Of the many chapters in the history of this country, perhaps the ugliest and most uncomfortable, is the plight of the Native American. As a healthcare ethics keynote speaker, healthcare ethics consultant and author, I find the unabated cycle of alcohol abuse and the lack of meaningful treatment services among the more unethical issues.
Healthcare issue?
The cycle of alcohol abuse among Native Americans has been the subjects of books, thesis and television programming. Deep rooted poverty, psychological problems, a lack of assistance and fraud have taken advantage of those without voices for the centuries. The issues have not gone away, merely been covered-up by disinterested politicians and the medical community.
In 2023 the cycle of abuse also includes massive Medicaid fraud by fly-by-night clinics. Arizona, by virtue of the large Navajo community presence has been beset by poverty, homelessness, alcoholism, drug addiction and despair. Instead of offering help, many treatment centers take advantage. It is not that Navajo alcoholics reject all forms of alcohol healthcare help; nothing could be further from the truth. It is that many native peoples have been badly burned.
The so-called sober-living homes range from excellent to frauds. In an article by Washington Post writer, David Ovale (September 18, 2023) we are introduced to 56-year-old Sylvia Foote. She is Native American, Navajo, a mom and an admitted alcoholic. She desperately wanted to gain sobriety. She was able to gain entrance to a sober home in 2021 that was a hotbed of bulling, physical abuse and fraud. For the Phoenix facility charged Medicaid thousands while “treatment” was virtually nonexistent.
“Addiction treatment,” Foote said, “consisted of long classes at a stuffy outpatient clinic owned by the same people that operated the sober home.”
The sober home closed; one of 200 outpatient clinics shut down for Medicaid fraud costing Arizona’s taxpayers hundreds of millions of dollars. Ms. Foote and her daughter went from homelessness to an abusive, unsafe environment to back out on the streets.
Her fate follows that of many Native American alcoholics and drub abusers, desperate for treatment, who found themselves stranded in towns across the Southwest, after sober living homes were shut down for fraud.
Stated the article (please read this important summary):
“Officials have described clinics allegedly billing for treatment services for children who don’t need help, or people who are dead or jailed. Clinics are suspected of falsely charging the state for patients who aren’t Indian under a Medicaid program for Native Americans. Recruiters in white vans are suspected of enticing Native Americans into group homes, sometimes plying them with drugs and alcohol, while offering little or no treatment, investigators said.”
As a healthcare ethics keynote speaker, healthcare ethics consultant and author I am outraged at the lack of oversight of the facilities and I too, call upon government to step in and criminally prosecute.
In Arizona more than 2,700 people overdosed and died in Arizona alone. Many of the addicted were dumped on the streets. Allegedly, the fraudsters make up to $1,200 per “resident” per day in these sober homes. There was an alleged ring that was caught in Nevada so they merely moved to Arizona. The amount of billing for the schemes runs into the hundreds of millions annually.
“It blows my mind there was no oversight. These are federal dollars,” Navajo Nation Attorney General Ethel Branch said. “Our people deserved as much care and concern for how services are being delivered to them.”
The “homes” literally hit the streets recruiting people. They shuttle the addicted victims to facilities offering them treatment. Nothing happens. It is incredulous that police and federal agents aren’t hitting the streets in counter-strike teams.
When there have been concerted efforts to go after fraudsters, the results are staggering. In just one case of a fraudulent agency owner, “Arizona’s Medicaid agency paid [Diana] Moore’s clinics $22.4 million. She purchased seven luxury cars, including four Mercedes-Benz vehicles, two Cadillac Escalades and a Land Rover Range Rover, plus dozens of other items, including designer purses, jewelry and art, according to court documents.”
Not one of the fraudsters who have been caught, cared in the least about helping any victim shake addictions. As a healthcare ethics keynote speaker, healthcare ethics consultant and author I wonder why the Federal Government has been so lax in these efforts. Then I think, forgive me for at least one conclusion, that the Federal Government has never been known for its ethical commitments toward Native Americans. It further troubles my soul.
