Category Archives: New York State Department of Health

NY State DOH Communicates but…

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If material presented by the New York State Department of Health  is to be believed, no DOH employee has ever mentioned Medicaid Fair Hearings in writing and the DOH has absolutely no policies and procedures when it comes to Medicaid Fair Hearings, not even one.

It is hard to imagine that the absence of any Medicaid Fair Hearing policies and procedures and the absence of any mention of them in writing by anyone in the DOH is anything but a willful act on the part of the DOH.

Some background. In December of last year this writer filed a FOIL (Freedom of Information Law)  request with the DOH seeking, and I quote:

– Any and all policies and procedures and any and all emails or other forms of written or recorded communications that are related to Medicaid Fair Hearings.

– Any and all policies and procedures and any and all emails or other forms of written or recorded communications that are related to the state’s traumatic brain injury waiver, the RRDCs ( Regional Resource Development Centers) and RRDSs (Regional resource Development Specialists) and assistant RRDSs and their role in Medicaid Fair Hearings

– Any and all policies and procedures and any and all emails or other forms of written or recorded communication that are related to directives from DOH (and or contract employees of DOH) that relate to TBI Waiver providers and their role in Medicaid Fair Hearings

– Any and all information that relates to DOH Policies and Procedures that apply to Medicaid Fair Hearings

In response to this request I received only a training binder for fair hearing officers, that’s it.

A case in point: DOH employee Maribeth Gnozzio has a seemingly well-earned reputation for, with rare exception, not returning phone calls or emails. Nevertheless, she communicates rather frequently with the the Traumatic Brain Injury Waiver’s RRDCs  she is charged with overseeing across the state. The RRDCs oversee waiver providers and participants in different regions.

However, it seems that despite sending in the neighborhood of 3,658 emails to RRDCs in 2010, she too never mentions Medicaid Fair Hearings once. A remarkable feat indeed since several sources say it was Gnozzio who told RRDCs during a phone conferences last year that waiver providers are not to appear in support of waiver participants in Medicaid Fair Hearings, a nasty Machiavellian directive to say the least and a directive that can only be designed to undercut a waiver participant’s chances in a fair hearing. The results have no doubt  been brutal for more than one person living with a brain injury since it no coincidence that this rather sadistic DOH directive was issued at a time when there seems to be a wide-ranging effort to discharge people from the waiver or notify them their services are being cut. To send some of us who live with brain injuries into a Medicaid Fair Hearing without our waiver case managers can be like asking someone to climb Mount Everest without oxygen, and the DOH knows it.

Here is a regional breakdown of the approximate number of emails sent by Gnozzio to RRDCs in 2010:

Capital District – 226

Buffalo – 236

Long Island – 886

Lower Hudson Valley – 506

New York City – 704

Adirondacks – 244

Rochester – 140

Binghamton – 260

Syracuse – 130

Sent to all RRDCs – 326

NY TBI Waiver: Not Always Health or Care

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I’ve been living in a new county in New York for four months now and I am still waiting for the TBI Waiver’s RRDC (Regional Resource Development Center), the contract employee of the state’s Department of Health that represents the DOH and oversees those who provide waiver services and waiver service recipients, like myself, in a particular region, to approve my service plan.

Not a surprise, though it should be.

Now, to say the the state’s DOH has been anything but impressive in it’s management of the waiver of late is an understatement. Let’s add another fact to the mix. The RRDC in my area is STIC,  the Southern Tier Independence Center in Binghamton.  Have you read about them before in this blog? Of course you have. They’re the ones who hired Timothy J. Feeney of fictitious college degree fame to play a major role in STIC’s new contract for the Neurobehavioral Project linked to, wait for it, the TBI Waiver.  When STIC’s executive director, Maria Dibble, was notified that Feeney’s claim to have a valid masters and doctorate was bogus, it apparently didn’t matter.

Is it any wonder there is some inexplicable delay in signing my service plan? I am waiting for a discharge from the waiver notice any day now claiming that somehow the brain injury I live with has, what, gotten better? In truth, it debilitating impact on my life has increased dramatically. But I don’t expect that matters to some either.

As a side note, or perhaps not so side note, it is also worth noting that I’ve yet to receive a decision from my Fair Hearing held on December 1, 2010, a Fair Hearing in which we sought to reverse the DOH’s denial of my request for a life alert and white noise machines given the increase in sound sensitivity I live with. And hey, this month is an anniversary of sorts, given that it is now one year since we first asked for them.

