Virtual Ruckus

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"Now that the process is over, I wish we'd taken the time to compare the scores and discuss them," says Lisa Brabo, director of aging services for the Denver Regional Council of Governments and a member of the review committee. "I can't recall ever having been involved in a [contract] situation where people disagreed so radically on the scores."

More troubling, to some observers, was the failure to include anyone on the committee who actually used home-care services. "The clients should have been allowed to participate in this," says Julie Reiskin, co-director of the Colorado Cross Disability Coalition, a statewide disability-rights organization. "It was a really fast process, and nobody from the community was invited."

Pring counters that the committee was "broad-based" and included one "exceptionally disabled" administrator who has used long-term-care services in the past. "I don't know how I would have chosen consumers," she says. "I've got the Arthritis Foundation, the multiple sclerosis organizations--it goes on and on."

Reiskin praises Adult Care as a progressive company that supported "client-directed programs" and attracted competent, caring staff and supervisors. In her view, the virtual-office concept had the potential to give clients more access to case managers, not less. "I don't think clients care where case managers do their paperwork," she says. "So much of the contact is in their own home. To me, this [contract change] is like saying, 'Let's keep doing the same old thing, because it's more lucrative.'"

By contrast, Reiskin says, Home Care executive director Florence Jones "hasn't made an effort to get to know the client community." She says her group has fielded several calls from elderly residents who've encountered difficulty obtaining services from Home Care since the contract changed hands July 1.

"There's a problem system-wide with case managers not being properly trained," Reiskin says. "I worry about people being needlessly institutionalized or being denied services when they should have them."

Lucile Weiss also questions Home Care's performance. An American Association of Retired Persons activist and Adult Care boardmember, she charges that Adult Care received dozens of complaints from former clients, as much as one per hour, during the first few weeks of the transition--complaints about not being assigned case managers or not knowing how to contact them, about being told that it would take months before they could obtain services. "We recommended that they call Home Care, and they'd call back to say they couldn't reach anybody," Weiss says. "All they got was voice mail or being put on hold."

Home Care's Jones, though, counters that the transition has gone quite well. She says she was scheduled to meet with Reiskin's group but was bumped off the agenda until later this year. And she insists no clients have been left begging for services. "We have not received any complaints," she says. "Not from consumers."

Pring says she's aware of only two complaints--both of them referred to her by Reiskin. Home Care wasn't fully staffed on the day the contract began, she notes, but the company has met all of the city's deadlines for the transition. "Were they functioning perfectly when they started? Of course not. No more than Adult Care did when they first got the contract."

The biggest problem in the transition, she adds, wasn't Home Care's scramble to hire and train qualified case managers, but the "bad blood" between the two competitors. "Once it was announced that Adult Care hadn't gotten the bid, things began falling apart," she says. "Staff quit--not surprisingly. Staff were demoralized. There was a lot of finger-pointing, a lot of frustration. I spent a considerable number of sleepless nights sorting it out.

"If there had been any kind of positive communication between Adult Care and Home Care, an easier transition might have been worked out, but there wasn't."

Through its attorney, Adult Care protested the contract award, arguing not only that the scoring process was "fatally flawed," but that Home Care lacked the resources to perform. (Home Care, which also has contracts with Arapahoe, Douglas and Elbert counties, hired dozens of new employees for the Denver contract, including twelve former Adult Care case managers.) Adult Care also contends that its rival's potential conflict of interest should have disqualified it from consideration; under a state waiver, Home Care also provides direct health-care services in other counties but has pledged not to refer cases to its own "providers" under the Denver contract. Both Jones and Pring say that the contract will be closely monitored and that the potential conflict is a non-issue. After review by Pring, the city attorney's office and the city purchasing office, the appeal was denied.

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Alan Prendergast has been writing for Westword for over thirty years. He teaches journalism at Colorado College; his stories about the justice system, historic crimes, high-security prisons and death by misadventure have won numerous awards and appeared in a wide range of magazines and anthologies.
Contact: Alan Prendergast