Friday, December 30, 2011

Okla. officials approve settlement of DHS lawsuit

If an outside organization has to come in and sue a state to stop abusing and neglecting children, would that be considered state sponsored torture or Medicaid fraud?

Gov. Mary Fallin and top legislative leaders on Thursday suggested revisions to a proposed settlement of a federal class-action lawsuit that accuses the state of failing to protect foster children in its care.
Members of the Contingency Review Board approved the revised agreement after meeting in executive session for nearly four hours over the last two days to discuss a plan to settle the suit filed by New York-based Children's Rights, a national child advocacy group.
The three-member board that consists of Fallin, House Speaker Kris Steele and Senate President Pro Tem Brian Bingman, did not discuss the revisions to the agreement. Children's Rights and the governing board of the Department of Human Services still must approve the changes before it can be submitted to a federal judge for final approval.
"All those terms are confidential at this point because the commission will now have to go back into session ... and vote on the proposed amended settlement," Fallin told reporters after the meeting. "I do think it's in the best benefit of this state, if it's fair to all parties and it's agreed upon, that we take an important step to move forward to get this lawsuit behind us so that we can start with the improvements of taking care of our Department of Human Services and our children in the state of Oklahoma."
But Marcia Robinson Lowry, executive director of Children's Rights, said she's not sure the revisions will be acceptable to both sides and that the case could still be heading for trial.
"I don't know what their changes are, and I do not know if those changes will be acceptable to the plaintiffs," Lowry said in a telephone interview with The Associated Press. "At this point, we are continuing our preparations for trial."
A pretrial hearing in the case is set for Jan. 6, and the trial is scheduled to begin on Feb. 21.
Filed in 2008, the lawsuit accuses DHS of victimizing foster children and inadequately monitoring their safety. It says children in DHS custody are subjected to violence, sexual abuse and neglect at rates more than four times the national norm, and at times rates of abuse and neglect of foster children surpass that for the Oklahoma's general population.
"What we've said all along, and it's not a secret, is that Oklahoma's child welfare system is not one that protects children. There are too few foster homes. The case loads are too high. It's a poorly organized, duplicative and largely dysfunctional system that does not protect children or ensure their well-being. All those things have to change. It cannot continue to do business as usual."
DHS spokeswoman Sheree Powell says the revisions to the settlement likely will be presented to the commissioners next week for approval, but contends the state has a strong defense and "we were ready to go to court in February if need be."
"We know that there is no perfect child welfare system. We're always working to continually improve our system," Powell said. "Some of those things are beyond DHS' control, so we're really looking forward to working with the governor and the Legislature in the future to work on some of those issues — to help reduce caseloads, to help recruit and retain more foster parents, to help actually get more therapeutic homes for children who have endured severe trauma and abuse."
DHS Director Howard Hendrick said the state's legal fees and other costs associated with the case already have topped $7 million. Lowry said the plaintiff's legal fees and costs have not been tallied, but that they have matched all of the state's legal filings in the case and that its legal fees will be "very expensive."
"It will certainly be in the millions and well more, in my view, than it should have been had the case been handled more reasonably," she said.

Wednesday, December 28, 2011

Michigan Going Broke Being Righteous

 I suggest every person who has to be tested to take a shot to fail the test then file a grievance to retake the test.  Then after being denied, file for administrative hearing.

Why?  Run up the bill to make it economically not feasible to implement such a program.

I suggest the state start maintaining a DNA database.  That way the state will fall into financial ruin monitoring its imperialistic morality parade.

Will the state offer assistance or referral services?  That would be another added cost.  Child Protective Service calls?  Think of the waste of tax dollars.

Department of Human Services says drug-testing welfare recipients is "feasible," agency still in early process of developing policy

