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| Stop Medicaid Fraud in Child Welfare |
Michigan refuses to admit it has a problem.
The Madame Maura Corrigan tried to cover it up to get released from federal monitoring.
Michigan is attempting to shift oversight through privatization.
Non-profits are subject to exclusions and exemptions of external audits furthering questionable billing practices.
SACWIS has no internal cost controls.
Michigan DHS and DCH have no referral mechanisms to report Medicaid Fraud in Child Welfare to the Attorney General Medicaid Fraud Control Unit.
I hope Children's Rights keeps the pressure on to keep the federal monitor in place because there is no oversight of operations.
I hope HHS and CMS do the same.
Computer problems plaguing child welfare system
LANSING – Persistent problems with a new computer system designed to help child welfare efforts in the Michigan Department of Human Services are instead frustrating workers, delaying payments to some foster parents and complicating state efforts to escape federal oversight.
State workers say the more time they have to spend on their computers, the less time they spend protecting kids from abuse. The late payments, they say, makes it hard to attract and keep good foster parents, which can affect the children. And problems with the system could prolong federal oversight of the state child welfare system, which has already cost taxpayers more than $10 million in legal and monitoring fees alone.
The Michigan SACWIS (Statewide Automated Child Welfare Information System), which came online at the end of April, was plagued with early problems that included files disappearing, information from unrelated cases being pulled into child welfare files, incorrect addresses being provided to child protective services workers, difficulty printing reports and closing out files, along with the delayed payments to foster care providers and contractors, among other issues.
Though many — if not most — of the early glitches have been fixed, state child care workers say a fundamental and far-reaching problem remains eight months after implementation: The system is slow and clunky and requires a series of complex and time-consuming steps to perform basic functions.
All states have to produce a SACWIS or something like it, and states such as Tennessee and Oregon have experienced similar system problems. Michigan rolled out its version, purchased from Pennsylvania-based Unisys Corp., six months late and its projected cost of $47.3 million has grown by more than $13 million to about $61 million.
The status of the computer system could be discussed at a hearing Monday in Detroit before U.S. District Judge Nancy Edmunds, who has oversight of the state's child welfare responsibilities as a result of a 2006 lawsuit brought by the New York-based watchdog organization, Children's Rights.
Data from SACWIS are critical to showing whether Michigan meets required benchmarks in areas such as state worker caseloads; medical, dental, educational and mental health services for children under state care, and details related to licensing of foster care parents.
Bob Wheaton, a spokesman for the Department of Human Services, said Friday: "The vast majority of issues have been fixed." The system is designed to track more data than the one it replaced, so it takes state workers more time to input data, Wheaton said. "Also, there is a learning curve for users of a new system, so it takes time for them to get up to speed," he said.
Ray Holman, legislative liaison for UAW Local 6000, which represents about 2,850 state child welfare workers who use SACWIS to investigate child abuse allegations and work with foster parents, said he waited eight months to speak out because he wanted to be sure workers weren't experiencing short-term problems that can be expected with any large new system.
It's "almost impossible to navigate," Holman said. "It's not efficient. I can't overemphasize how frustrating it is for the employees."
Workers are getting behind in their caseloads and "feel as if they are tied to their computers," he said.
Former Republican state Sen. Bruce Caswell, who chaired the Senate appropriations subcommittee for the Department of Human Services until he left the Senate on Dec. 31 after one term, said he held a series of summer and fall meetings with officials from both that department and the Department of Technology, Management and Budget as he tried to troubleshoot issues with the system.
"There is absolutely no doubt that this system is more work for the workers," he said. "It's supposed to be, because we are getting far more data."
Caswell said a major problem was inadequate and poorly executed training, with workers receiving about two hours of training about a year before the system came online. By the time they had to actually use the system, workers understandably "had forgotten everything" about how to use it, he said.
Holman said training was "ridiculously poor, up until just recently," but it's also a systems issue.
