Category Archives: Mental.Health

DCF Faulted For Oversight Of Privatized Agencies

Source: CBSMiami, April 20, 2015

Two reports presented to lawmakers last week criticized the Florida Department of Children and Families for poor oversight of the privatized agencies that deliver child-welfare, substance-abuse and mental-health services statewide. The reports arrived as the Legislature is considering further changes to all those services. The Florida Office of the Auditor General published its findings last month and reviewed them Thursday with members of the Senate Children, Families and Elder Affairs Committee. One report faulted the state’s oversight of what are known as managing entities, which oversee the delivery of substance-abuse and mental-health services. With lawmakers focused on improving those services this year, the managing entities could be revamped under a bill (SB 7068) ready for a vote by the full Senate possibly as soon as Wednesday. The House version (HB 7119) is ready to go to the full House. The other report criticized the state’s oversight of community-based care organizations, known as CBCs, which provide foster care, adoption and family-support services. The agencies have been under legislative scrutiny in recent years for a series of child deaths from abuse and neglect. Now, lawmakers are revisiting a child-welfare reform law passed last year — and the possibility of more funding for the CBCs to provide mental-health and substance-abuse treatment, among other services. Together, the reports point to shortcomings in the Department of Children and Families’ monitoring of the privatized agencies, which receive hundreds of millions of dollars a year to coordinate and deliver services in their regions.
Related:
Department of Children and Families and Selected Community-Based Care Lead Agencies – Oversight of Foster Care and Related Services – Operational Audit
Source: State of Florida, Auditor General, 2015-156, March 2015

Department of Children and Families and Selected Behavioral Health Managing Entities – Oversight of Substance Abuse and Mental Health Services – Operational Audit
Source: State of Florida, Auditor General, 2015-155, March 2015

Failed Hospital Deal Reveals Ties to Janek

Source: Terri Langford and Aman Batheja, Texas Tribune, April 16, 2015

Three years ago, a company called Geo Care Inc. failed to win a contract from the Texas Health and Human Services Commission to privatize the Kerrville State Hospital, one of the state’s 10 psychiatric facilities. So the company’s lobbyist, Frank Santos, circled back and provided HHSC Executive Commissioner Kyle Janek with a blueprint for how the agency could successfully privatize other state hospitals — maybe Austin, Kerrville, San Antonio and Rusk — which would then allow Santos’ client to bid for the work. …. The emailed communications between Santos and Janek, as well as phone calls and meetings, appear to break no laws. In fact, the state’s own statutes allow vendors to approach government agencies with “public-private partnership” ideas. But the optics for Janek, who has been bombarded with calls for his resignation, are something else entirely.
Related:
Texas Ditches Plan to Privatize Terrell State Hospital
Source: Terri Langford, Texas Tribune, March 25, 2015

A plan to privatize Terrell State Hospital is dead following a scathing audit that raps the state health commission for bypassing its own contracting procedures. The Texas Health and Human Services Commission canceled the deal — which was still being negotiated — immediately following the Wednesday release of a report by Texas State Auditor John Keel, commission spokeswoman Stephanie Goodman said. The review of the deal is the latest setback for Texas Health and Human Services Executive Commissioner Kyle Janek. The commission is already being investigated for the way it awarded a $20 million anti-Medicaid fraud software deal to a single bidder in 2012. And late last year, a state audit dinged the agency for a messy telecommunications contract with AT&T that ballooned from $48 million to $80 million. In this latest report, the state auditor took issue with the commission’s October decision to tentatively select Geo Care LLC to run the hospital, one of the state’s 10 psychiatric facilities. The audit found that the commission undervalued the contract and skipped having the deal blessed by the Texas attorney general’s office, as required…. GEO Care, which eventually became the company known as Correct Care LLC, issued a statement expressing regret over the state’s decision not to proceed. …

Audit reviewing state contract to run North Texas psychiatric facility
Source: Statesman, February 7, 2015

As state health officials continue to take fire over the agency’s technology contracts, they’re facing another investigation into a proposed deal with a private company to run a North Texas psychiatric facility. The State Auditor’s Office is conducting a review into whether the Health and Human Services Commission followed state procurement laws when it awarded Correct Care Solutions a tentative contract to run Terrell State Hospital. The cost and the scope of the proposed deal aren’t publicly known.

