from KKD: Man Who Bribed Son Into Penn Guilty in $1.3 Billion Health Fraud

https://www.bloomberg.com/news/articles/2019-04-05/man-who-bribed-son-into-penn-guilty-in-1-3-billion-health-fraud

A Florida man was convicted Friday of running an 18-year, $1.3 billion health-care fraud that prosecutors called the largest such scheme ever charged by the Justice Department.

Philip Esformes, a 50-year-old Miami Beach resident, used a network of nursing homes and assisted-living facilities in South Florida to defraud U.S. government health-care programs while providing inadequate and unnecessary care to patients, prosecutors said.

Esformes made off with at least $37 million for himself from 1998 to 2016, according to prosecutors, using the money to finance a lavish lifestyle of fancy cars and a $360,000 watch. Esformes also used some of the proceeds from the fraud to bribe the University of Pennsylvania basketball coach to help get his son into the school, prosecutors said. The coach pleaded guiltyto money laundering last year in connection with the case.

An attorney for Esformes didn’t immediately respond to requests for comment.

Read more: Celtics assistant coach is said to have taken bribes at Penn

Prosecutors said Esformes bribed doctors to admit patients to the facilities he operated. The patients didn’t get appropriate care and sometimes received unnecessary services for which Esformes then billed the U.S. government. Esformes also bribed a Florida state regulator to learn about surprise inspections of company facilities ahead of time, prosecutors said.

The total value of fraudulent claims that Esformes’ companies submitted to Medicare and Medicaid exceeded $1.3 billion, according to prosecutors.

A jury found Esformes guilty on 20 counts in U.S. district court in the Southern District of Florida. Charges included conspiracy to defraud the United States, receiving kickbacks, money laundering and conspiracy to commit bribery. Two co-conspirators pleaded guilty. Sentencing hasn’t been scheduled.

More than 4,000 Medicare fraud cases have been charged since 2007 by a special group of federal investigators. Medicare, which covers about 60 million mostly older Americans, and Medicaid, which covers 75 million low-income people, are considered by the Government Accountability Office to be vulnerable to fraud and abuse.

More than $700 billion, or 17 percent of federal spending, flowed through the Medicare program in 2017, according to the GAO. About $48 billion of that was considered improper — either payments in the wrong amount or that shouldn’t have been made at all. Improper payments aren’t necessarily fraudulent.

 

From Joanne:

And this is the real reason why Ken and I were suspended by the Illinois ARDC.  We talked about Esformes and then we were railroaded.

It happens all the time in Illinois Probate courts.  A grandma or grandpa is kidnapped, drugged and then a CCP211 form is signed declaring them to be incompetent.  Then all their paid up homes and cars are sold and proceeds are split between lawyers at $250 per hour, the Guardian, court room vendors (“care management”) and of course, nursing homes at $5k to $15k per month for “premium services”.  These people rarely see doctors and are just rushed to the hospital in time to die.

 

This has to end.

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From US DOJ; 24 individuals and businesses charged with $1.2 billion in medicare/medicaid fraud

This is exactly the reason why we do not have universal health care. This fraud has got to go.

https://www.justice.gov/opa/pr/federal-indictments-and-law-enforcement-actions-one-largest-health-care-fraud-schemes?fbclid=IwAR0VaKqGgmLl3khIV9GElPJH5iYWuYJrCvnNZyha9Qu3PksPX5WZAFKIA3I

Federal Indictments & Law Enforcement Actions in One of the Largest Health Care Fraud Schemes Involving Telemedicine and Durable Medical Equipment Marketing Executives Results in Charges Against 24 Individuals Responsible for Over $1.2 Billion in Losses

Hundreds of Thousands of Elderly and/or Disabled Patients Nationwide and Abroad Lured into Criminal Scheme; Center for Program Integrity, Center for Medicare Services, Takes Administrative Action Against 130 DME Companies That Submitted Over $1.7 Billion

