Jim Nobles’ special investigation report highlights how lax the oversight of the Department of Human Services has been. It also highlights the corruption within the Department:
Over a decade ago, and without authority, DHS officials decided that it would pay opioid treatment providers when their clients took medication at home.
A few years later, and again without authority, DHS officials decided it would pay tribal opioid treatment providers the Indian Health Service (IHS) encounter rate when their clients took medication at home. That’s just the tip of the proverbial iceberg. Here’s more:
Who made the decisions, why, and when is not clear because DHS officials never documented their decisions. Even during the interviews we conducted, DHS officials could not recall who was responsible. In addition, none of the DHS officials we interviewed could offer a credible rationale for paying health care providers for their clients taking medications at home.
Frankly, all of the people involved with this corruption should be terminated immediately. They’ve proven that they aren’t people of integrity, which is a requisite for the position. If they can’t be trusted, they shouldn’t be employed. Period.
On February 12, 2019, a representative of the Red Lake Nation e-mailed a DHS opioid treatment expert to find out if Red Lake’s opioid addiction treatment program could receive the IHS encounter rate for days when clients took treatment medications at home. Red Lake already operated an opioid addiction treatment program, but it had not given its clients treatment medication to take at home.
The DHS expert told Red Lake “yes”; Red Lake would be able to receive the encounter rate when clients took treatment medication at home. But another DHS official copied on the e-mail told Red Lake to wait for an official response.
The department did not, however, issue an official response to Red Lake until May 1, 2019. In a letter to Red Lake, Leech Lake, and White Earth, the DHS commissioner reversed the department’s long-standing practice of paying tribes for their clients to self-administer treatment drugs at home. The commissioner told the tribal chairmen that DHS can only pay the IHS encounter rate when there is a face-to-face interaction between a client and a health care professional.
There’s no way it should take 11 weeks to respond to a question that simple.
Also on May 1, 2019, the department finally implemented a policy and a payment control that stopped the department from making payments to tribes when clients take medication at home. The department took another three months to inform the White Earth and Leech Lake tribes that they must return all of the payments their tribes received from DHS for clients self-administering medications at home.
Leaders of the White Earth Nation and the Leech Lake Band of Ojibwe have expressed frustration with how DHS has communicated with them about the overpayment issue. They have placed responsibility for the overpayments on DHS and questioned their obligation to repay the state. The state could face legal challenges in its efforts to require White Earth and Leech Lake to return the overpayments.
Republicans have ideas to reform Human Services. Unfortunately, the DFL is interested in reforms only if terrible employees are protected. That’s because the DFL is owned by the public employee unions. This corruption can’t continue.