Fall of the “Good” Culinary Arts School: Le Cordon Bleu

February 9, 2016
Sacre Bleu!

Sacre Bleu!

Le Cordon Bleu announced Dec 23 2015 it would close all its campuses in October 2016. We have waited six weeks to learn if the “famous” chefs school would offer further insight into why they decided to bail out. We thought we might learn about a Gainful Employment guidelines warning from USDE. After all, they alluded to such in their press announcement. But nothing new has been released. It looks like Le Cordon Bleu simply cut its losses and bailed out on students, teachers and graduates.

This is a choice only the largest for-profit vocational schools under investigation for fraud can make. Apollo Group, the owners of Phoenix University, announced they have found a buyer for their failing campuses. The thousands of smaller operations will not have that choice. Like the Marinello Schools of Beauty they will be forced to close quickly as they can once they receive their bad news from the USDE. Many will choose the Cordon Bleu path – get out before the axe falls. This is not the first time a school has turned its back on everything and everyone who enriched the “educators” and it won’t be the last. Julia Child would choke on this ham dish.

“Le Cordon Bleu is considered to be the guardian of French culinary technique through its culinary programmes that continue to preserve and pass on the mastery and appreciation of the culinary arts that have been the cornerstone of French gastronomy for over 500 years.[1] The company cited “the impact of the federal government’s new regulations on career colleges” for its decision, referring to “the Obama administration’s gainful employment rule, which cuts off federal financial aid to schools where graduates borrow money at high rates to pay for school but earn little after graduation.” When reached by phone for further information or comment, a representative for the school hung up.”[2]

LCB table 2

Rules to play the counting grads game: The object is to diminish the denominator which increases the percentage! According to data reported by LCB to BPPE half the students graduated (“completed” and three quarters found jobs (“placement rate”). The following list of definitions are essential to coming up with as high a percent as possible.

students started – number of students who began the program minus the number of students who have died, been incarcerated or been called to active military duty

available for grad- number of students who completed the program within 100% of the published program period

graduate on time – number of graduates divided by the number of students availabl7e for graduation.

completion % – number of graduates minus the number of graduates that either died, etc.

grads available for employment – number of graduates employed in the field divided by the number of graduates available for employment

placement rate/percent – number of graduates who are gainfully employed within six months of graduation in a position for which the skills obtained through the employed in the field – education and training provided by the institution are required or provided a significant advantage to the graduate in obtaining the position

How the real world sees things: There are two Le Cordon Bleu campuses in California. In 2013 they enrolled 2360 students in nine programs granting diploma certificates (~$19,000) and associate of arts degrees (~$37,000). No program is longer than 11 months. The schools and programs are accredited by the ACICS [4]. Half of the students who began graduated and were available for employment. Seventy-four percent of those who graduated were available for employment which computes to 36% of those who started any LCB program. One could argue the “success rate” for Le Cordon Bleu students is slightly more than one third. This means two out of three students who begin a Le Cordon Bleu program fail find a job.

Among the 860 graduates working in the culinary field 40% were working part-time (less than 32 hours weekly). Twenty-two percent were earning $20,000 or less, 21% between $20,000 and $40,000; and 0.6% (five graduates) reported earning as much as $50,000. Le Cordon Bleu listed earnings for fewer than half of those reportedly working. It is unknown why LCB did not report employment for the remaining half of graduates they claimed were working in their chosen profession. It is also not known whether anyone else noticed this discrepancy.

This report has been prepared by Steven H. Stumpf, EdD / Health Core Possibilities / sstumpf@stevenstumpf.com / 818 571 3930



[1] http://www.cordonbleu.edu/home/en

[2] http://www.eater.com/2015/12/17/10401492/le-cordon-bleu-cooking-school-america-closing

[3] 74.3% of grads available for employment however that total is 36.4% of all students who started a Le Cordon Bleu program

[4] Accrediting Council for Independent Colleges and Schools and the American Culinary Federation

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Gainful Employment Guidelines Calendar: Save the Dates!

