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-3- <br /> <br /> eligibility. Legal Services proposed that the counties be held <br /> liable for sanctions when the 80% threshold is not met, even though <br /> delays in processing these particular cases can be caused by many <br /> external factors (the client, the state, a physician, an insurance <br /> company or bank, etc.). The State, however, would not share <br /> liability for delays in case processing caused by any failure on <br /> its part to return a timely determination to the sending county. <br /> Additionally, applicants with cases pending beyond 90 days would be <br /> entitled to' remedial fines, even thOUgh the client could be <br /> contributing to the delay by withholding necessary information. <br /> <br /> State's POsition <br /> <br /> Based-on four months of data, the Department estimates that roughly <br /> 33% of its 4000 current Medicaid disability caseload has been <br /> pending for more than 70 days for either applicant responsible <br /> information or for other requested evidence. These are cases which <br /> would be classed as "pending with good cause" under the federal <br /> regulations. Based on this information it is apparent that 90% <br /> compliance within 90 days is not an achievable goal in the absence <br /> of good cause provisions. <br /> <br /> In addition, the Medicaid disability caseload has increase~ from <br /> approximately 106 cases per week last year to approximately 366 <br /> cases per week this year. This escalation in caseload is expe0ted <br /> to continue, thereby exacerbating the problem of achieving 90% <br /> compliance. <br /> <br />The State and counties sought an 80% compliance threshold on a <br />permanent basis with continued provision for pending cases with <br />good cause. Legal Services would accept no alternatives to its <br />offer. <br /> <br />Summary <br /> <br />In summary, three provisions of Legal Services' most recent <br />offering were viewed as unacceptable from the counties' <br />perspective: <br /> <br /> (1) elimination of "good cause", a right given to agencies in <br />federal regulation; <br /> (2) 80% compliance for one year only, moving tO 90% compliance <br />next year in the face of clear evidence that this is not <br />achievable; <br /> (3) county liability for delays outside the scope of county <br />control. <br /> <br />AS previously stated, there were many other areas of disagreement, <br />some major and some minor, but Legal Services was unwilling to <br />continue discussions if they did not prevail on the handling of <br />Medicai~ disability cases. Legal Services required the acceptance <br /> <br /> '- <br /> <br /> <br />