Last Thursday’s hearing of the Senate’s Health and Human Services committees elicited important testimony, although it’s impossible to picture it having been pleasing. Michelle Benson is taking a trust-but-verify attitude towards Health and Human Services:

“For the most part, Commissioner Harpstead said all the right things in yesterday’s hearing,” said Sen. Michelle Benson (R-Ham Lake), chair of the Senate Health and Human Services Finance and Policy Committee. “Acknowledging they made errors and need to clean up their processes is an important step. One issue on which I will continue to demand a straightforward answer, however, is what will happen when the federal government asks Minnesota to return the $29 million in overpayments. Will DHS attempt to bury it in a forecast adjustment? Or will they be open and upfront? If it’s the former, I will have serious problems. I will be watching carefully to make sure they follow through on their promises and their accounting for these illegal payments is transparent.”

Sen. Benson didn’t pull punches:

Yesterday, Benson indicated major cultural changes need to happen at DHS. “If you want to know how much bureaucracy and unaccountability costs state government, look no further than DHS,” she said. “Several levels of management were either too incompetent or too indifferent to check for and identify obviously erroneous payments.” The OLA report yesterday indicated that no one in DHS has taken responsibility for the overpayments, and there is no documentation to determine who made the decision for the higher payment structure to the tribes. “There are six managers between the Opioid Treatment Authority Representative and the Commissioner,” Benson continued. “All of them failed—miserably. If none of them are going to take responsibility, none of them should keep their jobs.”

This is what happens when the people don’t care because it isn’t their money. It’s either corruption or incompetence or both. How do 6 managers not catch this simple mistake? This isn’t just about restructuring of DHS. It’s about getting rid of these potentially incompetent, corrupt employees. You’ll be shocked at Jim Nobles’ statement 4:20 into this video:

The standard payment for these opioid addiction programs is $455 when the patient visits the clinic and receives a dose of whatever medication they’re taking. According to Mr. Nobles’ testimony, there isn’t supposed to be a payment if the medication is self-administered at home. Mr. Nobles said that $455 was paid to the White Earth and Leech Lake tribes when patients self-administered their medication.

When the patient visits the clinic, then gets a dose of medication, that’s called the “encounter rate.” DHS kept paying the White Earth and Leech Lake tribes the encounter rate even when the patient self-administered. It isn’t surprising that these tribes refused to answer Mr. Nobles’ auditors’ questions when they did their audit. Further, DHS employees wouldn’t cooperate either.

The tribes have issued a statement saying that they won’t pay back any of the money because it wasn’t their fault. Knowingly accepting money that isn’t due to the tribes is certainly their fault. That being said, there’s no doubt that DHS is at fault, too. They’re the ones who made the allegedly unjustified payments. Nobles testified that “In fact, the tribes were told by officials at the Department of Human Services that they could receive those payments. That was direction and guidance that the Department gave.”

There’s no question that the tribes received a ton of money from this federal program. What isn’t known is who authorized the improper payments. If nobody at DHS admits who authorized the improper payments, that entire group of managers should get terminated. They didn’t have the statutory authority to approve those payments. If there wasn’t a clinic visit, there shouldn’t have been a payment. That isn’t difficult to figure out.

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