Improper Payments Cost Taxpayers Billons of Dollars Each Year

"Improper Payments"
Testimony  of:
Daniel R. Levinson
Inspector General
U.S. Department of Health & Human Services




In 2010, the Office of  Management and Budget (OMB) designated 14 programs as "higherror" based on improper payment information included in agencies' anual performance and
financial reports. HHS administers five of  these high-error programs - Medicare Fee-forService, Medicaid, Medicare Advantage, Children's Health Insurance Program, and Medicare
Prescription Drug Benefit. For fiscal year 2010, HHS reported improper payments totaling $56.8
bilion in Medicare Fee-for-Service and Medicaid alone.
OIG has long been at the forefront of measuring, monitoring, and recommending
actions to prevent improper payments, including developing the first Medicare payment error
rate in 1996, a time when there were few existing error rate models in Governent. OIG
identifies improper payments for specific products and services, assesses internal control and
payment vulnerabilities, and makes recommendations to prevent future improper payments. To
1
u.s. House of  Representatives, Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education,
and Related Agencies, March 17, 2011maximize the impact ofthese reviews, we assess program risks and employ data analysis to
target our audits, evaluations, and investigations.


To read the entire report please visit         


http://appropriations.house.gov/_files/031711DanielRLevinson.pdf

Separate reviews agree on some issues

May 7, 2009 in City

Kevin Graman
Staff writer

Tags: Children and Family Services Child welfare colville
Two separate reports, both critical of the state’s child welfare system in northeastern Washington, were released Wednesday by agencies investigating an unusually high number of complaints against the Colville office of the Washington Division of Children and Family Services.
A 10-month investigation by the Office of the Family and Children’s Ombudsman has found “a widespread crisis of confidence by the community in the child welfare system … that puts children and families at risk of harm.”
The Department of Social and Health Services Children’s Administration released its own report, which agreed with the ombudsman’s finding on a number of issues, but focused on a “systemic lack of communication and cooperation among all parties involved” in the welfare of dependent children.
The nearly simultaneous release of the two documents was apparently coincidence, said Mary Meinig, director of the ombudsman’s office, which is an independent watchdog over government agencies that have responsibility for child welfare.
Last June, Meinig’s office was asked by DSHS to review child welfare practices in the Colville office in response to concerns raised by state Rep. Joel Kretz and the advocacy group Washington Families United.
The Colville office covers Ferry, Pend Oreille and Stevens counties, where residents, including a grandparents’ support group, complained about child placement decisions.
Then, in March, Stevens County Prosecutor Tim Rasmussen wrote to Gov. Chris Gregoire and other state officials to state his concerns about alleged misconduct and corruption in the Colville office of the Division of Children and Family Services.
Rasmussen’s letter included allegations that Child Protective Services workers attempted to keep children from contacting their court-appointed advocates and “shopped” for health care and mental health care providers who would support their objectives in child placement.
Relatives were not notified or considered for placement of children, the prosecutor wrote. Other relatives had children taken from them and placed in foster care.
The ombudsman’s report supports some of these allegations.
Between Jan. 1, 2007, and March 31, 2009, the ombudsman’s office received 62 complaints regarding practices in the Colville office, of which 44 investigations have been completed. Of these the ombudsman found 16 adverse findings against the office, including violations of law, policy, procedure, “or simply poor social work practice.”
“These complaints had merit,” Meinig said. “Children were removed from placement for less than child abuse and neglect, which raises questions about how we are looking at relative placement.”
A Washington Families United spokeswoman said the problems cited in the ombudsman’s report in regard to the Colville office are present throughout the state.
“There is no one to hold these people accountable,” families advocate Linda Harris said.
In its report, Meinig’s office made several recommendations, including:
•That an outside professional mediation service address issues needing repair in the Colville area.
•That a diverse community board advises the Division of Children and Family Services.
•That the judiciary take leadership in addressing accountability, particularly in the appointment of mutually agreed-upon care providers.
The report also stressed the importance of keeping children with relatives in the absence of abuse or neglect, a clear violation of a court order, or imminent risk of harm.
Children’s Administration concurred with many of the ombudsman’s recommendations. But while Meinig’s office laid much of the responsibility with the child welfare agency, the Children’s Administration report focused largely on the strained relationship between the Colville office and the Stevens County Court Appointed Special Advocate Office.
“Both reviews identified similar areas needing improvement and provides an opportunity,” said Randy Hart, Children’s Administration interim assistant secretary. “We will work with our partners to implement the recommendations as appropriate.”
Contact Kevin Graman at kevingr@spokesman.com or (509) 459-5433.

