Media
Questions for President Obama about Syria
NewsHour Weekend reviewed
Here's the 1 Thing You Need To Know About Why I Can't Stop Looking At These 9 Questions You're Too Embarrassed To Ask About headlines
Public Universities Ramp Up Aid for the Wealthy, Leaving the Poor Behind
This story was co-published with The Chronicle of Higher Education.
Shauniqua Epps was the sort of student that so many colleges say they want.
She was a high achiever, graduating from high school with a 3.8 GPA and ranking among the top students in her class. She served as secretary, then president, of the student government. She played varsity basketball and softball. Her high-school guidance counselor, in a letter of recommendation, wrote that Epps was “an unusual young lady” with “both drive and determination.”
.right-sidebar-media { width: 290px; float:right; margin: 0 0 12px 12px; } .right-sidebar-media h2.definition { font-size: 20px; font-weight: bold; font-family: "ff-meta-serif-web-1", "ff-meta-serif-web-2", "Georgia", serif; margin-bottom: 10px; } .right-sidebar-media ul { list-style: disc; margin-left: 1.2em; } .right-sidebar-media ul li { font-size: 13px; left: 1.2em; margin-right: 1.2em; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; padding-bottom:1.3em; } .right-sidebar-media p.definition .termtbd { text-transform: uppercase; font-weight: bold; } .annotation { background: #cecbc3 ; border-radius: 3px; padding: 0px 3px; transition: all 0.10s ease-in-out; -webkit-transition: all 0.10s ease-in-out; -moz-transition: all 0.10s ease-in-out; cursor:pointer; } .annotation.tweet { background: url("http://propublica.s3.amazonaws.com/projects/projectx/tweet_icon.png") no-repeat top left #e8eef1; padding-left: 24px; background-size: 13px; background-position: 5px 2px; text-decoration:none; } .annotation.tweet:hover { background: url("http://propublica.s3.amazonaws.com/projects/projectx/tweet_icon_hover.png") no-repeat top left #d7dee1; padding-left: 24px; background-size: 13px; background-position: 5px 2px; text-decoration:none; } .annotation.tweet a:hover {text-decoration:none} Four Takeaways- State universities, which have a public responsibility to provide students with access to an affordable education, are giving a growing share of their grants to wealthier students, and a declining share to the poorest students.
- Public universities are increasingly mimicking private colleges by using financial aid to further their own goals such as enrolling students who will bring revenue or boost their spots in the rankings.
- Industry consultants who help schools with what’s called “financial-aid leveraging” say their clients at public universities are trying to offset budget cuts by using aid to enroll students who can “positively impact the bottom line.”
- State universities have been serving a shrinking portion of the nation’s needy students. More of those students have been heading to community colleges and for-profit schools.
Epps, 19, was also needy.
Her family lives in subsidized housing in South Philadelphia, and her father died when she was in third grade. Her mother is on Social Security disability, which provides the family $698 a month, records show. Neither of her parents finished high school.
Epps, who is African-American, made it her goal to be the first in her family to attend college.
“I did volunteering. I did internships. I did great in school. I was always good with people,” said Epps, who has a broad smile and a cheerful manner. “I thought everything was going to go my way.”
At first, it looked that way.
Epps was admitted to three colleges, all public institutions in Pennsylvania. She was awarded the maximum Pell grant, federal funds intended for needy students. She also qualified for the maximum state grant for needy Pennsylvania students.
None of the three schools Epps was admitted to gave her a single dollar of aid.
To attend her dream school, Lincoln University, Epps would have had to come up with about $4,000 per year, after maxing out on federal loans — close to half of what her mother receives from Social Security. It was money her family didn’t have, she said.
Public colleges and universities were generally founded and funded to give students in their states access to an affordable college education. They have long served as a vital pathway for students from modest means and those who are the first in their families to attend college.
But many public universities, faced with their own financial shortfalls, are increasingly leaving low-income students behind — including strivers like Epps.
It’s not just that colleges are continuously pushing up sticker prices. Public universities have also been shifting their aid, giving less to the poorest students and more to the wealthiest.
A ProPublica analysis of new data from the U.S. Department of Education shows that from 1996 through 2012, public colleges and universities gave a declining portion of grants — as measured by both the number of grants and the dollar amounts — to students in the lowest quartile of family income. That trend has continued even though the recession hit those in lower income brackets the hardest.
The Decline in Grants to Low-Income Students
Portion of institutional grants given to students in the lowest and highest income quartiles.
Students in the lowest quartile of income
Students in the highest quartile of income Source: ProPublica analysis of data from the U.S. Department of Education National Postsecondary Student Aid Study
Attention has long been focused on the lack of economic diversity at private colleges, especially at the most elite schools. What has been little discussed, by contrast, is how public universities, which enroll far more students, have gradually shifted their priorities — and a growing portion of their aid dollars — away from low-income students.
State schools are typically considered to offer the most affordable, accessible four-year education students can get. When those schools raise tuition and don’t offer more aid, low-income students are often forced to decide not just which college to attend but whether they can afford to attend college at all.
“The most needy students are getting squeezed out,” said Charles Reed, a former chancellor of the California State University system and of the State University System of Florida. “Need-based aid is extremely important to these students and their parents.”
There’s no data on the number of needy but qualified students who are “squeezed out” and don’t make it onto four-year college campuses. But what is clear is that while the number of needy students has been growing, state schools have not kept up.
Over roughly two decades, four-year state schools have been educating a shrinking portion of the nation’s lowest-income students, according to an analysis of Pell-grant data by Tom Mortenson, a senior scholar at the nonprofit Pell Institute. The task of educating low-income students has increasingly fallen to community colleges and for-profit schools.
Epps’ top choice, officially known as The Lincoln University, is about an hour’s drive from Philadelphia, and was one of the nation’s first historically black colleges. Founded in 1854 to serve African-Americans excluded from other colleges, the school became a public institution in the early 1970s, when the state legislature deemed its mission to be “completely compatible with the needs of the Commonwealth.”
All of the school’s own aid typically goes toward athletic or merit-based scholarships, regardless of students’ needs. In the 2009-10 budget, for instance, most of the roughly $3 million in institutional aid went to four specific “merit-based” scholarships — and the rest to athletics, international students, and study abroad, according to data supplied by Lincoln. The only need-based aid available to students is through separate donor-supported scholarships, some of which are earmarked for needy students, said university spokesman Eric Webb.
Aid given based on merit or other factors could still go to needy students, but that doesn’t appear to be happening much at Lincoln.
Data made available by the nonprofit Institute for College Access & Success show that 84 percent of the school’s grant dollars in the 2009-10 school year did not go to meeting students’ needs. (The data does not include athletic scholarships and certain other forms of aid.)
At Epps’ second choice, Millersville University of Pennsylvania, two-thirds of aid dollars in 2010-11 went to students who had no documented need for it, according to the latest data available. (East Stroudsburg University of Pennsylvania, the third school that accepted Epps, did not provide a breakdown of institutional grant aid.)
Why have public universities across the nation shifted their aid?
“For some schools, they’re trying to climb to the top of the rankings. For other schools, it’s more about revenue generation,” said Don Hossler, a professor of educational leadership and policy studies at Indiana University at Bloomington.
To achieve these goals, schools use their aid to draw wealthier students — especially those from out of state, who will pay more in tuition — or higher-achieving students, whose scores will give the colleges a boost in the rankings.
Private colleges have been using such tactics aggressively for some time. But in recent years, many public colleges have sought to catch up, doing what the industry calls “financial-aid leveraging.”
The math can work like this: Instead of offering, say, $12,000 to an especially needy student, a school might choose to leverage its aid by giving $3,000 discounts to four students with less need, each of whom scored high on the SAT, who together will bring in more tuition dollars than the needier student.
Those discounts are often offered to prospective students as “merit aid.”
Despite its name, “merit aid isn’t always going to the very best students,” Hossler said. “It’s an intentional strategy to help offset the loss of state support.”
Hossler knows this world firsthand. For years, he carried out such strategies as vice chancellor for enrollment services at Indiana University.
“One of my charges was to go after what I would call pretty good out-of-state students,” he said. “Not valedictorians, not the top of the class. Students who you didn’t have to give thousands and thousands of dollars to in order to get them to enroll.”