January 6, 2016

MONEY-BubbleJanuary 6, 2015

The Gainful Employment guidelines can force the closure of as many as 1,000 for profit post secondary schools in California. This could take place over the next 24 months. Here are the dates to keep in mind.

2009: US Secretary of Education Arne Duncan leads the White House initiative to close predatory for-profit schools that specifically market to students eligible to take on federally backed student loans.

2014: Final Rules for the Gainful Employment Guidelines are published by the USDE. Lawsuits that challenge the Guidelines follow which are defeated.

April 2015: Corinthian Colleges is indicted by the Federal Government for falsifying workforce placement outcomes. Corinthian closes 80+ campuses within 30 days. 350,000 students are abandoned. Anticipating the Guidelines job placement requirement, Corinthian created false graduation employment data.

July 1 2015: The effective date for implementation of the Guidelines arrives. All for-profit private post secondary schools will be evaluated in terms of meeting Guideline standards. All predatory for-profit schools have been required to report the same data for six years, however, they have never been held to the standards with sanctions in play.

August 2015: The White House announces a $3.6 billion pool will be set aside to help all 350,000 Corinthian students pay off their loans; approximately $10,000 per student.

Winter 2015/2016: The first announcements are made identifying for-profit private post secondary schools that are not in compliance with Guidelines. On Dec 23 Le Cordon Bleu announced it will close all 16 culinary schools, including two in California. The corporation cites federal guidelines as the cause. EDMC settles with 39 state Attorney’s General for more than $100 million while admitting fraudulent practices. Failures still to come will focus on loan default ratios, low graduation rates, and high percentages of graduates who fail to find work in their field. As a result these schools must publish these findings on their websites for the benefit of current and prospective students.billion pool will be set aside to help all 350,000 Corinthian students pay off their loans; approximately $10,000 per student.

Spring 2016: Students attempt to transfer out of the for-profit private post secondary schools. They realize their credits will not transfer to other schools with similar programs. However, their accounts can be sold!

Summer 2016:

ed debt

The second year of for-profit private post secondary schools reporting under the Guidelines begins.

Fall 2016: Enrollment in schools sanctioned for thir 2nd consecutive year drops off a cliff. The first wave of for-profit private post secondary schools begins cutting back operations.

Winter 2016/2017: The second announcements are released identifying for-profit private post secondary schools not in compliance with the GE Guidelines. Schools that have failed their second consecutive year must post on their websites enrollment warnings for current and prospective students. Calls for legislation are made across the nation to address the loans and workforce predicaments for effected students. California becomes ground zero for school failures and finger pointing chaos.

Spring 2017: Students begin to drop out and new enrollments go to zero. Schools begin closing overnight in droves. Crisis mode ensues in state legislatures and Congress.

30% (~2,000) of all for profit schools in the US are in California. The BPPE has oversight authority of these schools. The big name corporations such as Corinthian, ITT, Devry, EDMC and Phoenix (Apollo Group) account for no more than 10% of the for-profit private post secondary schools at risk in California. The greater danger is the small for-profit private post secondary schools owned by individuals and single shareholders. These small operations (as many as 1200) have far fewer financial resources than the large corporations and as a result will shut down immediately under the slightest financial pressure. Even though the signs are obvious that this collapse will take place, the BPPE has shown no initiative in making plans to prevent or mitigate the inevitable disaster. I believe at least 200 for-profit private post secondary schools will close in California impacting as many as 20,000 to 200,000 students. This will overwhelm and exhaust the $25MM Student Tuition Recovery Fund. I believe the riskiest for-profit private post secondary schools can be identified yesterday. The prudent and just action is to close these predatory operations before further damage is done to individuals, institutions and the state.

Writer’s note: The amount of news and documentation on the collapse of the for-profit private postsecondary schools is abundant. I plan to post a list of news articles and documented research on the phenomenon.

