More on CBMS

Under Allison Sherry's byline, the following story appeared in the March 3 issue of the Denver Post:

"Paperwork maze endangering Colorado Medicaid patients" 

You can access the full story at http://www.denverpost.com/search/ci_14502853

Here's an excerpt:

"Last summer, a 9-year-old Denver boy died after his mother was unable to fill his asthma medication prescription because the computer inexplicably said he was not covered by Medicaid. Zuton Lucero says she called the Denver County Human Services call center every three days. The county generated reports verifying that her son, Zumante, qualified for Medicaid — yet pharmacists said he wasn't in the system.
The boy still had an inhaler and nebulizer, but being without Advair was creating a life-threatening situation that his mother didn't recognize until it was too late.

"A band of legal advocates is pressing the state to not only answer for Zumante Lucero's death but also probe the computer problems or human mistakes that are disrupting Medicaid eligibility.

Denver Human Services called the boy's death a tragedy. County workers are in the middle of a "business review" of call-center responsiveness, including spring and summer 2009, the time of Zumante's sickness and death.

"The Colorado Attorney General's office has asked for more time to respond to the Lucero matter because of the complex computer programs responsible for Medicaid eligibility and enrollment".

The Colorado benefits Management System was converted on September 1, 2004 over the objections of the user community and with the promise of a fall back plan in case it didn't function properly.  It is still not functioning properly as we approach the sixth anniversary of the original conversion.  I've been in the IS world for much longer than you have as a consultant and an academic and I have seen and heard about many, many, systems failures. However, I've never heard of one that has stumbled along for almost six years.  Has anyone else?  Is this a record?

Read more: http://www.denverpost.com/search/ci_14502853#ixzz0hoVfElDX

Comments

[Richard Power]

Everyone complains but when help is offered, it is spurned. The situation reminds me of a man dying of thirst who rejects the offer of water because he had his mind made up in advance that the only thing acceptable is Gatorade.
The answer to automating welfare applications and service might not look like what those in charge have decided is the way it should look but the answer is actually relatively simple. The whole thing could be done in a couple of months and work with 100% accuracy. Welfare data is not all that sophisticated and the processing required is likewise not all that sophisticated.
Whenever people decide enough is enough, give me a call and I'll do a prototype free with the completed system not costing more than a few million dollars. I have satisfied customers all over the country, using software that is considerably more complex than what is required to manage welfare data.