Sunday, August 30, 2009

How states pull the wool over the feds' eyes

The following string of excerpts from federal and Michigan audits and evaluations is a working example of Medicaid Fraud in Child Welfare:

"Michigan staff, both at the Central Office and county level, did an excellent job of preparing for the review. Records were extremely well organized with necessary documentation of eligibility requirement readily located. The State provided a “reviewer friendly” environment for the review to take place. Of note was the willingness and untiring efforts made by the Program Office in leading this effort. DHS licensing and field staff, in partnership with personnel from the SCAO and the Wayne County Department of Children and Family Services, were most efficient in obtaining additional information or acting as resources during the onsite review. Additionally, DHS’ fiscal unit is recognized for the thorough and updated payment histories.

Michigan staff actively and enthusiastically participated in reviewing the cases.

(That's because they successfully covered up the Medicaid Fraud.)

Exemplary is the collaborative relationship between DHS and the State Court. This was evident not only in the presence of either the current or former Chief Justices of the Supreme Court at the entrance or exit conference, but also in the excellent quality of court orders observed during the review. In particular, the involvement of SCAO is noted for conveying title IV-E requirements to the court, instituting revisions to court orders and garnering greater consistency in the use of those revisions among the county courts. The ongoing collaboration between DHS and SCAO is a strong mechanism to foster an understanding of the need for and timely occurrence of appropriate and meaningful judicial determinations for children within both the child welfare and legal communities."
U.S. Department of Health and Human Services, Administration for Children and Families, Michigan Title IV-E Foster Care, Secondary Eligibility Review, April 1, 2006 through September 30, 2006, Conducted the week of March 26 through 29, 2007

“The state averted the loss of nearly $40 million in child welfare funding, thanks in part to the work of judicial branch staff.”

Clifford W. Taylor, Michigan Supreme Court Chief Justice, Annual Report 2007

“If DHS did not improve, it faced a possible penalty of $22 million”…. “The U.S. Department of Health and Human Services conducted the second eligibility review of DHS’s case files for foster care maintenance payments issued between April 1, 2006 and September 30, 2006. Prior to the review, DHS conducted an extensive case file review to identify cases that did not meet Foster Care: Title IV-E Program eligibility requirements. For cases that DHS determined did not meet the Foster Care: Title IV-E Program eligibility requirements, DHS changed the funding source on the cases to a funding source other than Foster Care: Title IV-E Program before April 1, 2006… As a result, those cases were not in the population reviewed during the federal review…The federal review concluded that DHS was in substantial compliance with federal eligibility requirements for the period April 1, 2006 through September 30, 2006.

We issued a qualified opinion on the Foster Care: Title IV-E Program. Our conclusion is different from the federal review because our sample included cases from the entire audit period.


Michigan Auditor General, 2007

Licensing

During the (Michigan) onsite review, (federal) reviewers determined that criminal background checks were in evidence for all foster home files that were examined. In instances where children were placed in child caring institutions, reviewers determined that law enforcement checks had been done on administrators. Particularly noteworthy is Michigan’s practice of screening all licensed foster homes against its child abuse register on a weekly basis.


U.S. Department of Health and Human Services, Administration for Children and Families, Michigan Title IV-E Foster Care, Secondary Eligibility Review, April 1, 2006 through September 30, 2006, Conducted the week of March 26 through 29, 2007

DHS had not developed a formal policy that defined when and for what service types criminal background checks and educational qualifications should be required as a part of a human service contract (includes foster care).

Michigan Office of the Auditor General, Performance Audit of Human Service Contracting, Department of Human Services, April 2008, Report No.: 431-0110-05
Post a Comment