The Olympian 

Our View: Is it just Colville with child welfare office problems?

May 10, 2009 in Opinion

The Spokesman-Review

The job of protecting children who are wards of the state can be confusing, contentious and highly subjective. Are children being properly raised? Are their emotional and physical needs being met? Is discipline needed? Is the choice or degree of discipline appropriate?
These are not easy decisions, but what ought to be obvious to all involved professionals is that the children’s interests are paramount. However, clashes are inevitable when foster families, school officials, health care providers, criminal justice personnel, court-appointed watchdogs and state case workers all have input.
Breakdowns in this coordinated effort are at the heart of the problem with the Washington Division of Children and Family Services regional office in Colville, according to two recently released reviews. One probe was conducted by the Office of the Family and Children’s Ombudsman and another by the Department of Social and Health Services Children’s Administration.
Both found an erosion of confidence between community professionals and the state’s child welfare office. The ombudsman said this contentiousness was putting some children at risk. It hasn’t helped that attitudes became hardened after some infamous cases, chief among them the death of Tyler DeLeon, who succumbed to dehydration after long-term abuse by his adoptive mother.
The ombudsman’s report found instances where DCFS has not complied with state law or its own policies. Both reports highlight what appears to be the larger issue, which is general distrust. The Colville office, in particular, seems to be suffering from a fortress mentality, which has hurt communication and collaboration.
As one medical professional noted: “the level of trust has deteriorated to a level that I hesitate to even get involved with the child welfare system but certainly if the lines of communication were open and more productive, cooperation could certainly begin to happen again.”
Even workers within the Colville office noted difficulties in dealing with their supervisors.
To repair the damage, the ombudsman’s office recommends professional mediation for disputes and a diverse local advisory board to inject impartiality. Those are good starting points for the Colville office, but the state agency ought to consider whether these problems are also plaguing its other operations.

Child Welfare System in Colville Faces Criticism Reports fault Colville child services

