On December 22, 2009, Wayne Freeman and Russell Maxwell signed a Corporate Integrity Agreement with the NYS Office of the Medicaid Inspector General and were required to pay $80,000 back to the New York State taxpayers. The CIA was a 27-page document that directed Medical Answering Services in how they were to run their business, including paying for an unrelated Independent Review Organization that would have constant and complete access to all MAS’ records. (To access the CIA, go to http://www.omig.ny.gov/data/content/view/171/248/ and click on Medical Answering Services.)
To me, the stunning surprise was Bob Hussar’s statement that OMIG did not find corrupt activities by MAS in the several other counties where they operate: the problem was in Onondaga County, where Kathy Hart and Zach Karmen brought MAS into being. The problem wasn’t in MAS; it was between Medical Answering Services and the Onondaga County Dept. of Social Services.
At the same time, another problem had cropped up in Medicaid services. Medicaid pays for home health aides for people who are too disabled to take care of themselves. I’m one of thousands of people who receive services. Most people get their aides through for-profit agencies like Home Aides of CNY or Stafkings, but some of us are in the Consumer Directed Personal Assistant Programs run by the independent living centers ARISE and Enable.
In the Consumer Directed Program, the client—that’s me—is assessed by a nurse and case manager from the Onondaga County Dept. of Long Term Care Services. They decide how many hours a week you can have aides and then refer it to Enable or ARISE, where a case manager helps you get set up with an aide. The aide comes to your home and signs in and out on a time sheet, which you audit and sign as supervisor, then the time sheet goes to the Enable case manager who also audits it before she signs off, then it gets sent to the county for payment.
The problem began when we were notified that all aides had to go to Enable and have their voices recorded because we were going to switch from paper time sheets to a computerized call-in process. For over a year we got jerked back and forth on this. We went to the call-in system, then back to timesheets because the call-in system wasn’t working right. Things would be changed, then they wouldn’t be changed, and we never knew what was going on. When the system was finally in full use, it didn’t work. Aides would stand in my living room cursing with frustration because the phone system wasn’t answering, or wasn’t accepting their information, or was getting it wrong.
Then things got one step worse: we were advised that we were now under the surveillance of the Medicaid Fraud Unit. What had we done wrong? Why were we under surveillance? County Medicaid Fraud investigators would call either the clients or their aides and ask demanding, intrusive questions and make threats. Aides were variously in tears or threatening to quit their jobs; clients were livid.
I began to investigate and learned, first, that the contract for the telephone call-in system had been let to a company that had never done this before. Onondaga County was its test case; they had no experience, and were marketing their system on the basis of fear: Medicaid fraud might reach astronomical proportions. Second, I learned that Zachary Karmen had arranged the contract, and he was the head of the Medicaid Fraud Unit. He was, again, contracting for services with a company that had no proven performance record, and through his abusive use of the fraud unit he was turning sick people and their hard-working aides into criminals.
Ever since I received the first letter from Zachary Karmen in which he illegally kicked me off Medicaid transportation, I had wondered whether he was working at the direction of DSS Commissioner David Sutkowy, or was he working on his own? Was Sutkowy dreaming up these things and telling Karmen to make it happen, or was Karmen the creator who merely got Sutkowy to agree with him? Who was in charge in the Dept. of Social Services? What was very clear was that neither the County Legislature nor the County Executive had any intention of reining in the brothers Sutkowy and Karmen in their crude, rude abuse of the poorest, sickest citizens who needed their help.
It now appeared that the greatest harm being inflicted had Zachary Karmen as its source and I was not going to put up with it, so I filed a complaint with the State of New York, Fifth Judicial District, Attorney Grievance Committee. These are the people who can put a lawyer out of business, which is exactly what I wanted for Zachary Karman. I charged that in his capacity as Chief Welfare Attorney of Onondaga County he violated my rights by denying me services without due process, was guilty of conflict of interest, had interfered with a state investigation, and had engaged in repeated acts of intimidation and selective prosecution.
I filed the complaint on the same day that Disabled In Action (DIA) met at Enable with Sutkowy and Karmen, County Legislators Thomas Buckel and Monica Williams, Barrie Gewanter from the Civil Liberties Union, attorney Michael Schwartz from the S.U. Law School, and a bunch of really angry clients in the Consumer Directed Personal Assistant Program. We wanted to know why we were under surveillance, and we wanted it stopped. The meeting began with excerpts from my letter to DSS Commissioner Sutkowy. (To be continued)