Capitol - Your Illinois News Radar » *** UPDATED x2 *** Rauner brags he’s “dramatically” reduced Medicaid enrollment, but hit on “failing” computer system
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*** UPDATED x2 *** Rauner brags he’s “dramatically” reduced Medicaid enrollment, but hit on “failing” computer system

Friday, Jun 22, 2018

* Gov. Rauner was asked on KMOX earlier this month about what he’s done so far as governor. Here’s an excerpt

Number two, we’re transforming Medicaid in Illinois. Medicaid has been broken and corrupt. It has been ripping off taxpayers and not providing high quality health services. We’ve reduced enrollment dramatically and we’ve increased the efficiency in Medicaid and saved many hundreds of millions of dollars transforming Medicaid. That’s historic.

* Some additional background is here. From the Alliance for Community Services…

280,000 Medical cards being sent out, due to glitches, backlog

The Rauner administration is mass mailing as many as 280,000 notices of temporary medical cards to persons whose applications are stuck in a backlog due to computer glitches and understaffing. The notices are called HFS2350 “Notice of Possible Entitlement to Temporary Medical Assistance.”

The federal government fines states for taking more than 45 days to process Medicaid and SNAP applications.

Some Human Services caseworkers report they are currently processing Medicaid applications filed in January of 2018. Caseworkers report that they were told as many as 280,000 cases are overdue.

The Alliance for Community Services considers these temporary medical cards to be a helpful step for those languishing in the IES-caused backlog, but also a tacit admission that the expensive new IES computer system is failing.

The Rauner administration needs to admit there are continuing glitches and fix them. In addition, the attempt to get a computer program, IES, to make policy and eligibility decisions, rather than trained caseworkers, is misguided.

*** UPDATE 1 *** I should’ve checked the governor’s claims before posting. My bad. According to the Illinois Department of Healthcare and Family Services, there were ​3,247,722 full and partial enrollees during Fiscal Year 2015, when Rauner took office. At the end of FY2017, there were 3,159,553. That’s a 2.7 percent decrease. Hardly dramatic and maybe even temporary if they were wrongly kicked off.

*** UPDATE 2 *** Heating up…

- Posted by Rich Miller        

  1. - Perrid - Friday, Jun 22, 18 @ 11:28 am:

    ” In addition, the attempt to get a computer program, IES, to make policy and eligibility decisions, rather than trained caseworkers, is misguided.”

    No. Yell about this specific failed rollout/product all you want but saying “These dang computers are ruining everything” is shooting yourself in the foot, ruining your own credibility.

  2. - Brownie - Friday, Jun 22, 18 @ 11:36 am:

    Deloittes contract for IES tripled what they bid it and still not work. Heck of a job Raunie!

  3. - WhoKnew - Friday, Jun 22, 18 @ 11:38 am:

    280,000 Backlog.

    That’s what a “Roughly Right” roll out will get you!!

  4. - VanillaMan - Friday, Jun 22, 18 @ 11:43 am:

    He especially reduced Medicaid costs in Quincy, didn’t he?

  5. - Sonny - Friday, Jun 22, 18 @ 11:47 am:

    Those “dang computers” have cost the state $250 million and counting.

  6. - Fixer - Friday, Jun 22, 18 @ 11:52 am:

    Had they bothered listening to front line staff that were testers for IES, they’d have known it wasn’t ready for prime time.

  7. - LTSW - Friday, Jun 22, 18 @ 11:54 am:

    While the new system isn’t helping timewise, the application backlog existed when Rauner took office and has only grown. There’s a backlog because there aren’t enough caseworkers to process all the apps timely. For Medicaid apps the feds will cover 75%, but we can’t seem to hire more staff. Doing timely redeterminations might also get some people off the rolls too.

  8. - BobO - Friday, Jun 22, 18 @ 11:55 am:

    Their new computerized enrollment system has denied people their food stamps and not allowed individuals with intellectual and developmental disabilities to maintain their enrollments for needed residential and day support services. No doubt that the system will show lower Medicaid numbers. Just in time for the November election!

  9. - LTSW - Friday, Jun 22, 18 @ 12:01 pm:

    Rep Harris needs to remember that system vendor was selected and contracted by the Quinn administration. Once development reaches a certain point your cost is cheaper to fix the flaws than start over. Deloitte should never get another state contract.

  10. - Honeybear - Friday, Jun 22, 18 @ 12:25 pm:

    Okay front line view,
    Customer comes in to the local office
    Usually it’s because they went to the pharmacy or the doctor wouldn’t let them schedule.
    Caseworker “your case is closed because you didn’t do your redetermination.
    Customer ” but I did do it and turned it in”
    Caseworker checks EDM (electronic document management)
    (curses under breath)
    “You sure did. Let me process that right now. I apologize for the inconvenience”

    Every day
    Every other customer

    It used to be when a rede or intake got close a supervisor would be on you. “This needs to be done by COB”

    Now nothing. I don’t know if management no longer gets reports. I don’t know if they just have too many.

    All I know is that I’m pulling people out of the ditch they got stuck in all day long.

    And this is serious as sepsis. I had a guy just two hours ago that was actually having a psychotic episode in my office. It got rough and security had to escort him out. He couldn’t get his meds.

    Yes IES is catching fraud and abuse. Yes it is detecting income and closing cases. That’s awesome.

