1122015 Gmail shy Fwd FW Joseph A Prezioso has shared a document with you

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampsearch=allampth=14aac1f1db6ec44bampsiml=14aac1f1db6ec44b 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Fwd FW Joseph A Prezioso has shared a document with you1 message

Joseph Prezioso ltjosephaprezioso14gmailcomgt Fri Jan 2 2015 at 1128 AMTo Kamala Harris ltKamalaHarrisdojcagovgt

Subject PERJURY BEFORE THE CALIFFORNIA STATE LEGISLATURE BY DHCS DIRECTORTOBY DOUGLAS

Discrimination Complaint Chief ALJ Romero 06shy04shy2012shysigned attpdf

REF Welfare and Institutions Code Section 1409306

Also seehttp1drvms1AiNX2khttp1drvms1xeOQtbhttp1drvms1xePqqP

THIS IS A FRAUDULENTLY ISSUED SARhttp1drvms1xePTsU

Also seehttp1drvms1xeQ6MXhttp1drvms1DbnSDchttp1drvms1Hl5dashttp1drvms1CZMmC4http1drvms1CZMGkf

And inappropriate conduct by US Attorney Travis Englandhttp1drvms1A0YQIshttp1drvms1A0ZmWY

PLEASE HELP

Joseph A Prezioso290 Turk St Unit 2San Francisco CA 94102shy3808(650) 308shy9422Linkedin

Gmail shy Read_ Due Process Of Law AG HARRISpdf72K

THINKSTRONG Joseph A Prezioso

405 N FOURTH ST B18

SAN JOSE CA 95112

408-883-5446

877-493-2031 fax

josephpreziosoattnet

State Department of Health Care Services (DCHS)

Office of Civil Rights MS 0009

PO Box 997413

Sacramento CA 95899-7413

Jonathan Clarkson Deputy Director Office of Civil Rights

SUBJECT DiscriminationCivil Rights Complaint CDSS Chief Administrative Law Judge Manuel A Romero

REF Hearing Request Submitted 31 March 2012 to CDSS State Hearings Division (Case s X5445 amp 4913810)

642012

Dear Deputy Director Clarkson

I believe I have been treated unjustly and discriminated against based on my disability due to my genetically

handicapped condition by Chief Administrative Law Judge Manuel A Romero California Department of Social

Services (CDSS)

My right to a fair hearing has been violated by Chief Administrative Law Judge Manuel A Romero due to his

gross negligence is the administration of the State Hearing Calendar and timely Scheduling of Hearing

Assignments His intentional violation of state and federal laws and constitutional protections is based on

discrimination of a whole class of citizens including myself that have hereditary genetic disorders

On 31 March 2012 I submitted a State Hearing Request via confirmed FAX to the State Hearings Division as

required I believe my State Hearing Request for a Fair Hearing was a clear expression that I want the opportunity

to present my case to the reviewing authority 42 CFR sect 431201 As of the date of this writing I have not

received a response or acknowledgement of any form WELFARE AND INSTITUTIONS CODE SECTION

sect10952 requires that hearings should commence within 30 working days after the request is filed and at least 10

days prior to the hearing all parties concerned receive written notice of the time and place of the hearing

Further WELFARE AND INSTITUTIONS CODE SECTION sect10950 states that applicants ldquo be accorded an

opportunity for a state hearingrdquo with ldquopriority in setting and deciding cases shall be given in those cases in which

aid is not being provided pending the outcome of the hearing ldquo The California Department of Health Care

Services (DCHS) received my application on May 4 2010 Federal law requires that the hearing be

conducted at a reasonable time date and place after adequate notice and by an impartial official who was not

directly involved in the initial determination of the action in question (42 CFR sect 431240(a))

The ldquofederalizationrdquo of the GHPP and CCS programs under Title XIX of the Social Security Act reclassifying these

programs as ldquoMedicaid waiver programrdquo has been effective since September 1 2005 with Centers for Medicare amp

Medicaid Services approval and Senate Bill 1100 legislation (Chapter 226 October 2005) This ldquofederalizationrdquo

was extended via the approval of the State of California Section 1115 Medicaid demonstration waiver submitted

and signed off by Secretary Douglas California Department of California Health Care Services on June 3 2010

and subsequently approved by the US Department of Health and Human Services Agency in a letter dated

November 2 2010 and signed by Donald M Berwick MD Administrator This waiver was granted under the

authority of section 1115(a)(2) of the Social Security Act

Joseph A Prezioso

2

NUMBER 11-W-001939

TITLE California Bridge to Reform Demonstration

AWARDEE California Health and Human Services Agency

My right to fair and equal treatment has been violated by Chief Administrative Law Judge Manuel A

Romero A basic tenet of the Code of Federal Regulations is that citizens ldquoBe notified of their rightsrdquo so that they

ldquomay exercise those rightsrdquo How can one have ldquodue processrdquo when one does not know what or how to avail

themselves of that due process In addition without the benefit of due process how can one have equal protection

One can only at best have ldquounequal protectionrdquo ndash and I would suggest that is no protection Chief Administrative

Law Judge Manuel A Romero has committed judicial misconduct by his complicity in concealing the fact that

every participant and applicant in the GHPP and CCS programs since they became Title XIX of the Social Security

Act programs have never received proper notice or were ever made aware of their rights to a Medi-Cal State Fair

Hearing This is the very reason why he has failed to act upon my State Hearing Request

I have a vested property right in and to apply for Medicaid coverage and benefits I have the right to count on my

US Constitutional protections of due process of law whenever the government wants to limit the full use of the

this property right or to take it away As a Medi-Cal applicant I have a right to adequate notice and to an

administrative fair hearing These rights are guaranteed by the Due Process Clause of the United States

Constitution (US Const amend XIV sect 1 42 USC sect 1396a(a)(3) 42 CFR sectsect 431200- 431250)

The very purpose of the Medicaid Act is to enable each State to furnish rehabilitation and other services to help

such families and individuals attain or retain capability for independence or self-care (42 USC sect 1396) The

Medicaid Act requires that each state Medicaid program be administered in the best interests of the recipients

(42 USC sect 1396a(a)(19) See also SRep No 404 89th Cong 1st Sess reprinted in [1965] US Code Cong amp

Admin News 1943 2104)

Medicaid agencies must make all rules and policies available to the public and provide copies to legal services

offices (42 CFR sect 43118) No one outside of the DCHS has ever been informed that the GHPP and CCS

programs were ldquoFederalizedrdquo under Title XIX of the Social Security Act effective September 1 2005

State Medicaid Programs must provide an opportunity for a fair hearing (42 USC sect 1396a(a)(3))

Medicaid applicants and beneficiaries are entitled to a hearing whenever a service or a request for a service is

reduced denied terminated or not acted upon with reasonable promptness (42 CFR sect 431200 et seq)

Goldberg v Kelley 397 US 254 (1970) Public assistance beneficiaries have a constitutional due process right to a

hearing prior to the termination of benefits This due process right includes adequate and timely notice

the opportunity to be heard by an impartial decision maker and a decision based upon evidence

adduced at the hearing Medicaid regulations governing fair hearings 42 CFR sect 431200 et seq provide

detailed requirements regarding content and timing of notice hearing procedures and the content and timing of

hearing decisions The due process requirements of the Medicaid Act are enforceable under 42 USC sect 1983

All categorically eligible beneficiaries must receive medical assistance that is no less than that provided to other

eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must be

Joseph A Prezioso

3

sufficient in amount duration and scope to reasonably achieve its purpose 42 CFR sect 440230(b) The amount

duration and scope provisions of the Medicaid Act and implementing regulations provide strong support to

challenge exclusions of treatment that fall within the scope of services covered There is a long line of judicial

decisions limiting states discretion to exclude medically necessary treatment that falls within the scope of a

covered service State Medicaid programs may not limit services based upon diagnosis type of illness or medical

condition 42 CFR sect440230(c) The operation of state Medicaid programs must be based upon reasonable

standards 42 USC sect 1396a(a)(17)

State Medicaid programs must include safeguards to ensure that services will be provided in a manner consistent

with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19)

A Notice of Action is if the state plan takes an action other than an approval including a denial or a deferral on a

providerrsquos request for any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate

the notice must be in writing and contain a statement of the intended action as well as the reasons and specific

legal support for the action (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In

addition the notice must contain an explanation of the individualrsquos hearing rights rights to

representation and to continued benefits (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c)

510141(c))

In the Americans with Disabilities Act (ADA) Congress provided that the Nations proper goals regarding

individuals with disabilities are to assure equality of opportunity frill participation independent living and

economic self-sufficiency for such individuals 42 USC sect 12101(a)(8) Title II of the ADA further provides that

no qualified individual with a disability shall by reason of such disability be excluded from participation in or be

denied the benefits of the services programs or activities of a public entity or be the subject of discrimination by

any such entity 42 USC sect 12132

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department of

Health Care Services on 18 November 2011 (SAR 99033765400) and was issued a California Medi-

Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) with further correspondence

from Department of Health Care Services stating that I have ldquofull scope Medi-Cal with no share of cost and you are

eligible to receive medically necessary servicesrdquo As of this date I have received no medical aid of any kind

Genetically Handicapped Persons Program Policy Letter G-01-1200 (Benefits) states

POLICY

GHPP shall authorize SCC services for all GHPP clients who are required by program policy to receive

care through GHPP approved outpatient special care centers

These services shall be authorized as GHPP benefits for all eligible GHPP clients

Joseph A Prezioso

4

IMPLEMENTAION

Referral of a client to a SCC

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make

specific the law enforced or administered by itrdquo

Failure to provide the service is a violation of the Hereditary Disorders Act (California HEALTH AND SAFETY

CODE SECTION Sections 124975-124996)

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney 406

US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from denying

benefits even temporarilyrdquo This delay in acting upon my application providing authorized medical

services and preventing me from having my right to a State Fair Hearing is an egregious violation

of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the Medicaid

Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all treaties

made or which shall be made under the authority of the United States shall be the supreme law of the land

and the judges in every state shall be bound thereby anything in the constitution or laws of any state to the

contrary notwithstandingrdquo

Chief Administrative Law Judge Manuel A Romero seems not to understand that Federal Law is ldquoSupremerdquo and

that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders de facto disabilities as

defined by the very statue that enacted the Medical Programs to provide for their care The vast majority are very

young children many very poor and born with complex medical disorders The majority are so young that they are

not even aware they are blessed to be citizens endowed with inalienable rights to life liberty and the pursuit of

happiness

However whatever our genetic defects may be and who among us has a perfect geneone we were created in the

image of our Creator whomever we are free to believe that creator to be if only Mom and Dad who endowed us

with those inalienable rights We are full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are

Joseph A Prezioso

5

entitled to legal protections that ensure us due process equal opportunity equal protection under the law and

equal access to the mainstream and all the best of American life We are entitled to our constitutional rights and

per Fourteenth Amendment (Amendment XIV) to the United States Constitution all state and local governments

shall recognize these substantive and procedural rights That includes Chief Administrative Law Judge Manuel A

Romero

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens with Hereditary Disorders It is a truth

I believe to be ldquoself-evidentrdquo

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the Department

of California Health Care Services (DCHS) CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) CALIFORNIA CHILDRENrsquoS

SERVICES (CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) program it is not possible to exercise your

right to a Medi-Cal State Fair Hearing

One of the reasons that this is true is due to CDSS Chief Administrative Law Judge Manuel A

Romero who is standing in the way blocking the entrance to the Administrative Court Hearing

Room Depriving us of the opportunity to present our case to the proper reviewing authority

and the right afforded us by the Constitution of the United States to speak on our own behalf and

be heard

Joseph A Prezioso

6

Sincerely

Joseph A Prezioso County of Santa Clara

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Kamala D Harris Attorney General California Department of Justice Jayne Kim Acting Chief Trial Counsel The State Bar of California Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services Thomas E Perez Assistant Attorney General US DOJ Civil Rights Division Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services Kathleen Sebelius Secretary US Department Health amp Human Services Edmund G Brown Jr Governor State of California Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley Eric H Holder Jr Attorney General of the United States US Department of Justice George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District Senator Barbara Boxer United States Senator State of California Senator Dianne Feinstein United States Senator State of California Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS) Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS) Toby Douglas Director Department of Health Care Services (DHCS) Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services Daniel R Levinson Inspector General Office of Inspector General US Dept Health amp Human Services State Senator Elaine Alquist California State Senate Assembly Member Nora Campos California State Assembly

122015 Gmail shy Read Due Process Of Law

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampsearch=inboxampth=14a97263a6778d9campsiml=14a97263a6778d9c 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Read Due Process Of Law1 message

Kamala Harris ltKamalaHarrisdojcagovgt Mon Dec 29 2014 at 944 AMTo Joseph Prezioso ltjosephaprezioso14gmailcomgt

CONFIDENTIALITY NOTICE This communication with its contents may contain confidential andor legallyprivileged information It is solely for the use of the intended recipient(s) Unauthorized interception review useor disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy ActIf you are not the intended recipient please contact the sender and destroy all copies of the communication

shyshyshyshyshyshyshyshyshyshy Forwarded message shyshyshyshyshyshyshyshyshyshyFrom Kamala Harris ltKamalaHarrisdojcagovgtTo Joseph Prezioso ltjosephaprezioso14gmailcomgtCc Date Mon 29 Dec 2014 094430 shy0800Subject Read Due Process Of Law

winmaildat5K

Joseph A Prezioso

2

NUMBER 11-W-001939

TITLE California Bridge to Reform Demonstration

AWARDEE California Health and Human Services Agency

My right to fair and equal treatment has been violated by Chief Administrative Law Judge Manuel A

Romero A basic tenet of the Code of Federal Regulations is that citizens ldquoBe notified of their rightsrdquo so that they

ldquomay exercise those rightsrdquo How can one have ldquodue processrdquo when one does not know what or how to avail

themselves of that due process In addition without the benefit of due process how can one have equal protection

One can only at best have ldquounequal protectionrdquo ndash and I would suggest that is no protection Chief Administrative

Law Judge Manuel A Romero has committed judicial misconduct by his complicity in concealing the fact that

every participant and applicant in the GHPP and CCS programs since they became Title XIX of the Social Security

Act programs have never received proper notice or were ever made aware of their rights to a Medi-Cal State Fair

