says lawmakers are trying to “prevent abrupt service interruptions and ensure the continuity of health care services at hospitals,” as well as “allow the state to coordinate long-term solutions when a hospital is in financial distress or experiencing an operational crisis.”

Tong said he supports the measure.

“We are aware of the proposal and would support an expansion of the state’s authority to intervene in these types of situations, including receivership which is not currently an option in Connecticut,” he said in a statement. “More broadly, we remain concerned by the growing influence of private equity over health care, and the challenges posed by consolidation of health care delivery in Connecticut. There needs to be greater oversight and transparency regarding these transactions and acquisitions.”

Nicole Rall, a spokeswoman for the Connecticut Hospital Association, said receivership and eminent domain don’t solve issues of financial distress.

“CHA looks forward to continuing conversations with lawmakers related to what would be helpful in preserving patient care and protecting jobs during a time of crisis, but we also must recognize that receivership and eminent domain do not solve the problems that cause financial hardship in the first place,” Rall said. “Important questions need to be answered about defining financial hardship, how receivership would be used, and why eminent domain for this use should even be considered. We look forward to continuing to work collaboratively on solutions.”

A spokesperson for Prospect Medical did not immediately respond to requests for comment Monday.

The Connecticut Mirror wrote about the lack of a receivership law in Connecticut last year as Prospect was dealing with financial difficulties and hospital officials were sounding the alarm about deteriorating conditions at the facilities.

The CT Mirror obtained emails that showed a top Lamont adviser raised concerns about the absence of a receivership policy.

“Other states [like Rhode Island] have clear authority to put a hospital into receivership, we do not,” Matthew Brokman, then a senior aide and now chief of staff, wrote in an email.

A spokeswoman for Lamont said Monday the governor plans to also put forward measures that would bolster state oversight of health care.

“We’ve yet to review [Anwar’s] proposal but the governor plans to re-introduce legislation this session that would strengthen the state’s oversight of financial transactions involving hospitals and other health care institutions,” spokeswoman Julia Bergman said.

Although bills that would regulate private equity investment in health care failed to win passage last year, Anwar said he’s optimistic the receivership bill will have good support this legislative session, especially in light of the bankruptcy filing.

“Unfortunately, because of some of the bad actors in private equity, we are seeing hospitals go through significant financial trouble,” Anwar said. “As a last resort, if things do not work out, the state has to [be able to] intervene. I feel like this is life insurance for health care system.”

A Yale New Haven Health spokesperson has said, “Prospect’s decision to file for bankruptcy is much larger than just the state of Connecticut – this is a national matter and of grave concern to many hospitals around the country.

“Yale New Haven Health raised the alarm about this inevitability in the lawsuit we filed last year, recognizing Prospect’s lack of investment and mismanagement of the Connecticut Prospect hospitals,” the spokesperson said recently. “The situation was further exacerbated by their lack of payment to the pension plans and growing debt to the state, local governments and vendors. Many of these same issues were referenced in lawsuits filed by the states of Pennsylvania and Rhode Island regarding Prospect’s mismanagement of their hospitals in those states. We will closely monitor the proceedings and determine what steps, if any, YNHHS will take as part of this process.”

Jenna Carlesso and Dave Altimari are reporters for The Connecticut Mirror (https://ctmirror.org/ ). Copyright 2025 © The Connecticut Mirror.

The detective, Robert Lawlor, claimed he saw the Black teenager standing outside a car holding a gun, but no firearm was ever recovered from the scene.

The jury in Hartford deliberated for nearly two days following the trial but ultimately chose not to convict the police officer on manslaughter and assault charges, leading to questions about why no people of color were selected for the jury.

Now, more than 15 years later, Bryant said the racial makeup of that jury still influences her views of Connecticut’s court system.

“I have no trust in the judicial system,” she said. “I don’t feel like everyone gets a fair chance. My brother’s case alone has made me think differently. I feel the judicial system failed us.”

It was that type of scenario that Connecticut’s judicial branch was trying to rectify when it overhauled its jury selection process in recent years.

Since 2020, state officials have expanded who is eligible to serve on a jury. They changed the notices that are sent to potential jurors. And they increased the number of people who receive jury summons in Connecticut’s largest cities to help ensure the pool of available jurors more accurately reflects the state’s diverse population.

Despite all of those reforms, however, new data collected by the state shows that, in several of Connecticut’s judicial districts, minority communities are still underrepresented.

That data, which includes self-identified information for more than 44,000 people who reported for court service between November 2023 and May 2024, provides the first public glimpse into the racial makeup of jurors in the state’s history.

And it suggests Connecticut may need to do even more to make sure the tens of thousands of people who report for jury service every year are truly representative of the communities they come from.

In the Stamford-Norwalk Judicial District, for instance, Black residents make up more than 12% of the jury-eligible population but less than 7% of the people who reported for jury service.

In the Windham Judicial District, the Hispanic community accounts for nearly 12% of the eligible population in that region but roughly 7% of prospective jurors.

And in the Hartford Judicial District, Hispanic residents make up more than 17% of the population but roughly 10% of the jury pool.

Those differences did not prevent Black and Hispanic residents from being selected to serve on most of the juries in those district courts. But state officials and law professors who study jury selection said such disparities can still erode public trust in the judicial system and make it more difficult to form racially diverse juries, which research has shown leads to more deliberation and a wider consideration of the evidence presented during a trial.

Richard Robinson, who previously served as the first Black chief justice on Connecticut’s Supreme Court, said the perception of fairness in the judicial system is enormously important to the day-to-day functioning of the courts, and he said juries are at the very heart of that system.

“If people either feel the system is failing them or the system actually is failing them, you’ve got a problem and you need to address that,” said Robinson, who helped to initiate the review of the state’s jury selection process.

Nina Chernoff, a law professor at the City University of New York who studies jury diversity, said public perception is even more important in situations where the majority of criminal defendants who are facing a trial are from the same racial or ethnic groups that are underrepresented within the pool of jurors.

That is certainly the case in Connecticut, where more than 60% of the criminal cases that proceeded with jury selection between late 2023 and early 2024 involved either a Black or Hispanic defendant, according to state records.

“The way we maintain a democratic judicial system is to have members of the community weighing in,” Chernoff said. “So to the extent that a jury fails to reflect the community, it’s unable to serve its core purpose, which is to insert the community’s voice into the judicial process.”

Bryant, whose cousin was also seriously wounded in the shooting in Hartford, said that voice was definitely missing during the 2009 trial.

Because the jury that acquitted the police detective was composed of white suburbanites, Bryant said, it felt like her entire community in the North End of Hartford was on trial.

Having people from the family’s neighborhood on the jury might have made a difference in how the case was perceived, she said.

Jurors told news reporters following the trial that the racial composition of the jury did not influence the verdict. But that did not change Bryant’s opinion — or the opinion of others from Hartford’s North End.

The acquittal provoked anger and mistrust of the justice system among many Hartford residents, according to news reports at the time.

“Here we were in the inner city, and we have a jury that may all be from the suburbs,” Bryant, now 41, said. “Honestly, I feel like Black people as a whole don’t get the same equality. I feel my brother didn’t get a fair chance.

“Not a day goes by that I don’t think about my brother,” she said. “And I never forgot the trial. I never forgot walking in and seeing an all-white jury.”

Rethinking the system

Much has changed with the state’s jury selection process since that time. And in many ways, Connecticut now leads the country when it comes to confronting the issue of jury diversity.

