Friday, September 17, 2010

My Recommendations to North Dakota Legislators: Stop Sipping Tea

When I first saw the headline, I had to sit back and prepare to peal back the layers of this political enigma.

Bill draft for family ombudsman program fails to advanceav


BISMARCK — Parents gave tearful testimony today as they told state lawmakers about social services taking their children away and the battles they’ve faced with the system ever since.

Here we have the first layer.  Parents lamenting to policymakers about the policies they made.  Child Protection is a taboo subject matter to extremist religious groups because it demands addressing the issues of transparency and accountability.  

Child welfare, in general, is considered to be an oxymoron to most politicians in the extreme factions of the new Tea Party, just examine the positions taken by Michele Bachmann.


In one moment Madame Bachmann wants to end Medicaid, yet in the same soundbite, supports the very same Medicaid programs she calls to end, Child Welfare.

Nine people testified in favor of creating a family and children’s ombudsman program in the state in what they said would create more accountability and offer an independent resource for families.

But after three hours of discussion, the bill draft did not get the votes to advance out of the legislative Judicial Process Committee. The vote was primarily along party lines, with Republicans against and Democrats in favor.

Under the proposal, the ombudsman office duties would include monitoring and ensuring compliance with rules relating to family and children’s services and the placement, supervision and treatment of children in the state’s care or in state-licensed facilities.

The ombudsman would be independent from the state Department of Human Services.
John Ford of Rugby said social workers “have absolutely no accountability.”

“Absolute power corrupts absolutely, and social services, the Department of Human Services have absolute power,” said Ford, executive director of the North Dakota Coalition for Child Protection Services and Foster Care Reform.

Kris Wishinsky, a UND student, said she has more than 25 years of experience dealing with the system.
“The current policy and procedures that families have as a resource for a grievance or an appeal is seriously a joke,” she said.

Lorie Hendricks ofLaMoure, who testified about not being allowed to adopt her grandchildren, said  taxpayers are paying for children to be raised by someone else when family would take them.

While lawmakers sympathized, some wondered if creating another layer of government was the answer.
“I get the sense from the people that testified that you feel it (an ombudsman program) will solve those problems, that it will be the panacea or the silver bullet for solving the problems that others like you have faced,” Sen. Curtis Olafson, R-Edinburg, said.

He said he isn’t sure there is any guarantee another agency would achieve that.

North Dakota is one of the states that does not have a Medicaid Fraud Control Unit therefore does not have the ability to investigate, prosecute and recovery Medicaid fraud in child welfare, which is the core of the issue.


Sen. Judy Lee, R-West Fargo, said the ombudsman program outlined in the bill draft would need an enormous staff and be extremely costly.

With the greatest of skill, Senator Lee has demonstrated her lack of preparedness to attend the hearing and make public statement.  The federal funding for an ombudsman program was enacted in 1994. This is how the other states fund their Omudsman programs and participate in the United States Ombudsman Association.

The program would pay for itself  by reducing the costs of extended stay in foster care and identify Medicaid fraud, which would be referred to the Medicaid Integrity Program.

The office could operate with a staff less than 8.

Rep. Kim Koppelman, R-West Fargo, didn’t favor establishing new bureaucracy.

“I do believe the fox is watching the henhouse perhaps, but I’m not sure if this is the right approach,” he said.

How can you not be sure of the right approach if you have not identified alternative approaches?

Tara Muhlhauser, director of Children and Family Services in the state Department of Human Services, said there are already avenues in place to hear constituents and address issues in the system.

“If there are children that aren’t being served or families that aren’t being heard, it’s my job to make sure somebody is hearing them and somebody is looking at the situation,” she said.

She said there’s a big difference between being heard and disagreeing with the outcome.

Carol Olson, executive director of the state Department of Human Services, said she would like more authority over counties in North Dakota’s state-supervised but county-administered child welfare system.
“I will admit that, yes, we have some areas of concern, of high concern in some of the counties,” she said. “Do we need to work on them? Absolutely.”

She gave lawmakers her word the department would “get down to the nuts and bolts of figuring out what is going to be the best way to deal with this and work it out.”

Olson also told lawmakers they don’t know the other side to the stories presented by the families.
Committee Chairwoman Rep. Shirley Meyer, D-Dickinson, told Human Services she hopes it prepares something by the legislative session.

“I hope that we are approached and we have something not just, you know, process as usual, but that we have some concrete, solid ‘What are we going to do about this?’” she said.

Here are your answers:

  1. Create legislation to establish a Medicaid Fraud Control Unit with authority to take referrals from the Medicaid Integrity Program;
  2. Construct a public exclusionary database contracted entities which have been excluded from participation in the Medicaid program having engaged in fraud. Access funding through electronic healthcare information technologies grants;
  3. Establish a central operation to process and maintain grievances in children's programming; funded through the aforementioned grants;
  4. Generate a public awareness program to report Medicaid fraud in child welfare;
  5. Revise the state's Medicaid policies to capture more funding by expanding access to education, housing, transportation, employment;
  6. Expand funding and access to indigent legal representation programs;
  7. Revise the state's False Claims Act;
  8. Publicly challenge your colleagues to present a solution to end Medicaid fraud in child welfare beyond calling for less government and the abolishing entitlement programs.
 I do support an Ombudsman program, as this is an economical means to addressing civil claims and it will function as a conduit to referral violations of law to the Attorney General, but the temporal issue with implementation is serious.  Something needs to be done now.

This is why I prefer the regulatory approach through the entitlement programs of national defense.  South Dakota, your Office of Attorney General needs a Medicaid Fraud Control Unit to defend the vulnerable citizens of your state and to protect the national treasury of the security of society.

Stop the revenue-maximization scheme.  Stop Medicaid Fraud in Child Welfare.   



Stop sipping tea, get off your arse and do something about it.

1 comment:

SRM said...

Beverly-

Want to point out that this was in NORTH Dakota, not South Dakota. I am one of the parents who has worked hard to get this issue before the legislature--we are certainly not done yet!