Leigh Roubideaux plays with her daughters. The children were taken by CPS in 2008 after straying near a busy street.Northwest Public Radio  Posted: Monday, May 11, 2009 COLVILLE, WA - A new Ombudsman report is critical of the child welfare system in Colville, Washington. The report seems to confirm what community leaders have been saying for months. Austin Jenkins has this report. It’s a spring evening in Colville. Leigh Roubideaux’s daughters - ages 7 and 4 – are playing on their swing set in their front yard. It was a very different picture last August. That’s when Roubideaux’s kids strayed into the busy street in front of their house. Someone called the police and soon Child Protective Services was knocking at the door. Roubideaux - who has developmental disabilities – remembers that day well. Leigh Roubideaux, Mother: “I was petrified. I was in tears.” CPS took the kids away. It took three weeks and the support of friends and neighbors – like local businesswoman Lisa Shinn - for Roubideaux to get her daughters back. Shinn thinks CPS discriminated against Roubideaux because of her disability and the fact she’s Native American. Lisa Shinn: “We would all have our children taken away if someone saw them playing in the street everyone would have their children taken by CPS if that is the criteria.” This is just one example of a litany of complaints against Children and Family Services in Northeast Washington. Stevens County Prosecutor Tim Rasmussen sits in an easy chair in his living room with two accordion files at his feet. In those files are the stories of people who feel they’ve been wronged by state child welfare officials. Tim Rasmussen: “There’s a lot of human tragedy here. There’s a lot of tragic, tragic situations.” For the past months – at the request of a state lawmaker - Rasmussen has collected accounts of what he calls a “pattern of misconduct” by the Colville, Washington office of Children and Family Services. In one of the more high profile cases, five children were removed from the home of a well-known foster family. A judge later called it a “slap in the face” and an “overreaction” that resulted in “tremendous upheaval” for the children. Rasmussen’s theory is that caseworkers overreacted because of something horrible that happened in Colville back in 2005. A 7-year-old boy named Tyler DeLeon was starved to death by his foster mother. Tim Rasmussen: “What’s happening now is just a different chapter in the book if you would. Tyler DeLeon is one chapter and they missed the mark in one direction and in some of the current cases they appear to have missed the mark in another direction.” Prosecutor Rasmussen recently wrote a letter to Governor Chris Gregoire that says he believes there’s a “culture of deceit and deception” within the Colville child welfare office. He’s even considering criminal charges against a CPS worker for violating a court order. Rasmussen isn’t the only one critical of Children and Family Services. Patty Markel runs the CASA program in Stevens County. These are the Court Appointed Special Advocates who represent the children in child dependency cases. She alleges that CPS caseworkers act in a “willy-nilly” fashion that’s personality driven and motivated by a fear of lawsuits. Patty Markel: “What I see now is more liability-driven decision making. And that’s concerning because that’s not necessarily – this whole system is supposed to be about the best interests of children” You hear a similar theme from Barry Bacon - a family physician in Colville. He says CPS workers often ignore the advice of local doctors like him. Instead, from what he’s seen, they take kids to Spokane – 70 miles away – to see the doctor. Dr. Barry Bacon: “They would rather continue with their opinion and destroy a child rather than admit that they’ve made a mistake. It’s unbelievable. I mean it’s like the Wild West. They are a law unto themselves which is one of the biggest issues we have with them.” The Department of Social and Health Services has reviewed the cases flagged by Prosecutor Rasmussen and in a recent report finds no wrongdoing by caseworkers. But in a separate investigation by state Ombudsman Mary Meinig, a disturbing portrait of the Colville office emerges. Over the past two years, the Ombudsman’s office has received 62 complaints regarding child welfare practices in the area. So far in 16 of those cases, the Ombudsman found, “violations of law, policy, procedure; clearly unreasonable actions; or simply poor social work practice.” Beyond that Meinig says her investigation revealed, a “culture of pervasive distrust” between CPS workers and other professionals in the community. But rather than pinning all the blame on CPS, Meinig says everyone involved needs to do a better job of working together. Mary Meinig: “Our report says the kids are at-risk and families are at-risk because of the lack of trust, cooperation, collaboration and communication that’s going on within the community.” The situation is so serious, Meinig believes, that the lives of vulnerable children are on the line. Mary Meinig: “Well if it doesn’t improve I would say it would be a matter of time before we have an even more serious incidents – possible child fatality or near fatality.” Meinig believes past tragedies are influencing the decisions made by CPS workers and have led to a climate of distrust. In haunting language, she writes the “ghosts of children past sit in the collective conscience as reminders of where the system failed.” But Meinig’s report has hope. She recommends several steps to start rebuilding trust including bringing outside professional mediators and creating a diverse community advisory board. How does Children and Family Services respond to all this? Marty Butkovich, DSHS Regional Administrator: “Obviously relationships need to be improved.” Marty Butkovich is the Administrator who oversees the Colville CPS office. He acknowledges there’s been a breakdown in communication. But he calls his staff “exceptional," and says he’s seen nothing to suggest his employees need to be disciplined or fired. Marty Butkovich: “We’re not the bad guy. This is very difficult work, very emotional work and some very difficult decisions are being made as it relates to kids and people have strong feelings about some of those decisions and not always in agreement.” As for whether a fear of lawsuits is driving decisions to take children away, Butkovich admits that does weigh on caseworkers’ minds. Marty Butkovich: “Liability is something that is very obvious and tort and being sued and deaths – all the real bad things that are out there – can be in a social workers mind and if they’re stressed and tired and so ya it can be there.” Department of Social and Health Services officials say they believe relations in Northeast Washington have improved over the past year but there’s still work to be done. The agency plans to put a corrective action plan into place. The problems in Colville have even reached Governor Chris Gregoire. She said in response to the Ombudsman report she wants the agency to, “refocus on what’s important,” the children they’re charged with protecting. Copyright 2009 KUOW On the web: Ombudsman report DSHS report Listen

