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CARP owes state $130K; patients being moved to other treatment centers

Financial and patient records were so poorly kept at CARP and efforts to correct them were so lacking that Florida penalized CARP — Palm Beach County’s oldest substance abuse treatment center for the poor — $14,000 in May 2014, according to a state oversight agency.

Reports obtained by The Palm Beach Post on Monday show that problems leading to CARP losing its $3 million in state funding this year include failing to test incoming patients for tuberculosis and sexually transmitted diseases; violating a patient’s HIPAA privacy rights; poor coordination of care, including prescriptions, for patients with mental illnesses; and revoking promised privileges for patients who made progress in their recovery, including denying daily phone calls and cutting one-hour family visitation to 30 minutes.

Since losing its state funding on Jan. 20, CARP has been forced to find alternative treatment programs and housing for its patients.While the exact number of people affected is unclear, CARP has estimated it serves more than 3,500 addicts and alcoholics a year in its residential and out-patient programs for the poor and homeless in Palm Beach County.

Ann Berner, CEO of the Southeast Florida Behavioral Health Network said her agency, which distributes and oversees funding from the Florida Department of Children and Families for Palm Beach County and Treasure Coast substance abuse programs, is keenly aware of CARP’s mission and the impact it would have on the community should CARP be forced to permanently shut its doors.

Berner said she attempted to work with CARP for 18 months to bring the center into compliance with state regulations, even penalizing CARP “to get the (CARP) board’s attention.”

“We did a financial penalty against their May invoice for not even making progress toward compliance,” Berner said. “CARP definitely was not a quality provider or compliance provider.”

CARP did not provide financial statements or a budget, which are needed for her agency to determine rates for future patient services, Berner said. A review of CARP’s finances from 2013-2014 revealed that CARP over-billed for services, Berner said.

Services for certain patients are supposed to be bundled, meaning the state pays a fixed amount for treatment, room and board. However, CARP billed the state separately for services included in the bundled amount, Berner said.

The agency required CARP to return $186,659 in overpayments. By the end of December, CARP had repaid $55,998 but still owed the state $130,661, according to a memo sent to the agency’s board.

In January, CARP demanded that the network pay for services it provided during the last 10 days of December. Normally, CARP submits an invoice to the network at the end of the month and is paid about three weeks later.

But Berner made an exception in December and allowed CARP to be paid early — for the first 20 days of December — because CARP was strapped for cash after making a large insurance installment payment, Berner wrote in the memo to her board. The remaining 10 days would be paid in the usual time frame, Berner said she told CARP officials.

But on Jan. 12, an attorney for CARP contacted Berner and demanded payment to CARP for the last 10 days of December by 1 p.m. The next day, Berner received a written notice threatening a lawsuit if payment was not made by 4 p.m.

“The financial circumstances of CARP appear to be so tenuous that they have retained “outside counsel” to demand immediate payment,” Berner wrote in the memo. On Jan. 20, the network’s board voted to cancel the state’s contract with CARP and to withhold payment for the last 10 days of December and put that money toward the $130,661 that CARP still owed for overpayments in 2013-2014.

Berner said the network has encountered other groups with problems but none as unwilling to make changes as CARP. As for the $3 million in state funding that CARP lost, the money has been divvied up among other substance abuse providers, including the Drug Abuse Foundation, Gratitude House and Wayside House, Berner said.

The chairman of CARP’s board of directors, Todd Weintz, declined to comment on Berner’s findings but said “more will be forthcoming — there is more to be told.”

Kelly Landers, CARP’s treasurer, also declined to discuss details but issued a statement saying CARP is “continuing to work diligently and cooperatively with SEFBHN to cure all deficiencies, to provide for the safety of our clients and ensure the longstanding mission of CARP.”

Victoria Nemerson, who became executive director of CARP in October, declined to answer questions, saying only that she left CARP on Monday. Nemerson succeeded Bob Bozzone, who had served as executive director since 1978.

CARP’s recent problems began 18 months ago, when DCF contracted with Southeast Florida Behavioral Health Network to manage contracts and grants it has with local mental health service providers. Before the network, DCF did its own review of the organizations it funded.

“I think DCF recognized they didn’t have the man-power to provide basic accountability because of lost staff and budget cuts,” Berner said. Some groups were not accustomed to the network’s close scrutiny. When non-compliance issues were found, the network attempted to work with the groups to bring them into compliance.

Berner said she could not make headway with officials at CARP.

“I wish we had been able to get through to the board sooner,” Berner said. “I think people with different agendas clouded the way.”

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