COUNCIL OF THE CITY OF PHILADELPHIA2 COMMITTEE ON LEGISLATIVE OVERSIGHT3 Room 400, City Hall6 Philadelphia, Pennsylvania Wednesday, November, 17, 20107 11:20 a.m. PRESENT: COUNCILMAN JAMES KENNEY, CHAIR10 COUNCILMAN W. WILSON GOODE, JR. COUNCILMAN WILLIAM K. GREENLEE11 COUNCILMAN CURTIS JONES, JR. COUNCILWOMAN JOAN L. KRAJEWSKI12 RESOLUTION 100725 - Resolution authorizing City Council's Committee on Legislative14 Oversight to hold public hearings to investigate how the Risk Management Division15 of the Finance Department manages its relationships with Third Party Administrators16 who provide services for City employees who are injured on the job.17 - - -19 2
Good2 morning, ladies and gentlemen. This is3 the Committee on Legislative Oversight,4 which is dealing with Resolution 100725,5 which is authorizing City Council's6 Committee on Legislative Oversight to7 hold public hearings to investigate how8 the Risk Management Division of the9 Finance Department manages its10 relationships with Third Party11 Administrators who provide services for12 City employees who are injured on the13 job.14 This hearing is a result of a15 number of years of ongoing communications16 with the Finance Department, with Risk17 Management, either making inquiries as to18 how a company that's established in the19 City, that's been doing business in the20 City accesses this potential work with21 City employees on one hand and, on the22 other hand, why companies that have been23 involved in providing this service to24 City employees, out of the blue25 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 sometimes, wind up being eliminated from2 the system, from the program, without3 prior notice, without any intercession on4 the part of Risk Management to find out5 what it is they are not happy about or6 what the Third Party Administrator is not7 happy about regarding the services8 provided by these companies, and on a few9 occasions, which we will discuss here10 today, these companies have basically11 been eliminated from the system with no12 notice, no warning, no intercession as13 far as how do we fix your issues, what14 you're doing or not doing right that15 we're not happy with, and in one16 circumstance, after three weeks of having17 no patients sent to them, the Business18 Manager for the company called Risk19 Management and was told that, by the way,20 you're out.21 We don't believe that that is22 the transparent way of doing this type of23 business and that we have longstanding24 companies in the City that have provided25 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 services or want to provide services to2 City workers and, for some reason or3 another, cannot get an answer as to why4 they can't get in or how they got out.5 So initially we were going to6 go with the Administration first, but7 I've decided that I'd like to bring up8 some of the people who have complained to9 me or I've had interaction with to10 determine just exactly how it happens11 that you get on and just exactly how it12 happens that you get off and what happens13 in between that period of time. And when14 you cannot access the system, if you're a15 longstanding provider of such services,16 what are the factors involved in you not17 getting access to providing services to18 City workers.19 So this is kind of an20 investigative hearing. Hopefully it will21 bring some enlightenment to the process,22 but at some point in time, if we can't23 figure out what it is that goes on, there24 will be legislation that will be drafted25 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 as a result of this hearing to determine2 how we fix this system and what exactly3 is going on with it.4 So we do not need a quorum5 today, because this is a hearing on a6 resolution, but in attendance is7 Councilman Goode, myself, Councilman8 Kenney as the Chair, Councilman Greenlee9 and Councilman Curtis Jones.10 I would like to ask11 representatives from Citywide Physical12 Therapy, Episcopal and Northeastern13 Occupational Medical Group, and Premier14 Comp Services, if they're here, could15 they please come forward.16 (Witnesses approached witness17 table.)18
You can use19 some of the other seats here and then20 we'll rotate. You can use some of the21 black seats.22 And just for matter of23 disclosure for the purposes of this24 hearing, I am an ex-officio member of the25 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 Board of Independence Blue Cross. I did2 not realize until the other day -- or I3 may have known in the past, but didn't4 realize that Blue Cross is an owner of5 CompServices. So I want to make sure6 that the record was clear that I'm7 disclosing that at this moment. And I8 don't see really any issue relative to my9 sitting on the Blue Cross Board, but I'd10 rather it be known for the record than to11 be discovered later on.12 What I would like the panel to13 do is to kind of talk about your company14 a little bit, the history of your15 company, what it is -- what services you16 do provide, how long you've been17 providing them, the number of employees18 you have in your company, where you're19 located and your experience either in20 trying to get into the system or having21 been removed from the system and what you22 think are the issues surrounding the23 current circumstances.24 So whoever would like to go25 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 first.2 And if any other Councilmember3 has anything they'd like to start with.4 (No response.)5
