Disability services providers accuse state of leaving clients vulnerable amid fraud crackdown

Minnesota needs a better system to help vulnerable people who are losing services amid the state’s fraud crackdown, according to social service providers, who said Wednesday that a recent death shows clients are falling through the cracks.

The man was receiving help through the Medicaid-funded Integrated Community Supports (ICS) program, which helps adults with disabilities live independently.

The state paused payments to Relief Health Services, the Roseville agency supporting him, as it investigated fraud allegations against the company. State officials have suspended payments to a number of ICS providers since September, when officials said they found cases of agencies billing for services that clients weren’t getting.

The client was found dead Monday in his St. Paul apartment only after the smell from the body disturbed neighbors.

It’s not uncommon for people in programs like ICS to die, said Zahnia Harut, board chair of the Residential Providers Association of Minnesota, but the fact that the client was potentially alone for a week “is so inhumane.”

She said the Department of Human Services needs to stop withholding payments in residential programs like ICS unless the state has found alternative placements for all the residents at a facility.

The ICS program offers housing and supports for adults with disabilities. Providers are supposed to train and assist clients with things like budgeting, cooking, getting around the community and developing crisis prevention and problem-solving skills.

“We don’t condone the fraud. We know there has been fraudulent activity. But the impact should not be leaving folks, the most vulnerable people in our communities, literally out in the cold,” Robertson said.

For months, social service providers and disability advocates have been pressing the state to develop a coordinated plan to ensure people aren’t left without services if the DHS halts payments to the company working with them, said Josh Berg, who works for a different service provider, Accessible Space, Inc.

“That hasn’t been developed yet, and now we have death on the hands of the administration,” Berg said.

Temporary DHS Commissioner Shireen Gandhi said she doesn’t have specific information on the death, but said “any amount of harm, and certainly death, is very upsetting.”

“When we put a stop payment in place, the providers have responsibilities to the individuals that they are providing care for. So legitimate businesses should be treating and working with their clients in a responsible manner,” Gandhi said.

Harut disputed Gandhi’s comment and said providers are not obligated to find services for clients — that’s work the state and county case manager should take over. Harut said Relief Health Services followed the proper procedures to try to get help for their clients.

In Relief Health Services’ letter laying out what led to the client’s death, they said they asked for details about the allegations against them so they could provide evidence refuting fraud, but the state denied that request.

“Despite this denial, our agency worked diligently to secure alternative care. We contacted nearly every known ICS provider but encountered a lack of capacity or willingness to accept new clients. Our team spent days cold-calling, coordinating with case managers, assisting clients with applications, and providing transportation to facility tours,” the letter reads.

Copies of emails shared with the Minnesota Star Tribune show staff with the company repeatedly sought help from the state as they attempted to find alternative places for their clients and asked the state to temporarily reinstate their payments as they coordinated transitions.

Relief Health Services wrote in their letter that they last saw the client, who died on Dec. 9, when they went with the man to tour and apply for another ICS provider. They attempted to visit him Dec. 11 and 12, but no one responded at the door and they assumed he wasn’t home, the letter reads. He was found Dec. 15.