Continuation of letter to DSS Commissioner David Sutkowy regarding attorney Zachary Karmen’s surveillance of disabled people and home health aides working through Enable and ARISE:
Now Mr. Karmen has taken another step toward criminalizing the most frighteningly poor people in our society: he has put us under surveillance by the Medicaid Fraud Unit. We were notified that henceforth every month a fraud investigator will be calling us. It was initially the agency’s understanding that the fraud investigators would be calling the consumers to verify that the aide was at work—the aide, mind you, who had been fully and effectively supervised by the consumer and the agency before the Medify telephone system was installed, would now be monitored by fraud investigators on the telephone. How much money is being spent on this? At a time when the taxpayers are groaning, why is Zachary Karmen being allowed to spend more money to do a job that doesn’t need to be done?
The typical consumer in the self-directed aide program is female, and poor because she’s too sick to work. We are people with spina bifida, cerebral palsy, muscular dystrophy and other degenerative ailments that affect the body but leave the mind intact. The typical aide in the self-directed program is also female, and among the working poor. She is usually a young woman who is working full time while raising her children alone. In order to get to work, she drives an old car that frequently needs repairs she cannot afford. She has little or no health insurance for herself, and her children are on some form of Medicaid. She works hard but doesn’t get paid enough by Medicaid to keep her children off Medicaid.
One county administrator justified the surveillance on the basis that ‘there are billions of dollars being spent on Medicaid, and the fraud goes where the money is.’ Maybe. Home health aides earn $10 an hour. I went to a physician at Upstate who saw me for six minutes and billed $220. My mother went to the pharmacy with a new prescription and was told it would cost $900 for thirty days. There is great potential for fraud among physicians and pharmacists. However, if an aide lies on her timesheet, the potential for fraud is only ten or twenty dollars. Let’s be realistic about where our surveillance money is best spent—and it certainly is not on home health aides.
We do not object to using a computerized check-in and check-out system: it is the year 2010 and that’s the way things are done. We do not object to Enable tying the computerized system into their payroll system: it is cost effective and good business. We do object strenuously to Zachary Karmen using the Medicaid Fraud Unit to maintain constant surveillance over innocent people. The Medicaid Fraud Unit is intended to investigate cases where there is a suspicion of guilt, not to put more than a thousand people under constant investigation simply because they are independent and self-sufficient.
The men and women who are aides and clients in the Consumer and Self Directed programs are decent, honorable citizens who should be treated with respect and understanding, not kept under surveillance. When you get a complaint of wrongdoing in the program, then you investigate it. Until then, Mr. Sutkowy, will you give us your assurance that we will be left alone? Will you direct Mr. Karmen to terminate the Medicaid Fraud Unit’s surveillance of us?
Sincerely, Anne C. Woodlen
At the meeting that day, various aides and clients—speaking through anger or tears—reported the impact of the Medicaid Fraud Unit’s intrusion into their lives. They had become afraid of their government. Barrie Gewanter, of the NY Civil Liberties Union, significantly made the point that the U.S. Constitution precludes keeping someone under surveillance solely because they are a member of a group. You can’t investigate me because I am an Arab-American, patronize a particular bar or root for the Mets. The government can only investigate an individual who has given cause, not all people in a single category.
Legislator Thomas Buckel asked—and kept asking until Sutkowy finally answered him—what event had occurred that precipitated the investigation. Why was it necessary to spend the taxpayers’ money to keep these people under scrutiny? Sutkowy’s answer was two-fold: first, the Consumer Directed Personal Assistant Program (CDPAP) was so good that many people joined it. Karmen, using the Medicaid Fraud Unit, was keeping participants in the program under surveillance because the program got big.
The growth of the CDPAP was a clear indication that the people had chosen what worked best for them, and a repudiation of the for-profit home care agencies, such as St. Joseph’s, Home Aides of CNY, and Stafkings. For that reason, the government was keeping them under surveillance. This is, without a doubt, a scary and horrific abuse of government power.
The second reason why DSS was keeping the CDPAP under scrutiny was because they could. In traditional for-profit agencies, there were too many aides assigned to clients on too-random a basis. CDPAP clients typically only had two aides over a period of six months, whereas for-profit agencies might supply six aids to a client in a single week. Medify had to have all the aides’ voices and clients’ phone numbers recorded to make their system work. Keeping all the clients and aides under close watch was too big a job; scrutinizing the participants in the ARISE and Enable programs was do-able.
At the end of the meeting, Commissioner Sutkowy agreed to rein in the dog: Attorney Zach Karmen was directed to suspend investigation of the people by the Medicaid Fraud Unit. For the rest of the story, see https://annecwoodlen.wordpress.com/2010/11/10/and-the-people-say-%e2%80%9choo-rah%e2%80%9d-part-iii/. (To be continued)