Hearing This is the very reason why he has failed to act upon my State Hearing Request

I have a vested property right in and to apply for Medicaid coverage and benefits I have the right to count on my

US Constitutional protections of due process of law whenever the government wants to limit the full use of the

this property right or to take it away As a Medi-Cal applicant I have a right to adequate notice and to an

administrative fair hearing These rights are guaranteed by the Due Process Clause of the United States

Constitution (US Const amend XIV sect 1 42 USC sect 1396a(a)(3) 42 CFR sectsect 431200- 431250)

The very purpose of the Medicaid Act is to enable each State to furnish rehabilitation and other services to help

such families and individuals attain or retain capability for independence or self-care (42 USC sect 1396) The

Medicaid Act requires that each state Medicaid program be administered in the best interests of the recipients

(42 USC sect 1396a(a)(19) See also SRep No 404 89th Cong 1st Sess reprinted in [1965] US Code Cong amp

Admin News 1943 2104)

Medicaid agencies must make all rules and policies available to the public and provide copies to legal services

offices (42 CFR sect 43118) No one outside of the DCHS has ever been informed that the GHPP and CCS

programs were ldquoFederalizedrdquo under Title XIX of the Social Security Act effective September 1 2005

State Medicaid Programs must provide an opportunity for a fair hearing (42 USC sect 1396a(a)(3))

Medicaid applicants and beneficiaries are entitled to a hearing whenever a service or a request for a service is

reduced denied terminated or not acted upon with reasonable promptness (42 CFR sect 431200 et seq)

Goldberg v Kelley 397 US 254 (1970) Public assistance beneficiaries have a constitutional due process right to a

hearing prior to the termination of benefits This due process right includes adequate and timely notice

the opportunity to be heard by an impartial decision maker and a decision based upon evidence

adduced at the hearing Medicaid regulations governing fair hearings 42 CFR sect 431200 et seq provide

detailed requirements regarding content and timing of notice hearing procedures and the content and timing of

hearing decisions The due process requirements of the Medicaid Act are enforceable under 42 USC sect 1983

All categorically eligible beneficiaries must receive medical assistance that is no less than that provided to other

eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must be

Joseph A Prezioso

3

sufficient in amount duration and scope to reasonably achieve its purpose 42 CFR sect 440230(b) The amount

duration and scope provisions of the Medicaid Act and implementing regulations provide strong support to

challenge exclusions of treatment that fall within the scope of services covered There is a long line of judicial

decisions limiting states discretion to exclude medically necessary treatment that falls within the scope of a

covered service State Medicaid programs may not limit services based upon diagnosis type of illness or medical

condition 42 CFR sect440230(c) The operation of state Medicaid programs must be based upon reasonable

standards 42 USC sect 1396a(a)(17)

State Medicaid programs must include safeguards to ensure that services will be provided in a manner consistent

with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19)

A Notice of Action is if the state plan takes an action other than an approval including a denial or a deferral on a

providerrsquos request for any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate

the notice must be in writing and contain a statement of the intended action as well as the reasons and specific

legal support for the action (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In

addition the notice must contain an explanation of the individualrsquos hearing rights rights to

representation and to continued benefits (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c)

510141(c))

In the Americans with Disabilities Act (ADA) Congress provided that the Nations proper goals regarding

individuals with disabilities are to assure equality of opportunity frill participation independent living and

economic self-sufficiency for such individuals 42 USC sect 12101(a)(8) Title II of the ADA further provides that

no qualified individual with a disability shall by reason of such disability be excluded from participation in or be

denied the benefits of the services programs or activities of a public entity or be the subject of discrimination by

any such entity 42 USC sect 12132

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department of

Health Care Services on 18 November 2011 (SAR 99033765400) and was issued a California Medi-

Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) with further correspondence

from Department of Health Care Services stating that I have ldquofull scope Medi-Cal with no share of cost and you are

eligible to receive medically necessary servicesrdquo As of this date I have received no medical aid of any kind

Genetically Handicapped Persons Program Policy Letter G-01-1200 (Benefits) states

POLICY

GHPP shall authorize SCC services for all GHPP clients who are required by program policy to receive

care through GHPP approved outpatient special care centers

These services shall be authorized as GHPP benefits for all eligible GHPP clients

Joseph A Prezioso

4

IMPLEMENTAION

Referral of a client to a SCC

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make

specific the law enforced or administered by itrdquo

Failure to provide the service is a violation of the Hereditary Disorders Act (California HEALTH AND SAFETY

CODE SECTION Sections 124975-124996)

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney 406

US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from denying

benefits even temporarilyrdquo This delay in acting upon my application providing authorized medical

services and preventing me from having my right to a State Fair Hearing is an egregious violation

of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the Medicaid

Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all treaties

made or which shall be made under the authority of the United States shall be the supreme law of the land

and the judges in every state shall be bound thereby anything in the constitution or laws of any state to the

contrary notwithstandingrdquo

Chief Administrative Law Judge Manuel A Romero seems not to understand that Federal Law is ldquoSupremerdquo and

that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders de facto disabilities as

defined by the very statue that enacted the Medical Programs to provide for their care The vast majority are very

young children many very poor and born with complex medical disorders The majority are so young that they are

not even aware they are blessed to be citizens endowed with inalienable rights to life liberty and the pursuit of

happiness

However whatever our genetic defects may be and who among us has a perfect geneone we were created in the

image of our Creator whomever we are free to believe that creator to be if only Mom and Dad who endowed us

with those inalienable rights We are full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are

Joseph A Prezioso

5

entitled to legal protections that ensure us due process equal opportunity equal protection under the law and

equal access to the mainstream and all the best of American life We are entitled to our constitutional rights and

per Fourteenth Amendment (Amendment XIV) to the United States Constitution all state and local governments

shall recognize these substantive and procedural rights That includes Chief Administrative Law Judge Manuel A

Romero

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens with Hereditary Disorders It is a truth

I believe to be ldquoself-evidentrdquo

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the Department

of California Health Care Services (DCHS) CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) CALIFORNIA CHILDRENrsquoS

SERVICES (CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) program it is not possible to exercise your

right to a Medi-Cal State Fair Hearing

One of the reasons that this is true is due to CDSS Chief Administrative Law Judge Manuel A

Romero who is standing in the way blocking the entrance to the Administrative Court Hearing

Room Depriving us of the opportunity to present our case to the proper reviewing authority

and the right afforded us by the Constitution of the United States to speak on our own behalf and

be heard

Joseph A Prezioso

6

Sincerely

Joseph A Prezioso County of Santa Clara

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Kamala D Harris Attorney General California Department of Justice Jayne Kim Acting Chief Trial Counsel The State Bar of California Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services Thomas E Perez Assistant Attorney General US DOJ Civil Rights Division Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services Kathleen Sebelius Secretary US Department Health amp Human Services Edmund G Brown Jr Governor State of California Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley Eric H Holder Jr Attorney General of the United States US Department of Justice George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District Senator Barbara Boxer United States Senator State of California Senator Dianne Feinstein United States Senator State of California Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS) Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS) Toby Douglas Director Department of Health Care Services (DHCS) Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services Daniel R Levinson Inspector General Office of Inspector General US Dept Health amp Human Services State Senator Elaine Alquist California State Senate Assembly Member Nora Campos California State Assembly

122015 Gmail shy Read Due Process Of Law

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampsearch=inboxampth=14a97263a6778d9campsiml=14a97263a6778d9c 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Read Due Process Of Law1 message

Kamala Harris ltKamalaHarrisdojcagovgt Mon Dec 29 2014 at 944 AMTo Joseph Prezioso ltjosephaprezioso14gmailcomgt

CONFIDENTIALITY NOTICE This communication with its contents may contain confidential andor legallyprivileged information It is solely for the use of the intended recipient(s) Unauthorized interception review useor disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy ActIf you are not the intended recipient please contact the sender and destroy all copies of the communication

shyshyshyshyshyshyshyshyshyshy Forwarded message shyshyshyshyshyshyshyshyshyshyFrom Kamala Harris ltKamalaHarrisdojcagovgtTo Joseph Prezioso ltjosephaprezioso14gmailcomgtCc Date Mon 29 Dec 2014 094430 shy0800Subject Read Due Process Of Law

winmaildat5K

Joseph A Prezioso

3

sufficient in amount duration and scope to reasonably achieve its purpose 42 CFR sect 440230(b) The amount

duration and scope provisions of the Medicaid Act and implementing regulations provide strong support to

challenge exclusions of treatment that fall within the scope of services covered There is a long line of judicial

decisions limiting states discretion to exclude medically necessary treatment that falls within the scope of a

covered service State Medicaid programs may not limit services based upon diagnosis type of illness or medical

condition 42 CFR sect440230(c) The operation of state Medicaid programs must be based upon reasonable

standards 42 USC sect 1396a(a)(17)

State Medicaid programs must include safeguards to ensure that services will be provided in a manner consistent

with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19)

A Notice of Action is if the state plan takes an action other than an approval including a denial or a deferral on a

providerrsquos request for any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate

the notice must be in writing and contain a statement of the intended action as well as the reasons and specific

legal support for the action (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In

addition the notice must contain an explanation of the individualrsquos hearing rights rights to

representation and to continued benefits (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c)

510141(c))

In the Americans with Disabilities Act (ADA) Congress provided that the Nations proper goals regarding

individuals with disabilities are to assure equality of opportunity frill participation independent living and

economic self-sufficiency for such individuals 42 USC sect 12101(a)(8) Title II of the ADA further provides that

no qualified individual with a disability shall by reason of such disability be excluded from participation in or be

denied the benefits of the services programs or activities of a public entity or be the subject of discrimination by

any such entity 42 USC sect 12132

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department of

Health Care Services on 18 November 2011 (SAR 99033765400) and was issued a California Medi-

Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) with further correspondence

from Department of Health Care Services stating that I have ldquofull scope Medi-Cal with no share of cost and you are

eligible to receive medically necessary servicesrdquo As of this date I have received no medical aid of any kind

Genetically Handicapped Persons Program Policy Letter G-01-1200 (Benefits) states

POLICY

GHPP shall authorize SCC services for all GHPP clients who are required by program policy to receive

care through GHPP approved outpatient special care centers

These services shall be authorized as GHPP benefits for all eligible GHPP clients

Joseph A Prezioso

4

IMPLEMENTAION

Referral of a client to a SCC

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make

specific the law enforced or administered by itrdquo

Failure to provide the service is a violation of the Hereditary Disorders Act (California HEALTH AND SAFETY

CODE SECTION Sections 124975-124996)

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney 406

US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from denying

benefits even temporarilyrdquo This delay in acting upon my application providing authorized medical

services and preventing me from having my right to a State Fair Hearing is an egregious violation

of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the Medicaid

Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all treaties

made or which shall be made under the authority of the United States shall be the supreme law of the land

and the judges in every state shall be bound thereby anything in the constitution or laws of any state to the

contrary notwithstandingrdquo

Chief Administrative Law Judge Manuel A Romero seems not to understand that Federal Law is ldquoSupremerdquo and

that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders de facto disabilities as

defined by the very statue that enacted the Medical Programs to provide for their care The vast majority are very

young children many very poor and born with complex medical disorders The majority are so young that they are

not even aware they are blessed to be citizens endowed with inalienable rights to life liberty and the pursuit of

happiness

However whatever our genetic defects may be and who among us has a perfect geneone we were created in the

image of our Creator whomever we are free to believe that creator to be if only Mom and Dad who endowed us

with those inalienable rights We are full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are

Joseph A Prezioso

5

entitled to legal protections that ensure us due process equal opportunity equal protection under the law and

equal access to the mainstream and all the best of American life We are entitled to our constitutional rights and

per Fourteenth Amendment (Amendment XIV) to the United States Constitution all state and local governments

shall recognize these substantive and procedural rights That includes Chief Administrative Law Judge Manuel A

Romero

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens with Hereditary Disorders It is a truth

I believe to be ldquoself-evidentrdquo

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the Department

of California Health Care Services (DCHS) CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) CALIFORNIA CHILDRENrsquoS

SERVICES (CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) program it is not possible to exercise your

right to a Medi-Cal State Fair Hearing

One of the reasons that this is true is due to CDSS Chief Administrative Law Judge Manuel A

Romero who is standing in the way blocking the entrance to the Administrative Court Hearing

Room Depriving us of the opportunity to present our case to the proper reviewing authority

and the right afforded us by the Constitution of the United States to speak on our own behalf and

be heard

Joseph A Prezioso

6

Sincerely

Joseph A Prezioso County of Santa Clara

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Kamala D Harris Attorney General California Department of Justice Jayne Kim Acting Chief Trial Counsel The State Bar of California Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services Thomas E Perez Assistant Attorney General US DOJ Civil Rights Division Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services Kathleen Sebelius Secretary US Department Health amp Human Services Edmund G Brown Jr Governor State of California Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley Eric H Holder Jr Attorney General of the United States US Department of Justice George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District Senator Barbara Boxer United States Senator State of California Senator Dianne Feinstein United States Senator State of California Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS) Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS) Toby Douglas Director Department of Health Care Services (DHCS) Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services Daniel R Levinson Inspector General Office of Inspector General US Dept Health amp Human Services State Senator Elaine Alquist California State Senate Assembly Member Nora Campos California State Assembly

122015 Gmail shy Read Due Process Of Law

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampsearch=inboxampth=14a97263a6778d9campsiml=14a97263a6778d9c 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Read Due Process Of Law1 message

Kamala Harris ltKamalaHarrisdojcagovgt Mon Dec 29 2014 at 944 AMTo Joseph Prezioso ltjosephaprezioso14gmailcomgt

CONFIDENTIALITY NOTICE This communication with its contents may contain confidential andor legallyprivileged information It is solely for the use of the intended recipient(s) Unauthorized interception review useor disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy ActIf you are not the intended recipient please contact the sender and destroy all copies of the communication

shyshyshyshyshyshyshyshyshyshy Forwarded message shyshyshyshyshyshyshyshyshyshyFrom Kamala Harris ltKamalaHarrisdojcagovgtTo Joseph Prezioso ltjosephaprezioso14gmailcomgtCc Date Mon 29 Dec 2014 094430 shy0800Subject Read Due Process Of Law

winmaildat5K

Joseph A Prezioso

4

IMPLEMENTAION

Referral of a client to a SCC

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make

specific the law enforced or administered by itrdquo

Failure to provide the service is a violation of the Hereditary Disorders Act (California HEALTH AND SAFETY