SAGINAW — The Department of Human Services says it is still in the “early process” of developing a drug screening policy for cash-assistance welfare benefit recipients.
David Akerly, DHS spokesman said the answers to the questions of how the policy would be implemented and when the policy would take effect are not available yet.
“We have determined it is feasible to do this testing,” Akerly said. “What the exact process would be -- that’s still to be determined... it’s being discussed, and I’d say it’s more than just a discussion. It’s a push in that direction, but it is not a done deal.”
Saginaw County has 1,863 cases of welfare cash assistance recipients, Bay County has 463 cases, and Midland County has 177 cases.
Michigan Radio reported Monday that "likely" drug using welfare recipients would receive the testing.
DHS officials say they want the new policy to be part of an overhaul of the state’s welfare-to-work program in the spring of next year.  The department submitted a report with its recommendations to the Legislature earlier this month.
A DHS report (read it here: dhsreport.pdf) says a variety of drug screening options are available, from simple questions on the application to professional screening tools.
The report says DHS would recommend a pilot program for suspicion-based drug testing of applicants and recipients using a drug screening process, but does not specify what would warrant suspicion. The agency recommended drug court treatment professionals and law enforcement’s assistance in formulating a proposal for drug testing applicants and recipients.
“One of the primary goals of a suspicion-based drug testing for FIP (family independence program) families should be removing any barriers associated with job readiness and family self-sufficiency,” the report said.
kenhorn.JPGView full sizeState Rep. Ken Horn, R-Frankenmuth
Rep. Ken Horn, R-Frankenmuth, says he supports drug testing welfare recipients.
“We want to make sure tax dollars are being paid in the state of Michigan are being used for their intended purpose,” Horn said.
However, before mandating testing, which he said is “popular,” Horn wants to make sure the state does not get struck down in the court like other states that have implemented such policies.
It is unclear how much drug testing welfare recipients would cost -- twelve states were surveyed by the Assistant Secretary for Planning and Evaluation for the federal Department of Health and Human Services, who found costs ranged from $92,487 to $20 million. In Michigan, that would not prove a net savings, and states at the higher end of the price spectrum also included drug treatment in their costs.
Urinalysis runs from $25 to $44 per test and hair follicle testing costs $75 to $150 per test.
Thirty-six states have proposed laws that would require applicants for and recipients of public aid programs to undergo drug testing by way of a urine sample.
Most recently, Florida and Missouri implemented drug testing laws, with different approaches.
Florida’s law became effective in July and required all welfare applicants to pass a suspicionless drug test as a condition for Florida’s Temporary Assistance for Needy Families program. In October, however, a federal judge issued an injunction preventing Florida’s Department of Children and Families from further drug testing.
Missouri’s law went into effect in August, and requires the state’s Department of Social Services to develop a program to screen each applicant or recipient of TANF benefits and drug test each person the department has reasonable cause to believe, based on a screening, engages in illegal use of controlled substances. 
Horn says the frequency of testing is something that causes concern and is what is leading the legislature to act with caution. He said one of the questions they are trying to answer is if recipients need to be tested when first entering the program, every time they receive a check and if every recipient is tested.
“It’s a big question,” Horn said. “The randomness of it is what causes the heartburn in the courts... we’re just acting cautiously.”
This isn’t Michigan’s first time drug testing welfare recipients. For several weeks in 1999, eligibility for cash assistance for some recipients was dependent on a successful test for substance abuse.
A pilot program ran, testing 435 applicants for the presence of marijuana, cocaine, opiates, amphetamines and phencyclidine. Forty-five, or 10.3 percent tested positive for drug use.
Initially the pilot program was to go statewide in April 2003, according to the DHS document, but after an American Civil Liberties Union lawsuit, the U.S. District Court for the Eastern District of Michigan ruled against DHS saying the drug testing violated Fourth Amendment rights of recipients because testing was being conducted without “individualized suspicion.”
The only way such suspicionless tests would be justifiable would be with a public safety “special need,” and that the state’s interest in child abuse and neglect prevention was not a sufficient public safety concern.
In October 2002, a panel of the Sixth Circuit Court of Appeals reversed the decision, and said the implementation of the state program to test applicants for drug use was constitutional as a condition of receiving benefits. The parties reached a settlement in 2003, and the injunction on suspicionless drug tests remained until 2007, unless the legislature created a replacement pilot program. No such program was created, and the injunction expired.
The DHS report says that cash-assistance program is designed to make families independent and self-sufficient -- considering many employers require applicants to submit to and pass a drug test before employment, illegal drug use is a barrier to employment and is a barrier to independence and self-sufficiency.
Horn says DHS agents would have to make judgment calls themselves on whether or not to test applicants.
“If a case worker notices someone is visibly intoxicated or visibly on drugs, they would have enough authority to ask for the test,” he said. “The conversation is good, we need to come to a very clear, concise policy platform we can work off of.”
According to the ASPE report, substance abuse varies widely nationwide among welfare recipients. Between 4 and 37 percent of recipients abusing substances was found, but ASPE credits the differentials to different data sources, definitions and measurement methods, especially different thresholds defining substance abuse. It said including abuse of alcohol and prescription drugs also changed the estimate.
Federal law allows drug tests for welfare recipients, and penalization for failing such tests. If a recipient fails the test or is convicted of a drug-related felony, they receive a lifetime ban on TANF and Supplemental Nutrition Assistance Program (food stamps).
Horn said it is unclear when progress will be made on drug testing mandates in the legislature, but it is likely to come up in the next few months. 
“Just like every other important policy decision, we just need to act cautiously,” he said. “This is an important issue, a popular issue and we want to make sure we’re on the right track, and make sure we’re not stepping on any land mines with anything we do.”
The Saginaw News left messages for state Rep. Jim Stamas, R-Midland, state Rep. Stacy Erwin Oakes, D-Saginaw, and state Sen. Roger Kahn, R-Saginaw Township.