We'll ask6 you to identify yourself for the record7 and, within those parameters, please8 proceed with your testimony. And please9 pull the microphone close to you.10
My name is John15 Mohollen. I'm from Citywide/Progress16 Physical Therapy, Director of17 Rehabilitation Services.18
Could you19 please, again, as I listed some of the --20 so for background information, how old21 the company is, what you provide, where22 you're located, what your relationship is23 with the City or has been with the City24 or is no longer with the City and what25 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 your concerns are relative to the2 situation.3
13 My name is John Mohollen. 15 Real quick, please allow me a16 moment to give you a brief history of our17 operation. Citywide/Progress Physical18 Therapy was founded over ten years ago,19 has 75 employees in our eight20 Philadelphia and surrounding area21 locations. We provide physical,22 occupational, hand, aquatic therapy and23 free patient transportation to assist and24 rehabilitate hundreds of people daily25 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 3 In January 2009, our Northeast4 clinic began providing physical,5 occupational and hand therapy services6 for injured City of Philadelphia7 employees who work in Northeast8 Philadelphia under the auspices of9 Premier Comp Solutions, LLC, contracted10 by the City of Philadelphia Department of11 Risk Management. Our Northeast clinic12 has employees who treat 250 patient13 visits a week. 17 By all accounts, the work18 performed by our physical and certified19 hand therapists with regard to injured20 City of Philadelphia workers exceeded the21 treatment guidelines and was reflected by22 referring three to five new patients per23 week from Premier Comp Solutions. Our24 working relationships with the panel25 10 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 physicians and case managers through2 non-compliance and weekly therapy updates3 was excellent, as were our efforts to4 control costs associated with providing5 these services. Since the services we6 were providing were so successful, hand7 and physical therapy referrals8 increasing, we needed to hire a second9 certified hand therapist and another10 driver to handle the increased11 transportation volume. 19 This success and commitment20 makes our recent termination as a panel21 provider for the City of Philadelphia22 even more confusing and frustrating. Our23 efforts received no notice -- I'm sorry;24 our offices received no notice whatsoever25 11 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 6 More upsetting is that the7 termination came to our attention only8 because we noticed the City employees9 referred to our facility dropped to zero10 over the course of the past month. As I11 am sure you are aware, this is no way to12 conduct business. 18 In closing, it is our hopes19 that the Committee on Legislative20 Oversight could assist us in getting21 answers as to why our contract was22 terminated without cause or merit. Based23 on our past success in providing these24 services, our clinical performances, the25 12 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 11 I'd like to thank Councilman12 Kenney and Councilwoman Krajewski for13 their guidance with this issue and14 members of the Committee for listening to15 my testimony. 20
So I21 understand your testimony, you were22 reading it, you indicate in your23 testimony that Premier Comp Services had24 never contacted you about the termination25 13 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 or the impending termination?2
Well, they did3 after three weeks of no -- three to four4 weeks of no patients. We noticed that5 the referrals were dramatically down.6
But did7 anyone from Premier Comp Services or Risk8 Management contact you and say, We're9 unhappy with your rate of return relative10 to the employee coming back to work,11 we're unhappy with the price that you're12 charging, we're unhappy with the services13 you're providing? I mean, was there any14 interaction, interface between Premier15 Comp Services, the administrator, and/or16 Risk Management Division?17
No19 complaints that you were aware of from20 employees that had come and received21 services?22
And no24 complaints from physicians who were25 14 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 referring?2
No. They were3 very happy with our outcomes. In fact,4 we took it a step further to build our5 relationship with Premier Comp in the6 fact that we flew out to Pittsburgh,7 tried to get an understanding of their8 systems, what we could do better to9 better serve the --10
