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*** UPDATED x2 *** Hearing today will look at why thousands were kicked off Medicaid

Monday, Apr 30, 2018 - Posted by Rich Miller

* Whoa…



Click here and scroll all the way to the bottom for January’s enrollment numbers. Now, click here and scroll to the bottom for March’s numbers. Enrollment fell by 178,883.

*** UPDATE 1 *** But of course…



*** UPDATE 2 *** Press release…

State Rep. Greg Harris, D-Chicago, and members of a House budget committee shined a light on the human face of the technical issues plaguing a Rauner administration IT upgrade that had incorrectly blocked tens of thousands from receiving services during late 2017 at a hearing Monday.

“Governor Rauner’s mismanagement of state contracts has led to misery for medically fragile children, nursing home residents and people with disabilities,” said Harris. “It’s another example of how the governor is focused on handing out contracts to private consultants and ignoring the plight of those at the bottom of the economic ladder.”

During the hearing, advocates from local social service agencies and frontline Department of Human Service workers testified as to how the new Integrated Eligibility System (IES) had failed residents.

“As a single parent of an adult with disabilities whose livelihood depends on Medicaid, I feel that the systemic Medicaid issues occurring in Illinois threaten the life I have worked so hard to achieve these last forty-one years for my daughter and myself,” said Shirley Perez, whose serves as Program Director of the Ligas Family Advocate Program and Executive Director of the Family Support Network of Illinois, and whose adult daughter was almost recently cut off from her Medicaid coverage. “When her redetermination notice failed, my heart just sank, even with years of experience as a parent and as a professional in the disability field who talks to other families about their issues daily. Please know that the impact of this problem is far greater than it might seem because it is a threat to our very existence.”

In 2017, the Illinois Department of Human Services began rolling out the second phase of the IES to process enrollment for several different services. However, in late 2017, more than 40,000 households lost their food stamp benefits. The IES change also created a state backlog in processing identification numbers for Medicaid patients, blocking some patients from receiving treatment. In both cases, officials had to scramble as thousands went without critical health and food benefits that often serve as the difference between life and death.

In addition to having technical issues, IES has gone way beyond its initial price tag, leading to a $300 million project whose extensions and amendments will end up costing more than the project’s original budget.

“The countless stories from families across Illinois on the widespread failures of the state’s new Medicaid computer system would be disastrous on their own,” Harris continued. “Yet the fact that the cost overruns on this failed system total more than $150 million makes it doubly outrageous. Taxpayers should not be coughing up hundreds of millions of tax dollars to actually make things worse.”

       

27 Comments
  1. - wordslinger - Monday, Apr 30, 18 @ 9:36 am:

    –Hearing today will look at why thousands were kicked off Medicaid–

    Answer: So Rauner could run digital spots claiming he “saved” $450 million in Medicaid “fraud.” As he’s doing today.


  2. - Anon221 - Monday, Apr 30, 18 @ 9:46 am:

    Related to this issue- SJR article

    Medicaid managed-care reboot pinching pharmacies, advocates say

    https://tinyurl.com/yapw6nap


  3. - A Jack - Monday, Apr 30, 18 @ 9:49 am:

    I hope you get answers, but this administration has been pretty consistent in blowing off the GA when answers are requested.

    If you want answers, you need to threaten to cut off IT appropriations for that system for next fiscal year until you get the answers you want.


  4. - Honeybear - Monday, Apr 30, 18 @ 9:58 am:

    It’s so so much worse than this. As someone who does this every day. IES is a nightmare. Ask any caseworker. Go to any DHS Lobby and see the throng of people there.
    This system started under Quinn and worked okay for intake function only.
    But Rauner pushed the schedule up before the bugs were worked out.
    It’s created years of work for us.
    89 yo woman had her case closed
    IES didn’t know her citizenship status
    Wah?
    She had been getting assistance for decades.
    That kind of thing


  5. - Just Me - Monday, Apr 30, 18 @ 10:10 am:

    Enrollment went down because people left Illinois to find jobs in other states where those state governments aren’t dysfunctional.

