VETERANS CHOICE – A TOXIC VA PROGRAM – A VETERAN’S NIGHTMARE
In the late summer of 2016, at the VA Clinic in Port Charlotte, Florida, I was told by Dr. Alice Higgins, that my cataracts had grown to the point where surgery would be necessary. She arranged for an appointment for me with an Ophthalmic Surgeon, Dr. Bethlehem Belachew, at the VA facility in Cape Coral. Because of the many senior Veterans in this area who need cataract surgery and the fact that Dr. Belachew is the only surgeon available, an appointment with Dr. Belachew could not be accomplished for several months. The scheduler at the Ophthalmology Department at Cape Coral told me that, in cases like mine, Veterans were turned over to the Veteran’s Choice program, which is administered by Healthnet, an insurance provider. Healthnet is contractually obligated to pay private sector medical providers for those same medical services provided at VA facilities, in cases where an appointment cannot be provided within a reasonable amount of time, or when distance to a VA facility is prohibitive.
The problem is, that, Medical Providers who will do business with the Veteran’s Choice program are difficult to find. It seems that Healthnet does not pay the Medical Provider for services rendered, or they pay only a small percentage of the invoice, even though they are contractually obligated to the VA to do so. I had been told by the VA, that finding a Medical Provider would be my responsibility. I did the research and began making calls. After being told NO by fifteen or so Medical Providers, I found a Company that would do business with Healthnet.
The Eye Associates: Bob Marshall CFO, 2111 Bee Ridge Road, Sarasota, FL 34239 – 941 923 2020
Cataract surgery for a patient with astigmatism, and in need of distance correction, requires the insertion of a Toric Lens during the surgery. When cataract surgery is performed at a VA facility, the VA provides Toric lenses for its patients who require them. During my first examination by Dr. Robert Friedman at The Eye Associates, I was told that Toric lenses are considered an upgrade by insurance companies and are not covered. I told him that I was a VA patient, and that, since the VA provided Toric lenses when cataract surgery was done at VA facilities, Healthnet was contractually obligated to the VA to cover the cost, which, in this case would be $4,000. During the following two months, an exhaustive negotiation took place between myself, The Eye Associates, and Healthnet. Healthnet simply refused to guarantee payment of the Toric lenses. I enlisted the help of the VA, and after another month or so, Healthnet agreed to guarantee payment of the Toric lenses.
My first surgery was on January 17, 2017. My second surgery was on March 28th, two months later. In late February I began getting phone calls from Bob Marshall, the CFO of The Eye Associates. It seems that Healthnet was not making the payment they had guaranteed to The Eye Associates. Mr. Marshall told me that, if Healthnet failed to pay for the lenses that I would be held responsible for payment. Once again, I called the VA for help, and they attempted to help. By mid-March the VA personnel had read the riot act to Healthnet, and Healthnet finally agreed to make the proper payment.
On April 11th 2017, I received a call from Bob Marshall. It seems that Healthnet had reneged on its promise to pay for the cost of the Toric lenses, They paid a small percentage of the invoice, and refused any payment at all for the Toric lenses. Unless this matter is resolved, The Eye Associates will have no choice but to hold me accountable for $4,000, the cost of the Toric lenses.
For the VA, the Veteran’s Choice program has become toxic. For the Veteran, in this case me, it has caused an impossible financial liability. Believe me, I am not the only Veteran who has been put in this position by Healthnet and their Veteran’s Choice program. I sought help in the Veterans Advocate’s Office in Cape Coral, Florida. Two advocates, Brett Kangas and Susan Billington, attempted to intervene with Healthnet, but after a while, Healthnet seemed to bully them into submission.
Here are two emails, from and to Susan Billington, a Veteran’s Advocate:
Dear Mr. Costello
I apologize for the delay as Mr. Kangas is not in. He did brief me on his efforts on your behalf before he departed. His discussions with our eye care specialists indicate the Toric surgery was not authorized in your case. Additionally, there is no authorization for this procedure in your Healthnet authorizations.
