Deal Flow

What actually happened with UHIP still remains a puzzle

Despite a new team in place to manage the delivery of health and human services, problems persist, and getting answers to what happened is still proving to be a difficult task

Photo by Richard Asinof

Rep. Patricia Serpa, left, chair of the House Committee on Oversight, questions Eric Beane, far right, the secretary of the R.I. Executive Office of Health and Human Services, at a hearing on June 21.

By Richard Asinof
Posted 6/26/17
The appetite for pursuing what went wrong with the roll out with the Unified Health Infrastructure Project appears to be diminishing, now that a new team is in place to manage the more than $400 million boondoggle. But the problems, while alleviated, have not gone away – there continue to be long waiting lines for customers going to DHS offices in person, and hours spent by customers on the phone on hold, waiting to talk to someone. The removal of Rep. Michael Chippendale from the House Committee on Oversight diminishes the capability of the committee to pursue questions around computer issues. However, Rep. Jason Knight is still attempting to hold the state’s feet to the fire to determine what actually happened.
Will the success of a federal whistle blower lawsuit against eClinicalWorks for failure to deliver on its promises for its software product prompt someone in Rhode Island to pursue a similar whistle blower lawsuit against Deloitte? What other kinds of potential conflicts of interest existed between the principals managing the UHIP rollout? What will happen if the proposed federal budget under President Trump is enacted, along with the current Senate version of Trumpcare to repeal and replace Obamacare, in terms of lost federal spending related to Medicaid and with fixing UHIP?
While much of the reporting on the passage of the FY 2018 budget has focused on the success of House Speaker Nicholas Mattiello in pushing through his agenda without new taxes, the more than $100 million gap in revenue was made up by what are known as “scoops,” taking revenue from quasi-public sources to plug into the general revenue stream.
As reported by Eli Sherman in the Providence Business News, those scoops included: a $12.5 million transfer from the ratepayer-funded System Reliability and Energy Efficiency and Conservation Procurement program; $6 million from the R.I. Health and Educational Building Corp.; $5 million from the Narragansett Bay Commission, $3.5 million from the R.I. Infrastructure Bank, $1 million from the Quonset Development Corp. and $1 million from R.I. Housing. There were also significant cuts made to the R.I. Department of Health budget.
At the same time that the House approved budget cuts in money for housing, protecting Narragansett Bay, protecting public health, and lead poisoning prevention efforts, lobbyists had a much more successful session advocating for clients: more than $9 million in cuts were restored to the Neighborhood Health Plan of Rhode Island; and Lifespan received a $4 million boost for its Graduate Medical Education programs.

PROVIDENCE – Call it a last skirmish during the current R.I. General Assembly session in the conflict over the rollout of the controversial Unified Health Infrastructure Project, or UHIP, the more than $400 million boondoggle that launched on Sept. 13, 2016.

When the House Committee on Oversight met late into the evening on June 21, what happened during the more than two hour hearing was clearly overshadowed by the intense political foreplay in budget maneuvers, which culminated a day later when the R.I. House of Representatives approved a $9.2 billion state budget on June 22, following a five-hour debate, in a 64-11 vote.

There were, however, a number of things that occurred during the Oversight hearing worthy of reporting:

A whole new management team is now in place under Gov. Gina Raimondo: Eric Beane is now the secretary of the R.I. Executive Office of Health and Human Services, replacing interim director Anya Rader Wallack, who in turn had replaced Elizabeth Roberts when she resigned; Courtney Hawkins is now the director of the R.I. Department of Human Services, having replaced Melba Depena Affigne, who was fired; and Patrick Tigue is now the director of the R.I. Medicaid Office.

Beane, Hawkins and Zack Shermam the director of HealthSourceRI, testified. In addition, Beane presented committee members with the latest report on what was termed “UHIP Turn Around Effort,” which included a monthly performance metrics dashboard.

Beane, in an understatement, said that it had been a “challenging” year.

The current backlog in the number of pending cases is now 7,503, according to Beane. But whether the decline has been due to greater efficiencies by the new management team or the discouragement of people seeking benefits deterred by long wait times was not quantified by the dashboard. The average lobby wait time in May was more than an hour and 20 minutes, according to the dashboard.

There are plans underway to hire some 40 new Department of Human Services staff to assist with the call center, according to Hawkins. Sherman acknowledged that there were often long wait times – longer than two hours – for people who phone the call center to access HealthSource RI.

Beane shared that there were continuing efforts to upgrade the Deloitte software system, including 374 upgrades made on June 3, including 249 code fixes and 125 data fixes. Those computer upgrades will continue until the fall, when the open enrollment for health insurance begins on Nov. 1.

In the past, the details of Beane’s testimony might have been pursued further by Rep. Michael Chippendale, who has a business expertise in coding and computer systems.

But Chippendale had been replaced on the committee by Rep. Bobby Nardolillo, a Republican candidate for the U.S. Senate, at the direction of Rep. Patricia Morgan, the House Minority leader.

“I was removed from Oversight without consent and without notification,” Chippendale told RIPR reporter Ian Donnis. “I feel that I have brought a lot of good knowledge and insight to the Oversight Committee and am unsure why I would have been removed.”

In his maiden voyage as a committee member, Nardollilo was mostly quiet, save for congratulating Beane and Hawkins on their new positions. After the hearing, Nardollilo was observed walking down the first floor corridor at the State House, armed with five cookies in one hand, part of the free food offered to committee members. Just desserts?

Committee Chair Patricia Serpa spent much of her time returning to questions about the $100 million spent on outside consultants, as identified in a report by Auditor General Dennis Hoyle in his May 2017 report.

Serpa criticized the reliance on outside consultants, calling the responses to date by Beane and his team “a lot of gobbledygook,” including a handout that listed the 13 active consulting contracts.

Rep. Lauren Carson pointed out that the updated handout did not identify which contracts were open to re-bidding and renewal, important details that had been omitted.

Serpa also wanted a more detailed analysis breaking down which firms were from Rhode Island that had received the $100 million. Further, Serpa wanted to know why the state was not investing in developing its own competent workforce, rather than relying on out-of-state contractors.

Serpa promised to hold a July meeting to hear further details from Beane and his team about the contractors.

Rep. Jason Knight displayed his legal skills as a former state prosecutor with the R.I. Department of Attorney General, honing in on the missing pieces of evidence about the chain of decision-making involved in the launch of the botched UHIP rollout.

In particular, Knight asked Beane to produce a missing letter that had been identified in a series of communications between the state and federal authorities. Beane promised that he would look for it.

The bottom line
The pursuit of what happened with UHIP, being actively rebranded as RI Bridges, is no longer front-and-center in the public eye, despite the continued, persistent reporting by WPRI’s Susan Campbell and dialogue from WPRO's Tara Granahan.

It doesn’t mean that the wait lines have diminished, or that the backlogs no longer exist: many of Rhode Island’s most vulnerable residents still have to endure demeaning barriers to gain access to benefits.

There are still the enormous headaches of reconciliation awaiting the recipients of interim payments for long-care services under Medicaid, nursing homes and assisted care facilities, which will need to be done sometime before 2018.

And, except for Knight, there appears to be no willingness to pursue alleged improprieties and potential conflicts of interest that occurred under Elizabeth Roberts and her former deputy, Jennifer Wood, and the current R.I. Director of Administration, Michael DiBiase.

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