NY State Dept. of Health’s manipulation and deceit

Manipulative and deceitful behavior by New York State Department of Health officials Mark Kissinger and David Hoffman will help you understand why the Center for Public Integrity recently gave New York a D-minus in a recent ranking of states and corruption.

I’ll get to the above referenced behavior in just a second. First, some background.

Governor Cuomo’s DOH seems determined to destroy the lives of thousands by ending the state’s Traumatic Brain Injury Waiver – established by the governor’s father, Mario Cuomo – and the Nursing Home Transition and Diversion Waiver by forcing waiver recipients into managed care.

Waivers provide services that both allow residents to remain in or return to the community as well as grow their independence as much as they can.

Now, Hoffman and Kissinger have been hosting a series of workshops they say are designed to make the transition run smoothly.  With only a few exceptions, the DOH workshop membership largely made of those who, whether they’ll admit it on the record or not,  are all for the DOH’s brutal transition plan.

That waiver recipients and their families and along with honest waiver providers have made it clear the waivers need to be protected has, so far, had little effect. That nearly all the witnesses at a an October 8 public hearing hosted by the Assembly Health Committee, Mental Health & Developmental Disability Committee, and Task Force on People with Disabilities warned the state’s plan would have catastrophic results, has not dissuaded the governor, or the DOH, or the many pawns in the DOH work group in the least.

Manipulation and deceit

I recently attended one of the DOH work group meetings. They are public meetings and members of the public, like me, can attend. When the public was asked to comment, some of us did.  A couple of weeks ago I sent Kissinger an email asking him to please send me a listing of who was on the DOH Workgroup. He forwarded the request to Hoffman, and then, Hoffman emailed me the list.

To my surprise, I and other members of the public were listed as members of the work group! Wrong. I emailed Hoffman and asked him of the mistake, pointing out that you can’t list members of the public as being members of the work group because it’s not true. And, they did it without asking permission.

I figured Hoffman (the DOH) would recognize the mistake and correct it. Wrong again.

When Hoffman responded he wrote. “Everyone in attendance is welcome to participate in comments and questions (as you saw) and so are included in the listing.” In other words, if you are a member of the public, and during the public comment portion of the agenda, say something, we’re going to list you as a member of the work group and we are going to do it without your permission.

Subsequent emails to Hoffman and Kissinger asking them to stop this deceit have resulted in a response the DOH has honed to perfection. Silence.

Now that I think of it, the Center for Public Integrity was generous when it gave New York a D-minus. Hell, I think giving  New York an F would be generous.





A win for all NY TBI Waiver Participants

As a result of the relentless pressure brought to bear on the NY State Department of Health by the Kahrmann Advocacy Coalition, several sources across the state this week confirmed that last month the DOH  instituted a form letter that will inform TBI Waiver complainants of the results of their complaints.

The letter will identify the content of the complaint received, the fact the investigation was carried out, whether the complaint was or was not substantiated, and, if substantiated, the steps that were taken as a result. Moreover, if the complaint is about the Regional Resource Development Center – the RRDC is the agency contracted with the DOH to oversee the waiver in regions throughout the state which includes investigating complaints – or the investigation is not within the RRDC’s abilities, the complaint will be forwarded to DOH for investigation. This is a huge win for the advocacy community and for all New Yorkers who live with brain injuries.

KAC members who relentlessly pressured the DOH to institute a policy of informing complainants of the results of their complaints deserve the heartfelt gratitude of all who live with brain injuries and their loved ones. This change would not have come about were it not for their efforts.

It is also very important to make note the following. This confirmed information did not come from Deputy DOH Commissioner Mark Kissinger, nor did it come from anyone in the DOH in Albany. This is important to know for a few reasons.