Deadlines continue to pass for state hospital privatization
Source: Gary E. Lindsley, Terrell Tribune, January 16, 2015

State officials had hoped to have a new operator for Terrell State Hospital by summer 2014. Then they hoped to have a new operator in place by early fall. That, of course, changed to Jan. 1. Jan. 1 has come and gone and Texas Department of Health and Human Services Executive Commissioner Dr. Kyle Janek still does not have a signed contract with Correct Care Solutions. CCS, according to state officials, operates six residential treatment hospitals in Florida, South Carolina and Texas that care for about 2,000 patients. Former state Rep. Lance Gooden on Jan. 8 told members of the Rotary Club of Terrell that a contract should be signed between Janek and CCS officials in the next few weeks. After that, it will take several months to work out the transition from state to CCS operation, according to Gooden…..

Column: Janek’s push for urgency in Terrell State Hospital privatization effort questioned
Source: Mike Elswick, Terrell Tribune, January 16, 2015

One of the big mysteries of the whole privatization push the executive commissioner of the Texas Department of Health and Human Services for putting operations of Terrell State Hospital in the hands of a private operator has been his sense of urgency. … It is baffling to those watching this convoluted process as to why he has placed such tight timelines on awarding a bid and of getting operations out of the state’s hands. After all, Terrell State Hospital has been a state operated institution since the 1880s. …. Unfortunately, Janek and the commission have practically ignored local input into the process and the details of the bid process have been so scant that it almost seems as if the apparent recipient of the bid, Geo Care’s Correct Care Solutions, was predetermined long before a single bid was submitted. In fact, the name of Geo Care was among those mentioned as potential operators long before bids were officially accepted. ….

Bid deadline extended again for Terrell State Hospital privatization proposals
Source: Gary E. Lindsley, Terrell Tribune, August 10, 2014
(subscription required)

The deadline for submitting proposals to operate Terrell State Hospital has been extended yet again.
Dr. Kyle Janek, who is the Texas Department of Health Human Services executive commissioner, originally set up a schedule which could have seen someone other than the state running the mental health facility by Sept.15….

Privatized hospital, hidden woes?
Source: Andrea Ball, Austin American-Statesman, June 30, 2014
(subscription required)

State leaders have quietly taken steps over the past year to privatize a troubled psychiatric hospital, a move that, if successful, could hide much of its work from public view. Earlier this month, the Department of State Health Services solicited bids to operate Terrell State Hospital, a Northeast Texas psychiatric facility that houses about 250 people with severe mental illnesses. The hospital came close to losing millions of dollars in federal funding last year after Medicare investigators said widespread problems threatened patients’ lives. The state has unsuccessfully tried to privatize its psychiatric hospitals multiple times over the past decade, saying a for-profit company might help save taxpayer money while caring for some of the most vulnerable people in Texas. This time, state leaders say they’re not seeking to save money, but rather to improve patient services. But paying an outsider to run Terrell State Hospital would make it much harder for the public to know what goes on there. Even when they take taxpayer money, the Texas Public Information Act doesn’t always apply to privately owned companies, which can withhold basic information that state hospitals are typically required to release.

13 Investigates: Bosses caught embezzling employee money

Source: Larry Barker, KRQE, February 7, 2015

…. Tri-County has been providing mental health and substance abuse counseling to clients throughout Taos, Colfax and Union Counties for 35 years. The non-profit healthcare agency is funded by private insurance, Medicare and Medicaid. However, last year Tri-County ran into financial difficulty. … According to a News 13 investigation, in a desperate move to avoid closing its doors, Tri-County secretly borrowed money from its employees. A portion of each employee’s paycheck was supposed to go to Blue Cross Blue Shield for health insurance. Instead of turning the money over to Blue Cross, Tri-County seized the employee insurance premiums and used the money to make payroll.

Big Step: Private group-home workers win breakthrough organizing victory

Source: AFSCME Council 5, Stepping Up, Vol. 9 no. 7, November/ December 2014

In an organizing drive that completely blind-sided their bosses, 173 workers at Stepping Stones for Living joined AFSCME in an overwhelming election victory. The new members work at 16 group homes in the Duluth area and at a day program in Hermantown. The workers provide residential and support services for adults with traumatic brain injury or mental illness. “Basically, we try to provide them the most normal life possible given the circumstances,” says John Pietz, a crisis float who helped lead the union drive. Many of Stepping Stones’ residents come from secure state sites such as Anoka Metro Regional Treatment Center. Council 5 represents hundreds of workers at such state facilities, but workers at Stepping Stones are the first members in private group homes in Minnesota. ….

