CMS Expects Report on Money Follows the Person

That report, which was due September 14, will show how the federal funds have been re-invested to expand long-term care services
The Lund Report
October 27, 2010 -- While a multi-level investigation is still under way by the Oregon Department of Justice into the Money Follows the Person program, James Toews acknowledged that his staff is in the process of compiling financial information to submit to the federal government.  
“We hope to send it within the next few weeks and detail all funding categories,” said Toews, assistant director of the Seniors and People with Disabilities Division. The report was delayed because “we’ve had to rework the numbers and had to go back and check all the expenses and go through the accounting and contracting records to make sure they were the right numbers.”
This report, which was due on September 14, is expected to show all paid expenditures since the program’s inception in April 2008. The Centers for Medicare and Medicaid Services has a requirement calling upon states that receive such funding to reinvest those dollars into initiatives that expand the capacity of long-term care services.
By mid-September, close to $1 million ($904,607) was said to have been re-invested. “It’s not the same as savings, but the difference between the enhanced federal match and what would otherwise would have been spent had we not had the grant to expand the community system,” Toews said.
Despite concerns that the division might have “cooked the books,” and spent the money to rebalance the Department of Human Services budget, Toews insisted that’s not the case. “These dollars haven’t been spent on other programs. It’s all been spent on the Money Follows the Person program.”
At the same time, an investigation by the Department of Justice is looking into allegations that some of these dollars might have been misappropriated. If that did happen, “we can always go back later if we find out that the numbers are wrong or weren’t expended correctly,” Toews said.
This is the first time CMS has required such a detailed report. Since 2008, Oregon has drawn down $14.9 million in federal Medicaid funds and spent $5.5 million from the state’s general fund on Money Follows the Person, which has moved 278 seniors and people with disabilities out of nursing homes into community-bases settings.
Currently the state has $40.7 million in federal funds available, and there have been 31.25 positions funded by the grant; seven in the administration office; the remainder in the field.
Until late August the program was run by Julia Huddleston who designed and implemented the program before resigning. Earlier she had worked with a budget analyst who told her there had been “no re-investment dollars set aside.”
Several errors had also been made “by the budget department in reconciling the program’s budget and accounting for grant funds in other ways,” according to a letter she sent Toews on September 23. In mid-August that budget analyst had been reassigned while the report remained unfinished, she wrote.
When asked to respond to Huddleston’s concerns about these budgetary problems, Toews declined to answer, citing the ongoing investigation.
Senator Jackie Winters (R-Salem), is also eager to get a copy of the report being sent to CMS. “We need to know what’s happened to these resources, and the status of the report,” she told The Lund Report.
Meanwhile, Huddleston told Toews she had voluntarily resigned because “I no longer had faith in the leadership of the agency,” adding, “since then I am being made the scapegoat for DHS’ sloppy budget practices and disorganized leadership. I have not been charged with any wrongdoing, informed of any grounds to investigate the program or my conduct, or asked to participate in any investigation.”
Huddleston also wrote, “Over the past three years the program has grown and thrived under my leadership. My decision to leave the program had nothing to do with the program itself, but rather resulted from my frustration with the way in which SPD (Seniors and People with Disabilities) is managed.”
Since writing the letter, Huddleston hasn’t been contacted by Toews or anyone from the Department of Justice about its ongoing investigation. “Come on, what are we investigating?” she asked. “How long does an investigation go on?”

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This program has been a complete boondoggle from inception and resulted in many bad outcomes (including deaths) for people duped into participating. Someone at DHS needs to be held accountable for the lack of transparency, harm to vulnerable people and creative math occurring. Where is the governor's office? Where is the legislative oversight?