Indiana University is not alone in thinking about financial aid this way. Consultants who work with schools on financial-aid strategies said they’ve seen an uptick in interest from public universities in recent years, with many focused on generating more revenue.
“When public [universities] come to us individually now, they won’t admit it, but they’re all looking for the same thing — smart students who can pay,” said an industry consultant who asked not to be named.
Another industry consultant, Mary Piccioli of Scannell & Kurz, said many of her firm’s public-school clients are looking to use financial aid “to positively impact the bottom line.”
College officials often argue that attracting students with more resources means they’ll have more aid to redistribute to those in need.
“There’s certainly some truth to that,” said Donald Heller, dean of Michigan State University’s College of Education, who has researched institutional-aid patterns extensively. “But I don’t think that’s really the motivating behavior for many institutions. The more dominant motivating behavior is interest in high-achieving students, which will help them with institutional prestige.”
Epps, apparently, didn’t generate that sort of interest.
She was in her high school’s computer lab, checking her email, when she saw the message from Lincoln University laying out her financial aid package: a mix of state and federal money but nothing from Lincoln.
“Once I saw it, I knew it wasn’t the amount that I needed,” Epps said. “Right away I knew it.”
Shauniqua Epps laughs with one of her counselors, Christina Santos of Philadelphia Futures. Epps attributes a lot of her success to the program, which helps low-income students get into and finish college. (Andrew Renneisen for ProPublica)
Epps had been getting guidance from Philadelphia Futures, an organization that helps low-income high-school students get into and complete college. When she went through the cost calculations with a coordinator there, it became clear: The money simply didn't add up.
At first, Epps said, she blamed herself for not qualifying for aid. She felt like a failure.
“I was kind of upset because I felt as though I worked so hard,” she said. “I kept thinking how I’m not a good test taker.”
Epps had scored a combined SAT score of 820 on math and critical reading. In fact, that’s solidly in the middle of Lincoln’s score distributions for many years, according to data reported to the U.S. Department of Education.
But what Epps didn’t know is that the school had committed to “continuously improving its SAT and GPA averages for incoming cohorts” — as language found in a strategic planning document put it. She also didn’t know that the school had been spending the majority of its financial aid on students who would help bring up those averages — regardless of whether they needed the money.
“To attract top students to your institution, you have to be able to offer them a competitive scholarship package,” said Lincoln University President Robert Jennings. “That’s usually a full-tuition scholarship, that’s a private room sometimes or laptop computer, or a whole bunch of other perks. That’s what schools do. All schools do it.”
Rather than giving small discounts to many students, as many colleges do, Lincoln focuses on giving free rides to top scorers – as a Lincoln admissions flyer lays out.
The strategy seems to have worked. Lincoln University has raised its scores in recent years. In 2002, half of Lincoln’s incoming freshmen scored between a 360 and 460 on the math section of the SAT. In 2012, half of students scored between 410 and 490.
The boost in scores has been no accident, according to Jennings. He said it was a mandate from the Board of Trustees.
“They wanted to increase the SAT averages of students coming to Lincoln,” Jennings said.
And what about students who may have once been a natural fit but aren’t hitting the higher scores? The school still wants to serve some of them — “because of our historical mission,” explained Jennings. But Lincoln has also increasingly been “trying to steer that lower tier of students — students who need much more help — into community colleges,” he said.
Jennings doesn’t see this as a departure from the school’s mission to provide public access. “Absolutely not,” he said. “That’s why you have community colleges. They, too, are public institutions, and we have built collaborative relationships with them.” He added that the school recently launched a campaign to raise more money for scholarships, some of which will go to providing more need-based aid.
Like Lincoln, both Millersville University and East Stroudsburg University — the two other colleges that accepted Epps — have created strategic planning documents that include language reflecting a desire to move up academically.
In a 2010-15 strategic planning document, East Stroudsburg University outlined the goals of becoming “more selective in each new year” as well as fostering “strategic alignment of financial aid” to better attract top students.
“High-achieving and access are not mutually exclusive,” said spokeswoman Brenda Friday. “As such, we look for and recruit students who present both. We also recruit these groups separately. There are funding possibilities available for both groups of students.”
East Stroudsburg and other regional public colleges are in a tough spot. Many don’t have very much aid to give, and most serve a higher percentage of needy students than more prestigious public flagship universities, which have more money from endowments, research and fundraising. It’s a common phenomenon in higher education – students with less money relegated to institutions with less money.
In Pennsylvania, as in most states, public higher education has faced steep cuts, especially since the most recent recession. Over the last five years, the state has cut funds for higher education by 18 percent. At public institutions, that’s worked out to about $2,000 less in state and local support per student — a 32 percentage-point drop, according to data from the State Higher Education Executive Officers.
“All the arrows point in a direction that shows what we are out doing now is raising revenue. The old business model has sort of broken down,” said Patrick Callan, president of the Higher Education Policy Institute and formerly the head of state higher-education boards and commissions in Montana, Washington and California.
“There have probably been no winners from all of this,” Callan said. “But the biggest losers were those who were disadvantaged on the front end.”
In high school, Epps went by the nickname “Neeks” with most of her friends. They were a mixed group. Some, like her, fostered hopes of attending college. Others just wanted to finish school and get a job.
Though she loved high school, Epps said that looking back she realizes that despite her own efforts, she didn’t get the best education.
About a third of the students at her high school didn’t graduate. After she left, the school was among roughly two dozen shuttered by the chronically underfunded School District of Philadelphia.
“On a couple of levels, systems are failing these students,” said Ann-Therese Ortiz, who worked with Epps as director of pre-college programs at Philadelphia Futures. Low-income high-school students could put in the same effort as their better-resourced counterparts, but “even with the same effort, it simply doesn’t yield the same fruit. And then there’s limited access to the same opportunities, because they’re not receiving the same educational foundation that really opens those doors.”
Those disadvantages can also show up in test scores. A substantial body of research shows that SAT scores are strongly correlated with family income.
“How do you separate merit from privilege?” asked Jerome Lucido, a professor and executive director of the University of Southern California’s Center for Enrollment Research, Policy, and Practice. “Merit needs to be tied to mission, not just who got a higher test score. We already know that has a direct correlation with family income.”
But the SAT and other tests are still crucial to how publications such as U.S. News & World Report and Barron’s formulate college rankings, which are widely regarded as measures of prestige.
Not surprisingly, colleges are constantly working to move up the lists. A prospective student flipping through Barron’s 1995 college-rankings guide would have found about 90 public institutions in the top three tiers of competitiveness and more than 170 in the less competitive or non-competitive tiers. In the 2013 guide, that top tier has grown by more than 40 colleges — about 46 percent — and the bottom tier has shrunk by 60.
“The whole system is constantly moving up, going upstream to get better and better students, and get students who can pay,” said Anthony Carnevale, director of Georgetown University’s Center on Education and the Workforce. “It all looks great for the press release. But you’re systematically leaving people behind.”
Carnevale, who has authored many studies analyzing this shift, likens the state of higher education to “hospitals for healthy people,” competing for the easiest to treat, most lucrative patients, rather than taking on the cases of those who stand to benefit the most. “The question is, are you trying to reach down or not?”
Schools might argue they are — in a way.
Many state schools have in recent years struck what are called “articulation agreements” — partnerships with community colleges that make it easier for community-college students to transfer to a four-year school. In the last two years, Lincoln University has established such agreements with 11 community colleges.
But even with improved transfer pathways, there’s still an inherent risk for students like Epps who “undermatch,” or don’t attend the most selective school they can get into. Low-income, minority and first-generation students frequently undermatch, research shows, and in doing so, they often end up at institutions with less support and far lower graduation rates.
Without any aid from Lincoln or the other colleges that accepted her, Epps weighed her options and chose a different route. She recently completed her first year at the Community College of Philadelphia — a school where about half of full-time freshmen don’t return for a second year.
“In a way, four-year colleges are asking two-year colleges to do the dirty work of selecting who’s worthy of a four-year college,” the Pell Institute’s Tom Mortenson said. In doing so, four-year colleges are not “taking on the responsibility from the beginning when they’re freshmen and making a real commitment to these students.”
