Wednesday, June 27, 2007

More Medicaid Malarky?

Is Dr. Robert Robinson, the current Director of the Division of Medicaid qualified to occupy that position?

The statute that creates the Director's position and establishes the criteria that must be met in order for him to be hired is SEC. 43-13-107 of the Mississippi Code of 1972. It states the following:
"Division of Medicaid created; director and other personnel; Medical Care Advisory Committee.....(2) The Governor shall appoint a full-time director, with the advice and consent of the Senate, who shall be either (a) a physician with administrative experience in a medical care or health program, or (b) a person holding a graduate degree in medical care administration, public health, hospital administration, or the equivalent, or (c) a person holding a bachelor's degree in business administration or hospital administration, with at least ten (10) years' experience in management-level administration of Medicaid programs, and who shall serve at the will and pleasure of the Governor."

The law is quite clear that the intent of the legislature when drafting this law was that the Director should have extensive experience along with a high level of expertise in the field of administering Medicaid programs or health care administration.

Unfortunately, Dr. Robinson does not meet the criteria as established by law. His biography on the DOM's website states:
"I chose Bob to serve in this position because of his leadership capabilities and many years of service in state government," Governor Haley Barbour said. "He served as Commissioner of Public Welfare, which is the predecessor of the Medicaid program today and understands the inner workings of state government. After a nation-wide search, he is the best person to fill this important role."
"Dr. Robinson is a graduate of the University of Southern Mississippi, and received his doctorate of business administration from Mississippi State University. He has served the state as Executive Director of the Mississippi Agricultural and Industrial Board, Executive Director of the Governor's Office of Job Development and Training, State Personnel Director, and as Executive Director of the Mississippi Department of transportation."
(Note: A check of the Bluebooks did not mention Dr. Robinson as Commissioner of Public Welfare although he could have served as an appointment. His term must have not been one that covered more than one governor's term at the most.)

Dr. Robinson fails to meet the minimum qualifications as specified by the statute. He is not a medical doctor. While he has a Doctorate of Business Administration, that is not the equivalent of a graduate degree in a field related to public health, health care administration, etc. as the law says only people with medical, health care administration, or public health related degrees are considered to be eligible. The law does not make an exception for a nominee possessing a Doctorate of Business Administration with no health care-related background. It does allow for a person to have such a degree, even only an undergraduate degree but then it specifies that the candidate must have ten years of experience in administering Medicaid programs, which Dr. Robinson does not possess.

Dr. Robinson was once the Commissioner of the Department of Public Welfare which was the forerunner to DOM until over twenty years ago. It received federal welfare allocations and was in charge of administering them, not just Medicaid-related ones (There is also no question that Medicaid has changed drastically in over twenty years). However, Dr. Robinson did not serve ten years in that position and the law does not make an exception for previous commissioners who only served for a few years. The law created a new set of specific qualifications to be met before a nominee can be approved. The legislature was well aware of DPW's history and scope when it created the Division of Medicaid but chose not to include a grandfather clause for prior Commissioners that exempted them from the new requirements.

There is no question that Dr. Robinson has a commendable history of public service and is obviously dedicated to improving state government. However, one must ask why Dr. Robinson was confirmed by the Senate, as it is that body's duty to scrutinize the qualifications of candidates before confirming them. Did none of the Senators take their duty seriously enough to determine if Dr. Robinson was even eligible to be Director? It is tempting to give the Senate the benefit of the doubt as Dr. Robinson was appointed on October 1, 2005 which means that he was confirmed during the aftermath of Hurricane Katrina, when the Senate obviously had much more pressing matters.

One must also ask why the Barbour administration chose to deal with a Medicaid tar-baby that was experiencing deficits of hundreds of millions of dollars by nominating someone who was not qualified. Is the Governor serious when he states that out of all the Medicaid experts or experienced health care administrators/experts in the country none are as qualified as his nominee who has no experience in these fields whatsoever? Haven't the Republicans for years railed against faceless bureaucrats regulating from the ivory tower fields in which they had no expertise?

Mississippi has had enough trouble and controversy with Medicaid programs over the years without allowing an unqualified Director to administer them. Under the Musgrove administration, Medicaid operated under a huge deficit. Since Dr. Robinson became Director, Medicaid has continued to face turmoil (taxing the hospitals, battling deficits, etc).

The law and intent of the legislature is clear as to who should run Medicaid: someone who is a health care professional and has experience in Medicaid programs along with government health care regulations, not a bureaucrat who has served in a variety of agencies from welfare to transportation to personnel to farming. The position demands a Medicaid expert, not a floating jack-of-all trades bureaucrat. Dealing with infant mortality and health care for children is very different from pouring asphalt, filling potholes, and selling soybeans.

The question that remains is: Will the Director of Medicaid's resume finally receive some much-needed scrutiny and will there be some accountability?

Update: See additional story at:

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Trollfest '09

Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).

Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.

In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.

Note: Security provided by INS.

Trollfest '07

Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

Note: Security provided by INS