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The Indiana Toll Road is a bold reminder of the state’s privatization push.
Not so with the privatization and so-called modernization of Indiana’s welfare system. The people who depend on it are often the least visible in society: nursing home residents, homebound seniors and people with disabilities and mental illness.
And unlike the $3.8 billion Toll Road pay-off, the yield from the contract to privatize the eligibility system for Medicaid, food stamps and other welfare benefits has to come from wrenching efficiencies out of that system. Sadly, those efficiencies appear to be coming at the expense of the people who need the benefits.
Advocates for a coalition of senior groups traveled the state last week to bring attention to a “broken” welfare eligibility system, and they called on both state and federal lawmakers to exercise more control over a contract that dictates services for Indiana’s most needy in the midst of an economic crisis. Given the reluctance of the Daniels administration to address the complaints, lawmakers should step in.
In 2007, Indiana’s Family and Social Services Administration signed a $1.16 billion contract with IBM Corp. and Affiliated Computer Services to implement a call system and Web program for welfare applicants. Previously, applicants had to visit a county welfare office, where they were assigned a caseworker to handle their application process.
Complaints surfaced soon after the program was implemented in 12 pilot counties in east central Indiana. Critics charge that the system is difficult for applicants to traverse – telephone appointments made by the contractor are not kept, paperwork is lost, and there is no consistency from one contact to another.
The program was rolled out in nine northeast Indiana counties in May. Sen. Robert Meeks, R-LaGrange, said he hasn’t received complaints from constituents, but he acknowledged that he heard plenty when he attended a Medicaid oversight panel hearing in Kokomo in August.
“The main thing I’m getting is the complexity of trying to get qualified and the hoops you have to jump through,” Meeks said Friday.
He said that he sent 15 to 20 pointed questions to the FSSA director, Mitch Roob, and that he expects to have them answered at the next hearing Oct. 22.
“Most of my questions have to do with the magnitude of the application. It now takes pretty close to 20 pages to get through this, and it’s not just a yes or no answer. … When you want to reduce the cost of services, you can make it so complex that people just finally give up. I don’t think the state is doing that – I think it’s the contractor.”
FSSA officials have insisted the system is better today than it was under the previous administration. State officials point to case error rate figures to back up their claims.
But advocates charge that FSSA created the case error rate calculation to bolster its own claims. In fact, the USDA’s Food and Nutrition Service awarded Indiana incentive payments averaging $12 million a year between 2002 and 2004, reducing the payment error rates and holding them below the national average. Indiana did not receive an incentive award for the last fiscal year.
Medicaid enrollment in the initial rollout counties showed a decrease of more than 4 percent between January and May, while the counties where the service had not yet been automated increased enrollment by almost 3 percent. The pilot area included Muncie and Anderson – both hard-hit by manufacturing losses.
Those numbers alone offer compelling evidence that something is seriously wrong with the new system. It’s time for lawmakers to step in.