CODE SECTION Sections 124975-124996)

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney 406

US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from denying

benefits even temporarilyrdquo This delay in acting upon my application providing authorized medical

services and preventing me from having my right to a State Fair Hearing is an egregious violation

of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the Medicaid

Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all treaties

made or which shall be made under the authority of the United States shall be the supreme law of the land

and the judges in every state shall be bound thereby anything in the constitution or laws of any state to the

contrary notwithstandingrdquo

Chief Administrative Law Judge Manuel A Romero seems not to understand that Federal Law is ldquoSupremerdquo and

that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders de facto disabilities as

defined by the very statue that enacted the Medical Programs to provide for their care The vast majority are very

young children many very poor and born with complex medical disorders The majority are so young that they are

not even aware they are blessed to be citizens endowed with inalienable rights to life liberty and the pursuit of

happiness

However whatever our genetic defects may be and who among us has a perfect geneone we were created in the

image of our Creator whomever we are free to believe that creator to be if only Mom and Dad who endowed us

with those inalienable rights We are full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are

Joseph A Prezioso

5

entitled to legal protections that ensure us due process equal opportunity equal protection under the law and

equal access to the mainstream and all the best of American life We are entitled to our constitutional rights and

per Fourteenth Amendment (Amendment XIV) to the United States Constitution all state and local governments

shall recognize these substantive and procedural rights That includes Chief Administrative Law Judge Manuel A

Romero

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens with Hereditary Disorders It is a truth

I believe to be ldquoself-evidentrdquo

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the Department

of California Health Care Services (DCHS) CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) CALIFORNIA CHILDRENrsquoS

SERVICES (CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) program it is not possible to exercise your

right to a Medi-Cal State Fair Hearing

One of the reasons that this is true is due to CDSS Chief Administrative Law Judge Manuel A

Romero who is standing in the way blocking the entrance to the Administrative Court Hearing

Room Depriving us of the opportunity to present our case to the proper reviewing authority

and the right afforded us by the Constitution of the United States to speak on our own behalf and

be heard

Joseph A Prezioso

6

Sincerely

Joseph A Prezioso County of Santa Clara

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Kamala D Harris Attorney General California Department of Justice Jayne Kim Acting Chief Trial Counsel The State Bar of California Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services Thomas E Perez Assistant Attorney General US DOJ Civil Rights Division Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services Kathleen Sebelius Secretary US Department Health amp Human Services Edmund G Brown Jr Governor State of California Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley Eric H Holder Jr Attorney General of the United States US Department of Justice George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District Senator Barbara Boxer United States Senator State of California Senator Dianne Feinstein United States Senator State of California Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS) Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS) Toby Douglas Director Department of Health Care Services (DHCS) Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services Daniel R Levinson Inspector General Office of Inspector General US Dept Health amp Human Services State Senator Elaine Alquist California State Senate Assembly Member Nora Campos California State Assembly

122015 Gmail shy Read Due Process Of Law

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampsearch=inboxampth=14a97263a6778d9campsiml=14a97263a6778d9c 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Read Due Process Of Law1 message

Kamala Harris ltKamalaHarrisdojcagovgt Mon Dec 29 2014 at 944 AMTo Joseph Prezioso ltjosephaprezioso14gmailcomgt

CONFIDENTIALITY NOTICE This communication with its contents may contain confidential andor legallyprivileged information It is solely for the use of the intended recipient(s) Unauthorized interception review useor disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy ActIf you are not the intended recipient please contact the sender and destroy all copies of the communication

shyshyshyshyshyshyshyshyshyshy Forwarded message shyshyshyshyshyshyshyshyshyshyFrom Kamala Harris ltKamalaHarrisdojcagovgtTo Joseph Prezioso ltjosephaprezioso14gmailcomgtCc Date Mon 29 Dec 2014 094430 shy0800Subject Read Due Process Of Law

winmaildat5K

Joseph A Prezioso

5

entitled to legal protections that ensure us due process equal opportunity equal protection under the law and

equal access to the mainstream and all the best of American life We are entitled to our constitutional rights and

per Fourteenth Amendment (Amendment XIV) to the United States Constitution all state and local governments

shall recognize these substantive and procedural rights That includes Chief Administrative Law Judge Manuel A

Romero

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens with Hereditary Disorders It is a truth

I believe to be ldquoself-evidentrdquo

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the Department

of California Health Care Services (DCHS) CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) CALIFORNIA CHILDRENrsquoS

SERVICES (CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) program it is not possible to exercise your

right to a Medi-Cal State Fair Hearing

One of the reasons that this is true is due to CDSS Chief Administrative Law Judge Manuel A

Romero who is standing in the way blocking the entrance to the Administrative Court Hearing

Room Depriving us of the opportunity to present our case to the proper reviewing authority

and the right afforded us by the Constitution of the United States to speak on our own behalf and

be heard

Joseph A Prezioso

6

Sincerely

Joseph A Prezioso County of Santa Clara

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Kamala D Harris Attorney General California Department of Justice Jayne Kim Acting Chief Trial Counsel The State Bar of California Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services Thomas E Perez Assistant Attorney General US DOJ Civil Rights Division Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services Kathleen Sebelius Secretary US Department Health amp Human Services Edmund G Brown Jr Governor State of California Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley Eric H Holder Jr Attorney General of the United States US Department of Justice George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District Senator Barbara Boxer United States Senator State of California Senator Dianne Feinstein United States Senator State of California Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS) Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS) Toby Douglas Director Department of Health Care Services (DHCS) Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services Daniel R Levinson Inspector General Office of Inspector General US Dept Health amp Human Services State Senator Elaine Alquist California State Senate Assembly Member Nora Campos California State Assembly

122015 Gmail shy Read Due Process Of Law

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampsearch=inboxampth=14a97263a6778d9campsiml=14a97263a6778d9c 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Read Due Process Of Law1 message

Kamala Harris ltKamalaHarrisdojcagovgt Mon Dec 29 2014 at 944 AMTo Joseph Prezioso ltjosephaprezioso14gmailcomgt

CONFIDENTIALITY NOTICE This communication with its contents may contain confidential andor legallyprivileged information It is solely for the use of the intended recipient(s) Unauthorized interception review useor disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy ActIf you are not the intended recipient please contact the sender and destroy all copies of the communication

shyshyshyshyshyshyshyshyshyshy Forwarded message shyshyshyshyshyshyshyshyshyshyFrom Kamala Harris ltKamalaHarrisdojcagovgtTo Joseph Prezioso ltjosephaprezioso14gmailcomgtCc Date Mon 29 Dec 2014 094430 shy0800Subject Read Due Process Of Law

winmaildat5K

Joseph A Prezioso

6

Sincerely

Joseph A Prezioso County of Santa Clara

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Kamala D Harris Attorney General California Department of Justice Jayne Kim Acting Chief Trial Counsel The State Bar of California Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services Thomas E Perez Assistant Attorney General US DOJ Civil Rights Division Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services Kathleen Sebelius Secretary US Department Health amp Human Services Edmund G Brown Jr Governor State of California Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley Eric H Holder Jr Attorney General of the United States US Department of Justice George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District Senator Barbara Boxer United States Senator State of California Senator Dianne Feinstein United States Senator State of California Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS) Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS) Toby Douglas Director Department of Health Care Services (DHCS) Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services Daniel R Levinson Inspector General Office of Inspector General US Dept Health amp Human Services State Senator Elaine Alquist California State Senate Assembly Member Nora Campos California State Assembly

122015 Gmail shy Read Due Process Of Law

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampsearch=inboxampth=14a97263a6778d9campsiml=14a97263a6778d9c 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Read Due Process Of Law1 message

Kamala Harris ltKamalaHarrisdojcagovgt Mon Dec 29 2014 at 944 AMTo Joseph Prezioso ltjosephaprezioso14gmailcomgt

CONFIDENTIALITY NOTICE This communication with its contents may contain confidential andor legallyprivileged information It is solely for the use of the intended recipient(s) Unauthorized interception review useor disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy ActIf you are not the intended recipient please contact the sender and destroy all copies of the communication

shyshyshyshyshyshyshyshyshyshy Forwarded message shyshyshyshyshyshyshyshyshyshyFrom Kamala Harris ltKamalaHarrisdojcagovgtTo Joseph Prezioso ltjosephaprezioso14gmailcomgtCc Date Mon 29 Dec 2014 094430 shy0800Subject Read Due Process Of Law

winmaildat5K

122015 Gmail shy Read Due Process Of Law

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampsearch=inboxampth=14a97263a6778d9campsiml=14a97263a6778d9c 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Read Due Process Of Law1 message

Kamala Harris ltKamalaHarrisdojcagovgt Mon Dec 29 2014 at 944 AMTo Joseph Prezioso ltjosephaprezioso14gmailcomgt

CONFIDENTIALITY NOTICE This communication with its contents may contain confidential andor legallyprivileged information It is solely for the use of the intended recipient(s) Unauthorized interception review useor disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy ActIf you are not the intended recipient please contact the sender and destroy all copies of the communication

shyshyshyshyshyshyshyshyshyshy Forwarded message shyshyshyshyshyshyshyshyshyshyFrom Kamala Harris ltKamalaHarrisdojcagovgtTo Joseph Prezioso ltjosephaprezioso14gmailcomgtCc Date Mon 29 Dec 2014 094430 shy0800Subject Read Due Process Of Law

winmaildat5K

THINKSTRONG Joseph A Prezioso

405 N FOURTH ST B18

SAN JOSE CA 95112

408-883-5446

877-493-2031 fax

josephpreziosoattnet

Department of Health Care Services (DCHS)

1501 Capitol Avenue MS 0000

Sacramento CA 95814

Toby Douglas Director

SUBJECT Official Misconduct Retaliatory Threats Conspiracy Against Rights Deprivation of Rights Under Color of Law

REF State of California Benefits Identification Card ID No 95486255E41325 Issue Date 11-21-2011

ldquoEncrypted DHCSrdquo email from David V Banda Chief Statewide Programs Section (SPS) DCHS 12-15-2011 (attached)

My email addressed to CDSS PIAR amp DHCS Section Chief Banda dated 4-1-2012

682012

Dear Director Douglas

In late November I received a State of California Benefits Identification Card ID No 95486255E41325

Issue Date 11-21-2011 from the California Department of Health Care Services along with a GHPP

Authorization SAR 99033765400 issued on November 18 2011 by Carol Hazell (GHPP) a State of California

licensed Public Health Nurse and Registered Nurse (License Numbers 46663403823)

Chief Banda in his ldquoencrypted DHCSrdquo email response to my inquiry dated 12-15-2011 stated unequivocally

ldquoOur system documentation indicates that you currently have full scope Medi-Cal with no share of cost and you are eligible to receive medically necessary servicesrdquo

Chief Banda I believe with malicious intent also threatened and tried to intimidate me by claiming that my

statement that my State of California Benefits Identification Card ID No 95486255E41325 Issue Date 11-21-2011 was

issued improperly and fraudulently was ldquodefamatoryrdquo

I want to also state for the record that I received a retaliatory threat from Carol Hazell (GHPP) a State of

California licensed Public Health Nurse and Registered Nurse (License Numbers 46663403823) in May 2011

for having the ldquoaudacityrdquo to contact Lisa Holmes County of Santa Clara Civil Rights Representative to

inquire as to the status of my application for the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL)

GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) received by the Department of Health Care

Services (DCHS) GHPP office on May 4 2010 (Case X3454) Carol Hazell made it quite clear that the

ldquopenaltyrdquo for ldquoinquiringrdquo was that I would ldquohave to submit a new application and this time we are going to do

everything by the bookrdquo

In regards to my State of California Benefits Identification Card ID No 95486255E41325 Issue

Date 11-21-2011 no one in the Social Services Agency County of Santa Clara Medi-Cal section had any

knowledge or could provide any information about this card I also contacted EDS Customer Service on

December 20 2012 and spoke with agent 434 who informed me ldquothere was no information at all as to

what this card entitled me tordquo

Joseph A Prezioso

2

I also want to state for the record that there is no evidence that I have or ever had ldquofull scope Medi-Calrdquo and can

state with absolute certainty I have not received to this date any medically necessary services of any kind But I

have been dis-enrolled from my County of Santa Clara DCHS approved LIHP MCE insurance plan and kicked out of my County of Santa Clara wholly owned and operated Federally Qualified Health Clinic (FQHC) the Santa Clara Valley Medical Center at Moorpark Clinic (the very MEDICAL HOME indicated on the California

Department of Health Care Services issued GHPP Authorization SAR 99033765400) by Shari Hurst

Director of Customer Service Santa Clara Valley Medical Center for the ldquoaudacityrdquo to file a grievance

Director Douglas is there any system documentation that indicates or ever indicated that I have or ever had full scope Medi-Cal with no share of cost and I am or ever were eligible to receive medically necessary services

Can you please answer that question and provide an explanation andor documentation

I believe that

David V Banda Chief Statewide Programs Section (SPS) DCHS

Carol Hazell Genetically Handicapped Persons Program (GHPP) office DHCS

Shari Hurst Director of Customer Service Santa Clara Valley Medical Center

have acted in concert and engaged in a conspiracy and their actions are violations of

California HEALTH AND SAFETY CODE SECTION 124985 which states

A violation of any of the provisions of the Hereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I also believe these are acts of Official Misconduct in violation of Conspiracy Against Rights 18 USC sect

241 Section 241 of Title 18 in the civil rights conspiracy statute It makes it unlawful for two or

more persons to agree together to injure threaten or intimidate a person in any state territory

or district in the free exercise or enjoyment of any right or privilege secured to himher by the

Constitution or the laws of the Unites States Unlike most conspiracy statutes Section 241 does not

require that one of the conspirators commit an overt act prior to the conspiracy becoming a crime

