New York Kiddy Kickbacks

Here we have it, another case of kiddy kickbacks in residential institutions that has been reduced to a case of injunctive relief.

This is a case of the inherent conflict of interest. Legal Aid, a state funded entity cannot "bite the hand that feeds it". That is why there is no action of monetary or punative reliefs.

Continuing along the line of inherent conflicts of interests, then you have the Attorney General, the same power that prosecuted these foster care cases. The same power that will represent these contractual agencies and residential institutions in a court of law is the same power that holds authority over its federally funded Medicaid Fraud Control Unit.

The Attorney General will not intervene as it does not want to "bite the federal Medicaid hand" that feeds it.

So, what you have is a recipe for the fraud scheme called kiddy kickbacks. The city gains greater levels of funding for extended stays in foster care and submits questionable costs when keeping the child in a contained environment. The institutions, in turn, receive more referrals from Administration of Children and Families and are allowed to keep a child longer in stay, not authorizing the release to the least restrictive settings.

On top of that, I will put some money on the fact that there is more than likely no pre-ten waiver, meaning there was no authorized approval according to federal mandated provisions.

The DHHS Office of Inspector General is encouraging innovation to end all forms of health care fraud, including Medicaid fraud. Innovation has never been a strong suit with Legal Aid.

This is a CRIPA and FCA case addressing kiddy kickbacks.

Foster Children Mistreated, Suit Against City Claims
By A. G. SULZBERGER
Published: May 12, 2010

A federal lawsuit is seeking to bar New York City from allowing troubled foster-care children to be kept in psychiatric hospitals after doctors have recommended their release, a practice that routinely adds months to a hospitalization despite laws that require such children to be placed in the least restrictive environment possible.

The suit, filed on Wednesday in United States District Court in Brooklyn, claims that the practice means that children who no longer require hospitalization are being kept in locked quarters where they have limited access to schooling, family visits and even walks outside.

The suit also claims that the Administration for Children’s Services, which oversees the care of about 16,000 foster children in New York City, and its subcontractors have been “using certain psychiatric hospitals as if they are detention centers,” sending some children to hospitals for disciplinary reasons, like breaking curfew, running away or getting in fights, rather than for mental health reasons.

A spokeswoman for the city’s Corporation Counsel declined to comment on the suit, saying the city had not yet had a chance to review it.

The suit was filed by the Legal Aid Society on behalf of three unnamed foster-care children who are currently hospitalized despite doctors’ recommendations that they be released.

“Every day that it continues, plaintiffs’ extended, wrongful confinement in these institutions is causing them irreparable damage,” the lawsuit says.

One of the children, a 6-year-old boy identified as S. M. who was placed into foster care last year, was hospitalized in Westchester in January, after “misbehavior” in his foster home, according to the complaint. The boy, who was in kindergarten, has been ready for discharge since April 2.

Another child, a 13-year-old boy identified as M. M., remains hospitalized on Long Island, though he was recommended for discharge on Jan. 26.

Legal Aid, a nonprofit group that represents foster-care children in New York, is seeking a preliminary injunction ordering the release of the three children, as well as a court order prohibiting the city from continuing to place foster-care children in hospitals unless doing so is medically necessary, and requiring that less-restrictive placements are made available for any child ready for release within 24 hours. The lawsuit also seeks financial damages.

Legal Aid requested class-action status for the lawsuit and identified two dozen more cases in which it claimed that children were held inappropriately, Nancy Rosenbloom, one of the Legal Aid lawyers handling the case, said. There is a high incidence of mental illness among foster-care children, who have been separated from their families, many after suffering physical or sexual abuse, said Marcia Lowry, executive director of the advocacy group Children’s Rights.

The suit cited a study by the group that estimated that about 14 percent of the foster care children in New York had been admitted to a psychiatric hospital in the course of a single year. Under both state and federal law, the city is required to place the children in the “most homelike” environment.

But foster homes, group homes and residential treatment centers can be unable or unwilling to accept children with mental illness or severe behavioral problems. The city has a policy against transferring children discharged from psychiatric hospitals to its Children’s Center, which temporarily houses other children during transition periods, according to Legal Aid.

“Some of these kids do have serious mental-health needs that may require hospitalization,” Ms. Rosenbloom said. “But the point of this case is once they’re ready to get out, they should get out.”