That’s largely because of the Connecticut Supreme Court’s decision to appoint a task force in 2020 to rethink nearly every aspect of how the state summons, screens and selects jurors.

That task force, which was composed of judges, lawyers and law professors, was the result of a Black juror being dismissed during a murder trial in New London due to the views he expressed about police and the criminal justice system.

The defendant in that murder case, Evan Holmes, appealed to the Supreme Court demanding a new trial and arguing the dismissal of that juror was the result of racial discrimination.

The Supreme Court ultimately upheld the guilty verdict that was handed down in Holmes’ case, but Robinson and the other justices chose that moment to order a top-to-bottom review of the jury selection procedures in Connecticut.

The formation of the task force coincided with a wider public reckoning with the nation’s criminal justice system following the murder of George Floyd, who died at the hands of a Minneapolis police officer, and it led to significant changes over the past four years.

At the recommendation of the task force, Connecticut lawmakers voted to allow green card holders to serve on juries for the first time, and they reduced the number of years that people with felony convictions need to wait before they can be considered for jury duty. They also required court administrators to send additional jury notices to residents in cities like Hartford and Bridgeport, where many summons historically have gone unanswered or returned as undeliverable.

Robinson personally appeared in front of the legislature in 2021 to support those measures, and he told lawmakers the changes recommended by the task force were some of the most important pieces of legislation they would consider that year.

“We know how bad 2020 was for the pandemic. We know how bad it was for social unrest,” Robinson told lawmakers. “A lot of what’s going on is people have lost faith in our government institutions, and in particular, the thing that I worry about is the judicial branch.”

“We have a constitutional right to have a jury of our peers,” Robinson added. “A lot of people aren’t feeling that is the case.”

The state’s judicial branch also asked legislators to consider increasing juror compensation in Connecticut to cut down on the number of people who ignore jury summons or are excused from jury service for financial reasons.

But lawmakers have repeatedly balked at that request due to the associated price tag, which could cost the state several million dollars per year.

Legislators did take the monumental step of making Connecticut one of the first states in the country to compile publicly available data on potential jurors, however.

Diagnosing problems

Connecticut has collected information about jurors for decades, but for much of the state’s history, that information was stored on paper records and was not disclosable to the public.

That changed in late 2023, after state law was revised and the judicial branch rolled out a new jury management system that enabled court officials to more effectively gather and store information on every prospective juror.

The Connecticut Mirror attempted to obtain juror data going back several years, but the judicial branch said the paper forms on which it once recorded that demographic information were discarded by the state.

The state’s new jury management system is now allowing the state to publicly assess whether it’s meeting its stated goal of forming juries that embody the state’s racially diverse population. And it puts Connecticut’s court system leagues ahead of most other states in the country — many of which do not collect or share demographic information on jurors.

A study published earlier this year by researchers at the University of California Berkeley School of Law found that only 19 states collect data on the race and ethnicity of jurors. And many of those only share the data with judges and attorneys.

Judge Kimberly Knox and Judge Peter Brown, who recently led a committee that analyzed Connecticut’s new juror data, said the state’s decision to gather and share that information is a remarkable step forward.

And while the data highlighted several lingering issues with jury diversity, Knox and Brown said the judicial branch can use that information to help improve the system.

“We’ve kind of opened the door to other areas of inquiry,” Brown said. “I believe it is a jumping off point.”

Paula Hannford-Agor, who is the director of jury studies at the National Conference of State Courts, agreed. She said states that don’t collect or analyze information on jurors are not able to address problems or inequities in the system.

“If you have concerns about the representativeness of your jury pool, you’re not going to be able to document whether that is your imagination or if it’s real,” Hannaford-Agor said.

“That is why you want to be able to use data. You can use it diagnostically to identify the barriers that you can fix,” she added.

Picking a jury

The underrepresentation of Black and Hispanic jurors in some of the state’s courts is of vital importance to the judicial branch, which plans to review the jury data every year moving forward.

But it may not matter that much from a legal perspective.

Prior rulings by the U.S. Supreme Court have held that criminal defendants need to prove that a distinct group of jurors was “systematically excluded” in order for a jury pool to be deemed unconstitutional. And that is a very difficult bar to clear in most cases.

Several defense attorneys in Connecticut said they have not seen the racial composition of juries in the state affecting the rights of their clients in court.

According to the state’s new data, there were at least 16 criminal trials between late 2023 and early 2024 in which no jurors of color were seated. That’s out of 117 criminal trials that went forward with jury selection over that time span.

Meanwhile, in Torrington Superior Court, four out of the five criminal juries that were assembled were all white. In all of those cases, the defendants were also white.

John Kaloidis, who previously served as the president of Connecticut Criminal Defense Lawyer Association, said he doesn’t automatically view race as the most important factor when selecting a jury, even if his client is from a minority community.

“The traditional school of thought, maybe 30 years ago, was you’re going to want a minority on the jury pool because they’re more likely to be sympathetic to another minority,” he said. “I think a lot of those old stereotypes that went along with picking a jury are out the window.”

Kaloidis, who represents defendants charged with murder, armed robbery and sexual assault, said Connecticut’s laws provide attorneys with the tools that are necessary to protect their clients.

The state has what is known as individual voir dire. That means lawyers have the opportunity to question people individually to determine if they should be seated on a jury.

That’s rather rare. Most states only allow attorneys and judges to question jurors in larger groups.

Kaloidis said he believes the answers that jurors give during that voir dire are often far more important than the race they marked on their jury questionnaire. Those answers can delve into the juror’s beliefs, values and life experiences.

“That is where it is on the defense lawyer to ask the appropriate questions,” he said.

Still, Kaloidis recognizes that the overall appearance of the jury pool can be intimidating for Black or Hispanic defendants who request a trial.

Some of Kaloidis’ past clients voiced apprehension as their jury selection began and a significant number of white jurors were paraded into the courtroom, he said.

“I have had clients that have said, “Look, I’m a little worried. I’m Hispanic, and the last five people have been white. And the next five people all sound like white guys and they all live in the suburbs,” Kaloidis said.

Outreach and income

Some believe one of the biggest barriers to forming representative jury pools is people’s hesitancy with the criminal justice system.

Scot X. Esdaile, president of Connecticut’s branch of the NAACP, said there still are sentiments within communities of color that serving on a jury is not in their best interest and could put a target on someone’s back if they help to acquit a criminal defendant.

Other people, he said, worry they may be seen as a “sell out” if they convict someone from their own community. There is a general sense that it is better to stay away from the court system completely, Esdaile said.

Esdaile, who served on Connecticut’s Jury Selection Task Force in 2020, is frustrated that more outreach hasn’t been done in the past four years to overcome those reservations and to increase the response rates among people of color in Connecticut.

During his time on the task force, Esdaile remembers discussing proposals such as using radio messaging in Black and Hispanic communities and passing out pamphlets to churches and civic organizations to increase jury participation. But he has not seen that outreach take place since then, he said.

“In order to educate, inform and engage communities, you have to get out into those communities and have conversations,” Esdaile said.

Law professors who study jury selection said people’s personal views on the judicial system are often cited in public as one of the main issues inhibiting jury diversity, but the bigger driver is often income, they said.

Studies have shown that when researchers account for income levels, white individuals and people of color respond to jury summons at similar rates. The fact is, however, that people of color are more likely to fall into those lower income brackets.

Elisabeth Semel, a law professor at the Berkeley School of Law who studied jury systems across the country, said the fear of losing out on a paycheck can prompt people with lower incomes to ignore a court summons when it arrives. It can also lead to judges dismissing more people from jury service due to financial hardship.

