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SEABHS ordered to correct problems
Thelma Grimes/San Pedro Valley News-Sun
The Community Partnership of Southern Arizona (CPSA) went from expressing concern about the business operations at the Southeastern Arizona Behavioral Health Services (SEABHS), requiring they make corrections or face elimination of a $35 million contract.
Neal Cash, president of CPSA, expressed concern in early December at the Arizona Attorney General investigation of numerous SEABHS employees for embezzlement, former SEABHS CEO Dana Johnson for borrowing and never repaying $150,000, a problem with the level of services being provided to patients and high-dollar spending on vehicles and auditing fees.
In an interview at the time, Cash said what is known in the industry as a "Letter of Cure" had not been sent, but the concerns had been expressed verbally. A Letter of Cure describes the areas a company must correct in order to continue receiving public funds.
After careful consideration, Cash said an official letter had to be sent because CPSA feels SEABHS has not followed requirements outlined in the contract between the two agencies. Since 2006, tax documents show CPSA has given SEABHS between $29 million and $35 million a year.
Without the funding, SEABHS' future would be uncertain, since it relies heavily on the public funding. SEABHS, which provides mental health services in Cochise, Greenlee, Graham and Santa Cruz counties, currently has 400 employees.
The Dec. 17 letter to Jim Rubio, acting CEO of SEABHS, outlines five specific areas that must be corrected by May 3. A plan of action was required from SEABHS by Jan. 19.
The areas SEABHS is required to correct concern finances and staffing levels, a lack of networking and sufficiency, financial instability outlined in recent audits and an inability to meet community expectations.
Since late November, the SEABHS Board of Directors has been at odds over how to rebuild the image of the company.
Marcelino Varona Jr. of Nogales has pushed for more board oversight while other board members argue that "micro-managing" is not in the best interests of the company.
Many of the issues pointed out by Varona in the monthly board meetings were stressed in the Letter of Cure, along with several other issues Cash said SEABHS must address in order to get a contract renewal.
Cash said the first area of concern centers around the money, with CPSA questioning whether or not SEABHS is providing services commensurate with the dollars they are provided each year.
In the letter, Cash said SEABHS has shown an "inability" to provide services consistent with funding for at least two years.
This also leads to the second problem outlined by Cash, regarding SEABHS staffing.
Cash said SEABHS has had a significant number of vacancies, and the positions have not been filled in a timely manner.
Because SEABHS did not meet required staffing levels, Cash said they were hit with a $13,000 sanction from the state in October. The fine was levied because SEABHS did not hire the high-needs case managers required in the state's "Meet Me Where I Am" initiative. Staffing levels must meet requirements set by the Arizona Department of Health Services (ADHS), Division of Behavioral Health Services (DBHS).
SEABHS must have a minimum of 18 full-time high-needs case managers on staff by Jan. 31, hire or subcontract for seven support and rehabilitation staff members by Feb. 28, and hire or subcontract for 3.5 case managers who will give 50 percent of their time to case management and 50 percent to rehabilitation support services.
Cash said to assure these guidelines are met, CPSA will be monitoring the situation monthly.
Cash also stressed a concern over there being a "significant turnover of supervisors" in SEABHS clinical sites in Benson, Bisbee, Douglas, Clifton, Nogales, Safford, Sierra Vista and Willcox.
A corrective plan is also required for SEABHS to improve the number of medical professionals on staff to care for children and adolescents. While staffing levels for childcare have improved in recent months, Cash said SEABHS must prove this level of efficiency can be maintained.
SEABHS has also fallen below standards in hiring medical professionals to care for adult patients in the fourth quarter of 2009, and the first quarter of 2010. Cash said no correction plan is required, but the company must maintain sufficient staffing levels.
Cash also expressed concern over SEABHS not having a human resource director on staff, noting the agency must provide assurance that the position will be filled, and must submit a plan to CPSA specifying how human resource functions will be administered.
The third area SEABHS must address is network efficiency. Cash said the company has not utilized community-based providers for delivery of support services.
As a result, SEABHS is not in compliance with designating a contractually required network development liaison and not in compliance with the requirements of a Substance Abuse Prevention and Treatment Block Grant.