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Predictions and Outcomes for the Affordable Act: May 2014

May 5, 2014

ACA-health-reform-logoWEBThe ACA was the political hot topic throughout 2013.

Multiple story lines emerged that were – and continue to be – focal points for and against the success of this landmark legislation. Now that the enrollment period is finally completed as of mid-April 2014, it is possible to look back and survey the main topics. How did things turn out? You may listen to Fox News or CNN, the Tea Party spokespersons or Nancy Pelosi and House Democrat leaders. We have summarized what we see as the main stories. We rank them in order of how HOT or COLD these stories are today at the start of the second quarter of 2014.

We have compiled a table of outcomes that were predicted for the Affordable Care Act. The debated outcome is in the center column. Positions pro and con are listed with a sample source for each side. The predictions are presented in order of their controversial temperature; that is, how HOT or COLD the topic is today at the start of the second quarter of 2014 after the initial data have been reported.

PRDXN-TABLEWEB

HOT TOPIC #1: Did a sufficient number of Millenials enroll? The economic viability of the ACA is predicated on having enough healthy young people in the premium-paying pool between ages 18 and 40. How many were needed? The target was 40% of total enrolled. The reported outcome has increased from 24% to 27% within months. We are gradually reaching our goal. This remains, in our view, the hottest topic and one that will remain vital in the coming year.

HOT TOPIC #2: President Obama announced in November 2013 that “you can keep your plan if you want it.” The White House had to scramble on this one because 6 million people lost their so-called “catastrophic” plans when the new minimum standards for ACA eligible health plans were clarified. What became clear was that 6 million insured persons lost their crummy plans while 8 million people were newly enrolled; a net overall gain. A related story was that premiums would generally increase. A recent OMB report estimates premiums will in fact decrease. Decreasing premiums also has its exceptional cases because states with low enrollments will likely see increases in premiums. The White House extended the deadline to dump non-conforming plans for a year, which cooled this story off a little… for a while. We expect the story will heat up again.

WARM TOPIC #3: Not enough people will enroll to make the ACA work. The target was 8 million and it was exceeded; California accounted for half! The next test will be whether enrollees pay their premiums. The number of estimated uninsured is between 30 and 40 million. Over the next decade these individuals must also be enrolled. 8 million is a very good start. Look for a new round of predictions for continued enrollment and the pace of enrollment especially around the Fall 2014 voting season.

NEUTRAL TOPIC #4: Will the Health Exchanges enroll enough people? The Health Exchanges are supposed to provide elective opportunities for citizens to change their current health plans (marking the end of catastrophic coverage plans which we refer to as “your money or your health”). This was the candy that incentivized insurance companies to offer conforming plans to would-be paying consumers; in other words the Health Exchanges encouraged greater competition among insurance plans. For many the concept of business competition among insurance plans was as incomprehensible as how reimbursements work (see Stephen Brill’s defining 2012 article). Many states with GOP governors elected to opt out of creating their own Health Exchange. The impact was to force residents in these states to enroll on the federal Health Exchange. Covered California is the largest state operated exchange and our enrollment was highly successful; 1.4 million new members under new plans. We believe this topic never got much traction the result of complicated essential questions: who is participating and who is not in terms of insurance companies, hospitals, and providers? With 13 insurance plans participating in the nation’s largest exchange –Covered California – enrollment was a sure winner.

COOL TOPIC #5: Are there enough providers to meet consumer demand? This is the “access to care” issue. According to an early LA Times article there were not going to be enough doctors to take care of the wave of newly eligible patients wanting services. It remains difficult to find information supporting the sufficiency position. Lawmakers in California have been working on expanding the practice scope of health professionals such as Physician Assistants, Nurse Practitioners, and Pharmacists. There are insurance plans with more physicians contracted than other plans which will surely lead to an imbalance of care for patients enrolled with fewer providers. What patients and analysts need to know is the ratio of contracted primary care providers and specialists for each plan. It will be awhile before we see those data.

