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An investigation finds little evidence of billing problems but finds notes about client activities were poorly maintained.
By JIM ROSS
© St. Petersburg Times, published July 24, 2001
LECANTO -- A state inspector general has finished a limited review of the Brown Schools.
The findings: a mixed bag.
The Department of Children and Families' inspector general checked three complaints that former Brown employees lodged. They alleged that Brown billed for therapeutic services that staff didn't provide, committed Medicaid fraud and allowed drunken workers on campus.
The inspector general, after interviewing dozens of witnesses and reviewing many documents, reached some unflattering conclusions about Brown.
For example, the agency's report said Brown managers did a poor job of teaching staff to complete forms that indicate what services clients received. Some employees inaccurately completed some paperwork, which eventually could be -- but in this case wasn't -- used for Medicaid billing.
Also, management's explanation of its effort to correct that poor training was "questionable" and certainly confusing to employees.
At the same time, the inspector general seemed to support -- or, at the very least, fail to refute -- Brown's assertion that its managers did nothing wrong.
The Medicaid question, for example, is largely moot because Brown has not sent any bills to Medicaid, the report noted.
Athough the paperwork training might have been lacking, former and current Brown employees denied ever completing therapy notes for work that wasn't provided, "and no information was obtained that would refute their claims," the report said.
Similarly, "All current and former (Brown Schools) therapists denied ever completing therapy notes for services that were not provided and denied being directed or asked to complete therapy notes for services not provided," the report said.
And the drunken worker? It was a woman from a temporary agency who reported to Brown for an early Saturday shift. Brown's leaders sent her home and told the agency never to send her back again -- a response the inspector general found satisfactory.
The inspector general recommended that Children and Families leaders in District 13, which includes Citrus, check each client's file and make sure it accurately reflects the services clients have received.
The report's authors also recommended that the Medicaid Fraud Control Unit of the state Attorney General's Office review the findings.
Brown officers had not received or reviewed the report late Monday, spokeswoman Donna Burtanger said. She said that the allegations came from disgruntled former employees.
"We always have room for improvement, and we will continue to" improve, she said. "This is yet another obstacle that we have gotten through. Things have proved to be unfounded. I would hope the community would see this as another way for us to gain their confidence back."
For the past year, Brown has occupied the former Heritage Hospital building off County Road 491 north of County Road 486. The for-profit company operates a residential treatment facility for adolescents who are severely emotionally disturbed.
Children and Families hired Brown to provide this service, but has criticized the company's performance many times. Some residents have escaped and committed crimes; others have damaged the building and caused countless false fire alarms.
Brown's former executive director, Matt Leary, has been charged with failing to report a child abuse allegation. He has pleaded not guilty and the case is pending.
Despite its well-documented travails, Brown has gained positive momentum in recent weeks. Children and Families lifted a long-standing admissions moratorium and later extended Brown's contract for six months, effective July 1, and renewed its operating license.
During a recent interview, Children and Families' top administrator in District 13 said he was "cautiously optimistic" Brown would perform well and win a new annual contract.
"I think they can do it," said the administrator, Patrick Howard.
The inspector general's report might not help Brown's case. But it doesn't seem to hurt it as badly as some critics might have hoped.
The inspector general, along with several other state agencies, became involved when a former Brown employee, Jeffrey Cooper, wrote a letter detailing several complaints. Cooper later said the letter included complaints from other former employees, as well.
Brown management "has not hired therapists for kids, even though they are documenting that the kids are receiving two group sessions per day and one individual session per week. This is just not happening," Cooper wrote.
Also: "Management has required staff members to complete therapy notes for sessions that the employees did not attend."
Staff from the inspector general interviewed one current Brown employee and four former staffers. All were therapists. All denied completing notes for therapy sessions not provided. And all said Brown managers never told them to lie.
Some clients might have missed therapy sessions, they told investigators. But when that was the case, the therapists said they noted the absence in the client's file.
Jo Johnson, the employee at Children and Families who monitors the agency's contract with Brown, told investigators that clients' therapy needs varied. She said a mental health clinician would have to review each client file to determine whether clients received the therapy he or she needed.
The allegations about drunken staffers were somewhat confusing.
In his letter, Cooper wrote that two female shift supervisors once returned to work while off duty. The women had been drinking. The letter also said that, in a separate case, a temporary worker showed up at Brown drunk.
When investigators asked about the first incident, Cooper said the information actually came from another former staffer, Steven Robinson.
So investigators interviewed Robinson. He told them the incident concerned two workers who returned to campus while off duty and tried to help him persuade a resident to come off the roof.
Had the women been drinking? Robinson said he didn't know. However, a co-worker -- whose name he didn't remember -- told him the women had been drinking. He also told investigators there was "no love loss" between him and the women, and that he believes they called Leary, then the executive director, to make him look bad.
As for the temporary worker, Leary told staff to send her home, which is what staffers did.
The alleged Medicaid fraud concerns Therapeutic Care Services and Rehabilitation Care Services forms. Those are technical names for the paperwork that mental health technicians are supposed to complete during each shift.
Workers on each shift are supposed to fill out the forms. The day shift, for example, is supposed to chart the students' performance in their "goals groups," afternoon workers monitor social skills, and the night crew documents life skills and hygiene, the report said.
However, many of the necessary forms weren't completed, in part because staff didn't have enough time. The result: staffers on the next shift sometimes completed the previous shift's work, even though the workers filling out the paperwork had no direct knowledge what the clients had done, according to several employees.
The inspector general said this was a troubling practice and was evidence of poor training. Investigators also took issue with a September meeting that Brown management called to discuss the problem.
Recollections of the meeting varied. However, several employees and former employees told investigators that, correctly or not, they felt pressured to fill out several forms, for hours on end, to document work they had done in the past.
Employees told investigators some forms were inaccurate.
Brown managers insisted that they did not tell workers to falsify records, and some employees told investigators they were never told to lie. When they learned that some documents might be false, they conducted an internal investigation.
They also said that none of the paperwork was submitted for billing purposes.