Tuesday, December 20, 2011

HHS rejects Michigan’s request for MLR adjustment

And why was Michigan denied?  Can you say Medicaid Fraud in Child Welfare?  I can.
By Sam Baker - 12/19/11 02:19 PM ET
The Health and Human Services Department on Monday denied a sixth states request for an adjustment to certain rules under the new healthcare law.

HHS rejected Michigans request for an adjustment to the laws medical loss ratio (MLR) requirements. The law requires insurance plans for individuals to meet an 80 percent MLR, meaning they must spend 80 percent of their premiums on medical costs. Only the remaining 20 percent can go toward profits and administrative costs.

Michigan had asked HHS to gradually phase in that standard over the next three years. But the department said Monday that most insurers in the state are either profitable enough to meet the 80 percent standard immediately or are adjusting their business practices to get there.

HHS has now denied six states requests for MLR adjustments — Delaware, Florida, Indiana, Louisiana, Michigan and North Dakota. It has approved modified standards in another six states.

The healthcare law allows HHS to phase in the 80 percent MLR in states where implementing it immediately would undermine consumers access to healthcare coverage.

Five more requests are still pending.

Don't Threaten To Cut Your Social Workers Throat - Baby LK Report For December 18th 2011

Baby LK recaps the week in news for the child protection industry.

Friday, December 16, 2011

Legally Kidnapped Daily Meditation 3: A CPS Christmas

Wednesday, December 14, 2011

Sexuality professor who helped youths in foster care systems is arrested on child sex charges

The rape of these foster children was all paid for by your taxpayer dollars.

Sexuality professor who helped youths in foster care systems is arrested on child sex charges

  • Dwain Pellebon, 54, arrested for rape and lewd acts
  • He worked with Court Appointed Special Advocates
  • Taught social work at Norman's University of Oklahoma

A social work professor who taught students about sexuality allegedly committed rape twice and lewd acts on a child under 16 years old.Dwain Pellebon, 54, of the University of Oklahoma in Norman, worked with a child advocacy group until recently but was arrested last Friday.University staff moved quickly to suspend Pellebon from contact with students but he has not yet officially been charged with anything.
Paid leave: Dwain Pellebon, 54, of the University of Oklahoma, has been arrested for allegedly committing rape twice and lewd acts on a child under 16 years old
Paid leave: Dwain Pellebon, 54, of the University of Oklahoma, has been arrested for allegedly committing rape twice and lewd acts on a child under 16 years old
He was a director on a local board for Court Appointed Special Advocates (CASA), which helps children in juvenile court and foster systems.But Pellebon took a leave of absence from the board earlier this year, a Cleveland County CASA spokesman told The Oklahoman.
Police are now investigating to find if there is more than one alleged victim involved and is on paid leave for now, reported The Oklahoman.But this could be changed to leave without pay when more facts emerge in the case, a university police spokesman said.

University: Pellebon is on paid leave for now, but this could be changed to leave without pay when more facts emerge in the case
University: Pellebon is on paid leave for now, but this could be changed to leave without pay when more facts emerge in the case
‘We can say there is one alleged victim, and we are working to determine if there are any additional victims,’ a police spokesman told KFOR.'We can say there is one alleged victim, and we are working to determine if there are any additional victims'
Police spokesman Pellebon has been arrested by police on two complaints of first-degree rape and one of lewd acts with a child aged under 16..His lawyer Ed Blau told KOTV that Pellabon denies all the allegations against him. Charges are expected to be pressed this week.Pellebon was taken to prison last Friday and released on $75,000 bail, a Cleveland County Sheriff's Office spokesman told The Oklahoma Daily.A university spokesman said they 'acted swiftly to suspend Mr Pellebon from any contact with students and from use of any university facilities'.

