CWA Local 1081
60 Park Place, Suite 501
Newark, NJ, 07102
Office (973) 623-1081
Fax: (732) 988-1081

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Newark Teachers Union

New Jersey Citizen Action Oil Group

February 15, 2016

 

Gaeta Maite, OPRA Custodian

County of Essex

465 Dr. Martin Luther King, Jr. Blvd.

Newark, NJ, 07102

 

Re: OPRA Request: Essex County Division of Welfare’s Medicaid Applications

      

Dear Ms. Maite:

 

The State of New Jersey and its county welfare agencies (CWA’s) have been under the threat of federal sanctions for failing to process Medicaid and Supplemental Nutrition Assistance (SNAP, formerly known as Food Stamps) for the past several years.

 

During 2015, according to various Comunications Workers of America Unions representing county welfare employees within the majority of New Jersey’s counties, CWA’s were reporting that their completion rates were better than 90%  and in accord with federal requirements in order to avoid fiscal sanctions. The Unions’ respective representatives belived that, based upon their knowledge and the reports of staff, the information reported by the county welfare agencies’ administrators was not accurate in all situations. Therefore, the Unions commissioned a review of available statistics.

 

For the purpose of analysys, Open Public Records Act (OPRA) requests were submitted to the New Jerse Division of Medical Assistance and Health Services (DMAHS, the administrative agency for Medicaid) and the New Jersey Division of Family Dvelopment (DFD), the administrative agency for SNAP) for available statistical reports with respect to applications processed, completion rates and in prior reports for correspondences citing potential sanctions by the federal agencies. Both state agencies provided some of the information requested, although they were not able to provide any information regarding completion rates ot processing times for new applications. Therefore, the Unions’ commissioned report has attempted, based upon available information, to analyze the processing of new cases by the county welfare agencies

 

Two types of reports were provided by the DMAHS:

1.      Medicaid applications pending.

2.      Medicaid applications processed.

 

Both of these are part of an overall monthly report, entitled “New Jersey FamilyCare Statistics”, compiled at the state level. However, these reports are based upon information, at least in some if not the majority of the counties, apparently manually gathered and report by the county welfare agencies. DMAHA does not have a fully functioning management information system to provide true and accurate statistical reports within many areas. The state’s last attempt to establish a new computer system, called CASS, had to be aborted within 2014 as unworkable after the state’s expenditure of many millions of dollars.

 

The information requested was for selected months, as this would enable the Unions to establish processing trends. Attached, please note the tow charts respectively summarizing the monthly data provided by the state:

 

1.      Medicaid Applications Pending: This chart recounts the months ending in May through December 2015. Between May and December, the state’s charts were maintained on a weekly basis. For the purposes of the Union’s commissioned report, the last week of the month was used for counties that reported timely. From October through December, the state’s reports were maintained on monthly bases.

2.      Medicaid Applications Processed 2015 (for Selected Months): This chart provides the number of applications received within the current month, approved during the month, denied during the month and the total processed (denied and approved).

 

The two above cited charts should correlate to some extent. This means that the number of applications pending, plus new applications taken during the month, minus the number of applications processed should approximate the number of applications pending the next month. However, overall the totals do not appear to match and counties appear to be processing more cases than were pending and newly-taken within a given month as highlighted by the following:

 

·         At the end of May 2015, there were 6,382 applications pending. In June 2015, 19,888 cases applications were reported received. Combining these two numbers would appear to indicate that there were a potential 26,270 applications to process. In June 2015, there were 27,935 cases processed which should have eliminated any backlog of cases on a statewide bases. However, the report for June 2015 reflects 2,196 cases pending.

·         At the end of September 2015, there were 1,033 cases pending. In October 2015, 11,649 cases were new and 17,078 cases were processed or almost 4,300 more that the number of applications there were to process (1,033 plus 11,649 equals 12,682).

·         At the end of November 2015, there were 3,348 cases pending and combined with 11,973 new applications taken in December 2015, 13,754 processed resulting in approximately 1,500 cases undone. However, at the end of December 2015 there were 2,265 cases pending.

 

Some of the discrepancies could have resulted from the different methods each CWA utilized in gathering the information, slight time differences and the problem with manually gathering the information. However, the discrepancies reported are highlighted by significant differences at the individual county levels as noted with several counties highlighted as examples.

 

Within the Essex County Division of Welfare, at the end of May 2015 Essex reported 3,450 cases pending. In June 2015, Essex had 4,038 applications and processed 2,885. This would result in more than 4,500 cases pending at the end of June 2015, but Essex reported only 586 cases pending at the end of June 2015. At the end of September 2015, Essex reported 168 cases pending and in October 2015 received 3,101 applications with 1,936 completed. Thus, at the end of 2015 there should have been 1,333 cases pending but the county only reported 11 cases as not completed.

 

The above cited statistics highlight that the information being reported to the state was highly inaccurate and unreliable and the no one could actually identify a true number of pending cases, an accurate percentage of cases completed on a timely basis and have a true comprehension of how counties were obtaining the data being reported and tracked. In the absence of valid information, neither the state nor many of the counties could make proper decisions how to handle the workflow. This is inherent within any system wherein data is tracked manually and underscores the need for a new computerized management information system within the state. Hopefully, the above indicates merely poor data management and not any attempt to purposely falsify reports or to misinform the state, federal agencies and the general public.

 

CWA Local 1081, CWA Local 1081, representing the non-supervisory employees of the Essex County Division of Welfare, respectfully submits this OPRA request that the County of Essex provide our Union the following:

 

1.      Documents delineating the number of the Essex County Division of Welfare’s Medicaid applications pending, respectively, within the months of May 2015 through December 2015.

2.      Documents delineating the number of the Essex County Division of Welfare’s Medicaid applications processed, respectively, within the months of May 2015 through December 2015.

3.      Documents delineating any intercourse between the Essex County Division of Welfare (and/or the Essex County Department of Citizen Services) and the DMAHS concerning the Medicaid applications pending, and processed, by the Essex County Division of Welfare, respectively, within the months of May 2015 through December 2015. Said documents shall include letters and email communications.

CWA Local 1081 thanks you, in advance, for your anticipated expeditious cooperation responding to this most sincere supplication.

 

Yours truly,

 

 

David H. Weiner, President

CWA Local 1081