Monday, February 28, 2005

More Meltdown in Colorado Aftermath





To follow up on my previous posts about the meltdown of the welfare system in Colorado, there is news today of how this is impacting pre-natal care in the state.

Most people do not understand the real nature of government assistance to the poor and lower middle class. People tend to assume that the benefits are a lot higher, and that more people get cash. Medicaid is often not thought about at all, but the reality is that to most of the people I deal with, the Medicaid is the most important assistance that they receive. And in many cases, Medicaid is the only assistance that people receive. For pregnant women, this is a very big deal.

Today the Rocky Mountain News reports:

"More Colorado mothers are getting little or no prenatal care, and it's beginning to show with more unhealthy babies, a hospital manager says.

"We're seeing more women show up in labor having no prenatal care," said Barbara Hughes, director of the Exempla St. Joseph Medical Center's midwife program.

Hughes blames a change in state policy last year that no longer allows counties or doctors to "presume eligibility" for Medicaid for a pregnant woman who seems to have very little money.


And here's the kicker:

She also blames the state's new $200 million Colorado Benefits Management System, which is supposed to determine eligibility for welfare payments, but has been beset by problems.

If a pregnant woman applies for Medicaid, but then has to wait three or four months to be approved, she loses out on most of the crucial prenatal care, say health officials who want presumptive eligibility restored.


A specific example of how bureaucratic stupidity effected a real person is cited by the story:

...one pregnant mother who applied for Medicaid last August, just before the change in presumptive eligibility. "She decided to wait for her Medicaid application to go through," Hughes said. "It took five months. She missed all her prenatal visits over that time." She finally showed up at St. Joseph, about 10 days before her baby's due date. "The baby was already dead," Hughes said. "It's so tragic."

The fact that the case was not certified in 15 days is due to the change in presumptive eligibility. The fact that the case was not certified in at least 30 days is due to this disaster of a computer system that was pushed through before it was ready, with no plan to deal with the possibility of it being a total flop, as has turned out to be the case. 5 months is an unheard of length of time to wait for an application for pregnancy Medicaid.

Again, Texans should be taking note, because there is good reason to believe that a meltdown is in the works here in the not too distant future.

Update: Today was the original Court-Ordered deadline for the state of Colorado to clean up at least 40% of it's backlog. Not suprisingly, they didn't meet the deadline. Here is the lattest from the Associated Press:

A new report says that nearly a thousand calls for urgent state welfare or Medicaid benefits remain unresolved following problems with Colorado's new computer system.

The computer system has been blamed for causing a backlog of nearly 30,000 people waiting to find out if they can receive benefits. District Judge John Coughlin ordered the state to reduce its backlog by 40 percent and open a phone bank to help people with emergencies within five days.

Coughlin originally set a deadline of today for the state to reduce its backlog and provide proof. He has agreed to give the state until March seventh to provide its report.

Rhonda Bentz is a spokeswoman for the Department of Health Care Policy and Financing. She says some cases have taken a while to resolve because the state has to track down information with the applicant or with the county where they live.


That last line is just an excuse. This information always has to be tracked down. That is the job of determining eligibility for the programs in question. The reason for the backlog, and the reason why they can't catch up is that they made a series of bad decisions that resulted in an implosion of the system, and now they have to try to fix a badly damaged ship while still at sea (because you can't just tell the poor that you get back with them in a year, after you sort all this through).