Tuesday, December 13, 2011

Judge sides with Godboldo, won't reinstate criminal charges

Maryanne Godboldo
Maryanne Godboldo (Detroit News file)
Detroit— Two judges in different Wayne County courtrooms sided Monday with a mother who resisted police forcing their way into her home last March to take her teenage daughter during a dispute with a Child Protective Services worker over medications.
A Family Court judge Monday afternoon accepted positive medical and education reports, and over the objections of an assistant state attorney general representing the Department of Health and Human Services, dismissed jurisdiction that had for nine months come between now 14-year-old Arianna Godboldo and her family.
Earlier Monday, a Wayne County Circuit judge refused to reinstate criminal charges, dismissed in August by a 36th District Court judge, that alleged the mother, Maryanne Godboldo, illegally resisted and assaulted police by allegedly firing a shot at them.
Family members hugged and issued thanks to the judges in both courtrooms, but authorities aren't done pursuing the Godboldos.
Wayne County Prosecutor Kym Worthy's office issued a statement Monday, vowing to make a third appeal to reinstate criminal charges.
And, Family Court Judge Lynne Pierce told Assistant Attorney General Deborah Carley, who complained it appears the girl has never received anything other than homeschooling her entire life, she is not barred from pursuing criminal truancy charges if she feels the parents are flouting state law that required the education of children.
"There may be some more evaluation to be done, but I don't see any more need of this court's continued involvement," Pierce said.
Wayne County Circuit Judge Gregory Bill ruled in the morning against claims by the prosecutor that 36th District Judge Ronald Giles committed judicial error in August when he threw out the criminal charges. Bill said Giles was correct in concluding there was insufficient evidence to order Godboldo to trial.
"It is clear to me that he (Giles) doesn't think the defendant shot at anybody," Bill said, concluding if a shot was fired inside the house, it was fired at the ceiling and perhaps not by the mother.
"Did the child get a hold of the gun? I don't know," Bill said. "There are so many statements that are conflicting evidence, and Judge Giles went out of his way to allow the prosecutor to clear this up."
Godboldo's lawyers have said all along this was about parental rights to make medical decisions on behalf of their children, and the government abused its authority in obtaining an order to take the child without a court hearing. They also said the improper action created a conflict with police that resulted in criminal charges.
"It is absurd," Godboldo lawyer Byron Pitts said about the possibility of another appeal. "Four different judges have said they believe this family did nothing wrong. This includes another District Court judge, Judge (Paula) Humphries, who ruled earlier on some matters. It has been clear to these judges that this all stems from one overzealous caseworker, and continued appeals now border on persecution."
Acting on a call from Wayne County Child Protective Services worker Mia Wenk — who told police she had obtained an order to remove the child on a claim of medical neglect — Detroit police officers on March 24 accused her of firing a handgun at them through a plaster wall after she refused to let them inside. It took hours to talk Godboldo out of the house. She was jailed for several days until her release on bond, and her daughter was held in a state psychiatric facility for almost two months.
Godboldo was charged with resisting and assaulting police, as well as use of a firearm in the commission of a felony. Giles tossed out the charges because he said the order used by police as authority to enter the house was invalid. It was never authorized by a judge, but had a rubber stamp signature. Police also testified they don't normally enforce civil court orders, but they had been told by the protective services worker it was a criminal warrant.
Bill said his opinion should not be considered as a criticism of Detroit police, but he raised questions about the behavior of the social worker, whom he described as "young." Bill hinted Wenk was impatient, filled out a legal order that was woefully inadequate, broke with established policy by calling 911 to have Detroit police enforce it rather then confront the woman herself, and then misrepresented the meaning of the order to police.
Pierce had ruled in September against the government's claims the mother had committed medical abuse by withholding a controversial anti-psychotic medication. The girl was being treated for a sudden onset of psychotic behavior the mother believes was caused by a bad reaction to immunizations.
Pierce determined Godboldo was within her rights to terminate the voluntary treatment program. The judge ordered the girl returned to the mother's home Sept. 29. A hearing to finalize the juvenile case also is scheduled for later Monday.
Godboldo said Monday she and her daughter had a difficult Sunday night because of heightened anxiety over the coming hearing. She said she hopes authorities will this time accept a judge's assessment of the situation and not appeal again.
"I hope they understand they are affecting people's lives," she said. "They should know of the damage they have done to my daughter because they broke the law."
Godboldo said her daughter had been doing better, but she was continuing to be home schooled because psychiatric troubles continue that she attributes to "effects from the immunizations." She said the girl, who wears a prosthetic leg, continues to enjoy studying dance and music, and playing her conga drums.
"She is coming along," Godboldo said. "She is doing better because she is at home where she belongs."

Monday, December 12, 2011

From The Deepest Darkest Pit Of The Foster Care System - The Baby LK Report For December 11th 2011

Friday, December 9, 2011

Feds say NH owes $35m in Medicaid funds

Looks like New Hampshire got busted "gaming" the system.

Feds say NH owes $35m in Medicaid funds

CONCORD — New Hampshire will pay back $35 million in federal Medicaid funds a federal agency ruled should not have been sent to the state in 2004.