    (snark)


  6. - Fixer - Monday, Apr 30, 18 @ 10:17 am:

    Honeybear is exactly right. This syst m as a whole should not have been pushed out in the state it was. Testers told administrators it wasn’t ready. Trainers told them it wasn’t ready. Now we are stuck with a system that at its best takes twice to three times longer to do the work, and frequently does it incorrectly. And the state continues to pay for this garbage, when there was a functional (albeit old) system in place that worked.


  7. - kitty - Monday, Apr 30, 18 @ 10:19 am:

    IES continues to be an unmitigated failure. The task-based casework system it requires is not working for long-term care and assisted living recipients, just ask nursing home and assisted living administrators, guardians, family members, elder care attorneys and advocacy groups for the elderly and disabled population. DHS needs to be directed return to facility based assignments for casework ASAP.


  8. - Whatever - Monday, Apr 30, 18 @ 10:41 am:

    “To err is human, but to really foul things up requires a computer.” Paul Ehrlich

    Thanks heavens we didn’t have a budget so the contractors didn’t get paid. /s


  9. - jimbo - Monday, Apr 30, 18 @ 10:42 am:

    This system was has had problems forever and the administration has tried to blame it on the workers. I retired 3 years ago and it did not work right then and still does not. Rauner’s people have spent $millions trying to fix it and still have not been able to make the system work.
    https://www.nbcchicago.com/investigations/Glitch-in-Illinois-Benefits-System-Bogs-Down-Process-Workers-Say-479341373.html


  10. - Langhorne - Monday, Apr 30, 18 @ 10:48 am:

    Time to dust off GA subpoena power. This is an enormously important issue affecting thousands of lives. It is not a minor PR embarrassment, like a few bad travel vouchers, to be swept under the rug.

    Look at almost any aspect of medicaid and there are serious, expensive, problems. Start w the auditor generals audit.


  11. - A Jack - Monday, Apr 30, 18 @ 10:56 am:

    To the update: Not really surprising that HFS and DHS won’t show. Perhaps the GA might try DoIT, the Governor’s answer to the state’s IT problems.


  12. - Mod Dem - Monday, Apr 30, 18 @ 11:08 am:

    It isn’t system error that is removing people off Medicaid, it is the old system required case worker intervention to remove them off the system. The new system does it automatically if a client does not send in the required paperwork. It is a policy decision to systematically remove Medicaid participants, rather than leave it to over-burdened caseworkers. The argument is that if you want the government to pay for your healthcare, then you must proactively manage it. I actually believe this from a policy perspective. What is also failed to mention is the 90%-10% match that this system was built under. The State did not pay for a $130+ million system, although I realize it makes a better headline.


  13. - A Jack - Monday, Apr 30, 18 @ 11:13 am:

    Possibly a good campaign ad for Pritzker might be to contrast his experience with IT projects and this administration’s failures with some very expensive IT projects such as this Medicaid program, the ERP system, and Morneau Schepell.


  14. - Henry Francis - Monday, Apr 30, 18 @ 11:20 am:

    Of course the agency heads won’t show up. The Guv told them all shortly after he took the big chair that HE was gonna take all the arrows. So everyone needs to just chill until he shows up to answer the questions.

    And I’m sure his responses won’t include any mentions of Madigan or nervous chuckles.


  15. - Moe Berg - Monday, Apr 30, 18 @ 11:23 am:

    Looking forward to the Chicago Tronc editorial denouncing the Rauner administration for not participating in a legitimate legislative inquiry.

    From the admin’s perspective, this is a success: slowing down government, keeping “the undeserving” from receiving benefits, shoveling taxpayer money to for-profit, private companies like Deloitte.


  16. - King Louis XVI - Monday, Apr 30, 18 @ 11:38 am:

    —Time to dust off GA subpoena power.—

    This.


  17. - Top of the State - Monday, Apr 30, 18 @ 11:39 am:

    Agree with Honeybear. I was trained on IES and it took way too long to roll-out and fix the “bugs”. I can’t understand why we needed a custom program in the first place. Why not “off the shelf” from another state that worked? The old DHS software was antiquated and needed to go however…..


  18. - Dome Gnome - Monday, Apr 30, 18 @ 1:00 pm:

    Let’s be honest, it was kind of a given that DHS and/or HFS would yawn sleepily and then not show. The bigger disappointment was that fewer than 1/3 of the Appropriations (Human Services) Committee bothered to show up. The witnesses had some heartbreaking stories to tell. They deserve to be heard.