But colleges — even those with an explicit public mission — have mounting incentives to avoid students like Epps. Carnevale points to the dawning of what’s known as the “accountability movement” — an effort by states to reform higher education by tying funding for public colleges to student outcomes and graduation rates. Last month, President Barack Obama announced that the federal government would also be moving in a similar direction — and hopes to eventually tie federal aid to certain performance measures.
Unless policymakers build in some incentives to take on more students at the margins, the accountability movement could drive schools further away from low-income and minority populations, which have lower graduation rates overall, Carnevale said. “The whole logic of this industry — and the reform of it as well — excludes low-income and minority students.”
While colleges strive to enroll wealthier and better-performing students, the demographics of the nation’s high-school graduates are moving in a different direction: As a group, tomorrow’s high-school graduates will be more racially diverse and more low-income than today’s.
“There is a significant misalignment. And I think the misalignment’s going to continue to grow,” said David Tandberg, an assistant professor of higher education at Florida State University who previously worked in the Pennsylvania Department of Education.
“The public really, really benefits from a first-generation student going to college. All sorts of wonderful outcomes come from that,” Tandberg said.
A more educated workforce has widespread benefits: It leads to more earning power for those who graduate, a stronger tax base for the state, and greater potential for economic growth in the future.
Public universities have the task of “balancing institutional striving with the public’s needs,” Tandberg said, which “are often two very different things.”
Epps still remembers going out and buying a new button-down shirt, slacks and dress shoes the night before her high-school graduation. She remembers the nervousness she felt the next morning, and the tinge of sadness.
“I was going to miss my friends. We had been together for four years, and we were all going in different directions,” she said. “I didn’t know how life was going to turn out.”
At graduation, in her white cap and gown, she was the mistress of ceremonies, introducing each of the speakers and making sure the ceremony flowed. She read out the theme of the year’s graduation, a rephrasing of a Thoreau quote: “Go confidently in the direction of your dreams. Live the life you have imagined.”
She’s certainly trying. Community college started up again last week. Epps has already signed up for a full schedule of six classes.
A year from now, she hopes to transfer, finally, to a four-year state school and eventually to get a bachelor’s degree. She’s thinking she might want to study accounting.
Jonathan Lin contributed research to this article.
Exchange Watch: Minnesota
The new black migration
Stories I'd like to see
Shortchanged
Audit Notes: Reporting numbers, The Onion on the hamster wheel, info consumerism
Johns Hopkins and the Case of the Missing NSA Blog Post
Sept. 10: This post has been updated.
Citing concerns about linking to classified material, Johns Hopkins University asked a professor this morning to remove a blog post discussing last week’s revelations about the NSA’s efforts to break encryption. The post had linked to government documents published by ProPublica, the Guardian, and the New York Times.
Several hours later, after computer science professor Matthew Green tweeted about the request, the university reversed itself.
Baltimore-based Johns Hopkins, which is short drive from the NSA’s headquarters at Fort Meade, works closely with the spy agency.
The university’s Applied Physics Laboratory, which employs about 5,000 people, does many projects with the NSA.
According to the lab’s website, “APL staff working with NSA are engaged in strategic planning, development of enterprise and program architectures, conducting quantitative analysis to support engineering decisions, development of engineering processes, and formulation of the governance structures for the work in the new Technology Directorate (TD).”
The website also notes that the lab “completed a strategic study that analyzed NSA’s global information technology infrastructure to determine the top locations for the large-scale data centers.”
Green said on Twitter that he had “been told” that someone from the Applied Physics Laboratory had first flagged his blog post.
Asked about the Applied Physics Laboratory’s role, Hopkins spokesman Dennis O'Shea said, “We are still tracing the path of this event, which all exploded into our notice over the past couple of hours. So I don’t think we’re ready yet with an answer on that.”
In an earlier statement, O’Shea said: “The university received information this morning that Matthew Green’s blog contained a link or links to classified material and also used the NSA logo. For that reason, we asked Professor Green to remove the Johns Hopkins-hosted mirror site for his blog.”
He continued: “Upon further review, we note that the NSA logo has been removed and that he appears to link to material that has been published in the news media. Interim Dean Andrew Douglas will inform Professor Green that the mirror site may be restored.”
Green removed the post from his university site but it remained mirrored on Google’s blogger service. Green has since removed the agency’s logo from the post on his blog.
An expert in the field of cryptography, Green was quoted in the story published by ProPublica and the New York Times.
In his blog post, Green linked to a document that outlines the NSA’s SIGINT Enabling Project, a program focused on subverting encryption products. The document is marked Top Secret and was part of the cache taken by former NSA contractor Edward Snowden.
Green added in the post that he has not seen documents beyond the ones published with the story last week.
Update Sept. 10: This afternoon Matthew Green received an apology from the dean who had asked him to remove the NSA blog post, Andrew Douglas of the Hopkins engineering school:
I write to apologize for any difficulty I caused you yesterday over the post on your blog. I realize now that I acted too quickly, on the basis of inadequate and – as it turns out – incorrect information. I requested that you take down the post without adequately checking that information and without first providing you with an opportunity to correct it.
As an academic and as a member of the faculty at Johns Hopkins for 30 years, I am wholly supportive of academic freedom and keenly aware of its centrality to our enterprise. It is for this reason that I attached the 1940 AAUP Statement of Principles on Academic Freedom and Tenure.
Moreover, as interim dean of the Whiting School of Engineering, I am also aware of the contributions you are making to your field of information security and of the relevance of your comments to the important public debate that is now under way.
I am sorry that my request to you yesterday may have, in some minds, undeservedly undercut your reputation as a scholar and scientist. I am also sorry if I have raised in anyone’s mind a question as to my commitment to academic freedom. I am pleased that we were able to correct the error quickly.
I hope that you understand that my motivation – again, based on inadequate information – was to protect the university and you from legal consequences. I look forward to discussing your work with you, as you suggested yesterday.
Separately, a Hopkins spokesman confirmed to ProPublica that someone from the Applied Physics Laboratory, which works closely with the NSA, had originally flagged Green’s post.
“[T]he federal government was not involved,” said spokesman Dennis O’Shea in an email. “The blog post originally was spotted by someone at the Johns Hopkins Applied Physics Laboratory. A message was sent from a staff member at APL to a staff member at the Homewood campus calling attention to the post. That message may have been understood as a request for action, though I am told it was intended only as an FYI. The Homewood staff member called the post to the attention of the dean. The dean wrote to Professor Green, and you know the rest.”
Politico publisher acquires Capital New York (UPDATED)
Un-coordinated
Inside a New York Drug Clinic, Allegations of Kickbacks and Shoddy Care
It didn’t take long for Lillian Imbert to conclude that her outpatient drug treatment program wasn’t helping her recovery. Fellow patients appeared to nod out in group therapy sessions that she found repetitive and shallow. They begged her to sell them her clean urine to fool the clinic’s weekly drug tests. The clinic itself was dingy and run down, and her counselors seemed harried trying to juggle heavy caseloads. Interactions with them were perfunctory. Outside the clinic, she said, a man she believed to be a patient openly sold drugs to those arriving for counseling.
Imbert said she desperately wanted to transfer to a program that took recovery more seriously. But she couldn’t. With rental assistance from the city of New York, she was living in a “sober home” — a place where indigent alcoholics and addicts typically reside four to a room while they undergo treatment. Imbert said her landlord set the rule: Either she went to a specific clinic, New York Service Network (NYSN) in Brooklyn, or he’d evict her. Seeing no other option, Imbert complied.
“I felt trapped,” Imbert said. “Most of the counselors were just going through the motions.”
A ProPublica examination of NYSN and the taxpayer-financed system that sustains it shows that Imbert’s experience isn’t unique. In New York, a lack of affordable housing gives sober-home landlords extraordinary power over their residents, who often are forced to attend specific outpatient treatment programs that can be of dubious quality. It’s a system that victimizes not only alcoholics and addicts — making an already challenging recovery more difficult — but taxpayers who pick up the tab.
Outpatient addiction treatment for the poor has become a mainstay of the social safety net, costing the federal, state and local governments $6.7 billion in 2009, the most recent figure available. The money pays for an estimated 1.5 million admissions a year, nearly three-fourths of them to outpatient programs like NYSN’s, according to a study by the National Center on Addiction and Substance Abuse at Columbia University.