Councilman15 Goode has -- we'll question you and then16 move down on those.17 So Councilman Goode, please.18
Thank you,19 Mr. Chairman.20 Thank you for your testimony.21 I agree this is no way for the City or a22 City contractor to do business, but I'm23 curious about a couple things you said in24 your testimony.25 15 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 Can you explain how you2 discovered that you weren't receiving3 referrals and how long it took for you to4 discover you weren't receiving referrals5 and what portion of your business the6 referrals account for?7
It was four8 weeks basically without receiving any9 physical therapy -- I mean, any referrals10 from Premier Comp Solutions, and the11 average weekly referral was three to12 five, and over 250 visits, it's about13 25 to 30 percent of our business, overall14 business. More importantly, because we15 have two certified hand therapists, that16 represents over 50 percent of our visits17 a week.18
So it took19 you four weeks to discover there were no20 referrals?21 (Witness approached witness22 table.)23
Pull up one24 of those chairs and identify yourself for25 16 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 the record.2
My name is3 Dean Hutchinson. I'm the Facility4 Director at 8019 Frankford Avenue,5 Citywide/Progress.6 The process he's discussing, it7 was over a four-week period that our8 referrals went from three to five a week9 to zero, and we in fact had set up a10 lunch to go out to Pittsburgh to meet11 with Premier Comps again. And we had12 called them to follow up on the lunch13 that we had set up and also asked what14 was going on, and that's when we were15 informed by Sharon, I think, that they16 just found out that both they and us had17 lost the contract.18
Premier Comp21 Solutions. So that's how it came about.22 They hadn't told us because I don't think23 they knew. But over three weeks, we got24 no patients, so we were calling to say,25 17 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 Should we come out to have a lunch to2 meet with you guys if we're still with3 you, and that's when everyone found out4 what had happened.5
But6 Progress and Premier are two separate7 companies?8
Fine. All10 right. I think Councilman Goode's11 question was why did it take four weeks12 for you to determine that you weren't13 getting anybody. I mean, was that14 something that --15
It's really16 just for informational purposes, how long17 it took for you to figure it out, what18 was the drop-off. I mean, was it -- was19 there a minimal drop-off for the first20 three weeks, what was the drop-off, and21 then again, because it does account for22 25 percent of your business, I don't23 understand how you don't notice it right24 away.25 18 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
And I'll let --2 I noticed it after the first week. I3 spoke to Erica Kopcha, who has the4 relationship with the Case Manager,5 Sharon Kress, from Premier Comp6 Solutions. She had called up there. And7 then where they had said -- she'll have8 to speak to what was said, but it9 basically came back to me that, no,10 there's no problems, it's just slow.11 Then two more weeks went by, and that's12 when I said, Maybe we need to set up a13 lunch and go out, because obviously14 there's something wrong, and that's15 when -- after that period, that's when we16 had found out that we were --17
Of course,20 over -- yeah. It stopped the following21 week from three to five referrals to22 zero.23
Okay. Thank24 you.25 19 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
But your2 initial inquiry was that it was slow.3 The answer to your initial inquiry on the4 drop-off was a slowdown?5
My name is Erica10 Kopcha. I'm the Director of Hand Therapy11 Services at Progress Physical Therapy.12 There's variation from week to13 week depending on caseload, and we can14 expect there would be some type of15 variation. So there were periods where16 we were a little bit slower, and so we17 accounted that or attributed it to that18 for the first week to two weeks. After19 that, it was so dramatic that we knew20 that there was some issue and that there21 was something else that we needed to look22 into. At that point, I contacted Premier23 Comp Solutions to try to set up a lunch24 to see if we could sit down and discuss25 20 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 if there were any issues that we were2 having so we could address those issues,3 and at that point, that's when we were4 notified that we were dropped.5
Now, so6 it's not confusing, because there's a lot7 of CompServices and Premier,8 CompServices, Inc. is the Third Party9 Administrator for the City?10
When it16 comes to Progress, before we get to17 Premier, is there any complaint18 mechanism, I mean, from CompServices,19 Inc. or from the City, any contact of20 dissatisfaction or inquiries, utilization21 inquiries, pricing inquiries, the length22 of time a person is getting service? Is23 there any of that, what's going on,24 explain this particular case?25 21 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
