The last thing Milwaukee County needed was another fiscal management fiasco to give an already skeptical citizenry yet another reason to distrust the inner workings of local government. Or to think less of the notion of “public service.” But news in recent weeks of the financial straits of the Family Care program -- and a back-door attempt to privatize a portion of it -- has done precisely that.
    The numbers are staggering. An estimated $3.3 million in overpayments the county received from the state. Another $2 million the county would have to set aside in reserve and $2.7 million in working capital to prove to state officials a Milwaukee County-managed Family Care program can stay in the black.
    “In all, it‘ll take about $10 million to bail us out,” said 12th District Supervisor Peggy West during a recent interview with AFSCME 48.
    As a result, the future of the program -- which by all accounts provides quality services and case management for 7,500 Milwaukee County seniors -- is anything but certain. And jobs for 30 to 40 AFSCME-represented workers are in jeopardy.
    While the County Board on May 27 ordered an audit into Department on Aging’s finances, and put at least a temporary kibosh on Department Director Stephanie Sue Stein’s attempt to privatize Family Care’s lead program management role, county officials only have until June 30 -- unless they get an extension -- to respond to the state request for proposals (RFP) to run the program beginning in 2005.

        “Our first priority must be the 7,500 seniors currently receiving basic services through the program,“ Patty Yunk, Milwaukee District Council 48’s director of public policy, wrote in a May 18 letter to Milwaukee County Supervisor Elizabeth Coggs-Jones, who chairs the Committee on Health & Human Needs. “The second must be the accountability to the community. The third priority must be to the persons who have dedicated themselves to providing these services -- both Milwaukee County employees and the employees of agencies throughout Milwaukee County.”

        A failure to communicate. If only Family Care’s top-level managers had come clean sooner. State officials tried to push the problems public. More than a year ago, the State Department of Health and Family Services told the county Department on Aging to submit a “corrective action plan” to meet that state’s working capital and risk reserve accounts. Seven months later, a state-hired auditor issued a scathing report on the department’s bookkeeping habits and skills.

        “The county was mismanaging the fiscal piece of the Family Care program,” Yunk said. “As a result, the state was on them. On numerous occasions.”

        But the County Board wasn’t. It couldn’t: Supervisors weren’t told of the fiscal woes until April 9 -- just a few days after Scott Walker was re-elected Milwaukee County Executive -- when Stein sent a memo to Milwaukee County Board Chairman Lee Holloway and Milwaukee County Supervisor Richard Nyklewicz, who chairs the Committee on Finance and Audit.

        In the memo, Stein wrote that the Department on Aging “likely … will realize a $1.2 million revenue shortfall” for fiscal 2003, due to “non-realized payment for persons receiving Family Care through the department’s Care Management Organization (CMO)“ and the department’s “inability to capture end-of-year revenue” through a rate adjustment or through negotiated retroactive payments.

        A month later, the board learned the deficit was a lot more than that.

        “Walker was elected into this office clamoring for ‘transparency of government,’ and accountability, something no one could refute,” Yunk said. “But if we’re going to have transparency, we need full disclosure. That didn’t happen here.”

        Another unwelcome surprise. Meanwhile, Stein had another bombshell for the board -- and her AFSCME-represented department employees: the county wouldn’t compete for the 2005-2009 Family Care program. Instead, Stein had a deal in the works to privatize part of the program -- to subcontract the case management portion to Community Care Organization Inc. (CCO), a non-profit that counts a few former Milwaukee County higher-ups among its management ranks.

        CCO employees knew about the deal April 26; in a letter to AFSCME dated April 27 (but received April 29), the Department on Aging notified AFSCME that there would be potential layoffs due to the decision to contract with CCO. On April 30, the county and CCO submitted a joint letter of intent to operate a Care Management Organization for Milwaukee County. Nothing transparent about this deal: No bid process, no board committee hearings, no public discussion.

        “Upon my inquiries of April 26, 2004, members of your staff denied knowledge of the huge deficit being run up by Stephanie Sue Stein and her incompetent managers in the Family Care CMO program, as well as her pursuit of a sweetheart contract with cronies to create a partnership between Milwaukee County and CCO,” District Council 48 Executive Director Rich Abelson wrote in a May 12 letter to Walker. “[But] … it is clear you and your staff had information concerning the impending budgetary crisis in the Department on Aging for a considerable period of time. You and your staff apparently consciously chose not to bring us into the loop, even though you knew that our members were at risk.”

        Of Stein and 'Sophie's Choice.' Perhaps feeling at least some of the heat, he stripped Stein of her fiscal management responsibilities on May 18. But he left Stein in charge. At county board committee meetings during the past two weeks, a few supervisors called for more accountability -- including Stein’s ouster. AFSCME’s Abelson has, too.

        “You should discharge Stephanie Sue Stein,“ he told Walker. “She has loaded up the Department on Aging with top-heavy management, and is now carving up programs and handing them out as gifts to cronies.”

        Added AFSCME’s Yunk: “At a recent Finance & Audit hearing, [Third District Supervisor Gerry] Broderick said that he felt the ‘sins of omission’ were significant, and that Stephanie Sue Stein has put us in the position of Hobson’s Choice,” or a choice without an alternative, Yunk said. “I would have said ‘Sophie’s Choice’-- either way, you can’t win.”

        But AFSCME officials realize there‘s a whole lot more at stake here than who‘s got the title of “Department on Aging Director.”

        “This is not a referendum on the director of the Department on Aging -- this is an issue of public policy,” Yunk said. “[Stein’s actions] have put public discussion in limbo. It’s going to be difficult to get beyond it.”

        Here’s hoping county supervisors believe they’ll be able to do so.

        On May 27, the County Board approved an audit of the Family Care program, and (supervisors hope) to buy a little time. The board voted to seek an extension from the state, which will decide among competing bidders this summer which agency/agencies will run the program beginning in 2005.

        And during a special (and rare) joint meeting of the Committee on Finance & Audit, and the Committee on Health & Human Needs on May 26, committee members directed Stein to “bring back three proposals -- three RFPs to be submitted to the state,” Yunk said. “One with the county continuing to do it as a stand-alone, one reflecting a move forward with the CCO group and a third one that would work with a consortium of agencies.”

        Health & Human Needs will meet on June 16; Finance & Audit, June 17.

        How can you help keep the program in the right hands? For starters, Milwaukee District Council 48 officials suggest AFSCME members to call committee members and:

        * Thank them for the leadership they‘ve shown in making the attempt to bring the Family Care program crisis back into the public-policy-making realm, which is where it belongs; and

        * “Encourage them strongly to make sure Milwaukee County maintains its lead role in providing these services,” as Yunk put it.

        Here’s how to contact the committee supervisors:

        Finance & Audit Committee: Richard Nyklewicz Jr. (278-4252), chairman; Ryan McCue, vice chairman (278-4231); Elizabeth Coggs-Jones (278-4265); Roger Quindel (278-4259); Michael Mayo Sr. (278-4241); Willie Johnson Jr.(278-4233); and Gerry Broderick (278-4237).

        Health & Human Needs Committee: Coggs-Jones, chairman (278-4265); Peggy West, vice chairman (278-4269); Quindel (278-4259); Johnson (278-4233); Paul Cesarz (278-4267); Toni Clark (278-4278); and Joseph Rice (278-4243).