Alexander

PROVIDENCE — With the full state Senate poised to vote Tuesday on Gary Alexander’s confirmation as the state’s new secretary of health and human services, a Bay State company whose principals include a friend of the nominee is taking credit for doing the lion’s share of the work that won Rhode Island unprecedented freedom in how it spends its federal Medicaid dollars.

On its own Web page, the Boston-based Lucas Group takes credit for having “originated” and “constructed” and then “led” the negotiations with federal officials that resulted in Rhode Island’s winning a far-reaching Medicaid waiver. The waiver is aimed at saving the state $67 million this year alone by steering the elderly away from nursing homes, redefining who is sick enough to be eligible for certain services and creating “selected” treatment networks for the people enrolled in this state- and federal-financed medical coverage program for the elderly and poor.

The partners in the company include former New Hampshire health and human services commissioner and unsuccessful 2008 New Hampshire GOP congressional candidate John Stephen.

The company’s claims appear to conflict with the Carcieri administration’s contention that Alexander was the chief negotiator who persuaded federal officials to grant Rhode Island the waiver from volumes of federal Medicaid regulations, in exchange for its commitment to live within a $12-billion five-year cap. They also raise anew questions about the Carcieri administration’s contention the company “volunteered” its time, without a contract or promise of remuneration.

Alexander did not respond to queries about the company’s description of its role in winning the waiver and then crafting a public-relations plan for selling the proposal to “differing audiences,” including state lawmakers, after the state’s congressional delegation raised serious questions about approving a waiver that could shred the “the safety net on which hundreds of thousands of Rhode Islanders rely.”

The Lucas Group has not been paid, according to the state controller’s office. But Alexander has declined to answer this yes-or-no question for weeks: has the Lucas Group or John Stephen requested payment for their roles in winning the Medicaid waiver?

Alexander referred the question to the governor’s spokeswoman, Amy Kempe, who has not answered it. Last week, one of the governor’s lawyers, Daniel Majcher, reminded The Journal in writing that the administration has up to 30 business days to respond. Attempts to reach John Stephen were unsuccessful. A woman answering the phone at the Lucas Group identified him as a partner in the company, but said: “I don’t believe he is in the office right now.”

As the $135,661-a-year acting secretary of the Executive Office of Health & Human Services, Alexander is responsible for the care of poor, elderly and disabled Rhode Islanders, as well as children in state custody, people in hospitals and those with mental or emotional illnesses.

The Senate postponed a first May 20 scheduled vote on Alexander’s confirmation after The Journal brought to light a contract with another a company employing Stephen — LifeShare Management Group. The disclosure led several senators to question why the nominee had not disclosed this contract earlier in response to questions about his hiring of consultants.

LifeShare was hired by a regional collaborative known as NESCSO to design less-expensive alternatives to nursing homes for Rhode Island’s low-income elderly and disabled, under NESCSO’s own $300,000 federally financed contract with Rhode Island. Having never worked with LifeShare before, NESCSO executive director Gerald Clay surmised his group hired the company on the recommendation of someone in Rhode Island.

Alexander would not say who recommended the company. As rumors persisted about the magnitude of the role played by a second company affiliated with Stephen — the Lucas Group — he again declined comment.

But he sent an e-mail noting Stephen’s credentials as a onetime health and human services commissioner in New Hampshire and a “leader in Medicaid reform.”

He also acknowledged hosting a March 2008 fundraiser at his home for Stephen, asserting that “it is in my rights as a citizen to do so … barring there are no conflicts of interest.”

On its Web page, the Lucas Group said: “Governor’s Office and DHS brought in The Lucas Group to improve operations and meet budgeted savings goals targeted by the Legislature.”

It said the company identified a potential $388 million in savings for the Department of Human Services, including “$60 million in new Medicaid savings initiatives that were inserted into a supplemental budget to ensure that the budgeted savings were on track.” It also took credit for the proposals Alexander pitched to lawmakers.

It said: “Lucas Group helped DHS refine existing savings initiatives, identified new initiatives that focused on areas, such as, nursing home diversion and transition, shared and independent living arrangements for persons with disabilities, emergency room diversion, competitive purchasing strategies and more cost-effective pharmacy benefit management.”

Sen. Rhoda E. Perry, chairwoman of the Senate committee that recommended Alexander’s confirmation, said she was unaware of the Lucas Group’s assertions and could not comment.

But a committee colleague, Sen. Joshua Miller, said “it is troubling that Lucas Group seems to be taking credit for something that the administration [in response] to all inquiries stated that Lucas Group hasn’t been paid for doing.”

“I am less troubled by a consulting firm trying to sell its wares than I am … an administration not being forthcoming … about how much work was outsourced,” said Miller, adding that he believes Alexander “has been honest” about the extent of his knowledge.

kgregg@projo.com