  • It is very likely the last thing  the DOH in Albany wants to do is give credit to any advocacy group for this policy change.
  • It is very likely the DOH did not publicly announce the change because in doing so they would have to admit their policy of not providing complaint results has been unjust and immoral all along.
  • And just to fire a warning shot across the bow of the good ship DOH, don’t even think about linking this change to the fact the Brain Injury Association of NY State’s contract for answering the complaint line ended as of October 1. BIANYS was never the reason complainants weren’t informed of the results.  The sole responsibility for that inhumane policy rests squarely on the shoulders of the DOH.

The care-less leadership in NYS’s DOH & TBISCC

I think I’ve reached the age where if someone is going to lie to me, the least they could do is make a little effort and be halfway good at it. Bad enough there are irresponsible, unethical people who have power over the lives of others, worse when those people lie and make the rules up as they go along, endangering lives of others in the process.

A November 5 article in the New York Times about the frightening state of affairs in New York State is chilling.  It also accurately reflects the kind of sloppy sub-standard oversight the New York State Department of Health has brought to the state’s Traumatic Brain Injury (TBI) Waiver

It is a well known fact that the DOH refuses to tell people who file complaints related to the TBI Waiver the results of their complaints. They never have. In fact, several Regional Resource Development Specialists, DOH contract employees who oversee the waiver in various regions throughout the state, have told this writer and others they are instructed not to provide the results.  Until recently when their contract to answer the complaint line ended, even the Brain Injury Association of NY State was never informed of the results.

This kind of mangled dysfunction may explain why Deputy DOH Commissioner Mark Kissinger  reminded me last week of the comedian Richard Pryor. Pryor used to tell the story of how his wife caught him in bed with another woman. “You gonna believe me or your lyin’ eyes?!” Pryor exclaimed. And so it was that when last week I emailed Mr. Kissinger asking – again – when the DOH was going to inform complaints of the results of their complaints, he wrote back saying the DOH does inform complainants of the results! Like I said, if someone is going to lie to me the least they could do is make an effort not to sound, well, like a fool. And so, I sent him the dates of complaints I filed in 2010 and 2011 and am still waiting for the results. I would be remiss if I didn’t tell you that a freedom of information request I filed this summer with the DOH asking for the results of my complaints was denied.

And then of course we have the chair of the Traumatic Brain Injury Services Coordinating Council Michael Kaplen who will never remind anyone of Richard Pryor. Kaplen, whose term on the council expired in 2004, still clings to his seat and chairmanship like his life depended on it. His true colors showed during the September 12 council meeting when he  immediately moved to adjourn the meeting  after the council was publicly informed  by this writer that the quality of lives and the lives themselves of waiver participants were at risk because of the DOH. And, when the DOH and New Yorkers with brain injuries could benefit from a TBISCC if it did what its supposed to do, provide proposals to the DOH to better the lives of New Yorkers with brain injuries, Kaplen cancelled the council meeting scheduled for November 15 and provided no follow-up date.

Neither Kaplen nor the DOH will explain the reasons for the cancellation. It has become clear that most if not all council members were given no explanation of the cancellation either.

Let me be clear, the TBI Waiver and the TBISCC are critically important to the lives of New Yorkers with brain injuries. They just need to be run by people who give a damn and who are inclusive in their approach.

Two things: if people suffer and or lose their homes or  lives because of the actions or inactions of the DOH, those in the DOH should be charged, tried, and, if found guilty, jailed. And if the DOH wants to, say, take one small step in the right direction, it might be interested to know that the New York City number it now gives out for the TBI Waiver complaint line belongs to someone who hasn’t worked for them in quite some time. And that’s no lie.


BIANYS & NY State DOH: Birds of a feather (my apology to the birds of the world)

Trying to get New York’s Brain Injury Association and Department of Health to openly deal with some of the challenges faced by brain injury survivors in the state is like trying to nail Jell-O to the wall.

A case in point. Both BIANYS and DOH are tied by contract to the traumatic brain injury waiver complaint line. I can tell you from first hand experience and from hearing the experience of others from all over the state that if you file a complaint you will never learn the results, not ever.

