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.

 

 

 

 

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If you’re going to lie to me….

I don’t ask for much in life other than respect, so, if you are going to disrespect me by lying  to me, the least you can do is make an effort to make it a good, show a little creativity for God’s sake.

I’ve decided to rummage around in my mind and, perhaps the minds of others, to develop some fun, at least for me, responses to people who lie to me so brazenly and obviously I don’t know whether to burst out laughing and ask them if they’re joking or simply stupid enough to think I believe them, or smack them upside their “head” with a verbal dagger that says, we both know you’re lying and you’re such a self-absorbed little twit you’re going to stand by your stench-rubbish anyway.

Anyone who knows me knows I have no ability to be silent when someone’s rights are being denied. I don’t care of it’s people with disabilities, people who are Jewish, African American, Latino, Muslim, veterans, members of the LGBT community, women, etc., etc., I’m not about to stay silent. People who know me also know it is very likely, particularly of you are a public official or someone in a position of authority, that I am going to expose your bigotry for all to see. 

All that aside, let me say there is a special place in hell for people whose claim to care about the rights of others is nothing more than lip-service smoke screens. A form of dishonesty so glaringly obvious I want to grab them by the throat and say, “Why not grow some backbone and say out loud that you don’t give a rat’s ass about these people and you just care about money and power?” 

What’s somewhat amusing is the feigned indignity performances I get to see when I call someone out for lying, for being a hypocrite. They put so much effort into their performance (without exception they’re lousy actors) I’m surprised they don’t snort and dribble out of the corner of their mouths, go into convulsions, and start speaking in tongues. Some feign astonishment to such I degree I expect them to allow their simian roots to take over and start pounding their chest.

Many of the lies I see these days  come from those who claim they are committed to protecting the rights of New York residents who live with brain injury disabilities. Since their commitment is limited to the effort it takes to say they are committed, the least they could do is make a commitment to develop their lying skills. I’ll probably catch them anyway, but at least catching them might pose a sliver of a challenge. However, exposing them will not.

So, here’s the thing, if you’re going to lie to me, make an effort, or give us both a break and shut up.

With their hearts on my mind

I will be testifying today at a public hearing being held by members of the New York State Assembly about Governor Andrew Cuomo’s plan to demolish the lives of New Yorkers with brain injuries by moving them into managed care and annihilating the services they need and deserve to protect their independence – and keep their homes.

I’ve got plenty of motivation. In addition to my own brain injury, I live with a bullet lodged in my brain as a result of being held up and shot in the head, I know hundreds of New Yorkers with brain injuries. Incredible individuals who only ask for respect, and respect includes access to the care they deserve and the independence they have a right to keep.

  • I know a young man who suffered his brain injury in a car accident; he witnessed the decapitation of two of his friends during the accident.
  • I know a woman who one winter day was walking through a park with her husband pulling her two toddlers on a sled. A drunk snowmobile driver crashed into them. When this woman came out of a coma she learned she would never again move from the neck down, and she learned that both her children had died in the accident.
  • I know a brave woman who is a wheelchair user as a result of her brain injury, an injury caused by meningitis caused by a mosquito bite.
  • I know five good men who, like me, suffered their brain injuries from being shot in the head.

That’s just a sampling of the many survivors of brain injuries I know. I can barely see through the tears now as I think about them all, and contemplate the suffering  the Cuomo administration wants to inflict on them. I will testify today with the hearts of thousands on my mind. Not at all incidentally, the very people in Cuomo’s Department of Health who devised this plan openly acknowledge they know nothing about the brain or brain injury.

Now, there are some truly good people in the New York State legislature.  I’ve met them. I even believe in them.  I know too that to do the right thing for New Yorkers with brain injuries they will have to stand up to some intense opposition from a governor who many say is something of a bully.

I do not fear bullies. Not even a little.

I believe members of the state’s legislature have it in them to stand up and do the right thing. Consider the document below. It is the triage assessment of me the morning I got shot. The circled area says, in part, Patient walked into the ER accompanied by the police. Profuse bleeding from head wound. It was five in the morning when I got shot. When I regained consciousness, there was no one around. I got back to me feet and got myself help. So, if I can stand up and get myself help after being shot in the head at point blank range, I have no doubt members of the NY State Legislature have the capacity to stand up and do the right thing for New Yorkers with brain injuries. The question is, will they?

