Erie County Comptroller Mark C. Poloncarz today commented on a report in The Buffalo News regarding possible waste or abuse in the joint State-County Medicaid-funded Traumatic Brain Injury ("TBI") program that assists patients with serious brain injuries.

The news report cited Erie County Social Services Commissioner Carol Dankert as conducting an investigation into mileage reimbursement payments for TBI clients and reporting her findings to Erie County Executive Christopher Collins who has apparently sent a letter to New York State Health Commissioner Richard Daines questioning certain allowable payments under the program.

Dankert specifically cited the example of one TBI patient repeatedly being driven to local Indian reservations to purchase cigarettes and the patient's driver submitting mileage reimbursement claims to the County. The Collins Administration is questioning the propriety of such travel and mileage reimbursement.

However, the Collins Administration and Dankert failed to acknowledge to The Buffalo News that their inquiry was only prompted by the Erie County Comptroller's Office, which contacted Commissioner Dankert on March 2, 2010 questioning these mileage reimbursement requests. During a routine review of vendor payment requests from the Department of Social Services ("Social Services"), the Comptroller's Office observed a number of TBI vendor invoices for four (4) patients with repeated, routine travel to/from two Indian reservations with the reason for such travel listed as "Rez," "Res," "cigarettes," "smokes," and "get smokes." The Comptroller's Office provided copies of those payment requests to Dankert personally which show that one patient visited a reservation twenty-five (25) times in a six (6) month period. Another patient visited a reservation fifteen (15) times in a three (3) month period to purchase cigarettes. All of these payment requests were originally authorized for payment by Social Services.

The Comptroller's Office also identified another payment request for a TBI client for a trip to and from Rochester to eat at the Dinosaur BBQ restaurant – a payment request which Social Services had previously authorized paying.

Since March 2nd, the Comptroller's Office repeatedly attempted to discern details about the TBI program and mileage reimbursement from Social Services. However, after weeks of not responding to the Comptroller's Office, Dankert finally asserted that she was not in charge of the program, did not know specific details about the program and limits on travel, and could not comment. She referred the Comptroller's Office to a private vendor which manages the TBI program. However that vendor, Headway, declined to speak with the Comptroller's Office and referred us to the New York State Department of Health. The Comptroller's Office is still waiting to hear back from the New York State Department of Health.

The Comptroller's Office has refused to pay said claims until such time as Social Services confirms that such claims are valid under New York State law. The Comptroller took issue with the fact that Dankert's own department authorized the vendor payments for such questionable travel to the reservations for purchases of cigarettes or to Rochester to a restaurant. The Comptroller noted that while Social Services staff frequently changed and altered all the mileage reimbursement requests for each individual trip of TBI clients, including often lowering the reimbursement, they appeared never to examine or question the stated reason for the travel. In addition, it is almost certain that this sort of situation has been occurring for quite some time.

During its investigation, the Comptroller's Office requested data from Commissioner Dankert concerning the TBI program, its allowances for patient travel, and rules or restrictions governing such travel. However, her office failed to respond and ultimately disclaimed any responsibility for program details.

"It is surprising that Commissioner Dankert would now attempt to question these payment requests after her department authorized payment for these claims and has since disclaimed any responsibility for properly monitoring the program's details," said Poloncarz. "It appears as though Dankert's own employees did not even review the invoices for the purposes of the trips, and they did not question the patients, their drivers, or the State about the propriety of these trips. It should not have taken a cursory review of these claims by my office's staff to find these payment requests and question them. I also find it ironic that county taxpayers are being asked to subsidize trips for TBI patients to Indian reservations for cigarettes, meaning that county taxpayers are paying the cost of travel so a TBI patient can avoid paying taxes on cigarettes. That is wrong."

Poloncarz concluded "I am pleased that after our office identified the questionable claims the Collins Administration is finally taking some action to inquire about the mileage reimbursements and apparent lack of limits for questionable travel within this program. Given the fiscal climate in this state and community, the taxpayers cannot afford to pay for such questionable costs and subsidize unhealthy behavior by Medicaid clients."