Under the agreement, the state will make quarterly payments over the next two years beginning in the first quarter of 2012 and ending in the last quarter of 2014.

The state will pay a total — including interest — of $35.8 million to the federal government, but does not acknowledge an error or wrongdoing in its use of the funds, according to the agreement state Health and Human Services Commissioner Nickolas Toumpas and Attorney General Michael Delaney signed Friday and federal officials in the regional office of the Centers for Medicaid and Medicare Services signed Monday.

At issue is the way the state distributed Disproportionate Share funds to reimburse hospitals for medical services patients did not pay for.

In a letter to Toumpas, the Center's regional director Richard McGreal said his agency is not planning to initiate an action to disallow the state's use of Disproportionate Share funds for years 2005 to 2009, but that does not preclude such an action in the future or an investigation by the Inspector General for the U.S. Department of Health and Human Services.

Click here to see details of the agreement (.pdf).

The agreement will require the state to find $9 million in the current fiscal 2012 state budget and $18 million in the 2013 budget. The state will also have to address a $9 million obligation for the yet-to-be-written 2014 budget.

House Speaker William O'Brien said the agreement will mean a $27 million hole for the current biennial budget that will have to be addressed.

“While we certainly hoped that the federal government would reconsider the state's appeal, the reality that we are facing a $36 million hole — and a $27 million hole in this budget — is now upon us. That's why we introduced a bill (House Bill 635) to give the state the opportunity to make spending reductions to bring our budget back to balance,” O'Brien said. “Obviously, we have a lean state budget, but we are going to need to do what the working families across New Hampshire are doing right now: tightening their belts to live within their means. Clearly, this is going to involve the House, Senate and Governor working together to bring fiscal responsibility in order to resolve this old debt.”

Under the agreement, each party will pay its own attorneys' fees and costs. The state also waives its right to contest the federal agency's action before the U.S. District Court or any other court or tribunal.

State revenues are about $46 million less than anticipated for the current fiscal year due largely to the Medicaid Enhancement Tax hospitals pay the state. Until this fiscal year, the hospitals received most of that money back in Disproportionate Share payments. This year hospitals used federal rules to reduce their payments to the state by about $50 million.

In July the state asked a federal appeals board to reconsider its decision penalizing the state $35 million for Medicaid program errors dating from 2004.

State Health and Human Services officials said federal regulators reviewed and approved the state's use of a Medicaid Enhancement Tax to boost federal reimbursements. The state used the reimbursements to help balance the state budget.

HHS claimed the Centers for Medicare and Medicaid Services ignored evidence that federal administrators cleared the state to continue its practice through 2005.

They said the plan was agreed to after then-Gov. Craig Benson met with U.S. Health and Human Services Secretary Tommy Thompson.

However, the state lost its appeal in October and has been negotiating with the federal agency on how it would repay the money.
New Hampshire HHS Medicaid Agreement

North Carolina Budget Suffers From Medicaid Fraud

More on the missing Medicaid money

DHHS leaders have been telling legislators they can’t accomplish all the Medicaid cuts they were ordered to make in this year’s budget. Secretary Lanier Cansler and others have said repeatedly that the only way they can reach the spending levels required by the budget is to make deep cuts to Medicaid services and rates.
Legislative leaders have said publicly they don’t want DHHS to make those deep cuts to Medicaid, and they’ll find extra money to help patch the shortfall if needed.

Here's the real low down:  North Carolina's Medicaid program is full of fraud.  It is because there are no regulations in the child welfare component.  This is the reason Governor Perdue created the North Carolina Medicaid Swat Team with Attorney General Roy Cooper.

But privately, they’re telling Cansler the money isn’t coming.

Really, these elected officials are telling their campaign donors not to worry about being busted in Medicaid fraud.

North Carolina’s Medicaid fraud investigators recovered more than $53 million and investigated dozens of cases of fraud and patient abuse in 2010, Attorney General Roy Cooper said Monday.

“Medicaid cheaters rob taxpayers, hurt needy patients and push medical costs higher for all of us,” Cooper said in a statement. “We’re stopping the waste and abuse and making violators pay.”

If these people would only stop the Medicaid fraud they would find out that they would be at a Federal Financial Participation rate of 75.70% instead of 65.28%.  Stop the fraud and the shortfall would disappear.

Here’s a timeline of what’s happened so far:

On October 27th, at a Gov Ops oversight meeting, DHHS Deputy Secretary Michael Watson told the committee that the Medicaid program is facing a cash flow shortfall of $139 million dollars. To make that up, Watson warned, would require the elimination of most “optional services” and a provider rate cut of as much as 18% for the final quarter of the fiscal year.