  19. - Anon221 - Monday, Apr 30, 18 @ 1:40 pm:

    I’m beginning to wonder if that phantom department with no computers but reams and reams of papers, was the fax machine in the closet that no one seemed to know about, that was receiving required Medicaid paperwork. Harris referred to this type of scenario near the end of the hearing today. There is a lot of ’splaining to do by the Administration.


  20. - dbk - Monday, Apr 30, 18 @ 1:46 pm:

    This sounds like a major IT application failure, exacerbated by everybody’s favorite not-in-charge gov, who doesn’t seem to grasp how now CMS’s come into being.

    When DoIT became centralized, were there permanent liaisons appointed from each agency? When the news software was being created, did the programmers receive ongoing input/feedback/critiques from those who would be using individual sub-programs (Medicaid, SNAP, etc.)?

    This sounds like a major outsourcing/performance scandal - maybe not as headline-grabbing as IVHQ, but incredibly harmful to innocent citizens.

    Note: one of my kids served as liaison for his agency (not in IL) for a similar project, for a total re-design of the agency’s CMS, which was outsourced. To get it right requires intimate knowledge of how the agency operates, what its employees and enrollees (all categories) need, and an ability to convey these needs in terms programmers can understand and translate into code. Approximately 50-70% of his time was occupied by the project for around six years. But: the CMS went live on schedule, cost overruns were modest, and … it works.

    Sounds like a good investigative subject for the Pro Publica IL data team.

    This is really bad, really. And it’s not easily fixable - a lot of code may need to be rewritten, some sub-programs completely.


  21. - union proud - Monday, Apr 30, 18 @ 1:51 pm:

    “It isn’t system error that is removing people off Medicaid, it is the old system required case worker intervention to remove them off the system.“

    IES was cancelling them If the rede was in the system but a worker hadn’t gotten to it yet. Also many who didn’t turn a rede in sent it to a fax number that the state provided but didn’t work.


  22. - vaeoih - Monday, Apr 30, 18 @ 2:36 pm:

    So DHS/HFS outsourced a project to develop a new, integrated system to streamline application and benefits management. This is exactly the type of project where, “running government like a business” could — potentially — yield benefits. A well run business, or government, would have a robust vendor management program in place to ensure that outsourced projects stay on track, within budget, and deliver expected results. This is an area that the State has been demonstrably and woefully deficient since forever. This is where the three headed horsemen of government apocalypse, WasteFraudAbuse, could be slain by a governor determined to do right by Illinois taxpayers.

    I guess this Governor is not that interested in managing well and doing good. Tis but a shame.


  23. - BobO - Monday, Apr 30, 18 @ 2:49 pm:

    IES is another stealth way for Illinois to save money. The powers that be are banking that a percentage those individuals who have been denied will not be enrolled again, thus saving Illinois thousands, if not millions of dollars.


  24. - RNUG - Monday, Apr 30, 18 @ 3:11 pm:

    Having dealt with contracts to write new systems and software on the past, I can tell you the State has to really rode herd on both the project and the people supplied. Big firms will promise you their best people then substitute trainees who.havr to learn as they go. It got do bad I started requesting explicit lists by name of the people being proposed for the contract, the number of hours each of they would work, and required tesumes for each person.

    So I’m not surprised by any of this …


  25. - Anonymous - Monday, Apr 30, 18 @ 4:02 pm:

    This is what happens when a state has a governor whom is not in charge.


  26. - JDuc - Monday, Apr 30, 18 @ 5:06 pm:

    Union proud and BobO - they both have it right.


  27. - Me Again - Tuesday, May 1, 18 @ 1:28 am:

    “Top Of The State - Why not “off the shelf” from another state that worked?”

    That is what Illinois did. Deloitte started with a copy of the Michigan “Bridges” system and then modified it to conform to Illinois laws and regulations.

    If we had wanted to go with an exact copy of another state’s computer system to do Medicaid/SNAP/TANF processing, we would have needed to change Illinois law to conform to the laws of the other state. Probably something that would never be done.


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