The4th meeting of the Subcommittee on Families and Children of the Interim Joint Committee on Health and Welfare was held on Wednesday, October 15, 2003, at 10:00 AM, in Room 125 of the Capitol Annex. Senator Katie Stine, Chair, called the meeting to order, and the secretary called the roll.
Guests: Dianne Andrews and Ron Kelien, Cabinet for Families and Children; Candace Kalisz, Alice Wilson, and Gerald Hoppmann, Office of the Auditor of Public Accounts; Rice Leach, Department for Public Health; and Sean Cutter, McBrayer, McGinnis, Leslie and Kirkland.
LRC Staff: DeeAnn Mansfield, Murray Wood, and Cindy Smith.
The minutes of the September 17, 2003 meeting were approved without objection.
The first item on the agenda was an audit update on the Temporary Assistance for Needy Families (TANF) and Food Stamp Programs by Dianne Andrews, Director, Division of Family Support, Ron Kelien, Branch Manager, Claims Branch, Cabinet for Families and Children, and Gerald Hoppmann, Director, Division of Performance Audit. Mr. Kelien said the total actual issuances for food stamps has increased dramatically each year, and the total overpayments is increasing because more claims are being identified. In fiscal year 2003, 2,841 out of 10,555 were fraudulent food stamp claims. They have 10 years to collect on a food stamp claim, while there is no time limit on a TANF claim. The total amount collected on food stamp claims has increased over the last 3 fiscal years. He said the amount collected has increased because they have improved their technology dramatically, and by doing federal and state tax intercept. In the first quarter of fiscal year 2004, they have collected $509,723 in over issuances. Based on that projection, they estimate that for federal fiscal year 2004, they should collect around $2.3 million.
Representative Nunn asked about the status of the electronic benefits transfer cards. Mr. Kelien said the EBT cards are now statewide and no longer use any paper coupons. Representative Nunn asked how the cards are used in a fraudulent way. Mr. Kelien said a client can sell their card for less than it is worth. Ms. Andrews said a client could declare they have no income and the state could then find out they do have income. For the period of time they received the benefits, that time is fraudulent.
Representative Burch asked what the penalty is for the person who buys the card. Mr. Kelien said that is referred to the Office of Attorney General and they investigate and prosecute that case. If fraud is proven then that individual is disqualified from participation in the food stamp program for one year for their first offense, two years for their second offense, and forever for their third offense.
Ms. Andrews said there are in excess of 212,000 families in Kentucky participating in the food stamp program, which is about 510,000 individuals.
Next, Mr. Kelien discussed TANF claims. In fiscal year 2003, there were 591 new claims, and $597,636 in overpayments. In fiscal year 2003, there were $12,579,917 total claims collected.
Ms. Andrews said the KTAP applications in the local offices have been stable this year, but have started to go up a bit in the last three months, due to the economy.
Next, Mr. Hoppmann discussed the establishment of TANF claims. In fiscal year 2001, there were 434 new claims. In fiscal year 2003, there were 591 new claims. In fiscal year 2001, there were $532,137 in overpayments. In fiscal year 2003, there were $597,636 in overpayments. In the area of food stamp claims, there were 2,218 new claims in fiscal year 2001. In fiscal year 2003, there were 3,181 new claims. He thinks there should be more focus in trying to reduce the overpayments. There has been a decrease in the collection of TANF claims, because the Cabinet for Families and Children is focusing more on food stamp collection due to a fear of federal sanctions. They do agree with the agency that the claims collection for food stamps has increased, which is attributed to additional collection focus, increased EBT technology related to recoupments and adjustments, and improved state and federal tax intercept programs. Next, he spoke about the food stamp error rates and federal enhanced funding. He said the error rate must be below 6 percent to receive enhanced funding. The Kentucky error rate in fiscal year 2000 was 5.81 percent, and in fiscal year 2002, the error rate was 7.71 percent. Kentucky did receive federal enhanced funding in 2000, but not in 2001 due to the error rate. He also discussed potential fraudulent food stamp claims or intentional program violations for the households. In fiscal year 2001, $3.4 million was identified and in fiscal year 2003, $3.7 million was identified. He indicated that it is positive that money was identified but he would like to know if the Cabinet collected on those amounts.
Next, Alice Wilson, Financial Audit Manager, said the compliance audit had two findings related to TANF and food stamps. One dealt with the Personal Responsibility and Work Opportunity Reconciliation Act (PRWOA) which put the 60 month limit on recipients receiving welfare benefits. The first 60 month deadline was in October. They tested 25 recipients when they were approaching the limit and found three that received benefits after their 60 month limit. The amount was about $3,000. They recommended to the Cabinet that they recoup those payments and that they monitor the 60 month limit more closely. They also found that the Cabinet should maintain and produce records to support expenditures in the TANF program. They tested 45 recipient files for documentation of expenditures and found that two of the files were missing. The PA 32s were missing in seven of the cases, and one PA 32 was incomplete. They found that the Cabinet needs to track and monitor expenditures more closely.