As Medicaid coverage expands under the new health reform law, millions more people are expected to become eligible for treatment. They’ll be entering a system that many experts say is loosely regulated, rife with unskilled providers and open to fraud and abuse. As the Columbia study notes, the success rate is low: Of those who enter outpatient care, only two in five complete treatment.
In Massachusetts, authorities have won convictions against sober-home employees who were sending residents to get drug tests at a company that paid kickbacks to the homes. In South Florida, a federal task force last year prosecuted halfway house operators who accepted illicit payments for sending patients to clinics for unneeded procedures. And in July, California halted payments to 16 centers amid reports by CNN and the Center for Investigative Reporting about phony billing.
Oversight of outpatient centers is mainly left to states, which typically perform inspections and paperwork audits but don’t necessarily delve deeply into clinic operations. Patient outcomes are self-reported by clinics, and counselors often lack medical training and are poorly paid. Clinics generally are compensated on a fee-for-service basis, creating an incentive to bill for as many visits as possible.
Some clinics “are just preying on people’s desperation,” said Susan Foster, director of policy research at the Columbia center. Foster served as the principal investigator for the center’s 2012 report on the state of U.S. addiction treatment, which found “widespread system failure in health care service delivery, financing, professional education and quality assurance.”
The case of Imbert, supported by her medical records and interviews with other patients and current and former clinic employees, provides a rare look at the inner workings of New York’s indigent drug and alcohol treatment system and the close relationships between sober homes and clinics.
When it comes to New York Service Network, former employees have filed complaints with regulators alleging falsification of records, padding of counseling sessions or payment of kickbacks to secure a steady stream of patients. Their claims track with some of Imbert’s experiences as a patient over five months, and with records in her patient file describing counseling sessions that she said never occurred.
Lazar Feygin, the doctor who owns NYSN, adamantly denied paying kickbacks in exchange for patient referrals. He also disputed allegations by Imbert and former employees, who said counseling records were sometimes fabricated so NYSN could justify its billings to the state. “My reputation is crystal clear,” Feygin said in an interview with ProPublica. “Why am I in this business? Because I like it,” he said. “I want to help people. I want to treat people as much as I can.”
NYSN, housed in an unassuming brick building along a quiet street of single-family homes, is one of about 500 outpatient programs in the state. New York Medicaid paid claims totaling nearly $437 million for outpatient drug treatment services last year.
NYSN's relationship with sober-home operators, which have provided nearly all its clients, helped it become the seventh-busiest, non-methadone-dispensing outpatient drug treatment clinic in New York City in 2011, state records show. The clinic saw nearly 1,000 patients that year. In 2012, it billed Medicaid for $3.2 million.
Clinics are licensed by the state Office of Alcohol and Substance Abuse Services (OASAS) and are inspected at regular intervals depending in part on the length of their license. The city sends monthly $215 rent stipends for indigent addicts directly to the sober homes, which are not licensed. Allegations of kickbacks paid by treatment clinics to the sober homes that feed them are common among patients, counselors and others inside the system. But they have seldom resulted in action by authorities.
No sober-home operator referred more patients to NYSN than Imbert’s landlord, Yury Baumblit. In a class-action lawsuit, advocates for tenants have called conditions in Baumblit’s homes unsafe and accused him of illegally evicting residents, allegations he denied in court filings. The 62-year-old Baumblit, who has operated sober homes under various business names, was convicted in 2009 on unrelated felony charges of bilking medical insurers for claims from fake car accidents. He declined several interview requests and did not respond to written questions sent to his attorney.
The attorney general’s office has received at least two complaints about NYSN and its relationship with sober homes. In 2010, NYSN’s program manager told an OASAS investigator the clinic had a “contract/agreement” with sober homes. The investigator determined the arrangement was improper, and the findings are under investigation by the attorney general, according to a spokeswoman for OASAS. A former NYSN staffer’s complaint alleging kickbacks involving Baumblit and NYSN also has been referred to the attorney general. In addition, three sources close to NYSN have told ProPublica they were part of or were present at conversations in which NYSN owner Feygin discussed payments to sober-home operators who sent patients to the clinic.
Also in 2010, an audit by New York’s Office of Medicaid Inspector General uncovered serious recordkeeping irregularities at NYSN. State officials ordered the clinic to give back $2.5 million in Medicaid “overpayments” — nearly half the clinic’s claims from 2003 to 2007. The money is being repaid over time by withholding part of NYSN’s billings.
The attorney general’s office declined to confirm whether NYSN is under investigation. As of early August, the clinic still owed approximately $1.1 million to New York’s Medicaid program. In March, it earned a new two-year license despite numerous deficiencies, including missing information in patient records and the lack of a written quality improvement plan. NYSN agreed to a “corrective action plan,” a routine remedial step.
Advocates for tougher oversight say there is a natural tendency by regulators to give clinics a break. Demand for drug and alcohol treatment far exceeds available resources, studies show, and some treatment is better than none at all. Patients at clinics like NYSN often have multiple health and psychological problems on top of their drug dependencies, factors that can complicate recovery.
Keeping services flowing to people in need can become more important than aggressively combating fraud, said James Sheehan, who formerly ran the Medicaid inspector general’s office. Clinics can be hard to prosecute, Sheehan noted, in part because people with substance issues can make unreliable witnesses. Providers often have the political clout with lawmakers to block tougher oversight, he said.
“Where is the constituency for making sure we pay only for the stuff we get?” Sheehan said. “It’s only a couple of legislators who don’t have clinics in their districts.”
Descent Into AddictionLong before Imbert ended up at NYSN’s door, she led an affluent life. Her father, a wealthy businessman, sent her to a fancy prep school. She had a successful career in high-end sales and married into wealth. While living in France, Imbert admitted to a drinking problem. At her family’s urging, she entered rehab, where she learned how to function without alcohol. Imbert said she remained sober for just shy of 18 years.
It was a riding accident that proved her undoing. Imbert was living in Greenwich, Conn., when a horse she was on crossed its legs and fell on top of her, crushing the left side of her body and cracking her skull. The accident left her with a broken collarbone, displaced hip and significant nerve damage. With slurred speech and vision problems, Imbert said she was unable to work and was largely bedridden for three years.
A doctor prescribed a cocktail of narcotics to tame searing pain from trigeminal neuralgia, a disorder affecting facial nerves sometimes called the “suicide disease” because it can be so debilitating. As medical bills mounted, her marriage dissolved under the strain. On June 22, 2012, Imbert said, she began to drink again. Her Manhattan landlord eventually moved to evict her, and relatives gave her an ultimatum: Prove she was serious about long-term sobriety, or they’d have nothing to do with her.
.right-sidebar-media { width: 250px; float:right; margin: 0 0 12px 12px; } .right-sidebar-media h2.definition { font-size: 15px; font-weight: bold; font-family: "ff-meta-serif-web-1", "ff-meta-serif-web-2", "Georgia", serif; margin-bottom: 10px; } .right-sidebar-media p.definition { font-size: 13px; font-family: "Helvetica Neue", Arial, sans-serif; } .right-sidebar-media p.definition .termtbd { text-transform: uppercase; font-weight: bold; } .source { font-size: 12px; font-family: "Helvetica Neue", Arial, sans-serif; font-style: italic; color: #999999; } Addiction Treatment by the Numbers$24 billion Spent nationally on substance abuse treatment (2009)
69 percent Amount of the total that’s publicly funded
$6.7 billion Public spending on outpatient treatment (2009)
1.5 million Admissions, publicly financed treatment (2009)
74 percent Share of admissions going to outpatient treatment (2008)
39 percent Completion rate for outpatient programs (2008)
44 percent Share of admissions from justice system (2008)
4.8 million Number who could qualify for addiction coverage under health care reform
Sources: “Addiction Medicine: Closing the Gap between Science and Practice,” June 2012 and National Expenditures for Mental Health Services and Substance Abuse Treatment, 1986-2009
Imbert checked herself into a New York hospital to begin detoxing from the alcohol and painkillers. The hospital kept her for only four and a half days, and Medicaid wouldn’t pay for a residential treatment program. She was nowhere near completing detoxification from more than six years of prescription drugs, including the potent opiates Dilaudid and fentanyl. Nevertheless, she was discharged to a public shelter. There she drifted in and out of consciousness as the painkillers drained from her system, leaving her damaged nerves in agony.
