A.G. Schneiderman Announces Agreement With Fishkill Nonprofit Serving New Yorkers With Disabilities To Repay Medicaid $363,000 For Using Unqualified Staff
Keli House Community Services Employed Individuals That Lacked Experience And Education Required By New York State
Schneiderman: People Suffering From Disabilities Deserve The Best Help Available
PEARL RIVER – Attorney General Eric T. Schneiderman today announced an agreement with Keli House Community Services, Inc., a Fishkill-based nonprofit serving New Yorkers with disabilities and their families, that used unqualified individuals to provide services to Medicaid recipients who participated in the Home and Community Based Services Program offered by the New York State Office of Persons with Developmental Disabilities (OPWDD). The settlement calls for Keli House to reimburse Medicaid $363,643.
“People suffering from disabilities deserve the best assistance available when exploring the option to stay in their homes,” said Attorney General Schneiderman. “Service providers that employ inexperienced staff deprive New Yorkers of the expertise needed to navigate and maximize all opportunities. We will crack down on anyone who shortchanges not only the most vulnerable members of our community but also our Medicaid program.”
Keli House Community Services provides a variety of services intended to decrease the risk of institutionalization for Medicaid recipients with developmental disabilities. These services include service coordination, which assesses the needs of the individual and connects them to programs designed to prevent their institutionalization.
OPWDD rules require individuals providing service coordination for organizations to meet certain minimum educational and experience requirements to ensure the quality of services provided to persons with special needs. Each coordinator must have at least an associate’s degree in a health or human services field and, either one year experience working with people with developmental disabilities or one year of service coordination experience. They must also complete a training program approved by OPWDD. During a three and a half year period ending in November 2009, Keli House employed ten persons to provide service coordination in the program, but only one was fully qualified to provide this service. Some of the coordinators had no experience while others held degrees in unrelated fields.
Keli House will reimburse the Medicaid program $363,643, which was the amount paid to the nonprofit for services provided by unqualified employees.
The Attorney General would like to thank the former Commission on Quality of Care and Advocacy for Persons with Disabilities, now part of the Justice Center for the Protection of Persons with Special Needs, for its assistance in conducting the investigation.
The case was investigated by Special Assistant Attorney General William McClarnon of the Medicaid Fraud Control Unit, Principal Special Auditor Investigator Jean Moss, Associate Auditor Investigator Sandra Alvarez, Investigator Timothy Connolly, with the assistance of Regional Director Anne Jardine, Supervising Investigator Peter Markiewicz and Assistant Chief Auditor Investigator John Regan. The Medicaid Fraud Control Unit is led by Acting Director Amy Held and is within the Division of Criminal Justice, which is led by Deputy Attorney General Kelly Donovan.
A copy of the settlement is available here.