MEDI-CAL: Treatment Center Accused Of Falsifying Claims
A drug and alcohol treatment center for women in San Francisco has come under attack by former employees for allegedly falsifying records and providing inferior care. The San Francisco Examiner reports that former employees are alleging that the Women's Alcoholism Center, which has "three group houses where pregnant women and mothers can recover from drug and alcohol addiction with their children at their sides," is "short-changing women on services and falsifying Medi-Cal information to meet its own financial goals." In response to the complaints, city contract monitor Martha Henderson has asked for the center to be put on probation and has called for a local and state investigation. "The situation is overwhelming," Henderson wrote in 1996 to superiors at the Health Department's substance abuse program. "I am under the opinion that we should place the WAC program on temporary suspension, until we can investigate the entire matter." However, according to Barbara Garcia, new head of the city's substance abuse program, it "appears the city did not investigate the complaints." At least nine workers at the center have complained to the city health department over the last two years, the Chronicle reports. Garcia said she will "take a hard look at the organization."
False Billing Charges
The Examiner reports that the "most serious allegations" of falsifying records "were centered around the summer of 1996." Mary Gomez Daddio, executive director of the center, said that changes have been made since then. "We've been very aggressive. We've answered all these questions to the county," she said, and added that "record-keeping policies have been tightened and managers have gotten extra training." Five former employees said "they were ordered to falsify attendance figures for counseling sessions or over-report the number of people staying at group homes" during a "push by managers to justify the amount the organization was paid in city grants and Medi-Cal reimbursements." According to an audit, the center may have overcharged the city by about $24,000 in a one-year period. However, the center was not charged for the overbilling because it was determined that the center provided more care than required by its contract. In addition, the audit did not investigate whether employees were encouraged to falsify records.
Some employees say that the problems are continuing, "particularly with the organization's push to justify $373,000 in federal grants it recently got for new and expanded programs at its outpatient counseling center and one group house." Alisa Kriegel, former director of the Lee Woodward Counseling Center, said, "The big message to us was get the numbers up. They didn't care whether people stayed with the program. ... We were told if we didn't get the numbers up we would lose our jobs." However, Daddio said that part of employees' responsibility is to fill their programs. "At Lee Woodward Counseling Center, the push is constant for the numbers. You can't just sit in a counseling office and wait for the clients to come in," she said. There are also continuing complaints that patient care has suffered due to the emphasis on "cutting costs." In 1996, city health inspectors "demanded the center clean up rodent infestation, peeling paint, a broken toilet and a moldy bathroom at one group home." There are also reports that the homes fail to provide "basic necessities," despite receiving $211 per woman per day, in addition to their food stamps and most of their monthly welfare checks (McCormick, 2/3).