The state’s effort to privatize foster care has hit another bump. The Health and Human Services Commission recently halted the bid process for a substantial foster care contract because an employee may have violated ethics rules or state law. The bid will remain on hold until the commission’s inspector general can investigate.
The suspended bid is another example of the Health and Human Services Commission’s perennial difficulties with developing, awarding, monitoring and evaluating contracts. In January, the Legislative Budget Board weighed in on the commission’s medical transportation contracts, and its findings were brutal: Costs per trip more than doubled after privatization, complaints soared, and the percentage of Medicaid patients served was cut in half. “These cost and quality issues have been due in part to procurement and contract management failures,” the report states.
The commission is trying harder than it once did, though. It was prodded by the 2015 Legislature to strengthen its contract oversight and revise conflict-of-interest polices and forms. The fact that the foster care bid was halted before the contract was awarded suggests that the legislative reforms are working. And the commission’s executive commissioner, Charles Smith, has asked lawmakers to approve a special Sunset Advisory Commission review of its contracting and procurement practices. That reflects an admirable openness to outside scrutiny and a desire to improve performance.
But legislative oversight needs to continue, as well. The money involved is sobering; last year, the state auditor compiled a list of 67 Health and Human Services Commission contracts with a total value of more than $62 billion. And the human costs are severe: How many Medicaid recipients who depended on the medical transportation program didn’t make it to dialysis or chemotherapy appointments?
Even with so much at stake, contracting hasn’t seized the attention of most lawmakers, voters or the state’s top executive. One lawmaker who is spending considerable energy on the issue is state Rep. Giovanni Capriglione, R-Keller. He notes that substandard procurement practices aren’t limited to the Health and Human Services Commission; he’s filed multiple bills that build on the contract reform measures passed last session.
Most important is HB 20, which gives the Legislative Budget Board ongoing authority to review contracts and requires state agencies to cooperate. The bill also allows the LBB to take enforcement actions against agencies that don’t adhere to state laws and regulations related to contracting. Given the state’s ongoing problems with contracting, these measures are necessary. The bill currently sits in the House Appropriations Committee. It deserves a hearing and committee members’ support.
At best, poor contract management wastes taxpayer dollars. At worst, it could cost some of the state’s most vulnerable residents their health or their lives.
