Thoughts on CDPAS Voice Recognition
Posted on May 7, 2009
By Roger Strickland, Director of Information Technology
Monroe County is mandating that CDPAS services must use a new voice recognition phone system to clock in on a shift and clock out. They also will do random spot checks to see if a clocked in attendant is still at the consumer’s home. I see many problems with this secretly developed system that they are now quickly trying to jam down our consumer’s throats.
They said that they were developing this system for “consumer safety”. If their main concern is consumer safety, why didn’t the business card say “Consumer Protective Specialist” instead of “Medical Antifraud Specialist”? This is not a quality of care program. The County is selectively targeting the disability community and CDPAS services in particular. Don’t try to slip us a three dollar bill. This initiative isn’t for all home care services. It is just focused on the service managed by people with disabilities. Discrimination is discrimination no matter how big your smokescreen.
I have several concerns about this new mandated system. Number one is that the County has not thought this through before mandating its implementation. From my perspective, the system will likely produce many false alarms of potential Medicaid fraud and be as effective as the boy who cried wolf. How many false alarms are we to chase down and who pays for all the wasted time? Taxpayers.
If people fail to answer the periodic shift spot check, the system flags them as violators. I am concerned that this may suggest attendants cannot go with consumers out to get a hair cut or shop for groceries. Attendants are also not always available to answer the phone. An attendant may be helping an individual in the bathroom when the phone check occurs. Will the attendant worry that they need to have to run out of the bathroom and leave the consumer unattended so they don’t get flagged for possible fraud? Will they be calling people’s home during the overnight shifts while family members or the consumer are sleeping?
Do County employees put themselves under the same scrutiny? They are getting paid using taxpayer dollars. And they get paid a whole LOT more than attendants. If I call a County employee’s desk and they don’t answer, can I assume they are cheating on their hours and demand my money back? Of course not.
If an attendant’s shift starts at 9:00 and for whatever reason the attendant cannot make their call right at 9:00 and calls in 15 minutes late? Do we pay the attendant for a 9:00 actual start or a 9:15 start like the phone record may indicate?
The County staff also seemed shocked when we said CDR provides sick and vacation time to the CDPAS attendants. Their system doesn’t address the need to request and pay for such benefits. I guess the County didn’t even consider that attendants should get leave benefits. How would County employees feel if this assumption was applied to THEM?
It seems like this system is just designed to go after poorer people. And I bet someone with a lot of money is making a lot more by doing this.
I am also concerned about the fact that the system requires the use of the consumer’s phone. If the consumer has a tracfone like I do, each call reduces the prepaid minutes even though it’s a toll free number. Is the County mandating that the consumer pay for this? Or is the county mandating that to get CDPAS service at all they must have a working phone?
The County never talked about reimbursing consumers for the use of the phone. I am very careful with my minutes and can see that the cost could become a barrier for some people. If a consumer’s track phone minutes get used up or if the consumer’s phone gets shut off, the attendant won’t be able to call in and will be flagged as a violator.
I know people leave their homes for many reasons, but many people make their voice heard on ADAPT actions, just like the one held in Washington, DC. The County seemed shocked when I pointed out that a consumer’s location may be on a bus to DC to participate in a protest. From the reaction, I guess consumers aren’t allowed to do these kinds of things.
This sounds like “House Arrest”.
Perhaps ankle bracelets would be a cheaper alternative.
The County still seems to think in terms of consumers being warehoused and locked away. They don’t get the “Community” in “Community Based Services.” They may say they do (perhaps to be politically correct), but their actions speak otherwise.
There are other problems as well. They have no mechanism for access if the attendant is Deaf and uses a TTY. When I asked about that, they said “Uhh…we will need to look into that.” I would think the County would be aware that we have the highest per captia number of Deaf people in the country. It seems that access for the Deaf community isn’t a priority for them. Will Deaf individuals automatically be flagged as “violators” under this system?
What about consumers and attendants who don’t speak English? One person at the meeting said CDR is responsible for providing an interpreter. I’m not sure how that would even be possible. Another said we must teach all of the Spanish-speaking attendants to use English. They said they successfully “trained” a Russian-speaker to use the English system without a problem. Now roll over and play dead. Good boy, have a Scooby snack.
