How New York Governor Andrew Cuomo can talk about the need for ethics reform while heading up a secretive, dysfunctional, and, at times, ruthless state department of health s beyond me. But, then again, self-serving lip service from a politician is nothing new, and nothing to praise.
This blog has for years now documented the problems with the state’s DOH, particularly its approach to New Yorkers with brain injury disabilities (BID). The state’s Traumatic Brain Injury (TBI) Waiver, a form of Medicaid reimbursement designed to provide services to people with BID so they can remain and or return to the community is headed up by Maribeth Gnozzio, whose sole claim to fame was not being prosecuted by the federal government as part of an arrangement between her husband, Robert Janisewksi, former Hudson County executive in New Jersey, who was prosecuted for taking bribes and sentenced to 42 months in federal prison, and the FBI.
Knuckles Gnozzio, as I like to call her (we met once at a meeting and when shaking hands at the end of the meeting I discovered Knuckles is one of those folks who for some odd reason thinks its impressive (or scary?) to squeeze someone’s hand as tightly as possible in a handshake) issued a verbal directive in October 2010 blocking TBI Waiver Providers from advocating for waiver participants at Medicaid Fair Hearings. These fair hearings are designed to allow Medicaid recipients to contest decisions to cut or end services altogether, a task not easy to accomplish when your BID makes speech, memory, hearing, noise management, etc. a challenge. Something the DOH knows perfectly well. Nothing depicts the lack of commitment to PWBID more clearly than the fact the DOH does not require staff involved in overseeing the TBI Waiver to have any training in the brain whatsoever.
In some (not all) respects, the DOH’s handling of the waiver has been highly unethical from the start. For example, from 1995 until recently, waiver participants who filed complaints with the DOH related to the waiver were never told the outcome of their complaints. Can you imagine filing a complaint with a law enforcement or regulatory agency, company or school and never being informed of the outcome?
Equally troubling was the fact the Brain Injury Association of New York State (BIANYS) remained dead silent on the fair hearings and complaint issues and the state’s Traumatic Brain Injury Services Coordinating Council (TBISCC) did nothing about either. Until recently, the TBISCC was simply a forum for its leaders to grandstand and its contingent of truly committed members to be stifled.
It was almost beyond comprehension to discover in late 2012 that council chair at the time, Michael Kaplen (former BIANYS president) and council vice-chair, Judith Avner, (current executive director of BIANYS) were still at the head of the table even though their terms had expired nine years and eight years earlier – Avner’s on Aug. 9, 2003 and Kaplen’s on Feb. 12, 2004. Kaplen is no longer chair and Avner is no longer vice-chair. Some thought their true colors emerged at the last council meeting when, no longer being at the head of the table, both left the meeting during the lunch break and never returned. The council has a new chair and BIANYS has a new president so this pen is somewhat hopeful things will change. But, as the saying goes, actions speak louder than words.
As if all this weren’t enough to make one question the sincerity of Cuomo’s commitment to ethics reform, consider this. Last year New York State spent something in the neighborhood of $133 million in New York dollars for the care of New Yorkers placed in out-of-state medical settings. However, if you are a family member who is concerned about the care your family member out of state is getting, you will get no help or support from the DOH. They will tell you they do not have jurisdiction over out-of-state facilities (which everyone knows). What they don’t tell you is that until a few years ago, the DOH did have staff who would follow up on the concerns of family members, request and get case notes, set-up meetings between concerned family members and the respective facilities, and help resolve the issues at hand. Not anymore. So, again, the governor can talk about the very real need for ethics reform all he wants, but somebody better tell him, actions speak louder than words.