San Francisco courts recently undertook a pilot program that increased juror pay to $100 per day for anyone who earned less than 80% of the region’s median income, which showed significant results. It increased the likelihood of people with lower incomes participating in jury service and found those people were predominantly from minority communities.

Jurors in Connecticut are compensated at a higher rate than many other parts of the country. The state requires Connecticut businesses to pay their employees during the first five days of jury service, and the state reimburses jurors up to $50 per day after that.

But that level of pay can still be unworkable for lower-income households. Fifty dollars per day only equates to roughly $6.25 per hour.

That is why the state’s judicial branch has spent the past several years asking lawmakers to raise juror up to the state’s minimum wage and to consider allowing jurors to expense the cost of family care and travel during their jury service.

State prosecutors, defense attorneys and judicial officials all voiced support for those proposals, but lawmakers abandoned the request after legislative staff estimated the change could cost several million dollars per year.

Robinson, who recently returned to private practice after his 11-year stint on the Connecticut Supreme Court, said he views juror compensation as a major component to improving the state’s jury system. And he is hopeful that state lawmakers will eventually get behind the idea.

“This is not just a process that is going to take a year or a month,” Robinson said. “This is a process you have to continue looking at.”

Andrew Brown, Jenna Carlesso and Renata Daou are reporters for The Connecticut Mirror (https://ctmirror.org/ ). Copyright 2024 © The Connecticut Mirror.

Dowd, a Coventry resident, said she feels at ease in Connecticut, which is considered a “safe haven” state for its abortion protections, but she’s wary of traveling to places where the same rights aren’t offered. Aside from a trip to Tennessee to visit her parents, Dowd doesn’t plan to travel to states with restrictions during her pregnancy in case something happens that puts the health of her or her unborn child at risk.

“Life in general is chaotic and unpredictable, and while I understand the likelihood of things going wrong is fairly low, I still worry about something like a car accident or slipping and falling,” Dowd, 35, said. “If something unpredictable did happen, I don’t want my life or the life of my future child to be at risk because I’m in a state where you have to actually be dying [to get care] versus being willing to take care of me before then.”

By The Numbers: Abortion and maternal health in CT, two years post Dobbs

In the wake of Roe v. Wade’s defeat over two years ago, access to reproductive care, including abortion, contraception and fertility treatment, has been front and center in the discourse surrounding the upcoming presidential election. Dowd said because of her fears about what could happen to reproductive access under a second Trump administration, she plans to vote for Democrats in state and national races.

“I do worry that if Donald Trump and JD Vance got into office, they would attempt a nationwide abortion ban,” said Dowd. “I will be voting a straight blue ticket.”

During a debate in September, former President Donald Trump would not answer when asked whether he would veto a national abortion ban, though he subsequently vowed to turn away any such legislation. Vice President Kamala Harris has said she would work with Congress to pass a law to codify the federal protections that existed under Roe v. Wade.

While issues like the economy and immigration consistently rank among the most important for voters overall, reproductive rights are a key focus for a subset of people.

Where Harris and Trump each stand on key issues

An October KFF survey of women voters found that abortion has become the most important issue for women under 30, surpassing inflation, which was the top issue for that demographic earlier this summer. During the September presidential debate, “abortion” was the most searched political issue in all but one state, according to a snapshot released by Google Trends.

According to a poll conducted for The Connecticut Mirror, nearly half of voters — and nearly three quarters of Democrats — identified abortion and reproductive rights as an issue that was important to them in the upcoming election.

Many Connecticut voters who see expansion of reproductive access as a crucial issue going into the November election feel, like Dowd, that while rights in the state are secure, they want to vote for candidates that will continue to defend those rights, both here and nationally. Anti-abortion advocates are also looking ahead to the election with hopes that supporters of the policies they support will win spots in federal and state government.

Voters who support the expansion of reproductive rights applaud the measures that the legislature has taken to secure access to care in-state.

An estimated 14,840 clinician-provided abortions were performed in Connecticut in 2023, according to data from the Guttmacher Institute’s Monthly Abortion Provision Study.

“The Democratic Party in Connecticut did a really great job of protecting our reproductive rights,” said Aanya Mehta, 22, a reproductive justice advocate from Simsbury who is currently completing a master’s degree in public administration at the University of Connecticut.

Legislation passed in 2022 made Connecticut a legal “safe harbor” for those who travel here from another state to receive an abortion and for the clinicians who perform them. It also expanded the type of providers who can perform first-trimester abortions to include nurse midwives, advanced practice registered nurses and physician assistants. In 2023, lawmakers passed a bill protecting medical providers in Connecticut who face disciplinary action in other states for performing abortions.

“It’s things like that that give me hope in our state — that they’re thinking about people everywhere,” said Iyanna Liles, a Hamden-based gynecologist, regarding Connecticut’s legal protections for providers regardless of the patient’s home state.

Despite the state’s abortion protections and broad access to contraception, officials with Planned Parenthood Votes! Connecticut said many believe the stakes are high at the federal and state levels this election.

“When I’m talking to supporters across our state, they are scared of what could happen not only on the national level, but also in Connecticut,” said Gretchen Raffa, vice president of public policy, advocacy and organizing with Planned Parenthood Votes! Connecticut. “Voters across our state and country are fired up and know what’s at stake.”

Liles said that, since the overturning of Roe v. Wade, she’s had patients come in concerned about what would happen if they left the state or if a national abortion ban ever passed. People are making sure they have reliable contraception and, in some cases, electing to undergo permanent sterilization at younger ages.

“Abortion is the linchpin of how we got here, but I think contraception is on the line. IVF access is on the line. Maternal mortality and morbidity is on the line,” she said. “All of women’s health is on the line.”

Mehta agrees that reproductive justice is one of the most important issues for her heading into November, but she still feels as if the topic of voting is complicated, particularly because of concerns she has regarding foreign policy.

“Specifically, our tax dollars and what they’re being used for abroad,” said Mehta, adding that other activists she knows are wrestling with the same concern ahead of November.

Anti-abortion advocates acknowledge that it’s unlikely Connecticut will overturn decisions regarding abortion access, but they hope the upcoming election will bring wins for candidates that will fight against what they called “extreme” proposals from Democrats, including bills that would legalize aid-in-dying and measures affecting Catholic hospitals.

“Maintaining religious freedom and religious precedent are our top goals,” said Chris Healy, executive director of the Connecticut Catholic Conference. “Obviously, the issue of abortion rights in Connecticut is sadly settled for now, but we’re concerned about extreme positions [that go] past that.”

Peter Wolfgang, president of Family Institute of Connecticut Action, which advocates against abortion, said Democrats and advocates for reproductive rights are being dishonest about the stakes in the election.

“Abortion is, unfortunately — as far as I’m concerned — very secure in the state of Connecticut,” he said. “The ability to have a legal abortion in Connecticut is not ending anytime soon, if ever. So what the folks on the other side are doing is pushing the panic button to juice up their base.”

But Liles said it’s critical to continue fighting, even if reproductive rights seem secure, because there is a consistent effort to curb those rights in the state. For example, in recent years, Republicans in Connecticut have introduced bills that would require minors to notify their parents when seeking an abortion. The measures did not advance.

“There is an underlying current and we are able to keep it at bay,” said Liles. “We’re trying to be vigilant. We’re trying to not be quiet, like we did with Roe.”

Katy Golvala and Jenna Carlesso are reporters for The Connecticut Mirror (https://ctmirror.org/ ). Copyright 2024 © The Connecticut Mirror.