COLD Topic #6: There appears to be considerable confusion and misunderstanding concerning participation of non-white persons, especially Latinos, in the health exchange. The overall enrollment goal has been met however, the national enrollment demographics are unclear. Slightly more than half of California’s population is Latino, yet only twenty-eight percent of enrollees in California have identified themselves as Latino.  Outreach and education programs, in particular targeting Latinos, were late getting started. When these programs did get underway they may have helped  account for the late surge in Latino enrollment over the final 60 days. As a population group Latinos are younger and more healthy. The participation of eligible Latinos in the ACA is critical to its success.

ICY TOPIC #7: The federal ACA website rollout was big news in the fourth quarter of 2013. It was the most talked about failure of the ACA. People were not able to enroll in healthcare plans. How could the government penalize would-be enrollees for not having insurance if it was not possible to login and sign up? Now that the initial enrollment deadline has passed, and the initial target has been reached, this story is colder than San Francisco in August.

Looking into the future we anticipate the following stories will provide plenty of material for the media and policy analysts in 2014.

What will be the follow-through on the 8.2 million who signed up? How many will actually pay their first premium? And how many will renew their enrollment come the October 2014 enrollment period?future-next-exitWEB

How many new enrollees are projected in 2014-2015? With a target between 30 and 40 million over five years what is the White House enrollment forecast through 2018?

How will wait-times-to-be-seen by a physician – one form of access to care – and the availability of providers to see newly insured patients, play out? We expect to see more of these stories reported this Summer and Fall.

California is the mule team pulling this wagon. This bodes very well for California and the ACA. Some folks will be very unhappy about this. However, we believe more will be happy.

This article was prepared by Mary Bezjian and Steve Stumpf. Ms. Bezjian is a senior at California State University Northridge majoring in Health Administration.

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White Collar Unions for Healthcare Providers

June 9, 2013

opeiu_logoI attended the tri-annual Office and Professional Employees International Union – OPEIU – conference in San Diego last week. The event is as much a gathering of the tribes as it is a working convention of the 50-plus OPEIU member unions and guilds. I took pages and pages of notes as I sat through presentations in the main hall, and met in small groups with the OPEIU leaders, as well as leaders of member unions or guilds. Here is what I came away with.

White collar professionals will comprise the new members of unions and guilds. They will join because they need protection that can only come with numbers.

As John Mattiacci, President of OPEIU Guild 45/The First National Guild for Healthcare Providers of the Lower Extremity, said “The issue is not political. It is economic. We are fighting big business. I joined the OPEIU for its influence.”

Unlike unions a guild does not collectively bargain and it does not strike. Mattiacci had organized his own independent podiatric guild with a thousand members when he approached the OPEIU in the mid 1990s. He wanted a law passed that would expand podiatrists’ scope of practice so they could reconstruct ankles for which they had been trained.

“40 years we couldn’t get this law passed. Once I was in the OPEIU the law was passed in 30 days.”

Mike Goodwin President OPEIU

Mike Goodwin President OPEIU

I have been working with acupuncturists since 2008 trying to figure out how to organize them under the National Guild of Acupuncture and Oriental Medicine (NGAOM). Our guild has grown from 6 members in 2008 to 25 one year ago to 100 today. The Podiatric guild has 6500 members of 16,000 DPMs in the nation. There are approximately 25,000 licensed acupuncturists (LAcs) in the country. California has a plurality with about 10,000.

The hurdles that must be cleared have gotten lower since this meeting. They include the following.

1. Work within mainstream medicine if we want to earn a living wage. This has been a contentious issue within acupuncture but it is no longer. The national professional organization of acupuncture understands this is the only path to survival and success.
2. LAcs must market themselves as healthcare providers which means LAcs must learn to work within medicine, “speak medicine,” refer back and forth with mainstream providers, act and look like they are a part of mainstream medicine.
3. Join the NGAOM so we have strength in numbers. The NGAOM is small. But the OPEIU with 103,000 members across all the member unions and guilds is big. The AFL-CIO of which OPEIU is a member is huge. With all our brothers and sisters we are 4 million strong.