I also believe these acts are a violation of Deprivation of Rights Under Color of Law 18 USC sect 242 This

provision makes it a crime for a person acting under color of any law to willfully deprive a person of a right or

privilege protected by the Constitution or laws of the United States For the purpose of Section 242 acts under

color of law include acts not only done by federal state or local officials within the their lawful authority but

also acts done beyond the bounds of that officials lawful authority if the acts are done while the official is

purporting to or pretending to act in the performance of hisher official duties It is not necessary that the crime

be motivated by animus toward the race color religion sex handicap familial status or national origin of the

victim

Joseph A Prezioso

3

And yes I believe that it is an unequivocal fact that both the CALIFORNIA MEDICAL ASSISTANCE

(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) and the County of

Santa Clara Low Income Health Plan (LIHP) Medicaid Coverage Extension (MCE) plan approved by

the Department of Health Care Services (DCHS) are Title XIX of the Social Security Act programs

These programs are covered under the California Section 1115 Medicaid demonstration waiver

NUMBER 11-W-001939 which represents a contractual agreement between the State of California and the

Federal Government and must be administered in conformity with specific requirements of Title XIX of the Social

Security Act and regulations outlined in Chapter IV of the Code of Federal Regulations The State Plan contains all

information necessary for the Centers for Medicare and Medicaid Services (CMS) to determine if the State can

receive Federal Financial Participation (FFP)

This waiver as approved by the US Department of Health amp Human Services also affords me a property right in

my governments Medi-Cal Title XIX Federally funded healthcare programs In addition my property right

guaranteed me by the Constitution of the United States of America shall not be deprived without due

process of law Furthermore the Constitution of the United States of America provides me the right to Equal

Protection of the law stating no state shall deny to any person within its jurisdiction the equal protection of

the laws The Equal Protection Clause is intended to secure the promise of the United States professed

commitment to the proposition that all men are created equalrdquo

Director Douglas am I less equal than any other citizen

I have the right to count on my US Constitutional protections of due process of law whenever the government

wants to limit the full use of my property right or to take it away As a Medi-Cal applicant I have a right to

adequate notice and to an administrative fair hearing These rights are guaranteed by the Due Process Clause of

the United States Constitution (US Const amend XIV sect 1 42 USC sect 1396a(a)(3) 42 CFR sectsect 431200-

431250)

The very purpose of the Medicaid Act is to enable each State to furnish rehabilitation and other services to help

such families and individuals attain or retain capability for independence or self-care (42 USC sect 1396) The

Medicaid Act requires that each state Medicaid program be administered in the best interests of the recipients

(42 USC sect 1396a(a)(19) See also SRep No 404 89th Cong 1st Sess reprinted in [1965] US Code Cong amp

Admin News 1943 2104)

Medicaid agencies must make all rules and policies available to the public and provide copies to legal services

offices (42 CFR sect 43118) State Medicaid Programs must provide an opportunity for a fair hearing

(42 USC sect 1396a(a)(3)) Medicaid applicants and beneficiaries are entitled to a hearing whenever a service or a

request for a service is reduced denied terminated or not acted upon with reasonable promptness (42

CFR sect 431200 et seq) Goldberg v Kelley 397 US 254 (1970) Public assistance beneficiaries have a

constitutional due process right to a hearing prior to the termination of benefits This due process right

includes adequate and timely notice the opportunity to be heard by an impartial decision maker

Joseph A Prezioso

4

and a decision based upon evidence adduced at the hearing Medicaid regulations governing fair

hearings 42 CFR sect 431200 et seq provide detailed requirements regarding content and timing of notice

hearing procedures and the content and timing of hearing decisions The due process requirements of the

Medicaid Act are enforceable under 42 USC sect 1983

All categorically eligible beneficiaries must receive medical assistance that is no less than that provided to other

eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must be

sufficient in amount duration and scope to reasonably achieve its purposerdquo 42 CFR sect 440230(b)

The amount duration and scope provisions of the Medicaid Act and implementing regulations provide strong

support to challenge exclusions of treatment that fall within the scope of services covered There is a long line of

judicial decisions limiting states discretion to exclude medically necessary treatment that falls within the scope of

a covered service State Medicaid programs may not limit services based upon diagnosis type of illness or medical

condition 42 CFR sect440230(c) The operation of state Medicaid programs must be based upon reasonable

standards 42 USC sect 1396a(a)(17)

State Medicaid programs must include safeguards to ensure that services will be provided in a manner consistent

with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19) A Notice of

Action is if the state plan takes an action other than an approval including a denial or a deferral on a providerrsquos

request for any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate the notice

must be in writing and contain a statement of the intended action as well as the reasons and specific legal support

for the action (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In addition the

notice must contain an explanation of the individualrsquos hearing rights rights to representation and to

continued benefits (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c))

In the Americans with Disabilities Act (ADA) Congress provided that the Nations proper goals regarding

individuals with disabilities are to assure equality of opportunity frill participation independent living and

economic self-sufficiency for such individuals 42 USC sect 12101(a)(8) Title II of the ADA further provides that

no qualified individual with a disability shall by reason of such disability be excluded from

participation in or be denied the benefits of the services programs or activities of a public entity

or be the subject of discrimination by any such entity 42 USC sect 12132

Genetically Handicapped Persons Program Policy Letter G-01-1200 (Benefits) states

POLICY

GHPP shall authorize SCC services for all GHPP clients who are required by program policy to receive

care through GHPP approved outpatient special care centers

These services shall be authorized as GHPP benefits for all eligible GHPP clients

IMPLEMENTAION

Referral of a client to a SCC

Joseph A Prezioso

5

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make specific the

law enforced or administered by itrdquo

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney

406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from

denying benefits even temporarilyrdquo This delay in acting upon my application providing authorized

medical services and preventing me from having my right to a State Fair Hearing is an egregious

violation of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the

Medicaid Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all

treaties made or which shall be made under the authority of the United States shall be the supreme

law of the land and the judges in every state shall be bound thereby anything in the constitution or

laws of any state to the contrary notwithstandingrdquo

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Joseph A Prezioso

6

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

David V Banda Chief Statewide Programs Section (SPS) DCHS Carol Hazell Genetically

Handicapped Persons Program (GHPP) office DHCS and Shari Hurst Director of Customer

Service Santa Clara Valley Medical Center do not seem to understand that it is not right to interfere

with my rights ndash these are not their programs these are my programs They do not make the laws

they must obey the laws If you do not want to abide by Federal law then give back the Federal

money ndash this brings disgrace upon the good people who are the State of California

Dear Director Douglas are you not my Director of the Department of Health Care Services

The courtesy of a response DIRECTLY FROM YOU IS REQUESTED NOT THE GENERAL

COUNSEL of the DEPARTMENT OF HEALTH CARE SERVICES who has NO INTEREST in

representing MY INTERESTS

Chief Counsel Douglas Michael Press Department of Health Care Services wanted to meet with

me in person What an honor However he seemed quite displeased when I suggested that it

might be more appropriate to have such a meeting with a representative of the United States

Department of Justice

Director Douglas what is there to hide Wouldnrsquot it be more proper and transparent to have a

representative of the United States Department of Justice Civil Rights Division present for a

meeting between the Chief Counsel of the Department of Health Care Services and a poor

disabled and deprived shelter resident at the Emmanuel House who is receiving no medical care

Director Douglas who is looking out for and protecting this citizenrsquos interests

I respectfully request an answer I trust and hope you have the character to provide a forthright

and sincere one to this citizen

Sincerely

Joseph A Prezioso County of Santa Clara

Joseph A Prezioso

7

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Agency

Kamala D Harris Attorney General California Department of Justice

Jayne Kim Acting Chief Trial Counsel The State Bar of California

Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services

Thomas E Perez Assistant Attorney General US Department of Justice Civil Rights Division

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services

Kathleen Sebelius Secretary US Department Health amp Human Services

Edmund G Brown Jr Governor State of California

Kim Madsen Executive Officer California Board of Behavioral Sciences

Linda Whitney Executive Director Medical Board of California

Dennis Burns Chief of Police City of Palo Alto Police Department

Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley

Eric H Holder Jr Attorney General of the United States US Department of Justice

William B Zielinski San Francisco Regional Commissioner Social Security Administration

Tani Cantil-Sakauye Honorable Chief Justice Supreme Court of California

M June Horner Director Civil Rights Health Resources amp Services Administration (HRSA) US HHS

John F Moroney Regional Administrator Health Resources amp Services Administration (HRSA) US HHS

George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara

Mary K Wakefield Administrator Health Resources and Services Administration (HRSA) US HHS Services

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

Stephanie Douglas Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services

Scott R Seaman Chief of Police Los Gatos Police Department

Anna M Caballero Secretary State and Consumer Services Agency

Jonathan Clarkson Deputy Director Office of Civil Rights Department of Health Care Services

Charlene Popke District Manager San Jose Office Licensing and Certification Program (LampC) CDPH

Louise R Bailey Med RN Executive Officer Board of Registered Nursing

David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS)

Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS)

Chris Moore Chief of Police San Jose Police Department

Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

State of CaliforniamdashHealth and Human Services Agency Department of Health Care Services

TOBY DOUGLAS EDMUND G BROWN JR DIRECTOR GOVERNOR

March 02 2011 The Honorable Mark Leno Chair Joint Legislative Budget Committee 1020 N Street Room 553 Sacramento CA 95814 Dear Senator Leno On behalf of the Department of Health Care Services (DHCS) I am providing you with the information pursuant to Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103 (Chapter 228 Statutes of 2004)

All children who are enrolled with a managed care contractor who are seeking CCS program benefits shall retain all rights to CCS program appeals and fair hearings of denials of medical eligibility or of service authorizations Information regarding the number nature and disposition of appeals and fair hearings shall be part of an annual report to the Legislature on managed care contractor compliance with CCS standards regulations and procedures This report shall be made available to the public

The following County Organized Health Systems (COHS) provided capitated California Childrenrsquos Services (CCS) benefits in Calendar Year 2010

bull Partnership Health Plan of California (Napa Solano and Yolo Counties)

bull The Health Plan of San Mateo

bull CenCal Health (formerly known as the Santa Barbara Regional Health Authority and only provides CCS benefits in Santa Barbara County)

The County CCS programs have case management responsibilities in the five counties served by these COHS including determination of medical eligibility and approval of medically necessary services for children with a CCS eligible condition

Directors Office 1501 Capitol Avenue MS 0006 PO Box 997413

Sacramento CA 95899-7413 Phone (916) 440-7400 Fax (916) 440-7404

Internet Address httpwwwDHCScagov

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

Joseph A Prezioso

2

I also want to state for the record that there is no evidence that I have or ever had ldquofull scope Medi-Calrdquo and can

state with absolute certainty I have not received to this date any medically necessary services of any kind But I

have been dis-enrolled from my County of Santa Clara DCHS approved LIHP MCE insurance plan and kicked out of my County of Santa Clara wholly owned and operated Federally Qualified Health Clinic (FQHC) the Santa Clara Valley Medical Center at Moorpark Clinic (the very MEDICAL HOME indicated on the California

Department of Health Care Services issued GHPP Authorization SAR 99033765400) by Shari Hurst

Director of Customer Service Santa Clara Valley Medical Center for the ldquoaudacityrdquo to file a grievance

Director Douglas is there any system documentation that indicates or ever indicated that I have or ever had full scope Medi-Cal with no share of cost and I am or ever were eligible to receive medically necessary services

Can you please answer that question and provide an explanation andor documentation

I believe that

David V Banda Chief Statewide Programs Section (SPS) DCHS

Carol Hazell Genetically Handicapped Persons Program (GHPP) office DHCS

Shari Hurst Director of Customer Service Santa Clara Valley Medical Center

have acted in concert and engaged in a conspiracy and their actions are violations of

California HEALTH AND SAFETY CODE SECTION 124985 which states

A violation of any of the provisions of the Hereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I also believe these are acts of Official Misconduct in violation of Conspiracy Against Rights 18 USC sect

241 Section 241 of Title 18 in the civil rights conspiracy statute It makes it unlawful for two or

more persons to agree together to injure threaten or intimidate a person in any state territory

or district in the free exercise or enjoyment of any right or privilege secured to himher by the

Constitution or the laws of the Unites States Unlike most conspiracy statutes Section 241 does not

require that one of the conspirators commit an overt act prior to the conspiracy becoming a crime

I also believe these acts are a violation of Deprivation of Rights Under Color of Law 18 USC sect 242 This

provision makes it a crime for a person acting under color of any law to willfully deprive a person of a right or

privilege protected by the Constitution or laws of the United States For the purpose of Section 242 acts under

color of law include acts not only done by federal state or local officials within the their lawful authority but

also acts done beyond the bounds of that officials lawful authority if the acts are done while the official is

purporting to or pretending to act in the performance of hisher official duties It is not necessary that the crime

be motivated by animus toward the race color religion sex handicap familial status or national origin of the

victim

Joseph A Prezioso

3

And yes I believe that it is an unequivocal fact that both the CALIFORNIA MEDICAL ASSISTANCE

(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) and the County of

Santa Clara Low Income Health Plan (LIHP) Medicaid Coverage Extension (MCE) plan approved by

the Department of Health Care Services (DCHS) are Title XIX of the Social Security Act programs

These programs are covered under the California Section 1115 Medicaid demonstration waiver

NUMBER 11-W-001939 which represents a contractual agreement between the State of California and the

Federal Government and must be administered in conformity with specific requirements of Title XIX of the Social

Security Act and regulations outlined in Chapter IV of the Code of Federal Regulations The State Plan contains all

information necessary for the Centers for Medicare and Medicaid Services (CMS) to determine if the State can

receive Federal Financial Participation (FFP)

This waiver as approved by the US Department of Health amp Human Services also affords me a property right in

my governments Medi-Cal Title XIX Federally funded healthcare programs In addition my property right

guaranteed me by the Constitution of the United States of America shall not be deprived without due

process of law Furthermore the Constitution of the United States of America provides me the right to Equal

Protection of the law stating no state shall deny to any person within its jurisdiction the equal protection of

the laws The Equal Protection Clause is intended to secure the promise of the United States professed

commitment to the proposition that all men are created equalrdquo

Director Douglas am I less equal than any other citizen

I have the right to count on my US Constitutional protections of due process of law whenever the government

wants to limit the full use of my property right or to take it away As a Medi-Cal applicant I have a right to

adequate notice and to an administrative fair hearing These rights are guaranteed by the Due Process Clause of

the United States Constitution (US Const amend XIV sect 1 42 USC sect 1396a(a)(3) 42 CFR sectsect 431200-