Imbert said she was “so spaced out, I didn’t know who I was.” She fainted, hit her head and awoke shoeless in an ambulance rushing to the hospital.
This time she persuaded the hospital to hold her for six days. The hospital social worker referred her to an outpatient program in Manhattan and discharged her to a sober home in Brooklyn. The home informed Imbert she had to attend NYSN as a condition of residency, she said. Extreme vertigo, lethargy and elevated blood pressure drove Imbert back to the hospital. When she got out, however, the sober home no longer had a bed for her. Imbert didn’t want to return to the shelter. She ended up in a different sober home for women, this one run by Baumblit.
Nothing in Imbert's background had prepared her for what was to come. The house, in a rough section of Brooklyn called East New York, was part of a row of buildings that together can hold as many as 100 addicts, mostly men. It’s a 90-minute subway commute to NYSN, in the Mapleton neighborhood, but that is where she said Baumblit required her to attend treatment. Court filings and interviews with other patients echo her experience: Five other tenants, in affidavits and testimony for the class-action case, said they also had been required to attend NYSN.
Imbert said she feared for her life at Baumblit’s house. Drug and alcohol use was common. One of her housemates was selling sex for prescription drugs, something a former Baumblit employee told ProPublica was not uncommon. In the year that ended June 14, police were called to Baumblit’s row of homes on New Lots Avenue more than 100 times in response to medical emergencies, disputes and reports of robberies and drug crimes, according to an NYPD spokesperson.
Baumblit insisted that residents sign a contract, called the “House Rules,” agreeing to attend outpatient treatment. When Imbert started at NYSN, she was required to attend five counseling sessions a week — four group sessions and one individual. Five counseling sessions was the standard weekly schedule for almost all new patients, according to former NYSN staffers and patients, although clinic owner Feygin said all counseling schedules are tailored to individuals.
With straw-colored hair and striking blue eyes, Imbert stood out in NYSN’s overwhelmingly male and minority patient population. Her determination to keep her sobriety also set her apart.
Active substance abuse by fellow patients didn’t surprise her because it was so routine. Prices for illegal narcotics were discussed in the waiting room. The going price for clean urine was $20. Despite a need for money, Imbert never succumbed to the temptation to sell, she said. Neighbors of the clinic also told ProPublica they have been accosted for clean urine and witnessed drug dealing outside the clinic.
In the interview, Feygin said he can control only what happens on his own property. The Russian-born doctor, whose unwrinkled face belies his 66 years, acknowledged that clients are frequently ill-mannered and might offend neighbors, many of whom are Orthodox Jews and Muslims. Feygin provides a security guard and “no loitering” signs to help maintain order. He said any neighborhood drug dealing and urine sales are unrelated to his clinic.
Toward the end of her time at NYSN, Imbert realized that one of her group counselors was becoming increasingly incoherent and unable to focus during sessions. Former staffers said the counselor relapsed and is no longer with the program. Feygin said that, as far as he knows, the counselor left because of an illness.
“I was really shocked,” Imbert said. “Here was someone who was treating addicts, and he was using himself.”
‘Cut and Paste’ RecordkeepingState regulations require comprehensive evaluations of new patients entering outpatient treatment. The evaluation includes personal histories that cover medical issues, family life and education. Those kinds of details are present in Imbert’s evaluation. They just don’t always correspond to her life history.
Imbert graduated high school from Culver Academies in Indiana. Her evaluation lists “coulver acadamey boarding school” but then reports that she "dropped out of high school" and received her “G.E.D.” while in “job corps” before she started “running the streets.” The evaluation also claims she wants “to go back to answering phones for work in the near future” — a job Imbert said she has never had.
The evaluation accurately lists her parents as deceased. Yet further down on the form, in answer to the question, "Who do you go to when you need to talk things through?" it states: “the client reported, i call my mother because i can talk with her about anything.” Glancing through her patient file after requesting it from NYSN, Imbert pointed out the discrepancy to a staffer, who fixed it. Imbert kept a copy of the original and provided it to ProPublica.
What the misinformation illustrates was a common practice at NYSN, according to Maxine Mathis, a counselor who left the facility last year. The staff called it “cut and paste.” Rather than go to the trouble of thoroughly interviewing a patient — as specified by the regulations — and noting the details on the evaluation forms, counselors would simply copy material from the forms of previous patients to save time, Mathis said.
New York Service Network in the Mapleton neighborhood in Brooklyn, N.Y., became the seventh-busiest, non-methadone-dispensing outpatient drug treatment clinic in New York City in 2011, state records show. (Melanie Burford for ProPublica)
Despite the 2010 inspector general’s audit, recordkeeping irregularities continued at NYSN, according to former staffers, patients and Imbert’s patient file. Another common practice involved something staffers call “ghosting.” In ghosting, counselors claimed that individual treatment sessions were longer than they actually were or simply fabricated them, according to Mathis and two other former NYSN staffers. The documentation is required to back up Medicaid billing.
Former staffers said Feygin repeatedly pressured counselors to “increase his numbers,” which they understood to mean see more patients for longer treatment sessions. “He would come into staff meetings and say, ‘I don’t like where my numbers are, you need to see more’” patients, said Theodore Raffudeen II, a former medical biller at the clinic who filed the complaint alleging kickbacks.
Imbert said her schedule called for one individual counseling session a week, as a counselor-signed treatment plan from February 2013 shows. With the exception of two meetings to discuss reducing her counseling load, the weekly one-on-one sessions never lasted more than 10 to 15 minutes, she said.
Yet Imbert’s NYSN records report more than 16 individual sessions of 45 minutes and two of 35 minutes between Dec. 10 and Feb. 25, sometimes two or three a week. Her file shows three 45-minute sessions in the last week of February. For 45-minute sessions, Medicaid pays about $126, its maximum fee for individual counseling, in the New York City area. The state pays lesser amounts for sessions shorter than 38 minutes.
The counselor’s notes for Imbert’s individual sessions contain boilerplate comments that could apply to any patient. When they are specific — for example, “client has had no headaches in a long time” or that she had a brain injury as a result “of falling on a bed of ice” — they are often wrong.
Shown records of Imbert’s individual counseling sessions from the last week of February, Feygin confirmed that the clinic had billed for them. He insisted the records were accurate, despite Imbert’s assertion that she never attended more than one such session a week. “I don't care what she says,” Feygin said. “I have a document here.”
Feygin strongly denied that he would encourage fraud or falsifying records. He said he encourages his staff to be productive and blamed allegations of ghosting on disgruntled staff he’d fired, including Mathis.
Mathis, however, said she left the clinic after she was ordered to backdate patient files to make it appear that they had a nurse’s approval. When Mathis refused, she was demoted, she said, and then suspended for continuing “insubordination.” She found another job and quit while still on a 30-day suspension, she said.
Although Feygin described Mathis as well-educated and knowledgeable about treatment, he said he asked her to leave after other counselors complained that she was difficult. NYSN's attorney, Joseph J. LaBarbera, said clinic policies and confidentiality requirements prevented further comment.
A Landlord’s PowerImbert soon discovered that her landlord, not her counselor, had final say over many aspects of her treatment.
While she attended NYSN, Imbert also voluntarily participated in daily 12-Step meetings. She credits the meetings, not NYSN, for helping her maintain her sobriety. Still, her family wanted proof that she had graduated from an outpatient program before they would begin to trust her again. When her NYSN counselor wouldn’t certify that she’d completed treatment, Imbert begged him to at least cut back the number of group counseling sessions she had to attend so she could start to look for work.
“I was never a drug addict, and if I stay here I will become one,” Imbert said she told him. “I’m a grateful recovering alcoholic, and I want out of here.”
Imbert said her counselor agreed to drop two of her group sessions. When she skipped the first time, however, she said Baumblit intervened to get the sessions restored. She was forced to do a make-up the next Saturday. Imbert believed that if she did not go along, Baumblit would evict her.
Discussions between staffers at NYSN and the sober homes concerning patients were routine, according to former staffers of both. Mathis said counselors would sometimes accede to the directives of sober-home operators out of fear that clients would lose their housing if they didn’t.
