It is the job of local,state, and federal prosecutors to enforce and prosecute all laws with fairness and equity and not deny any person the equal protection of the law (14th and 5th Amendments. This Link Political Patronage Briefly reviews how the political patronage system entices local prosecutors and others to refuse to enforce the law. This Link former US Attorney General Eric Holder also addressed serioius abuses of prosecutorial authority

US Congressman Bill Pascell has efforts to have nursing homes regulated by CMS by US Department of HHS which was revolked by Trump Administration.2 Million dead (250,000 a year) since 2014 as a result of medical error. The online databases show that actually began paying in 2010 to deny patients treatment for pre-existing conditions and block prosecution:

1. Link to Exhibit Page 12 Washington State Makes Disability Determination Begins To Default On Contract & Medical Work

2. Exhibit #A Recommendation to Investigate Dr. Shane Dunaway December, 2005

3. Exhibit #B Dr. Jose Pinon-Consulting/December, 2005

4. Exhibit #C- Dr. Shaun Harper Cardiac Specialist/December, 2005

5. Exhibit D Recommended For Federal Grand Jury December, 2005 Terrorist Acitivities Involving Washington DSHS Secretary

6. Link to Exhibit Page 14 Social Security Appeals Council Impeachs Washington State Doctors and Findings

This Link Washington State has a long history of organized and criminal activities throughout the eastern part of the State

On December 30, 2004, Washington State Auditor Brian Sonntag officially released the Fiscal Year 2004 audit of the state's $6.1 billion (50 percent federal funds) annual Medicaid program. Among the 22 audit findings issued against the Department of Social and Health Services (DSHS) for its handling of the Medicaid program, the state auditor (SAO) took the highly unusual step of "disclaiming" the entire Medicaid program.

SAO noted: "Disclaim' is a term used in auditing standards that means we cannot conclude, based on documentation and other evidence we were provided, whether all of these costs were allowable or whether all clients were eligible for services given to them and all providers were eligible for payments made to them."

SAO's official Medicaid audit release follows the unprecedented public release of the audit's draft findings by DSHS on the agency's website on December 14, 2004. According to SAO, some of these draft findings were altered by DSHS. The findings the Department of Social and Health Services released on its website on December 14, 2004, were preliminary drafts and were not completed. In addition, some of the findings the Department presented were worded differently from the drafts we gave the Department at the exit conference on November 24, 2004. The following document is the State Auditor's Office official special report on our audit of the Medicaid Program for fiscal year 2004.

Among the audit's official findings, DSHS:

paid $22 million to individuals who did not provide valid Social Security Numbers (SSN) or offered no SSN at all; paid more than $1 million to individuals claiming a deceased relative's SSN; provided $1.3 million in unallowable medical services to illegal aliens; cannot account for more than 1.4 million in pills worth in excess of $529,000; and did not cooperate with SAO's audit, leading to the disclaiming of the $6.1 billion Medicaid program.

Regarding the lack of cooperation extended by DSHS, SAO made the following statements throughout its audit: [DSHS] personnel attempted to thwart particular audit procedures by questioning our authority to either expand the scope of our audit or to obtain certain information. [DSHS] altered information related to sample transactions while we were attempting to complete our review.

In some instances, we were unable to independently interview line staff without the presence of management or without management's selection of the employees to be interviewed....

1. The refusal of Dr. Dunaway to follow through with his contract agreements and statement of Dr. Mike Fitch of Urgent Care Clinic that he was fired or threatened by DSHS represenative resulted in this Notice of Appeal to the Office of Appeals in Washington State.

2. Several request by Social Worker Shira Corcoran such as challenge to recent US Supreme Court rulings. The US Supreme Court ruled in Schindler Schiavo v. Michael Schiavo that patients have an absolute right to accept or decline medical treatment and choose their own doctors.