I am sorry we could not provide a more favorable reply
Susan G. Billington
I am a bit stunned by your email. I never saw a VA eye specialist. I assume you mean Dr. Belachew, who I never met. I was enrolled in the Veteran’s Choice program by Dr. Belachew’s assistant, without being examined by Dr. Belachew. It was Veteran’s Choice followed by Healthnet that claimed Toric lenses were not authorized for VA patients. And it was Dr. Belachew’s office that confirmed that, when necessary because of astigmatism or distance correction, Toric lenses are provided during cataract surgery performed at VA facilities. Healthnet is contractually obligated to pay private sector medical providers who perform identical services to those performed at VA facilities. Healthnet is notorious for not paying out benefits for Veterans who are enrolled in the Veterans Choice Program. Healthnet, is an insurance provider that is contracted by the VA to administer the Veteran’s Choice Program. Healthnet is a for-profit corporation that has a long history of taking monies ear marked for Veterans, and lining their pockets. Benefits eat into profits.
In my opinion, Mr. Kangas has been remiss in his duties as an advocate for Veterans. He seems to be advocating for Healthnet. Healthnet has obviously bullied him into submission. The medical provider involved, The Eye Associates, will now attempt to collect the four thousand dollar fee for the Toric lenses from me personally. It is my opinion, and the facts are on my side, that a government contractor, Healthnet Inc, is lining its pockets with monies ear marked for Veterans. It is my opinion that Mr. Kangas has forgotten who pays his salary.
I will not rest until this outrage is resolved. I have made this matter known to Suzanne Klinker in Bay Pines, as well as the office of Secretary of Veteran’s Affairs Shulkin, Senators Rubio and Nelson, Congressman Rooney, and White House senior staff. I’m quite certain that I am not the only Veteran who has fallen victim to the Veteran’s Choice Program, and its criminal administrator, Healthnet Inc.
I have been helped by Ms. Billington in the past and was shocked that both she and Mr. Kangas seem to have been bullied into submission by Healthnet. The Veterans Choice Program is dysfunctional because Healthnet has a long record of not paying medical providers. In this case, I spoke with 15 medical providers, all of whom refused to deal with Veterans Choice because of past unpaid invoices; before I finally found The Eye Associates in Sarasota. After two months of negotiating, between Healthnet and Bob Marshall, the CFO of The Eye Associates, Healthnet finally guaranteed payment for the Toric lenses. Two weeks later they, once again, refused to make payment.
With a large invoice from The Eye Associates looming in my immediate future, I sought help from those whose good offices seemed appropriate in the solution of my problem. Listed below are those from whom I sought help, and how they responded.
For those keeping score, here’s the scorecard:
Senator Marco Rubio
I received three emails, one snail mail, and two phone calls. I was told that my problem was being handled by a senior staffer in Orlando.
Congressman Tom Rooney
I received two emails, one snail mail, and one phone call. I was told that Rooney’s office had submitted a Congressional Inquiry to the Congressional Liaison Office at the VA.
Senator Bill Nelson
I was ignored.
Secretary of Veterans Affairs Shulkin
I was ignored.
Director of the Bay Pines VA Healthcare System Suzanne Klinker
I sent two detailed letters. Both were ignored.
President Donald J. Trump
I was ignored.
Only two out of six responded, which, while not surprising, is still a disappointment. To my knowledge, the medical provider in Sarasota has still not been paid, and the VA has washed its hands of this event, a problem of their creation, and of their responsibility. The two alleged Veterans Advocates; Susan Billington and Brett Kangas, no longer respond to my emails or phone calls. Any day now, I expect the invoice from The Eye Associates for approximately $5,000, which Healthnet has refused to pay.
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A LETTER TO MY CONGRESSMAN – A Homeless Veteran’s Journey
August 3, 2015
Congressman Thomas J. Rooney
226 Taylor Street – Suite 230
Punta Gorda, Florida 33950
Dear Congressman Rooney,
I am a 71 year old Veteran who, until recently, was homeless. Through the interdiction of your office in Punta Gorda, and the help of organizations like Jewish Family and Children’s Services, The Punta Gorda Veterans Village, and the VA’s Hud/Vash program, I have been able to find permanent and affordable housing. When confronted by demands from the HUD office, to provide documentation from the IRS that was impossible for me to obtain, I turned to your office in Punta Gorda for help. I was graciously received by your staff, who gave that help with enthusiasm and dispatch. Within 48 hours, and with the help of a Congressional liaison named Linda Berkman, I received the necessary documentation in the mail. This is supposed to be the way America works, but all too often, does not. I am grateful to your staff for their assistance, and for the gracious demeanor with which that assistance was given.