Premier Comp5 Solutions would regularly be in contact6 with our facility, weekly.7
You're not11 the Third Party Administrator for the12 City?13
No. I'm Third14 Party Physical Therapy Network.15 CompServices is the --16
So you have25 22 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 a subcontract with CSI?2
I have a contract3 with CSI and there's an addendum that was4 put into effect in August of 2008 by CSI5 on behalf of the City of Philadelphia.6
Okay. So7 any complaints or concerns would be your8 contact with Progress?9
Right. Progress10 is one of our network providers that's11 contracted with us, as are the other12 physical therapy providers in our network13 across the State of Pennsylvania.14
So if there15 were issues relative to Progress, you16 would be the person contacting or someone17 in your office --18
What24 contacts were there relative to25 23 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 dissatisfaction or complaints?2
Well, again, there3 were weekly progress reports that our4 company would supply to Premier on a5 weekly and ongoing basis. If there were6 specific issues, they would call us, talk7 specifically to the therapist, if there8 was issues related to length of patient9 care, explanations to how that care was10 utilized, and obviously we would make11 those needed changes on a case-by-case12 basis. But I think overall, we had very13 few of those kinds of interactions,14 because our care was exceptional.15
I would say maybe18 one to two times a month maybe we would19 get some feedback either through phone or20 e-mail.21
And how22 long did Progress provide services to23 City employees in this manner, how many24 years?25 24 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
Thank6 you, Mr. Chairman.7 Just a basic question. You may8 have said this and I may have missed it.9 With Progress, who was the contract or10 the agreement with? Is it with --11
And what14 stipulations or terms were in there as15 far as notification or anything, or was16 there a timeframe in this? I mean, how17 long did the agreement -- was there a set18 timeframe?19
So when24 was it up?25 25 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
And was15 there anything in there about ending it16 if you didn't meet certain goals or17 anything like that?18
There was a19 60-day notification from either party20 that they could terminate the contract.21
No. We haven't24 been terminated from Premier Comp25 26 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 Solutions. Premier Comp Solution was2 terminated from --3
So you were8 technically still under contract, but9 without any patients?10
Right, because11 Premier Comp Solutions lost the City12 contract.13
I'm17 getting confused here myself. But with18 Premier, did you -- what was your19 contract with the City? Kind of the same20 question I just asked.21
We had a Physical25 27 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 Therapy Network contract.2
You have to3 pull the microphone close to you and pull4 it down so you're speaking directly into5 it.6
We've had a7 Physical Therapy Network contract with8 CompServices for approximately seven9 years. Two years ago -- well, in August10 of 2008, CSI contacted us to do a11 separate agreement on behalf of the City12 of Philadelphia at a much lower,13 discounted rate. We were giving14 CompServices a 17 and a half percent15 discount off the fee schedule for all of16 their clients statewide, but then they17 asked if we would go 30 percent below18 that, which approximately 47 percent19 below the fee schedule, if we wanted to20 get the City work, which meant21 approximately $95 a day. It was the best22 rate that we would ever -- I had to23 really think hard about this, because the24 margins were thin, but I thought about25 28 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 the volume and the volume that could be2 given to the City providers, the physical3 therapy providers located in the City,4 and I felt that with the volume, it made5 sense to do the contract. So I entered6 into that contract in August of 2008.7
No. CompServices14 didn't terminate their contract. City of15 Philadelphia didn't terminate the16 addendum. In that contract with17 CompServices, it states that they can18 cancel for any reason with 90 days'19 notice, and if we breached the contract,20 they -- I actually attached the contract21 in the folder, so you have them. But22 also says that if we breach the contract,23 they can cancel immediately, but --24
But have25 29 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 you ever officially been told you were2 cancelled?3