Holt had been with the Center for Medicare Advocacy since 2014, overseeing the group’s advocacy and outreach efforts and helping craft state and federal Medicare-related legislation. Her first day as health care advocate will be Sept. 30, though her nomination must be approved by the Connecticut General Assembly when it convenes in January.

Sean King, who has been serving as interim health care advocate for over a year, will continue as general counsel for the office.

“I am thrilled to accept Gov. Lamont’s nomination as Connecticut’s health care advocate, working to ensure every Connecticut resident has the best possible access to affordable, quality health care,” Holt said in a statement Wednesday. “In addition to [helping] individuals obtain access to health care services, the Office of the Healthcare Advocate represents the collective voice of all Connecticut patients. I look forward to collaborating with health care providers, insurers, employers, other state agencies, and state and federal legislators to coordinate, deliver, oversee, and improve health care in Connecticut.”

The Healthcare Advocate Advisory Committee, a panel appointed by Democrat and Republican legislative leaders, recently completed a search and evaluation for the position, sending a list of recommended candidates to Lamont, including Holt.

Holt worked previously for Cigna in Bloomfield, as an administrator for New Britain Memorial Hospital and for Northwest Hospital in Seattle, and as a special assistant state’s attorney for the U.S. Department of Health and Human Services. While with HHS, she drafted health law opinions, litigated in federal court, and served as an in-house lawyer for administrative law judges, officials with Lamont’s office said.

She also founded a Seattle-area law practice that specialized in the needs of older adults and people with disabilities.

Holt is chair of the board of directors at Lawrence + Memorial Hospital in New London, a commissioner with the Mansfield Housing Authority and a public member of the Connecticut Teachers’ Retirement Board. In taking over as health care advocate, she will step down from her role on the Lawrence + Memorial board, a spokeswoman for Lamont said.

Holt has a Master of Business Administration in health care management from the University of Connecticut and a law degree from the Seattle University School of Law.

“I am very excited that Kathy Holt has accepted our offer to serve as Connecticut’s next health care advocate because she has an incredible amount of experience, both here in our state and on the national level, in helping people access the coverage they need and advocating on their behalf, especially for people who are older [and] people who have disabilities,” Lamont said in a statement. “Kathy is going to be an excellent partner for our administration, the legislature, and the people of Connecticut to help develop the policies we need to strengthen access to affordable, high-quality health insurance.”

Holt replaces Ted Doolittle, who left the position last summer to become a federal immigration judge. Doolittle had served in the role since 2017.

During his tenure, Doolittle helped educate residents on referral and prior authorization procedures and the appeals process for health care plans, fielded questions about enrollment and billing, and intervened on behalf of residents in matters of claim denial and pre-authorization problems.

Holt will begin formally serving a four-year term once her nomination is confirmed by the legislature, which starts work on Jan. 8.

Sen. Saud Anwar, D-South Windsor, co-chair of the Public Health Committee, issued a statement supporting Holt.

“I look forward to working with Kathleen Unger Holt on pressing matters impacting health care in Connecticut,” he said Wednesday. “Her experience advocating for Medicare and quality health care for our older populations and people with disabilities will be valuable and I know she will be focused on fixing issues patients face in getting care. Her career has spanned a variety of professional and legal roles in the health care industry and I’m confident that her breadth of knowledge will benefit many in our state.”

The Centers for Medicaid and Medicare Services notified state officials as well as Athena Tuesday evening that because of the “facility’s failure to meet Medicare’s basic health and safety requirements,” funding will be stopped as of Sept. 10 for any new patients and within 30 days for all patients.

The unprecedented step by federal officials in effect will close the 205-bed facility because most of its residents are Medicaid or Medicare recipients and not private payers. State officials said late Tuesday night they will being working with the Long Term Care Ombudsman’s office to relocate residents.

“Involuntary termination of a provider agreement is generally a last resort after all other attempts to remedy the deficiencies at a facility have been exhausted,” the CMS letter states.

“In this instance, CMS has found that Abbott Terrace Health Center is out of compliance with CMS’s health and safety requirements. While we understand that relocation of residents and patients can be challenging for all parties involved, CMS prioritizes patient safety and care quality.”

Athena officials did not immediately return requests for comment.

Department of Public Health Commissioner Manisha Juthani and Department of Social Services Commissioner Andrea Barton Reeves issued a joint statement Tuesday evening.

“Today’s relatively unprecedented decision by CMS was not taken lightly and was necessitated by the repeated failures of Abbott Terrace’s owner and management team to prioritize the health and safety of its residents,” the commissioners said.

The commissioners said that the announcement does not mean that Abbott’s residents have lost their coverage. Residents will still be covered when they move to a facility that participates in the Medicare and Medicaid programs.

“Our focus now turns to ensuring that Abbott Terrace’s owner and management use the next 30 days to assist residents with finding and transitioning to new living arrangements while also adhering to the regulations governing residents’ health, safety, and well-being at the facility,” they said.

“DPH will have monitors at Abbott Terrace daily until the last resident has left the facility. Our agencies will also work with the Long Term Care Ombudsman to help ensure residents understand their rights, explore available living arrangement options, and have as smooth a transition as possible to their next home.”

Mairead Painter, the state’s long-term care ombudsman, said the termination raises “significant issues” about continuity of care, potential displacement of residents and the well-being of people who live at the facility.

“The Office of the State Ombudsman is deeply concerned about the recent announcement that Abbott Terrace, a skilled nursing facility in Waterbury, had their Medicare and Medicaid provider agreement terminated. This leaves many residents and their families vulnerable as they face uncertainty and potential distress,” Painter said Tuesday.

“State oversight agencies work to ensure that the skilled nursing facilities in Connecticut provide good quality care. However, my office and state oversight agencies can only do so much,” she said. “It is the responsibility of the facility, its owners, and management companies [to] maintain financial stability and deliver quality care. If they are not stable or choose to put profits over the residents in the facility, then the outcome and care concerns can be significant.”

Painter said while she waits to hear what’s next for the facility, her office is helping ensure residents’ rights are upheld and is providing emotional support to patients.

“We are here to listen to their concerns, offer guidance and connect them with resources that can help them through this difficult period,” she said.

Abbott Terrace is Athena’s largest remaining facility. It has 205 beds, and 192 were occupied as of the end of August, according to DSS records.

DPH officials made several visits to Abbott Terrace over the first six months of this year. The inspections showed staff shortages, particularly nurses, large holes in the tile floors and at least one incident where an employee told a resident with incontinence problems “they could smell them in the hallway.”

The Connecticut Mirror has chronicled the growing financial problems at Athena over the past 18 months and legislators’ concerns about how the fiscal troubles are impacting residents’ care.

Several employees have contacted The CT Mirror with stories of being unable to pay medical bills and having medical procedures canceled because Athena owed nearly $3 million in employee health care claims.

They also owe back taxes to several municipalities and closed two nursing homes late last year: the Crestfield Rehabilitation Center in Manchester and Middlesex Health Care Center in Middletown.

Athena also recently sold five facilities — Newtown Rehabilitation & Health Care Center, Beacon Brook Health Center in Naugatuck, Montowese Health & Rehabilitation Center in North Haven, Sharon Health Center and Evergreen Health Care Center in Stafford Springs — to National Health Care earlier this year.

Athena still owns 14 long-term care facilities including Abbott Terrace. State officials have been discussing whether there will be a need to place other facilities in receivership.