During my months of homelessness, I was exposed to the system, on many levels – good and bad, through which homeless Veterans struggle to navigate, with the hope of eventually finding permanent and affordable housing. From the VA’s Medical Center in Bay Pines, to local transitional housing situations like Stillwater House in Port Charlotte, and the Punta Gorda Veteran’s Village, run by the Volunteers of America; and the VA’s Hud/Vash program, I have lived through it, and thought it my responsibility to share my experiences, both positive and negative, with your office. The positive aspects of my transition from homeless Veteran to affordably housed Veteran should be applauded; and the negative aspects, so desperately in need of fixing, need to be fixed. The plight of the homeless Veterans has become a media-intensive issue in America, and it seems only right and just to bring my own experiences to the attention of my Congressman, particularly since that Congressman’s office had been so helpful to me.
So, here is an outline of my journey, good and bad, from homeless to affordably housed. But first, let me preface this description by explaining that homelessness has been on my horizon for the last two years. Because, for most of my life, I was self employed, my Social Security stipend is quite small, and impossible to live on. Supplemental income that had enabled me to pay my monthly bills dried up, leaving me with a deficit at the end of each month, and I was aware that those months had become numbered. During the past few years I have sought the help of many VA representatives who have given no help whatsoever. Prevention of homelessness seemed to have no place in the VA’s agenda, while chronic homelessness was a different matter. I saw a man named David Donohew on three separate occasions. He ran the Veterans Office at Charlotte County Human Services. Donohew seemed like an affable and friendly guy, but each time I saw him he told me the same thing, “Come back and see me when you’ve been homeless for one year. Then I can help you.” This made no sense to me. By not preventing homelessness, the VA was exacerbating the situation. I needed to get into the VA’s system, in order to profit by it. And so I did.
On April 14 of this year, then officially a homeless person, I checked myself into the Psychiatric Unit at the VA’s Medical Center in Bay Pines Florida. I would spend nine days in this facility. The staff, from top to bottom, seemed experienced and capable. I saw a psychiatrist and a social worker every day I was there. They were goal oriented and the goal, in my case, was finding permanent, affordable housing. Most of the patients suffered from drug and alcohol addiction, or combat related conditions like PTSD. I suffered from none of these problems. I just needed an affordable place to live.
The psychiatrist was eager and focused on getting me into some kind of transitional housing so that I could resume my life. The social worker was enthusiastic but inexperienced, so that she needed constant back up for any questions or problems. She wanted to help me find housing, but had no real world knowledge of what that housing would be. The nursing staff, without exception, were attentive, and caring. There were Veterans at this facility with serious problems and they seemed to be getting serious care. Two days before I was discharged, the social worker told me that she had found me transitional housing in Port Charlotte, where I had lived for the last ten years. This seemed like good news. The problem was that the social worker had never visited any of the facilities she was to recommend, so she relied on the opinions of the people who managed them. I was to go to Stillwater House, a transitional housing facility subsidized by the VA, and live there while I attempted to find permanent, affordable housing. I was excited at the prospect, having listened to the glowing description of the place from the eager but inexperienced social worker. I was told that my all-inclusive rent would be $300, which seemed reasonable enough.
On April 23rd I was discharged from the Bay Pines facility and headed south to Port Charlotte. I arrived at Stillwater House about Noon that day. It was a small, two story building located in the center of Port Charlote, close to the library, the Cultural Center, and the local hospitals. I was greeted by a woman named Trish (I never knew her last name) who showed me a few of the available rooms. I was stunned. The rooms were tiny, dirty, and decrepit. Trish then announced that I needed to give her a rent check for the $500. I was to pay each month. I was horrified. I immediately got on the phone with the social worker at Bay Pines, who had bought Trish’s glowing description of her venue, and told her the reality of this place, and the $500. that Trish was trying extort from me for rent. She called back, giving me the name and phone number of Gilbert English, who she claimed would be able to help me. She also told me that the rent would be $300. and to pay no more. I chose the least offensive room, gave Trish a check for the pro-rated portion of the month’s rent, and got on the phone with Gilbert English. He seemed friendly, and told me he would meet me an hour later at the Coalition for the Homeless in Port Charlotte.
Gilbert English turned out to be my salvation. I spent about an hour with him, during which time he gave me several names and phone numbers, and the order in which I should call them. For any homeless Veteran who might wind up reading this document, and who lives in this part of Florida, Gilbert English is the man to see. His number can be found through any VA social worker. The first person on Gilbert’s list that I called was Michelle Hammond at Jewish Family and Children’s Services, a well funded, Veteran-friendly organization that Gilbert said could provide help. The second was a man named Tom Yanoti, who worked at Punta Gorda Veteran’s Village, a transitional housing facility. I spent an hour with Michelle the next afternoon, providing her with personal information, and making a list of the documentation that would be necessary for me to provide in order to receive their help. I then stopped by Tom’s office and got on the waiting list for space at Veteran’s Village.
