Sunday, December 12, 2010

Fiscal Fiasco

Survey Tax: cut to close deficit

If the state continues to minimize the budget crisis by limiting its options to "cut and tax", we are in for a bumpy ride.

There are other ways of addressing the fiscal fiasco. The first, and foremost would be to implement some oversight mechanisms for Medicaid funded programs. In particular, I speak of those social programs that are protected under the Freedom of Information Act. The top of the list would be the state's child welfare system because anything dealing with children's issues are sequestered from public scrutiny.

As these programs function devoid of any accountability, the first instance would be to effectuate financial sanctions and contractual debarment with privatized agencies. Then, as most privatized agencies operate as not-for-profit, they are excluded from external audits. The largest federally funded component of child welfare is not the Social Security Title IV-E, as everyone would like to believe, it is Medicaid: Targeted Case Management.

Secondly, the state needs to decrease its percentage in the federal formula for Medicaid funding. Right now it is at 50%. It seems it is more cost effective for the state to continue sinking money into a dysfunctional child welfare system than come into federal compliance with its operations, such as enforcing existing accountability statutes in dealing with fraud. Even though there is a resounding paranoia of violating the federal settlement agreement, only dealing with a portion of the child welfare system, this is not justification for miserably failing to address waste and abuse by the funding of fraudulent activities.

Thirdly, Michigan needs to finally step up to the plate and start aggressively going after Medicaid fraud in child welfare. If the Attorney General is ever able to release himself from the statutory constraint of only advocating for transgressors of law, the recovery percentage of the federal portions of the fraud would be situated at 10%, bringing back in billions of lost funds from over the past few years.

Simply put, the state cannot prosecute itself. Michigan Federation for Children and Families, accredits the fraudulent activities of these privatized child placing agencies through its lobbying and non-existent continuous quality improvement operations.

Lastly, as Michigan is the only state that does not breakdown its Medicaid spending reports, no one knows how much is streamed through child welfare and adults. This means top heavy local administrations do not have to streamline the operations of child welfare because they are held accountable to nobody, not even the taxpayer. Basically, it's a "don't ask; don't tell" policy in dealing with waste, abuse, and fraud in child welfare.

The answer to this fiscal fiasco is sitting right under the noses of our state leaders, published in the State Auditor General Reports.

If the state will not do anything, then I will.

Beverly Tran

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