Auditor finds
QUEST still flawedMarion Higa says the program continues
to suffer from inadequate planning and design
The state's QUEST health care program for the poor, which was found in 1996 to have management problems due to inadequate planning and hasty implementation, still suffers from such deficiencies, according to a follow-up audit released yesterday.
"We found that QUEST continues to experience problems from inadequate planning and design that hamper the development and expansion of a managed-care approach to health care," a summary of the report by state Auditor Marion Higa stated.
"After nine years, enrollment and participation in QUEST are basically unchanged, and planning efforts to incorporate the aged, blind and disabled population have ceased."
In response to the auditor's report, state Human Services Director Lillian Koller said her agency agrees with many of the recommendations and is continually evaluating the QUEST program.
"We acknowledge the concerns you raise in your report, and we are committed to implementing as many of your recommendations as practicable, given our current and attainable resources," Koller wrote in a letter to Higa.
The QUEST Demonstration Project was started in 1994 to provide managed care for poor people who did not qualify for other types of assistance.
It left out thousands of elderly, blind and disabled clients who previously had been in the Medicaid program. Health care for those groups was to be incorporated as the second of several phased expansions of the program.
The state reached a $7 million agreement in March to settle all legal action that began in 1995, alleging that the state discriminated against the blind and disabled.
The 1996 audit found that management problems led to an inability by the department to substantiate the program's effectiveness and efficiency claims, and recommended that the concerns be resolved before any planned expansions are undertaken.
Although the agency's Med-QUEST Division, which oversees the program, had overcome some operational weaknesses, the most recent audit said other management problems still hamper effectiveness that could lead to ineligible applicants qualifying for benefits.
Higa's report also noted that although it took six years, the agency finally had implemented a management information system.