"They have been doing fixes — hundreds and hundreds of fixes — and still it's a whack-a-mole situation," he said. "It's like a tube of toothpaste, you press down on one end and it creates problems on the other end."
Holman said late payments make it hard to attract and retain good foster parents.
On that point, Wheaton said the department is "working to resolve foster care payment issues and have made great progress since the system launched.
"The dollar amount of our weekly foster care payroll has been about the same as before the launch ... so we know that the vast majority of foster parents are getting their payments on time."
As for the cost of the new system, the $61.2 million includes the original contract cost of $47.3 million; an add-on of about $4.4 million to pay for items such as enhanced training materials; an extra $7.6 million to have Unisys work closely with state officials on taking over technical support, and $1.9 million to add juvenile justice features, Wheaton said.
The federal government, which mandates the computer systems for all states, covers about 80% of the costs.
"We knew that there would be maintenance and operational support costs for this system, as this is the case for any system," Wheaton said. "But we didn't allocate a specific dollar amount for this in the budget."
Unisys spokesman Brad Bass said the "system has been successfully rolled out," and state officials are "satisfied with its overall performance."
"We are proud of our collaborative work with the state that has allowed the rollout to occur in such a short time frame, and we are excited by the feature-rich functionality that the system is providing," Bass said. "We look forward to continuing our partnership with the state to further enhance the system."
The state, in a Dec. 2 motion asking that federal oversight be ended or significantly scaled back, said SACWIS was "still a work in progress, but the system is exceeding expectations."
Wheaton said federal officials who conducted an on-site visit in July said Michigan's SACWIS system was already as mature as similar systems in other states that had been running for three years.
But the Department of Human Service's own records cast doubt on those characterizations.
In a June 30 memo, two months after the system went online, the department's Children Services Administration said officials were "working around the clock to resolve as many issues as possible," and "averaging approximately 60 to 100 defect fixes per month, and in some cases, we are scheduling emergency releases, one to two times per week, to quickly resolve those defects that have a substantial impact on critical functions, like centralized intake, payments, and reports."
The memo said there would be "major releases" in July "to launch a complete redesign of centralized intake and correct payment defects" and other ongoing problems.
Children's Rights attorney Sara Bartosz said in a Dec. 30 court filing urging Edmunds to continue the federal oversight, that "a significantly delayed, and to-date still incomplete, implementation of the state's new data system ... continues to impair DHS' ability to accurately measure agency performance..."
"The absence of a stable and fully operable data reporting system dispels defendants' assertion that a durable remedy has been achieved," Bartosz said. "DHS cannot effectively manage or sustain performance on what it cannot measure."
The Children's Rights lawsuit that lead to the federal oversight alleged a range of failings by the state, including maltreatment or neglect of foster children while in state custody; inadequate health services for foster children; excessively long stays in state custody, and too many movements from one foster home to another.
The state said in its court filing it has "paid more than $10 million to plaintiffs' counsel and the court-appointed monitoring team, and spent millions more in staff time to comply with reporting requirements," and "would now like to redirect these resources to improving services to children."
Computer system affects federal oversight
Problems with the Statewide Automated Child Welfare Information System (SACWIS) could affect how long the Michigan Department of Human Services remains under costly federal oversight on child welfare issues.
■ Federally appointed monitors say the state has complied with 112 of 211 commitments required to escape federal oversight.
■ The state says it has substantially complied with 53 other requirements, though the monitors have not yet formally recognized those achievements, and that of the 46 remaining requirements, 10 are directly related to complete functioning of the SACWIS system.
■ But attorneys for the advocacy group that sued Michigan, Children's Rights, dispute those numbers. They say the state is too biased to judge whether any requirements other than those identified by the monitors have been met. And they say data produced by SACWIS is needed to show compliance with a significant number of the benchmarks DHS must reach.
■"DHS cannot effectively manage or sustain performance on what it cannot measure," a Children's Rights attorney said in urging continued federal oversight.
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