The grant funding was supposed to go toward residential facility services for substance-using women with dependent children. SEABHS must submit a plan outlining how the requirements of the grant will be met.
The fourth issue raised by CPSA is SEABHS' financial instability.
"Recent audits have pointed out inadequate internal controls," Cash said. "SEABHS must submit a plan to review, revise and implement internal controls, policies and procedures to ensure processes are in place requiring segregation of duties and restricted access to blank checks, petty cash and check deposits. These processes must assure the safeguard of company assets and prevent staff from embezzling company cash and other assets."
In December, the Attorney General indicted Sylvia Nerey, a former SEABHS employee, for allegedly embezzling more than $30,655 between October 2006 and October 2008.
The charges are the result of a joint investigation by the Nogales Police Department, Benson Pol-ice Department and the Attorney General's Office Special Investigations Section and Medicaid Fraud Control Unit.
According to allegations, Nerey is accused of forging 18 SEABHS checks, which were either deposited into her personal accounts or cashed.
The checks ranged from $605.95 to $2,103.73.
Another former employee is being investigated for using SEABHS services to maintain a personal vehicle.
The Attorney General has also named former CEO Johnson as a suspect for misuse of funds after borrowing and never repaying $150,000 in 2004.
Johnson was terminated in November.
Company policy at the time Johnson's loan was approved by an executive board did allow employees to borrow company funds. In December, the board eliminated the policy with a recommendation from Rose Weston, the SEABHS legal director, who said the company should not be in the loaning business.
Starting this month, SEABHS is required to submit a monthly financial report to CPSA's chief financial officer.
For the company's costly vehicle fleet, Cash said SEABHS will be required to submit a plan to review current expenses and reduce unnecessary expenses incurred on company vehicle costs.
Varona has pushed for more public discussion on the cost of the vehicle fleet and auditing fees. Last year, SEABHS spent $500,000 on auditing fees and $650,000 to maintain and manage a 119-car vehicle fleet.
Before termination, Johnson had been driving a 2007 Cadillac, and other administrators in the company, such as Weston, are driving Jeep Liberties and a Dodge Ram.
Despite Varona's ef-forts, during board meetings in November and December there have been a few reports of costs, and who is driving company cars, but no board action has been taken.
The CPSA order means the issue will no longer be ignored.
"SEABHS must update its policies and procedures to ensure appropriate use of company vehicles for SEABHS business and personal use by staff driving vehicles home and back to their assigned work sites," Cash said. "SEABHS must appropriately report the monetary value for staff's personal use of a company vehicle on the employee's W-2 in accordance with IRS regulations. These steps are necessary to prevent IRS assessment of penalties for incorrect reporting of staff's personal use of company-owned vehicles and the reporting of company payroll tax obligations."
The final area SEABHS must address is community expectations.
"CPSA has received community feedback demonstrating a community perception of SEABHS as a closed and retaliatory system lacking transparency and unwilling to work collaboratively with other community stakeholders," Cash said in the four-page letter. "To counter this negative community perception, SEABHS must not only take all necessary steps to meet contractual requirements in substance, it must also develop and implement a comprehensive communications plan to address community concerns and improve community communication."
To date, SEABHS remains unresponsive to allegations against them. Rubio has not returned calls for comment from Wick Communications since early December.
In November, after agreeing to an interview to discuss how SEABHS would be moving forward to fix its image and overcome adversity, Rubio canceled. His secretary promised to call and reschedule. The call never came, and Rubio and some SEABHS board members remain unresponsive to media inquiries.
While Rubio did not return calls for comment last week, Cash confirmed that SEABHS did comply with the CPSA order to submit a corrective plan of action by the Jan. 19 deadline.
Cash said CPSA is reviewing the letter, has requested more information on some issues, and will issue an official statement to SEABHS by Feb. 2.
"They have responded appropriately," Cash said. "We'll see where we go from here. Ideally, the goal here is to make sure things get better down the road."
It may be a long road to recovery, however, since SEABHS must correct four years of financial issues, a lack of communication and pending indictments from the Attorney General.
The Community Partnership of Southern Arizona (CPSA) went from expressing concern about the business operations at the Southeastern Arizona Behavioral Health Services (SEABHS), requiring they make corrections or face elimination of a $35 million contract.