How For-Profit Prison Corporations are Undermining Efforts to Treat and Rehabilitate Prisoners for Corporate Gain

Source: Caroline Isaacs, American Friends Service Committee, in collaboration with Grassroots Leadership (Austin, TX) and the Southern Center for Human Rights, November 2014

From the summary:
American Friends Service Committee, in collaboration with Grassroots Leadership (Austin, TX) and the Southern Center for Human Rights (Atlanta, GA), is releasing a groundbreaking report that exposes the ways in which for-profit prison corporations are adapting to historic reductions in prison populations by seeking out new markets previously served by non-profit behavioral health and treatment-oriented agencies.

“The Treatment Industrial Complex: How For-Profit Prison Corporations are Undermining Efforts to Treat and Rehabilitate Prisoners for Corporate Gain” highlights the expansion of the incarceration industry away from warehousing people and into areas that traditionally were focused on treatment and care of individuals involved in the criminal justice system–prison medical care, forensic mental hospitals, civil commitment centers, and ‘community corrections’ programs such as halfway houses and home arrest.

These developments pose a tremendous threat of unintended consequences for states seeking to reform their criminal sentencing practices. The greatest financial gains for incarceration companies are in residential settings that allow a company to charge a “per diem” rate. If the stated goal is simply to reduce prison populations, there is real danger that the result will simply be “prisons by another name.”

Plan to privatize Missouri youth psychiatric facility brings more uncertainty

Source: Nancy Cambria, St. Louis Post-Dispatch, September 26, 2014

It was not the rescue plan supporters of Cottonwood Residential Treatment Center had in any way hoped for. Employees say a new state plan to privatize and restructure the youth psychiatric facility may be better than a previous one to shut it down. But many suspect the cost-cutting plan will leave children and youth without appropriate treatment. This week, more than 90 employees at the facility in Cape Girardeau, Mo., began to digest a 17-page presentation released by the Department of Mental Health. It detailed Cottonwood’s planned transition from a state-owned facility to one run by Community Counseling Center, a state contracted agency in the region that currently provides behavioral health services and referrals. … But employees — most of whom expect to lose their jobs — said they are devastated for themselves and for the children. The restructuring proposes cutting the residential center’s capacity by half while increasing home-based options. … Under the plan, all of the facility’s employees will lose their jobs. Some with longer tenure will be given priority to fill jobs at other state facilities. Others will be encouraged to apply for jobs at the private facility, though it appears pay and benefits are lower. Some employees are even being encouraged — by Schafer — to open their homes to young patients and work as “professional parents” who are paid a daily rate to care for the children as they receive outpatient therapies. …

Day wants to privatize Rockland County jobs

Source: Laura Incalcaterra, lohud.com, August 25, 2014

Rockland County Executive Ed Day wants to cut dozens of county jobs in hopes that the workers would be hired by private employers. Most of the jobs are at Summit Park Hospital and Nursing Care Center, which is in the process of being sold to a private owner. …. Day wants the Rockland Legislature to approve a resolution that eliminates entire programs, including posts held by security aides, laundry workers, mental health clerks and radiology technologists. …

Alabama to extend prison rehab contract

Source: Mary Sell, Decatur Daily, July 5, 2014

The Alabama Department of Corrections wants to extend by 14 months and $9.1 million a contract with a New Jersey company to provide substance-abuse counseling, rehabilitation and training to prison inmates.
The contract, which will total $27.4 million since 2012, is on the agenda for Thursday’s Legislative Contract Review Committee. According to a summary on the committee’s agenda, services provided under the contract with Community Education Centers Inc. help “reduce prison crowding by transitioning medium security inmates to work release/community centers.”…

Going public on privatization / Consider security, hidden costs, prison board told

Source: Sandy Scarmack, Sharon Herald, July 16, 2014

…County Commissioner Chairman John Lechner has explained at several commissioners meetings that he believes the move toward privatization is a financial need and is “in no way” tied to either contract negotiations or the lawsuit. According to Lechner, the $7 million annual jail budget eats up about a quarter of all tax monies paid by residents. By adding in state and federal dollars the county gets to operate the prison, it still takes nearly 12 percent of the county’s total $56 million operating budget. Opponents to the privatization issue have primarily been the guards, who likely would be facing a 50-percent pay cut, looking at their wages being hacked from a top end of $24 an hour to $12 an hour under a private contractor….

