Los Angeles County Computer System Improperly Denies Medi-Cal Benefits
A Los Angeles County computer system that was designed to automate welfare eligibility determinations is millions of dollars over its $152 million budget and "wrongly den[ies]" health benefits to many Medi-Cal beneficiaries, the Los Angeles Times reports. The Los Angeles Eligibility Automated Determination Evaluation and Reporting system, or LEADER, combines 18 smaller systems and was first used in county offices in October 1999. The system was supposed to make "faster and more accurate" decisions about welfare eligibility. Los Angeles County processes about 700,000 aid applications every year. Advocates for the poor say that they have received "hundreds of complaints" that eligible people have been denied health benefits. Federal and state officials are concerned too, noting that programs that potentially affect two out of every three Medi-Cal beneficiaries have not been integrated into the automated system. Officials at the county Department of Public Social Services, who say the "major glitches" in the system are fixed and the minor problems can be "worked around," blame the "majority" of system malfunctions on employee errors. However, a report conducted by the county employees' union found that 33% of 200 workers surveyed said the system had improperly denied benefits to someone in the preceding two weeks. In some cases, workers said that they did not know why benefits were denied because the computer system did not provide an adequate explanation. In the previous six months, 67% of workers surveyed said they had issued "trouble tickets" to the department's technology experts describing problems with the system, but some complaints went unresolved for months.
The Times reports that cost overruns in developing and integrating the computer system have been building for several years. After the county changed its cash aid programs, it had to pay an extra $27 million in December 1998 to system designer Unisys to cover software changes. The county also paid $20 million extra when Unisys officials complained they had underbid the contract at $86 million. But at that time, the county chose not to update some Medi-Cal programs, instead deciding that county workers could "temporarily make eligibility calculations by hand, then override the system." Kim Lewis, a staff lawyer for the Western Center on Law and Poverty, has asked the county Department of Public Social Services to review all benefit denials and terminations to determine whether they were computer or worker errors. However, the Times reports that the department has been "hesitant to agree." The county Board of Supervisors last month ordered the department to report remaining system problems and to determine the cost for integrating remaining Medi-Cal programs (Larrubia/Liu, Los Angeles Times, 2/17).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.