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David Stanley Ford

Agencies could lose $37 million
State agencies could lose $37 million

By Josh Rabe    Comments Comment on this article11
Published: February 18, 2008

The impending loss of $37 million in federal money means fewer child welfare services and less assistance for the developmentally disabled in Oklahoma.

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An emergency rule change made to Medicaid policy in December declared state employees such as juvenile probation officers and child welfare workers can't be paid with federal Medicaid dollars because they are performing a state-level function. Because it was an emergency rule change, the issue wasn't argued in Congress.

According to the Centers for Medicare and Medicaid Services, the cuts are a result of the Federal Deficit Reduction Act of 2005. Medicaid hopes to cut $1.28 billion in spending by 2013.

The Department of Human Services will take the largest hit, losing $34 million for services it provides for child welfare and developmental disability services. The state Office of Juvenile Affairs would lose $3 million, which supplements case management of juvenile offenders.

About 5,000 Oklahomans receive services like direct care in their homes, said Sheree Powell, spokeswoman for the developmental disabilities division of DHS.

The agency employs about 300 case managers to make sure those services are provided and paid for, but relies on Medicaid to supplement salaries, she said. Case managers earn an average of $36,000 annually from state and federal funding.

Powell said DHS director Howard Hendrick is writing a letter protesting the rule change.

The Targeted Case Management program has been available to states since the early 1990s to help people in getting medical, educational and other necessary social services, but Medicaid officials argue states are now relying far too much on federal dollars to fund social services not directly tied to Medicaid.

According to the state Health Care Authority, Oklahoma spent $54 million on Targeted Case Management programs last year. Of that, the state paid $17 million and Medicaid supplied $37 million.

Juvenile agency seeks delegation's help
The change also will cut funding for Office of Juvenile Affairs employees who monitor delinquents.

Employees of the agency's juvenile service unit don't just monitor delinquents to make sure they're obeying the law, said Kim Sardis, the unit's administrator. Youth under watch are evaluated from home life to educational, psychological and medical needs. She said this monitoring is crucial to keeping young offenders from becoming criminals as adults.

"It's a more holistic approach to juvenile offenders,” Sardis said. "It's a way to look at what's causing their behavior to try to change it before they become adult offenders.”

Gene Christian, the agency's director, said he plans to urge the state's congressional delegation to lobby against the rule change. If the rule isn't overturned, the agency will seek more funding from the state.

"Targeted Case Management is a proven tool in our arsenal, and we are going to continue to provide that,” Christian said. "We are very upset this was done in the form of an emergency rule change, and there was no opportunity for debate.”

Christian said he also fears his agency will lose its status as a Medicaid provider under the new rule, which would jeopardize another $5 million in federal funding.

Medicaid funding accounts for a third of the agency's spending on mental health and substance abuse treatment for delinquents in community group homes. Of the 222 beds currently available, at least 74 could be lost.

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David Stanley Ford


Related Topics: Law, Health and Fitness, Medicine, Welfare Policy, Public Finance, Domestic Policy, Social Policy, Federal Budget, Political Policy, Politics, Criminal Law, Government Spending, Juvenile Justice, Social Work, Health Care Policy, Health Care Costs, Health Care Issues


