A firm accused of mishandling its taxpayer-funded health services for mentally ill homeless people, and so far has declined to publicly respond to the claims, was granted a $2 million expansion this week by Orange County supervisors.
Telecare Corporation, a privately-held contractor based in the San Francisco Bay Area, has received at least $15 million in Orange County government contracts since last March focused on mental health services for homeless people with serious mental illnesses.
The company has been the subject of complaints of failing to provide health treatment it was supposed to, not cleaning dirty rooms at a facility it was overseeing, and unnecessarily escalating a situation with a patient into a physical confrontation. Telecare has repeatedly declined to respond to questions from Voice of OC since the accusations surfaced last summer.
A grand jury in Santa Cruz County last year found a lack of county oversight over Telecare’s contract there, and noted a local National Alliance on Mental Illness (NAMI) report from 2016 expressing concerns about the company’s care for patients. Those concerns included services seemingly “in disarray” after a “significant” turnover in the company’s regional leadership, according to the NAMI report.
A member of the Orange County Mental Health Board said last year Telecare was not providing actual treatment at the Baymont Motel, where the county hired Telecare to provide mental health services to homeless people who had been required to leave the Santa Ana riverbed.
And in December, a Telecare employee publicly told the Orange County Board of Supervisors the company “failed” homeless people despite the taxpayer money it was receiving.
Telecare representatives declined to comment last year when the allegations were raised, and didn’t respond to messages Wednesday seeking comment.
Board Told Homeless Reported Being Treated Badly
On Tuesday, Orange County supervisors were scheduled to vote on a $2.1 million expansion to the company’s existing contract, which runs through June 2020. The extra money is for outreach and to purchase two vehicles – one to “provide outreach and identify potential individuals in need” and another for providing mental health treatment, according to the county staff report.
Before supervisors took their vote, three residents who work closely with homeless people told the supervisors that many homeless patients reported they were treated badly by the Telecare’s staff.
“They were kept in jail-like conditions, deprived of outside contact, deprived of food – while being mentally and physically assaulted by staff,” said Jeanine Robbins, an Anaheim-based resident and homeless advocate, referring to treatment of homeless people at the Baymont who were supposed to receive services from Telecare.
“Not one more penny should be given to Telecare. In fact, they should be prosecuted for their treatment of the homeless population that were placed in their care,” Robbins said.
Thomas Fielder, an Anaheim resident who delivered food to people at the Baymont, told supervisors homeless people there described the company’s treatment of them.
“I heard their horrible descriptions of how they were treated. I have to wonder, where is the oversight here? Who’s evaluating Telecare? Who’s evaluating their performance? And what performance measures should we use to evaluate them?” Fielder said.
“Has anybody gone out and interviewed the homeless to see the actual clients of Telecare, to see what they think? I doubt it because otherwise you you wouldn’t give a second thought to firing these people. They treat their clients horribly. There’s no excuse for giving them more money. So don’t do it.”
Question of Oversight
Supervisor Andrew Do pointed to data in the staff report, saying it showed the people served under Telecare’s contract experienced “significant declines” in the number of days they were hospitalized, in jail, or homeless.
“That information speaks for itself,” Do said. “But the last speaker posed a very thoughtful question, [which] is, who’s providing the oversight and what oversight is given? Like, for instance, at the Baymont?”
Richard Sanchez, the county Health Care Agency director, replied his agency’s staff provides oversight to make sure Telecare is complying with its duties under the contract. Decisions on whether to cancel contracts and change vendors are up to the county Board of Supervisors.
Supervisor Doug Chaffee asked county staff if there is an alternative option from Telecare, and what the alternative is.
“I’m sure there are other providers,” Sanchez replied. “We have a contract with Telecare currently. So this [proposal is] additional funding for services related to full-service partnership, FSP. So it’s an expansion of an already-existing agreement we have with Telecare.”
There were no follow-up questions about alternative vendors.
Telecare is authorized to serve up to 200 people, and 80 people were currently enrolled, said Annette Mugrditchian, chief of operations for county Behavioral Health Services, under the Health Care Agency, in response to a question from Chaffee.
The supervisors – Do, Chaffee, Lisa Bartlett and Michelle Steel – then voted 4-0 to authorize the $2.1 million increase to Telecare.
“It is concerning that despite consistent concerns from every angle and regularly finding Telecare clients in streets or shelters instead of [permanent supportive housing], they did not even open the bid to hear from other [vendors],” said Brooke Weitzman, one of the lead attorneys representing homeless people in an ongoing federal civil rights lawsuit.
Joy Torres, who serves on the county Mental Health Board as a representative for people who receive mental health services, told Voice of OC last year there was no real treatment happening at the Baymont, and that Telecare and motel staff wouldn’t allow people to visit people staying there.
“They never implemented treatment,” Torres said last May, adding Telecare didn’t have a treatment program until Thursday, May 17, despite the company’s county contract for Baymont services starting in March.
“They kicked out a lot of [people], because they really need a lot of help,” Torres said at the time.
Robbins and other advocates also raised specific allegations about Telecare at the May 8, 2018 supervisors’ meeting.
“The county has failed again while spending huge sums of money,” Robbins told supervisors regarding the Baymont. “Basic food is not adequate nutritionally. Peanut butter and jelly sandwiches are given to those who have a fatal allergy to peanuts. Donuts [are served] for breakfast.
“There’s no refrigerator or cooking abilities in any room. Just yesterday a refrigerator was delivered by a private citizen for a diabetic woman who has to have [her] insulin stored. The staff was so hostile about accepting the refrigerator to store in their offices for her medication,” she added.
“[There are] reports of taking their [electronic food stamp] monies or their food allowance, disqualifying them for general relief,” Robbins continued. “So I would hope that maybe somebody would get over there and investigate what is happening. Advocates have been banned. We had a flatbed trailer yesterday that had thousands of pounds of food from the food bank to give to those residents there, and it was not allowed on property.”
At the end of Robbins’ comments, then-Supervisor Todd Spitzer asked county CEO Frank Kim if he could “make sure your staff looks into those particular allegations and get back to the board?”
“Absolutely,” Kim replied.
County spokeswoman Jen Nentwig said later that month an investigation was completed regarding the concerns raised at the May 8 supervisors’ meeting. She declined to say what it found.
In a July 2018 federal court filing, Weitzman and her colleague Carol Sobel said Telecare’s services at the Baymont “fail to meet even minimum standards of care.”
“Only the Baymont, operating out of fear and ignorance, stripped the rooms of all amenities, even sheets and shower curtains at the outset, treating people as if they were in a locked-down facility even though they were guilty of no crime. The phones were removed from all of the rooms, leaving people unable to call for emergency assistance,” states their court filing, which was an update to their lawsuit complaint.
“Once individuals were assessed as [seriously mentally ill] and placed at the Baymont, they did not receive supportive treatment. Except for one day when a nurse practitioner came to the motel, no other medical support was provided,” the court filing states.
“Telecare asked clients to sign an onerous ‘contract,’ with conditions that violated fundamental constitutional and statutory rights, including an agreement in advance to excuse Telecare from any liability for anything and everything that might occur at the placement,” the filing states, adding, “Initially, people at the Baymont were left without food for weeks.”
Nick Gerda covers county government and Santa Ana for Voice of OC. You can contact him at ngerda@voiceofoc.org.