Dave Altimari and Jenna Carlesso are reporters for The Connecticut Mirror (https://ctmirror.org/ ). Copyright 2024 © The Connecticut Mirror.

Small group policies will go up by an average of 7.8%.

Insurers had sought higher increases — an average of 8.3% for individual plans and 11.9% for small group plans. The policies cover about 200,000 people. The increases apply to plans that are fully insured, subject to regulation by the state.

“Our priority is always the consumer. Our team of actuaries and professionals has carefully reviewed and appropriately reduced the requested health insurance rate increases for 2025,” Insurance Commissioner Andrew Mais said in a statement. “While we’ve made progress in mitigating these increases, the challenge remains in addressing the root causes driving health care costs upward. Our objective is clear: to ensure that Connecticut consumers have access to a competitive health insurance market while managing costs effectively.

“The rates … reflect our commitment to protecting consumers from unsupported increases and ensuring that health insurance remains both fair and accessible in Connecticut.”

But Attorney General William Tong said the year-over-year rate hikes on health plans are unaffordable for Connecticut families and individuals.

Rates went up by an average of 9.4% on individual plans this year and 7.4% on small group plans. In 2023, individual plans roseby an average of 12.9%, while small group policies increased by an average of 7.9%.

“I appreciate that the Insurance Department reduced the requested rate hikes, but these year-after-year increases remain simply unaffordable and unsustainable. They reflect the inability of insurers to negotiate provider reimbursement rates that are consistent with other measures of inflation in the Connecticut economy,” he said. “I agree fully with Commissioner Mais that we need to address the root cause of these ballooning rates — the skyrocketing cost of health care. Insurers are not passive players in this broken dynamic — in fact, they profit from it. If insurers are unwilling or unable to effectively negotiate cost controls, we need to take a tough look at our incentives and our laws to force that change.”

Residents, legislators and advocates took issue with the proposed rate hikes at a public hearing last month, and the head of the state’s Office of Health Strategy said the increases are far higher than Connecticut’s health care cost growth benchmark.

Three insurers sell policies on the exchange: Anthem Health Plans, CTCare Benefits Inc., and ConnectiCare Insurance Company Inc.

Anthem asked for an average increase of 9.8% on its individual policies next year; it was granted a 5.6% hike. The plans cover 33,939 people.

It also sought a 14.9% average increase on its small group policies that cover 27,565 residents. The insurance department approved 5.1%.

ConnectiCare Benefits Inc. requested an average hike of 12.7% on individual plans that cover 64,482 people. A 10.3% increase was authorized.

And ConnectiCare Insurance Company Inc. asked for a 17.5% average increase on individual policies but was granted 15.3%. About 12,000 people are enrolled in these plans.

Earlier this year, the legislature’s Insurance and Real Estate Committee considered a measure that would have required the state to weigh affordability during its annual rate review process for health plans, but the committee concluded its work without passing any bills.

“We appreciate Commissioner Mais and the Connecticut Insurance Department’s willingness and diligence in ensuring that individual and small business health insurance rates are not excessive,” said Rosana Ferraro, program lead for health justice policy and advocacy for the Universal Health Foundation of Connecticut. “We are disappointed that we have not been able to legislate a consideration for affordability in these rates, as even with [the department’s] lowering of rates, individuals and small businesses are struggling to cover health insurance costs.

“Rates for these markets are the canaries in the coal mine — these rising rates mark the higher costs for health insurance for everyone across all markets. These rates are indicative of a problem we all struggle with — affording care we need.”

“[Office of the Health Care Advocate] is grateful that Commissioner Mais and his team at the insurance department conducted a thorough and thoughtful review of the eight rate filings,” added Sean King, the state’s interim health care advocate. “Unfortunately, this reduction of insurer profits and premiums may not be enough for many of the 200,000 Connecticut residents who rely on these coverage options to meet their needs.

“Health care in Connecticut is still at an inflection point, and policymakers will need to take more bold and swift actions to improve access and affordability for all.”

Open enrollment for the 2025 coverage year begins Nov. 1.

But so far, leaders of SEIU 1199 New England, which represents about 12,000 care aides, say troubles with payroll have persisted since the new agency, GT Independence, took over last spring.

Many home care workers have received late paychecks, sometimes by a few days or weeks. Others aren’t being compensated properly for paid time off that was granted under a recent contract. And some haven’t received pay raises that were supposed to take effect on July 1, union officials said.

Under the contract approved in March, employees earning the minimum rate went to $20.50 per hour, and those over the minimum rate received a 2.5% pay increase. Some staff who were supposed to get a 2.5% raise have not seen the increase in their paychecks, said Diedre Murch, home care director with SEIU 1199 New England.

“We understand that in a transition that involves 12,000 workers and thousands of consumers, there are going to be non-payment issues. They’re going to happen,” she said. “So, for us, the measure of success is, how quickly can they get these issues resolved with the minimal amount of pain for workers and consumers who are trying to get back to their everyday life of living independently.”

“We’ve had a pretty high number of grievances around paid time off,” Murch said. “There were also just raises that went into effect, and we’ve seen some widespread problems with the raises.”

Notices of nonpayment filed by home care workers with 1199 have risen in recent months since GT Independence took over managing payroll. The union received 39 notices in February, 87 in March, 162 in April, 103 in May, 175 in June, and 113 in July, according to data recorded by 1199. Written grievances, in which union officials highlighted concerns in depth and asked the state for a meeting, also increased. SEIU 1199 reported five grievances in February, seven in March, nine in April, 18 in May, 15 in June and 29 in July.

Officials with GT Independence could not be reached for comment.

Christine Stuart, a spokeswoman for the state Department of Social Services, said payroll problems have been reduced under the new agency.

“The transition from (previous manager) Allied to GT Independence happened between March 24 and April. Getting used to a new payroll system for our PCAs took some time, but we can say definitively that the number of late payments have been reduced since transitioning to GT Independence,” she said. “There were two pay rate increases, one in May and another in July, both were implemented with minimal errors. We continue to work with GT Independence and 1199 to make sure any issues that arise are fixed. In fact, GT Independence is able to more frequently offer a payroll correction instead of making a PCA wait for a new payroll period than the previous contractor.”

Pamela Hunt, a personal care aide from Norwich, said she was paid promptly when GT Independence first came on board but has since been paid late twice. Instead of receiving a paycheck on Fridays, she’d get it the following week.

“I was doing some business with the bank, and they were looking for a specific paycheck during a specific week. And I said, ‘Well, I did work, but there was no paycheck,’” Hunt, 64, said. She typically would be paid on Fridays, but “now I’m being kicked over the weekend and then not getting paid on Monday, and bills are due. And I said, ‘this is really causing a hardship.’”

The late payments pose problems for care aides, some of whom live paycheck to paycheck, union officials said.

In a 2022 survey by SEIU 1199 New England, roughly one-third of the personal care aides reported being behind on their rent or mortgage payments during the last year. Forty-two percent said they had paid late fees or were referred to a collection agency for unpaid bills, and more than one in five received a shutoff notice for utilities or had their utilities turned off during the past year.

Thirty-seven percent of the aides said they rely on food stamps, and a third could not afford groceries or did not have enough food to feed their families over the last year. Seventy-two percent reported using some form of state assistance.

“We hear from workers, ‘I have to pay my rent or I’m going to get evicted,’ and ‘I can’t pay my rent without my paycheck.’ We know of PCAs who are living in their cars. We know of PCAs who are bouncing between the couches of family and friends trying to stay afloat while working full time,” Murch said. “We also hear of people who say, ‘I’m going to quit. I can’t stay in a job where I’m not getting paid.’ Sometimes we hear, ‘I don’t have gas to get to my consumer’s house. I can’t care for them because I didn’t get my paycheck.’

