Report says Idaho welfare errors widespread

BOISE – State auditors have uncovered more serious errors and inefficiencies at the Idaho Department of Health and Welfare, according to a new report highlighting a loss of millions of dollars.

The errors and oversights noted in the 20-page summary include the department’s failure to monitor a private contractor’s recovery of Medicaid dollars, failure to process Medicaid applications in a timely manner and enrolling hundreds of ineligible children to the state’s Children’s Health Insurance Plan.

The report released Thursday covers the period from July 1, 2003, to June 30, 2004, and lists nine major new areas of concern. It also references problems from the previous year, when an audit discovered a 15 percent error rate in determining food stamp eligibility. That problem still exists, the new report said.

The health insurance plan is a program intended to provide health insurance for children who live in families where the household income is between 100 percent and 150 percent of the poverty level. To qualify, a family must also have less than $5,000 in other assets and no other private insurance.

Legislative auditors sampled 30 Idaho cases. Of those, 10 turned out to be ineligible for the benefits; either because the family made too much money or already had insurance. Extrapolating from that, the audit determined that as many as a third — hundreds — of enrolled children could be ineligible.

Don Berg, managing auditor with the Legislative Services Office, said the auditors did not seek information outside of the case files to find the errors.

“We just looked at the same data that the caseworker collected,” Berg said. “In some of the more blatant ones, the people said right on their application that they did have insurance. The box was checked `yes.”’

The health insurance plan problem alone likely cost the state $1 million and the federal government $4 million in fiscal 2004, Berg estimated, and the errors and omissions throughout the entire report added up to between $20 million and $30 million in lost taxpayer money.

Tom Shanahan, spokesman for the Department of Health and Welfare, said Director Karl Kurtz believes the agency must fix the repeated and expensive errors.

“We know we have a problem,” Shanahan said. “We’ve started developing quality assurance teams to look at where we’re making common mistakes, and paying particular attention to them.”

Gov. Dirk Kempthorne was traveling in Asia on a trade mission this week, and his staff was not available for comment late Thursday.

But Berg said it should serve as a wake-up call; not only to the department but also to lawmakers, who have refused to provide the dollars necessary to upgrade the department’s Reagan-era computer system and add the staff necessary to manage higher case loads.

State Sen. Dick Compton, R-Coeur d’Alene, is chairman of the Senate Health and Welfare Committee, which is responsible for setting department policy.

“This is serious stuff and we (the Legislature) need to look at it closely,” Compton said. “If it’s lack of funding and staff, then we need to fix that. If it’s a management problem, then we need to fix that.”

Berg refused to lay the blame on any single doorstep, but he said the common thread throughout the Health and Welfare Department’s problems has been its reliance on a computer system that was designed in the early 1980s.

“I don’t know how you manage this thing,” he said. “If it were a business, it would just say, `Let’s invest in a new system and it will pay for itself six years down the road.’ But in government, the question is always, `how much does it cost this year?”’

The full Health and Welfare Department annual budget amounts to more than $1.5 billion, including federal and state dollars.

The audit will be formally presented to the Legislature’s budget committee when it meets June 15 in Pocatello.