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M, I understand you don't like DHS. Shouldn't there be hard evidence somewhere if what you say is true? There are so many people working for the state, is everyone the same & they are all corrupt? If they are, why would they be like that? There are good people everywhere & it is hard for me to believe all the bad are pooled in one agency.
Southern Rebel, Oklahoma City - Mar 1, 2008 at 2:24 pm
Like any other die-hard liberal, people wanting to reform the system are well intentioned but grossly misinformed. I was a Child Welfare worker 1997-98. I was an eye witness to scandal. I took a voluntary demotion to get out of Child welfare. The folks at DHS laugh at efforts to “get on the same page.” These fiends will agree to anything on the surface while continuing what they have always done. I will admit that I am still with the agency in a differnt capacity & I can tell you these people are ruthless. To get promoted higher than the lowest level you have to sell your soul. I have not been promoted because I love the truth. People who run that place hate the truth because the truth exposed their treachery. Even now, they are thinking only in terms of damage control & who is expendable. If they stick to their old pattern, they will find a scapegoat & hope the problem just goes away. They are counting on the people of Oklahoma to care more about American Idol than the children of Oklahoma. It saddens me to say they are probably right. They see themselves as somehow the defining authority of the truth, when in fact, they are the exact opposite. If you think the Clintons were ruthless in the way they came after those who opposed them in the 90's, that's children's games compared to what they do to former and current employees that speak out. Whistle blower laws protect those that get court admissible evidence. This kind of evidence has a tendency to permanently vanish. Folks this is a Stalinist régime here in the heartland.
M, Truth - Feb 18, 2008 at 2:35 pm
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Please understand that Targeted Case Management (TCM) is simply: a referal to an educational, social, or medical service, assessment of need, and follow-up on services. It is NOT the service itself. The Feds are simply trying to further shift the cost of CW services to states.....In other words, your state taxes will be paying 100% of what the feds previously had picked up at a 70% match.
John, Oklahoma City - Feb 18, 2008 at 11:51 am
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What sucks about Oklahoma is the prevailing mentality, as evidenced by voting trends. I believe the statistics show that close to one in eleven Oklahomans has or has had involvement with corrections, even higher among minority populations. We currently incarcerate more women than any other place on the planet, mostly for economic crimes. But, by gawd, we will not consider raising taxes except to support sports. Even though Oklahomans tend to vote along the lines of religious beliefs, which generally propose that the more affluent should take care of the poor, we fail to support social services in favor of expanding punishment efforts. What would Jesus do?
Kevin, Oklahoma City - Feb 18, 2008 at 11:30 am
That's why Oklahoma SUCKS.
Cletus, Mayberry - Feb 18, 2008 at 10:39 am
I think that is what Frank Keating had in mind, with his family being major stock holders in private prisons in Oklahoma.
Kevin, Oklahoma City - Feb 18, 2008 at 10:20 am
I guess all the state can do at this juncture is transfer the case files from Juvee to the D.O.C. and have an adult probation officer take over the cases. They are most likely going to wind up there anyway so why not just save some time and make the transfer now.
burt, edmond - Feb 18, 2008 at 10:08 am
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It would seem it all comes down to money--in order to have 'qualified' people to provide the services, wages would have to be higher in order to attract and retain qualified employees. Of course, our governor has put emphasis on higher wages for teachers, though has left other critical areas in the lurch. Child welfare workers, if they so choose, have their 'fast track' program available to become MSW's, though once achieving that degree, have little monetary incentive to stay with child welfare. In essence, at present, underqualifed people are in positions to determine State policy and procedure. Your tax dollars at work for you! Should we propose a State Lottery to support Child Welfare and OJA? The only real difference between kids in the Child Welfare system and kids in the Juvenile Justice system is that kids on probation tend to be a bit older, indicating that if problems could have been intervened appropriately upon at an earlier age, kids would be less likely to enter the Juvenile Justice system, and therefore, fewer would merely graduate to DOC once they turn eighteen or are bridged over through the Juvenile Offender program. Hey, we're dead last in the Nation in providing mental health services to our citizens, but lets refurbish an almost new arena instead!
Kevin, Oklahoma City - Feb 18, 2008 at 9:24 am
So to finish my opinion, if the Dept of Mental Health and the Dept of Human services were to use licensed professionals, there would be no immunity to these state employees for performing malfeasance or incorrect acts that might harm the public. Licensed professionals would be required to be watched by their respective licensing board. The state does not want any watchgroups inside their agencies.
ge-mo, Oklahoma City - Feb 18, 2008 at 9:17 am
Kevin, my opinion is the same reason that child welfare case workers in oklahoma do not have education or proper training to be licensed social workers. Caseworkers can have a degree in music and recieve 5 weeks training on child welfare policy and go out into the public to make judgements about terminating your parental rights. There is no licensing board for case managers or caseworkers in Oklahoma to protect the public.
ge-mo, Oklahoma City - Feb 18, 2008 at 8:53 am
Explain to me why that all other mental health service providers are required to go through several weeks worth of training(and cost for said training) in order to become 'certified case managers,' while state employees have no such requirement? If state employees were in fact certified case managers, as all others are required to be in order to be eligible to bill Medicaid for case management services, would this make a difference? Not even ODMHSAS employees, who have corner on the market for providing this training, have any requirement to be certified case managers.
Kevin, Oklahoma City - Feb 18, 2008 at 7:55 am

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