by Johnna Grzywacz, CPC
The Reauthorized Workforce Investment Act of 1998 (WIA) is one of many legislative reforms since the inception of nationwide job training and job search assistance programs more than six decades ago. The goal: better response to the workforce development needs of businesses, job seekers and provide the job skills necessary to obtain such employment opportunities.
America has long been served an alphabet soup of failed federally funded training programs masked by endless statistical shams and lack of oversight. With each new administration, a new veneer, wider loopholes allowing fraud and abuse, conflicting rules and administrative structures remain the hallmarks of this multi-billion dollar boondoggle. If you think NH is immune to this beehive of activity, think again.
On a local level job training programs are identified as “eligible training providers” marketed by “One Stop” unemployment offices to seekers of training who are awarded a $4K grant and must choose from a “list” of vendors licensed and approved by both NH Postsecondary Education Commission and Workforce Opportunity Council (WOC) with some endorsed by NH Department of Health and Human Services.
The underbelly of this system assumes a pinky-ring mob-connected mentality. In an arena where profits and bribes take center stage some proprietary programs don’t operate in a vacuum. A “front person” delivers a trumped up sales pitch designed to medicate with high hopes, “shills” paid to endorse the program and the license and approval of above state and federal agencies make it all possible. Often instructors willingly participate in luring students.
The Healthcare Industry is most harmed by tinsel training. For example, the $4K federal grant spent in a short term government sponsored program will get you a bloat of word and excel classes peppered with a few quick intro medical type courses leaving students ill prepared to land employment for what these programs advertise: “Medical Billing and Coding Specialist” or “Office Administrator”. Hiring managers viewing resumes containing alphabet bargain bin certificates along with the terms “Coding Specialist” or “Administrator” laughingly reject applicants and mentally wipe these programs from their short lists. According to Naomi Preble of Rochester, former student of BSTI Blended Solutions stated, “I no longer list the name of this school on my resume as it is more a liability than a benefit in the job search”. She hastened to mention she was awarded only a “certificate of attendance” which was mailed to her by the school two years after she left the program.
Herein lies the problem: If a program on “the list” is not chosen the grant which is also referred to as an ITA voucher must be forfeited. It cannot be used for choice industry preferred training from organizations recognized by hospitals and physicians. Since Medical Coders do not require a license this leaves ample room for these short programs to truncate or omit vital courses, still at the approval of Postsecondary Commission.
A Compliance Officer from a local Healthcare System testified at House Bill 1211 in January 2008. The Bill was sponsored to have coursework align with employer requirements. The testimony mentioned that the physicians from this system will not allow hiring from these programs. Medical Coders shield physicians from OIG audits by properly coding patient procedures, surgeries and diagnoses using current federal regulations. They prevent the loss of millions in revenue due to improper coding and affect worldwide morbidity and mortality statistics. And the ramifications to you as a patient are enormous when your medical chart is handled by unqualified persons.
The non-passage of this Bill allows further scamming of those in search of job training to land gainful unsubsidized employment. Other programs in question include, “Become a Phlebotomist, Transcriptionist or LPN in just a few weeks”. In reality, in-depth long term training with proper certification is required to be considered for these positions.
New Hampshire ranks lowest in producing Medical Coders credentialed thru the American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA), the only two recognized organizations according to physicians and hospitals and as job boards indicate.
In addition, these speedy programs offer NO diploma, NO credits, NO advisory board, NO accreditation, NO continuing education units and NO direct paid vendor affiliation with AAPC or AHIMA; all factors impacting employers turning away applicants. And the calamity doesn’t stop there. A deeper shade of fraud reveals a local program owner on “the list” as fabricating written success stories as lures indicating students landed jobs in local hospitals as Medical Coders right after the training; a pathetic way to rip-off the unemployed who have no lobbyists. This program remains licensed by Postsecondary.
Ellen Wallpe, CPC, General Surgery Practice Manager in Dover stated during her testimony at HB1211 “I would not place a short term trained person in any part of the revenue cycle in my office, our physicians want those trained by PMCC instructors from AAPC or instructors approved by AHIMA”. The short stint programs do not offer these types of on-site approved instructors.
Senate Bill 173 prevents vouchers from being used to obtain training from these preferred organizations; therefore, you cannot get on the “A” list with your own tax dollars. The unemployed are forced to take the bait or not be trained. Many risk going into hock for thousands and even if they utilize their voucher many enrollees think its “free” training when in fact it is their own money they paid into the system. Think of it as a found bag of money that has your name on it.
In other professions, standardization has occurred thru legislation, educational changes, public demand and media attention. For example, uniformity exists in the nursing field focusing on responsibilities that pose a risk to patients if performed by unqualified persons. Although Health Information Management personnel do not provide direct care, coding of diagnoses, procedures and services can influence and affect subsequent treatment and or reimbursement decisions which affect patient care.
After complaining to the VP of WOC about the truncated coursework of one program, I was told “Well, that’s just the way it is”. The Licensing and Approval Administrator for Postsecondary Commission testified at HB 1211 “I just don’t have time to look into these complaints”. I received her document stating: “Postsecondary voted against HB 1211, but we care”. Both Postsecondary and WOC approved and licensed for more than 3 yrs. the annual renewal application which allowed a current Manchester training provider to operate a job training program in a backyard shed in Rye, NH and receive federal funds. Absent of fire and building code, no windows, no elevator, no ramp leaving the disabled unwelcome to this location on “the list” where WIA employment counselors referred the unemployed. One would wonder if this, too, is an expression of “caring”. This location continues to enroll despite several documented complaints with WOC and Postsecondary. One students’ complaint pertains to a web-cam in the bathroom.
Massachusetts fares better at squeezing out unscrupulous gigs and placing students in safe environments. For example, state overseers actually make site visits with little notice to question instructors then corral students interviewing them individually, I am told. In contrast, one or more NH licensing agencies offer up different solutions; the paper shuffle, a blind eye to marketing abuses, and unqualified instructors within these programs according to dozens of prior and current students who, scammed beyond belief, now turn to non-governmental advocacy groups to detail their complaints and black list scam schools.
HB 1331, a welfare reform bill passed in 2006 requires recipients to enroll in job training before returning back to their welfare status. At $4K a pop you can see why training providers cruise the local “One Stop” centers sizing up the school of fish. When entitlements pay more than a job will following the training it is the taxpayer who foots the bill for able bodied citizens to belly up into their lazy-boys, indefinitely. And while the unemployed displaced workers may require training to land the next job it is usually the employer that trains new hires and receives either tax credits or payments thru the NH Job Training Fund, leaving many proprietary training gigs unnecessary and worthless.
When collusion keeps unscrupulous training programs afloat with the millions of dollars that flood this state annually we see the emphasis more on operating within an orgy of greed than actually preparing the unemployed for jobs.
One of the recent amendments to the reauthorized WIA downgrades “customer satisfaction” from a required reporting measure to the state and federal government, to just an “option”. Translation: Not happy with the training or conditions? Have complaints? No resolution. Buyers beware strategies firmly in place cannot be understated.