Neal Cash, president of CPSA, expressed concern in early December at the Arizona Attorney General investigation of numerous SEABHS employees for embezzlement, former SEABHS CEO Dana Johnson for borrowing and never repaying $150,000, a problem with the level of services being provided to patients and high-dollar spending on vehicles and auditing fees.
In an interview at the time, Cash said what is known in the industry as a "Letter of Cure" had not been sent, but the concerns had been expressed verbally. A Letter of Cure describes the areas a company must correct in order to continue receiving public funds.
After careful consideration, Cash said an official letter had to be sent because CPSA feels SEABHS has not followed requirements outlined in the contract between the two agencies. Since 2006, tax documents show CPSA has given SEABHS between $29 million and $35 million a year.
Without the funding, SEABHS' future would be uncertain, since it relies heavily on the public funding. SEABHS, which provides mental health services in Cochise, Greenlee, Graham and Santa Cruz counties, currently has 400 employees.
The Dec. 17 letter to Jim Rubio, acting CEO of SEABHS, outlines five specific areas that must be corrected by May 3. A plan of action was required from SEABHS by Jan. 19.
The areas SEABHS is required to correct concern finances and staffing levels, a lack of networking and sufficiency, financial instability outlined in recent audits and an inability to meet community expectations.
Since late November, the SEABHS Board of Directors has been at odds over how to rebuild the image of the company.
Marcelino Varona Jr. of Nogales has pushed for more board oversight while other board members argue that "micro-managing" is not in the best interests of the company.
Many of the issues pointed out by Varona in the monthly board meetings were stressed in the Letter of Cure, along with several other issues Cash said SEABHS must address in order to get a contract renewal.
Cash said the first area of concern centers around the money, with CPSA questioning whether or not SEABHS is providing services commensurate with the dollars they are provided each year.
In the letter, Cash said SEABHS has shown an "inability" to provide services consistent with funding for at least two years.
This also leads to the second problem outlined by Cash, regarding SEABHS staffing.
Cash said SEABHS has had a significant number of vacancies, and the positions have not been filled in a timely manner.
Because SEABHS did not meet required staffing levels, Cash said they were hit with a $13,000 sanction from the state in October. The fine was levied because SEABHS did not hire the high-needs case managers required in the state's "Meet Me Where I Am" initiative. Staffing levels must meet requirements set by the Arizona Department of Health Services (ADHS), Division of Behavioral Health Services (DBHS).
SEABHS must have a minimum of 18 full-time high-needs case managers on staff by Jan. 31, hire or subcontract for seven support and rehabilitation staff members by Feb. 28, and hire or subcontract for 3.5 case managers who will give 50 percent of their time to case management and 50 percent to rehabilitation support services.
Cash said to assure these guidelines are met, CPSA will be monitoring the situation monthly.
Cash also stressed a concern over there being a "significant turnover of supervisors" in SEABHS clinical sites in Benson, Bisbee, Douglas, Clifton, Nogales, Safford, Sierra Vista and Willcox.
A corrective plan is also required for SEABHS to improve the number of medical professionals on staff to care for children and adolescents. While staffing levels for childcare have improved in recent months, Cash said SEABHS must prove this level of efficiency can be maintained.
SEABHS has also fallen below standards in hiring medical professionals to care for adult patients in the fourth quarter of 2009, and the first quarter of 2010. Cash said no correction plan is required, but the company must maintain sufficient staffing levels.
Cash also expressed concern over SEABHS not having a human resource director on staff, noting the agency must provide assurance that the position will be filled, and must submit a plan to CPSA specifying how human resource functions will be administered.
The third area SEABHS must address is network efficiency. Cash said the company has not utilized community-based providers for delivery of support services.
As a result, SEABHS is not in compliance with designating a contractually required network development liaison and not in compliance with the requirements of a Substance Abuse Prevention and Treatment Block Grant.
The grant funding was supposed to go toward residential facility services for substance-using women with dependent children. SEABHS must submit a plan outlining how the requirements of the grant will be met.
The fourth issue raised by CPSA is SEABHS' financial instability.
