I talked to people. I called up lots of offices and talked to all kinds of people. What I learned was that all kinds of people were hot to trot to prosecute Medicaid recipients but nobody in the world was going to prosecute Medicaid providers—particularly not ones with government contracts.
I called the Onondaga County District Attorney’s Office—after all, when I was on the witness stand testifying for the Special Prosecutor’s Office I was asked why I hadn’t gone to the District Attorney. So now I went to the District Attorney’s Office—and got told that they don’t take complaints anymore. I would have to file a complaint with the Sheriff’s Department in order to get the matter before the D.A.’s Office. I called the Sheriff’s Dept. and they said they didn’t do that sort of thing—“that sort of thing” being corrupt practices in Medicaid transportation dispatch.
I called the Onondaga County Dept. of Social Services Medicaid Fraud Unit. Nope, they were only going after recipients of social welfare, not the DSS’s subcontractor.
I called the local branch of the NYS Attorney General’s Office and they also declined.
Why is it that if a poor black woman steals a few thousand dollars from Medicaid then she gets her picture on the front page of the newspaper being marched off to jail in handcuffs, but if you are a wealthy white businessman ripping off tens of thousands of dollars while providing services under Medicaid then nobody is going to ask any questions? Why is that?
So, following Rule One of Effective Citizenship, I decided to go over Kathy Hart’s head and talk to her boss. I called and got an appointment with David Sutkowy, commissioner of the Dept. of Social Services. And then I got a call from his secretary canceling the appointment. How about that? I was told that he couldn’t meet me at the scheduled time but I could call back and re-schedule. Yeah, right. Every time I called back I was told that Sutkowy was unavailable. Years later, when I did get to sit down with him—and a couple students from the Syracuse University Law Clinic—he said that I had an appointment and failed to keep it. Sutkowy said that he sat and waited for me. Uh-huh.
In 2008, David Sutkowy, aged 54, was pulling down a salary of $97,667, which rose ten percent to $107,253 in 2011. He supervised 773 employees and had a budget of about $244 million. I was an ex-psychiatric-patient-Medicaid-recipient with a Social Security Disability income of about $8000, and I supervised one aide about ten hours a week. Does anybody in their right mind think Commissioner Sutkowy sat and waited for me? Do you, in fact, think that years later he would have remembered such a failed appointment? Or does it seem more likely that David Sutkowy is a liar?
David Sutkowy’s boss was County Executive Nick Pirro and what could I say to him? It never even occurred to me to approach him, however, those guys were all in the executive branch of government so why not try the legislative branch? If going up the government ladder doesn’t work then try crossing over to another branch of government. I called Kathy Rapp, my elected representative in the Onondaga County Legislature. She was a Republican, but so what? I still believed in right, truth and justice and didn’t really—not really—believe that all things were political.
Kathy Rapp came and sat in my living room with me and my case manager. She knew absolutely nothing about Medicaid transportation so I explained it to her, then reported our conversation to a couple of vendors on August 19, 2004:
“This afternoon I had a ninety-minute meeting with County Legislator Kathleen A. Rapp regarding Medicaid transport dispatch and Medicaid Director Kathy Hart.
“I related to Ms Rapp some of the problems with Rural Metro dispatch, including but not limited to—
- Long waits before Rural Metro answers the phone
- Ride orders sent to the wrong vendors
- Ride orders dropped
- Orders sent for the wrong times and wrong addresses
- Building and office numbers not sent to vendors
- Return pickup times not sent to vendors
- Vendors not getting paid because of incorrect information
- Inability of Wayne Freeman to effectively manage personnel
- Unwillingness of Kathy Hart to solve problems
“Regarding Kathy Hart, I described her duplicity, lack of cooperation, and pattern of willful hostility, disrespect and contentious relationships with clients and vendors.
“I told Ms Rapp that there is no reason for Medicaid transport dispatch to exist. Its functions consist solely of messing up orders and verifying Medicaid. Medicaid recipients routinely contact the doctors, pharmacies and laboratories of their own choosing, and those persons and places independently verify the recipient’s Medicaid; it should be exactly the same way with medical transport companies. The systemic blockage that is Medicaid dispatch should be removed so that clients and vendors can choose each other without impediment.
“I recommended that the Medicaid dispatch center be closed and the funding re-directed to the vendors to hire their own personnel to take ride orders and verify Medicaid, with the portion of funding each vendor gets to be pro-rated based on the number of rides the vendor has carried in the previous year.
“I recommended that Kathy Hart be fired.
“Ms Rapp has an employment background in executive business management, and has recently had two units in the Department of Social Services reviewed by a management team for the purpose of changing procedures to provide better service at less cost. I was impressed by Ms Rapp’s intelligence, thoughtfulness and intention to act. She was quite taken aback at the recital of all the problems with Medicaid transport dispatch. She didn’t know what we go through every day.
“Ms Rapp stated that she would start by calling Dept. of Social Services Commissioner David Sutkowy tomorrow morning, though reaching him is questionable (he has been undergoing treatment for a major medical problem). She said she might also contact Wayne Freeman.
“Ms Rapp is requesting that the vendors speak up; she wants to hear your point of view. She has remarkable listening skills.
Kathleen A. Rapp
County Legislator—5th District
437 Jewell Drive
Liverpool, NY 13088
“Change will not come rapidly, but it will come eventually if we start now.
“Please copy and forward this memo to the other medical transport companies, whose names and addresses I do not have.”