“There’s a whole cascade of impacts, both to the worker and to the consumer needing care, when people who work paycheck to paycheck — or who work a paycheck or two behind — don’t get paid on time.”

Union leaders said they are hoping to have direct communication with GT Independence to resolve issues. They currently funnel complaints through the state Department of Social Services.

They also have asked GT Independence to release internal data on the number of incoming calls received, hold times, late payment notifications and other information.

“Are the hold times reducing since the transition to acceptable levels? How many payments are being processed on time versus a few days later? Those kinds of things can help us track and hopefully celebrate some progress, because I think the data will show that things can and will get better,” Murch said. “But without the data, we can’t make that case to our members.”

Prior to GT Independence, personal care aides for years complained of difficulties with pay under the previous payroll manager, Allied Community Resources. In 2022, the union received 1,653 grievances against Allied from personal care aides over payment problems.

The issues were highlighted in a Connecticut Mirror series last year on gaps in the state’s elder care services. As Connecticut tries to recruit and retain more home care workers for a ballooning older adult population, union officials said Allied’s payment troubles were undercutting those efforts. Missed payments can mean workers are behind on paying bills and in some cases can lead to eviction or threat of eviction. In other cases, late payments have caused some employees to leave the industry.

State officials announced last November that they had selected GT Independence to replace Allied.

Jenna Carlesso is a reporter for The Connecticut Mirror (https://ctmirror.org/ ). Copyright 2024 © The Connecticut Mirror.

Sometimes it presents as pain, tingling or numbness in her leg. Her vision may blur. At times, an arm hurts, or she feels crushing fatigue.

But getting treatment for those ailments has become equally problematic. She hasn’t been able to get an MRI for more than two years — a scan crucial for her doctor to see whether and how her condition has progressed. Some of her physicians, including her primary care doctor, won’t allow her to make an appointment. And the facility that draws her blood recently threatened to cut off services due to unpaid bills.

Iszczak, 45, said the problems started after Athena Health Care Systems — one of the largest nursing home chains in the state and the company where she has worked as a certified nursing aide for 22 years — stopped paying employee health care claims on its self-insured plan.

She estimates she has received medical bills totaling more than $85,000, and collection agencies have been calling, even though Athena continues to take $35 from her paycheck each week for insurance coverage.

These days, Iszczak said, she is living with more pain.

“I’ve always been the type of person who’s pushed through, but you can only push through so much,” said Iszczak, who works at the Litchfield Woods nursing home in Torrington. “I’ve been waiting over two years to have an MRI done, and they have not approved it. Anytime I have pain in my head or something’s off, I wonder if there’s a new lesion forming. If I have pain in my arm, maybe there’s a new spot. I constantly worry. It’s very stressful, not knowing.”

Athena CEO Lawrence Santilli has acknowledged in letters to staff that the company is behind on paying employee health claims.

In a November 2023 email, previously reported by The Connecticut Mirror, Santilli said the company was six months behind on paying claims.

“Unfortunately, the employee health plan currently has a significant funding shortfall,” Santilli wrote in the memo to staff. “Athena has not been able to promptly meet all the funding requirements of the employee health plan. … It is our intention to fully fund all outstanding claims in the upcoming new year.”

But several workers from Connecticut and Massachusetts who spoke to the CT Mirror say that so far this year, the problem has not been resolved.

Some said they cannot schedule routine appointments with primary care doctors, gynecologists or specialists because of unpaid health claims. Others can’t get approval for X-rays or mammograms. Some hesitate to seek treatment or arrange procedures.

Employees who spoke to the CT Mirror say Athena has continued to take money from their paychecks for insurance — some as much as $140 per pay period. They question where the money has gone. And workers have filed complaints with several state agencies, from the Attorney General’s Office to the Department of Insurance.

Additional memos from Santilli to staff obtained by the CT Mirror show that Athena’s issues with paying health care claims date back to 2021, farther than what was previously known publicly.

On Oct. 28, 2021, Santilli wrote: “We are aware of certain communications some employees may have received that caused understandable concern regarding medical coverage. … Payments continue to be made weekly to the health plan … we are, however, behind on those payments and doing our best to catch up.”

He blamed the COVID pandemic, saying additional federal and state money directed to nursing homes was not “sufficient to fund all our COVID costs and lost revenues.”

A little more than a year later, on Dec. 1, 2022, he sent another note: “One of the federal sources of income we have been working hard on since January of 2022 is finally materializing. … We anticipate that all outstanding claims processed through November 29, 2022 will be paid no later than January 9, 2023.”

But in November 2023, he issued the memo saying the company was six months behind on worker claims.

Several Athena workers who spoke to the CT Mirror described receiving unexpected medical bills, some for hundreds of dollars and others for tens or hundreds of thousands. Many are being hounded by collection agencies.

A spokeswoman for Athena said the company continues to communicate with staff about the health claims.

“We understand outstanding health insurance claims are a significant concern for our employees and their families, and we are actively working to address this issue,” Savannah Ragali, a spokeswoman for the company, said in an email. “Athena has not been able to promptly meet the funding requirements of the employee health plan. As a result, we are behind in paying submitted health claims.

“Due to the plan design, employee contributions fund 10% of the health insurance plan and Athena funds the remaining 90%. Though payments are still being made, the volume of claims has exceeded the ability to process them in a timely manner.”

She did not answer questions about how much in total the company owes for health care claims or how far back the unpaid claims date.

The most recent documentation shows that 2,447 employees are enrolled in Athena’s health plan, though the company last month sold five of its facilities and does not yet have updated numbers, Ragali said.

As part of the sale of the five homes to National Health Care Associates, National agreed to add $2.6 million to the health insurance fund to cover benefits for employees of those facilities.

Athena still operates 14 skilled nursing facilities in Connecticut, 16 in Massachusetts and five in Rhode Island.

State agency leaders and Attorney General William Tong are directing workers who have filed complaints with their offices to the U.S. Department of Labor. The federal DOL’s deputy regional director for public affairs said he could not comment on a pending investigation.

“The whole point of paying for health insurance is that it’s there for you when you need care. That hasn’t been the case for Athena employees, and that’s unacceptable,” Tong said. “As Athena’s self-insured plan is federally regulated, state agencies are limited in what we can do to intervene. That being said, we have been working closely with the U.S. Department of Labor and have encouraged any Athena employee experiencing health insurance challenges to file complaints with both DOL and the Athena ombudsperson.”

Ragali said the company is working with the federal DOL and state agencies.

“We are continuing to work diligently to address this critical issue and are communicating with our staff about the significant payment delays of their health care claims,” she said. “We are also collaborating with the U.S Department of Labor as well as state and local officials to address this situation.”

Complaints mount

Since January 2022, 49 complaints have been filed with the Connecticut Insurance Department against Athena for non-payment of health claims.

Records identify Athena’s insurance provider as S&S Health.

The department doesn’t have the authority to regulate self-insured health policies, which is the type of plan Athena’s employees are enrolled in. But the complaints have mounted.

The grievances are varied.

“I am in collections with Western CT Health Network (Nuvance) … for the unpaid claims by my employer of $234,285 for treatment of my deceased spouse,” one worker wrote in January 2023. “He passed away on 3/5/21. I have received numerous letters from this law office that have been brought to my employers’ attention at the corporate level.

