Computer glitch hurting DHHS clients

AUGUSTA – As the chief executive officer of a company that provides services for the mentally ill and mentally retarded, Bonnie Brooks is used to responding to difficult questions.

Lately, she’s been running out of answers when clients and other service providers ask her when the state is going to pay its share of health care costs.

Speaking to State House reporters Wednesday, Brooks, the executive director of the Bangor-based firm OHI, explained how a month-long problem with a new computer program at the state Department of Health and Human Services was making life miserable for her clients.

Mandated by the federal government, the software program manages $31 million in claims filed under the MaineCare system each week. MaineCare, as the federal and state Medicaid health care program for low-income Americans is called here, covers a broad array of services including medical treatment, mental health services and social support interventions.

As of Monday, the snarl at the department had produced a $50 million backlog in payments to providers, many of whom are now seeking bridge loans or second mortgages to stay in the black until the state’s past due payments are received.

Brooks, who also represents the Maine Association of Community Service Providers, said she recently met with health care providers from Cherryfield, Machias and other Down East communities who have no idea how they will make ends meet while the state tries to figure out what’s making its computer system go haywire.

“They are desperate. They don’t know how they are going to do their food shopping this week, and they don’t know how they’re going to pay the rent,” she said. “As of Monday, those few small providers I met with were owed $1.9 million.”

Rep. Arthur Lerman is an Augusta Democrat who works in the health care service provider industry when the Legislature is not in session. He organized Tuesday’s afternoon press conference to inform Maine residents about the DHHS computer problem and to crank up the heat on the department which maintains it has been trying to resolve the issue for the past month.

“Unfortunately, it is true that the squeaky wheel gets the attention,” Lerman said. “The last couple of days I have been having more direct conversations with the (Baldacci) administration, and I have noticed a shift in the amount of attention being placed on this matter (at DHHS).”

Lerman said the software problems at Maine’s largest state agency have created a “nightmarish financial crisis” for nearly 7,000 health care providers. Since the new system went online, Lerman said payments to providers have been significantly delayed, mistakenly suspended or rejected without notice.

“Providers have received little reliable information as to when the money will arrive,” Lerman said. “The payments continue to be sporadic at best, and often incomplete.”

While all of the providers have struggled to cope with cash flow problems resulting from the computer glitch, Lerman said there have been more extreme consequences for a couple of smaller health care service companies. In those instances, he said employees were laid off, and, in one case, a firm simply closed its doors when it couldn’t meet its payroll.

“Providers who serve MaineCare patients exclusively are feeling the most pain with virtually no money coming in,” he said.

Lerman, Brooks and others suspect DHHS moved too quickly during the new software’s implementation phase without performing adequate tests to ensure its proper operation.

Jack Nicholas, commissioner of DHHS, told the Legislature’s Appropriations Committee on Wednesday that interim payments were being made to providers and problems have been identified with the program’s software vendor.

“I think that we’re beginning to get ahead on correcting a lot of these,” Nicholas said. “I promised the committee that, by the end of this week, we’ll have a plan that will identify the amount of resources we’ve employed, where we think there are problems, how they’ve been fixed and what our plan of action will be going forward to make the system fully operational.”

That information can’t come soon enough for Bonnie Brooks.

“I’m having a very tough time when people with disabilities walk through the door of my office and tell me they’ve heard things or from parents who are calling me on the phone to ask what is going on?” she said. “They want to know when we are going to get money and if their son or daughter is going to have a home. I’m not able to answer these questions. As the CEO of my organization, I have not been given an answer about why we aren’t receiving money or when we’re going to.”