"Recent audits have pointed out inadequate internal controls," Cash said. "SEABHS must submit a plan to review, revise and implement internal controls, policies and procedures to ensure processes are in place requiring segregation of duties and restricted access to blank checks, petty cash and check deposits. These processes must assure the safeguard of company assets and prevent staff from embezzling company cash and other assets."
In December, the Attorney General indicted Sylvia Nerey, a former SEABHS employee, for allegedly embezzling more than $30,655 between October 2006 and October 2008.
The charges are the result of a joint investigation by the Nogales Police Department, Benson Pol-ice Department and the Attorney General's Office Special Investigations Section and Medicaid Fraud Control Unit.
According to allegations, Nerey is accused of forging 18 SEABHS checks, which were either deposited into her personal accounts or cashed.
The checks ranged from $605.95 to $2,103.73.
Another former employee is being investigated for using SEABHS services to maintain a personal vehicle.
The Attorney General has also named former CEO Johnson as a suspect for misuse of funds after borrowing and never repaying $150,000 in 2004.
Johnson was terminated in November.
Company policy at the time Johnson's loan was approved by an executive board did allow employees to borrow company funds. In December, the board eliminated the policy with a recommendation from Rose Weston, the SEABHS legal director, who said the company should not be in the loaning business.
Starting this month, SEABHS is required to submit a monthly financial report to CPSA's chief financial officer.
For the company's costly vehicle fleet, Cash said SEABHS will be required to submit a plan to review current expenses and reduce unnecessary expenses incurred on company vehicle costs.
Varona has pushed for more public discussion on the cost of the vehicle fleet and auditing fees. Last year, SEABHS spent $500,000 on auditing fees and $650,000 to maintain and manage a 119-car vehicle fleet.
Before termination, Johnson had been driving a 2007 Cadillac, and other administrators in the company, such as Weston, are driving Jeep Liberties and a Dodge Ram.
Despite Varona's ef-forts, during board meetings in November and December there have been a few reports of costs, and who is driving company cars, but no board action has been taken.
The CPSA order means the issue will no longer be ignored.
"SEABHS must update its policies and procedures to ensure appropriate use of company vehicles for SEABHS business and personal use by staff driving vehicles home and back to their assigned work sites," Cash said. "SEABHS must appropriately report the monetary value for staff's personal use of a company vehicle on the employee's W-2 in accordance with IRS regulations. These steps are necessary to prevent IRS assessment of penalties for incorrect reporting of staff's personal use of company-owned vehicles and the reporting of company payroll tax obligations."
The final area SEABHS must address is community expectations.
"CPSA has received community feedback demonstrating a community perception of SEABHS as a closed and retaliatory system lacking transparency and unwilling to work collaboratively with other community stakeholders," Cash said in the four-page letter. "To counter this negative community perception, SEABHS must not only take all necessary steps to meet contractual requirements in substance, it must also develop and implement a comprehensive communications plan to address community concerns and improve community communication."
To date, SEABHS remains unresponsive to allegations against them. Rubio has not returned calls for comment from Wick Communications since early December.
In November, after agreeing to an interview to discuss how SEABHS would be moving forward to fix its image and overcome adversity, Rubio canceled. His secretary promised to call and reschedule. The call never came, and Rubio and some SEABHS board members remain unresponsive to media inquiries.
While Rubio did not return calls for comment last week, Cash confirmed that SEABHS did comply with the CPSA order to submit a corrective plan of action by the Jan. 19 deadline.
Cash said CPSA is reviewing the letter, has requested more information on some issues, and will issue an official statement to SEABHS by Feb. 2.
"They have responded appropriately," Cash said. "We'll see where we go from here. Ideally, the goal here is to make sure things get better down the road."
It may be a long road to recovery, however, since SEABHS must correct four years of financial issues, a lack of communication and pending indictments from the Attorney General.
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The following are comments from the readers. In no way do they represent the view of bensonnews-sun.com.
about time wrote on Feb 1, 2010 5:13 PM:
" Two and half years ago I brought some of these issues to the attention of Dana Johnson...guess I spoke to the wrong person. "
Current employee wrote on Feb 3, 2010 8:10 AM:
" I work at SEABHS and we are taking aggressive action to address CPSA's concern. One of the most effective "corrective actions" was to remove board member Varona, which occurred last week. The man was new to the board and never quite grasped some essentials of SEABHS. For instance, he complained that we didn't have the company's logo on vehicle.
