By Steve Weinstein
By Devon Maloney
By Tessa Stuart
By Alison Flowers
By Albert Samaha
By Jesse Jarnow
By Eric Tsetsi
By Raillan Brooks
While ways were found to award additional subsidies to favored owners, the fundamental Pataki deal with the homes was an administration asleep at the oversight and enforcement switch, saving the industry the costs of better care. The result is the worst scandal of the governor's two terms, exposed on the front page of the Times on four consecutive days recently in a series written by Clifford Levy that may well win the Pulitzer Prize, despite how much it has been ignored by the other print and TV media.
Federal prosecutors in Brooklyn and Manhattan have opened probesalready indicting a doctor who allegedly performed unnecessary eye operations on the mentally ill referred for cash by an adult home. Assemblyman Martin Luster has already chaired one assembly hearing, boycotted by Pataki officials, and plans a second on June 6, with administration apologists expected.
Included in Levy's findings was the apparent Pataki decision not to enforce a law that went into effect when the new governor took office, requiring a report on every death that occurs in adult homes. Nearly 1000 have died since January 1995, and only three reports have been filed. The same 1994 package of reforms also strengthened the authority of state officials to revoke licenses and impose grave penalties where they found "failures in systemic practices and procedures," but in fact the new powers have almost never been used.
Levy also reported that Pataki cut the state survey staff so severely that the NYC office, for example, went from 25 to five adult-home inspectors. Leaders of the Public Employee Federation testified at a May 10 assembly hearing that the number was down to three. Alan Shulkin, a union leader who works at the State Department of Health (DOH), told the committee that "there are 10 to 12 referrals for enforcement stemming from inspections out of the NYC office alone sitting in Albany, only two of which have been acted on." Half of the city inspections, according to Shulkin, "have not been done" in the 12- to 18-month period required under state law. "We are so backlogged that everything is triaged," complained Shulkin. "Even the triage is triaged."
The Empire State Association Web site boasts how it convinced state officials in the first Pataki year to adopt "a more reasonable" survey process, making "positive, sweeping changes" in "inspection protocols." Owners like Tenenbaum say that inspectors were told to list "minor violations" as mere "findings," what he called a "welcome" softening of inspections.
The oversight and enforcement function was even quietly shifted, with the support of ESA lobbyist Coppola, as part of Pataki's 1996 proposed budget. It moved from the Department of Social Services (DSS), which had become far more aggressive in the final Cuomo years, to DOH. Enforcement has been so weak since that even advocates like former DSS and DOH executive Karen Schimke, who heads the Schuyler Center for Analysis and Advocacy, and has been named to Pataki's new emergency task force on adult homes, told the Voice, "Adult homes were simply not a high priority when they were shifted to DOH. It took quite a while for the agency to transition. There was a lot of laxness."
Pataki even cut the teeth out of the only outside monitor, the state's quasi-independent Commission on Quality of Care for the Mentally Disabled. The commission's founder and former chair, Clarence Sundram, told the Voicethat his agency was so decimated by Pataki budget slashes that the NYC staff went from 15 to three. "No one came out and said to me, 'Don't investigate this or that,' " said Sundram, who worked under Hugh Carey, Cuomo, and Pataki. "But the Pataki approach was very different, especially involving the whole notion of an independent agency. They believed that what all agencies should do ought to come from the governor's office. It was a general philosophy that was clearly understood."
Sundram said that the Pataki team "didn't believe in government interference with the private sector," and that this point of view led to "a reduction in the monitoring" of adult homes and other private, subsidized facilities by state agencies, as well as the cuts in his commission staff. Since Sundram's departure in 1998, the commission has dramatically reduced its own oversight, even failing since 1999 to complete a legally mandated annual report. While Sundram used to regularly issue a half-dozen special investigative reports a year, the commission only released one in all of 2000 and 2001, a report on financial abuses in one home that made no assessment of DOH diligence.
Though the state's top investigator of adult homes and other facilities that were receiving hundreds of millions in public support, Sundram never had a meeting or phone conversation with Pataki. The only time he ever heard from the governor was an acknowledgment note when he resigned three and a half years into Pataki's first term. In sharp contrast, he said he frequently talked with Carey and Cuomo, both of whom "believed in our mission and supported us even though we put out a lot of critical reports" about DSS, DOH, and the Office of Mental Health (OMH), which oversees psychiatric services for adult-home residents. "I don't know if Pataki believed in our mission," he said.