431250)

The very purpose of the Medicaid Act is to enable each State to furnish rehabilitation and other services to help

such families and individuals attain or retain capability for independence or self-care (42 USC sect 1396) The

Medicaid Act requires that each state Medicaid program be administered in the best interests of the recipients

(42 USC sect 1396a(a)(19) See also SRep No 404 89th Cong 1st Sess reprinted in [1965] US Code Cong amp

Admin News 1943 2104)

Medicaid agencies must make all rules and policies available to the public and provide copies to legal services

offices (42 CFR sect 43118) State Medicaid Programs must provide an opportunity for a fair hearing

(42 USC sect 1396a(a)(3)) Medicaid applicants and beneficiaries are entitled to a hearing whenever a service or a

request for a service is reduced denied terminated or not acted upon with reasonable promptness (42

CFR sect 431200 et seq) Goldberg v Kelley 397 US 254 (1970) Public assistance beneficiaries have a

constitutional due process right to a hearing prior to the termination of benefits This due process right

includes adequate and timely notice the opportunity to be heard by an impartial decision maker

Joseph A Prezioso

4

and a decision based upon evidence adduced at the hearing Medicaid regulations governing fair

hearings 42 CFR sect 431200 et seq provide detailed requirements regarding content and timing of notice

hearing procedures and the content and timing of hearing decisions The due process requirements of the

Medicaid Act are enforceable under 42 USC sect 1983

All categorically eligible beneficiaries must receive medical assistance that is no less than that provided to other

eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must be

sufficient in amount duration and scope to reasonably achieve its purposerdquo 42 CFR sect 440230(b)

The amount duration and scope provisions of the Medicaid Act and implementing regulations provide strong

support to challenge exclusions of treatment that fall within the scope of services covered There is a long line of

judicial decisions limiting states discretion to exclude medically necessary treatment that falls within the scope of

a covered service State Medicaid programs may not limit services based upon diagnosis type of illness or medical

condition 42 CFR sect440230(c) The operation of state Medicaid programs must be based upon reasonable

standards 42 USC sect 1396a(a)(17)

State Medicaid programs must include safeguards to ensure that services will be provided in a manner consistent

with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19) A Notice of

Action is if the state plan takes an action other than an approval including a denial or a deferral on a providerrsquos

request for any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate the notice

must be in writing and contain a statement of the intended action as well as the reasons and specific legal support

for the action (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In addition the

notice must contain an explanation of the individualrsquos hearing rights rights to representation and to

continued benefits (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c))

In the Americans with Disabilities Act (ADA) Congress provided that the Nations proper goals regarding

individuals with disabilities are to assure equality of opportunity frill participation independent living and

economic self-sufficiency for such individuals 42 USC sect 12101(a)(8) Title II of the ADA further provides that

no qualified individual with a disability shall by reason of such disability be excluded from

participation in or be denied the benefits of the services programs or activities of a public entity

or be the subject of discrimination by any such entity 42 USC sect 12132

Genetically Handicapped Persons Program Policy Letter G-01-1200 (Benefits) states

POLICY

GHPP shall authorize SCC services for all GHPP clients who are required by program policy to receive

care through GHPP approved outpatient special care centers

These services shall be authorized as GHPP benefits for all eligible GHPP clients

IMPLEMENTAION

Referral of a client to a SCC

Joseph A Prezioso

5

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make specific the

law enforced or administered by itrdquo

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney

406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from

denying benefits even temporarilyrdquo This delay in acting upon my application providing authorized

medical services and preventing me from having my right to a State Fair Hearing is an egregious

violation of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the

Medicaid Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all

treaties made or which shall be made under the authority of the United States shall be the supreme

law of the land and the judges in every state shall be bound thereby anything in the constitution or

laws of any state to the contrary notwithstandingrdquo

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Joseph A Prezioso

6

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

David V Banda Chief Statewide Programs Section (SPS) DCHS Carol Hazell Genetically

Handicapped Persons Program (GHPP) office DHCS and Shari Hurst Director of Customer

Service Santa Clara Valley Medical Center do not seem to understand that it is not right to interfere

with my rights ndash these are not their programs these are my programs They do not make the laws

they must obey the laws If you do not want to abide by Federal law then give back the Federal

money ndash this brings disgrace upon the good people who are the State of California

Dear Director Douglas are you not my Director of the Department of Health Care Services

The courtesy of a response DIRECTLY FROM YOU IS REQUESTED NOT THE GENERAL

COUNSEL of the DEPARTMENT OF HEALTH CARE SERVICES who has NO INTEREST in

representing MY INTERESTS

Chief Counsel Douglas Michael Press Department of Health Care Services wanted to meet with

me in person What an honor However he seemed quite displeased when I suggested that it

might be more appropriate to have such a meeting with a representative of the United States

Department of Justice

Director Douglas what is there to hide Wouldnrsquot it be more proper and transparent to have a

representative of the United States Department of Justice Civil Rights Division present for a

meeting between the Chief Counsel of the Department of Health Care Services and a poor

disabled and deprived shelter resident at the Emmanuel House who is receiving no medical care

Director Douglas who is looking out for and protecting this citizenrsquos interests

I respectfully request an answer I trust and hope you have the character to provide a forthright

and sincere one to this citizen

Sincerely

Joseph A Prezioso County of Santa Clara

Joseph A Prezioso

7

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Agency

Kamala D Harris Attorney General California Department of Justice

Jayne Kim Acting Chief Trial Counsel The State Bar of California

Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services

Thomas E Perez Assistant Attorney General US Department of Justice Civil Rights Division

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services

Kathleen Sebelius Secretary US Department Health amp Human Services

Edmund G Brown Jr Governor State of California

Kim Madsen Executive Officer California Board of Behavioral Sciences

Linda Whitney Executive Director Medical Board of California

Dennis Burns Chief of Police City of Palo Alto Police Department

Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley

Eric H Holder Jr Attorney General of the United States US Department of Justice

William B Zielinski San Francisco Regional Commissioner Social Security Administration

Tani Cantil-Sakauye Honorable Chief Justice Supreme Court of California

M June Horner Director Civil Rights Health Resources amp Services Administration (HRSA) US HHS

John F Moroney Regional Administrator Health Resources amp Services Administration (HRSA) US HHS

George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara

Mary K Wakefield Administrator Health Resources and Services Administration (HRSA) US HHS Services

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

Stephanie Douglas Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services

Scott R Seaman Chief of Police Los Gatos Police Department

Anna M Caballero Secretary State and Consumer Services Agency

Jonathan Clarkson Deputy Director Office of Civil Rights Department of Health Care Services

Charlene Popke District Manager San Jose Office Licensing and Certification Program (LampC) CDPH

Louise R Bailey Med RN Executive Officer Board of Registered Nursing

David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS)

Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS)

Chris Moore Chief of Police San Jose Police Department

Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

State of CaliforniamdashHealth and Human Services Agency Department of Health Care Services

TOBY DOUGLAS EDMUND G BROWN JR DIRECTOR GOVERNOR

March 02 2011 The Honorable Mark Leno Chair Joint Legislative Budget Committee 1020 N Street Room 553 Sacramento CA 95814 Dear Senator Leno On behalf of the Department of Health Care Services (DHCS) I am providing you with the information pursuant to Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103 (Chapter 228 Statutes of 2004)

All children who are enrolled with a managed care contractor who are seeking CCS program benefits shall retain all rights to CCS program appeals and fair hearings of denials of medical eligibility or of service authorizations Information regarding the number nature and disposition of appeals and fair hearings shall be part of an annual report to the Legislature on managed care contractor compliance with CCS standards regulations and procedures This report shall be made available to the public

The following County Organized Health Systems (COHS) provided capitated California Childrenrsquos Services (CCS) benefits in Calendar Year 2010

bull Partnership Health Plan of California (Napa Solano and Yolo Counties)

bull The Health Plan of San Mateo

bull CenCal Health (formerly known as the Santa Barbara Regional Health Authority and only provides CCS benefits in Santa Barbara County)

The County CCS programs have case management responsibilities in the five counties served by these COHS including determination of medical eligibility and approval of medically necessary services for children with a CCS eligible condition

Directors Office 1501 Capitol Avenue MS 0006 PO Box 997413

Sacramento CA 95899-7413 Phone (916) 440-7400 Fax (916) 440-7404

Internet Address httpwwwDHCScagov

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

Joseph A Prezioso

3

And yes I believe that it is an unequivocal fact that both the CALIFORNIA MEDICAL ASSISTANCE

(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) and the County of

Santa Clara Low Income Health Plan (LIHP) Medicaid Coverage Extension (MCE) plan approved by

the Department of Health Care Services (DCHS) are Title XIX of the Social Security Act programs

These programs are covered under the California Section 1115 Medicaid demonstration waiver

NUMBER 11-W-001939 which represents a contractual agreement between the State of California and the

Federal Government and must be administered in conformity with specific requirements of Title XIX of the Social

Security Act and regulations outlined in Chapter IV of the Code of Federal Regulations The State Plan contains all

information necessary for the Centers for Medicare and Medicaid Services (CMS) to determine if the State can

receive Federal Financial Participation (FFP)

This waiver as approved by the US Department of Health amp Human Services also affords me a property right in

my governments Medi-Cal Title XIX Federally funded healthcare programs In addition my property right

guaranteed me by the Constitution of the United States of America shall not be deprived without due

process of law Furthermore the Constitution of the United States of America provides me the right to Equal

Protection of the law stating no state shall deny to any person within its jurisdiction the equal protection of

the laws The Equal Protection Clause is intended to secure the promise of the United States professed

commitment to the proposition that all men are created equalrdquo

Director Douglas am I less equal than any other citizen

I have the right to count on my US Constitutional protections of due process of law whenever the government

wants to limit the full use of my property right or to take it away As a Medi-Cal applicant I have a right to

adequate notice and to an administrative fair hearing These rights are guaranteed by the Due Process Clause of

the United States Constitution (US Const amend XIV sect 1 42 USC sect 1396a(a)(3) 42 CFR sectsect 431200-

431250)

The very purpose of the Medicaid Act is to enable each State to furnish rehabilitation and other services to help

such families and individuals attain or retain capability for independence or self-care (42 USC sect 1396) The

Medicaid Act requires that each state Medicaid program be administered in the best interests of the recipients

(42 USC sect 1396a(a)(19) See also SRep No 404 89th Cong 1st Sess reprinted in [1965] US Code Cong amp

Admin News 1943 2104)

Medicaid agencies must make all rules and policies available to the public and provide copies to legal services

offices (42 CFR sect 43118) State Medicaid Programs must provide an opportunity for a fair hearing

(42 USC sect 1396a(a)(3)) Medicaid applicants and beneficiaries are entitled to a hearing whenever a service or a

request for a service is reduced denied terminated or not acted upon with reasonable promptness (42

CFR sect 431200 et seq) Goldberg v Kelley 397 US 254 (1970) Public assistance beneficiaries have a

constitutional due process right to a hearing prior to the termination of benefits This due process right

includes adequate and timely notice the opportunity to be heard by an impartial decision maker

Joseph A Prezioso

4

and a decision based upon evidence adduced at the hearing Medicaid regulations governing fair

hearings 42 CFR sect 431200 et seq provide detailed requirements regarding content and timing of notice

hearing procedures and the content and timing of hearing decisions The due process requirements of the

Medicaid Act are enforceable under 42 USC sect 1983

All categorically eligible beneficiaries must receive medical assistance that is no less than that provided to other

eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must be

sufficient in amount duration and scope to reasonably achieve its purposerdquo 42 CFR sect 440230(b)

The amount duration and scope provisions of the Medicaid Act and implementing regulations provide strong

support to challenge exclusions of treatment that fall within the scope of services covered There is a long line of

judicial decisions limiting states discretion to exclude medically necessary treatment that falls within the scope of

a covered service State Medicaid programs may not limit services based upon diagnosis type of illness or medical

condition 42 CFR sect440230(c) The operation of state Medicaid programs must be based upon reasonable

standards 42 USC sect 1396a(a)(17)

State Medicaid programs must include safeguards to ensure that services will be provided in a manner consistent

with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19) A Notice of

Action is if the state plan takes an action other than an approval including a denial or a deferral on a providerrsquos

request for any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate the notice

must be in writing and contain a statement of the intended action as well as the reasons and specific legal support

for the action (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In addition the

notice must contain an explanation of the individualrsquos hearing rights rights to representation and to

continued benefits (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c))

In the Americans with Disabilities Act (ADA) Congress provided that the Nations proper goals regarding

individuals with disabilities are to assure equality of opportunity frill participation independent living and

economic self-sufficiency for such individuals 42 USC sect 12101(a)(8) Title II of the ADA further provides that

no qualified individual with a disability shall by reason of such disability be excluded from

participation in or be denied the benefits of the services programs or activities of a public entity

or be the subject of discrimination by any such entity 42 USC sect 12132

Genetically Handicapped Persons Program Policy Letter G-01-1200 (Benefits) states

POLICY

GHPP shall authorize SCC services for all GHPP clients who are required by program policy to receive

care through GHPP approved outpatient special care centers

These services shall be authorized as GHPP benefits for all eligible GHPP clients

IMPLEMENTAION

Referral of a client to a SCC

Joseph A Prezioso

5

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make specific the

law enforced or administered by itrdquo

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney

406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from

denying benefits even temporarilyrdquo This delay in acting upon my application providing authorized

medical services and preventing me from having my right to a State Fair Hearing is an egregious

violation of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the

Medicaid Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all

treaties made or which shall be made under the authority of the United States shall be the supreme

law of the land and the judges in every state shall be bound thereby anything in the constitution or

laws of any state to the contrary notwithstandingrdquo

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Joseph A Prezioso

6

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

David V Banda Chief Statewide Programs Section (SPS) DCHS Carol Hazell Genetically

Handicapped Persons Program (GHPP) office DHCS and Shari Hurst Director of Customer

Service Santa Clara Valley Medical Center do not seem to understand that it is not right to interfere

with my rights ndash these are not their programs these are my programs They do not make the laws

they must obey the laws If you do not want to abide by Federal law then give back the Federal

money ndash this brings disgrace upon the good people who are the State of California