Like I said, the TBI Waiver is not always healthcare because sometimes it lacks commitment to health and sure as hell lacks care.

NY State DOH: Anything but Open

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If change under new Governor Andrew Cuomo includes a new spirit of ethics and openness, the message has yet to reach the state’s department of health.

As this blog noted in a January 11 post, the DOH’s response to a FOIL (freedom of information law) request for any and all DOH policies and procedures and emails regarding Medicaid Fair Hearings resulted in their sending only a slim training binder for fair hearing officers. If this is an honest and comprehensive response, it means the DOH has no fair hearing polices and procedures and no DOH employee has ever ever ever sent email discussing referencing fair hearings in any way. So, are we looking at incompetence, dishonesty, or a healthy dose of both?

Now, today, I received a letter from Robert “Jake” LoCicero, an attorney in the state’s Records Access Office. I’d sent in a FOIL request seeking the following linked to DOH officials Mary Ann Anglin and Maribeth Gnozzio.

– Any and all emails or other written forms of communication authored by Maribeth Gnozzio to any and all RRDCs in the state from January 2009 to the date of this request.
– Any and all emails or other written forms of communication authored by Mary Ann Anglin that were sent to or copied to Maribeth Gnozzio.

In today’s letter LoCicero let me know efforts are underway to gather the information but  they may want to charge me “an amount equal to the hourly salary attributed to the lowest paid agency employee who has the necessary skill required to prepare a copy of the requested record.” I already called the NY State Committee on Open Government. Over the years I’ve filed dozens of FOIL requests and the law says you can be charged no more than 25 cents a page.

Anyway, nice to know our department of health has thus far, despite our new governor, found a way to continue its secretive, insular, non-cooperative patterns of behavior.

NY State’s DOH Dysfunction Continues

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There is no doubt New York’s new governor Andrew Cuomo has his work cut out for him in his push for ethical and accountable behavior on the part of state employees and state agencies. Evidence of the widespread dysfunction is certainly on display in the response I received in yesterday’s mail  to a FOIL (Freedom of Information Law) request I filed on December 12, 2010 seeking documents from the state’s department of health.

The December 12 FOIL request asked for the following (quoted directly from the request itself):

– Any and all policies and procedures and any and all emails or other forms of written or recorded communications that are related to Medicaid Fair Hearings.

– Any and all policies and procedures and any and all emails or other forms of written or recorded communications that are related to the state’s traumatic brain injury waiver, the RRDCs ( Regional Resource Development Centers) and RRDSs (Regional resource Development Specialists) and assistant RRDSs and their role in Medicaid Fair Hearings

– Any and all policies and procedures and any and all emails or other forms of written or recorded communication that are related to directives from DOH (and or contract employees of DOH) that relate to TBI Waiver providers and their role in Medicaid Fair Hearings

– Any and all information that relates to DOH Policies and Procedures that apply to Medicaid Fair Hearings

And what arrived in yesterday’s mail as a response, a slim binder used to training fair hearing officers. A disturbing and seemingly disingenuous response to say the least. Upon reflection here is what is far more disturbing; I wasn’t surprised.

I’ve filed another, far more specific, FOIL request.

Stay tuned.

Brain Injury Summit II This Friday

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The second Brain Injury Summit will be held Friday morning in Albany.  Those invited included the Brain Injury Association of NY State, the New York State Department of Health, the New York State Commission on Quality of Care, the Providers Alliance, the Brain Injury Coalition of Central NY, and the Kahrmann Advocacy Coalition.

Given that effective and fluid communication between all is a challenge not uncommon in any multifaceted system, communication will be the primary focus.

The DOH of late has taken a great deal of heat, both from this “pen” and from others. It is my sincere hope that some of the challenges now being faced by survivors, providers, advocacy groups and, not incidentally, the DOH are clarified so when all parties leave the summit, heads are in a more serene place, there is greater clarity all around,  and the commitment to open and effective communication is, in some instances renewed and in other instances begun.

All parties actively took part in the first summit and I fully expect the same this time. There are some justifiably frightened survivors across the state and some understandably worried providers. To say lives are at risk is anything but an understatement.