That meeting led to a round of fingerpointing: lawmakers said they weren’t told that some of the cuts they asked for were unrealistic, or that there were several outstanding “off-budget” items from years past that the program still has to pay for.

DHHS denied both those arguments.

After that meeting, House Speaker Thom Tillis told reporters better-than-expected state revenues could be used to help patch the shortfall.

“We’re working on a $150 million dollar surplus that could be appropriated for those areas where we’re coming up short without necessarily having to go back and cut any reimbursement rates or programs, which was suggested by somebody in the press. Makes no sense if we can avoid it,” Tillis said.

“And there are other measures. People have to realize that we’ve put money in the rainy day fund, $125 million, and other areas that could be potential sources for some of these things where we may just have to bridge the gap before the waivers are granted and the savings are actually being accrued,” Tillis added.

At the same meeting, House HHS Budget Chair Nelson Dollar, R-Wake, said he doubted federal Medicaid officials would approve the drastic cuts, anyway. “The amount of reduction in rate that would have to be approved by CMS would be beyond what I would think CMS would contemplate approving," he told reporters.

On Nov. 8th, at a Joint HHS Oversight Committee, Cansler repeated Watson’s warning about the cuts that would be needed to cover the shortfall, and asked the committee for direction.

Dollar told him not to move forward with those cuts. "We are not going to cut services, and we are not going to cut rates to make up for one-time liabilities," said Dollar.

A week later, on Nov. 15th, Cansler sent this letter to Speaker Tillis and Senate Leader Phil Berger, asking for more details on their plans to help offset the Medicaid shortfall.

On Nov. 17th, Tillis and Berger sent Cansler this reply, essentially saying that Cansler should move forward with cuts because no additional money would be forthcoming from the legislature.

Asked for clarification, Tillis’s spokesman Jordan Shaw said GOP leaders have been “pretty consistent” in their actions.

“We came back into session and you notice we didn’t send them any money,” Shaw pointed out.
Regarding Tillis’s remarks about using other funds to bridge the gap, Shaw said, "I hate to mince words, but he did say that it could be appropriated. He didn’t say that it would be."

Shaw said Tillis's comment “was kind of a hopeful and a best-case scenario."

"There’s a lot that goes into these types of discussions," he added. "What I can speak to as far as the letter and our action, they’ve been consistent with one another."
Rep. Dollar told Bruce Mildwurf yesterday that Cansler and the governor should look to other areas within the HHS budget to find the cash needed to cover the shortfall. 

Monday, December 5, 2011

Beverly Tran on Proposed Revision of Performance Standards for State Medicaid Fraud Control Units, December 5, 2011

Never before has anyone ever spoken of Medicaid Fraud in Child Welfare with such finesse and no one else ever will because I have all intentions of running this game.

What is a Medicaid Fraud Control Unit?  According to the National Association of Medicaid Fraud Control Units, it states:

Medicaid provider fraud costs American taxpayers hundreds of millions of dollars annually and hinders the very integrity of the Medicaid program. State Medicaid Fraud Control Units (MFCUs) have long been in the forefront of health care fraud enforcement. A Medicaid Fraud Control Unit is a single identifiable entity of state government, annually certified by the Secretary of the U.S.Department of Health and Human Services, that conducts a statewide program for the investigation and prosecution of health care providers that defraud the Medicaid program. In addition, a MFCU reviews complaints of abuse or neglect of nursing home residents. A Unit may review complaints of the misappropriation of patients’ private funds in these facilities. The Unit is also charged with investigating fraud in the administration of the program and for providing for the collection or referral for collection to the single state agency and overpayments it identifies in carrying on its activities. 
The Ticket to Work and Work Incentives Improvement Act of 1999 extended the jurisdiction of the Units to allow them, with the approval of the Inspector General of the relevant federal agency, to investigate fraud in any federally funded health care program, such as Medicare. This authority is limited to those cases that are primarily related to Medicaid. This law allows the MFCUs the option to investigate complaints of abuse or neglect of those residing in board and care facilities, regardless of the source of payment.
As one can easily see, the population of child Medicaid is omitted.  This is why groups such as Children's Rights has to file lawsuits to get States to protect the children in the foster care system.

Furthermore, this is the reason why there are no statistical reports of murder, rape, torture and drugging children in foster care.  Child Welfare Services in foster care are funded through Targeted Case Management,  a.k.a. Medicaid; therefore, MFCU is suppose to investigate abuse and neglect in foster care but does not.  The typical state reaction to reports of abuse and torture in foster care is to move the child to a new placement.  Some states have special "death squads" to secretly investigate and destroy evidence of a child murder in foster care.  These reports are never made public, it is rare that anyone is prosecuted, and not one penny of Medicaid is recovered.