No. They never4 cancelled it. They still use us. We5 still get referrals from CompServices,6 but City of Philadelphia removed us from7 the panels before notifying us.8 Okay. Here's what happened:9 We were blind-sided on October 12th. I10 received a phone call from Carrie Blouse11 from CompServices, and she said, I don't12 think anyone told you this, so I'm going13 to tell you this. The City removed you14 from the panels, their panels, your15 network, yesterday or last Thursday. We16 just found out about it from the City17 last Thursday. And this was a Tuesday,18 October 12th.19 And I said, What? I was20 blind-sided. What do you mean? I had21 never received even one complaint. I22 send monthly utilization reports,23 physical therapy utilization reports to24 the City. We saved the City $518,000 so25 30 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 far in 2009 below the fee schedule. We2 saved them another 509,000 already as of3 September 30th, which we projected to4 save them 650,000. There was never an5 e-mail or phone call or any6 dissatisfaction. Tell me why.7 She said, I really don't have8 an answer for you. You're going to have9 to contact Barry Scott from the City of10 Philadelphia.11 I said, Now, why would you12 reissue the panels and get them out there13 so I can't fix it? Like I felt I was14 already behind the eight ball. You call15 me after you reissue the panels. So the16 panels -- all our providers - Progress,17 Aquahab, Bustleton, Outreach - were18 removed from the panels, didn't give me19 an opportunity to discuss it with them so20 they would understand that they were21 going to lose the volume.22 I pleaded with her, because23 getting the City with this utilization24 control program they wanted required us25 31 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 to hire a full-time physical therapy2 director, which cost us $100,000 a year.3 It's one that I never had before and4 didn't hire until January of 2009.5 I said, Do you understand I6 have contracts with him? I can't just7 say, Hey, I don't need you anymore. I8 need some notice. The contract says -- I9 know you can cancel for any reason, but10 it says in the contract 90 days. You can11 cancel for any reason for 90 days, but12 you haven't done that.13 The answer was, We are not14 cancelling our contract with Premier Comp15 Solutions. The City is just not using16 you.17 I said, Well, geez, it's the18 same effect. You abruptly stopped using19 us. I would like to have a reason,20 something believable that I could convey21 to our network providers, Progress/Wide22 Physical Therapy and the others. And23 Carrie deferred me. She said that we did24 an excellent job, CSI valued their25 32 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 relationship with Premier Comp, that I2 had to respect the fact that the City of3 Philadelphia was their client and they4 had to follow their directives, and if I5 wanted answers, I had to contact Barry6 Scott.7
The8 impression that I've gotten in my9 conversations and staff conversations in10 my own with various people in the11 Administration is that CompServices, Inc.12 was contracted and hired to kind of be13 the clearinghouse for all this, that they14 were the ones making the decisions --15
-- on17 whether or not a company came on board or18 a company left, and it kind of took the19 City kind of out of the decision-making20 process directly, because they didn't21 want to make it look like they were being22 favorable to one person or another, one23 company or another. So this kind of24 generic CompServices, Inc. would make25 33 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 decisions to bring people in or let2 people go, just without any influence3 from the City.4 That's not the impression I'm5 getting from your testimony, and, that6 is, that CompServices is telling you,7 Hey, look, we really don't have any8 complaints with you, we've been told by9 the City you got to go.10
We're not13 going to send you any more.14 So my concern has been and the15 reasons for this hearing is that, is it16 CompServices, Inc. that's making the17 decisions on adding a company to a panel18 or removing them, or is it the City19 telling CompServices who they want on and20 who they want off?21
I haven't been22 able to get a straight answer on that23 and -- I believed what Carrie told me at24 the time, but I had a subsequent25 34 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 conversation with her that said, Well,2 that's not entirely true. So I guess I'm3 here today to find out what the answer4 is.5
Well, it's not8 entirely true that it was the City's9 decision. First, I wanted to know why10 the decision was made. When I got with11 Barry, when I talked to Barry, Barry12 said, I'm so sorry we handled things this13 way. It was so inappropriate for us to14 do that. You've done a great job.15 I said, Okay, you're sorry, but16 we're losing the business. What did we17 do wrong? I would like to know.18 He said, You didn't do anything19 wrong.20 Okay. Did any of our providers21 do anything wrong?22 No.23 Okay. Why did we lose the24 business?25 35 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 Well, we just decided to -- we2 wanted to have direct relationships with3 the providers.4 And I said, You wanted to5 contact them directly?6 And he said, Yes.7 I said, Well, in our contract8 with you, it stipulates that you have the9 ability to contact directly our10 providers.11
