Montana Woman Becomes Good Will Ambassador for Medicaid Reform

Published September 1, 2005

Every state department of social services could use someone like Sharon Rivera, to ease Medicaid benefit cuts and make the reform process a little less painful for recipients and government officials alike.

On August 1, the Missouri Department of Social Services sent a letter to 339,000 Medicaid recipients. The letter detailed service cuts to the state Medicaid system, and it listed a phone number–the wrong phone number, as it turns out–for a help line for the hearing- or speech-impaired.

That number belonged to Rivera, a Montana woman who runs a small business with the 800 number erroneously listed in the Missouri letter. The typographical error resulted in hundreds of calls to Rivera.

No Correction Sent

A day after the error was discovered, Missouri government officials announced they would not send a letter of correction, deeming it too expensive. The first letter, explaining changes in Medicaid benefits taking effect September 1, had cost the state $80,000 to send. The state’s Department of Social Services budget director, Brian Kinkade, told the Associated Press the department hoped the confusion would die down on its own.

The most remarkable part of the story is that Rivera, who lives in Kalispell, Montana, did not hang up on the people who called her number, many of them crying or angry. She listened to their concerns and problems and patiently gave them the correct number for Medicaid in Missouri.

By the end of the week, Missouri officials were working with Rivera to steer people in the right direction, and they pledged to reimburse her for the charges to her 800 number. Her home-based business arranges concerts and sells music for a Blackfoot Indian musician and storyteller.

On August 10, Department of Social Services Director Gary Sherman released a statement saying the source of the error had been discovered: “We have thoroughly investigated every step of the process that led to the production of the notice,” said Sherman. “I am shocked and disappointed to learn that employees did not follow established protocol. This is unacceptable and will not be tolerated. Disciplinary actions ranging from reprimand to suspension are being taken.”

Montanan Was ‘Very Gracious’

Sherman referred to the importance of correctly informing Medicaid recipients of the changes being instituted due to rising program costs in the state. “Changes are being made that need to be communicated clearly to all those affected; accuracy and timeliness are absolutely essential. There is no excuse for a mistake of this magnitude. I am committed to systematically rooting out systems that are not working and improving performance to prevent glitches like this,” said Sherman.

“We deeply regret the confusion to Medicaid beneficiaries seeking help understanding the changes and the inconvenience to Ms. Rivera and disruption to her business,” Sherman said. “We deeply value and are working to achieve excellence in public service; this was a very unfortunate incident.”

State officials praised Rivera for her reaction.

“She’s been very gracious,” not only to the callers but to state officials, said Social Services spokesperson Deborah Scott in a statement.

Susan Konig ([email protected]) is managing editor of Health Care News.