Medicare Billing

Re “Kaplan’s Return Needs 2nd Look,” Ventura County editorials, Oct. 3.

How can The Times blame Stephen Kaplan for the $15.3 million that the Ventura County Mental Health Department billed Medicare for the past nine years?

Kaplan was director of the drug and alcohol program from 1989 to 1996 before taking over as Behavioral Health director. Behavioral Health was a combination of the drug and alcohol and mental health departments.

Pierre Durand, Health Care Agency director, has been responsible for the billing throughout this time. He had been told a long time ago that the mental health clinics and medical facilities throughout the county were out of compliance with billing Medicare at the higher hospital reimbursement rate. Why, then, isn’t Durand being taken to task? He is the one person who should be answering to the (some) uneducated Board of Supervisors.

It must be remembered that Kaplan’s proposal was for the Behavioral Health Department to stand alone, an arrangement that had been adopted in several other counties before Ventura. One main reason Kaplan and the Mental Health Board majority supported this was that Behavioral Health was a cash cow supporting Ventura County Medical Center instead of using those funds to expand mental health services. Durand prioritized the solvency of the medical center at the expense of mental health by convincing the Board of Supervisors that it would be beneficial to transfer millions of dollars of mental health funds to the county hospital. If the clinics provide services to the private sector as well as Medi-Cal and Medicare patients, shouldn’t they generate enough revenue for the hospital?

The Times and other publications continue to report only one side of this dysfunctional situation. As audits have suggested, staff (former or current) are petrified to speak for fear of retribution.

Hopefully, the grand jury will get to the truth. The voters should and will remember the ill-informed criticisms and comments by some of this county’s supervisors. Election results will confirm that several did not do their homework.

It is time that Ventura County care about our special needs citizens, both mentally challenged and substance dependent. It is crucial that the politics be put aside. It is time for more education, prevention and treatment.

It is time for the Board of Supervisors to make Pierre Durand responsible and accountable for the $15.3 million.

LYNN WITHERN

Ojai

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The editorial staff of The Times owes an apology to its readers and to Stephen G. Kaplan for its inflammatory and inaccurate editorial of Oct. 3.

The editorial blamed Mr. Kaplan for the loss of $15 million of county money during the merger of mental health and social services. This money, however, was the settlement of a federal lawsuit over improper billing practices from 1990-99, of which the merger was only the last eight months.

Furthermore, in my opinion, the Board of Supervisors settled this lawsuit too quickly. The so-called “illegal” billing was actually a new way of providing mental health services that was carefully thought out with technical assistance from the state Department of Mental Health. This was a new way of doing business with the federal government that was done publicly with no intent to defraud. This method was copied by counties throughout the state because of its innovative nature.

The lawsuit should have been defended with the state’s assistance, but the board settled quickly to try to avoid further penalties for improper billing for satellite medical clinics. By giving up this money, and even more importantly by allowing the removal of the previous administration including Steve Kaplan, the Board of Supervisors has crippled the system of care for the mentally ill in a failed attempt to cover up separate Health Care Agency improprieties.

Rather than fueling the fires that are consuming what was once a state-of-the-art public mental health system by printing provocative editorials, The Times should be investigating the true causes of this “disaster,” such as the politics mentioned in your editorial.

PHILIP MALINAS

Former medical director

of Children’s Mental Health

Ventura County