Roach fires back with a purpose

Saturday, 2/14/2009
By MARK KLAAS

Auburn Reporter Editor
Feb 13 2009, 8:00 AM 

Sure, Pam Roach has ruffled a few feathers.
She can be gruff and abrasive. She can be gentle and kind.
Make no mistake, she shoots from the hip.
It's her cut-to-the-chase nature. After all, she is a state Republican senator in search of answers while serving her constituency, which includes rural Auburn.
Lately, the senator's patience and resolve have been put to the test. Her latest crusade has turned emotional and confrontational – and it deserves all the attention she can muster.
Roach is exposing the inadequacies and troubles with the Department of Social and Health Services/Child Protective Services. In essence, she wants more accountability from an agency critics often attack for its careless, ineffective performance.
CPS violations and corrective legislation are on the table, and Roach is having her say.
“CPS has not been following the guidelines, lacks internal accountability, and is not self-corrective. Consequently, children are dying, and families are needlessly torn apart. We have reached a crisis level,” said Roach, who last week joined Washington Families United in hosting a “Families First” rally at Olympia.
About 150 people converged on the Capitol to demand greater rights for families embroiled in cases with DSHS, which is responsible for protecting children from abuse. Roach was there, front and center at the rally, pleading for change.
Roach promoted the rally, spurred by cases in which the state failed to stop abuse, including one in which a 14-year-old Carnation girl was starved.
Other cases in the area have attracted considerable public outcry.
"On one hand, they don't protect kids. On the other, they take kids away from parents," Roach said.
Roach is fighting back by proposing bills that would change the child welfare system. Among her ideas are dividing DSHS, one of the largest state agencies, into several smaller departments, improving grandparents' legal standing, and requiring court-appointed volunteers to represent children to report their financial and family status.
“Too many times press accounts of allowed atrocities are glossed over by DSHS, and corrective measures are not addressed,” Roach said. “It is hoped that drawing attention to the failings of CPS will change administrative policy, create accountability, require the department to follow state law and help children.”
Roach, a former substitute teacher and graveyard shift postal worker, said she understands the importance of family. A mother of five and a grandmother of 10, she has been outspoken against abortion and has been recognized for her support of many social programs.
Roach also has been by the side of an Enumclaw family locked in a long, bitter custody battle. For months, the Stuths lost custody of their grandchild. Only recently, did they get her back. The state welfare system failed in this case originally, as Roach contends, preventing caring blood relatives from gaining custody of a child from an unfit mother. It was a terrible fight, but one in which Roach was not afraid to intervene.
In wake of the controversy, DSHS officials understand how important staying with relatives can be for children and have been moving more kids to those homes.
Children placed with relatives have fewer behavioral problems and switch homes less frequently than children placed with foster parents, research indicates.
Still, there are too many cases that have gone awry. And still, there is much more that needs to be done to improve the system.
As far as Roach is concerned, this battle is far from over. No doubt, the fiery senator will be heard from again.

Auburn Reporter Editor Mark Klaas can be reached atmklaas@reporternewspapers.com or 253-833-0218, ext. 5050.

DSHS complaints hit ‘all-time high,’ ombudsman says

Agency recommends changes to system

Rebecca Nappi
Staff writer

At a glance

The Office of Family and Children’s Ombudsman reviewed more than 150 child fatalities and near-fatalities in 2007 and 2008. A “fatality review” report is expected soon.
An investigation into the Colville Division of Children and Family Services is under way after Rep. Joel Kretz expressed concerns about practices there.
The 2007 and 2008 report is available at www.governor. wa.gov/ofco/reports.

Vulnerable children in Washington need to be placed in permanent, safe homes – preferably with caring relatives. And the quicker, the better.
That’s the main message in a 102-page report issued this week by Mary Meinig, director of the Office of Family and Children’s Ombudsman, an agency that investigates concerns about the Department of Social and Health Services.
Among the highlights in the 2007 and 2008 report:
The ombudsman’s office responded to more than 2,000 inquiries, received more than 1,200 complaints, and completed 521 complaint investigations in 2007 and 627 in 2008. This was “an all-time high,” according to the report, and “the Ombudsman found a higher percentage of agency violations in 2008 than in any previous year.”
The Division of Children and Family Services, which includes Child Protective Services, Child Welfare and Adoption Services and Family Reconciliation Services, received the most complaints. “The safety of children living at home or in substitute care, as well as issues involving the separation and unification of families, were by far the most frequently identified issues in complaints,” the report said.
One in eight investigations in 2007 and one in five investigations in 2008 resulted in an “adverse finding” in which the agency violated a law, policy or procedure or acted unreasonably. In some cases, no violations were found, but “harm to the child or family had occurred as a result of poor practice.”
One of the report’s main recommendations: Increase long-term placements of dependent children with competent relatives. The ombudsman continues to hear complaints from relatives who were never considered as possible permanent caregivers for an abused or neglected child. One grandparent discovered via a news report that her grandchild had been placed in foster care after the arrest of a parent. Relatives also complained of poor communication with DSHS.
In a prepared statement, DSHS responded: “It’s important to note that the Ombudsman’s office reports that it deems nearly two-thirds of the complaints it receives unfounded. We will review the report and recommendations and will be working with the Ombudsman and her staff to find ways to better protect children in this state from abuse and neglect by their adult caretakers and bring permanence to their lives.”
Reach Rebecca Nappi at rebeccan@spokesman.com or (509) 459-5496.

