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Director's Message
August 27, 2004
To: DHS Employees
From: Gary Weeks, Director
Bolstering program integrity
Most of our budget — more than 80 percent — goes out in direct payments to clients, partners or providers.
As stewards of these public dollars, we must do everything we can to ensure that funds aren't paid out inappropriately, and to recover any improper payments. This work is often referred to as program integrity.
As you know, accountability and continuous improvement are key values for us, and for all of state government. Accordingly, we're looking at our program integrity work across the department, seeking ways to strengthen and, where appropriate, standardize these systems.
Multiple strategies. There are many program integrity activities in an agency as large and diverse as ours. For example, in addition to pursuing instances of fraud, abuse and error, we:
— Determine whether reimbursement is due to us from insurance companies for medical bills that we have paid.
— Identify lawsuit settlement money that should be used to reimburse our programs.
— Recover money spent for health care and other services from the estates of clients who have died.
— Determine whether people who are being cared for in institutions have resources, including insurance coverage, to help pay for their care.
A closer look. Program integrity activities occur in many parts of our organization. Approaches, procedures and priorities differ from area to area. As a result, different parts of the agency may disagree about whether or how to pursue claims. Or, the same potential payer may be contacted multiple times.
With the help of a contractor, we are looking at program integrity efforts across the department to determine how we might improve efficiency, communication, coordination and results.
We currently recover more than $41 million each year in improper payments — an admirable achievement that reflects the dedication of employees across the department. This amount is far above the costs of the employee positions devoted to these activities.
In addition, some overpaid funds are identified by providers and returned to us.
However, strengthening our systems can lead to greater recoveries. As we strive to increase accountability and public confidence in our stewardship of resources, it's important that we look for better ways to minimize improper payments and to recover funds whenever we can.
Citizenship and services
It's a common question — one that you may have heard as an employee of DHS: "Why does it seem that people who enter the country illegally are eligible to receive cash assistance or other social services?"
The answer: With very narrow exceptions, social services programs require applicants to verify U.S. citizenship, or if they aren't citizens, to present documentation showing that they are in the country legally.
Our application processes include careful inspection of any Immigration and Naturalization Service (INS) documents that are required. We also use an INS online system to verify applicants' status.
Providing supports. There are, however, some cases in which our programs provide services regardless of immigration status.
The Citizen Alien Waived Emergency Medical (CAWEM) benefit, for example, provides emergency medical services. Although citizen status is not considered, the people served must meet other Medicaid eligibility requirements.
In our Temporary Assistance for Domestic Violence Survivors program, citizenship requirements may be waived if a person is fleeing or at risk of domestic violence. And we waive citizenship requirements for our Temporary Assistance to Needy Families program if enforcing them would put a family at risk of domestic violence.
There are other circumstances, too, in which we provide service without regard to citizen status. These include treatment of a communicable disease and the protection of abused or neglected children.
Many nuances. This can be a complex area. Federal law has provisions for various kinds of residency and citizenship status.
For instance, a foreign student or visitor may be a legal resident, allowed to remain in the United States for a limited time. On the other hand, some non-citizens may be allowed to remain in the United States indefinitely, and may become citizens after living in the country for a specified period of time.
In addition, a child may be a U.S. citizen even though one or both parents are undocumented.
The state and federal laws and rules governing human services programs are very specific on the required citizenship status of applicants, and we follow these requirements as we operate the programs.
A time for giving
The state employee Charitable Fund Drive is about to begin.
In early September, site coordinators will distribute forms that you can use to designate which charitable organizations will receive your contributions. The completed forms will be due to the site coordinators by October 15.
This is an excellent way to direct your giving to organizations and causes of particular interest or importance to you. As you'll see when you receive your form, there are many options.
Contributions can be made in various ways, including by payroll deduction. If you choose this option, the deductions will begin in January.
Our agency, with its focus on helping disadvantaged people, has a tradition of generous giving through this campaign. I appreciate the generosity that you have shown, and thank you in advance for your continued commitment.
Donations of time. Janet Gerling, of our Office of Information Services, recently became chair of the statewide committee that oversees the fund drive from year to year, with responsibilities that include choosing the participating charities.
The DHS coordinator for this year's drive is Judy Murdza of Health Services.
I'd like to thank Janet and Judy for their work on this important activity.
Questions? More information about the fund drive is available from the various DHS site coordinators. A list of the coordinators is available online.
Food for thought
"How wonderful it is that nobody need wait a single moment before starting to improve the world."
— Anne Frank
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This message is intended for all Department employees. Please read it electronically, if possible. Managers and supervisors are asked to share the message each week with employees who do not have email access.
If you have a disability and need a document on this Web site to be provided to you in another format, please send an email to dhs.forms@state.or.us or call (503) 945-7021, fax (503) 373-7690 or TTY (503) 947-5080. If you know of others who need this accommodation, please let them know it is available.
Oregon Department of Human Services
Director's Office
500 Summer St. NE E15, Salem, OR 97301-1097
Phone: (503) 945-5944
Fax: (503) 378-2897
TTY: (503) 947-6214
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