Contact. They14 wanted the ability to call up our15 providers if they wanted to.16 I said, You have that ability.17 It's in the addendum. And you'll see the18 e-mails. I forwarded him the addendum.19 And this is the reason why I didn't20 contact all of them right away, because I21 thought I could fix this. I thought22 maybe there was a misunderstanding with23 Barry, because he thought he could not24 contact our providers directly, and I'll25 36 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 just show him, here's the contract. For2 two years you never even attempted to3 contact any of our providers directly,4 but if you want to now.5 So I asked him, Have you ever6 tried to contact one of our providers and7 they didn't want to talk with you?8 He said, No.9 Okay.10
But my11 issue is -- and we'll get to that12 question when the City's portion of the13 testimony comes -- is that I didn't think14 that was -- I thought that the purpose15 for hiring CompServices, Inc. was to get16 the City out of that contact, that17 CompServices, Inc. would be the18 administrator that would have the19 interaction, have the contact, make the20 complaints, do the remediation or let the21 person go -- or let the company go. And22 I still don't understand yet what23 CompServices, Inc.'s role in this whole24 process is, if in fact the City needs to25 37 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 contact providers directly.2
Exactly my point.3 When we got the contract, I initially got4 the contract, that was the first time in5 August of 2008 that I met -- well,6 actually, in January of 2009 was the7 first time I met with Barry Scott, and8 today is the second time I'm seeing him9 today. So I met with him at the10 recommendation of CompServices. He11 selected Premier Comp Solutions. We gave12 him a list of our providers in the City.13 He selected the four - Progress,14 Bustleton, Outreach and Aquahab. He15 selected them. I did not. I just gave16 him a list.17 Starting February 1st, they18 started utilizing us, and then I was told19 by CSI -- I was first told that I would20 have to attend quarterly meetings with21 the City when they went over physical22 therapy utilization. And then I was23 told, no, Comp Services will have all24 those meetings; if they need me, they25 38 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 will get in touch with me. But I was to2 submit monthly physical therapy3 utilization reports and savings reports4 to CompServices, and they assured me they5 would have the meetings and convey all6 the information. I received an e-mail7 saying, You are not to have any direct8 communication with the City, we are your9 sole contact. The only issue is, I sent10 these physical therapy utilization11 reports every month, and I never even got12 a reply like, Hey, thanks; Hey, we like13 the report. So I would call and say, I14 haven't received any feedback. Don't you15 think they're great, or anything?16 Oh, no news is good news. The17 City is happy with you. You'll hear from18 us, believe me, if anything is wrong.19 I believed that. For months --20 for two years, every single month I21 faithfully sent these savings reports,22 faithfully sent these utilization23 reports. Our physical therapy24 director -- and you'll see, they're 2025 39 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 and 18 pages a piece -- made2 recommendations to file utilization3 reviews with the Bureau, and no one from4 CSI ever did it. So I'm not even sure5 why we were doing what we were doing and6 giving it to them, because they weren't7 doing anything with our recommendations.8 So when you're asking me this9 question, I don't know whose role was10 whose.11
Thank you,17 Mr. Chairman.18 Does your contract have a19 specific dollar value?20
No. Actually, I21 should back up a little bit. We're a22 certified woman-owned business and a23 certified disadvantaged business.24
I'm going25 40 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 there.2
But does5 your contract have a specific dollar6 value?7
They never gave me8 a copy of the contract that they did with9 the City. They utilized us as a WBE, I10 understand.11
I'm not25 41 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 interested in that.2
There's no7 commitment in terms of dollars related to8 your contract?9
In CSI's15 proposal, were you guaranteed anything16 specifically in terms of commitment?17
I never was given18 a copy. I was asked for my certificate19 and they wanted to utilize my network for20 the City contract.21
But they22 never said that you would get a23 percentage of the business?24