“I am fearful that at this time, my wages could be garnished and/or I am in danger of losing my home!!”

The CT Mirror received copies of the complaints through a public records request. The names and personal medical information of those who filed them were redacted.

“I carry my husband on my insurance plan and have money taken from my check weekly. This past Friday I received a collection notice,” said an employee of Athena’s Beacon Brook nursing home in Naugatuck, in an April 2023 grievance. “My husband’s co-pay was paid by him. Apparently, the payment did not happen by the insurance company. I have spoken to HR, who is reaching out to corporate. Regardless, I am beyond frustrated with the negligence that is going on. All bills should be paid.”

Another worker wrote in November 2023 that they were left with a bill for $13,823 after an operation.

“I had my gallbladder removed on 5/3/23. I received a letter beforehand that the surgery was approved,” the employee said. “I received a letter in July from the hospital stating they had not received any response from the insurance company for payment. I then received a bill from the hospital.

“I have made several calls to the insurance company and the hospital but have not gotten any resolution.”

A telephone message left with S&S Health was not returned.

State insurance officials are referring the Athena workers to the federal Department of Labor.

Thirteen complaints were filed with the Connecticut Attorney General’s Office during the same timeframe, and six were submitted to the state Office of the Health Care Advocate.

The state Department of Labor received two complaints. State labor officials said one is under investigation and the other awaiting assignment to an investigator. The department has opened an investigation because the company took money from employee paychecks but did not fund the health claims.

In interviews, several Athena workers described the stress of being pursued by collection agencies and of being unable to access medical care.

Yvonne Smith has worked as a nurse at Parsons Hill Rehabilitation & Health Care Center in Worcester for 25 years.

Smith, 63, said she pays $140 per paycheck to get Athena’s “gold” health care plan for her and her husband. So when debt collectors started calling about medical bills that weren’t being paid, she was angry.

“The whole thing ticks me off. Where is our money going that’s been taken out of my check every week for all these years?” she said. “Now I have debt collectors calling me all the time because Athena is not paying the bills.”

Smith said she has had two medical procedures canceled because some hospitals no longer accept Athena’s health insurance. An endoscopy scheduled at UMass Memorial Medical Center in Worcester was called off earlier this year, and a treatment for her osteoporosis was canceled a few months ago when she told the doctor she had health coverage through Athena.

Smith said nearly everyone she works with is getting harassed by debt collectors.

“Our insurance is like a bad credit card. Nobody wants to take it,” Smith said. “It’s impacting everybody’s health because of the stress that people are under when they can’t even get their routine doctor appointments.”

Cindy Bennett, a certified nursing assistant at the Litchfield Woods nursing home, has been battling lung cancer.

Bennett, 61, estimated she has received medical bills totaling about $80,000 — some of them from unpaid radiation treatments — and she has heard from collection agencies. A CT scan recently revealed two spots that were concerning to her doctors, and she worries she won’t be approved for a follow-up PET scan.

“That scares me every day. I mean, you’re going through lung cancer and all of a sudden they could say, ‘No, you can’t come here,’” Bennett said. “I can’t afford a PET scan [without insurance], but I need it. That’s going to see if the cancer is still there.

“I could die from this and you aren’t paying my bills. How fair is that to me? I work hard there every single day.”

Rachel Allard, a nurse at Parsons Hill, said she has medical bills that are well over a year old and she’s had at least one therapist refuse an appointment because of unpaid medical bills.

Allard has become a point person at the facility in helping others with their insurance issues and trying to talk to Athena’s corporate officials.

“They keep saying they are working on it, but they still aren’t paying our medical insurance bills here,” she said.

Many employees get their care through the local UMass hospital and are having trouble getting appointments because doctors are reluctant to take Athena’s insurance.

Allard said some employees have contacted the Massachusetts Attorney General’s office and sent copies of overdue bills or notices from debt collectors.

“People are stuck either choosing to pay bills themselves because they need the medical attention or deal with constant harassment from debt collectors and the stress of not knowing if they can even go to their doctors,” she said.

‘It’s unimaginable’

Sen. Jorge Cabrera, co-chair of the Connecticut General Assembly’s Insurance and Real Estate Committee, was contacted by a former Athena employee in February about the payment issues.

“I worked full time for Athena Health Care Systems … During that time I was enrolled in the insurance program and had weekly deductions from my paycheck for that purpose,” the worker wrote in a letter to Cabrera. “Unfortunately, Athena has not funded the insurance program properly and is extremely delinquent in paying the insurance company. Therefore, the insurance company … has not paid my medical bills.

“I have received numerous medical bills of which I have no member responsibility and have had to start payment plans in order to avoid being sent to collections.”

The CT Mirror obtained a copy of the letter through a Freedom of Information Act request.

In an interview, Cabrera, D-Hamden, called the lapse “unacceptable.”

“It’s an awful situation,” he said. “They should pay the claims. That’s the bottom line. It’s unacceptable. I’m sure some people are delaying and forgoing care, and that’s dangerous for people’s health.”

Rep. Jane Garibay, D-Windsor, co-chair of the Aging Committee, said the non-payments send a bad message at a time when nursing home and home care agencies are desperately trying to recruit and retain staff. Connecticut’s aging population is estimated to grow dramatically in the coming decades.

“It’s unimaginable,” she said. “We have to find a fix for this in some way. We’re trying to attract workers. They should get what they were promised and not have to worry about going bankrupt because they can’t pay their medical bills or being unable to go to the doctor because they owe money that was not paid.”

Garibay said she hopes to explore legislation that further scrutinizes nursing homes’ use of taxpayer money.

The non-payment of health claims is one of several financial issues Athena has faced in recent years.

In 2022, Athena agreed to pay a $1.75 million fine to the Massachusetts Attorney General’s office for admitting people with substance abuse issues to its facilities without being able to provide appropriate treatment.

Six temporary employment agencies filed lawsuits against Athena in Connecticut, alleging the company failed to pay them more than $142,000 for employees they provided since 2021 to offset staff shortages. Another lawsuit claimed Athena owed nearly $2 million for temporary workers provided by a separate company. And an Iowa-based insurance company filed a federal suit alleging Athena failed to pay more than $6 million in health insurance claims from its employees, an issue that prompted state officials to contact the U.S. Department of Labor to investigate.

A federal judge in Iowa has ruled the case should be tried in state court. The lawsuit is pending in Connecticut, but the plaintiffs have asked the court to issue a direct verdict against Athena because the company has not responded to court filings. A judge has yet to rule on that motion.

Athena was being represented by Hartford-based law firm Murtha Cullina, but in March, the firm dropped out of the case because Athena had not paid the attorneys any money. Athena told the firm “it no longer has the funds” to pay for legal representation in the case, according to court records.

In February, The CT Mirror reported that Athena owed more than $750,000 in overdue taxes, utility costs and interest on missed payments to municipalities.

Jenna Carlesso and Dave Altimari are reporters for The Connecticut Mirror (https://ctmirror.org/ ). Copyright 2024 © The Connecticut Mirror.

Insurers are seeking an average increase of 8.3% on 2025 individual plans and 11.9% on small group policies. The proposed hikes are lower than what was requested the last two years, but similar to those sought in 2021.

Last year, insurers asked for an average rate increase of 12.4% on individual plans and 14.8% on small group. The state approved a 9.4% average hike for individual policies and 7.4% for small group.

The plans collectively cover about 200,000 people.

Attorney General William Tong said residents can’t keep paying higher rates.