By not investigating abuse and neglect in foster care, a direct correlation is constructed to another neglect3ed area of regulation in Child Welfare, the contracts and services.  Here the amounts of Medicaid fraud will nationally rise into the billions.

These MFCU were created the same time of CAPTA.

Without further adieu, experience the publishing of why Medicaid Fraud in Child Welfare is the nation's dirty little secret.

Public Comment of Beverly Tran on Proposed Revision of Performance Standards for State Medicaid Fraud Contr...

Federal Register Notice: Proposed Revision of Performance Standards for State Medicaid Fraud Control Units

Stop Child Medicaid Fraud

Psych Med Special - Baby LK Report For December 4th 2011

Baby LK recaps the week in news for the child protective industry.

Saturday, December 3, 2011

VIDEO – ABC – DAY THREE – Mind-Altering Psych Drugs for a 7-Year-Old

Of course I do not know the details,  but did anyone ever stop to consider she might just want her mommy?

You do not have to be a perfect parent to adopt but you must be a perfect parent to give birth and keep your child.

VIDEO – ABC – DAY THREE – Mind-Altering Psych Drugs for a 7-Year-Old

Dec 2nd, 2011 | By Ken Kramer | Category: Drugging

Mind-Altering Psych Drugs for a 7-Year-Old
Dec. 2, 2011
Not long ago, 7-year-old Brooke was on a medical regimen that might seem extreme, even for an adult: The 43-pound girl was prescribed multiple mind-altering psychotropic drugs.
Dealt a tough hand early in life — her birth mother had a history of drug dealing and prostitution — Brooke was prone to extreme tantrums and wild behavior. Her foster mother, Lisa Ward, says a Florida foster care agency instructed her to take the girl to a mental health clinic. The clinic prescribed anti-psychotic medication, often used to treat schizophrenia and bi-polar disorder.
“Within a few weeks, probably two, they decided that it wasn’t working. They needed to do something else,” Ward recalled. “At this point, she’s getting worse, she’s not getting any better.”
Brooke was given 10 different prescriptions in four months, with the clinic frequently increasing her doses.
As a foster mother, Ward felt she had no choice. She worried that the state would take Brooke away if she didn’t give the girl the medication.
“We were told to put our faith in the system and that’s what we did,” Ward said. “They kept saying she needs more medication.”
Foster children are medicated with psychotropic drugs up to 13 times more than other kids. Michael Piraino, the chief executive of the National CASA Association, a foster children’s advocacy group, said that, as a population, foster children tend to be more troubled than their peers.
“If you’ve been hurt the way these kids are, you or I would feel the same way,” he said.
But Piraino said helping the children is not about always trying “to change their brain chemistry.”
“When a doctor tells me that the drug is working, I would ask, ‘Who’s it working for? Is it working for the kid? Is it working for the caretaker? Is it working for the system? It only matters to me whether it’s working for the kid,” he said. “Frankly, we want the doctors and nurses who are prescribing these medicines to look at their behavior and think – and ask this question: ‘Are we doing something wrong here?’ And to the extent that we are, individually or collectively, let’s change that.”
Delaware Sen. Tom Carper held a congressional hearing Thursday, demanding changes in the foster care system.
“In my judgment, no children in this country should be taking at the same time five different kinds of psychotropic drugs,” he said. “None.”
A Different Kind of Medicine
Despite the increases in dosage, Brooke’s rages continued. Finally, Ward had enough — she decided to pay for the services of a private doctor, Dr. Luis Quinones. a psychiatrist.
Quinones was stunned by the pills Brooke was taking.
“The first thing we’ve got to think about: Is the medicine causing this?” he said. “There always has to be a high index of suspicion when we’re using these agents.”
Brooke is now being weaned off all her medication, and while she still has emotional challenges, she is learning to take advantage of a different kind of medicine.
“What’s another choice over a tantrum? What’s a good choice?” Ward recently asked her.
“To hug you,” Brooke replied.
Recently, there was a new reason for hugs — and it was a happy one: Ward adopted Brooke and her older sister, Kayla.
Besides being Brooke and Kayla’s mom, Ward also recently took on another role: fighting for all of Florida’s foster children.

ABC NEWS – December 1, 2011 – Psychiatrists Put Kids at Risk With Mind-Altering Drugs

Actually, it is not really the psychiatrists who do the Axis III diagnosis of children.  Someone needs to check out what social workers and foster care case workers believe they have the power and expertise to do.  The psychiatrist will make chicken scratch signatures of the prescription pad at a rate that will allow the pseudo-doctor to easily rack up 200 plus patients a day.

