JEFFERSON CITY - Budget Committee members questioned health department officials about why they are still working with a private contractor that failed to fulfill the terms of their $11.4 million contract. The company, SynCare LLC, was hired to provide support and assessment of care plans but weren't able to handle the sheer volume of calls, said Deputy Director of the department Peter Lyskowski . Lyskowski told the committee they hesitate to terminate the contract but feared it would result in further delays in patient care.

More than 50,000 Missourians using home and community-based services have experienced a lapse in service since SynCare began working in May. Clients have been on hold for extended periods of time and waited more than the allotted 15 days to recieve their plan which delays care. Lyskowski said the department has heard of some people being forced into nursing homes because of poor service.

The St. Louis Post-Dispatch reported that SynCare laid off 29 employees and began to miss payroll, further delaying services. Before the first quarter of the contract had passed, 33 state employees were needed to help SynCare deal with patient calls.

"How long can we expect SynCare to bleed the way they're bleeding and continue to perform," said Rep. Randy Asbury R-Higbee.

A provision in the contract fines SynCare $5,000 every month they do not fulfill the contract and only allows them to bill the state for 50 percent of their work. Members of the committee questioned Lyskowski about terminating the contract. Lyskowski said the procedure to terminate a contract typically takes 90 days.

"I'm concerned with not what we're gonna do in the next 30, 60, 90 days but what we're gonna do now," said Rep. Jeff Grisamore R-Lee's Summit.  Lyskowski said improvements were being approached on a day-to-day basis and there is no long-term plan.

Lyskowski argued for continuing the contract until service improves. 

"We want to make sure that whatever happens there isn't some vacuum or void where services are not delivered," said Lyskowski.

"It would seem that the missteps in the last few months have created a void and it's a crisis," said Grisamore.

When the contract was announced in 2010, there were 11 initial offers. None of the companies had prior experience in this kind of consulting. Renne Slusher from the Office of Administration said the contract was awarded to the best, responsible and lowest bidder and there were no red flags when evaluating SynCare.

"I think generally we understood that there was a risk because none of these were proven performers," said Slusher. She said the decision-making process consisted of assigning points to attributes of each company and weighing the costs of their methods.

House Budget Committee Chairman Ryan Silvey R-Kansas City, read aloud from the comments on SynCare's evaluation from the Office of Administration. Concerns included the fragmented nature of providing service, poor ratio of supervisors to staff, lack of detail in their execution model and no back-up plan. According to the document "there is concern with the plan with oversight to ensure satisfactory performance."

Rep. Dave Schatz R-Sullivan said "I think the department has failed here miserably."

No representative from SynCare was present at the hearing, and administrators were not available for comment.