I personally think it is a big waste of tax payer dollars and a big boondoggle. They must have watched the last Batman movie “Dark Knight” and want to turn all cell phones into high frequency generator receivers. This is unethical, dangerous, and wrong. Spying on people with disabilities is not part of my job description. They want to catch the Joker, but at what cost?
What’s next, WebCams so we can SEE that the attendant is working?
What kind of Orwellian world are we marching toward?
Sie sind unter Misstrauen Ihrer Regierung.
You are under suspicion of your government.
Also, at the meeting they told us the implementation date is May 1st of this year. They showed us the system for the first time on May 4th. We better jump in our Delorean and go back in time to get all the data in the system and call everyone in to train them how to use it.
Finally, what other technology will they use next? Perhaps they will just micro-chip all CDPAS consumers and attendants and have a GPS alert when they are separated by more than 100 yards. We already put micro-chips in dogs.
For the record, I’m all for hunting down and stopping Medicaid fraud, but this is just intrusive and a huge waste of taxpayer funds. I believe this system will cost more than it saves and add a lot of additional complexity.
Who’s idea was this anyway?
What is their name? And what is their job title?
Step into the light, so the people can give you proper recognition.
Filed Under Advocacy, Attendant Services, Attitudes, CDR Programs, Community-based services, Computers, Consumer Directed Personal Assistance, Deaf Community, Home Care, Independence, Independent Living, Medicaid, Medicaid Fraud, Roger Strickland, Technology |
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First, get off your high horse — this is my money paying for the services being provided. I prefer that fraud not be a part of it — there for as Reagan said — trust but verify. Just who do you think you are? This is not your money? It is OUR money. I want it spent correctly. Face it Personal Assistance Services are nothing but an invitation for fraud and abuse. Tell you what — make the client responsible for any fraud or theft — and then I will discuss how to make your “clients” better. Otherwise —- GET OFF YOUR HIGH HORSE — THIS IS MY MONEY TOO!
And no - it is not intrusive — the disabled want my tax money — then accept that it has conditions. Live with it. Talk about a waste and boondoogle — then let me ask - why is my tax dollar paying an immediate family member to do — what God intended for them to do — on their own. Quit sucking off the government teat!
Lastly, you seem damned worried about your money for your cell phone — but obviously you don’t give a diddle damn about the taxpayers money or the inherent fraud in this program. Some of you people are out of control.
The issue is not just regarding fraud, the whole long term care issue is something the US and the whole world has to deal with due to declining birth rates and increased life span and it’s not to do with ‘the disabled’ its to do with the chances of becoming disabled which can happen at any time to anyone. Do the government have a right to say that you should be monitored 24/7 to receive any kind of assistance? Do they do it to more vocal minorities? I don’t think so.
I agree that in the challenging economic times we currently face there needs to be more oversight, however I’d like to see the government pass a monitoring system this tight on other groups claiming.
Bottom line, I work hard, I earn my money and I agree with the battle against fraud but disagree that if I work my career and want to retire and may need a little help in my later days that I should consider my home a prison and worry about being a criminal just for being away when someone calls.
Mark,
As I stated previously - if you don’t want conditions - don’t accept government money. Sorry but there has to be verification. Look at the California program — indictments are flying - supposedly this program is failing due to allowing inmates in prison to be “caregivers” as well as “clients” being their own “caregivers” by using fraudulent Social Security numbers. You simply don’t get it Mark — if you take the money — you take the conditions. Live with it! Otherwise — get your immediate family to care for you — at no cost to me.
In response, I was not saying that I didn’t want monitoring and fraud protection for the service, I agree there needs to be, but to have a system like this that only checks on you briefly and has no human side to it is flawed. Your also dealing with cunning people. I’m pretty sure a person could and will figure a way to bypass the system with call forwarding or an answering machine and then your left with no actual people for quality assurance because the state deemed the system a success and cut the budget for monitoring it.
Oh and please, California is a big old sink hole for cash and will be the poster boy for fraud for a long time to come, they will be discovering fraud every day for the next five to ten years while they sort that state and it’s systems out.
and FYI, just because I posted defending the article does not mean I’m automatically receiving benefits or care. Bottom line we agree that we need a system, we simply disagree on the type of system.
