Problems with Minnesota's PCA Program

Personal care assistants, or PCAs, provide a vital service for thousands of Minnesotans who need help with the tasks of everyday life. And while many of these care givers are good, honest people, the FOX 9 Investigators discovered this publicly funded, multi-million dollar program that provides those services is ripe for fraud, and is putting some of our most vulnerable citizens in danger.

Wes Winkleman was just 24-years-old when a motorcycle accident left him a quadriplegic and unable to speak.

Wes was Maria Winkleman's first-born. She would visit him everyday at Mayfair Meadows in St. Louis Park, where they would hold hands and watch TV together.

Then, something terrible happened. A personal care assistant was giving Wes a shower. She claims she was unaware the water temperature was a scalding 250 degrees,

By the time the PCA noticed something was wrong, Wes had already suffered second and third-degree burns to his stomach, genitals and legs.

Later, in a court deposition, the PCA would describe how Wes' skin blistered and was sliding off, and how she was concerned he needed medical attention, but that Mayfair owner Julie Osemeka put egg on his wounds instead.

"I asked the owner if she had called 911 and she argued with me for a while," Maria Winkleman said.

Maria wasn't notified of her son's burns until a couple of hours after it happened. By the time she arrived at Mayfair Meadows, 911 still had not been called.

Finally, more than three hours after being scalded, Wes was taken to a hospital. Five months later, Wes died from a severe infection related to the burns. He left this world the way he entered it -- in his mother's arms.

"You know when you hold that baby there's just nothing that you can say, when you hold them again, and they're dying," Winkleman said.

Julie Osemeka now faces criminal charges for neglect of a vulnerable adult. She's also accused of felony theft for scamming the state out of nearly $120,000.

According to the criminal complaint, Osemeka billed the state for Medicaid-funded services that were never provided.

For example, the personal care assistant who gave Wes Winkleman the scalding hot shower was fired by Osemeka after the incident. But prosecutors say Osemeka continued to bill the state as if the PCA was still offering care to other clients.

The FOX 9 Investigators found the state is swamped with similar cases of fraud. We obtained copies of internal files from now-closed state investigations. They paint a picture of a system getting milked by a number of cheats.

In 2007, more than 50 personal care assistants were busted for billing the state for work they didn't do. More than 20 PCA companies were shutdown for stealing hundreds of thousands of dollars.

So significant is the problem, the Minnesota Legislative Auditor's office recently labeled the PCA program "unacceptably vulnerable to fraud and abuse."

"We need accountability for that service," Program Evaluation Coordinator Joel Alter said.

When state investigators randomly audited 26 firms, they found some alarming irregularities, like care assistants claiming to have worked more than 24 hours in a day, for weeks at a time.

"There were certainly cases which caused us a lot of concern because it said to us that there weren't adequate controls and assurances that there wasn't fraud," Alter said.

Just about anyone can start a PCA company -- no license is required. Funding for the program comes through the Minnesota Department of Human Services.

The legislative auditor says the agency needs to aggressively step up its oversight of more than 500 companies which offer PCA services.

Maria Winkleman makes a point of attending every hearing involving Julie Osemeka's fraud and neglect case. Winkleman has already won a civil suit against Osemeka for the pain and suffering Wes encountered, but Osemeka, she says, hasn't paid a dime.

Not a day goes by that Maria doesn't think about her son and what he would be like now. She believes we all live our lives with a mission, and she feels Wes' mission was to expose a wrong in a system that's supposed to be all about helping people.

"I will never get my son back, I'll never be able to hear his voice, but I want her to spend time behind bars realizing what I have lost," Winkleman said.

The Department of Human Services acknowledges the PCA program has some major problems and is trying to address them. For starters, it has implemented a new, computerized tracking system to catch over-billing.

The Department of Human Services is trying to rein in the cost of the PCA program. They hope to save $7 million next year by cutting a couple thousand people from PCA services. They also want PCA agencies and staff to be better trained.

For further information or questions on this topic email: trish.vanpilsum@foxtv.com