Every speaker from the dais began their presentation with the words “brothers and sisters.” It was not corny. It was heartfelt. The diversity among OPEIU groups was astounding. Here is partial list: Allstate agents (the “good hands” company tried to fire all the employees then hire them back as independent contractors without benefits of course), real estate appraisers, actuaries, street vendors, tax drivers, civil service employees in a group of South Florida towns and cities, and 10,000 nurses across the nation.

Acu Guild President Steve Paine chats up Richard Trumka AFL-CIO President

Acu Guild President Steve Paine chats up Richard Trumka AFL-CIO President

Mattiacci has begun to organize a profession that has to be the least likely to ever be organized under a guild or union: physicians. He explained why he believes this will happen by confirming something I have observed in my hometown. Private hospitals are buying up private physician groups as doctors have come to understand they will never be able to realize their traditional exit strategy: selling their office files to a younger version of themselves seeking to start his or her own private practice. Those days are gone. Doctors are selling to private hospitals so they can continue to work without the burdens of malpractice insurance, overhead, staff salaries, diminishing reimbursements, and less autonomy.

Mattiacci points out “this has created an unexpected consequence. All those doctors are now employees. And employees can be organized as a group.” If you do not think doctors are feeling burned and left out of decisions about how they work, then you do not know many doctors.

Acupuncturists have never been organized. In fact, many profess to be content to exist outside the realm of medicine with its insurance, pharma and governmental nuisances. This view is not less simplistic than Mattiacci’s view with one major difference. Being isolated leaves you alone. Being organized gives you a say in your destiny.

NGAOM member Mario Mancici, OMD, joined us for a day at the OPEIU conference. We visited his clinic which is decidedly mainstream. He is a graduate of a California program and has a thriving acupuncture practice in San Diego. He has 14 individual treatment rooms and is opening his version of a community acupuncture treatment room where he will treat up to 10 patients at a time in a group setting filled with negative ions. He does not use a sliding fee scale but he does accept health insurance, works with the only group in the nation that feeds referrals to LAcs – American Specialty Health or ASH, and he is enrolled in Medicare. Each of these choices remains controversial among many acupuncturists.

Acu Guild meets with Podiatry Guild

Acu Guild meets with Podiatry Guild

Here are a few excerpts from his brochure which, in my mind, offer a guideline for how to market oneself as an LAc who wants to work with and be seen as a partner for other healthcare providers.

His Center for Integrative Care is focused on optimal health and personalized patient-centered care.

His purpose is to help patients achieve optimal health and to educate them about the benefits of nutrition and Oriental medicine.

He educates patients to focus on a lifestyle of optimal function for health and wellness instead living by disease maintenance.

Mario lists a range of diagnostic tests none of which exceeds his scope of practice and common conditions he helps none of which are fantastic or outside an evidence base.

Here is how he explains acupuncture. “Acupuncture or needling therapy stimulates the nervous system to increase the flow of blood bringing oxygen, nutrients, hormones and immune cells to targeted areas of the body. Acupuncture points are junctures on the body where blood vessels and a dense collection of nerves intersect.”

Mancini believes acupuncture belongs in functional medicine which is something integrative physicians have told me. The way Marion sees it “functional medicine is the biomedicalization of acupuncture.” The path is clear. Those who choose to follow it will find strength in numbers and a new community of brothers and sisters.

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Affordable Care Act: Handicapping the Players

March 20, 2013

Peter_LeeCalifornia is set to be the flagship for the implementation of the Affordable Care Act (ACA). Our state has the largest contingent of about-to-be newly insured. Our state has gone all-in with regards to enrollment, technology, and spending. We are among the first states to establish our own Health Benefits Exchange. While red states with similarly huge numbers of uninsured – who could and should be among the soon-to-be newly enrolled such as Texas are dragging their feet to make further pointless political statements – California is moving full steam ahead to make the White House proud. At least we look like we are moving that quickly. (more…)

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Knox-Keene license is the entry ticket to the Affordable Care Act

March 13, 2013

ACA_signingWEB The Knox-Keene license is about to become more important than ever before. The holder of a Knox-Keene license has the right to create and offer health plans in the California healthcare marketplace. That market is about to undergo the greatest change in 50 years. The Medicare Act that was created in 1965 changed everything about healthcare by providing government sponsored coverage for two vulnerable and uninsured populations – elderly and the poor. It’s déjà vu all over again. (more…)

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How Did They Decide to Award the $1B?

