Remember in the movie Casino, when Nicky Santora was sexing Ace Rothstein's wife Ginger? Remember that scene where Ginger got mad at Ace and went up to Nicky's restaurant to try to put a hit out on her husband and Nicky violently responded? After he threw her down the stairs and she sped off he told his goon, "I really [explicative] up this time." Then a little later in the movie, right before Nicky died he had a powerful statement. "We had heaven on earth and we managed to [explicative] it all up." Those two scenes describe the players of the community mental health industry. When I say players, I'm speaking of the service providers (agencies, companies). And we did manage to screw everything up.
Just like there are the teachers that are just concerned with getting a paycheck and could care less about the educational welfare of the children, there are the agencies preaching all types of wellness to the poor, black community and could really care less. In fact, most agencies and their owners prefer these communities stay the way they are, if not get worse, so they can still have a business. This is nothing new. Do you think the president of Old English 800 really drinks that stuff? Highly unlikely, but it brings in the bread.
With this unethical mindset, many agencies did whatever it took to increase their brand and revenue stream. As little as five years ago there were several companies who were making clients (for their company) out of family members, giving cigarettes to project mothers in exchange for referrals, paying truancy officers for lists of kids, and using other interesting methods to expand their business. These crafty methods of marketing set respectable community members on fire; and many parents, teachers, coaches, and others began to openly denounce the existence of intensive in-home programs. Naturally, this outcry aroused the attention of the industry's main funding source, Medicaid. But the reasons for skepticism didn't stop there.
These same companies were sending uneducated and minimally experienced people they called "counselors" into the homes of some of the most disturbing homes in the state. Some of these employees were even ex-felons with violent records. These "counselors" were supposed to provide "therapeutic interventions to prevent an out of home placement for the child." Some did do that, the overall majority did not. Many counselors didn't even show up for appointments even though they still billed Medicaid for the service. And those that did do the job submitted documentation that hardly reflected a high school education much less a college one. All of this left many companies out of compliance with state and Medicaid regs, families in worse positions than when services started, and many agency owners hood rich. Which leads to this final point.
Just like the dopeman, one day you would see an in-home company owner taking the bus. The next week he would pull up on 4th Avenue in the S550; Gucci(ed)-down. You could catch the owner whose company promotes home stability spending stacks at the bar for him and his club chick while his wife is taking care of their infant daughter. He would buy the house in Brandermill and throw outlandish Christmas parties where the birth of Christ better not be mentioned. He was flamboyant and rude to his employees; and sometimes he wasn't paying them. All this from a business that is geared to prevent kids from going to a group home or juvenille detention.
So here's Medicaid, looking at all these rich niggas (term used to emphasize the obvious)and saying "this will stop today." And so a slew of new regulations (which probably should have been put in place at the beginning) were implemented. Among other things, these regulations targeted three main areas--marketing, staff qualifications, and client approval for services. It crushed many of these new money boys [and girls] and their perceived conglomerates; and even sent some to federal prison. The most disturbing part about all of this is that black people, who made it public that they existed to help black people, took advantage of black people, and it led to more impoverished and desperate black people. At a civic league meeting in Norfolk some years ago, I heard a Young's Terrace resident say, "we were supposed to trust y'all." That cut me to the core. Because although we didn't participate in hiring unqualified staff or bribes, we did ball out to a degree. Nor did we, or I, speak up enough about the injustice of our people in this arena; until now.
These days Medicaid changes are threatening the existence of our entire industry. And there are these companies banding together to build cases against Medicaid and the state to lift restrictions and all that stuff. A useless move. And this isn't every agency that committed these attrocities, but the exception is the good ones--and that's not good. Now your four-letters and your three-letters are running around complaining and soapboxing; because it's soon going to be a wrap. But this isn't the situation where we can point the accusatory finger, because the reality is...we did this to ourselves.
Peace
Wow. That's a lot to take in.
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