James Toews to Brief Legislators on ‘Money Follows Person’

November 10, 2010 -- James Toews is likely to face another grilling by legislators about the Money Follows the Person program (MFP) when he testifies before the Emergency Board on Dec. 15.

 

The Department of Justice is still conducting a multi-level investigation into that federally-funded program, which has moved 278 seniors and people with disabilities out of nursing homes into community-based settings since May 2008.

 

Toews, who runs the Seniors and People with Disabilities Division, insists the program will be up and running after the investigation ends. “It’s not our intent to shut down the program permanently. We intend to reopen it and name a new project director at that point.” Once that occurs, the new operations protocol and budget for 2011 will be known, said Toews, adding, “We’re not proposing any changes right now.”

 

Until then, he’s busily preparing a report on all the grant programs in his agency, including MFP, which will be submitted to the Legislative Fiscal Office by November 15. Legislators will review that report at their Emergency Board meeting in December.    

 

“Typically we have tons of federal grants, and they all have reporting cycles,” he told The Lund Report. “Legislators have asked us to report on all the grants and how they fit together.”

 

His agency was also required to submit a report to the Centers for Medicare and Medicaid Services (CMS) showing – for the first time – how the re-balance dollars, accumulated in 2009, had been spent. That report, which was due September 14, was sent to CMS last week.

 

Those re-balance dollars amounted to approximately $2.8 million, not the $904.607 the agency quoted earlier, according to Toews, who was unable to answer specific questions about the dollar flow. Also, although that report is labeled “quarterly,” Toews insisted it represented the entire 12-month period. To take a look at that report, click here.

 

“This was a brand new report,” said Toews. “It’s all broken into tiny subcategories. I’d have to drill down to get some fiscal people who prepared that to look at where the dollars have been spent.”

 

These “rebalance dollars,” Toews said, “represent what otherwise would have been spent without the grant, and the additional federal match for the 12 months from the entire group of people who’ve been moved.” Since the program’s inception, the state has drawn down $14.9 million in federal Medicaid dollars and spent $5.5 million from the state’s general fund.

 

CMS requires that the “re-balance dollars” be used to either expand community-based long-term care services or offer behavioral, peer support and home modifications. The November 15 report is expected to show how many people have been served.  

 

There’s also no intent to eliminate positions in the MFP program, although that statement is mentioned in the report’s narrative.It states "We believe that our costs will adjust as we eliminate positions that had been previously been associated with our MFP program and re-allocate our workforce." Instead, the 39 people who had worked at the Eastern Oregon Training Center have completed their work and are being shifted to other positions not associated with this program, according to Toews.

 

However, according to our sources, there was only one MFP person at this training center -- a transition coordinator.

 

Officials from CMS declined to comment on the report, saying, “We are still looking into the situation in Oregon and believe it's premature to discuss it,” according to Mary Kahn, spokeswoman.

 

“CMS knows our investigation is going on,” Toews said. “And they’ll wait until we’re done. They’re not involved in the investigation.”

 

Toews has been in touch with Senator Jackie Winters (R-Salem) who’s raised questions about why legislators weren’t told about the CMS report. “I’ve talked to her a couple of times and explained why the report was delayed,” he said.

 

Meanwhile, rumors are circulating that people who’ve participated in the MFP program have either died or been re-hospitalized – an issue Toews didn’t deny. “We have very frail fragile people live in these programs; I wouldn’t doubt people have died,” he said. “All the people in this program have expressed an interest in moving, and have signed consent forms. People want to return home from hospitals and nursing homes, and we honor their choice. But we also have a responsibility not to place people in dangerous situations.”

 

Since the program was halted, its project director, Julia Huddleston, who resigned August 30 hasn’t been contacted by any state officials.

 

“I don’t know who’s been contacted and who hasn’t,” Toews said.

 

Before Huddleston left, she had worked with a budget analyst who told her there had been no rebalance dollars set aside. Several errors had also been made “by the budget department in reconciling the program’s budget and accounting for grant funds in other ways,” according to a letter she sent Toews on September 23. The budget analyst she’d been working with had been reassigned in mid-August, according to her letter, “while the report remained unfinished.”

 

Huddleston also told Toews she had voluntarily resigned because “I no longer had faith in the leadership of the agency,” adding “since then I am being made the scapegoat for DHS’ sloppy budget practices and disorganized leadership. I have not been charged with any wrongdoing, informed of any grounds to investigate the program or my conduct or asked to participate in any investigation.”

To learn more about the Money Follows the Person program, visit www.oregon.gov/DHS/spd/mfp.