For the next three and a half weeks I would live at Stillwater House, while every day setting up and going to appointments with the objective of obtaining affordable permanent housing. At 8AM on the day following my appointment with Gilbert English my phone rang. It was Gilbert, checking up on whether I had called the numbers he had given me. He was pleased to find that I had two appointments already, and rewarded me by letting me know that he had given my name to the Hud/Vash office in Bay Pines in order to get me into the Hud/Vash System. This was good news since Hud/Vash was the portal to a Hud voucher, which would enable me to obtain affordable housing. Gilbert is a relentless advocate for his Veterans.
Life at Stillwater house could best be described as problematic. Stillwater House exists under the corporate umbrella of Renaissance Manor, both being non-profits that are federally subsidized in order to provide low cost housing and care for those in need, primarily Veterans. As at the psychiatric unit at Bay Pines, most of the Veterans at Stillwater House are substance abusers, or have serious psychiatric problems requiring care. Unfortunately, at Stillwater House, care is the very last thing they receive. Not once, in the three and a half weeks I lived there, did I see the presence of a single medical professional of any kind. The facility is completely unsupervised. This is tragic because most of the men who live there are in need of psychiatric counseling. Instead of providing care for its residents, Stillwater House appears to be a storage venue, where needy Veterans are shelved and forgotten.
My first week there, one of the Veterans told me that I had mail, which could be found on a table in the lobby. It was one of those super strong plastic envelopes that the VA uses to ship pharmaceuticals, impossible to open without a knife or scissors. When I picked it up I noticed that it had been cut open. Every Vet knows these containers, and that they contain prescription drugs. Someone, one of the many substance abusing residents, had sliced it open hoping to find recreational drugs. None of my prescriptions fit that description, so nothing was missing, but I was disturbed that someone had violated my mail.
I waited a few days, giving myself time to think it over, and decided that it should be reported. I called Trish at Renaissance Manor. I told her that something disturbing had happened and that I would like to discuss it with her in person. She demanded to know the nature of the event, but I insisted that it was not a matter for telephone discussion. She said that she was quite busy and couldn’t see me. I then called her boss, a man named Todd Abbott. He was not in and I left several messages on his voicemail. The next day, I assume because Todd Abbott told her of my calls, Trish called me and told me to come to her office at Renaissance manor in Punta Gorda. When I told her of the opened mail, she was defensive, dismissive and adversarial. She seemed angered that I was reporting a problem, almost as though by reporting it, I was creating it. It seemed that Stillwater House was a mess that she did not want to deal with. Later that day Todd Abbott called me and had basically the same attitude. Problems at Stillwater House? Ridiculous. Abbott made some vague suggestion that he would do something about it, but of course, never did. So the Veterans at Stillwater House, many of whom were in need of counseling and care, continued on without it, shelved and forgotten, victims of a corrupt bureaucracy, and the laziness of management. There were many incidents during my stay at Stillwater House that were a result of behavioral problems exhibited by needy Veterans, too many to mention here. Stillwater House, in my opinion, should either be closed, or placed under new management. These men need care.
During the next few weeks I was relentless with Tom Yanoti, stopping by his office every other day, reminding him that I was his next best tenant. Veteran’s Village appeared to be a well run facility, and I desperately wanted to move there. I quickly moved up on the waiting list, and moved into apartment 221 on May 18th. The next day I sent an invoice to Todd Abbott at Renaissance Manor, asking for a refund of the rent I had paid for the month of May, which I had paid in full on May 1st. My request was for that pro-rated portion of the month (13 days) that I was not in residence, having moved to Veteran’s Village on May 18th. It is now August and I have sent Todd Abbott three invoices, with cc’s to his boss Scott Eller. They have gone unanswered. So, the management of Stillwater House are not only abusers of Veterans in their care, but are deadbeats as well. Why am I not surprised.