June 27, 2012

Grant writing is competitive. The greatest stakes are at the federal level where the awards are the largest and the competition is most fierce. Proposals I often find myself working on involve community healthcare which means coordinating between multiple entities such as community clinics, FQHCs, hospitals and community based organizations (CBOs). A substantial funding pie was divided into 107 slices this month as the CMS Innovation Center (created as part of the Affordable Care Act announced the awardees for the $1 billion Innovation Challenge competition. The program was well received by the national healthcare community involved with Medicare and especially Medicaid services. Approximately 3,000 proposals were received in a very tight 60 day window between November 2011 and January 2012 during the busiest holidays of the year. There’s a challenge! The ambitious timetable for processing and evaluating the avalanche of proposals in March was predictably extended another 90 days. Seventeen California proposals comprised the largest number of awardees among the 52 states, Puerto Rico and one site “not geographically defined.” Massachusetts and New York were next with 12 awards each. (more…)

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The California Senate is Concerned with How the California Acupuncture Board Functions

March 14, 2012

On March 12, 2012 the Senate Committee on Business, Professions and Economic Development conducted a hearing under its Sunset Review function during which the California Acupuncture Board (CAB) Chair and Executive Director were advised, in the opinion of the committee, the CAB was “too caught up in professional issues.” The CAB was instructed to respond to the committee’s Background Paper [click here Acupuncture Board Background Paper 2012TRUNC], which is a worthwhile read for those interested in California acupuncture or in the legislative oversight process. The very brief 20 minute hearing ended with the committee letting the CAB Chair and Executive Director know the committee was “concerned about how the board functions.” (more…)

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The Ark and the Mothership

April 19, 2011

I have been waiting for months to write this post. I wanted to attend the April 8-10 CANference in Portland and learn what the most innovative organization in the acupuncture world has been planning before writing anything more about changes taking place in the acupuncture profession. I found out the CAN folks are building an ark.

It is no longer difficult to build a persuasive case describing how the acupuncture profession has been drifting for at least a decade. Until recently, the Community Acupuncture Network (CAN) spent considerable energy trying to blow holes in the belly of that ship. The workforce papers I co-wrote provided a few torpedoes. Now CAN has shifted their energies. The perception among conventional acupuncturists and acupuncture leadership organizations has been that CAN is destructive, led by unruly amateurs who enjoy their outlaw image. Just when the heat created by CAN hit a level that began melting the eyeballs of those who would try to peer within, they have shifted direction 180 degrees. CAN is no longer interested in upending the acupuncture profession. They are re-inventing it. (more…)

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What will the National Healthcare Workforce Commission do? A lot.

October 6, 2010

less providers + more patients = system breakdown

The Patient Protection and Affordable Care Act (PPCA) of 2010 – aka healthcare reform – included a provision to create a National Healthcare Workforce Commission (NHWC). The purpose is to create a body of expert representatives who are “who are nationally recognized in health care labor market analysis including workforce, health financing and economics, health facility management, heath plans and integrated delivery systems, workforce education and training, health care philanthropy, and providers of health care services” [http://phinational.org/]. Their job is to “serve as a national resource for the purpose of assessing if the demand for health care workers is being met, identify barriers to coordination between federal, state and local levels, and encourage innovations” [Summary of the Health Workforce Provisions in the Patient Protection and Affordable Act: H.R. 3590, March 2010, Rachel Morgan, Senior Health Policy Specialist.] (more…)

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