3. US Supreme Court Ruling Thersea Schiavo-Schindler, et al. v. Michael Schiavo, et al. protects the rights of patients to choose their medical treatment over the objection of medical or government officials. Online documents

4. Deprivation of rights under color of law Whoever, under color of any law, statute, ordinance, regulation, or custom, willfully subjects any person in any State, Territory, Commonwealth, Possession, or District to the deprivation of any rights, privileges, or immunities secured or protected by the Constitution or laws of the United States, or to different punishments, pains, or penalties, on account of such person being an alien, or by reason of his color, or race, than are prescribed for the punishment of citizens, shall be fined under this title or imprisoned not more than one year, or both; and if bodily injury results from the acts committed in violation of this section or if such acts include the use, attempted use, or threatened use of a dangerous weapon, explosives, or fire, shall be fined under this title or imprisoned not more than ten years, or both; and if death results from the acts committed in violation of this section or if such acts include kidnapping or an attempt to kidnap, aggravated sexual abuse, or an attempt to commit aggravated sexual abuse, or an attempt to kill, shall be fined under this title, or imprisoned for any term of years or for life, or both, or may be sentenced to death.

1. The denial of appropriate medical treatment specified in the patients advanced medical directive shown at the borrom of the page or with chronic medical history of life threatening issuesis likely to result in servere injuries or death

a. Patient Rights To Be fully informed by a physician of his or her total health status and to be afforded the opportunity to participate on an immediate and ongoing basis in the total plan of care. (42CFR §483.10(c))

b. Be fully informed in advance about care and treatment and of any changes in care or treatment that may affect the resident. (42 CFR §483.10(c)(2),(4))

c Participate in planning care and treatment or changes in care or treatment unless adjudged incompetent or otherwise found to be incapacitated under State law. (42 C.F.R. §483.10(d)(3), 42 CFR §483.10(c))

d. To receive all information that is material to his or her decision concerning whether to accept or refuse any proposed treatment or procedure. (42 CFR §483.10(c)(5)(6))

2. US Supreme Court Ruling Thersea Schiavo-Schindler, et al. v. Michael Schiavo, et al. protects the rights of patients to choose their medical treatment over the objection of medical or government officials as the operation of fact and law. Online documents

3. Deprivation of rights under color of law Whoever, under color of any law, statute, ordinance, regulation, or custom, willfully subjects any person in any State, Territory, Commonwealth, Possession, or District to the deprivation of any rights, privileges, or immunities secured or protected by the Constitution or laws of the United States, or to different punishments, pains, or penalties, on account of such person being an alien, or by reason of his color, or race, than are prescribed for the punishment of citizens, shall be fined under this title or imprisoned not more than one year, or both; and if bodily injury results from the acts committed in violation of this section or if such acts include the use, attempted use, or threatened use of a dangerous weapon, explosives, or fire, shall be fined under this title or imprisoned not more than ten years, or both; and if death results from the acts committed in violation of this section or if such acts include kidnapping or an attempt to kidnap, aggravated sexual abuse, or an attempt to commit aggravated sexual abuse, or an attempt to kill, shall be fined under this title, or imprisoned for any term of years or for life, or both, or may be sentenced to death.

Mr. Chris Walters
DSHS Claim 349148
C/o PO Box 1209
Vancouver, WA 98666
Tuesday, Dceember 27th, 2005
Welfare Fraud Hotline
PO Box 45817
Olympia, WA 98504-5817

RE: Question of Suspending Payments SeaMar Clinic
Failure to provide services

Dear Welfare Fraud Hotline:

I am in a GAU disability determination process and on 12-7-2005 acquired the services of a Primary Care Provider:

Dr. Shane Dunaway
SeaMar Clinic
204 E 35th Street
Vancouver, WA 98663
(360-896-5128
Fax 360-896-5179

1. On 12/7/2005 Dr. Dunaway asked me to set a follow up appointment on 12/28/2005 to review the results of the 3 medical test requested by DSHS doctors.

2. The SeaMar front office staff has declined to set the follow up appointment and ignored request made in 2 office visits in person; 3 phone calls; 1 fax; email to Dr. Dunaway and 1 physical letter.

