On June 21, the Santa Barbara County Board of Supervisors unanimously renewed a contract for an Atlanta-based physician staffing company that once provided a hiring recommendation for a doctor who turned out to have faked his credentials.
The county renewed with Jackson and Coker, which provided a hiring recommendation for Ernest Addo, the man who posed as a doctor, to Agape Senior Primary Care in Columbia, S.C.
In a region where the demand for mental health services is high, contracting with a non-local agency is a matter of necessity, said Suzanne Grimmesey, a spokeswoman for the county’s Department of Behavioral Wellness.
“Often times we have an open position for a civil service physician, so to have the option of using locum tenens to make sure we have our patient care flowing consistently becomes a very valuable option,” Grimmesey said.
Locum tenens”literally meaning “to hold a place” in Latin”essentially means staffing provided to alleviate shortages. It’s a term that’s often connected to the medical industry.
According to The Times and Democrat in Orangeburg, S.C., Addo passed himself off as a real doctor for at least six months, working at a state mental health facility before being hired by the South Carolina Care Center. He gave examinations and even wrote prescriptions”including for himself”until he was discovered as a fake in 2012.
Addo was arrested for fraud, and investigators in South Carolina discovered that insurance paid at least $400,000 for Medicaid and Medicare billings. Addo was later found guilty of aggravated identity theft and sentenced to two years in prison, court records show.
Jackson and Coker was later named as a defendant in a class-action lawsuit where it was accused of negligently referring Addo, however the company was dismissed from the case in 2014.
Representatives from Jackson and Coker didn’t respond to the Sun’s phone calls or emailed questions before press time.
However records show that Santa Barbara County has contracted with Jackson and Coker since 2014 to provide psychiatrists, positions the county has struggled to fill in recent years due to a shortage of mental health care providers in the area.
“We’ve had a lot of vacancies,” said Alice Gleghorn, director of the county’s Department of Behavior Wellness. “We’ve been trying, but it’s been very difficult to recruit full-time staff to these positions.”
This time, the county’s renewal of Jackson and Coker’s contract was for more than $1.7 million for the 2016-17 fiscal year starting in July.
According to an online map of the California Office of Statewide Health Planning and Development, the Department of Behavior Wellness designates much of the Central Coast from San Luis Obispo to Santa Barbara as a “mental health-health professional shortage area,” meaning it lacks “access to mental health care in surrounding areas because of the excessive distance, overutilization, or access barriers.”
Part of the reason why the Central Coast is so short, according to Santa Barbara County 3rd District Supervisor Doreen Farr, is because salaries don’t go as far on the Central Coast”or in California in general. There are several factors to this, she added, namely housing and the general cost of living.
It’s not just mental health services that the Central Coast needs, Farr said, but medical professionals in general, such as medical doctors, physician assistants, nurses, etc.
Because of the shortage, Farr echoes Gleghorn’s assertion that the county must contract with companies to fill empty spots.
To find out whether the Addo incident would’ve impacted the supervisors’ votes on Jackson and Coker if they had known about it sooner, the Sun reached out to each of the supervisors via telephone. Farr was the only one who called back.
She said Addo’s fraud would have affected her vote. But she added that the supervisors are dependent upon the information received by the departments that recommend contracted services. The county’s counsel and auditor-controller also have a hand in reviewing contracts as well, Farr added.
“We are relying upon the due diligence and the recommendation of the department that’s bringing the contract,” Farr told the Sun. “It’s not like it’s unusual that the board might hear something negative.”
In the past, the county has awarded contracts to other companies with troubled histories. Take Corizon Health, the Tennessee-based company that provides medical services for county jail inmates, whose contract renewal was initially denied on a conditional basis in June 2015 but eventually extended for 18 months the following September during a contentious supervisors meeting.
Corizon faces several state and federal lawsuits in Santa Barbara County and elsewhere in the U.S. alleging substandard medical care.
Renewing the contract with Jackson and Coker had more to do with continuity in services than anything else, according to Farr.
“It’s always unfortunate when we need to contract out in certain circumstances,” Farr said. “We really want to be responsible to clients and their families, and it’s unacceptable to make them wait an indefinite amount of time.”
Staff Writer David Minsky can be reached at dminsky@santamariasun.com.
This article appears in Jul 28 – Aug 4, 2016.