Dear Director Douglas are you not my Director of the Department of Health Care Services

The courtesy of a response DIRECTLY FROM YOU IS REQUESTED NOT THE GENERAL

COUNSEL of the DEPARTMENT OF HEALTH CARE SERVICES who has NO INTEREST in

representing MY INTERESTS

Chief Counsel Douglas Michael Press Department of Health Care Services wanted to meet with

me in person What an honor However he seemed quite displeased when I suggested that it

might be more appropriate to have such a meeting with a representative of the United States

Department of Justice

Director Douglas what is there to hide Wouldnrsquot it be more proper and transparent to have a

representative of the United States Department of Justice Civil Rights Division present for a

meeting between the Chief Counsel of the Department of Health Care Services and a poor

disabled and deprived shelter resident at the Emmanuel House who is receiving no medical care

Director Douglas who is looking out for and protecting this citizenrsquos interests

I respectfully request an answer I trust and hope you have the character to provide a forthright

and sincere one to this citizen

Sincerely

Joseph A Prezioso County of Santa Clara

Joseph A Prezioso

7

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Agency

Kamala D Harris Attorney General California Department of Justice

Jayne Kim Acting Chief Trial Counsel The State Bar of California

Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services

Thomas E Perez Assistant Attorney General US Department of Justice Civil Rights Division

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services

Kathleen Sebelius Secretary US Department Health amp Human Services

Edmund G Brown Jr Governor State of California

Kim Madsen Executive Officer California Board of Behavioral Sciences

Linda Whitney Executive Director Medical Board of California

Dennis Burns Chief of Police City of Palo Alto Police Department

Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley

Eric H Holder Jr Attorney General of the United States US Department of Justice

William B Zielinski San Francisco Regional Commissioner Social Security Administration

Tani Cantil-Sakauye Honorable Chief Justice Supreme Court of California

M June Horner Director Civil Rights Health Resources amp Services Administration (HRSA) US HHS

John F Moroney Regional Administrator Health Resources amp Services Administration (HRSA) US HHS

George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara

Mary K Wakefield Administrator Health Resources and Services Administration (HRSA) US HHS Services

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

Stephanie Douglas Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services

Scott R Seaman Chief of Police Los Gatos Police Department

Anna M Caballero Secretary State and Consumer Services Agency

Jonathan Clarkson Deputy Director Office of Civil Rights Department of Health Care Services

Charlene Popke District Manager San Jose Office Licensing and Certification Program (LampC) CDPH

Louise R Bailey Med RN Executive Officer Board of Registered Nursing

David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS)

Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS)

Chris Moore Chief of Police San Jose Police Department

Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

State of CaliforniamdashHealth and Human Services Agency Department of Health Care Services

TOBY DOUGLAS EDMUND G BROWN JR DIRECTOR GOVERNOR

March 02 2011 The Honorable Mark Leno Chair Joint Legislative Budget Committee 1020 N Street Room 553 Sacramento CA 95814 Dear Senator Leno On behalf of the Department of Health Care Services (DHCS) I am providing you with the information pursuant to Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103 (Chapter 228 Statutes of 2004)

All children who are enrolled with a managed care contractor who are seeking CCS program benefits shall retain all rights to CCS program appeals and fair hearings of denials of medical eligibility or of service authorizations Information regarding the number nature and disposition of appeals and fair hearings shall be part of an annual report to the Legislature on managed care contractor compliance with CCS standards regulations and procedures This report shall be made available to the public

The following County Organized Health Systems (COHS) provided capitated California Childrenrsquos Services (CCS) benefits in Calendar Year 2010

bull Partnership Health Plan of California (Napa Solano and Yolo Counties)

bull The Health Plan of San Mateo

bull CenCal Health (formerly known as the Santa Barbara Regional Health Authority and only provides CCS benefits in Santa Barbara County)

The County CCS programs have case management responsibilities in the five counties served by these COHS including determination of medical eligibility and approval of medically necessary services for children with a CCS eligible condition

Directors Office 1501 Capitol Avenue MS 0006 PO Box 997413

Sacramento CA 95899-7413 Phone (916) 440-7400 Fax (916) 440-7404

Internet Address httpwwwDHCScagov

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

Joseph A Prezioso

4

and a decision based upon evidence adduced at the hearing Medicaid regulations governing fair

hearings 42 CFR sect 431200 et seq provide detailed requirements regarding content and timing of notice

hearing procedures and the content and timing of hearing decisions The due process requirements of the

Medicaid Act are enforceable under 42 USC sect 1983

All categorically eligible beneficiaries must receive medical assistance that is no less than that provided to other

eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must be

sufficient in amount duration and scope to reasonably achieve its purposerdquo 42 CFR sect 440230(b)

The amount duration and scope provisions of the Medicaid Act and implementing regulations provide strong

support to challenge exclusions of treatment that fall within the scope of services covered There is a long line of

judicial decisions limiting states discretion to exclude medically necessary treatment that falls within the scope of

a covered service State Medicaid programs may not limit services based upon diagnosis type of illness or medical

condition 42 CFR sect440230(c) The operation of state Medicaid programs must be based upon reasonable

standards 42 USC sect 1396a(a)(17)

State Medicaid programs must include safeguards to ensure that services will be provided in a manner consistent

with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19) A Notice of

Action is if the state plan takes an action other than an approval including a denial or a deferral on a providerrsquos

request for any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate the notice

must be in writing and contain a statement of the intended action as well as the reasons and specific legal support

for the action (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In addition the

notice must contain an explanation of the individualrsquos hearing rights rights to representation and to

continued benefits (42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c))

In the Americans with Disabilities Act (ADA) Congress provided that the Nations proper goals regarding

individuals with disabilities are to assure equality of opportunity frill participation independent living and

economic self-sufficiency for such individuals 42 USC sect 12101(a)(8) Title II of the ADA further provides that

no qualified individual with a disability shall by reason of such disability be excluded from

participation in or be denied the benefits of the services programs or activities of a public entity

or be the subject of discrimination by any such entity 42 USC sect 12132

Genetically Handicapped Persons Program Policy Letter G-01-1200 (Benefits) states

POLICY

GHPP shall authorize SCC services for all GHPP clients who are required by program policy to receive

care through GHPP approved outpatient special care centers

These services shall be authorized as GHPP benefits for all eligible GHPP clients

IMPLEMENTAION

Referral of a client to a SCC

Joseph A Prezioso

5

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make specific the

law enforced or administered by itrdquo

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney

406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from

denying benefits even temporarilyrdquo This delay in acting upon my application providing authorized

medical services and preventing me from having my right to a State Fair Hearing is an egregious

violation of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the

Medicaid Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all

treaties made or which shall be made under the authority of the United States shall be the supreme

law of the land and the judges in every state shall be bound thereby anything in the constitution or

laws of any state to the contrary notwithstandingrdquo

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Joseph A Prezioso

6

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

David V Banda Chief Statewide Programs Section (SPS) DCHS Carol Hazell Genetically

Handicapped Persons Program (GHPP) office DHCS and Shari Hurst Director of Customer

Service Santa Clara Valley Medical Center do not seem to understand that it is not right to interfere

with my rights ndash these are not their programs these are my programs They do not make the laws

they must obey the laws If you do not want to abide by Federal law then give back the Federal

money ndash this brings disgrace upon the good people who are the State of California

Dear Director Douglas are you not my Director of the Department of Health Care Services

The courtesy of a response DIRECTLY FROM YOU IS REQUESTED NOT THE GENERAL

COUNSEL of the DEPARTMENT OF HEALTH CARE SERVICES who has NO INTEREST in

representing MY INTERESTS

Chief Counsel Douglas Michael Press Department of Health Care Services wanted to meet with

me in person What an honor However he seemed quite displeased when I suggested that it

might be more appropriate to have such a meeting with a representative of the United States

Department of Justice

Director Douglas what is there to hide Wouldnrsquot it be more proper and transparent to have a

representative of the United States Department of Justice Civil Rights Division present for a

meeting between the Chief Counsel of the Department of Health Care Services and a poor

disabled and deprived shelter resident at the Emmanuel House who is receiving no medical care

Director Douglas who is looking out for and protecting this citizenrsquos interests

I respectfully request an answer I trust and hope you have the character to provide a forthright

and sincere one to this citizen

Sincerely

Joseph A Prezioso County of Santa Clara

Joseph A Prezioso

7

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Agency

Kamala D Harris Attorney General California Department of Justice

Jayne Kim Acting Chief Trial Counsel The State Bar of California

Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services

Thomas E Perez Assistant Attorney General US Department of Justice Civil Rights Division

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services

Kathleen Sebelius Secretary US Department Health amp Human Services

Edmund G Brown Jr Governor State of California

Kim Madsen Executive Officer California Board of Behavioral Sciences

Linda Whitney Executive Director Medical Board of California

Dennis Burns Chief of Police City of Palo Alto Police Department

Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley

Eric H Holder Jr Attorney General of the United States US Department of Justice

William B Zielinski San Francisco Regional Commissioner Social Security Administration

Tani Cantil-Sakauye Honorable Chief Justice Supreme Court of California

M June Horner Director Civil Rights Health Resources amp Services Administration (HRSA) US HHS

John F Moroney Regional Administrator Health Resources amp Services Administration (HRSA) US HHS

George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara

Mary K Wakefield Administrator Health Resources and Services Administration (HRSA) US HHS Services

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

Stephanie Douglas Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services

Scott R Seaman Chief of Police Los Gatos Police Department

Anna M Caballero Secretary State and Consumer Services Agency

Jonathan Clarkson Deputy Director Office of Civil Rights Department of Health Care Services

Charlene Popke District Manager San Jose Office Licensing and Certification Program (LampC) CDPH

Louise R Bailey Med RN Executive Officer Board of Registered Nursing

David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS)

Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS)

Chris Moore Chief of Police San Jose Police Department

Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

State of CaliforniamdashHealth and Human Services Agency Department of Health Care Services

TOBY DOUGLAS EDMUND G BROWN JR DIRECTOR GOVERNOR

March 02 2011 The Honorable Mark Leno Chair Joint Legislative Budget Committee 1020 N Street Room 553 Sacramento CA 95814 Dear Senator Leno On behalf of the Department of Health Care Services (DHCS) I am providing you with the information pursuant to Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103 (Chapter 228 Statutes of 2004)

All children who are enrolled with a managed care contractor who are seeking CCS program benefits shall retain all rights to CCS program appeals and fair hearings of denials of medical eligibility or of service authorizations Information regarding the number nature and disposition of appeals and fair hearings shall be part of an annual report to the Legislature on managed care contractor compliance with CCS standards regulations and procedures This report shall be made available to the public

The following County Organized Health Systems (COHS) provided capitated California Childrenrsquos Services (CCS) benefits in Calendar Year 2010

bull Partnership Health Plan of California (Napa Solano and Yolo Counties)

bull The Health Plan of San Mateo

bull CenCal Health (formerly known as the Santa Barbara Regional Health Authority and only provides CCS benefits in Santa Barbara County)

The County CCS programs have case management responsibilities in the five counties served by these COHS including determination of medical eligibility and approval of medically necessary services for children with a CCS eligible condition

Directors Office 1501 Capitol Avenue MS 0006 PO Box 997413

Sacramento CA 95899-7413 Phone (916) 440-7400 Fax (916) 440-7404

Internet Address httpwwwDHCScagov

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

Joseph A Prezioso

5

GHPP clients shall be referred to the appropriate GHPP-approved SCC for diagnosis evaluation medical

management and coordination of care when the client has or is suspected of having a GHPP medically

eligible condition requiring SCC evaluation and follow-up

CMS Information Notice No 03-03 published by the Director of the California Department of Health Care

Services contained the following statement

ldquoAs you know the general purpose of having regulations is to implement interpret or make specific the

law enforced or administered by itrdquo

As a Title XIX of the Social Security Act program 42 USC Sec 1396a (a) (8) requires that medical assistance

must ldquobe furnished with reasonable promptnessrdquo Chief Justice Rehnquist stated in Jefferson v Hackney

406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that Title XIX ldquowas intended to prevent States from

denying benefits even temporarilyrdquo This delay in acting upon my application providing authorized

medical services and preventing me from having my right to a State Fair Hearing is an egregious

violation of the ldquoamount duration or scope requirement of the compatibility provisionrdquo of the

Medicaid Act

The ldquoSupremacy Clauserdquo of the United States Constitution Article VI Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuance thereof and all

treaties made or which shall be made under the authority of the United States shall be the supreme

law of the land and the judges in every state shall be bound thereby anything in the constitution or

laws of any state to the contrary notwithstandingrdquo

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulated three purposes

for passage of the statute

to override certain kinds of state laws

to provide ldquoa remedy where state law was inadequate and

to provide ldquoa federal remedy where the state remedy though adequate in theory was not

available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become a powerful statute for

enforcing rights secured by the Fourteenth Amendment First it held that actions taken by state governmental

officials even if contrary to state law were nevertheless actions taken ldquounder color of lawrdquo Second the Court held

that injured individuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions also violated

state law In short the statute was intended to provide a supplemental remedy The federal forum was

necessary to vindicate federal rights because according to Congress in 1871 state courts could not

protect Fourteenth Amendment rights because of their ldquoprejudice passion neglect [and]

intolerancerdquo

Joseph A Prezioso

6

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

David V Banda Chief Statewide Programs Section (SPS) DCHS Carol Hazell Genetically

Handicapped Persons Program (GHPP) office DHCS and Shari Hurst Director of Customer

Service Santa Clara Valley Medical Center do not seem to understand that it is not right to interfere

with my rights ndash these are not their programs these are my programs They do not make the laws

they must obey the laws If you do not want to abide by Federal law then give back the Federal

money ndash this brings disgrace upon the good people who are the State of California

Dear Director Douglas are you not my Director of the Department of Health Care Services

The courtesy of a response DIRECTLY FROM YOU IS REQUESTED NOT THE GENERAL

COUNSEL of the DEPARTMENT OF HEALTH CARE SERVICES who has NO INTEREST in

representing MY INTERESTS

Chief Counsel Douglas Michael Press Department of Health Care Services wanted to meet with

me in person What an honor However he seemed quite displeased when I suggested that it

might be more appropriate to have such a meeting with a representative of the United States