Well, I was25 42 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 contacted by the Office of Economic2 Opportunity, which is odd, about two3 months ago and they wanted to make sure I4 was getting this business, because I was5 listed as a subcontractor on CSI's6 contract with the City, and they asked me7 the billed dollar amount at that time,8 which was like August or something they9 contacted me, and I had to run a report10 for them and I gave it to them.11
We received direct18 payments from CSI and we pay the19 providers.20
But you had21 no specific dollar commitment from CSI?22
There might have23 been one in their contract with you, but24 I've never seen it.25 43 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
No. I'm2 talking about in your contract, you had3 no dollar commitment from CSI?4
I just12 wanted to know if they happen to know the13 names of the PT providers that the City14 is utilizing in place of your network15 providers.16
Do you18 happen to know why the City selected19 these providers?20
La Fortaleza21 Physical Therapy has always been on the22 panel and they remain on the panel today.23 I asked Barry why they were on and we're24 off. Because they're a minority-owned25 44 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 business and we're a woman-owned2 business. I just wondered what was the3 difference.4 He just said, No reason.5 They remained on. So La6 Fortaleza still has it. NovaCare, who7 was removed from the panel two years ago,8 which is why we were -- we were9 approached two years ago because we were10 told that NovaCare was over-utilizing the11 physical therapy and they wanted an12 alternative to NovaCare. That's why the13 City wanted CSI to do a contract with us.14 So it was very surprising to me when I15 found out that NovaCare, the one that16 they dumped two years ago, was put back17 on the panel.18
I don't23 even care about the "dumped" part. When24 you say "they," is it CSI or the City?25 45 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
It was both of2 them. When I met with CSI, NovaCare had3 over-utilized -- and I'm just quoting4 from what Barry told me. I guess they5 had tried to give some box seats to the6 City people, and that's in violation of7 the vendor code, and then they were8 removed from the panel, and then Dan9 Bradley, their CEO, went to the Mayor to10 try to get --11
So he went to the18 Mayor, and Barry was upset because Dan19 Bradley had gone over his head. So Barry20 had told me he didn't want anything to do21 with NovaCare, and as long as we could22 save him -- and I had estimated at the23 time that I could save the City a half a24 million dollars a year, and I was praying25 46 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 I could meet that goal, and I did. And2 he said as long as I could save that kind3 of money for the City, I don't have to4 worry, I'll always have a contract -- I5 mean, I'll always get the work. I don't6 have to worry about NovaCare giving box7 seats to people at CSI or anybody like8 that. I don't have to worry about that.9
But10 Councilwoman Krajewski's question was who11 else --12
One17 more question. Is there any reason you18 can possibly think of which caused the19 City to abruptly remove you from their20 service?21
I'd24 like to know.25 47 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
I would love to2 know, and I'm hoping that after they3 testify, I will find some answers. I4 have asked everybody. I've asked5 Barry -- I mean, I've been given answers6 that don't make sense.7
Well,8 this isn't the first time; there are9 others too that had the same problem.10
Well, I guess11 others are having the same problem, but12 the problem -- Barry told me he wanted to13 have direct contact. That was the reason14 he gave me. That's the reason. But he15 had direct contact in the contract. It16 stipulated it. And I thought by17 e-mailing him the contract, it was going18 to fix this whole thing. He'd say, I'm19 sorry for the mistake, and put you back20 on. Then he --21
Is22 there any way we could find out,23 Mr. Chairman?24
Find out?25 48 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251 I'm sorry.2
Why? What4 we did today was, we had these folks come5 testify first to kind of frame the6 problem, and the Administration is here7 to respond, hopefully respond, to the8 issues that are raised.9
I've sent numerous12 e-mails that I have not received any13 response on. So I have tried ad nauseam14 to find out the reason. I wish I could15 answer your question, and I hope today to16 find out.17
What I'd18 like to do is just kind of finish up this19 particular panel.20 And just reiterate again, how21 many employees do you have in your22 facility?23
Twenty-five24 people in our Northeast location.25 49 11/17/10 - LEGISLATIVE OVERSIGHT - RES. 1007251
They're the2 folks who were affected potentially by3 the loss of the City contract?4
And you6 have locations other than Northeast7 Philly?8
Yes, we do. We9 have eight locations. Yes, we have eight10 locations.11
And so was12 the only facility being utilized by the13 City the Northeast location?14
We had a hand18 therapist, but due to the volume, we19 brought on a second hand therapist20 that --21