MONEY for expensive lunches and unnecessary trips out of town. Money to hire friends as well as to start some programs that were unnecessary. That scandal-filled history of excessive spending belongs to the $100 million Medicaid Trust Fund in the D.C. Department of Human Services. According to department employees, the fund was used like a money tree by department officials. They took money from the fund as they pleased, without any supervision from the mayor, city council or even Congress. Now the effects of that profligate spending are coming into public view. DHS has been singled out by District Budget Director Gladys Mack as the city agency that most overspent its budget in the past year. And the single item in DHS that accounts for most of the overspending is -- you guessed it - the Medicaid Trust Fund.
But even in cutting back on the often wasteful spending that took place with money from the trust fund, DHS is finding that it has problems. The shutdown of the trust fund is ending abuse of the money, but it also is stripping some good programs of necessary people and supplies. Apparently, some past agency officials used the trust fund to pay for anything -- good or bad -- that they wanted done quickly and without questions from the city's budget officials. As a result, there is no clear pattern to be found concerning what the money was used for. And no decisions have been made by current DHS officials as to which people or programs previously paid for through the fund are in fact essential to the department. Similarly, thoughtless and large-scale cuts are being made in DHS as a result of the city-ordered decreases in the size of the department's regular budget as well. As a result, many important programs are being left without staff and supplies.
For example, staff writer Susan Okie reported Sunday that many of the city's disease prevention programs are being done away with -- almost inadvertently -- as a result of helter-skelter firings and limits put on spending for supplies. This policy leaves the city without a program to deal with food-poisoning outbreaks, flu epidemics and diseases like tuberculosis. The District has the third-highest tuberculosis rate of any city in the United States.
What is needed now is a review, position by position and program by program, of DHS' spending. The review is necessary to provide a sound basis for future decisions on which services or people can be eliminated from DHS with the least effect on the services the department gives to the city. Random reductions in staff and supplies are dangerous. No matter how severe the budget crisis, the city cannot risk leaving an epidemic unchecked.
While reductions are made in the department's size, some attention must be given to preventing future abuse of money in the Medicaid Trust Fund. The $100 million that goes into the fund annually comes from the federal government in payment of one-half of the city's Medicaid costs. Instead of allowing DHS to keep that money in the future and use it in any way it pleases, the city should begin requiring that the money be returned to the city treasury every year after receipt from the federal government. Once the funds are in the treasury, the council or the mayor can decide the best use for them. Mayor Barry and DHS Director James Buford should make a point a getting the Medicaid Trust Fund out of harm's -- and the DHS's -- way.