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Despite challenging the audit, HRA significantly altered the new contract with HS Systems, imposing more rigorous pricing and service standards. The company will no longer be paid for every medical examination, but instead for making a ruling on the level of a client's disability, even if it involves multiple tests.
"They'll pay you for having made that determination," said Connell. "The city no longer cares how much testing you do."
Other changes to the contract reflect long-standing concerns about HS Systems' treatment and evaluation of disabled New Yorkers. For the past few years, the Legal Aid Society, the Urban Justice Center, and New York Legal Assistance Group have complained about overcrowding, lack of privacy, hasty medical assessments, bad record keeping, and poor services for the mentally ill at HS Systems.
The single HS Systems site is located on West 44th Street in Manhattan. On regular visits to the center in recent months, The Village Voice found that disabled clients leaning on canes were sometimes kept waiting for more than an hour after their scheduled appointment time, even in the rain and snow.
Inside, clients complained of lack of privacy. "There is no separation of the sexes," said Joan, a woman in her mid fifties who asked that her real name not be used. "Men and women stand together in little paper gowns."
Advocates for the disabled also said there was a lack of privacy in the medical record keeping. "One of my clients had to discuss their HIV status in front of others," said Matthew Schneider, a staff attorney for New York Legal Assistance Group."HS Systems sucks."
Critics charged that HS Systems frequently failed to look at clients' previous medical records or other doctors' recommendations, though the company is required to do so by law. One result, they said, is that disabled people have been wrongly forced to work. In 1997, doctors at HS Systems found Marsha Motipersad, a 5O-year-old woman with a history of serious heart disease, to be employable. Motipersad died of a heart attack while on a break at her WEP job in Coney Island. There is also an outstanding lawsuit from Mikhail Fridman, who says he had a heart attack as a result of working in a Sanitation Department garage for his WEP benefit. Fridman had been cleared, despite his hypertension, by an HS Systems doctor.
HRA has conducted on-site visits to the center every three years since HS Systems began to work for the city in 1975. The most recent HRA evaluations gave the center "very good" to "excellent" ratings.
In 1993, HRA even gave the center a certificate for outstanding performance and quality services. The same year, an HS Systems doctor, Koshi Padnani, was suspended for ordering excessive testing, prescribing controlled substances inappropriately, and maintaining inadequate medical records.
In its new three-year, $30 million contract, HS Systems has agreed to a number of changes that may solve many of the problems cited above. The contract mandates, for instance, that there be sufficient room inside, so that clients do not have to queue up outside. HS Systems will also open three additional sitesin Brooklyn, Queens, and the Bronxso that clients from the outer boroughs do not have to come all the way into Manhattan for screening.
The new deal took effect on April 1. The comptroller's office could not comment, however, because the contract had not yet been sent over by HRA.