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.

 

 

 

 

A coward named Cuomo

Whether you liked him as the governor of New York or not, only a fool would doubt the courage of Mario Cuomo. He stood fast in his opposition to the death penalty (I oppose it too) even when he knew many disagreed.  He was courageous man. Not so his son, the current governor of New York, Andrew Cuomo. All I know makes it clear to me he is a coward and, if you permit me a redundancy, a wimp.

Numerous sources tell me about the bullying he likes to do behind the scenes. Bullies are cowards. Able to act all tough and strong when there is no one to challenge them. Leave it to Cuomo  to run around New York playing like he’s John Wayne when inmates David Sweat and Richard Matt escaped. Notice Cuomo was always surrounded by state police. Easy to play tough guy when you have some real-life armed toughs as your escort.

And now, Cuomo has his Department of Health on the brink of pulverizing the lives of New Yorkers with brain injuries and the business stability of those who provide services to them under the state’s Traumatic Brain Injury Waiver Program. A waiver is a Medicaid reimbursement program that provide services so a vulnerable part of the population can live in the community or return to community life. It’s been in this state for 21 years now.  And under whose watch did it come to be?  Mario Cuomo’s, the Cuomo with the courage and integrity and compassion for others. Andrew’s DOH wants to shove the waiver into a form of managed care that will destroy the lives of New Yorkers with brain injuries, remove their housing subsidies, and get rid of their case managers. 

In other words, the son wants to destroy something great built by his father.

 

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

Open letter to New York Governor Andrew Cuomo

Dear Governor Cuomo,

I am a native New York who lives with a brain injury. I also head up the Kahrmann Advocacy Coalition. KAC is  grassroots advocacy coalition based in New York, that has, for some time now, tried to work in a cooperative manner with your New York State Department of Health to make sure New Yorkers with brain injuries receive the best possible care and, of course, have their equal rights both respected and protected. 

This not what New Yorkers with brain injury disabilities are experiencing from your DOH. Getting your DOH to work with us (or anyone for that matter) and protect the rights of NYers with brain injuries doesn’t work. Your DOH doesn’t care.

In fact, the dysfunctional and denial-of-rights-respect-and-dignity climate your DOH perpetuates includes the following: anyone providing care to New Yorkers on the state’s Traumatic Brain Injury Waiver Program is not required to have any expertise at all in the brain and brain injury. Those in your DOH who oversee the waiver are also not required to know a thing about the brain and brain injury, and yet, they are the one’s deciding who will or won’t get services as well as who will or will not remain on the waiver.

You are also aware, unless of course the DOH is making it a point to keep this secret from you, that New Yorkers placed in out-of-state facilities receive zero protection or oversight from New York State. Your DOH’s rote response to this is, we have no jurisdiction in that state, a response which is, on the face of it, true, but there is, and the DOH knows this, nothing preventing New York State from filing a complaint with CMS (Centers for Medicaid and Medicare Services), the very entity that allows a state to have a waiver in the first place. And, NY does nothing to protect its own outside NY’s borders, even though millions of New York dollars are spent on their care.

Over the years the problem with those DOH staff involved in the lives of NYers with brain injuries has been pointed out, more than once but these people stay in place. People like Mark Kissinger, Maribeth Gnozzio, Lydia Kosinski, and Shelly Glock, to name a few, should be transferred or fired outright. Their mandate appears to be, Be as uncooperative with members of the public and as unsupportive of the rights of New Yorkers with brain injury disabilities as you can possibly be. I’ll give you an example which, in fairness to you, I know you are not aware of. Some months ago I filed a FOIL (Freedom of Information Law) request asking for the names of those in the DOH who were drafting the TBI Waiver Manual. Before filing the request I asked Mr. Kissinger directly via email and received no response. At any rate, a month or so later I received notice from the Records Access Office letting me know that the DOH (Mr. Kissinger) needed another 30 days  to gather this information.  After more than two months, I finally received the answer to who in the DOH was drafting the TBI Waiver Manual. You’ll never guess. Mr Kissinger and his staff. The delay in your DOH’s  response was deliberate.