Department of Justice

Director Douglas what is there to hide Wouldnrsquot it be more proper and transparent to have a

representative of the United States Department of Justice Civil Rights Division present for a

meeting between the Chief Counsel of the Department of Health Care Services and a poor

disabled and deprived shelter resident at the Emmanuel House who is receiving no medical care

Director Douglas who is looking out for and protecting this citizenrsquos interests

I respectfully request an answer I trust and hope you have the character to provide a forthright

and sincere one to this citizen

Sincerely

Joseph A Prezioso County of Santa Clara

Joseph A Prezioso

7

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Agency

Kamala D Harris Attorney General California Department of Justice

Jayne Kim Acting Chief Trial Counsel The State Bar of California

Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services

Thomas E Perez Assistant Attorney General US Department of Justice Civil Rights Division

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services

Kathleen Sebelius Secretary US Department Health amp Human Services

Edmund G Brown Jr Governor State of California

Kim Madsen Executive Officer California Board of Behavioral Sciences

Linda Whitney Executive Director Medical Board of California

Dennis Burns Chief of Police City of Palo Alto Police Department

Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley

Eric H Holder Jr Attorney General of the United States US Department of Justice

William B Zielinski San Francisco Regional Commissioner Social Security Administration

Tani Cantil-Sakauye Honorable Chief Justice Supreme Court of California

M June Horner Director Civil Rights Health Resources amp Services Administration (HRSA) US HHS

John F Moroney Regional Administrator Health Resources amp Services Administration (HRSA) US HHS

George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara

Mary K Wakefield Administrator Health Resources and Services Administration (HRSA) US HHS Services

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

Stephanie Douglas Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services

Scott R Seaman Chief of Police Los Gatos Police Department

Anna M Caballero Secretary State and Consumer Services Agency

Jonathan Clarkson Deputy Director Office of Civil Rights Department of Health Care Services

Charlene Popke District Manager San Jose Office Licensing and Certification Program (LampC) CDPH

Louise R Bailey Med RN Executive Officer Board of Registered Nursing

David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS)

Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS)

Chris Moore Chief of Police San Jose Police Department

Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

State of CaliforniamdashHealth and Human Services Agency Department of Health Care Services

TOBY DOUGLAS EDMUND G BROWN JR DIRECTOR GOVERNOR

March 02 2011 The Honorable Mark Leno Chair Joint Legislative Budget Committee 1020 N Street Room 553 Sacramento CA 95814 Dear Senator Leno On behalf of the Department of Health Care Services (DHCS) I am providing you with the information pursuant to Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103 (Chapter 228 Statutes of 2004)

All children who are enrolled with a managed care contractor who are seeking CCS program benefits shall retain all rights to CCS program appeals and fair hearings of denials of medical eligibility or of service authorizations Information regarding the number nature and disposition of appeals and fair hearings shall be part of an annual report to the Legislature on managed care contractor compliance with CCS standards regulations and procedures This report shall be made available to the public

The following County Organized Health Systems (COHS) provided capitated California Childrenrsquos Services (CCS) benefits in Calendar Year 2010

bull Partnership Health Plan of California (Napa Solano and Yolo Counties)

bull The Health Plan of San Mateo

bull CenCal Health (formerly known as the Santa Barbara Regional Health Authority and only provides CCS benefits in Santa Barbara County)

The County CCS programs have case management responsibilities in the five counties served by these COHS including determination of medical eligibility and approval of medically necessary services for children with a CCS eligible condition

Directors Office 1501 Capitol Avenue MS 0006 PO Box 997413

Sacramento CA 95899-7413 Phone (916) 440-7400 Fax (916) 440-7404

Internet Address httpwwwDHCScagov

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

Joseph A Prezioso

6

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs must allege two elements

the action occurred ldquounder color of lawrdquo and

the action is a deprivation of a constitutional right or a federal statutory right

David V Banda Chief Statewide Programs Section (SPS) DCHS Carol Hazell Genetically

Handicapped Persons Program (GHPP) office DHCS and Shari Hurst Director of Customer

Service Santa Clara Valley Medical Center do not seem to understand that it is not right to interfere

with my rights ndash these are not their programs these are my programs They do not make the laws

they must obey the laws If you do not want to abide by Federal law then give back the Federal

money ndash this brings disgrace upon the good people who are the State of California

Dear Director Douglas are you not my Director of the Department of Health Care Services

The courtesy of a response DIRECTLY FROM YOU IS REQUESTED NOT THE GENERAL

COUNSEL of the DEPARTMENT OF HEALTH CARE SERVICES who has NO INTEREST in

representing MY INTERESTS

Chief Counsel Douglas Michael Press Department of Health Care Services wanted to meet with

me in person What an honor However he seemed quite displeased when I suggested that it

might be more appropriate to have such a meeting with a representative of the United States

Department of Justice

Director Douglas what is there to hide Wouldnrsquot it be more proper and transparent to have a

representative of the United States Department of Justice Civil Rights Division present for a

meeting between the Chief Counsel of the Department of Health Care Services and a poor

disabled and deprived shelter resident at the Emmanuel House who is receiving no medical care

Director Douglas who is looking out for and protecting this citizenrsquos interests

I respectfully request an answer I trust and hope you have the character to provide a forthright

and sincere one to this citizen

Sincerely

Joseph A Prezioso County of Santa Clara

Joseph A Prezioso

7

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Agency

Kamala D Harris Attorney General California Department of Justice

Jayne Kim Acting Chief Trial Counsel The State Bar of California

Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services

Thomas E Perez Assistant Attorney General US Department of Justice Civil Rights Division

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services

Kathleen Sebelius Secretary US Department Health amp Human Services

Edmund G Brown Jr Governor State of California

Kim Madsen Executive Officer California Board of Behavioral Sciences

Linda Whitney Executive Director Medical Board of California

Dennis Burns Chief of Police City of Palo Alto Police Department

Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley

Eric H Holder Jr Attorney General of the United States US Department of Justice

William B Zielinski San Francisco Regional Commissioner Social Security Administration

Tani Cantil-Sakauye Honorable Chief Justice Supreme Court of California

M June Horner Director Civil Rights Health Resources amp Services Administration (HRSA) US HHS

John F Moroney Regional Administrator Health Resources amp Services Administration (HRSA) US HHS

George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara

Mary K Wakefield Administrator Health Resources and Services Administration (HRSA) US HHS Services

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

Stephanie Douglas Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services

Scott R Seaman Chief of Police Los Gatos Police Department

Anna M Caballero Secretary State and Consumer Services Agency

Jonathan Clarkson Deputy Director Office of Civil Rights Department of Health Care Services

Charlene Popke District Manager San Jose Office Licensing and Certification Program (LampC) CDPH

Louise R Bailey Med RN Executive Officer Board of Registered Nursing

David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS)

Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS)

Chris Moore Chief of Police San Jose Police Department

Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

State of CaliforniamdashHealth and Human Services Agency Department of Health Care Services

TOBY DOUGLAS EDMUND G BROWN JR DIRECTOR GOVERNOR

March 02 2011 The Honorable Mark Leno Chair Joint Legislative Budget Committee 1020 N Street Room 553 Sacramento CA 95814 Dear Senator Leno On behalf of the Department of Health Care Services (DHCS) I am providing you with the information pursuant to Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103 (Chapter 228 Statutes of 2004)

All children who are enrolled with a managed care contractor who are seeking CCS program benefits shall retain all rights to CCS program appeals and fair hearings of denials of medical eligibility or of service authorizations Information regarding the number nature and disposition of appeals and fair hearings shall be part of an annual report to the Legislature on managed care contractor compliance with CCS standards regulations and procedures This report shall be made available to the public

The following County Organized Health Systems (COHS) provided capitated California Childrenrsquos Services (CCS) benefits in Calendar Year 2010

bull Partnership Health Plan of California (Napa Solano and Yolo Counties)

bull The Health Plan of San Mateo

bull CenCal Health (formerly known as the Santa Barbara Regional Health Authority and only provides CCS benefits in Santa Barbara County)

The County CCS programs have case management responsibilities in the five counties served by these COHS including determination of medical eligibility and approval of medically necessary services for children with a CCS eligible condition

Directors Office 1501 Capitol Avenue MS 0006 PO Box 997413

Sacramento CA 95899-7413 Phone (916) 440-7400 Fax (916) 440-7404

Internet Address httpwwwDHCScagov

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

Joseph A Prezioso

7

CC Jill Abramson Executive Editor The New York Times Diana S Dooley Secretary California Health and Human Services Agency

Kamala D Harris Attorney General California Department of Justice

Jayne Kim Acting Chief Trial Counsel The State Bar of California

Michael Leoz Acting Regional Manager IX Office for Civil Rights US Department Health amp Human Services

Thomas E Perez Assistant Attorney General US Department of Justice Civil Rights Division

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department Health amp Human Services

Kathleen Sebelius Secretary US Department Health amp Human Services

Edmund G Brown Jr Governor State of California

Kim Madsen Executive Officer California Board of Behavioral Sciences

Linda Whitney Executive Director Medical Board of California

Dennis Burns Chief of Police City of Palo Alto Police Department

Harry Byrd III Case Manager Emmanuel House The Salvation Army Silicon Valley

Eric H Holder Jr Attorney General of the United States US Department of Justice

William B Zielinski San Francisco Regional Commissioner Social Security Administration

Tani Cantil-Sakauye Honorable Chief Justice Supreme Court of California

M June Horner Director Civil Rights Health Resources amp Services Administration (HRSA) US HHS

John F Moroney Regional Administrator Health Resources amp Services Administration (HRSA) US HHS

George Shirakawa SupervisorndashDistrict 2 The County of Santa Clara

Mary K Wakefield Administrator Health Resources and Services Administration (HRSA) US HHS Services

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

Stephanie Douglas Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Reneacute Mollow MSN RN Chief Medi-Cal Eligibility Division California Department of Health Care Services

Scott R Seaman Chief of Police Los Gatos Police Department

Anna M Caballero Secretary State and Consumer Services Agency

Jonathan Clarkson Deputy Director Office of Civil Rights Department of Health Care Services

Charlene Popke District Manager San Jose Office Licensing and Certification Program (LampC) CDPH

Louise R Bailey Med RN Executive Officer Board of Registered Nursing

David Sayen Regional Administrator Centers for Medicare amp Medicaid Services (CMS)

Michael E Estrada Chief of Investigations Audits amp Investigations Department of Health Care Services (DHCS)

Chris Moore Chief of Police San Jose Police Department

Jim Tashima Bureau Chief Civil Rights Bureau California Department of Social Services

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

State of CaliforniamdashHealth and Human Services Agency Department of Health Care Services

TOBY DOUGLAS EDMUND G BROWN JR DIRECTOR GOVERNOR

March 02 2011 The Honorable Mark Leno Chair Joint Legislative Budget Committee 1020 N Street Room 553 Sacramento CA 95814 Dear Senator Leno On behalf of the Department of Health Care Services (DHCS) I am providing you with the information pursuant to Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103 (Chapter 228 Statutes of 2004)

All children who are enrolled with a managed care contractor who are seeking CCS program benefits shall retain all rights to CCS program appeals and fair hearings of denials of medical eligibility or of service authorizations Information regarding the number nature and disposition of appeals and fair hearings shall be part of an annual report to the Legislature on managed care contractor compliance with CCS standards regulations and procedures This report shall be made available to the public

The following County Organized Health Systems (COHS) provided capitated California Childrenrsquos Services (CCS) benefits in Calendar Year 2010

bull Partnership Health Plan of California (Napa Solano and Yolo Counties)

bull The Health Plan of San Mateo

bull CenCal Health (formerly known as the Santa Barbara Regional Health Authority and only provides CCS benefits in Santa Barbara County)

The County CCS programs have case management responsibilities in the five counties served by these COHS including determination of medical eligibility and approval of medically necessary services for children with a CCS eligible condition

Directors Office 1501 Capitol Avenue MS 0006 PO Box 997413

Sacramento CA 95899-7413 Phone (916) 440-7400 Fax (916) 440-7404

Internet Address httpwwwDHCScagov

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

State of CaliforniamdashHealth and Human Services Agency Department of Health Care Services

TOBY DOUGLAS EDMUND G BROWN JR DIRECTOR GOVERNOR

March 02 2011 The Honorable Mark Leno Chair Joint Legislative Budget Committee 1020 N Street Room 553 Sacramento CA 95814 Dear Senator Leno On behalf of the Department of Health Care Services (DHCS) I am providing you with the information pursuant to Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103 (Chapter 228 Statutes of 2004)

All children who are enrolled with a managed care contractor who are seeking CCS program benefits shall retain all rights to CCS program appeals and fair hearings of denials of medical eligibility or of service authorizations Information regarding the number nature and disposition of appeals and fair hearings shall be part of an annual report to the Legislature on managed care contractor compliance with CCS standards regulations and procedures This report shall be made available to the public

The following County Organized Health Systems (COHS) provided capitated California Childrenrsquos Services (CCS) benefits in Calendar Year 2010

bull Partnership Health Plan of California (Napa Solano and Yolo Counties)

bull The Health Plan of San Mateo

bull CenCal Health (formerly known as the Santa Barbara Regional Health Authority and only provides CCS benefits in Santa Barbara County)

The County CCS programs have case management responsibilities in the five counties served by these COHS including determination of medical eligibility and approval of medically necessary services for children with a CCS eligible condition

Directors Office 1501 Capitol Avenue MS 0006 PO Box 997413

Sacramento CA 95899-7413 Phone (916) 440-7400 Fax (916) 440-7404

Internet Address httpwwwDHCScagov

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

The Honorable Mark Leno Chair Page 2 of 2 March 02 2011

Findings Fair Hearings During calendar year 2010 there were no fair hearings for denial of medical eligibility or medical services requested by Medi-Cal beneficiaries who were CCS applicants or clients and who lived in the five counties identified above Appeals Each of the five counties maintains files on the appeals that are submitted by CCS clients or applicants living in the county These appeals are filed in response to a Notice of Action or letter of denial issued by the county CCS program pursuant to Title 22 California Code of Regulations Section 42700 et seq The Santa Barbara County CCS program with two appeals was the only county reporting appeals of medical eligibility or medical services during the 2010 reporting period The appeals did not result in fair hearings (the CCS clientparentslegal guardian did not request a fair hearing in response to the CCS programrsquos written reply to the appeal) If you have any questions regarding this information please contact Mr Louis R Rico Chief Systems of Care Division at (916) 319-9363 or Robert J Dimand MD Chief Medical Officer Childrenrsquos Medical Services at (916) 327-3076 Sincerely Original signed by Toby Douglas Director