    But it’s also making it hard as heck to process timely, to restore benefits, or to maintain benefits.
    Three hour wait in the lobby
    Every day
    You’ll never get through on the phone
    Not enough caseworkers
    I told you
    We are nearing collapse
    Just wait post Janus
    Who would work for the state?
    Only the loyal
    And Rauner is doing everything
    To drive them away

  11. - Anon - Friday, Jun 22, 18 @ 12:26 pm:

    IES “WAS” a good system. There was poor planning during the proposal writing (prior to Rauner taking office) which left giant holes for the contractor to exploit which drove up cost.

    Caseworkers who can’t do their job for what they are paid is another matter.

  12. - Perrid - Friday, Jun 22, 18 @ 12:37 pm:

    To Harris’ tweet, HFS can account for the majority of the $7 billion, the correct hit would be something like “HFS/Rauner can’t fully account for the full $7 billion given to MCOs”. I think the audit said HFS had encounters for about $5.6 of the $7 billion, and the rest is (probably) due to problems with the encounter record reporting but we don’t know.

  13. - revvedup - Friday, Jun 22, 18 @ 12:59 pm:

    Addenda to Honeybear’s post “from the inside”, only as a Medicaid applicant and recipient:

    5 months for Medicaid approval.
    Duplicate applications allowed, despite Policy Manual and Worker Action Guide saying “not allowed”.
    No way to phone and reach caseworker or name on a Statement of Facts filled out by local office; nobody answers main office number, voicemail not set up, voicemail in previous caseworker’s name,
    caseworker phone list not updated in auto-answering system.
    One Medicaid appeal took 364 days due to repeated Hearing Office errors.
    Local Office Hearings Coordinator admitted during one hearing they can’t train caseworkers properly due to caseload and turnover.

  14. - Me Again - Friday, Jun 22, 18 @ 1:20 pm:

    Speaking from a state programmer perspective, the IES project followed the same formula as other Deloitte-managed projects:

    State MIS managers, who never fully understood the old system, write oversimplified proposals for a new replacement system without any input from the other parts of MIS - programmers, system analysts, policy experts or the system’s users.

    Deloitte gets the job by underbidding, knowing that they can miss deadlines and raise the price later.

    Deloitte software produced is extremely poor. State MIS programmers have done their part of the project on-time and under/budget, but Deloitte programmers are never available for consultation.

    As testing and implementation deadlines are missed, state MIS managers and Deloitte managers blame each other.

    Eventually the (working) old legacy system is shut down and the (defective) new replacement system is brought up. Users/caseworkers and customers/clients start complaining. No one listens to them. Months go by.

    Lather, rinse, repeat.

    Basically in a nutshell, incompetent State MOS management and unscrupulous Deloitte management combine in a perfect storm to create (new) failed systems.

  15. - Subz - Friday, Jun 22, 18 @ 1:27 pm:

    -Me Again- Deloitte programmers are never available because the actual programmers are subcontractors based in Harrisburg, Pennsylvania.

  16. - Me Again - Friday, Jun 22, 18 @ 1:49 pm:

    -Subz- That’s correct. These programmers are mostly non-citizens who are paid very low wages. They don’t know anything about the sustems they are working on. The only people Deloitte make available to us are top-level managers who are unable to answer technical questions. When we do get to see snippets of Deloitte’s coding, it is amateurish - making the most basic of mistakes. Testing is a nightmare, since there is no partner at the other end.

  17. - Annonin - Friday, Jun 22, 18 @ 1:52 pm:

    Didn’t BG4BP cite Medicaid as on his great achievement on the Maze show this week. We think he refers to the managed care which is a fancy wordvf

    For rationing

  18. - Me Again - Friday, Jun 22, 18 @ 2:15 pm:

    Rauner became responsible for IES when he took office in 01/2015.

    Unfortunately he never seemed to take much of an interest in it. He created DoIT a year later to consolidate most State IT shops, but DoIT basically ignored anything but their new software projects. Existing legacy systems and newer projects to upgrade or replace legacy systems were ignored.

    Nevertheless, Rauner owns these failures.

  19. - Langhorne - Friday, Jun 22, 18 @ 2:20 pm:

    Medicaid audit should be the subject of at least 3 hard hitting ads by JB. When Rauner gripes they were faulty, JB can point to the agency comments agreeing to the findings.

  20. - Anon - Friday, Jun 22, 18 @ 2:52 pm:

    As many state workers post on this site all day long with their “expert” opinions, I’m surprised anything gets done. Someone please pay them the raises they deserve so they can get back to work and stop complaining.

  21. - Oswego Willy - Friday, Jun 22, 18 @ 2:55 pm:

    ===As many state workers post on this site all day long with their “expert” opinions…===

    So what are you saying…

    ===I’m surprised anything gets done.===


    ===Someone please pay them the raises they deserve so they can get back to work and stop complaining.===

    … says the person “assuming” so many state workers are here, wasting time, and then… complaining about it.



  22. - I Miss Bentohs - Friday, Jun 22, 18 @ 3:24 pm:

    Could this thought be possible?

    Rauner tells the whopping lie of “we’ve reduced enrollment dramatically and we’ve increased the efficiency” only as a test for the Interim Director? If she backs him, she is in. If she is honest, she is out.

  23. - Me Again - Friday, Jun 22, 18 @ 4:20 pm:

    -Anon- I guess that the concept of “taking a day off” is something you’ve never heard of?

  24. - BIG R. Ph. - Friday, Jun 22, 18 @ 4:22 pm:

    If putting pharmacies and other medical providers out of business due to low or below cost reimbursements is good then he has been successful.
    Making the MCO’s rich should not be the primary purpose of the Medicaid program!

  25. - Arsenal - Friday, Jun 22, 18 @ 4:32 pm:

    In this political moment, bragging about kicking people off of health care may not be all that helpful.

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