The only thing the FDA or HHS will do is to firmly slap a pseudo-doctor on the wrist with a "no-more-naughty" reprimand letter.

ABC NEWS – December 1, 2011 – Psychiatrists Put Kids at Risk With Mind-Altering Drugs

Doctors are prescribing foster children drugs at doses beyond what the Food and Drug Administration has approved,
according to a new report by the federal Government Accountability Office. (Getty Images)
Doctors Put Foster Children at Risk With Mind-Altering Drugs
Dec. 1, 2011
Across America, doctors are putting foster children on powerful, mind-altering drugs at rates up to 13 times that of children in the general population. What’s more, doctors are prescribing foster children drugs at doses beyond what the Food and Drug Administration has approved, sometimes in potentially dangerous combinations, according to a new report by the federal Government Accountability Office.
“It’s just almost beyond comprehension,” said Sen. Thomas Carper, D-Del., who asked for the GAO investigation. “We want the doctors and nurses that are prescribing these medicines to look at their behavior and think and ask this question. Are we doing something wrong here?”
In Florida, regulators have been grappling with that question since a 7-year-old boy, Gabriel Myers, killed himself in 2009 after being prescribed a powerful mix of psychotropic medication.
His psychiatrist, Dr. Sohail Punjwani, had, at different times, prescribed two drugs that carry black box labels — warning of the need to carefully monitor patients because of the increased risk of suicidal thoughts and behavior in children, which call for careful monitoring. However, even though Gabriel visited Punjwani’s office seven times, his foster father said Gabriel usually only spent about five minutes talking to the doctor.
Gabriel’s death was ruled an accident, but investigators pointed to the possibility that the medication may have contributed to his death. The tragedy triggered a storm of outrage across the state.
“I don’t accept that the only way to reach a child who is 7 years old is through psychotropic drugs,” said Florida Sen. Ronda Storm, during hearings over Gabriel’s death. “I do not accept that.”
The boy’s doctor settled a lawsuit in 2010 accusing him of prescribing a toxic cocktail of psychotropic drugs to a 16-year-old patient, who suffered a sudden heart attack and died. Punjwani settled that case but admitted no wrongdoing.
Additionally, Punjwani was arrested for driving under the influence and cocaine possession. He pleaded not guilty to those charges but went through a court-ordered rehabilitation program.
When ABC News caught up with Dr. Punjwani, he told us, “Sad stories happen but that does not mean that everything else the doctor is responsible for it because we are in the business of taking care of these children,” he said.
Antipsychotic medication, which can cause a litany of health problems such as severe weight gain, an increased risk of diabetes and irreversible movement disorders, is among the top-selling drugs in America.
Four drug makers have paid a total of more than $2 billion to settle claims they illegally marketed antipsychotics to children. All deny wrongdoing.
“How do antipsychotics, drugs supposedly for people who have lost touch with reality, how do they develop such a wide market?” said neuropsychiatrist Dr. Stefan Kruszewski, who won millions of dollars as a key whistleblower against drug companies.
There have been very limited long-term studies on antipsychotics in children. And for drugs already on the market, the duration of the studies that were used to get FDA approval for children have been as short as three to six weeks.
ABC News interviewed a social worker now working in a state foster care system, who asked not to be identified.
“Every child that I saw was basically on some type of psychotropic medication,” the social worker told ABC News. “It’s much easier to medicate a child than it is to physically restrain them, than it is to pay $200 an hour to a therapist to talk through their problems with them.”
Dr. Charles Zeanah, a prominent child psychiatrist who is careful to use a minimum of psychotropic medication in children, said that doctors are under pressure from all corners to do something with these troubled children and medication is one of their tools.
“The pressures that I’m aware of are pressures that come from families and schools who have kids with troubling behavior,” he said. “They want something done. They want something done quickly.”
Still, he adds, “The general consensus is that when you’re treating young children, you always try behavioral intervention before you go to medication.”
The problem has not gone unnoticed by some state officials. In the state of Washington, doctors and regulators have implemented a new system to oversee psychotropic medication and identify red flag cases that exceed safety limits, by dosage or number of medications, or arise because of the young age of the child. In those red flag cases, a second opinion by a child psychiatrist is needed before medication can be dispensed.
And some states including Louisiana, Florida and New York are even going so far as kicking out high-prescribing doctors out of Medicaid.
Sen. Carper, who called for the GAO investigation, said he was shocked by the findings.
“The idea that these kids are taking one, two, three times the regular dose for a child or for an adult — it’s just the wrong thing to do,” he said. “We need to get to the bottom of this and do the best that we can to stop it, not just the Congress, not just the doctors, not just the states. All of us together.”