How to File criminal charges on CPS workers

The information contained within this blog is for informational purposes only.And not intended to be used as legal advice. To obtain legal advice please contact an attorney.




In some Child Dependency cases there are fraudulent claims made to the courts by Social workers to remove children from homes.Upon researching this I have found that most County Prosecutors refuse to follow up with criminal charges. Even when supplied with evidence supporting the criminal act.
To pursue criminal charges you should first make an appointment with your local prosecutor and provide them with your information.If you have evidence that a crime has been committed and they refuse to file charges, Try discussing the following case laws.

RCW 36.27.020 Duties
        The prosecuting shall:
(6) Institute and prosecute proceedings before magistrates for the arrest of persons charged with or reasonably suspected of felonies when the prosecuting attorney has information that any such offence has been committed and the prosecuting attorney shall for that purpose attend when required by them if the prosecuting attorney is not then in attendance upon the superior court.

RCW 36.27.020 defines mandatory duties of the county prosecutor and is supported by the following Shepardized case that has not been over turned;

Faunce v. Carter, 26 Wn. 2d. 211; 173 P.2d 526 (1986), "With reference to powers and duties imposed by statute on public officers, it is often difficult to determine whether they are mandatory or merely directory. Generally speaking, however, where the provisions effect the public interest or are intended to protect a private citizen against loss or injury to his property, they are held to be mandatory rather than directory."

Romano v. Yakey, 43 Wash. 15; 85 P. 990 (1906) "But we think the better and more responsible rule is established by the decisions of the courts of New York, Ohio, Indiana, Illinois, and Iowa, which hold the opposite doctrine, and maintain that when the question is one of public right, and the object of the mandamus to procure the enforcement of a public duty, the relator is not required to show that he has any legal or special interest in the result, it being sufficient if he shows that he is interested, as a citizen, in having the laws executed and the right enforced. (People v. Collins, 19 Wend 56; People v. Halsey,37 N.Y. 344; State ex rel Huston et al v. Commissioners of Perry County, 5 Ohio 498; The County of Pike v. The State, 11 Ill. 202; City of Ottawa v. The People, 48 Id. 233; Hall ex rel v. people, 52 Id. 307; Hamilton v. The State, 3 Ind. 452; State v. County Judge of Marshall County, 7 Iowa 186.)
        Section 6695, Bal. Code ( P.C., sec. 3114), permits any person to make complaint that a criminal offence has been committed, and if the magistrate  to whom the complaint is made wrongfully refuses to act in the manner, we think the party applying for the warrant has a sufficient interest in the performance of the public duty to compel action by mandamus. This is especially true where it is made to appear that the prosecuting attorney is resisting the application.

Perjury cases are difficult to prove. So don't try to get charges filed purely upon a case of perjury. Unless you have very compelling evidence that show intent to provide false information to the court. What I'm finding is case workers are allowed to slip perjury through court purely on "MISTAKEN" information. Despite the fact the law states "Whether intentional or unintentional" it's perjury to supply misinformation to the court. The courts give loop holes for them to slip through. So document everything. Record everything. Try to do all your communications in writing.
So when you have several claims which are documented you can go to the prosecutor to pursue criminal charges.

5th and 14th Amendments

The information contained within this blog is for informational purposes only.And not intended to be used as legal advice. To obtain legal advice please contact an attorney.




In the Matter of Gentry the Supreme Court Ruled. " A parent's right to the custody of his or her children is an element of Liberty GUARANTEED by the 5th and 14th Amendments of the United States Constitution"
Similar rulings can be found in:
Murphy v. Morgan 1990
P.O.P.S v Gardner 1993
Nunez v. City of San Diego 1997
Doe v. Irwin 1985
Wallace v. Jaffree 1985
Elord v. Burns 1976
Yick Wo v. Hopkins 1886
Santosky v. Kramer 1982
Matter of Delaney 1980
Langton v. Maloney 1981
Bell v. Milwaukee 1984

This blog is intended to supply information to parents fighting for their children. It's time the parents in this Country educate themselves on just how few rights they have when they enter family court. Whether your in a family dispute, divorce custody case or a CPS case. You need to know your rights. Start with your basic civil rights to the custody of your children.