Punta Gorda Veteran’s Village would become my home for the next month, and was an altogether different kind of facility. Located on Taylor Street in Punta Gorda, the Veteran’s Village takes up four two story buildings and houses up to forty Veterans. It even has a swimming pool. Like Stillwater House, Veteran’s Village houses many Veterans with drug and alcohol problems and psychiatric disorders. But unlike Strillwater house, here the Veterans are offered the care they need. The manager is Kerrie Wilson, who has a difficult and sometimes thankless job to do, and does it well. Homeless Veterans can be a disgruntled and difficult group, who can, and sometimes do, lash out at those who are trying to help them. During my time there I saw Kerrie fall victim to much undeserved criticism from Veterans she was trying to help. I found her to be a caring, even loving overseer of a difficult bunch. Two days a week Kerrie receives help from Linda Briggle, a small woman with enormous energy, who, when confronted with a problem, simply rolls up her sleeves and attacks it. One day a week Kerrie and Linda are joined by Barbara Sousa, whose official title is: Grant Per Diem Liason/VA Homeless Program. (Liaison is misspelled on her card) Barbara acts as liaison between the Village and the VA. She is knowledgeable, and offers Veterans help navigating their way through the sometimes complicated maze of the VA bureaucracy. I will be forever grateful to these people for the help they gave me and the care they showed me at a time when I needed both.
At Jewish Family and Children’s Services I was turned over to a woman named Mindy Saldana, who would become my case worker. Mindy is a tireless and caring advocate for those in her charge. During the following month, JFCS would pay almost a thousand dollars to have my car repaired, purchase a new bed for the apartment I would eventually obtain through Hud/Vash, pay the security deposit on that apartment, as well as deposits for utilities, and supply my new apartment with many household items. JFCS, an organization I previously was unaware of, would become an integral component in my return from homelessness to a normal life.
Obtaining a HUD voucher should be the goal of any homeless Veteran who is serious about permanent housing. Navigating the VA’s Hud/Vash system is not without its difficulties, but if you are resourceful and determined, it can provide a homeless Veteran with the road to affordable housing. My Vash case worker was new at his job, so I took it upon myself to make sure that the HUD people were provided with the enormous amount of documentation they require in order to qualify for their help. The Vash personnel are the VA’s liaison to HUD, which holds the purse strings for housing. HUD has the power, and power corrupts, so I found the HUD people a bit arrogant to deal with. They hold all the cards and they know it. My advice to any Veteran going through this process is to remain patient, but to be determined and persistent. Do not wait for anyone to do anything for you – do it yourself.
After several interviews with HUD personnel, during which I had to provide, in my opinion, a ridiculous amount of documentation, I was granted a HUD voucher. It was now up to me to go out into the community and find available housing that my HUD voucher would pay for. This was no easy task. The voucher is County specific. I live in Charlotte County where the availability of affordable housing is quite limited. I was able to obtain lists of apartment complexes that were Hud-friendly and got on many waiting lists. The HUD voucher has time constraints. You have three months from the date the voucher is issued, to obtain appropriate housing. If you do not, then the voucher becomes invalid. So I pounded the pavement in search of an appropriate apartment. By sheer luck, I wound up at the Charleston Cay apartment complex in Punta Gorda. The manager Keith Livermore, told me that there was a six month waiting list, and asked if I was a Veteran. When I answered yes, he told me that Veterans go to the front of the list. Within two weeks I had a two bedroom apartment. I moved in to the Charleston Cay complex on July 25th.
My journey, from checking myself into the VA’s psychiatric facility at Bay Pines, to moving into my new apartment took three and a half months. I had to navigate my way through the mine fields of bureaucratic obstacles that lay waiting for any pilgrim who undertakes this process. I received so much help along the way from friends, family, and the organizations I have mentioned here, for which I shall be forever grateful. To any homeless Veteran reading this epistle, who wishes to undertake the same journey, I would give this advice: You’ve got to want it to make it happen. Do not get discouraged. It’s not easy. Stay the course. You’ve got to be determined and persistent. Do not take no for an answer. If I could do this, so can you.
I send this chronicle to you Congressman Rooney, with the hope that your good office can take the lead in Congress to eliminate the problem of homeless Veterans in America. I hope that becoming aware of my personal journey, will inspire you to take action. To help and federally fund those organizations that are so helpful to homeless Veterans like; Jewish Family and Children’s Services, The Punta Gorda Veterans Village, and so many others. And to defund and close down facilities like Stillwater House, a storage venue for Veterans in need, who are ignored and forgotten while in residence.
I hope that you find this information useful.
For purpose of disclosure, I should inform you that it is my intention to post this letter on my Blog: shauncostello.com
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