One of the largest health care fraud schemes investigated by the FBI and the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) and prosecuted by the Department of Justice resulted in charges against 24 defendants, including the CEOs, COOs and others associated with five telemedicine companies, the owners of dozens of durable medical equipment (DME) companies and three licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $1.2 billion in loss, as well as the execution of over 80 search warrants in 17 federal districts.  In addition, the Center for Medicare Services, Center for Program Integrity (CMS/CPI) announced today that it took adverse administrative action against 130 DME companies that had submitted over $1.7 billion in claims and were paid over $900 million.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Sherri A. Lydon of the District of South Carolina, U.S. Attorney Craig Carpenito of the District of New Jersey, U.S. Attorney Maria Chapa Lopez of the Middle District of Florida, Assistant Director Robert Johnson of the FBI’s Criminal Investigative Division, Deputy Inspector General for Investigations Gary Cantrell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Chief Don Fort of the IRS Criminal Investigation (CI) and Deputy Administrator and Director of CPI Alec Alexander of the CMS/CPI made the announcement.

Today’s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division’s Fraud Section in conjunction with its Medicare Fraud Strike Force (MFSF), as well as the U.S. Attorney’s Offices for the Districts of South Carolina, New Jersey and the Middle District of Florida.  The MFSF is a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG.  In addition, IRS-CI and other federal law enforcement agencies participated in the operation.

The charges announced today target an alleged scheme involving the payment of illegal kickbacks and bribes by DME companies in exchange for the referral of Medicare beneficiaries by medical professionals working with fraudulent telemedicine companies for back, shoulder, wrist and knee braces that are medically unnecessary.  Some of the defendants allegedly controlled an international telemarketing network that lured over hundreds of thousands of elderly and/or disabled patients into a criminal scheme that crossed borders, involving call centers in the Philippines and throughout Latin America.  The defendants allegedly paid doctors to prescribe DME either without any patient interaction or with only a brief telephonic conversation with patients they had never met or seen.  The proceeds of the fraudulent scheme were allegedly laundered through international shell corporations and used to purchase exotic automobiles, yachts and luxury real estate in the United States and abroad.

“These defendants — who range from corporate executives to medical professionals — allegedly participated in an expansive and sophisticated fraud to exploit telemedicine technology meant for patients otherwise unable to access health care,” said Assistant Attorney General Benczkowski.  “This Department of Justice will not tolerate medical professionals and executives who look to line their pockets by cheating our health care programs.  I commend the Criminal Division prosecutors and our partners from U.S. Attorney’s Offices and law enforcement agencies across the country for their unrelenting efforts to stop this alleged fraud before more money was stolen from American taxpayers.”

“Simply put, the law applies equally to all in South Carolina,” said U.S. Attorney Sherri Lydon.  “The same spoon that serves indictments on drug dealers, felons in possession of firearms, and corrupt officials will also feed those companies and individuals who engage in Medicare fraud.  White collar crime is not victimless.  All taxpayers will endure the rising cost of health care premiums and out-of-pocket costs as a result of fraud on our Medicare system.  I am honored to stand with our partners at the FBI, HHS-OIG, and IRS-CI, who led this outstanding and nationally significant investigation from right here in South Carolina.”

“The indictments we are unsealing today charge the defendants with running a complex, multilayered scheme to defraud our Medicare system and avoid detection by government regulators,” said U.S. Attorney Craig Carpenito.  “The defendants took advantage of unwitting patients who were simply trying to get relief from their health concerns.  Instead, the defendants preyed upon their weakened state and pushed millions of dollars’ worth of unnecessary medical devices, which Medicare paid for, and then set up an elaborate system for laundering their ill-gotten proceeds. We are proud to join our law enforcement partners in New Jersey and around the country to put a stop to this unscrupulous criminal activity.”

“Protecting the integrity of America’s health care programs is necessary to ensure that our citizens receive the care they have paid for and deserve,” said U.S. Attorney Chapa Lopez.  “The mammoth coordination and cooperation demonstrated among the various offices, districts, and agencies involved in this case leaves no doubt. We will leverage the full weight of our resources to combat fraud and abuse, wherever it is found.”

