Jackson Jambalaya

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."
(http://www.dom.state.ms.us/Executive_Director/executive_director.html)
(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:http://kingfish1935.blogspot.com/2007/07/more-medicaid-malarkey.html