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The company running a Harris County program that diverts non-emergency 911 calls to social workers and mental health professionals, may have billed the county for the same hours it was working for a California jurisdiction, according to a preliminary review by the county auditor’s office.
The county’s Holistic Assistance Response Team was created in 2022 as an alternative response to police for 911 calls involving residents experiencing non-emergency mental and behavioral health or homelessness issues.
The idea is that using medically trained responders allows the Harris County Sheriff’s Office to focus on emergency calls involving violent crimes and threatening situations. In the first few months of the program, the teams responded to hundreds of calls that otherwise would have resulted in the dispatch of law enforcement officers, county data shows.
According to a preliminary audit memo obtained by the Abdelraoufsinno, the Harris County Auditor’s office identified issues with invoices for a medical director and case manager working for the HART program.
The memo states that the medical director, who was not identified, billed $9,612 to Harris County over a four-week stretch while charging Sonoma County $11,800 for work during those same weeks.
The HART case manager charged Harris County about $4,500, at a rate of $30 an hour, while also billing Sonoma County nearly $8,000, at a rate of $53 an hour, the auditor’s memo states. The work totaled about 300 hours from April 16, 2023 to May 13 for both counties.
The auditor’s office also reviewed DEMA billings for a 2022 contract with Harris County to run its SmartPod Services Program, which aims to bring mental health resources to underserved parts of the county. At the same time, the company was providing services for the homeless to Sonoma County.
Auditors found that from August 1, 2022 to September 3, 2022, there were at least four instances of double billing that occurred with Harris and Sonoma counties under the SmartPod program. Three of those employees charged more than 400 hours of work between the two jurisdictions during the one-month period, auditors found.
The auditor’s review was prompted by a Waste, Fraud and Abuse complaint triggered by Sonoma County, which contacted Harris County officials in April about the possibility DEMA was double-billing both jurisdictions.
Commissioners Court also asked the Harris County Attorney’s Office to spearhead a separate audit to be conducted by a third party.
Payment dispute
DEMA Chief Financial Officer Celeste Cramer pushed back on the county’s initial findings, saying the audit was not yet complete.
“And so far,” she said, “they have not found anything. And we provided them with everything that they needed so far.”
DEMA owner Michelle Patino and Cramer said the company had turned in all time sheets to the county auditor, documents they say show their workers did work the hours they submitted.
For example, Patino said, the HART case manager audited “worked 16 hours a day” divided between both counties.
“We've given them the documentation to show that that was accurate,” Patino said. “She turned in her hours to a bookkeeper... (who) verified those hours.”
Patino agreed to share those documents with the Abdelraoufsinno, but did not respond to a subsequent request by deadline.
Harris County Auditor Michael Post declined to comment about the preliminary audit findings.
The preliminary findings come nearly a week after Commissioners Court had a lengthy and divisive discussion about whether to pay DEMA $270,000 for previously billed services over the past two months.
Harris County Precinct 2 Commissioner Adrian Garcia said he supports HART, but will not stand for a “single taxpayer dollar being used to pay for potential fraud.”
“There are too many red flags from the contractor’s work, both in California and here in Harris County, to ignore,” he said in a statement last week.
Precinct 3 Commissioner Tom Ramsey issued his own statement this week, saying it never made sense to have an out-of-state organization run HART when the county is “home to some of the best health and medical care in the nation.”
Committed to program
DEMA was founded in California in 2020 before expanding to Texas. Patino said the company recently moved its operation to Texas with plans to expand throughout the state.
Precinct 1 Commissioner Rodney Ellis voted in favor of paying DEMA.
“I am committed to working together to ensure that our dedicated first responders are paid for the work they've already done while also making sure HART has the resources to stay operational as we determine the best path forward for the program based on transparency, accountability, and safety,” he said in a statement.
Precinct 4 Commissioner Lesley Briones has an item on next week’s Commissioners Court agenda to ask Harris County Public Health, which is responsible for overseeing HART, to develop a plan to keep the program running.
“I am committed to collaborating with my colleagues on Commissioners Court to find a path forward for this critical work, while upholding our fiduciary duty to Harris County taxpayers,” Briones said in a statement.
County Judge Lina Hidalgo, who also was in favor of approving the payments, declined comment.
First Assistant County Auditor Leslie Wilks Garcia told the court last week that although the audit was not yet complete, she was comfortable approving the payment.
“We determined that Public Health is stating that those procedures were done, and, again, we’ve checked them back to the contract that’s current,” Wilks Garcia said. “And they are billed at the appropriate rates.”
DEMA employees are allowed to split their days working for both Sonoma and Harris counties without violating their contract, Wilks Garcia said. She also said the company is not required to maintain timesheets for salaried employees, which can make it more challenging to pinpoint wrongdoing.
Ellis and Hidalgo voted in favor of the payment while Ramsey voted against. Garcia and Briones abstained.
Commissioners Court rules require a majority vote of those present to pass agenda items.
Without that payment, county officials said, DEMA would be unable to make payroll related to the program. However, law enforcement and DEMA confirmed that the HART program has continued to operate.
Needed concept
While there have been some frustrations with a lack of 24/7 coverage and slow expansion of the program, deputies have bought into the program, said Chief Deputy Mike Lee of the Harris County Sheriff’s Department.
Lee said he does not support any misuse of taxpayer dollars, but he fears losing his deputies’ trust in a necessary program if a disruption is caused and Commissioners Court does not act quickly to find another provider.
“It took a lot of work to get a program like this off the ground,” Lee said. “I hate to see it go away. Like I said at the very beginning, the concept is needed.”
Patino blamed the program’s slow expansion on the county’s failure to pay DEMA for the last 11 months, saying the company is owed $1.4 million.
“I can understand the frustrations but without payment, how do they expect a company to continue to operate and expand?” she said.
The county auditor did not respond to a request for the county’s payment history to DEMA.
Commissioners Court’s call for an investigation into the county’s contracts with DEMA followed an audit by Sonoma County, Calif., that found officials could not account for 40 percent of the company’s billing. The auditors also said they struggled to properly assess DEMA because the company had not tracked the work of its salaried employees.
The Sonoma County audit was sparked by a July 2023 investigation by the Santa Rosa Press Democrat that revealed DEMA was awarded $26 million in no-bid emergency contracts in a little more than two years and raised questions about $800,000 worth of billing for one employee.
Patino said she would attend Commissioners Court next week.
“I greatly appreciate and respect my relationship with Harris County,” she said. “I'd like to continue operating.”
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