The situation that was left behind when an Indianapolis-based company’s contract to handle Medicaid needs assessments for the state was terminated was called by some a “crisis.” The Director of the Department of Health and Senior Services says that crisis is now over.
Margaret Donnelly says since September 2 when DHSS began handling those assessments it has acted on over 13,150 individual cases, and with faster service and shorter wait times than Syncare. She says that includes all the cases that were part of the so-called “backlog” left by that company.
The Department continues to handle all new cases that have come in for assessment, re-assessment and care plan changes. She puts that at over 200 cases every day.
Donnelly says it is costing less for DHSS to handle those assessments than it would have to have operated under the Syncare contract. She wants to see the Department continue in the role through the end of the fiscal year.
Getting the state’s money back
In October DHSS referred the matter to the Attorney General’s Office. Since then, Donnelly says the state has recovered all of a $670,000 performance bond. The Attorney General’s office is still working to recover money from Syncare, who she says was paid a little over $1 million on a $5.5 million contract.
Donnelly says assessment of the Department’s performance is ongoing. “We are continuing to meet regularly and frequently with the stakeholders including the provider groups and advocates and legislators to discuss how services should be provided over the long term.” She says the chief concern for providers has been that clients needs are met in a timely, efficient manner. “And of course, all of us have the goal of making sure that is done in the most cost-effective way.”
The Department is also looking at other states that have systems in which providers take an active role in care plan development after assessments are completed. “It will take a while for us to develop the technology in that system, but we are in active discussions with the providers about increasing that role.”
What has changed since September
Donnelly is glad the situation has developed as it has. “I’m just really happy that we were able to get staff hired on a very tight timeline and get people the services that they need.” To those who experienced delays while Syncare was under contract, and after, she says, “I am very happy that the staff has come forward and we have had people just working long hours to be sure that we get the situation where it is today, which is that we are now moving forward with all new assessments and care plan changes being handled in a timely way, and that the cases which came to us from Syncare have all had action taken upon them.”
Lieutenant Governor Peter Kinder in October called on the Nixon Administration to allow the state’s healthcare providers to conduct assessments to clear the backlog left by Syncare as quickly as possible.
In response to Director Donnelly’s update on the situation, his office released this statement:
“Missouri law dictates these in-home healthcare assessments are to be completed within two weeks from when they are requested, yet it’s taken DHSS more than three months merely to get caught up with the backlog. In the meantime, how many new cases have been set aside? How many seniors and disabled Missourians have been denied assessments while DHSS has slowly whittled away at this backlog that shouldn’t have existed in the first place? What assurances do we have that DHSS will be able to prevent future backlogs?
“I will continue to work closely with seniors, senior advocates and in-home healthcare providers to make sure these assessments are being done on a timely basis and that those who need care and qualify for care are getting it. The Legislature also will address this through legislation in the coming session, and I will work with lawmakers, as well, to make sure we come up with a solution to keep this travesty from occurring again.”