PROVIDENCE – A month after the Sept. 13 launch of the Unified Health Infrastructure Project, known as UHIP, the $364 million build out of an integrated eligibility system for health and human services benefits in Rhode Island, agency officials held a briefing on Oct. 7 to review its implementation and try to tamp down concerns raised by the news media around a number of reported glitches, saying that, for the most part, they had been resolved.

The members from Gov. Gina Raimondo’s team conducting the briefing were: Elizabeth Roberts, secretary of the R.I. Executive Office of Health and Human Services, Michael DiBiase, director of the R.I. Department of Administration, and Melba Depeña Affigne, director of the R.I. Department of Human Services.

Among the reported glitches that had been reported resolved were as follows:

• Some people had reported a zero balance in their SNAP accounts or reduced allotments. The officials reported that most of these cases had been resolved promptly, and that just a small number of cased remain outstanding.

• Some child care providers experienced a delay in receiving their payments in the last payments. Officials reported that 98 percent of child care providers had been paid on time. Checks were reported to have been issued to the 18 out of 743 providers that did not receive timely payment because of a processing error.

• Multiple issues with EBT cards were identified after the launch of the new system. Officials reported that, in general, EBT cards had been successfully processed. There were problems with some customers who were unable to access benefits after the launch, but these problems were reported to have been promptly resolved. Further, officials said that EBT cards had been successfully recharged for approximately 94,000 existing customers and more than 3,000 new SNAP recipients had been processed and issued benefits through the new system.

• Many individuals experienced a delay in receiving their state supplemental SSI payments. Officials reported that many customers had experienced a delay in these payments due to processing errors. All of the payments have now been made.

• Customers have also experienced issues getting through on the DHS phone lines, with long wait times. Officials reported that the state is adding more phone lines to expand capacity and working on strategies to more effectively to handle incoming calls.

• Customers have reported long wait times in the lobby of the DHS field offices. Officials reported that this is an ongoing concern, and that they were hopeful that once the system was fully operational, it would reduce the number of people who needed to visit offices in person.

• Incorrect termination dates were displayed in the new system for some Medicaid members. Officials reported that this is an ongoing concern; some 100 out of more than 280,000 Medicaid enrollees were found to have incorrect termination dates. A temporary fix was initiated to ensure that no one is inappropriately terminated from coverage. A long-term fix is underway.

• Finally, some HealthSourceRI accounts were placed in maintenance mode, preventing some customers from making account changes on their customer portal. Officials reported that coverage had not been disrupted.

Fencing with reporters
Questions from the news media led to some cordial yet difficult exchanges, as reporters attempted to share what customers had been telling them, which sometimes differed from what the officials were saying.

Some of the information gleaned from the give-and-take:

Both Roberts and DiBiase expressed confidence in the working relationship with Deloitte, the major vendor for UHIP. They said they did not know if any part of the contract had been outsourced to India. Further, while DiBiase confirmed that there were contract provisions that called for potential financial penalties for poor performance, there had never been a situation those clauses had been invoked causing money to be paid back to the state.

“Obviously, there is a give-and-take in any of these contractual relationships. We have a couple of years’ experience in doing work with Deloitte,” DiBiase said.

At a briefing on Aug. 26, DiBiase had announced that some 70 layoffs were planned. [See link to ConvergenceRI story below.] However, DiBiase updated that information at the Oct. 7 briefing, saying that first official layoff notices will be sent out on Oct. 16, but he expected many of those affected to find other jobs within state government.

Both Roberts and DiBiase said that the projected cost savings derived from implementation of the new software system, some $15 million in FY 2017 and $40 million in FY 2018, were still on track, to be generated by decreases in waste and fraud and greater efficiencies in business systems practices, according to Department of Administration officials.

After fencing a bit with Ted Nesi from WPRI, Roberts admitted that the Centers for Medicare and Medicaid Services had expressed “concern” about glitches with the implementation, saying that she had spoken with the CMS regional office a few days ago.

“They read the newspapers; they want to hear directly from us about how things are going,” Roberts said. “They’re concerned, as we are.”

Editor's note: Turns out there were more than just concerns voiced; there were two letters from the feds who administer the SNAP benefits program, warning DHS not to move forward with the Sept. 13 implementation because of flaws; excellent reporting by WPRI revealed the letters' existence on Oct. 11. The letters warned that federal funding could be at risk. Three big questions: if there are financial penalties assessed by the feds, will Deloitte be held responsible? And, was Gov. Gina Raimondo aware of the letters? Further, did the Governor push for the roll out on Sept. 13, despite the warnings?

Reassurance
The tone taken by the officials at the briefing was one of reassurance – that the implementation of the system was working well, for the most part, for the 318,000 Rhode Islanders being served, and that, by the numbers, some 400 million fields of data had been converted from the legacy system.

A fact sheet was handed out, citing additional metrics achieved during the first month of operation. But, as reporter Alisha Pina from The Providence Journal asked, what was the message that should be given to the person who had waited for five hours in person at the office, only to return the next day and was unable to access his account online at the district office?

The next day, sitting down to write this story, ConvergenceRI tried to put into words the disconnect between the questions the reporters had been asking, based on complaints from customers who were frustrated in their interactions with the new system, and the answers that had been given by the officials in response.

Then he remembered: in 1992, while leading a communications workshop for members of the legal services staff in New Bedford, he had asked all the participants to draw a picture of how they saw themselves and their work at the legal services office, without using words.

All of the participants in the workshop drew pictures of long lines of people waiting in line to get services, with none ever appearing to leave. Save for one, a paralegal, who lived in the community, who drew of picture of her home and the people in her neighborhood, asking for help, but they were too far away and no one could hear what they were saying.

If the state officials had to stand in line for hours, without being seen, in an effort to get their paychecks or their health benefits, or couldn’t get through on the phone, or found out that they couldn’t access their online portal, would that change the equation?

There is something very humbling about having to confront a bureaucracy that doesn’t seem to work for you when you are in need.