Missouri hiring temporary workers for Medicaid assessments

Thursday, September 15, 2011 | 8:05 p.m. CDT

JEFFERSON CITY — The director of the state Department of Health and Senior Services said Thursday that temporary workers were being hired to evaluate the needs of thousands of Missouri Medicaid patients after a contractor hired to do the work dropped out.

Margaret Donnelly, the director of the state health agency, estimated that about 130 temporary workers could be needed to handle the assessments, and 59 have been hired so far. She said an analysis found that it would take 45 days for 130 workers to resolve a backlog of roughly 9,300 cases while also keeping up with new evaluations that come in.

Donnelly said it would cost $8 million to keep all 130 workers for a full year but that it was unknown for how long the employees would remain on the state payroll.

"It's the plan to deal with getting people their services immediately, and everyone who is hired is coming in under an emergency appointment, which makes them a temporary employee," Donnelly said while testifying before a House committee responsible for crafting the agency's budget.

Indiana-based SynCare LLC was hired under a 2010 state law to determine whether Medicaid recipients qualified for home-based health care and help with performing daily activities such as cooking, bathing and getting dressed. The law was intended to save money and avoid potential conflicts of interests in which home-care providers conducted assessments of the care clients needed.

SynCare won a contract worth up to $5.5 million per year to conduct the evaluations. Earlier this month, the company quit after complaints about its service and disagreements with state officials. The concerns have included inordinately long telephone wait times and reductions in the hours of allowable care. Others described being ignored entirely.

Company CEO Stephanie DeKemper has said SynCare fell short but that state officials bear some responsibility because they underestimated the amount of work the firm would perform. The health agency said SynCare knew state officials were about to terminate the contract.

In addition, the St. Louis Post-Dispatch reported Wednesday that a state Health Department official involved in approving the contract for SynCare began working for the company several months later.

The Post-Dispatch reported that documents show Christine Larsen was among four officials who examined 11 companies that bid for the state contract. Larsen, then the chief of the Bureau of Program Integrity, wrote in a January memo that her office agreed with the recommendation to give the contract to SynCare.

The state Health Department said Larsen resigned June 22, and she accepted a position with SynCare. The state agency said in a statement that it notified employees who faced layoffs that there could be an opportunity for employment with SynCare.

Larsen declined to discuss her role in hiring SynCare or her employment with the company, telling the newspaper that she felt uncomfortable doing that.

Jacqueline Lapine, a spokeswoman for the state Department of Health and Senior Services, said in a statement to the Post-Dispatch that cost was the main factor in awarding the contract. Records show SynCare's bid was for $6.8 million. Competitors bid between $9.8 million and $11.4 million.

The Post-Dispatch also reported that Centene Corp. in a financial statement last year disclosed $400,000 in loan guarantees for DeKemper to buy and operate SynCare. DeKemper previously worked for Centene.

Centene said it was not involved in SynCare's bid for the Missouri contract and has not been involved in its management, operations or implementation. The company has contracts to manage Medicaid programs in numerous states. In 2006, it stopped providing Medicaid services in the Missouri and Kansas markets.

During the past five years, Centene and its executives have donated several hundred thousand dollars to the campaigns of Missouri elected officials. Gov. Jay Nixon has received about $85,000, and Lt. Gov. Peter Kinder has gotten about $12,625.


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