A legislative committee on Tuesday approved a 10-month extension of a company's contract to assess the needs of disabled Arkansans despite several lawmakers' complaints about the number of people who have been disqualified from assistance as a result of the company's work.
Under a motion by Senate President Pro Tempore Jim Hendren, the Legislative Council's Review Subcommittee's approval was conditioned on receiving monthly reports from the Department of Human Services on the steps that have been taken to improve the assessments.
Lawmakers will then decide within the next few months whether they want the department to re-bid the contract, a process department officials said would take about eight months.
"I think we all share the same concern that this needs to be fixed," Hendren, R-Sulphur Springs, said.
The contract extension calls for the department to pay Optum Government Solutions, a division of United Health Group in Minnesota, up to about $16.4 million through June 30 to continue assessing the eligibility of mentally ill, elderly or disabled Arkansans for Medicaid benefits.
The Human Services Department hired the company in 2017 to perform the assessments using a tool, based on one developed in Minnesota, that involves asking recipients hundreds of questions about their care needs.
The assessments started in January for two Medicaid programs. One is the assisted-living program, which serves up to 1,200 people in about 60 facilities around the state.
The other is ARChoices, which provides in-home care, including help with daily living tasks such as dressing and bathing, to about 8,800 Arkansans.
At the Review Subcommittee meeting Tuesday, lawmakers said they've been inundated with calls about elderly Arkansans who have been told they no longer qualify for help because of the assessments.
In some cases, recipients have been told their benefits have been canceled because the assessor was unable to reach them by phone, lawmakers said. They said other recipients have scheduled appointments with assessors who never showed up.
"We're dealing with a population here -- mostly elderly, fragile -- that when you shake their world up, their health can go down tremendously," Sen. Terry Rice, R-Waldron, said.
Many elderly people, when being quizzed by the Optum nurses who perform the assessments, might minimize the amount of help they need with daily living tasks, he added.
"This is from a generation of people that are proud, independent, that worked their lives to be self-sufficient," Rice said.
Previously, Human Services Department nurses performed assessments for the two programs using a different tool, known as ArPath.
Of the 331 people who had been assessed by Optum through May 30 for eligibility for the assisted-living program this year, 146, or 44%, were found to be ineligible, Mark White, deputy director of the department's Aging, Adult & Behavioral Health Services Division, has said.
Those found to be ineligible included 78, or 47%, of the 165 residents who had previously been found eligible after assessments using ArPath, and 41% of 166 new applicants who were assessed.
Similarly, 951, or 31%, of the 3,047 Arkansans assessed for eligibility for ARChoices were found to be ineligible.
That included 27% of those who had been previously found to be eligible and 37% of new applicants.
In June, the Human Services Department announced that it would review all the assessments that have resulted in a Medicaid recipient being disqualified for services.
The next month, the House and Senate committees that deal with issues affecting the aging population voted to conduct their own review of the Optum contract.
Rep. Charlene Fite, R-Van Buren and chairwoman of the House Committee on Aging, Youth, Legislative and Military Affairs, said she later learned that it would be difficult to schedule a meeting before Tuesday, so she encouraged members to go to the Review subcommittee meeting to voice their concerns.
Department officials said Tuesday that they've been making changes to the assessment tool and have encouraged Optum nurses to consider their own observations and information from recipients' family members in rating the recipients' needs.
In a July 29 letter, the department told Optum it would assess a penalty of more than $200,000 for the company's failure to meet deadlines for completing the assessments.
The company responded with a letter last week asking the department to reconsider the penalty, saying in part that changes made by the agency have increased the amount of time needed to complete an assessment from about an hour to an hour and a half or more.
"I would have liked to have seen Optum fired now, but I think this is second-best," Fite said after the meeting. "There are a lot of eyes on it now, and I think they'll do better assessments."
Metro on 08/22/2019