Well, there's a federal privacy law, HIPPAA, which governs protected medical information, including anything that identifies someone as a client of a behavioral health agency. If I'm driving my vehicle and transporting a client, which I do on a very regular basis, the client sits in the back seat. (The passenger side has been shown to be the most dangerous seat in a vehicle. Also, I have my work piled there, so the back seat gives the client plenty of room.) What happens when I stop at a light and Joe X looks up and sees his friend sitting in the back of a SEABHS vehicle? Well, it doesn't take a genius to come to the conclusion to his friend, our client, is getting behavioral health treatment. That's why SEABHS vehicles don't have logos -- to protect the privacy of those we transport. And believe me, we transport a LOT of people.
Mr. Varone failed to grasp that simple concept, and he just did not "get" the role of a non-profit behavioral health agency. OK, he'd been some administrator for Nogales schools and some city official. Behavioral health is very different from those. Protecting the privacy and confidentiality are of utmost importance. Sadly, society at large still has a negative perception regarding people who need psychiatric treatment. At SEABHS, we take protecting clients' rights and confidentiality very seriously. "
Well, there's a federal privacy law, HIPPAA, which governs protected medical information, including anything that identifies someone as a client of a behavioral health agency. If I'm driving my vehicle and transporting a client, which I do on a very regular basis, the client sits in the back seat. (The passenger side has been shown to be the most dangerous seat in a vehicle. Also, I have my work piled there, so the back seat gives the client plenty of room.) What happens when I stop at a light and Joe X looks up and sees his friend sitting in the back of a SEABHS vehicle? Well, it doesn't take a genius to come to the conclusion to his friend, our client, is getting behavioral health treatment. That's why SEABHS vehicles don't have logos -- to protect the privacy of those we transport. And believe me, we transport a LOT of people.
Mr. Varone failed to grasp that simple concept, and he just did not "get" the role of a non-profit behavioral health agency. OK, he'd been some administrator for Nogales schools and some city official. Behavioral health is very different from those. Protecting the privacy and confidentiality are of utmost importance. Sadly, society at large still has a negative perception regarding people who need psychiatric treatment. At SEABHS, we take protecting clients' rights and confidentiality very seriously. "
Hypocrisy in action wrote on Feb 3, 2010 8:28 AM:
" I find it curious that Neal Cash, CEO of CPSA, is ordering SEABHS to take "corrective action." Perhaps Mr. Cash should take some corrective action of his own. While social service agencies struggle to survive, an Oct. 12, 2007 article in the Arizona Daily Star noted that his salary is $340,501, plus another $54,543. (He gets more in benefits than I earn!)
Perhaps if Mr. Cash were to to take a 25 percent pay cut (at least), more funds would be available for services.
It's curious to note in that Arizona Daily Star that CEOs/Executive Directors of all of the major behavioral health agencies (CODAC, La Frontera, SEABHS, COPE) were earning salaries well into the six figures.
The person who was making the least was -- Dana Johnson of SEABHS, who at slightly over $100,000 was making less than half of what her peers earned.
It would be interesting if the Star (or the News-Sun) would do a follow-up 16 months later to see what the salaries and "benefits" behavioral health agency CEOs were receiving. I suspect they've not been hit very hard by the recession.
Meanwhile, as ALL behavioral health agencies have been letting people go, I've yet to hear of anyone at CPSA being laid off. "
Perhaps if Mr. Cash were to to take a 25 percent pay cut (at least), more funds would be available for services.
It's curious to note in that Arizona Daily Star that CEOs/Executive Directors of all of the major behavioral health agencies (CODAC, La Frontera, SEABHS, COPE) were earning salaries well into the six figures.
The person who was making the least was -- Dana Johnson of SEABHS, who at slightly over $100,000 was making less than half of what her peers earned.
It would be interesting if the Star (or the News-Sun) would do a follow-up 16 months later to see what the salaries and "benefits" behavioral health agency CEOs were receiving. I suspect they've not been hit very hard by the recession.
Meanwhile, as ALL behavioral health agencies have been letting people go, I've yet to hear of anyone at CPSA being laid off. "
Move On wrote on Jan 28, 2010 9:10 PM: