LITTLE ROCK — Legislative action may not be necessary to implement recommendations made by outside consultants who reviewed the state’s public welfare programs, the chairman of the House Public Health, Welfare and Labor Committee says.
Earlier this month, The Alexander Group presented to the House and Senate public health committees a report containing 32 recommendations for short-term and long-term initiatives that the Pennsylvania-based consulting firm estimated could save the state between $65 million and $98 million a year in the short term and between $46.8 million and $63 million a year in the long term.
Rep. John Burris, R-Harrison, said this week that the recommendations — such as setting performance goals for programs, establishing metrics for measuring performance, consolidating contracts and monitoring high-cost Medicaid cases to identify inefficient expenditures — probably could be implemented administratively rather than through legislation.
"I don’t know that there’s a lot to address in the session specifically," Burris said. "I think they can do it all internally."
In testimony before the public health committees on Nov. 18, state Medicaid Director Andy Allison did not endorse any specific recommendations but said he welcomed the report.
"I think a second opinion, an outside and independent voice, is valuable. I think it’s one of the things that a large program, a public program, needs to have," Allison told legislators.
The state Medicaid budget, including a 70-30 federal-state match, is $5.3 billion for the current fiscal year. Nearly 800,000 Arkansans were enrolled in the program last year, according to the state Department of Human Services.
The Joint Budget Committee voted during this year’s regular legislative session to pay The Alexander Group $220,000 to do the study at the request of House Majority Leader Bruce Westerman, R-Hot Springs.
The firm’s owner, Gary Alexander, is a former Rhode Island human services director and former secretary of public welfare for Pennsylvania who is known for obtaining a global Medicaid waiver for Rhode Island and implementing controversial reforms there that included a cap on total Medicaid spending.
Some Democratic legislators have questioned the objectivity of the consultants and their study. Sen. Linda Chesterfield, D-Little Rock, said this week she would have been more comfortable "if we could have found an objective group that gave me empirical evidence instead of opinion. .... I didn’t see too much empirical evidence."
Among other things, the report asserts that "a well-known feature of public-welfare programs is that they trap recipients in welfare dependency."
Rep. Reginald Murdock, D-Marianna, vice chairman of the House public health committee, said many of the recommendations in the report overlap with measures already being implemented by the state.
At this time it is probably premature to implement many of the recommendations, Murdock said, because the state is waiting to see whether expected savings materialize as a result of the private option, the state’s plan to use federal Medicaid money to buy private health insurance for the working poor.
But Murdock also said the fact that DHS officials did not object to the report helped him be comfortable with it.
"I’m OK with it because they’re OK with it," he said.
Murdock said he thought the motivation for requesting the report was ideological. He said the report was requested during the health care debates of this year’s session and said he believed it was hoped that the report would show that Arkansas is not doing a good job of managing Medicaid dollars.
Instead, Murdock said, the report praised the state for fiscally responsible measures such as the creation of the office of Medicaid inspector general.
The report "didn’t end up being much of a revelation or the impact that it was expected to be," he said.
Westerman said he did not request the study for political reasons.
"The purpose of having the report was to have someone other than a state agency look at the (Medicaid) program," he said. "We wanted to get an outside set of eyes to look at it in an objective manner."
Burris said he had expected the report to be more controversial.
"I was actually very surprised," he said. "I guess maybe I let a promulgation of a stereotype affect what I was expecting, because I saw the report and heard it presented and heard the tone, and I thought it was very, very reasonable and very well received and laid out some possibly attainable goals that will make for a better program."