It's only a matter of time before Chautauqua County hires a compliance officer.
County legislators have spent the past several months trying to figure out if the position is required by law, with resolutions creating the position were tabled in February and again at the legislature's voting session in August. It will very likely be part of the county's budget when the spending plan is adopted in November.
Blame that on New York state and its seeming desire to nickel and dime county taxpayers throughout the state straight to the poorhouse.
In 2005, Gov. George Pataki established a requirement that any provider of Medicaid services or anybody that billed anything to the Medicaid program must implement a regulatory compliance program. Pataki's legislation established the Office of the Medicaid Inspector General and outlined seven or eight elements in New York of what a compliance program needed to include. Actual program requirements didn't take effect until 2008 or 2009, according to a consultant hired by the county to begin building the compliance program. Compliance activities are handled, right now, through a position in the Chautauqua County Home but will need to be transitioned to the county payroll. While the position focuses right now on Medicaid and Medicare (through a similar federal statute) it will eventually include oversight for departments like the county Office for the Aging, Mental Health, CARTS, County Jail, District Attorney's Office, Public Defender's office and Legal Aide.
There are risks associated with continuing without a formal compliance officer and policy. HIPA violations pursued by the Office of Civil Rights have cost at least one county more than $200,000. Improperly handled Medicaid or Medicare claims could result in much larger fines. Legislators on the Audit and Control and Administrative Services committees said they understand why the position is needed, but need more information about how it impacts county departments, existing consulting or contracts for compliance work and how much benefits will add to the proposed $43,131-$66,053 salary.
Those discussions are necessary, but ultimately are merely window dressing. As John Runkle, R-Stockton, said during Audit and Control Committee discussions on the position, "If we did everything the state government told us we were supposed to do then we would be broke."
This, state legislators, is exactly what local government officials mean when they talk about unfunded mandates and the frustration of fitting those unfunded mandates into the state's 2 percent tax cap.
Something's got to give.