Mark, Here is the deal - you want monitoring? you want fraud protection - then hire an agency - yes it costs more — but consumer directed options are done on the cheap. You cannot have it both ways. If you want my tax dollars — you will only get them when I am satisfied that my money is used wisely. Fact of the matter is that personal care assistance services or if you prefer - consumer directed options — leaves too much leeway for fraud. I would prefer that an agency — one that is — LIABLE AND CAN BE SUED — is providing services. Not someone’s cousin or brother or father — that’s just nuts! But don’t worry - with the amount of fraud we are starting to see in personal assistance services - this system will go the way of dinosaurs.
Mark, as California goes - so goes the rest of the states. Get your facts right — the monitoring is for the caregiver — not the client. No one wants to spy on a client - stop the lies. Verification of services rendered is reasonable and yes, prudent. If you want my money — accept the condition — otherwise - you don’t get services. Pretty simple actually. Why should I “trust” a caregiver to simply say — yes I worked today - and pay them without verification. And don’t even try to say that the client will verify it — collusion is already a major factor of fraud in California’s IHSS program. Face it — Consumer Directed Care is a license to steal. It should be stopped.
You want a system that costs more, simply because IF you find out they are stealing, then you can sue them?
I really do think that to continue with the broken system of institution care is wrong and I will continue to support the CDPAS system, that is cheaper than keeping people in nursing homes.
I do hope that if there ever comes a time that you have to care for someone, that you are able to do it for free, I’m sure that them needing 4 or 8 or 12 hours of care per day will allow for you to maintain a job as clearly you won’t want to be paid for your work, as that would be hypocritical.
People do steal and commit fraud, there needs to be monitoring, but to have a system that is so random and in my mind has no human side to it is a big flaw in these plans.
Mark — you want consumer directed options? Fine — then accept conditions. BTW, most personal assistance services are not even covered by Workers compensation — guess those clients will love losing their homes to their caregiver — when the caregiver slips a disc in their back moving them. Oh yeah, your last comment — guess what — nothing in life is — free. Immediate family members should never be paid by our Government to do what ethically and morally is their personal responsibilty. To do otherwise is in my mind hypocritical and basically theft from every US taxpayer. BTW, don’t put words in my mouth - I am for home care — if — the client is within certain parameters. My gripe is with hiring immediate relatives — this is simply nuts. Our country is going broke - and all you people want to do is pad your pockets. It is sickening. But your not worried — you think this will go on forever — trust me, it won’t. And the immediate relatives will get the axe first — and should. Why? Because they have an innate resposibility to care for their own — Face it — this is about putting money in a relatives pocket - nothing else.
I would simply like you to answer this. If a person is geographically prohibititve or has a 24/7 condition, and cannot find support from agency workers to do this, then what, the person should not recieve paid care for the hours they need it because they can only find a family member to assist them?
“I would simply like you to answer this. If a person is geographically prohibititve or has a 24/7 condition, and cannot find support from agency workers to do this, then what, the person should not recieve paid care for the hours they need it because they can only find a family member to assist them?”
Here is your answer — Mark - what is the unemployment rate in your county? Your state? Let me tell you — it is probably double digit. Don’t sit there and tell me that you cannot find anyone to do the work, including an agency. And no, you don’t seem to understand — in my state - as in thirty plus other states - it is the RESPONSIBILITY AND DUTY of the immediate family member to care for the person who needs care. Not the governments responsibility to pay the immediate family member. It’s called filial responsibility - a concept that has been in existence since the Poor Act of 1600.It is the basis for Divorce actions where one parent is required by law to pay for the upkeep of their children. Conversely it is the adult child’s responsibility - under law - to care for their elderly parents. To abbrogate that duty - under law - by paying the adult child with my tax dollars is simply — wrong and in my view a violation of law and historical ethics.
You want help taking care of an immediate relative - fine - find an agency or have the government pay a worker directly - BUT NOT AN IMMEDIATE RELATIVE. Your the reason this country is going broke — you need to take some personal responsibility.
I think you’ll find if you checked the rules for CDPAS in NY state that the Attendant cannot be a member of direct family.. parent, spouse, son, son-in-law, daughter or daughter-in-law. These are rules put in place by the NYS department of Health.
So bottom line there are agencies, and the attendant can’t be direct family. So essentially they are doing what you want… and CDPAS is still cheaper than institutions.