The next item on the agenda was an update on the Child Care Assistance Program, by Mike Cheek, Division of Child Care, Cabinet for Families and Children. Mr. Cheek said during state fiscal year 2003, the Cabinet served 77,658 children in the child care assistance program with total CCCP expenditures for state fiscal year 2003 of $148 million, which is a 7 percent increase over state fiscal year 2002. The monthly average of children served in fiscal year 2003 was 57,046, with expenditures being $12.55 million. In the first quarter of fiscal year 2004, the monthly average of children being served was 57,002, with expenditures being $12.32 million. Effective September 1, the Cabinet began offering assistance to 1,983 of the children on the waiting list, which was over 10,000. They also updated the waiting list to reflect those families that meet the lower eligibility level of 150 percent of the federal poverty guideline. The eligibility level was lowered from 165 percent of poverty on October 1. This, however, is a slow process and decreases in the waiting list may not appear until November. Additionally, during this state fiscal year, the Cabinet has transferred and additional $10.9 million in TANF funds to CCDF and plans to increase the total TANF transfer to 30 percent ($54 million).
The last item on the agenda was a discussion on autism awareness by Barbara Bonar, parent of an autistic child, Jim Donnelley, Board Member, Autism Society of Kentuckiana; Dr. Boyd Haley, Ph.D., Chairman, Department of Chemistry, University of Kentucky. Ms. Bonar said they were at the meeting to let the members be aware of the increase in the autism population in the last twelve years in Kentucky. She said that Kentucky is one of the leading states in autism awareness. Her daughter was born in 1991 and for over two years she developed normally. In those two years, her daughter received 36 vaccines, which were mandated by the federal government. She said all of those vaccines contained a preservative, called thirmerosal, put in by the drug companies. Her daughter was diagnosed with autism at two and a half years old. Through the urging of the American Association of Pediatrics, in 1999, drug companies partially removed thirmerosal from the vaccines.
Mr. Donnelley said autism is a disability that robs a child of the communication, comprehension, interaction, and perception skills that most people take for granted. Autism affects 1 in every 150-250 children in the U.S. with a 4:1 ratio of affected boys vs. girls, that equates to an injury of 1 in every 80 boys. In the previous 10 years, Kentucky has experienced a nearly 2600% increase in the incidence rate of autism. The life of an autism family is a challenge that places the family foundation in jeopardy. The children have behavioral problems that hinder a family’s ability to go outside their own home, participate in social situations or even find short-term care or supervision for the child. In 2002, the CDC acknowledged autism as an epidemic. The most plausible research to date identifies a direct relationship between autism and the use of thimerosal, a poorly tested preservative used in childhood vaccines. Thimerosal is, by weight, nearly 50 % ethylmercury, a well-established neurotoxin. On the day a child is born, it typically receives a mercury exposure exceeding 40 times the EPA’s safety margin. By the time they are 18 months old, that cumulative exposure is hundreds of time the acceptable limit. Research exists that suggests a genetic inability to tolerate the mercury introduced into these children’s bodies. Thimerosal was first added to childhood vaccines in the 1930’s. Autism was first identified in 1943 among children who were born in the 1930’s and received these vaccines, suggesting an introgenic effect from thimerosal. For 60 years there has been a constant correlation between the introduction of new thimerosal containing vaccines and the rising rate of autism. He said there is a unique opportunity for Kentucky to move to the forefront in prevention and reduction of autism cases. He suggests prohibiting the use of thimerosal in vaccines administered to Kentucky’s children. It is reasonable to assume the autism rate could be reduced with such a measure. Upon establishment of causality, consider accountability from those who are found responsible for placing this burden on Kentucky's taxpayers, schools, medical community, and the children.
Dr. Haley said in his family he has no autism or neurological diseases. He is pro-vaccine also. When mercury is injected in a child on the day it is born, you bypass nearly two-thirds of the protective process this child would have. The study he looked at was about mercury in the birth hair of autistic children because he had a hint that autistic children did not have much mercury in their hair. Mothers that have amalgam fillings are subjecting their children to mercury. Certain people can not excrete mercury and are very susceptible to certain types of diseases. In regard to data on birth hair, the mercury level in normal children’ hair goes up with the number of amalgam fillings in the birth mother. The autistic children do not have this level of mercury in their birth hair. As the mercury level in birth hair decreases the severity of the disease increases, indicating that autistic children are less capable of excreting mercury.
Next, Rice Leach, Commissioner, Department for Public Health said he has three children with neurological problems, but nothing as devastating as autism. As a public health officer, he is very concerned about the increase in autism, and is very concerned for what it does to the children, the families and what it will do in time to the financial resources to whomever is taking care of them. He said he is not qualified to challenge Dr. Haley’s work, but there are people who might, and they will be available through the Centers for Disease Control. He said his Department follows the recommendations of the Advisory Committee on Infectious Practices. He has found that their research, although it doesn’t say what is being said is wrong, it does say that they can’t show the same kind of statistical link. The mercury has been withdrawn from every vaccine given to children, except one form of the Hepatitis B vaccine. He said that vaccinations do work and do protect.
The meeting was adjourned at 12:10 p.m.