“Today, one of the largest health care fraud schemes in U.S. history came to an end thanks to close collaboration and coordination between the FBI and partners including HHS-OIG and IRS-CI,” said FBI Assistant Director Robert Johnson.  “Health care fraud causes billions of dollars in losses, it deprives real patients of the critical health care services they need, and it can endanger the lives of real patients so individuals like those arrested today can profit from their criminal activity.  Through today’s coordinated national effort, we put an end to this egregious and costly health care fraud scheme, and the public can rest assured the FBI will continue to make health care fraud investigations a top priority.”

“Our law enforcement officers are focused on preventing and uprooting health care fraud schemes like those alleged today,” said Deputy Inspector General for Investigations Gary Cantrell.  “These schemes divert money from taxpayer-funded federal health care programs into the hands of criminals.  Working closely with our law enforcement partners, our agency will continue to investigate and disrupt attempts to undermine Medicare and target beneficiaries.”

“The breadth of this nationwide conspiracy should be frightening to all who rely on some form of healthcare,” said IRS-CI Chief Don Fort.  “The conspiracy described in this indictment was not perpetrated by one individual.  Rather, it details broad corruption, massive amounts of greed, and systemic flaws in our healthcare system that were exploited by the defendants.  We all suffer when schemes like this go undiscovered and I’m proud of the work our agents did in working with our partners to uncover this complex scheme.”

“The Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity (CPI) is proud to work very closely everyday with our law enforcement partners to stop exploitation of vulnerable patients and misuse of taxpayer dollars,” said Deputy Administrator and CPI Director Alec Alexander.  “In this case CMS has taken swift administrative action and has suspended payments to 130 distinct providers thereby likely preventing billions of additional dollars in losses.  CMS remains committed to protecting the millions of beneficiaries we are honored to serve and to preventing fraud of all sorts in the Medicare and Medicaid programs.”

According to allegations in court documents, some of the defendants obtained patients for the scheme by using an international call center that advertised to Medicare beneficiaries and “up-sold” the beneficiaries to get them to accept numerous “free or low-cost” DME braces, regardless of medical necessity.  The international call center allegedly paid illegal kickbacks and bribes to telemedicine companies to obtain DME orders for these Medicare beneficiaries.  The telemedicine companies then allegedly paid physicians to write medically unnecessary DME orders.  Finally, the international call center sold the DME orders that it obtained from the telemedicine companies to DME companies, which fraudulently billed Medicare.  Collectively, the CEOs, COOs, executives, business owners and medical professionals involved in the conspiracy are accused of causing over $1 billion in loss.

The Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

*********

Amongst those charged by Strike Force attorneys include:

In the District of New Jersey, charges were brought against Creaghan Harry, 51, of Highland Beach, Florida; Lester Stockett, 51, of Deefield Beach, Florida; and Elliot Loewenstern, 56, of Boca Raton, Florida; the owner, CEO and VP of marketing, respectively, of purported call centers and telemedicine companies, for their alleged participation in a $424 million illegal health care kickback and international money laundering scheme related to the solicitation of illegal kickbacks and bribes in exchange for the referral of DME orders to DME providers.  In addition, Joseph DeCoroso, M.D., 62, of Toms River, New Jersey, was charged in a $13 million conspiracy to commit health care fraud and separate charges of health care fraud for writing medically unnecessary orders for DME, in many instances without ever speaking to the patients, while working for two telemedicine companies.  The cases are being prosecuted by Fraud Section Acting Assistant Chief Jacob Foster and Trial Attorney Darren Halverson.

In the Middle District of Florida, charges were brought against Willie McNeal, 42, of Spring Hill, Florida, the owner and CEO of two purported telemedicine companies, for his alleged participation in a $250 million scheme related to the solicitation of illegal kickbacks and bribes in exchange for the referral of DME orders to DME providers.  The case is being prosecuted by Fraud Section Acting Assistant Chief Jacob Foster and Trial Attorneys John Michelich, Catherine Wagner and Sara Clingan.

