TALLAHASSEE --The Florida Department of Elder Affairs is pushing back against critics who say the state’s watchdog program for long-term-care facilities, which the department oversees, is losing steam after several high-level departures.
Six weeks ago, the department lost its state long-term care ombudsman, Jim Crochet, who took early retirement while under investigation by the agency. The former deputy ombudsman for field operations, Don Hering, said he resigned in mid-August because he was being investigated as well. And the chair of the state Long Term Care Ombudsman Council, Carol Weideman, resigned in July --- over what she called “shabby treatment” by a department official.
The exits sparked editorials calling for the Department of Elder Affairs to appoint its third state ombudsman in less than three years.
Critics pointed to Florida’s transition to Medicaid managed care for seniors who need long-term care --- a transition that started Aug. 1. --- as reason for the watchdog program to be at full strength.
“As a result (of the departures), the state ombudsman’s office stands diminished, this time accused of being nothing more than a rubber-stamp for the long-term-care industry,” editorialized the South Florida Sun Sentinel on Aug. 19. “It’s a harsh assessment, but there’s evidence to back it up.”
The following week, the department tapped James M. Croteau as interim state ombudsman and blasted media reports that the program was losing steam.
“For the past two years, Florida’s long-term care ombudsman program has been bombarded by an onslaught of negative press which has cast a shadow over the hard work of its staff and volunteers,” the department said in an Aug. 27 news release. “Increasingly over the past few weeks, attacks have been used to publicly bemoan an imagined decline of Florida’s ombudsman program and to spread gross misrepresentations of program policies and decisions.”
The press release noted that Florida has 25 percent more volunteer ombudsmen than it did in early 2011, while the percentage of elder-care residents who are dissatisfied with the program’s services has dropped.
The reason for the department’s investigation of Crochet, who oversaw the rise in volunteers and the drop in complaints, is unclear. Employees were told not to communicate with him. Department spokeswoman Ashley Marshall said she can’t comment while the case is open and doesn’t know how long it will take to complete.
But Hering, the former deputy ombudsman, confirmed that he was questioned by the department’s Office of Inspector General about his handling of the transition to Medicaid managed care.
On Aug. 1, thousands of low-income Florida seniors began the shift. Almost all state Medicaid beneficiaries eventually will end up enrolled in HMOs or other types of managed-care plans. Approved by lawmakers and Gov. Rick Scott in 2011, the changes have long been controversial, with critics questioning the care Medicaid patients will receive.
Hering said many Medicaid beneficiaries might need an ombudsman to help understand the managed-care choices they’ll be making.
“They are going to have trouble interpreting some of that stuff --- about whether I should take Plan A, Plan B or Plan C,” he said.
Both Marshall and Liz Dudek, secretary of the state Agency for Health Care Administration, have said their agencies are trying to address such concerns via collaboration and outreach.
Hering, as deputy ombudsman for field operations, said he tried to prepare his volunteers to answer questions about the changeover. He told them to find out who their contacts would be at the Area Agencies on Aging. Known as Triple-As, those are private non-profits established by the Older Americans Act to coordinate and fund elder-support services in their regions.
“My point to the regional manager and the district manager was, you better understand who in the Triple-A area is going to be the case manager in case you have questions,” Hering said. “We weren’t getting information and things were beginning to happen.”
Subsequently, according to Hering, the Department of Elder Affairs accused him of unprofessional conduct. He said Inspector General Taroub King interviewed him for two hours in Tampa last month, after Susan Anderson, the deputy ombudsman for legal matters, had instructed him and others not to talk to people in the field about Medicaid managed care.
“I did not violate instructions, because I had already talked to them before I was told not to do it,” Hering said. He resigned rather than participate in the investigation.
Marshall said the department doesn’t have an official policy for volunteer ombudsmen dealing with Medicaid managed care.
“Many of our program staff and volunteers across the department have contact with individuals seeking assistance, whether switchboard staff, program specialists, SHINE volunteers, Elder Helpline staff, ombudsmen, and others about a variety of issues,” she wrote in an email.
“Leaders from our division of statewide community-based services continue to train all of these groups on updates regarding the (state Medicaid managed care) long-term-care program, including contact information and where to direct questions,’’ the email said. “Additionally, ombudsmen will be a part of the Independent Consumer Support Program. …Through this program, ombudsmen will assist (enrollees) with complaint resolution through coordination with managed-care plan case managers and DOEA compliance staff.”
But Weideman, who is still active as a volunteer ombudsman despite her resignation from the state council, said the volunteers aren’t ready for the switch. “We know it’s coming, but there’s been nothing said about how it would affect us,” she said.