While I cant see what the problem is inside of the SeaMar organization the problem has created serious problems in my completing the obligations to DSHS which I have had to bring to the attention of my Social Worker here in Vancouver, CSO. Under the circumstances I would recommend not paying SeaMar Clinic for all or part their services and would be happy to recommend their front office staff for employment as linebackers for the GreenBay Packers foot ball team.

With Kindest Regards
Chris Walters,DSHS Client
PS Dr. Shaun D. Harper of Cascade Heart completed the echocardiogram today
#First Class Mail 12-19-2005

Saturday Janurary 1, 2005 is a slow day so I go over to see my Primary Care Physician PA. Mike Fitch for some antifungal creme. Mike explains Washington State or a medical company called him and threatened him if he provide any additional medical work. This appears to violate Title 18 USC 242 Deprivation of rights under color of law where the patient has a guaranteed right to choose or select his or her own medical treatment as cited

1. US Supreme Court Ruling Thersea Schiavo-Schindler, et al. v. Michael Schiavo, et al. protects the rights of patients to choose their medical treatment over the objection of medical or government officials. Online documents

2. Deprivation of rights under color of law Whoever, under color of any law, statute, ordinance, regulation, or custom, willfully subjects any person in any State, Territory, Commonwealth, Possession, or District to the deprivation of any rights, privileges, or immunities secured or protected by the Constitution or laws of the United States, or to different punishments, pains, or penalties, on account of such person being an alien, or by reason of his color, or race, than are prescribed for the punishment of citizens, shall be fined under this title or imprisoned not more than one year, or both; and if bodily injury results from the acts committed in violation of this section or if such acts include the use, attempted use, or threatened use of a dangerous weapon, explosives, or fire, shall be fined under this title or imprisoned not more than ten years, or both; and if death results from the acts committed in violation of this section or if such acts include kidnapping or an attempt to kidnap, aggravated sexual abuse, or an attempt to commit aggravated sexual abuse, or an attempt to kill, shall be fined under this title, or imprisoned for any term of years or for life, or both, or may be sentenced to death.

This is the echo cardio gram requested by DSHS Doctor Dr. Eric Strandberg. The report suggest the Doctor or technician could not locate several parts of the heart. Dr. Harper explains the results are incomplete because his technician got bad results.

1. The denial of appropriate medical treatment specified in the patients advanced medical directive shown at the borrom of the page or with chronic medical history of life threatening issuesis likely to result in servere injuries or death

a. Patient Rights To Be fully informed by a physician of his or her total health status and to be afforded the opportunity to participate on an immediate and ongoing basis in the total plan of care. (42CFR §483.10(c))

b. Be fully informed in advance about care and treatment and of any changes in care or treatment that may affect the resident. (42 CFR §483.10(c)(2),(4))

c Participate in planning care and treatment or changes in care or treatment unless adjudged incompetent or otherwise found to be incapacitated under State law. (42 C.F.R. §483.10(d)(3), 42 CFR §483.10(c))

d. To receive all information that is material to his or her decision concerning whether to accept or refuse any proposed treatment or procedure. (42 CFR §483.10(c)(5)(6))

2. US Supreme Court Ruling Thersea Schiavo-Schindler, et al. v. Michael Schiavo, et al. protects the rights of patients to choose their medical treatment over the objection of medical or government officials as the operation of fact and law. Online documents

3. Deprivation of rights under color of law Whoever, under color of any law, statute, ordinance, regulation, or custom, willfully subjects any person in any State, Territory, Commonwealth, Possession, or District to the deprivation of any rights, privileges, or immunities secured or protected by the Constitution or laws of the United States, or to different punishments, pains, or penalties, on account of such person being an alien, or by reason of his color, or race, than are prescribed for the punishment of citizens, shall be fined under this title or imprisoned not more than one year, or both; and if bodily injury results from the acts committed in violation of this section or if such acts include the use, attempted use, or threatened use of a dangerous weapon, explosives, or fire, shall be fined under this title or imprisoned not more than ten years, or both; and if death results from the acts committed in violation of this section or if such acts include kidnapping or an attempt to kidnap, aggravated sexual abuse, or an attempt to commit aggravated sexual abuse, or an attempt to kill, shall be fined under this title, or imprisoned for any term of years or for life, or both, or may be sentenced to death.