I recently wrote to DOH Deputy Commissioner Mark Kissinger pointing out the injustice, not to mention the possible violation of due process set forth in the Constitution’s 14th amendment. He wrote back saying he would have his staff look into it and get back to me soon. Never heard another word from him, despite follow-up emails on my part.

Then I wrote to the BIANYS board president, Marie Cavallo, and executive director, Judith Avner, asking BIANYS to take a public stance citing the injustice of complainants being ignored. The request was ignored. Scary that these two are the leaders of a non-profit organization that on its website makes the following claim: “Since 1982, we have provided information, resources, programs, advocacy, and support services to brain injury survivors, family members, health care professionals, and educators.” They are absolutely right when they talk about the provision of information and resources and, to some extent, programs, but it is highly disingenuous of them to claim they are an advocacy organization because they are not.

Keep in mind, I’ve asked Avner and Cavallo, in writing, on more than one occasion, to take a public stance regarding the complaint line. They  ignored the request. I’ve asked them in writing to take a public stance regarding the DOH directive blocking TBI Waiver staff from advocating for their clients at Medicaid Fair Hearings. They ignored the request. I asked them in writing to take a stance regarding DOH’s mangling of the rent subsidy which has resulted in quite a few brain-injured individuals getting eviction notices. They ignored the request. I asked them in writing to issue some kind of public statement regarding the heartbreaking case of Francine Taishoff who had her life put in jeopardy by the DOH. They ignored the request.  And I’m a BIANYS member!

I hope the BIANYS board steps in and either straightens out or replaces both of them.

And then we have the DOH.

I sent several emails to Maribeth Gnozzio asking her to address the directive she gave last year blocking waiver staff from advocating for their clients at Medicaid Fair Hearings. Gnozzio ignored the emails. So did the DOH officials copied on them: Kissinger, Mary Ann Anglin and, of course, the DOH’s “tough guy wannabe” Carla Williams.

The pattern in both groups, at least as far as their leadership is concerned, is to do ignore anyone and everyone who holds them accountable and, God forbid, calls on them to do what they say they do in the first place.

NYS DOH considering the possibility of justice

The NYS Department of Health says it will consider telling those who file complaints related to the state’s TBI Waiver  – primarily people with disabilities who live with brain injuries -  the results of their complaints. Currently complainants are never told. In fact, several RRDCs (Regional Resource Development Centers) throughout the state say they’ve been directed by DOH not to tell complainants the outcome of their complaints. RRDCs are agencies under contract with DOH to oversee waiver providers and participants.

On June 30th this writer sent an email to NYS Deputy DOH Commissioner Mark Kissinger which read, in part, “On behalf of Kahrmann Advocacy Coalition members and all those who care about brain injury survivors in the state, I am asking you to immediately issue a directive requiring that those who file complaints related to the TBI Waiver are to be informed of the results of their complaint within 60 days of filing the complaint.  Right now complainants are never informed of the outcome of their complaints – never.”

Kissinger responded via email saying, “I will have staff look into your suggestion and get back to you within a reasonable period of time.” I’ve heard nothing yet. It takes more than two weeks to decide if justice should be served?

I wonder what DOH staff have to look into? Are people really sitting around a table somewhere wondering whether complainants should be told the outcomes of their complaints? Who would argue that they shouldn’t? Well, the DOH for one.  Groups like the state’s Traumatic Brain Injury Services Coordinating Council and the Brain Injury Association of NY State need to publically speak up. Any and all groups who say they are committed to the notion that people with disabilities deserve equal justice under the law and equality on the regulatory front should be outraged, and outraged so others notice. Silence is not an option for them. To remain silent is to support the DOH’s continued assault on the rights of people who live with brain injuries.

If you want to let DOH know your feelings on this, you can write to Mark Kissinger at mlk15@health.state.ny.us or call his office at 518-402-5673.