KAHRMANN 3

Why I fight (the bullet)

The x-rays of the bullet lodged in the frontal lobe of my brain make the point; life happens to us whether we like it or not. So does death.  So do experiences whose realities are so ruthlessly sudden and savage that when (if) you come out the other side with something resembling your wits about you,  you’ll likely find yourself viewing things from a new perspective.  Kahrmann Head Xray 3

Now, needless to say, when I was held up in Brooklyn  in 1984 and shot in the head, things changed. Far, far more than even I realized at the time. The mind and body, it seems, have a way of digesting certain realities over time, particularly when trauma is involved. Were they to absorb so massive a reality in one fell swoop, I suspect some would implode. That would’ve been my fate.

It must be said, I suppose, that all my life I’ve acted, in one way or another, to expose and, hopefully, deplete bigotry’s presence. Whether  its racism, homophobia, anti-Semitism, sexism, the unforgiveable treatment of our senior citizens, and so on, I’ve never been able to sit on my hands, as it were, when  people are being oppressed, having their rights denied, and, as so often is the case when it comes to persons with disabilities (PWD), dehumanized. A reality that came home to roost when I became a PWD as a result of my brain injury and PTSD.

PWD are on the receiving end of some of the most vicious forms of bigotry imaginable. They are perceived and treated as if they are little more than revenue streams for the greedy, and, equally despicable, tattered remnants of humanity whose only purpose is to be trotted out  for display purposes when various agencies decide to use them as bait for donors, or visual fuel for self-aggrandizement, or both.

It would be naive to think this kind of behavior is linked solely to for-profit companies. Not so.   I’ve known and know some non-profits run by arrogant, self-absorbed, self-aggrandizing cretins who, in truth, don’t care a wit about the people they say they care about.  Next time you run across a non-profit company in business to help PWD, find out how many PWD they employ. Find out how many PWD are on their board of directors. And, while you’re at it, find out Kahrmann Head Xray 2what they do with the money they raise. See how much is used to directly benefit the lives of those they are said to care about. Find out – to the penny.

I am writing this essay, in part,  to help some people understand (many already do) why I advocate the way I do. Why, as some have rightly observed, my  advocacy style might be rather aggressive. Some would say, too in the oppressor’s face. Some have wondered why I’ve continued to advocate even after losing all my income in 2008 for doing just that (I would not remain silent when an Albany-based New York State Traumatic Brain Injury (TBI) Waiver Provider was  blatantly denying program participants their rights). Why I’ve continued to advocate even after the New York State Department of Health, also unhappy with my advocacy, simply took away my housing subsidy, and, along with the aforementioned provider and others, damaged my ability to be employed in the field of brain injury in New York State and, I suspect, Massachusetts as well.

All that backlash because I would not remain silent when I saw, in this case, individuals with brain injury disabilities having their rights denied,  sometimes brutally so. One particularly abhorrent creature comes to mind.  When a program participant would tell this creature about something they were having a tough time dealing with, this vile thing would invariably respond with, “To bad, so sad.” The program’s owner was well aware of this person’s behavior, and yet he works there still. Testimony,  I believe,  to the owner’s profit-before-people mindset.

As to why have not stopped my advocacy. There’s a constellation of reasons.  I was raised in a civil rights family, our minister marched with Dr. Martin Luther King Jr. Growing up me heroes included King and Geronimo. My list of heroes grew to include Mandela, Elie Wiesel, Medger Evers, Gandhi, Malcolm X, and more. All of whom suffered more for their advocacy than I ever have.  Since the shooting I’ve met others who are heroes of mine. People who are not household names. Here is a taste.

  • A remarkable woman who, while walking with her husband one wintry day pulling their two children on a sled, was hit by a snowmobile driven by an intoxicated human being. When she regained consciousness, she learned she was permanently paralyzed from the neck down.  She also learned her two had died in the accident.
  • A woman who sustained a brain injury and forever lost her ability to walk because of mosquito bite that led to meningitis.
  • A young man who,, while in a car on his way to a party with friends, was in a car accident. He suffered a brain injury and witnessed the decapitation of two of his friends during the accident.
  • A several women who suffered strokes in childbirth.

That’s just a few, I could go on. I have a long list of heroes. I also have quite a list of graves too. Those who didn’t make it, sometimes because the greed-based system failed.  I have plenty of motivation to fight.

And then, of course, for me there is that moment I came to on the ground after I was shot. That moment when I knew I was going to die. I was completely alone in that experience. One of the gifts of having survived that is this, there is nothing any government or provider or company or agency or individual can do to me that comes close to that hell. Not even a little.

 

Cuomo’s dysfunctional Department of Health remains unchecked

An attorney for New York State’s records access office says the state’s Department of Health does not maintain records identifying how many New York State Medicaid recipients with brain injuries are placed out of state. A shocking admission given the DOH has spent roughly 1.5 billion of the state’s Medicaid dollars on New Yorkers placed out of state from 2003 to 2013.