“I will be closely scrutinizing each of these requests and expect to play a very active role in every step of this process,” he said. “Connecticut families and small businesses cannot continue to absorb these increases year after year. The burden of proof will fall on the insurers to justify every penny here.

“Decisions here will have an enormous impact on the cost of health care for every one of us.”

Here’s what to know about the proposed rate hikes.

How much of an increase are insurers requesting for plans on the exchange?

Three carriers are selling policies through the state’s health insurance exchange, known as Access Health CT: Anthem Health Plans, ConnectiCare Benefits Inc., and ConnectiCare Insurance Company Inc.

Anthem is seeking an average increase of 9% on its individual plans; the proposed hikes range from 4.3% to 18%, depending on the plan, and cover 63,277 people. It has also requested an average increase of 13.6% on small group policies that cover 37,667 people.

ConnectiCare Benefits is asking for an average hike of 7.4% on individual plans. The suggested increases range from 6.4% to 9% and cover 73,465 residents.

And ConnectiCare Insurance sought a 12.5% average hike on individual policies — with a range of 10.8% to 15.1% — that cover 4,392 people.

Insurers are also asking for increases on off-exchange policies.

What happens next?

Insurance department actuaries will review the requests for increases. As part of the review, they will look at trends in unit cost (total expenditure incurred by the company), utilization of services, and expected severity of claims. The department will issue questions to the insurers and seek clarification if needed.

After that, the department can choose to approve the full requested increases, reject them or amend them. The final changes will be published later this summer.

Why are insurers seeking increases?

Insurance companies have attributed the proposed rate hikes to increased demand for medical services, rising health care costs (including prescription drugs), the impact of Medicaid unwinding (the expiration of a pandemic policy that prevented states from kicking people off Medicaid), and adjustments needed to reflect COVID expenses in 2025 (at a level higher than previously assumed), according to the insurance department.

Will the public have a chance to weigh in?

Residents can post comments online (by clicking “select” under each rate proposal) or mail letters to the Connecticut Insurance Department at P.O. Box 816, Hartford, CT 06142-0816.

A public hearing will be held later this summer, at a date yet to be announced.

When does open enrollment start?

Open enrollment for 2025 health plans begins Nov. 1.

The purchase price was not disclosed.

The state Department of Public Health recently approved the deal, transferring the five Athena Health Care facilities to National Health Care Associates, a long-time nursing home provider based in New York.

The five homes that are now owned by National are the Newtown Rehabilitation & Health Care Center, Beacon Brook Health Center in Naugatuck, Montowese Health & Rehabilitation Center in North Haven, Sharon Health Center and Evergreen Health Care Center in Stafford Springs.

The five nursing homes have about 500 residents combined as of the end of May, according to state Department of Social Services data. The homes are at about 67% occupancy, lower than the statewide percentage of 86% occupancy.

CT nursing home gets state OK to close; facility seeking new placements for residents

The terms of the DPH licensure agreement highlight some of the financial difficulties that have befallen Athena — which, with this sale, is no longer the largest nursing home provider in the state. Athena still owns 14 nursing homes, down from 22 a year ago.

As part of the licensure transfer, DPH is requiring National to pay all vendors that Athena owed money to within 120 days, pay any back taxes owed to the towns where the facilities are located and contribute $2.6 million to its employees’ health care insurance fund to cover all medical bills.

Athena owed nearly $47,000 in back taxes to four of the communities where the nursing homes are located, records show.

Kevin Battistelli, National’s chief development officer, said the company has delivered quality post-acute care to residents throughout the northeast for more than 30 years. National already owns 14 nursing home in Connecticut, according to its website.

“We look forward to providing the same quality and compassionate care to these centers,” he said.

Rep. Jane Garibay, D-Windsor, who co-chairs the Aging Committee, said National “has been a good provider and responsive to DPH when there have been issues in their facilities over the years.”

“They are a known entity in Connecticut, so I can only hope that is a good thing for our elderly residents,” she said.

Long Term Care Ombudsman Mairead Painter said her office has had mostly good interactions with National, and she sees the sale as a chance for residents and staff to “start new.”

“This potentially could be a really good deal for the residents and staff in these homes,” Painter said. “Hopefully the quality in these homes will improve and they can finally move forward.”

Athena Health Care spokeswoman Savannah Ragali wouldn’t say whether the company is looking to sell any of its other facilities. Besides the 14 Connecticut nursing homes, it also owns 16 in Massachusetts and five in Rhode Island.

“We are actively working to create a sustainable model and are evaluating all options to ensure the best outcomes for Athena Health Care Systems, its residents and employees,” Ragali said.

“We continue to run our 14 skilled nursing centers above the state average in occupancy, which reinforces our commitment to care and to provide access to care for residents,” she added.

The sales are the latest changes in the state’s nursing home industry, which has seen several homes close permanently and others sold to out-of-state providers over the past 18 months as the industry continues to recover from the pandemic.

Besides Athena, national chains such as Genesis have systematically been selling Connecticut facilities. Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, said seeing National step up to buy some of the struggling Athena homes is a good sign for the industry.

“While the Connecticut nursing facility sector has been in a period of transition with a significant increase in ownership changes and facility closures since the COVID-19 public health emergency, it is certainly reassuring to the facility residents and staff when the new operator is a well-known health care provider with a long and strong history of delivering quality skilled nursing facility care in Connecticut, as is the case with National Health Care Associates,” Barrett said.

The Connecticut Mirror has chronicled the financial problems at Athena over the past several months and legislators’ concerns about how the fiscal troubles are impacting residents’ care.

Several employees have contacted The CT Mirror with stories of being unable to pay medical bills and having medical procedures canceled because Athena was allegedly behind in paying employee health care claims.

In a memo to more than 2,500 employees last winter, Athena’s President Larry Santilli acknowledged the problem.

“Athena has not been able to promptly meet all the funding requirements of the employee health plan. As a result, we are approximately 6 months behind in paying submitted health claims. In our continuing efforts to address shortfalls with funding the health plan, we have hired outside personnel to assist us to properly administer the health plan moving forward.”

Santilli promised the company “intended to fully fund all outstanding claims,” but some employees said recently that medical expenses still aren’t being paid.

Ragali said Wednesday that Athena is still working on the health insurance issues.

“Athena Health Care Systems is continuing to make progress in paying outstanding employee health insurance claims,” Ragali said. “We are actively meeting with the Department of Labor to rectify this situation and ensure that all claims are resolved properly.”

DPH spokesman Christopher Boyle said a key requirement of the sale is the independent nursing consultant, whom National will have to hire for at least a year. The consultant will work 12 to 40 hours per week monitoring nurse staffing levels and quality of care at all five facilities.

Two of the five homes that National purchased have been cited for “immediate jeopardy” orders — findings that indicate violations in a nursing home caused or were likely to cause harm or death to residents — since 2022, records show.

The Newtown facility was issued an immediate jeopardy order in 2023 for a lack of staff that left many residents stuck in beds without trips to the bathroom or diaper changes. Some nursing aides reported having as many as 20 residents to care for during shifts.

Other conditions that DPH has placed on National:

• Appointing a free-floating registered nurse supervisor for first and second shifts to assess patient care.
• Designating a registered nurse to do at least eight hours of training for employees who deal with residents.
• Contracting with an environmental consulting firm to evaluate each facility.

Dave Altimari and Jenna Carlesso are reporters for The Connecticut Mirror (https://ctmirror.org/ ). Copyright 2024 © The Connecticut Mirror.