Related:
Mercer County may privatize jail
Source: WYTV, July 15, 2014

…Just weeks after receiving a 100 percent rating from the Pennsylvania State Department of Corrections, union leaders at the Mercer County Jail are questioning why the Mercer County Prison Board is thinking about privatizing it. Members of the Mercer County Prison Board, who oversee the jail in Mercer County, said the answer to rising costs may be to hire an outside company to run the lockup. Members of the board gathered Tuesday to discuss the possibility….Columbiana County privatized their operations and uses Corrections Education Center(CEC). The company is paid just over $3 million to operate the jail in Lisbon, which has 100 fewer beds than Mercer. The agreement saves Columbiana County about $1 million per year. Recently, CEC officials toured the Mercer County Jail but no other negotiations or move to elicit a bid from the company occurred. No official proposals have been solicited or submitted from any company….

Jail privatization mulled / County considers options with eye on saving money
Source: Melissa Klaric, Sharon Herald, June 19, 2014

Mercer County stands to save millions of dollars if it hires a private company to run the county jail, and that decision could be made by the end of the year, county Commissioner John Lechner said…. The jail, in Findley Township, opened in November 2005 at a cost of $21 million. Lechner said a private company could take over the canteen fund, commissary, food service, medical services, counseling, and labor to manage and operate the jail….One private company, Community Education Centers, toured the jail and made a presentation to the prison board this week on what they could offer….She said CEC lacks a pension plan, its 401(k) plan does not match employee contributions, and salaries could be cut in half if the company kept current employees…. Lechner said a lawsuit filed by corrections officers had nothing to do the board considering privatization. The suit, filed by 57 present and former corrections officers, alleges that the county owes them hundreds of thousands of dollars in unpaid overtime. Lechner said it would just be like a job change for them. “My understanding is that there would be no union, but the workers would still have the ability to form a union again. The union currently represents the employees throughout the county, and they’d no longer be employees under the county,” he said….

In Turnabout, N.Y. Moves to Shut Troubled Rehab Clinic

Source: Jake Bernstein, ProPublica, May 1, 2014

Records show state officials knew for years about problems at New York Service Network, including allegations of overbilling and violations of patients’ rights exposed by a ProPublica investigation….ProPublica has now learned that the agency is moving to revoke NYSN’s license. In a Feb. 11 letter and report to NYSN’s owner, the agency explains what investigators found. The agency’s report lists six separate categories of violations, ranging from infringing on patient rights to failing to determine what treatment they needed. Patients were required to attend at least five counseling sessions a week regardless of their individual clinical needs. The inspectors found cookie-cutter treatment plans in the files they reviewed instead of plans tailored to individual patients. Program notes were incomplete or not consistent with actual patient experiences….
Related:
Inside a New York Drug Clinic, Allegations of Kickbacks and Shoddy Care
Source: Jake Bernstein, ProPublica, September 9, 2013

…A ProPublica examination of New York Service Network (NYSN) and the taxpayer-financed system that sustains it shows that Imbert’s experience isn’t unique. In New York, a lack of affordable housing gives sober-home landlords extraordinary power over their residents, who often are forced to attend specific outpatient treatment programs that can be of dubious quality. It’s a system that victimizes not only alcoholics and addicts — making an already challenging recovery more difficult — but taxpayers who pick up the tab.

Outpatient addiction treatment for the poor has become a mainstay of the social safety net, costing the federal, state and local governments $6.7 billion in 2009, the most recent figure available. The money pays for an estimated 1.5 million admissions a year, nearly three-fourths of them to outpatient programs like NYSN’s, according to a study by the National Center on Addiction and Substance Abuse at Columbia University. …

…In Massachusetts, authorities have won convictions against sober-home employees who were sending residents to get drug tests at a company that paid kickbacks to the homes. In South Florida, a federal task force last year prosecuted halfway house operators who accepted illicit payments for sending patients to clinics for unneeded procedures. And in July, California halted payments to 16 centers amid reports by CNN and the Center for Investigative Reporting about phony billing.

Oversight of outpatient centers is mainly left to states, which typically perform inspections and paperwork audits but don’t necessarily delve deeply into clinic operations. Patient outcomes are self-reported by clinics, and counselors often lack medical training and are poorly paid. Clinics generally are compensated on a fee-for-service basis, creating an incentive to bill for as many visits as possible. …

…When it comes to New York Service Network, former employees have filed complaints with regulators alleging falsification of records, padding of counseling sessions or payment of kickbacks to secure a steady stream of patients. Their claims track with some of Imbert’s experiences as a patient over five months, and with records in her patient file describing counseling sessions that she said never occurred.

Lazar Feygin, the doctor who owns NYSN, adamantly denied paying kickbacks in exchange for patient referrals. He also disputed allegations by Imbert and former employees, who said counseling records were sometimes fabricated so NYSN could justify its billings to the state. …