Governor, I not only liked your father, I admired him and believe him to be one of the finer governors New York has ever had. At the moment, I do not feel the same about you. I sincerely hope that changes. Overtures earmarked for you are to no avail, they  get waylaid or referred elsewhere, which is why this letter to you is being sent publicly, in the open. This will not be the last letter, there will be more.

Now, you have the reputation, perhaps unfairly, of being  something of a bully. I don’t know if this is true or not. But in the event there is any truth to the reputation, please know  I am not worried about bullies. You see, Governor, I live with a brain injury. In 1984 I was held-up on the streets of Brooklyn and shot in the head at point blank range. The bullet remains lodged in the brain. I was able, somehow, to get back on my feet after getting shot. The two aforementioned realities make two things clear: I do not fear bullies and I do not doubt my willpower and tenacity. 

Sincerely,

Peter S. Kahrmann

NY State’s assault on NYers with brain injuries continues unchecked

The New York State Department of Health is refusing to release the names of the people  drafting the new manual for the state’s Traumatic Brain Injury Waiver.  To his credit, Deputy DOH Commissioner Mark Kissinger has revealed the state’s  opinion of New Yorkers with brain injuries, particularly those participating in the TBI Waiver. He ignores them. He now ignores written requests for the names of those DOH staff (and contract employees, if any, are involved) designing the TBI Waiver Manual. Moreover, the DOH, thus far,  has not honored a Freedom of Information Law request for the names filed by this writer.

The TBI Waiver is a Medicaid program designed to keep those with brain injury disabilities living in the community and to help others return to the community. Kissinger, who has more than once and no doubt will again profess DOH’s desire to work with all stakeholders – has proven that assertion to be glaringly disingenuous. It’s too bad because the likes of the Brain Injury Association of NY State, the state’s Traumatic Brain Injury Services Coordinating Council, Disability Rights New York (the state’s protection and advocacy agency),  the Kahrmann Advocacy Coalition, along with people with brain injury disabilities, their  families a friends, experts in the field of neurology, and more,  are all willing and eager to work collaboratively with the DOH. The DOH is not interested in collaborating with anyone.

Disrespecting New Yorkers  with brain injury disabilities is nothing new for the DOH. Things have gotten even worse under Governor Andrew Cuomo. Several, who have asked not to be named out of fear of reprisal from the governor, have said Cuomo is something of a bully. I’m not surprised. It would be nice to learn otherwise, but actions speak louder than words and given that Cuomo has a well-earned and even admirable reputation for keeping close tabs on all state agencies, it is impossible to believe he is unaware of the DOH’s disrespectful and ruthless treatment of NYers with brain injury disabilities, not to mention the similar treatment the state inflicts on those waiver providers struggling to provide the best services for their clients. There has not been an increase in reimbursement rates for them since 2007 and providers receive zero reimbursement for training their staff in brain injury.

All this brings us back to the DOH’s refusal to release the names of those designing the TBI Manual. I suspect one of the underpinnings for the refusal is this: those developing the manual have no expertise whatever in the brain or brain injury. A sickening and scary truth.

Please don’t think this is the only example of the DOH savaging the rights of New Yorkers with brain injuries.  Until November 2011,  if you filed a complaint related to the TBI Waiver you were never ever informed of the outcome of the complaint. If you were a waiver participant and your rights were denied in some way or you’d been abused or had your belongings stolen by a staff member and you filed a complaint with the DOH, you were never told the outcome of the complaint. The DOH acknowledges this. And, when it claimed to have changed this policy, agreeing to inform participants of the outcomes of their complaints, one DOH official admitted  the DOH was unable to provide the outcomes for the thousands of complaints previously filed. Given the waiver came to New York in 1995 were talking about complaints filed over a span of 16 years whose outcomes will never be provided to the complainants. Interestingly,  the DOH official who openly admitted the DOH was unable to provide the outcomes to these complaints was none other than Deputy Commissioner Mark Kissinger, the very same DOH official who now ignores requests for information New Yorkers legally have a right to.

You wonder if the likes of Kissinger and Cuomo forget they work for New Yorkers. Perhaps they simply don’t care.