Category Archives: TBI Waiver

NY’s TBISCC Meeting Agenda for April 14th

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One of the things that must happen is improved communication across the board. Having said that, here is a copy of the agenda for the Traumatic Brain Injury Services Coordinating Council (TBISCC) meeting this April 14th. The meeting is open to the public.

 

Traumatic Brain Injury Services Coordinating Council

NYS Department of Health

Empire State Plaza, Room 125 (near Concourse entrance to Corning Tower)

Thursday April 14, 2011

10:30 AM – 3:30 PM

AGENDA

 

10:30am – 10:45am Welcome, Introduction of New Members,

Review and Approval of Minutes from the December 6, 2010 Council Meeting

10:45am – 11:15pm DOH senior staff attendance to discuss the following to the extent possible:

· executive budget – possible implications for TBI

· identification of new administration/staff

· report back on service coordinator involvement in fair hearing process

· update on the status of the universal screening tool/its potential to replace the PRI for appropriate access to TBI waiver services

11:15pm – 12:00pm Presentation: Analysis of the TBI service provider surveys with follow-up questions and TBISCC member discussion/input.

12:00pm – 12:45pm Lunch (members on their own)

12:45pm – 1:15pm Subcommittee reports –

· Healthcare Reform/Non-Waiver Service Needs

· Public Awareness/ Injury Prevention and Information Dissemination

1:15pm –1:45pm Veteran’s Activities and Service Update (to be confirmed)

1:45pm – 2:00pm TBI Waiver Update

2:00pm – 2:30pm Carry Over Issues from Last Meeting

2:30pm – 3:15pm Public Comment/Summary/Next Steps/Adjournment

3:15pm – 3:30pm Meeting Wrap-Up/Date for next meeting

 

Actions Speak Louder than… (you know the rest)

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Last year I had a face to face meeting with three officials from the New York State Department of Health: Mark Kissinger, deputy commissioner, Mary Ann Anglin, Division Director, and Carla Williams,  a deputy director and tough-guy wannabe.

Our conversation at the time, one the three officials insisted not be recorded, probably because Williams knew she was going to launch into what can best be described as laughable attempt to be intimidating, revolved around the state’s decision to sign a contract that would allow Timothy J. Feeney back into the state’s TBI waiver knowing full well he misrepresents his credentials. The contract was signed with STIC (Southern Tier Independence Center) in Binghamton. “STIC’s the one that’s on the hook” said Williams, mustering up a dramatically poor imitation of a snarling delivery. “If they don’t live up to the contract it’s on them.”

I left the meeting thinking there may have been at least some sincerity in their claim that survivors would be treated well and with respect and my oh my how all three said they cared so much. I was wrong, though, even now, I think Anglin might. I say I was wrong because Feeney while operating under the contract and being paid by your tax dollars continues to misrepresent his credentials and even though a complaint was filed with the DOH, they have not responded.  Why? They simply don’t care.

Don’t believe me? Ask them. Write to Kissinger at mlk15@health.state.ny.us or Anglin at Maa05@health.state.ny.us or Williams at Crw03@health.state.ny.us

If you want some real fun, write to the DOH’s Beth Gnozzio who issued a directive in a phone conference that TBI Waiver staff are not allowed to appear in support of their clients in Medicaid Fair Hearings. As her why she and the DOH refuse to put this directive in writing? Gnozzio can be reached at mjg07@health.state.ny.us

And copy me if you’d like. peterkahrmann@gmail.com

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

A Short Story: The Heart of Sidney Chest

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Sidney Chest sits erect in his custom made Ermenegildo Zegna suit made by Mr. Kelly at La Rukico Tailors, joking that the blue dress shirt he has on is his least favorite but it was the only clean one he had left in his lambskin overnight bag. He has, after all, stayed over an extra night in the city of Patch Falls to help guide his company’s handling of those Sidney Chest refers to as my TBI people. TBI meaning traumatic brain injury, injuries sustained from a blow to the head, falls, assaults, car accidents, bicycle accidents and so on. Sidney Chest owns and runs a company that provides supportive services, or so they are called, to men and women who live with brain injuries so they might continue to live in the community rather than in institutions. Their injuries have robbed them of their peoplehood in the eyes of many, including the hazel eyes of Sidney Chest, who feigns caring about those poor TBI people who are viewed by Chest and his ilk as a plethora of cottage industries – profit makers.

Leaning back in his leather desk chair, Sydney Chest makes a mental note to have the chair cleaned. It was given to him by his wife Alice on their fifth wedding anniversary. "So what is the issue here with Allen Small?"

"He’s not happy with his staff. Says they talk to him like he’s a child." These words come in bored tones from Sally Stipple, a rather rotund woman with two strands of thick black beads around her neck and matching earrings. Her lips are large, pasty and pointless, like two dollops of silly putty hastily applied. She wears no make-up save for bright red lipstick. She wears a nose ring. She is 44 years old, looks 60, is divorced, no children, and, is a former nursing administrator. She sees the TBI people for what she knows they were. Needy, often misguided beings who are, if not entirely absent any purpose in life, entirely absent any real future in life. These people, though they aren’t really people any more, at least not completely, are stuck in place, damn lucky to get the services they are getting, and would do themselves a bit of justice, yes they would, if they’d just learn to show a little gratitude. They are forever complaining they are being talked too like they are children when they ought to be glad people are talking to them at all.

Sally Stipple runs a tight ship and Sidney Chest likes her for it and will go on liking her for it as long as Sally Stipple’s dictatorial streak keeps the billing up to speed which keeps the money coming in. In Sydney Chest’s world, Sally Stipple is what health care is all about, at least the health care his company is about if he has anything to say about it thank you very much. the company he boisterously calls the best of its kind in Patch Falls and the surrounding area.

Sydney Chest keeps the stress on billing by crying poverty (he’s actually very wealthy) at all times. He knows it was important to instill in his employees the fear-producing belief that the company is always one billing cycle away from total collapse, that if it wasn’t for his willingness to infuse the company’s coffers with his own personal money and the money of his darling wife Alice for that matter, the entire operation would collapse into a pile of dust and be swept away by the day’s first breeze.

His feigned poverty  underscores the hideously misguided belief that his is a generous heart when he deigns to take a survivor of brain injury out for breakfast or lunch and feigns listening with genuine interest and concern, sending the survivor back into the day program that, like many other programs of its kind, proves there is such a thing as community-based warehousing. Sadly, if there is naiveté or perpetual hunger in the heart of the survivor, quite a few, not all mind you, find themselves blinded by the wondrous portions of food just consumed, thanks to the beneficent Mr. Chest, and  Mr. Chest’s willingness to even order him or her a coffee to go. They return to the confines of the day program and talk about how kind Mr. Chest is, not realizing, at least in the moment, that the heart of a cadaver has more warmth than the organ that beats greed in the bosom of Sydney Chest.

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.