Policy nightmares and political distractions

Our state has a problem. We don’t handle contract procurements very well. Recently, the Department of Human Services (DHS) has received deserved attention for mismanaging multiple eligibility contracts. It’s a big problem, but it’s not new, and the solutions aren’t all that complicated.

The Eligibility and Enrollment Framework (EEF) is a great example of how projects can become policy nightmares, and then a political distraction. Both are harmful.

The EEF is the software backbone of program integrity for most benefit systems (not just the Private Option, as some have intentionally stated). It will, when functioning, determine and track an enrollee’s eligibility criteria, which is usually an income limitation.

DHS began construction on this project nearly two years ago. They dedicated no project manager, sole-sourced contracts, and paid under a “time and material” agreement. In other words, no one was responsible for project success or failure, and bureaucrats were managing multiple vendors. The result was vendors who could not cooperate, DHS employees with no ability to demand an outcome, and the state wasting tens of millions of dollars.

Worst of all, everything was predictable. This article from March 2013 is just one of many that highlighted state challenges when building technology systems. Though Arkansas isn’t mentioned, it’s the same vendors and the same problems.

The problems with EEF are not a discovery. It was ignored for too long so it has only grown worse. The Executive Branch can solve this specific problem, while taking steps to improve the state’s handling of projects in the future. The Governor’s office is now increasing its role in contract management as a whole. They should also look at structural reform to the state’s procurement process. The system should be transparent, competitive, and based on paying for success.

Meanwhile, the Health Reform Task Force is past halftime, created in January with a report of solutions due in October. If not careful, old problems from the old days can become a distraction for those who are charged with finding new solutions for a new day.

Contracts, in reality, are really just the implementation of the policy direction decided on by the policy-makers. So becoming bogged down in debates over old contracts is almost precisely the same as re-debating an old policy. That’s not to say there aren’t lessons to be learned and problems to be fixed.

But there are some who want to continually debate old policies – like the Private Option – and they hope to exploit any problem at DHS in hopes of finally winning (in their mind) the old debate. That’s because no one – not even a Governor – can simply declare an emotional debate over, especially one as divisive as healthcare. It takes leadership to actually move forward, which means establishing new guiding principles and then utilizing respected authority to move others toward those guiding principles.

Without that, the result is just to drift, hopelessly and without direction, re-debating the old instead of creating the new. The Governor has said he doesn’t want that. He certainly can’t afford to let it happen, since he’s counting on the Legislature to discover a new solution for healthcare that can obtain a three-fourths vote of the General Assembly.

Debates over audits and contracting issues – while important – aren’t going to deliver a future path for healthcare in Arkansas.

Procurement reform can be accomplished at the agency level through executive direction. That’s what should happen, while the task force continues to move towards its goal of reforming all of healthcare by October. That way we solve the policy nightmare of EEF now, and avoid the political distraction that simply creates another policy nightmare later.