On December 30, 2004, Washington State Auditor Brian Sonntag officially released the Fiscal Year 2004 audit of the state's $6.1 billion (50 percent federal funds) annual Medicaid program. Among the 22 audit findings issued against the Department of Social and Health Services (DSHS) for its handling of the Medicaid program, the state auditor (SAO) took the highly unusual step of "disclaiming" the entire Medicaid program.

SAO noted: "Disclaim' is a term used in auditing standards that means we cannot conclude, based on documentation and other evidence we were provided, whether all of these costs were allowable or whether all clients were eligible for services given to them and all providers were eligible for payments made to them."

SAO's official Medicaid audit release follows the unprecedented public release of the audit's draft findings by DSHS on the agency's website on December 14, 2004. According to SAO, some of these draft findings were altered by DSHS. The findings the Department of Social and Health Services released on its website on December 14, 2004, were preliminary drafts and were not completed. In addition, some of the findings the Department presented were worded differently from the drafts we gave the Department at the exit conference on November 24, 2004. The following document is the State Auditor's Office official special report on our audit of the Medicaid Program for fiscal year 2004.

Among the audit's official findings, DSHS:

paid $22 million to individuals who did not provide valid Social Security Numbers (SSN) or offered no SSN at all; paid more than $1 million to individuals claiming a deceased relative's SSN; provided $1.3 million in unallowable medical services to illegal aliens; cannot account for more than 1.4 million in pills worth in excess of $529,000; and did not cooperate with SAO's audit, leading to the disclaiming of the $6.1 billion Medicaid program.

Regarding the lack of cooperation extended by DSHS, SAO made the following statements throughout its audit: [DSHS] personnel attempted to thwart particular audit procedures by questioning our authority to either expand the scope of our audit or to obtain certain information. [DSHS] altered information related to sample transactions while we were attempting to complete our review.

In some instances, we were unable to independently interview line staff without the presence of management or without management's selection of the employees to be interviewed.

Staff members informed us that they had to obtain permission from management prior to speaking with auditors. During our review of the allowability of certain medical procedures and of procedures provided to undocumented aliens, we were never granted permission to speak with the medical consultants who had approval authority.

The audit liaison system, as actually used by the Department, hindered our access to data and obstructed our contact with line staff. Additionally, the audit liaison system attempted to force us to rely on the Department's representations as to the existence or accuracy of evidence. In effect, the Department was attempting to perform the work of the auditor, instead of allowing the auditors to perform an independent audit and reach a valid conclusion.

It is inappropriate for the Department to withhold information because it believes it is not relevant or significant. The auditor should be given the information requested and have an opportunity to examine it and discuss it with the Department before the auditor decides its importance.

Auditors of the Medicaid Program were subjected to undue criticism of their integrity, independence, competence, objectivity, and knowledge. These charges against audit staff were made both in person and through e-mail, and we believe they were intended to deter us from completing our audit.

It is worth noting the contrasting attitude displayed by the Department of Health (DOH) in response to one audit finding issued jointly against DOH and DSHS: "We concur with the finding of the State Auditor's Office . . . Thank you for the professional work by your staff." Despite DOH's acceptance of the audit finding, DSHS did not concur with the finding.

With Washington's $6.1 billion Medicaid program at risk, legislators must finally exercise long overdue oversight and ensure audit corrective action occurs. Many of the findings issued against DSHS in SAO's 2004 audit are repeats from previous years. By making an example out of DSHS, legislators would also send a strong message to other state agencies that frustrating the efforts of the people's elected auditor will not be tolerated. Accountability and transparency for tax dollars must be the first responsibility of all state officials.

Prepared by: Jason Mercier | Budget Research Analyst | 360.956.3482

POLICY HIGHLIGHTER
Volume 15, Number 1
January 11, 2005

Evergreen Freedom Foundation
P.O. Box 552, Olympia, WA 98507
Phone: (360) 956-3482,
Fax: (360) 352-1874
Email: effwa@effwa.org