Feygin also made it clear on numerous occasions that NYSN counselors had to comply with requests from the sober-home operators, current and former staffers told ProPublica. Crossing Baumblit could result in dismissal. NYSN Counselor Lyudmila German said she learned this lesson the hard way.
In January 2012, a patient came to German saying that Baumblit was going to evict him and that he had nowhere to go, German said. She gave the patient a pamphlet from a nonprofit called MFY Legal Services about the rights of residents of sober homes, or as they also are known in New York, three-quarter houses. MFY is the legal advocacy group that had sued Baumblit over conditions in his homes. “The only person who can evict you from a three-quarter house is a judge,” the pamphlet states.
Baumblit called German later that day at NYSN, she recounted in an interview with ProPublica. He told her that if she still had a job at the clinic the following day, he would tell his tenants to boycott NYSN. According to several staffers, Baumblit had made such threats before and followed through. Residents at his houses would stay away from the clinic en masse until Baumblit got what he wanted.
Shortly after her conversation with Baumblit, Feygin called German to his office, she said. Feygin told her that he depended on Baumblit for his business and that she should stay at home for a few days. Several days later, a letter arrived from NYSN notifying German she was fired for “numerous failures ... to follow directives given by your supervisors.” German had worked at NYSN for 10 years.
“She was fired legally,” said Feygin, who declined to go into detail about the circumstances.
Feygin denied that Baumblit has any sway over his business. “Yury cannot require anything,” he said. But he confirmed that most of NYSN’s clients come from sober homes. Former medical biller Raffudeen, whose job involved tracking patients, said that in 2012 more than half were referred by Baumblit.
Patients were carefully monitored by the use of slips, like the one above, according to interviews with NYSN patients, current and former staffers, and allegations in the MFY lawsuit.
The comings and goings of patients were carefully monitored, according to interviews with NYSN patients, current and former staffers, and the MFY lawsuit. After every counseling session, each NYSN patient who was a sober-home resident was given a slip to indicate they received a clinic service. They were required to return to their sober house with the slip. Those who came back without one were given an opportunity to make up the treatment session. If not, they risked eviction.
“It was clear that I had to bring back a slip, or I would be kicked out,” Imbert said. Asked about the slips, Feygin declined to say whether it was he or Baumblit who required them. He described them as a way for the sober homes to ensure that clients were receiving treatment.
Staffers close to Baumblit and Feygin said that the slips were used to track “points.” At the beginning of each month, they said, Baumblit and at least one other sober-home operator would come to the clinic to pick up checks based on how many points they accumulated.
“Dr. Feygin is paying these sober houses to send clients to his program and paying them a lump sum of money per month to keep his program stocked with clientele,” according to the complaint Raffudeen submitted to the Office of Medicaid Inspector General in April 2012. “They are threatened to come to N.Y.S.N. five days out of the week or the clients get kicked out of their living quarters.”
Federal and New York laws make it a crime to knowingly and willfully accept or offer remuneration of any kind to influence the referral of patients for Medicare and Medicaid services. Raffudeen's complaint was forwarded to the attorney general's office.
Feygin adamantly denied paying sober-home operators for patients. Asked if he had a financial or business relationship with Baumblit, Feygin replied: “It is absolutely not true.”
NYSN attorney LaBarbera denied any wrongdoing and said the clinic is "unfamiliar with the alleged complaint to the attorney general." He said NYSN "takes pains to assure that its business ... is conducted in an appropriate manner in accordance with applicable laws, rules and regulations."
Within the outpatient treatment community, it is common to hear stories about landlords soliciting kickbacks. “We have been approached by sober-home operators who ask, ‘What are you going to pay me?’” says Gary Butchen, executive director of a well-regarded outpatient program in the New York area called Bridge Back to Life Center. He said he instructs his employees to decline the offers.
MFY filed its class-action case against Baumblit in 2010 on behalf of residents in his sober homes. The lawsuit, in New York Supreme Court, alleges that Baumblit’s operation lured residents by making false promises, forced them to sign unfair contracts and unlawfully evicted them as part of an unjust enrichment scheme. Addicts were told they would receive vocational training and help finding permanent housing, the lawsuit claims, though none was actually provided.
The lawsuit also alleges Baumblit had “financial interests” in residents’ attendance at outpatient treatment programs.
In court filings, Baumblit disputed the accusations. All residents of his homes are required to sign a contract that sets out a curfew, mandates outpatient treatment, prohibits drug use and gives him the right to evict tenants for violations. “The House Code is designed to encourage the participants to live a more stable life, and to prevent the disruption of the quiet use and enjoyment of the premise,” a court document says.
Five months before Imbert arrived at Baumblit’s row of houses, Judge David B. Vaughan tossed out MFY’s lawsuit, ruling that Baumblit was running a transitional housing program that wasn’t subject to tenant-protection laws. The one-paragraph ruling did not address other matters. MFY has appealed.
No regulations dictate who can or can’t run a sober home in New York. Baumblit was sentenced to six months in jail and five years’ probation after his 2009 conviction for fraud and money laundering. He was released from jail after three months. The New York attorney general had indicted Baumblit, his wife and others in a scheme to fabricate car accidents and send people who were purportedly injured to medical clinics in which Baumblit secretly held an interest.
Baumblit is not the only sober-home operator to send patients to NYSN, and other outpatient clinics also take his residents. Because sober homes are unlicensed in New York, there is no official count of how many exist. Interviews by ProPublica with five other NYSN patients who were residents of three different sober homes echoed Imbert — they, too, were required to use the system of slips that tracked attendance and observed poor conditions in the homes and drug use by residents.
Working with a coalition of housing advocates, New York’s John Jay College of Criminal Justice is finalizing a report about sober homes. Advocates identified 317 addresses of three-quarter houses, primarily in Brooklyn, but caution that it is likely not a complete census. According to Robert Riggs, the principal author, researchers interviewed 43 residents, many of whom have similar stories about the slip requirement, mandated attendance at clinics and the threat of eviction for not attending outpatient treatment.
“People should be able to choose what treatment they go to,” Riggs said. “There is a coercive aspect when you tie housing, unlicensed by OASAS, to treatment.”
A History of ProblemsDuring the past three years, regulators have found problems at NYSN time and again.
In October 2010, an investigator with OASAS interviewed Fred Middleton, then the program director for NYSN, about the clinic’s relationship with sober homes. The inquiry was in response to a complaint from an NYSN patient, who said he told his counselor about intimidation at Baumblit’s house. The counselor informed Baumblit, who then evicted the patient, the complaint said.
Middleton told an OASAS investigator the facility had a “contract/agreement” with Baumblit’s operation and another sober-home operator who sent clients to NYSN. Middleton also described frequent consultation between NYSN and sober-home operators, “usually about attendance or toxicology results.” According to the investigator’s notes, Middleton said none of that discourse was recorded in patients’ charts because “the charts would be too voluminous.”
Middleton also expressed “concern” about the way the sober homes were run. “He does not feel residents are treated fairly,” the investigator wrote. A final report on the complaint concluded that “the communication between NYSN and the sober homes is inappropriate clinically and violates the client’s right to privacy.”
Outpatient Treatment: Where To Learn MoreThe Substance Abuse and Mental Health Services Administration, a federal agency, has a search tool to find alcohol and drug abuse treatment or mental health facilities and programs nationwide.
If your clinic is in New York, the state regulator has a scorecard that rates licensed programs. Keep in mind that much of the information is self-reported by clinics.
The National Center on Addiction and Substance Abuse at Columbia University publishes annual reports on the state of addiction services and hosts links to treatment resources.
The National Association of Addiction Treatment Providers also hosts a provider lookup.
Alcoholics Anonymous has a search tool to find meetings in your area, as does Narcotics Anonymous.
Asked what came of the 3-year-old inquiry, OASAS spokeswoman Jannette Rondó said it is under investigation by the attorney general’s office. A spokeswoman for the attorney general said that as a matter of policy, the office does not confirm or comment on the status of investigations.
Feygin said he did not know about the OASAS investigation and that Middleton was wrong about the existence of any “contract/agreement.”
In June 2012, Mathis also filed a complaint against NYSN alleging “excessive Medicaid billing,” problems with documentation and a counselor who inappropriately touched patients. Mathis was contacted by a representative from OASAS for more specifics but did not provide them, according to the complaint file. By that time, Mathis told ProPublica, she had taken another job and didn’t want to have anything more to do with NYSN.