In a March 21 letter responding to a FOIL (Freedom of Information ) request filed by this writer asking, in part, how many New York State Medicaid recipients with brain injury disabilities are currently placed out of state, Elizabeth Sullivan, an attorney for the state’s records access office,  says “the department [of health] does not maintain Medicaid data for those diagnosed with (brain injuries) as no such coding exists exclusively for these diagnoses.”

Just when you think it impossible for the state’s DOH to appear even more dysfunctional – and disingenuous – the DOH proves you wrong. There is ample evidence of disingenuousness when it comes to the DOH. One example would be a sentence in Ms. Sullivan’s letter to me: “Upon further review of your conversations with Mr. (John) Harper (of the state’s Office of Health Insurance Programs) this office has determined the following enclosed tables are responsive to your request.”  Kudos to Ms. Sullivan for a well-written sentence. One minor problem with its content; I never had conversations with Mr. Harper. As for the tables she references. They list the numbers of New York residents on Medicaid placed out of state but whether they have brain injuries or not is anyone’s guess.

Another example of the DOH’s disingenuousness is its public assertion that it cares about New Yorkers who live with brain injuries yet when those who are stakeholders seek to work with the DOH to improve the lives of NYers with BID, the DOH gives them the straight arm. The DOH recently took part in a phone conference with representatives from  the Brain Injury Association of NY State, the Center for Disability Rights, Disability Rights NY (the state’s protection and advocacy agency), the Traumatic Brain Injury Services Coordination Council (TBISCC) and the state’s Justice Center. It didn’t matter that the DOH had the agenda for a week, nor did it matter the agenda asked the DOH to clearly identify the number  of New Yorkers with BID placed out of state, and, clearly identify what support family members of those placed out of state could count on from the DOH. DOH representatives on the call provided none of the information sought. The DOH would not commit to a follow-up meeting with the stakeholders.

There is an effort underway to create an independent office for brain injury in the state. Good idea. But the current effort asks that the office remain in the control of the DOH. The very notion of the office being under the control of the DOH is a betrayal of New Yorkers with BID and their families. In truth, the office would be well-situated in a non-state agency, a non-profit that knows the plight of those who live with disabilities: CDR (Center for Disability Rights) would, at this point, be this writer’s choice. In fact, if the Cuomo administration wants to prove their claim of caring about individuals with BID is more than lip service (as well as his voiced commitment to ethics reform), then it should recognize that both the TBI and Nursing Home waivers  would be well-served under CDR’s leadership.

Over the past few years this blog has more than once memorialized the truly sickening mess that is the DOH. Examples abound: for 15 years plus  if you were a participant in the state’s Traumatic Brain Injury (TBI) Waiver and filed a complaint, the DOH never informed you of the results of your complaint. For 15 years the DOH’s most powerful person, when it came to the TBI Waiver, was Timothy J. Feeney, who then and now misrepresented his educational credentials, telling all the world he had a PhD and a Masters Degree when, in truth, both documents were issued by a now defunct diploma mill off the coast of Australia and were not and are not recognized as valid anywhere on planet earth.

Then, of course, you have the saga of Maribeth “Knuckles” Gnozzio. Knuckles, who wields enormous power on both the TBI Waiver and the Nursing Home and Transitions Waiver fronts, appears to have escaped federal prosecution thanks to a deal cut by her husband, Robert Janiszewski, who was convicted in 2002 of extortion and tax evasion by federal prosecutors. As this blog pointed out in January, Cuomo’s stated commitment to ethics reform is nothing more than smoke and mirrors if Gnozzio remains in place.  Reform “doesn’t seem to be on Knuckles Gnozzio’s mind. In 2010 she was the one who issued the verbal directive blocking waiver staff from advocating for waiver participants at Medicaid Fair Hearings, a move that has undermined the ability of many to truly represent themselves, which was Knuckles plan? Was it Cuomo’s plan as well? Or did he simply not know what his DOH was doing. He has known for some time now, and still not change. It was also Knuckles Gnozzio that directed that the housing subsidy this writer was receiving when he was on the TBI Waiver be taken away and it was Knuckle’s Gnozzio who led the effort to deny this writer a request for white noise machines secondary to sound sensitivity related to my brain injury. Gnozzio needs to go and, if Cuomo is telling the truth about his commitment to ethics reform, she will. If he isn’t, she won’t.”

It seems to me that the best thing that could happen for New Yorkers, in and out of state, who live with BID, is for the DOH to be removed from the equation altogether.