In the Northern District of Texas, charges were brought against Leah Hagen, 48, and Michael Hagen, 51, of Dalworthington Gardens, Texas, owners and operators of two DME companies, for their alleged participation in a $17 million illegal health care kickback scheme related to the payment of kickbacks in exchange for the referral of medically unnecessary DME orders.  The case is being prosecuted by Fraud Section Trial Attorneys Brynn Schiess and Carlos Lopez.

In the Western District of Texas, Christopher O’Hara, 54, of Kingsbury, Texas, the owner of a purported telemedicine company, was charged in an $40 million scheme related to the alleged solicitation of illegal kickbacks and bribes in exchange for the referral of DME orders to DME providers.  The case is being prosecuted by Fraud Section Trial Attorney Kevin Lowell.

In the Eastern District of Pennsylvania, Randy Swackhammer, M.D., 60, of Goldsboro, North Carolina, was charged for an alleged $5 million conspiracy to commit health care fraud that involved writing medically unnecessary orders for DME while working for a telemedicine company, in many instances with only a brief telephonic conversation with the patients.  The case is being prosecuted by Fraud Section Trial Attorney Adam Yoffie.

In the Central District of California, charges were brought against Darin Flashberg, 41, of Glendora, California, and Najib Jabbour, 47, of Glendora, California, owners of seven DME companies, for their alleged participation in a $34 million scheme related to their payment of kickbacks and bribes in exchange for medically unnecessary DME orders.  The case is being prosecuted by Fraud Section Trial Attorney Robyn Pullio.

*********

In addition to the Strike Force prosecutions, other enforcement actions were taken, including the execution of search warrants to support related investigative efforts in seven additional U.S. Attorney’s Offices to include in various investigations conducted by the District of New Jersey, District of South Carolina, Southern District of California, District of Nebraska, Middle District of Florida, Eastern District of Missouri and Western District of Washington.
In the District of South Carolina, charges were brought against Andrew Chmiel, 43, of Mt. Pleasant, South Carolina, owner of over a dozen companies involved in the scheme, for his alleged participation in a $200 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary DME orders.  The cases are being prosecuted by Assistant U.S. Attorneys Jim May and Will Lewis of the District of South Carolina.

In the District of New Jersey, charges were brought against Neal Williamsky 59, of Marlboro, New Jersey, and Nadia Levit, 39, of Englishtown, New Jersey, owners of approximately 25 DME companies, for their alleged participation in a $150 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary DME orders.  Albert Davydov, 26, of Rego Park, New York, was also charged for his alleged participation in a $35 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary DME orders.  The cases are being prosecuted by Assistant U.S. Attorneys Brian Urbano and Stephen Ferketic of the District of New Jersey.

In the Middle District of Florida, search and seizure warrants are being executed at 20 different business locations, including numerous DME companies and a fraudulent telemarketing company. The search and seizures are being executed by over 100 law-enforcement officers from six federal agencies, including HHS-OIG, FBI, IRS-CI, VA-OIG, SSA-OIG, and USPS-OIG.  In addition to the 20 search warrants, millions of dollars and other assets tied to the conspiracy are being seized and/or frozen, including through a civil injunction naming 13 defendants as authorized under 18 U.S.C. § 1345.

The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with MFSF teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices in the District of New Jersey, District of South Carolina, Southern District of California, District of Nebraska, Middle District of Florida, Eastern District of Missouri and Western District of Washington; and agents from the FBI, HHS-OIG, IRS-CI and other federal law enforcement agencies.

A complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Any doctors or medical professionals who have been involved with alleged fraudulent telemedicine and DME marketing schemes – including Video Doctor USA, AffordADoc, Web Doctors Plus, Integrated Support Plus and First Care MD – should call to report this conduct to the FBI hotline at 1-800-CALL-FBI.

Additional documents related to this announcement will shortly be available here: https://www.justice.gov/opa/documents-and-resources-april-9-2019-press-release-health-care-fraud.

