August 25—four months till Christmas. I dreamed that I was on Marshall Street (the commercial shopping area of Syracuse University two blocks away from my home) and, amid much joviality and merriment, they were taking down most of the bright and splendid Christmas decorations even though it wasn’t Christmas yet. What remained were decorations that were purple and black. My brother, who died last year, was cheerfully calling to me “Come on over!”
Yesterday I called five agency people who are supposed to be involved with getting me home health aides or admission to a skilled nursing facility. I got five voice mails.
The only call that was returned was from Cathy Dutton, who is a supervisor at Onondaga County’s Office of Aging, Long Term Care Resource Center. Cathy and R.N. John Terry came to my home on Monday and informed me that my aide hours would be doubled from 12½ hours a week to 24½ hours a week.
The county, e.g., Cathy Dutton, et al, maintain a “call-out” list, i.e., a list of home health care agencies that are under contract to the county to provide home health care aides to people on Medicaid. This is the poor people’s list. If you are not poor then you can get aide service started within 24 hours of the order being placed. Home health care agencies are not about caring for sick people; they are about caring for sick people who have money.
I have been in the Consumer Directed Personal Assistant Program through Enable independent living center, but on Tuesday morning I notified John Terry that I am no longer capable of being self-directed. I am no longer suitable for the “consumer-directed” program, except the services of Amelia. She has been my aide in the consumer-directed program for nearly two years and she no longer needs any direction from me. She knows what to do and proceeds to do it with efficiency and respect.
So the new hours that the county has authorized—“effective immediately,” which was Monday, August 20—are to go on the call-out list. John says it will take him two hours to do the paper work, including but certainly not limited to sending me two letters of my right to a fair hearing.
Two hours of paper work. Two hours, before I can even get into the system for getting the home aides that I needed “immediately.” Why is a nurse doing two hours of paper work? Why isn’t a nurse doing medical evaluations and a clerk processing the paper work? Why is there so much paper work?
Because everybody is covering their butt. Does Anne really need help? But are you sure? Isn’t there some way to deny her services? That, ladies and gentlemen, is what it’s all about. At every step in the payment of your taxes for my services, there is a steady increase in the required documentation that I actually need help. Your money is not being spent on services to the end-point user. It is being spent on paper work.
I have to sign thirteen sets of papers every year to renew my lease in a HUD property. When the nurse did the Patient Review Instrument documenting that I needed to be in a nursing home, one of the papers I had to sign said that Medicare was not being billed. We now have to tell the government what we are not doing, which opens the door for literally endless paper work.
These people—these people who are being paid by Medicare and Medicaid—come into my home every year, every six months, every three months, now every week, and hand me new forms to be signed. “This is a new form that we’re required . . .” And when I ask them, every single one of these people says no, no they’ve never had any form discontinued.
Government agencies have, as their first priority, proving that they’ve done nothing wrong—and “wrong” in this case always means “I have not let a poor person get anything the law doesn’t allow.” My ass is covered, and the poor person has been denied services. I phoned in a complaint to the “hotline” of the Onondaga County Medicaid Fraud Unit for the Visiting Nurse Association illegally denying me skilled nursing care.
It took Medicaid Fraud ten days to return my phone call. When they did call, they said that they do not investigate provider agencies. The county only investigates recipients. Poor sick people can be illegally denied services that they have a right to under the law, and the county won’t do anything about it. What the man did do was pull out a phone book and give me the phone number of the NYS Attorney General’s Office (AGO).
And when I called the AGO, they told me that they only investigate criminal cases. Now you tell me, how can they tell if it’s a criminal case unless they investigate it? And if it’s not a criminal case, then what is it? A civil case? Ain’t no civility in this system.
Wayne Freeman, co-owner of Medical Answering Service, got a quarter-million-dollar no-bid contract from the county and provided substandard Medicaid transportation to the county’s 22,000 poor people and nobody would do anything about it. Until the governor created the NYS Office of the Medicaid Inspector General. Check out their web site at http://www.omig.ny.gov/data/content/view/275/01/. It used to have a list of excluded providers—physicians and dentists and pharmacies that got caught running multi-million-dollar scams—but I can’t find it.
Anyway, the big money to be made in Medicaid fraud is by the provider, not the recipient. And the biggest rip-off? The biggest rip-off of the bazillion dollars you’re paying to Medicare and Medicaid is the paper pushers. How many people do you know whose services are being billed to Medicaid? The agency clerk who lives down the street? The county case manager who sits next to you at the movies? The “supervisor” parked next to you at the grocery store?
They are all being paid to push papers and you’re the one who’s paying.