Monday, June 9, 2003

Reforms planned for private care

Ohio lawmakers likely to increase oversight of contractors

By Debra Jasper
Columbus Enquirer Bureau

COLUMBUS - State reforms that would hold private firms who care for the mentally retarded more accountable and crack down on government contractors who misspend millions of tax dollars are expected soon to pass the Ohio legislature.

Citing separate Cincinnati Enquirer investigations that exposed serious problems, Sen. Jeff Jacobson, a suburban Dayton Republican, inserted two reform amendments into the budget bill that passed the Senate last week.

The bill, which will now be fine-tuned in a House and Senate conference committee, would increase oversight of private firms that care for the mentally retarded. It also would force agencies to stop doing business with any government contractors who misspend tax money and never repay it.

The Senate plan would require the state auditor's office to list companies that owe money to public agencies. Officials must check the list and, if money is owed, work out a repayment plan with the company or hire a different firm.

"Basically, we're saying the government can't do business with companies that owe it money unless they first pay it back," Jacobson said. He expects the amendment to stay in the budget bill with no opposition from House members.

"We have yet to hear the first negative reaction to it," he said.

The reforms were announced by Jacobson and State Attorney General Jim Petro in May in the wake of an Enquirer investigation that showed little had been done to recover $346 million in misspent tax money.

An analysis of state audits since 2000 revealed that private foster-care companies alone spent nearly $16 million in tax money on questionable items including a Mercedes Benz, plastic surgery and Rolling Stones tickets. The companies have repaid just $117,000 - less than a penny on the dollar.

Not everyone applauds the proposed reforms.

Jennifer Campbell, director of public policy for the Ohio Association of Nonprofit Organizations, said private companies should be accountable for the use of public money. But her members are concerned that the bill could keep companies from doing business with the state if there is a dispute over repayment that hadn't been resolved.

"We want a common-sense approach to this," she said.

In addition to pushing the government to get more misspent tax money back, Jacobson added an amendment to the budget bill to improve oversight of private firms that spend tax money to care for the mentally retarded.

The bill requires company workers caring for people who live in their own homes to check in once they arrive at the home. Managers must then monitor their caller ID or other identification system to ensure the workers are actually on site.

If the caregiver doesn't show up, the firm must send out a replacement within an established period of time.

"If they wait too long to send out a replacement worker, they are directly accountable for negligence if something happens," Jacobson said. "The bottom line is, if a company provides care for people who live on their own at home, they better monitor it and make sure it's delivered."

Jacobson said he decided to push for the reforms after a 2002 Enquirer investigation, "Ohio's Secret Shame" revealed that abuse, inadequate oversight, neglect and poor living conditions are widespread in the system that cares for the mentally retarded.

The series found that 80 to 120 people die avoidable deaths each year, and most Ohio counties didn't even know if the workers they hired to care for people did good jobs or showed up at work.

Jacobson said the system must change.

"We know there are problems and abuses," he said. Still, while those reforms are moving forward, others may end up a victim of a state budget crisis that officials say is the worst since WWII.

In November, Jacobson and 19 other lawmakers sent a letter to then State Auditor Petro, citing the Enquirer series and asking for performance audits of private firms that provide at-home care. The letter said Ohio must do a better job keeping the mentally retarded safe and asked the state auditor to determine if private contractors were misspending funds and putting people in danger.

At the time, Petro - whose office had just uncovered millions in misspending by private foster care firms - said similar audits of private mental retardation firms were clearly needed and should be done. But Petro left the office in January to become Attorney General and his successor, new State Auditor Betty Montgomery, disagreed with his opinion that the state could legally audit private firms.

Montgomery said she isn't sure she has the authority to examine how private agencies spend tax money, and wants a law clarifying her authority. In addition, she has said her office can't always afford to go after agencies that misspend tax money, even if wrongdoing is occurring.

In the case of private mental retardation firms, for example, Montgomery's spokesman, Joe Case, said either the Ohio Department of Mental Retardation or the private firms themselves would have to agree to pay for the audits, which could cost as much as $300,000, depending on their scope.

Jacobson said he agreed to withdraw his request for the audits after Ken Ritchey, director of the mental retardation department, said he couldn't afford to pay for the extra oversight and promised to improve the system.

"Ritchey said, 'Please save me from spending $300,000 I can't afford to spend right now,' " Jacobson explained. "So I agreed. But if they don't (make improvements), I think we should put the pressure on again and do the audits."

Robert Jennings, spokesman for the department, said Ritchey believes the audits aren't needed.

"We have made and continue to make system-wide improvements" in health and safety, he said.

The department already is closing institutions for the mentally retarded and making other changes to save money. Under the current budget system, spending money to audit private mental retardation firms "would be a challenge," Jennings said.

Case said Jacobson's decision to hold off on his request for audits means the state auditor can't legally do the audits, even if Montgomery believed they were necessary.

"She has to be invited in, either by the legislature or the entity that we would be auditing," Case says. "She stands ready and willing to do the audits, but she's getting the message there is no need."

Jacobson said he is surprised to learn Montgomery must be invited by an agency to do an audit. If that's the case, he said she might want to focus on changing those rules, too.

"I'm concerned the auditor says she can't do her job unless somebody asks her too," he said. "I've never heard of that."


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