From FB: Many prescription and non prescription drugs linked to dementia

Common Prescriptions Linked to Increased Dementia Risk

there are a ton of drugs to avoid, but the real problem I am seeing is:

  1. grandma has money AND greedy children.
  2.  grandma is drugged with psychotropic drugs from an unethical MD
  3.   grandma is kidnapped away from her home and drugged.
  4.   grandma is taken to a psychiatrist and he fills out a form she is incompetent (but in reality she is drugged)
  5.   the form is taken to probate
  6.   one of the greedy relatives is appointed Guardian
  7.   Grandma’s home is sold, she is placed in a series of nursing homes and then narcotized to death when the money runs out.

What safeguards are in place to prevent all of this?

 

Answer:  absolutely none. Sykes case, Alan Frake case,  Dolores Bedin case, and many, many others.

We wish it wasn’t the case but, unfortunately, memory loss is a hot topic. People have countless questions about brain diseases such as Alzheimer’s and dementia. What really causes it? Will there ever be a cure? Are there any natural preventatives? How do my other medications that I’m taking affect my risk of such problems?

Many prescriptions have been linked to memory loss! We hope to answer these questions and more below. So, if you or a loved one is worried about or currently living with this problem, please keep reading…

 

How Common Is Alzheimer’s Disease?

Most people associate Alzheimer’s with memory loss, one of first and most common symptoms of the disease. On average, the progressive (and currently) irreversible brain disorder starts affecting people after 60 years of age. [1] However, there are many factors that contribute to an individual’s experience such as their genes, diet, lifestyle habits, and more.

According to Alzheimers.net, there are 44 million people who have Alzheimer’s or a related dementia, approximately 5,700,000 of whom are American. Health officials expect that number to rise to 16 million by 2050. And because it’s the sixth leading cause of death in America – the only one in the top 10 that cannot be cured, prevented, or slowed – it demands everyone’s attention. [1,2]

 

10 Early Warning Signs and Symptoms of Alzheimer’s

  • Memory loss
  • Inability to plan things or solve problems
  • Difficulty completing simple tasks
  • Getting confused about times, dates, and places
  • Inability to understand spatial relationships and visuals
  • New problems when it comes to speaking or writing
  • Forgetting where you put stuff and being unable to retrace steps
  • Increasingly poor judgement
  • Growing less and less social
  • Uncharacteristic changes in mood and personality

How About Dementia?

Not unlike Alzheimer’s disease, the most common form of dementia, general dementia is also a progressive syndrome that impairs your cognitive function. That is, your ability to think, reason, remember, and behave properly (if at all). Many of the symptoms actually overlap with those of Alzheimer’s disease. [1]

Growing by 10 million new cases per year, there are around 50 million people worldwide currently living with dementia… According to the World Health Organization, that’s a figure that we expect to hit 82,000,000 by 2030 and 152,000,000. [4]

Although these numbers are alarming, there are numerous ways to decrease your risk of development Alzheimer’s disease or other forms of dementia – naturally and otherwise. But the possibility of keeping the number of dementia cases to a minimum seems unlikely when so many people are on medications that can increase the likelihood of getting it.

 

Common Drugs Like Benadryl Linked to Increased Dementia Risk

In March 2015, researchers published a prospective cohort study in JAMA Internal Medicine called “Cumulative Use of Strong Anticholinergics and Incident Dementia.” The University of Washington and Seattle healthcare system, Group Health, conducted the long-term study which tracked 3,434 men and women who were aged 65 and up, and had no dementia when the study began. [5]

The team accessed every participant’s history of drug use for the previous decade, including both over-the-counter and prescription drugs. Over a 7-year timeline, they followed up with all the participants every two years, during which 797 participants developed dementia (637 of whom developed Alzheimer’s disease).

As researchers looked back on what those 797 individuals took, anticholinergic drugsbecame the main suspect. The most common anticholinergics participants used were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics. Compared to those who didn’t take anticholinergic drugs, people who did for as little as three years were 54% more likely to develop dementia.

