Justice 1 NYS DOH 0

It took the combined efforts of the NYS Commission on Quality of Care, an RRDC (Regional Resource Development Center) with real principles, the Kahrmann Advocacy Coalition, and the threat of legal action to get the NYS Department of Health to drop its efforts to block this writer’s request for three-white noise machines needed to manage marked noise sensitivity secondary to my brain injury.

A complete recount of my efforts to get the white-noise machines and the DOH’s determination to prevent me from doing so can be read in a preceding blog post. Suffice it to say that a ruling resulting from a December 1, 2010 Medicaid Fair Hearing overturned the DOH’s denial of my white-noise machine request, telling them that they needed to consider more evidence documenting the need for the machines.

More evidence was provided and the Southern Tier Independence Center, the RRDC in my area,  sought to approve the request before the DOH’s Maribeth Gnozzio stepped in and blocked the approval. How do you spell retaliation? Try G-n-o-z-z-i-o. However, were Gnozzio the exception to the rule at DOH she’d be long gone, but she’s not, which tells us she is an example of what the rule is at the DOH, and those DOH employees who do care, are in the minority.

Once Gnozzio blocked the white-noise machine request a request for an expedited Medicaid Fair Hearing went into effect. Once that happened, and once, I am sure, Gnozzio and the DOH realized their actions would accurately be seen as retaliation, a knowing attempt to harm me, and a flat-out violation of the ADA, they backed off. Gnozzio and the DOH also realized they were dealing with an RRDC who truly does care and was not about to back off its principles for anyone.

If the DOH wants to reveal that Gnozzio is an exception to the DOH mindset or signal that it is committed to changing it’s mindset, I’ve got a two-word suggestion that would go a long way on both fronts: fire Gnozzio.

NY State DOH Communicates but…

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

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’s DOH Dysfunction Continues

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.

No Brain Injury Training for NY RRDSs

The very people hired by the New York State Department of Health to oversee the implementation of the state’s traumatic brain injury waiver receive no mandatory training in brain injury or the brain. 

Two Regional Resource Specialists from the Capitol Region, Maria Relyea and Robert Korotich, acknowledged in a meeting this week that the Department of Health requires no mandatory training in brain injury for RRDSs statewide. 

Given the fact it is the RRDSs who issue the decisions that brain injury survivors will have the services cut or denied altogether, the fact those issuing these decisions are not required to undergo any training about the brain is inexcusable. It’s tantamount to hiring a couple of folks off the street to have them oversee the care of those who’ve sustain spinal cord injuries or are dealing with Parkinson’s  when, with few exceptions, they don’t know anything about SCIs or Parkinson’s.

When you couple this with the fact the state’s Department of Health knowingly signed a contract that will funnel hundreds of thousand of dollars in the direction of Timothy J. Feeney, a PhD wannabe who continues to misrepresent his educational credentials and who has had, according to his own resume, no real training in brain injury, it is hard to reach any conclusion other than the DOH and those of Feeney’s ilk don’t give a damn about those of us who live with brain injuries.

The other conclusion that can be, I think, safely drawn, is the DOH feels it is appropriate to hire people to oversee  the TBI Waiver and directly influence the services waiver participants get or don’t get who are simply not qualified to do so. This is not only unfair, immoral and damaging to brain injury survivors, it is unfair, immoral and damaging to the many companies and individuals around the state who provide services to brain injury survivors. After all, they are expected to following the DOH/RRDS marching orders when the latter tandem knows less about brain injury than the providers do. 

The meeting this week referenced above was the conference I’d asked for that is allowed to take place before a Fair Hearing. My fair hearing is scheduled for December 1. Although I’d written to these RRDSs asking for the conference provided for before a fair hearing, both claimed they didn’t realize this weeks conference was the conference before the fair hearing, claiming that they thought I just wanted to talk about the DOH’s denial of my assistive technology requests.

And just when you thought things could get any slipperier.

Oh, almost forgot. I did inform both Ms. Relyea and Mr. Korotich that I want to have the pre-fair hearing conference with them before the fair hearing. I followed that up with and email confirming this.