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Mandel also billed for lunch.
"There were hot meals served at Paraclete, right across the street," says Roxanne Kelly-King, a former therapist. "But JoAnne would not allow them to go. Instead, someone at ROHA would drop off some peanut butter sandwiches or cold cuts, or, on a good day, some stew or chicken soup. And these were supposed to be people with a serious illness. All so she could bill for another hour a day."
Indeed, Mandel had a lot to gain by billing for as many sessions as she could. Her therapists were independent subcontractors, earning $25 to $30 for each session. Because they were required to prepare materials and keep post-therapy charts on their own time, their wages were diluted to about $10 or $15 an hour.
But Mandel was billing third-party insurers at the high end of the market scale for the type of group therapy being provided: $110 an hour (individual sessions cost $135 an hour).
Under ordinary circumstances, Mandel would use the money from Medicare to cover her costs. But all of the costs associated with the care and housing of H.E.L.P. House residents are covered by the HOPWA grant, so Mandel's Medicare reimbursements would seem to represent pure profit.
J.M. Allen, the city's HOPWA coordinator, said he was unaware that a HOPWA grantee appeared to be profiting off the grant. Allen pointed out that such an arrangement would appear to violate federal guidelines that prohibit HOPWA grantees from obtaining "a personal or financial interest or benefit" from the award.
But otherwise, Allen was not inclined to believe the complaints relayed to him about H.E.L.P. House when first contacted by the Press. Apparently, he figured that if none of the clients or employees had griped to him -- "They do know this is a HOPWA program, don't they?" -- how bad could it be?
Of course, Allen had some evidence that all was not right as early as last October, when the city issued a review of ROHA's 1995 grant for $175,000. Mandel had proposed to house 40 HIV-positive men. According to city records, she housed only 13. Meanwhile, she spent a whopping $145,500 of the $175,000 grant on salaries and operating costs.
Allen had more information worth checking out in May, when he received a copy of the complaint Susan Ray filed with the state social workers board. Allen didn't acknowledge that he had been warned that Mandel was discriminating against men who were otherwise eligible for housing. But he didn't exactly deny it, either.
"That would be something we would be concerned with, of course," Allen said. "But no one from her staff or any of the residents has ever made that allegation."
It didn't occur to Allen how much in common that attitude has with JoAnne Mandel herself, who apparently figured that, given their desperate circumstances, her disenfranchised clients would remain silent. Or, perhaps because they also happened to be receiving treatment at a mental-health facility, no one would believe them.
Allen says the city will be "monitoring" the H.E.L.P. House closely, and will be checking out complaints that he recently received from two former residents. That attention comes a little late for Gilbert Blair, who is now spending $400 of his $560 in monthly Social Security benefits on a new apartment. (In what would be another violation of her HOPWA contract, Mandel, according to Blair, never referred him to another agency for rental assistance.)
But Blair remains optimistic, perhaps because there are few things worse than a disease for which there is no cure. His is the kind of New Age attitude that JoAnne Mandel probably read about somewhere along her spiritual path.
"I stuck it out this long because I knew I had no choice," Blair says. "I'll make it the best way I know how.