While OASAS licenses and inspects clinics, the state’s Medicaid Inspector General focuses on financial fraud and abuse. The 2010 audit requiring NYSN to reimburse the state for $2.5 million in overpayments was conducted during Sheehan’s tenure as inspector general.
Auditors spent months going through NYSN’s records covering the period of May 2003 through December 2007. They found patient files missing treatment records, missing dates and signatures, and "excessive/unapproved visits." There was at least one error in 98 out of 100 patient files reviewed. The money was to be repaid by withholding 15 percent of NYSN’s future Medicaid billings. When Feygin later claimed financial hardship, the state reduced the amount it would withhold to 10 percent.
Recordkeeping problems and staffing deficiencies were identified during licensing reviews in 2010 and again this year. In four days at the clinic this past February, reviewers pulled 15 patient files for examination, as is standard practice. They cited NYSN for more than two dozen violations, including missing patient evaluations and signatures, incomplete treatment plans and mismatched Social Security numbers and birthdates. NYSN also lacked qualified staff to provide family counseling and coordinate health services, the reviewers found.
NYSN crafted a corrective action plan, and the state approved a two-year license.
The state can issue licenses for as little as six months to clinics that need more supervision. John Walden, who became NYSN’s new program director in late July, said NYSN was lucky to get a two-year license given the number of issues reviewers identified.
Feygin said that hiring and keeping qualified staff, particularly licensed clinical social workers, has been a constant challenge. Walden blamed past problems at NYSN on poor supervision and a difficult patient population. Many have mental health issues in addition to their substance abuse, he said, yet outpatient treatment is the most basic level of care they can get.
Experts say licensing inspections are typically too superficial to identify billing fraud. "They are feeble in detecting lies as long as you bill your lies correctly," said Malcolm Sparrow, a professor at Harvard's John F. Kennedy School of Government who has studied Medicaid and Medicare fraud. The key is to drill in with more rigorous audits at clinics that demonstrate a pattern of bad practices, he said.
Butchen, Bridge Back to Life’s executive director, said there have always been providers who take shortcuts, and the state does a poor job of ferreting them out.
“A real unethical provider can easily get a three-year license,” said Butchen, who is a past president of the Addiction Treatment Providers Association of New York State. “It’s not indicative of the greater proportion of people who actually care about what we do and run credible organizations.”
New York is in the midst of reorganizing substance abuse treatment in the state. A recent change limits the number of counseling sessions for which clinics can receive full payment to 75 per patient in a fiscal year. Payments for additional sessions are at reduced rates.
The state also has plans to contract with managed care companies to oversee patient care and move away from the fee-for-service model of payment. The hope is to “improve patient outcomes and assure that associated resources are well managed,” spokeswoman Rondó said.
NYSN is rated highly in one patient outcome tracked by OASAS on clinic scorecards the agency publishes.
The agency measures the rate of “discontinued use” — patients who successfully stay sober while in treatment — using a formula that takes into account length of stay, substance use and whether counseling is completed. The measure is self-reported by clinics, however, and NYSN’s rate of 85 percent is 10 percentage points higher than any other clinic its size or larger in New York City.
Feygin expressed surprise when informed of this. “I didn’t know it was that good,” he said.
“Not There to Help”On March 11, Imbert officially completed her treatment at NYSN.
Fearing she might be evicted before she could move to a new place, Imbert approached Baumblit. According to her account, he told her she could only stay if she went to a different outpatient program, pretended she was new to recovery and started the process all over. In the end, she said Baumblit agreed to let her remain for four days after her NYSN graduation.
The city’s Human Resources Administration, which distributes housing assistance, had already paid Imbert’s rent for the entire month.
A relative helped her pay move-in costs for a room in a better house, and after a few weeks she found a job in sales.
Imbert’s education and family support set her apart from most of the addicts and alcoholics she met at NYSN and in the homes. Today, she said she’s been sober almost a year. She believes it was a miracle she survived.
“NYSN and the sober houses associated with them are not there to help people,” Imbert said. “They are there to exploit Medicaid.”
If you or a loved one has an experience in a drug treatment clinic as a counselor or patient that you would like to share, please email Jake at Jake.Bernstein@propublica.org.
4 Syrian journos: We want Western help
In Syria, freelancer demand amidst increasing restrictions
Advance Publications scraps AnnArbor.com
Even more interactive news
Must-reads of the week
For Prosecutor Under Fire, A Verdict at the Polls
The year was 1990. George H.W. Bush was president. The song “Hold On” by Wilson Phillips was number one on the Billboard chart. And Charles “Joe” Hynes, celebrated for his role as a special prosecutor in a racially charged case in Howard Beach, began his first term as Brooklyn District Attorney.
Bush’s presidency came and went; his son’s did too. Wilson Phillips went on a 10-year hiatus; then got back together in 2004.
Hynes, all along the way, has done exactly what that top 1990 ballad instructed: He’s held on. He’s been Brooklyn’s top law man for nearly 24 years, making him one of the longest serving district attorneys in New York City history.
But Hynes’s once firm grasp on the position could be imperiled. Buffeted by controversial cases, charges of misconduct in his office, and concerns about possibly preferential treatment for Jewish residents of the borough, Hynes is seen by political strategists to be facing a serious challenge from Kenneth Thompson, an African-American former federal prosecutor. On Tuesday, Sept. 10, voters in the Brooklyn Democratic primary could deny Hynes a chance at a seventh term.
Almost all prosecutors who stay in office for lengthy terms wind up facing a familiar array of complaints – about cases lost, creeping arrogance, political gamesmanship. Robert M. Morgenthau, revered by many across his decades as Manhattan’s top prosecutor, had his share of critics and embarrassments, the troubled prosecution of five teenagers for the rape of a woman in Central Park among them.
Some of the complaints about Hynes, then, fit that mold: He’s been accused of hiring and firing people based on favoritism and political connections and he’s been taken to task for some failed or underwhelming prosecutions. Even his once reliable base of support, the borough’s Orthodox Jewish community, has seemed to split, some angered that Hynes has made a series of pedophilia cases against people in their ranks, others disappointed that he was late to the issue and overly lenient in his handling of the cases.
But Thompson, who served in the U.S. Attorney’s Office for the Eastern District of New York, has focused his criticism on the question of wrongful convictions and possible misconduct by prosecutors over the years in Hynes’s office.
On the campaign trail Thompson, for instance, has cited withering criticism from two federal judges over the way one of Hynes’s top prosecutors won a wrongful conviction in a high-profile murder case.
In the last several weeks, Thompson has gained endorsements from the Service Employees International Union, the Citizens Union, and several Brooklyn-based representatives in Congress.
Hynes has defended the work of his office, rejecting any claims that he permits or encourages misconduct. He has campaigned on what he asserts are his myriad novel and effective approaches to fighting crime.
Both the district attorney’s office and Hynes’s campaign did not respond to requests for comment.
Little public polling has been done in the race. Turnout could play a role. And Hynes, whatever his arguable travails, has history on his side.
No incumbent district attorney has lost an election in any of New York’s boroughs since 1955. A Brooklyn district attorney hasn’t been unseated via the vote since 1911.
Here are some issues that may figure into the election’s outcome.
Michael VecchioneSome of Hynes’s campaign woes can be traced to the conduct of Michael Vecchione, the head of Hynes’s Rackets Bureau. He’s a polarizing figure who has drawn heavy criticism for his conduct in and out of the courtroom.
Two federal judges have lambasted Vecchione for withholding evidence and for his handling of several witnesses in a high-profile murder case.
Now the defendant, a Brooklyn man named Jabbar Collins who spent 16 years in prison, is suing the city for millions as part of a far-reaching wrongful conviction lawsuit. His lawyer, Manhattan-based attorney Joel Rudin, is attempting to make the case that misconduct in Hynes’s office is so pervasive that Hynes must have actually condoned it.
Vecchione’s career in the district attorney’s office spans more than two decades. In 2003, the district attorney’s office was forced to vacate the conviction of a man they suspected of being involved in at least three murders when a federal court agreed to hear allegations that Vecchione had withheld evidence in the man’s trial.