What Are Anticholinergics?

Usually, these types of drugs are prescribed to treat problems including urinary incontinence, Parkinson’s disease, and chronic obstructive pulmonary disorder (COPD). Anticholinergic drugs’ main purpose is to block the actions and effects of acetylcholine, a neurotransmitter which causes muscles to contract, activates pain responses and regulates endocrine and REM sleep functions. [6]

It’s just a natural fact of life – as we age, our bodies’ ability to produce acetylcholine decreases. [7] Since the brain actually contains many acetylcholine-producing cells, as Harvard editor Beverly Merz highlights, “blocking its effects can deliver a double whammy to older people.” [8]

If you want to keep your head clear and brain functioning as highly as possible, steering clear of anticholinergic drugs seems ideal. However, it is important to recognize that the long-term study revealed only a small portion of drugs was interfering with cognitive function. So, please discuss with your doctor if you’re thinking of getting off any prescribed medications.

 

Experiencing Memory Loss? It’s Not Necessarily Alzheimer’s

There are reversible dementias that, although worrisome, people can treat and even overcome. Some of these problems might surprise you: [9]

1) Delirium

Although this condition seems similar to dementia, the mental changes that occur in delirium happen within days in comparison to months or years. Another key distinction between these two problems is that with dementia, you maintain consciousness; with delirium, you don’t.

2) Depression

People with depression have likely experienced moments of forgetfulness and disorientation. A simple way to tell the difference between depression and dementia is looking at the timeline. Depressed people become depressed first and experience memory-related symptoms later, whereas people with dementia become depressed as a result of their declining cognitive function.

3) Vitamin B12 Deficiency

This crucial deficiency can lead to pernicious anemia, a rare condition associated with confusion, slowness, apathy, and irritability.

4) Thyroid Disease

Individuals with hypothyroidism will likely exhibit dementia-like symptoms.

5) Alcoholism

People who are alcoholics can suffer bouts of confusion and amnesia which can mimic the same experiences as someone with Alzheimer’s disease. Although alcoholism can deteriorate the ability to remember and orientate oneself, abstinence and overcoming addiction can help reverse side effects.

 

Sources: 
theheartysoul.com

[2] Alzheimer’s Statistics. (n.d.). Retrieved from https://www.alzheimers.net/resources/alzheimers-statistics/

[3] 10 Early Signs and Symptoms of Alzheimer’s. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/10_signs

[4] Dementia. (n.d.). Retrieved from http://www.who.int/news-room/fact-sheets/detail/dementia

[5] Gray, S. L. (2015, March 01). Strong Anticholinergics and Incident Dementia. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2091745

[6] Anticholinergics: List, Side Effects, and More. (n.d.). Retrieved from https://www.healthline.com/health/anticholinergics

[7] Acetylcholine (ACh). (n.d.). Retrieved from http://memorylossonline.com/glossary/acetylcholine.html

[8] Merz, B. (2017, May 23). Common anticholinergic drugs like Benadryl linked to increased dementia risk. Retrieved from https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667

[9] What’s Causing Your Memory Loss? (n.d.). Retrieved from https://www.helpguide.org/harvard/whats-causing-your-memory-loss.htm#top

[1] Alzheimer’s Disease Fact Sheet. (n.d.). Retrieved from https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet

From FB: New Hamp. is the leader in human rights and civil rights violations. What a goal?

http://www.peteearley.com/2019/04/09/new-hampshire-puts-mentally-ill-in-prison-because-it-lacks-treatment-beds-disability-group-applauds-decision-to-not-built-new-hospital/?fbclid=IwAR2JpczCIAcV0Fy53y9jdUXfvIiKRYvnj5c7pNClOX3MNjPNEHy2dTZQDlc

Therapy cages at state prison

(4-9-19) New Hampshire’s abhorrent practice of housing its seriously mentally ill citizens, who have not been charged with crimes, inside a state prison rather than treating them in a hospital is again making headlines.

