By Mark David Blum, Esq.
OK boys and girls: We are well aware that many of you are graduates of the Syracuse City School system, so we will try and make this easy.
Here is a simple math problem. I give you $100.00. You put that money in a shoebox. One day, you take $50.00 out of that shoebox and put it in your sock drawer. The day after, you take another $25.00 and put give it to your mom because she is so wonderful.
Question: How much money did I give you?
If you are employed by the Onondaga County Department of Social Services, the answer is that I gave you $175.00. If you are dependant upon assistance by the County or State and D.S.S. has to qualify you, then your sudden financial paper windfall will disqualify you from relief.
Here is how it translates: I know someone (not a client) who is a self employed business person. As such, they have a family checking account and a family savings account. Additionally, the business has its own checking and savings accounts. Depending on need and the situation and timing, payment received by this business owner is disbursed amongst one or more of these accounts at various times. If the owner receives $100.00 for a job, he has been known to do any number of transactions with it; including cashing it out. At times, the owner has been paid in cash and none of it made it to any of the bank accounts. Obviously, the payment is recorded in the general ledger so as to appease the I.R.S. overlords.
New York is blessed to provide its poor and working poor citizens a health care program called Child Health Plus and Family Health Plus. Depending on income levels, children and families are eligible for a whole host of medical coverage, dental coverage, and even eyeglasses every two years. The insurance company used by Onondaga County is not the best and the coverage plan is not welcomed by an overwhelming majority of local medical providers. In today’s world, medical care is medical care and some is always better than none.
Every year, the recipient or applicant has to be recertified based on income. Under normal circumstances, the applicant supplies their tax forms and fills out a questionnaire on lifestyle. Based on the bottom line of income, DSS determines the level of coverage and notifies the recipient.
Last year, DSS trotted out a new program for fraud investigation. In doing so, Onondaga County recovered $51,000 through Medicaid fraud prosecutions, got back $67,000 in Medicaid money that shouldn't have been paid out and avoided $2.2 million in costs from up-front fraud detection. The County managed to accomplish this fete without a single cost increase or handing out of money or patronage.
Random recipients of Family Health Plus were identified and targeted for audit. The person being discussed here was one such person and received notice thereof. One day, he received a request for information from DSS which included, “every monthly bank statement for all accounts” for the tax year at issue. Within a month, the person received a letter cancelling their coverage “immediately” leaving a family suddenly without any medical coverage. Two of three family members are on life saving medication and one is under ongoing treatment. When the pills are gone, we taxpayers are at risk of a much more expensive mess on our hands.
Here is what an inquiry revealed: Onondaga County DSS is in fact engaged in some form of fuzzy math seemingly designed to cancel and end qualification for untold numbers of desperate and needy citizens. Looking at every one of the bank statements for all four bank accounts, DSS came back and reported that the person earned nearly 3x his stated GROSS business income. When questioned as to the source of that data, I was told the formula employed was to “just add up all deposits in all bank accounts” and in doing so, the higher number “proved” they earned all that extra money.
The problem is that DSS only looked at “deposits”. Remember the $100.00 and the shoebox mentioned above? Once the worker decided the business owner made 3x his stated income, that number would not be excised from the computers. This is so despite lengthy and detailed explanations about the shoebox, sock drawer, and your Mom.
Infectious invalidity has corrupted the system at DSS. Somewhere, somebody must have once upon a time filed an application for coverage and that person’s bank account “deposit” records did not match the person’s stated income. That is seen by DSS as proof of fraud. Yet despite their assertion, should you demand they send your file to prosecutors, you are ignored. Send them a copy of your general ledger so they can try and recreate every financial movement of money between accounts and they ignore you. Ask for a Fair Hearing and your words go unheaded.
From my conversations with the business owner and his family, I find myself torn between shocked laughter and stunned anger. “Seriously”, says my friend. “If I made that kind of money, then I would have my own insurance and wouldn’t be bothering them in the first place.” I cannot disagree.
While I am concerned about exorcising this accounting formula demon from the processes and procedures at DSS, there is a bigger question. My friend has the courage and energy to stand up and take on the system. Query how many others who don’t see a way to challenge the false totals, just give up and find themselves helpless. I bet a quick survey of our emergency room visitors would a good place to start.
I understand the desire to cut down on fraud. I will never understand why this County always targets its weakest and most defenseless.
Then again, math has never been the County’s forte. As a result of the fraud investigation referenced above, the County Legislature also decided to “get aggressive”. Specifically, the county hired two new fraud investigators for the Department of Social Services, a new assistant district attorney to prosecute those cases, and two specialists at Social Services to find and enroll some 4,800 candidates for managed care. Forensic consultants were hired to help develop fraud cases. The cost to create the investigative jobs and the assistant district attorney post: $450,000 for the first six months of last year.
By no means am I a math genius, but being savant is not required to see the mess the Legislature dropped into the laps of taxpayers. Assuming the same number of indigent cheats and frauds are caught next year and the year after, then it should only take the County less than two and a half years to realize its first million dollar loss on just this one project. After all, spending five hundred thousand dollars to recoup one hundred thousand is obnoxious and insane. Other than handing out patronage jobs to “two new fraud investigators for the Department of Social Services, a new assistant district attorney to prosecute those cases, and two specialists at Social Services”, we the taxpayers get no benefit except more hungry people and less effective government.
Then, there are the costs involved. As it is and with no extra cost, investigators and prosecutors managed to ‘recover’ $118,000.00 from cheats. Being that successful with the resources they had begs the question as to why they threw that savings away. Add to that the costs of investigation, prosecution, incarceration, and alternative public services, and somehow that savings evaporated into thin air. There also will be retirement plans, medical plans, office supplies, cars, and other expenses to be added into the annual salaries being allocated. Doing so on the backs of the poor and defenseless is fast becoming the trademark of this County and its main City.
Rich or poor; a thief is a thief and a criminal is a criminal. The law should treat each the same. Society however, is not so burdened. Query whether the County has invested the same amount of energy into catching the white collar thieves who steal millions and corrupt government employees who are bilking the system, running up overtime, and using the system as a personal police force or fiefdom.
Ultimately what I see from all of this is an entire County Legislature that has no clue in how to do basic math. Throwing another half a million dollars to save one hundred thousand is the proof in the pudding. Though at a certain level, we can’t blame them. Had they invested the same energy in our schools as they do in chasing down the hungry and homeless, then perhaps our Legislators would have a better understanding how bad is their math.
I had hoped that when the votes were tallied after last year’s election, we would see a whole new Legislature; one concerned on fiscal responsibility, focused on protecting the weak, and one which can do basic math.
Instead, we get fuzzy math and abuse our own. Just the hours invested by my friend tangling with the DSS accounting procedures could have paid a year’s worth of medical insurance premiums. Instead of working and producing, he had to deal with the infection that will not go away; an infection that is spreading like a cancer and harming the most desperate amongst us.
The solution is as simple as adding 1 + 1.