In 2006, Vecchione tried to prosecute former FBI agent R. Lindley DeVecchio for helping arrange the murders of gangsters on behalf of mob boss Greg Scarpa. Hynes called it “the most stunning example of official corruption [he] had ever seen.” But the case fell apart just days into trial when it became clear that Vecchione’s chief witness was unstable and had given false testimony.
More recently, The New York Post reported that Vecchione instructed staff not to preserve exculpatory evidence in sex-trafficking cases during a training session in 2012.
Vecchione has denied all charges of misconduct, and he testified under oath that he did not remember the details of what took place at the training session for sex-trafficking cases in 2012.
Hynes has staunchly defended Vecchione, who continues to be one of the highest-paid prosecutors in the office. Earlier this year, Hynes allowed Vecchione to be a featured character in a CBS television show called Brooklyn DA.
ProPublica in 2013 has published a series of articles investigating prosecutorial misconduct and the lack of consequences for prosecutors who commit serious violations of the law. Vecchione was the subject of one of those articles.
Hynes’s office did not respond to ProPublica’s request for comment on Vecchione’s history and its possible impact on Hynes’s re-election effort.
50 Possibly Troubled CasesLast spring, Hynes asked a judge to vacate the conviction of a man his office had mistakenly prosecuted for the murder of a Brooklyn rabbi. Hynes blamed a detective in the case for the wrongful conviction, and ordered his office to review 50 cases involving the detective.
The investigation has obvious implications for the now-retired detective, Louis Scarcella, who has publicly denied he ever did anything wrong. But Hynes’s prosecutors had vouched for the detective’s work in the cases, using the confessions he had allegedly won or the evidence he had produced to send people to prisons. Two of the prosecutors involved in Scarcella cases have gone on to work as New York State judges; four are now senior officials in the district attorney’s office.
Thompson and other critics of Hynes pounced when it became clear that a 12-member panel of lawyers and judges appointed by Hynes to oversee the review of the 50 cases included three people who had donated to Hynes’s campaign.
Hynes has said he is convinced of the panel’s independence, and that the investigation will go where the evidence takes it.
The New York Times reported Friday that its examination of some of Scarcella’s cases showed that prosecutors either ignored warning signs or made missteps of their own.
Hynes told the Times that the investigation so far had not turned up evidence that would require revisiting the propriety of a conviction. But he did not address the paper’s findings about the conduct of his prosecutors.
Detaining WitnessesHynes’s training procedures and office policies have also come under fire.
A Brooklyn man seeking to have his murder conviction overturned has accused Hynes’s office of holding a witness against his will until he agreed to testify as prosecutors wanted in the case.
That case, which is now before a federal judge, has fueled an effort by Jabbar Collins’s lawyer to establish that Hynes’s office routinely detained and coerced witnesses in violation of the law. The accusation, made as part of Collins’s lawsuit against Hynes and the city, deals with a powerful legal tool called the material witness order. The orders are supposed to be used only under rare circumstances, usually when prosecutors fear a potential witness might flee instead of testifying in court.
New York law requires that prosecutors bring any material witness straight to court.
But Collins’s lawyer, along with several other defense lawyers are seeking to hold prosecutors accountable for abusing the orders, alleging that witnesses were never brought before a judge or provided with a lawyer, as the law requires.
Hynes has denied allegations that his prosecutors failed to abide by the law in their handling of witnesses.
FavoritismHynes’s hiring and firing decisions have also proven fodder during the campaign, and Thompson has seized on them.
The New York Post reported this summer that Mark Posner, a lawyer in the office’s powerful Rackets Bureau, was caught using his office phone to call prostitutes. The Post article said Posner was found out by his own colleagues, who were investigating a local prostitution ring.
Posner is the son of a longtime ally of Hynes, Charles Posner. The elder Posner had served as Hynes’s liaison to Brooklyn’s Orthodox Jewish community, and Hynes had later recommended him for a judgeship. Posner, who died in 2004, served as a State Supreme Court justice for nearly a decade.
Hynes did not fire Mark Posner after learning of his misconduct. Instead, he suspended him for 10 days and transferred him to the Early Case Assessment Bureau, a low-level desk where prosecutors analyze arrests and make judgments on what charges to pursue.
At the time Posner was caught, Brooklyn DA spokesman Jerry Schmetterer told the Post that Hynes acted as soon as he learned of Posner’s conduct by suspending him, ordering him to seek counseling, and demoting him.
Posner didn’t immediately respond to a voice message left at his home. And neither Hynes’s office nor his campaign responded to questions from ProPublica.
In January 2012, Hynes hired a woman named Angel DiPietro to become an assistant district attorney. It was a hire with a backstory.
Eight years earlier, DiPietro was a witness in the murder case of Mark Fisher, a Fairfield University student-athlete in Prospect Park South. She was with Fisher and friends in Brooklyn the night he was killed. At the time, a spokesman for the police department told the New York Times that DiPietro demonstrated “a lack of full-hearted cooperation.” Police Commissioner Ray Kelly himself described DiPietro and seven of her other friends as “uncooperative.”
Eventually DiPietro testified at trial and two people she was with that night were found guilty of the murder.
DiPietro’s father, a defense attorney in Brooklyn, had been a regular contributor to Hynes’s political campaigns, and in the months after DiPietro was hired, he donated another $3,000 to Hynes’s 2013 political campaign.
DiPietro, contacted by telephone, referred ProPublica to the spokesman for the district attorney’s office. The spokesman did not respond to request for comment.
James DiPietro, Angel’s father, did agree to an interview.
“I wish I could’ve given him more,” DiPietro’s father said of his donations to Hynes. He said that his daughter was first offered the job in 2010 and fully deserved it on her own merits. And he asserted that his daughter had in fact cooperated fully in the Fisher murder investigation.
Selective ProsecutionsIn 1996 Hynes indicted a Brooklyn political gadfly named John O’Hara. The charge was modest: voting from his girlfriend’s apartment, which was outside of his own election district. After three separate trials, O’Hara was found guilty, lost his law license, and was sentenced to community service.
O’Hara has always claimed that Hynes went after him because he’d run for city council and assembly seats against some of Hynes’s allies.
Thirteen years later, in 2009, a grievance committee bolstered O’Hara’s account. It restored his license, saying there were “grave doubts that Mr. O’Hara did anything that justified his criminal prosecution.”
In 2012, The New York Times ran a stinging series of articles on how Hynes’s office for years handled investigations of accused sexual predators in the Orthodox Jewish communities. The series established that Hynes had allowed many of the accusations to be handled by rabbinical courts rather than prosecuting the cases himself.
Hynes initially defended the way he handled the sex abuse cases, but eventually pledged reforms and began prosecuting them with more vigor.
A weakened Washington Post, a serious ethical breach
Today's popular content
- Resources for Investigating ALEC/NRA Gun Bills (27,301)
- Wisconsin Bill Would Treat Organic Milk, Sharp Cheddar, Brown Eggs as "Junk Food" (22,688)
- Marco Rubio, Geo Group, and a Legacy of Corruption (17,553)
- The Health Care Industry vs. Health Reform (15,669)
- Blessed Unrest for a Wiser Earth: John Stauber Interviews Paul Hawken (15,143)
- How Far Have We Really Come from the "One-Drop Rule"? (10,254)
- This Is Going to Hurt: What Your Doctor Doesn't Say Can Cost You (9,555)
- Backgrounder: the History of the NRA/ALEC Gun Agenda (9,125)
- About ALEC Exposed (7,757)
- A Side of Climate Change Denial with Your Coffee? ALEC Dishes up Some Hard to Swallow Spin with the Heartland Institute (7,414)
Readers' Comments
-
Voters SupressionSubmitted by: Anonymous
-
ANON. Comments SHOULD be DeprecatedSubmitted by: pbarnrob
-
Bee health - Jim ScottSubmitted by: EarlBowden
-
extra chargesSubmitted by: Anonymous
-
its not the governmentSubmitted by: Anonymous
-
primary care doctors commentsSubmitted by: Anonymous
-
doctors visitSubmitted by: Anonymous
-
doctors visitSubmitted by: Anonymous
-
As someone with a brainSubmitted by: Anonymous
-
What about discharging theSubmitted by: AndrewG