Governor Chris Sununu sought to stop this horrific practice by requesting $26 million in funding to build a 60-bed state hospital that would be opened by June 2021 with its own secure unit.

But Democrats on the state’s finance committee rejected Sununu’s plan, opting instead to spend $5 million to renovate rooms in an existing state hospital for a limited number of higher-need patients.

What makes this dispute newsworthy is it has pitted two groups, both created to help patients, against each other.

Disability Rights Center-NH opposed building a new state hospital. In a statement, it agreed that civilly committed patients should not be housed in a state prison, but it argued that building a new state hospital would “divert precious funds and workforce from where they are most needed: community-based mental health services.”

 “Spending millions of dollars to significantly expand the state’s mental health health institutional bed capacity undermines the state’s ability to invest in much needed sustainable changes to the state’s community mental health system.” 

It called for more spending on assertive community treatment, supportive housing, supported employment and mobile crisis response teams.

The CEO of the New Hampshire (state) Hospital, Lori Shibinette, issued a sharply-worded rebuttal. The need for a 60-bed facility was documented through a “thorough, public and collaborative process” during a two year period, she noted. The Disability Center’s preferred alternatives, she said, “would do absolutely nothing to help people in hospital emergency departments (needing) a bed in a psychiatric facility…”

For the most seriously mentally ill patients, she wrote, such programs as housing first, assertive community treatment, job help and other supports simply are “stop gap measures at best.”

Sadly, while this debate is going on, there are no immediate plans to stop sending patients, who have been involuntarily committed, to the state prison. Although their only crime is that they got sick, they are housed behind barbed wire fences and relegated to solitary confinement.

Republicans could try to restore the governor’s plan when the finance committee’s recommendations are voted on April 11th, but that is judged unlikely.

The underlying issue here is a never ending argument about whether or not all individuals with serious mental illnesses can have their needs met in a community or if some need longer term care.

This is not a new debate nor are the two sides newcomers to it.

The Disability Rights Center – NH is part of a national network of what commonly are known as Protection and Advocacy [ P&A] organizations. Here’s their roots.

The Protection and Advocacy concept was initially triggered by a series of local television news broadcasts that Geraldo Rivera did for the ABC News affiliate in New York City in 1972. Rivera’s investigative reporting exposed abuse, neglect and lack of services and supports at Willowbrook, a state institution for people with intellectual and other disabilities on Staten Island. These broadcasts galvanized the state’s senior senator, Jacob Javits, to action, incorporating the first P&A program – PADD (Protection and Advocacy for People with Developmental Disabilities) – in 1975 in the renewal of the Developmental Disabilities Assistance and Bill of Rights (DD) Act.

The DD Act provided for the governor of each state to designate an agency to be the P&A and to assure that the P&A was, and would remain, independent of any service provider… The initial focus of PADD and subsequent P&A statutes was to safeguard the well-being of individuals living in institutions…

While P&As were created to monitor and protect persons in institutions, over time, most have expanded their mission to become advocates for all disability issues.  In this role, P&As have fought against the construction of any new institutions.

I will yield to legislative experts here, but my reading of Sen. Javits’ legislation finds no language stating that P&A’s should block construction of hospitals. Rather, this thinking appears based on the argument that institutions, by their nature, are dehumanizing and destructive to mental health.

While this proved true in our past, there are mental hospitals that are humane and help patients. A prime example is McLean Hospital. But these hospitals are only available to those with big checkbooks. They have managed to avoid the horrors of the old state hospital system because they are well-funded.

So what is the answer?

The solution for both sides would be to stop fighting over scraps and demand that individuals with mental illnesses have a full array of services available to meet their individual needs – whether that be longer term care, crisis care or community assistance. Persons with mental illnesses are not cogs.

The New Hampshire legislature would be wise to listen to what CEO Lori Shibinette wrote in her statement about the most seriously mentally ill: “We need to stop trying to fit this population into a system of care that does not meet their needs.”