State Attendant Care Program
Written by Annette Tucker
Thursday, 26 January 2012
Topeka/Parsons, Ks (Dave Ranney/KHI News Service-KLKC) – On Monday, the Kansas Senate Ways & Means Committee conducted a hearing on a new electronic verification system implemented by the Kansas Department of Social and Rehabilitation Services.
According to a report written by Dave Ranney with the KHI News Service, the program was intended to track the working hours of those providing in-home services to the disabled and frail elderly. Committee member Senator Vicki Schmidt of Topeka said the new system has been fraught with administrative errors and false starts. A spokesperson for the Kansas Department on Aging, Sara Arif, attended the hearing, but Schmidt noted the SRS should have been represented by Pedro Moreno, deputy secretary in charge of disability and behavioral health services.
It was learned Tuesday that Moreno had resigned and planned to return to Florida. Moreno was involved with implementing the electronic tracking system designed to prevent attendant care workers from billing the state’s Medicaid program for services they did not provide. Arif told the committee the agencies have had to “resolve a bunch of issues” since September when a contractor, First Data, began installing the system which was scheduled to go on line January 16th a holiday recognized by the state as Dr. Martin Luther King Day.
Organizations like the SKIL Resource Center, based in Parsons serve as fiscal agents and provide payroll services for Personal Care Attendants. During the first week of January, all plans of care created for those needing services had to be re-written for whole hour schedules because it was learned the program did not recognize decimals.
SKIL CEO Shari Coatney noted the agency represents about 2-thousand PCAs statewide. The new system was supposed to eliminate paper time sheets that were signed by the customer. Now PCAs can use a cell phone to call an 800-number when they begin and end their duties. However, lines are often busy. 15-minute delays have been reported in the process of logging in and out. Coatney said going over the PCA’s time allotment can result in the denial of payment. Not all of the bugs have been worked out of the electronic system which is also supposed to begin handling Physical Disability and Head Injury waiver programs starting February 1st.
An earlier change that was implemented in November caused providers to get paid less for their Financial Management Services. The new electronic verification system has made this work take about ten times longer to process. That means more work and less compensation. These changes also resulted in many direct service workers getting paid less in many cases. The average worker gets $8.98 an hour, regardless of seniority or job duties which could range from dusting to changing a colostomy bag. According to Coatney, fiscal agents were not asked to participate in developing the program, but the state is now asking agencies about their concerns.
Coatney was in Topeka Tuesday and listened to testimony of Deputy Attorney General Loren Snell who appeared before the House Social Services Budget Committee. Dave Ranney with the KHI News Service reports that the head of the AG’s Medicaid fraud unit told legislators it was easy to cheat programs that provide in-home services for the disabled and the frail elderly. Snell said “What we have is a program that relies on honesty, but we don’t live in a society that’s always honest.”
According to Snell, his office has about 60 active cases, most of which involved case managers or attendant care workers who had figured out how to bill the state’s Medicaid program for services that weren’t provided. He expressed doubt that a recently installed electronic verification system will do much to deter fraud. The committee’s chairman, Rep. David Crum of Augusta, said he thought that a 2011 audit that tied the Center for Independent Living in Southwest Kansas to more than $790,000 in undocumented Medicaid billings was just the “tip of the iceberg.”
The center abruptly went out of business in March. Its operations remain under investigation. Late last year, Snell’s office charged nine people – a mix of attendant-care workers and physically disabled adults – in southeast Kansas with knowingly billing Medicaid for services that weren’t provided. All nine used Southeast Kansas Independent Living (SKIL) center as their payroll agent. Their cases are pending. Coatney was quoted as saying “What wasn’t mentioned was the fact that (SKIL) … discovered the fraud and abuse and … reported it.” She noted “(SKIL has) been working with the Attorney General’s Office on this for two years now.” Coatney also said “(She) know(s) how much time and effort (SKIL has) spent looking for (fraud) and can honestly say it’s less than 1 percent. It’s not as widespread as what was heard (Tuesday).” Coatney later commented that it’s the job of providers to protect the integrity of programs.