1

Joseph A Prezioso

From Press Douglas (DHCS-EXEC-OLS) [DouglasPressdhcscagov]Sent Monday June 04 2012 805 PMTo josephpreziosoattnetSubject RE Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103

(Chapter 228 Statutes of 2004)

Hello Mr Prezioso

My job is to advise my client DHCS and on occasion I have found that by having adiscussion with someone I can learn a good deal more about what the issue is and how tosolve it Email is not a very efficient medium to resolve issues like this as the manyemail have shown

-----Original Message-----From Joseph Prezioso [mailtojosephpreziosoattnet]Sent Monday June 04 2012 0759 PM Pacific Standard TimeTo Press Douglas (DHCS-EXEC-OLS)Subject RE Section 1409306 of the Welfare and Institutions Code as amended in SenateBill 1103 (Chapter 228 Statutes of 2004)

Chief Counsel Press

Thank you for looking into the matter

First NO ONE AT DHCS has communicated with me in the past except Section Chief Banda via aldquosecurerdquo email that was very troubling

Second coming by to meet and discuss could be a good idea ndash as this issue is best explainedby looking at the paper trailhellipbut I assume you are in Sacramento I am in San Jose ndash and I amquite ill and reside at the Emmanuel House ndash where would we meet

Third please donrsquot misinterpret ndash but as I understand it you are a VERY SENIOR ATTORNEY inthe State of California Government (giving briefs on the Supreme Court ACA hearings etc) ndashI am a poor disabled shelter resident ndash as I understand your duty (and I take no offense ndash Ijust want to clarify) it is NOT YOUR JOB TO HELP ME YOUR JOB IS TO DEFEND THE DHCS - I ammaking what I believe are fairly serious accusations against my government ndash which I do nottake lightly (but the facts do back me up ndash did you listen to the tape)hellip

What would be the purpose of our meeting If you believe there is any validity to myallegations at all given that your duty is to the State (which I am a citizen of and wouldexpect you to defend it with all you best efforts)but I feel a bit ldquoout gunnedrdquo Would it not

2

be more proper to have someone from the US Department of Justice participate in ourdiscussion and also inquiring into this matter

I feel that no one in my government is protecting my rights ndash there is so many disturbingdocuments that are clear violations of the law it is hard to know where to begin And I havebeen threatened by DHCS employees for trying to report this to Local amp State Civil Rightsrepresentatives ndash and this can be corroborated by a witness who actually called the GHPPoffice on my behalf who has an impeccable relationship ndash not the word a ldquoweirdrdquo homelessperson

And sir again no respect ndash the very fact that the ldquoChief Counselrdquo is responding to suchbasic inquiries into the DHCS such as ldquohow to fill out a formrdquo to get access to my PHI isvery disconcerting ndash I do not expect you to say that what I allege is true but I would hopeyou could understand that these feelings are quite rationale I donrsquot believe many Medi-Calshelter applicants get an audience with the Chief counsel from DHCS

I do want to COOPERATRE WITH MY GOVERNMENT in a good faith effort to right something if itis indeed wrong ndash but based on the entirety of my experience there is no evidence to supportldquotrustingrdquo my government ndash and please know that this issue has been looked at by some veryfine attorneyrsquos ndash I was a CFO before my health started to rapidly declinehellipno one (includingthe District Attorney of Santa Clara) has been able to refute the argument ndash but no one wantsto get near it or do anything about ithellip

I look forward to hearing back

Thank you

Joseph Prezioso

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

From Press Douglas (DHCS-EXEC-OLS) [mailtoDouglasPressdhcscagov]Sent Monday June 04 2012 143 PMTo josephpreziosoattnet

3

Subject RE Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill1103 (Chapter 228 Statutes of 2004)Sensitivity Confidential

Hello Mr Prezioso

I have been reviewing your email from last week and from over the weekend and looking intothe matter I have become aware that other staff at DHCS have communicated with you in thepast about the issues below or at least related to them If you would like to come by DHCSto meet and discuss I would find that helpful In your email there is a great deal ofmaterial there but it is difficult for me to get a sense as to where to start

Thanks very much

Douglas Press

From Joseph Prezioso [mailtojosephpreziosoattnet]Sent Thursday May 31 2012 855 PMTo Press Douglas (DHCS-EXEC-OLS)Cc Inspector General Levinson Regional Administrator Sayen Chief of Police Burns ElaineAlquist Case Manager Byrd Chief Trial Counsel Kim Executive Editor Abramson SecretarySebelius Director Rodriguez Regional Manager Leoz Chief Police Seaman AssistantAttorney General Perez Douglas Toby (DHCS-DIR) betsythompsoncmshhsgovSubject Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103(Chapter 228 Statutes of 2004)Importance HighSensitivity Confidential

Chief Counsel Press

California HEALTH AND SAFETY CODE SECTION 124985 states A violation of any of theprovisions of the Hereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

This statue was passed by the legislature branch of our government and approved by theGovernor of our state making it in fact law ndash and more importantly a reflection of the willof ldquoWe the Peoplerdquo of the State of California

4

CMS Information Notice No 03-03 published by the Director of the California Department ofHealth Care Services contained the following seemingly obvious statement

ldquo As you know the general purpose of having regulations is to implement interpret or makespecific the law enforced or administered by itrdquo

Perhaps when it comes to the law stating the obvious sometimes should be considered a goodthing

The ldquofederalizationrdquo of the GHPP and CCS programs under Title XIX of the Social Security Actreclassifying these programs as ldquoMedicaid waiver programrdquo has been effective since September1 2005 with Centers for Medicare amp Medicaid Services approval and Senate Bill 1100legislation (Chapter 226 October 2005)

This ldquofederalizationrdquo was extended via the approval of the State of California Section 1115Medicaid demonstration waiver submitted and signed off by Secretary Douglas CaliforniaDepartment of California Health Care Services on June 3 2010 and subsequently approved bythe US Department of Health and Human Services Agency in a letter dated November 2 2010 andsigned by Donald M Berwick MD Administrator

This waiver

middot NUMBER 11-W-001939

middot TITLE California Bridge to Reform Demonstration

middot AWARDEE California Health and Human Services Agency

middot Under the authority of section 1115(a)(2) of the Social Security Act

This ldquowaiverrdquo Is not just our great statersquos ldquobridge to reformrdquo but I would opine an importantldquobridge to a better futurerdquo for our state and its citizens A very well thought out plan inthe great tradition of the State Of California to lead the way as we have so many times inthe past ndash and set the trend for our great nation In this case working to find a solutionfor providing healthcare access to all our citizens our most important assets and balancethat worthy goal with the very grim realities that our budget constraints and economicconditions have put us in

I salute it and I support it But Chief Counsel Press I believe there is a fatal flaw in ourldquobridgerdquo ndash a flaw so fundamental that if not corrected jeopardizes the entire structure andldquobridge to reformrdquo will turn out to be a true ldquobridge to nowhererdquo

5

Since that day September 1 2005 when our state government with the consent and approval ofour Federal Government ldquoFederalizedrdquo these and other programs three major things I believehad to change

1) Access to Federal Funds to support the goals of these noble programs

2) The ldquoCarving Outrdquo of certain requirements to quite properly allow for experimentationand new delivery care models to take advantage of potential efficiencies and optimize the useof these well deserved Federal dollars

These things have happened

The third requirement

3) Bringing these programs up to Federal standards and compliance with the protectionsunder Title XIX of the Social Security Act as well as full compliance with all otherapplicable federal law such as the Americans with Disabilities Act Protection of basic dueprocess rights including timely and adequate notice and grievance appeal procedures andMedi-Cal State Fair Hearing rights regarding eligibility coverage medical necessityquality of care nondiscrimination and confidentiality

This has not occurred - and that is a fatal flaw

For how can one have ldquodue processrdquo when one does not know what or how to avail themselves ofthat due process And without the benefit of due process how can one have equal protectionOne can only at best have ldquounequal protectionrdquo ndash and I would suggest that is no protection

A basic tenet of the Code of Federal Regulations is that citizens ldquoBe notified of theirrightsrdquo so that they ldquomay exercise those rightsrdquo

So in the attached report to State Senator Leno the ldquoFindingsrdquo regarding State Fair Hearingsstate

ldquoDuring calendar year 2010 there were no fair hearings for denial of medical eligibility ormedical services requested by Medi-Cal beneficiaries who were CCS applicantsrdquo

An impressive record for sure for this program especially when looked at in light of therelatively poor reputation the program had and still has in the eyes of many

6

But perhaps there is an alternate explanation for such a good record one that does require afreedom of information act to confirm Since that day September 1 2005 and continuing untilthis present day every single notice issued to every single applicant or plan beneficiaryhas been ldquodefectiverdquo and not in compliance with Federal Law If one does not know they have aright to request a ldquoMedi-Cal State Fair Hearingrdquo it is not surprising that no one requestsone ndash and I believe that is fundamentally unfair

As an attorney I am sure you are aware of the Supremacy Clause of our wonderful and proudconstitution

Article VI lthttpenwikipediaorgwikiArticle_Six_of_the_United_States_Constitutiongt Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuancethereof and all treaties made or which shall be made under the authority of the UnitedStates shall be the supreme law of the land and the judges in every state shall be boundthereby anything in the constitution or laws of any state to the contrary notwithstandingrdquo

I beleive that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders defacto disabilities as defined by the very statue that enacted the Medical Programs to providetheir care The vast majority are very young children many very poor and born with complexmedical disorders The majority are so young that they are not even aware they are blessed tobe citizens endowed with inalienable rights to life liberty and the pursuit of happiness

But whatever their genetic defects may be and who among us has a perfect geneone they werecreated in the image of their Creator who endowed them with those inalienable rights Theyare full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are entitled tolegal protections that ensure them due process equal opportunity equal protection under thelaw and equal access to the mainstream and all the best of American life

They are entitled to their constitutional rights and all state and local shall recognizethese substantive and procedural rights

How can the California Department of Health Care Services let public servants acting onbehalf of their governmental authority commit acts that deprive any person of rightsprivileges or immunities secured or protected by state or federal law

7

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulatedthree purposes for passage of the statute

middot to override certain kinds of state laws

middot to provide ldquoa remedy where state law was inadequate and

middot to provide ldquoa federal remedy where the state remedy though adequate in theory wasnot available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become apowerful statute for enforcing rights secured by the Fourteenth Amendment First it heldthat actions taken by state governmental officials even if contrary to state law werenevertheless actions taken ldquounder color of lawrdquo Second the Court held that injuredindividuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions alsoviolated state law In short the statute was intended to provide a supplemental remedy Thefederal forum was necessary to vindicate federal rights because according to Congress in1871 state courts could not protect Fourteenth Amendment rights because of their ldquoprejudicepassion neglect [and] intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs mustallege two elements

(1) the action occurred ldquounder color of lawrdquo and

(2) the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens

Our great state has a program that is designed to protect and help citizens that aregenetically disabled ndash and that program in its entirety is in violation of the American withDisabilities Act And the legislature when passing the Hereditary Disorders Act explicitlyprovided a statutory provision that states ldquoA violation of any of the provisions of theHereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I would tell you that there shall be no misdemeanors nor shall anyone be punished ndash becauseIT IS IMPOSSIBLE FOR ANY CITIZEN IN THE STATE OF CALIFORNIA to report this misdemeanor andthe entire law enforcement infrastructure from the California Department of Justice to theDistrict Attorneyrsquos offices down to every local law enforcement department has never heardof or is aware of this law So I believe that in the history of this legislature not a singlereport has ever been filed or anyone punished ndash which much like the ldquoperfectrdquo record of StateFair Hearings is an incredible feat of compliance with the law or more likely due to the lackof knowledge or any enforcement efforts of any kind by the executive branch of government Aldquocriminal actrdquo defined by statute to protect people with disabilities that has no provisions

8

or efforts in place to report investigate or prosecute this misdemeanor that rdquoshall bepunishablerdquo

Six and a half years and counting ndash when will someone have the courage to correct this wrongndash and stand up for these innocent children who are not even aware their rights are beingtrampled upon

Plato hoped that the best men would be good at respecting established laws and he explainedwhy ldquoWhere the law is subject to some other authority and has none of its own the collapseof the state in my view is not far off but if law is the master of the government and thegovernment is its slave then the situation is full of promise and men enjoy all theblessings that the gods shower on a staterdquo

Aristotle went further advocating for the rule of law ldquoIt is more proper that law shouldgovern than any one of the citizensrdquo

But perhaps the Ancient Roman ltfileCwikiAncient_Romegt statesman CiceroltfileCwikiCicerogt said it best We are all servants of the laws in order that we maybe free

Chief Counsel Press I can do nothing ndash I canrsquot even get my own ldquoMedi-Cal State Fair Hearingrdquondash but you can ndash stand up for those children That would an act of great courage and greatcharacter Above all we are a members of we the people and we all have a responsibility todefend the lawhellipbecause the law is the only thing that defends us

Soon I will be meeting with my Congressional Representative Congresswoman Zoe Lofgren As aproud resident of Californiarsquos 16th Congressional District I had the honor of speaking withher last week She could not be more kind or more concerned This issue is bigger than me itaffects many of my fellow citizens ndash and if I am incorrect ndash then please sir ndash just explainit to me

If I am not qualified for this program why not issue me a proper Notice of Action

If I am not qualified for this program why was I issued a fraudulent State of CaliforniaBenefits Identification Card

If I am not qualified for this program why was a fraudulent unsigned application ldquoapprovedrdquofor me

If I am not qualified for this program why was I issued a SAR for medical evaluation at anEndocrine Center when I have a suspected Metabolic Disorder

If I am not qualified for this program why was a SAR issued without a NEW REFERRAL CCSGHPPCLIENT SERVICE AUTHORIZATION REQUEST DHCS 4488 being submitted and signed by a licensedCalifornia Physician

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

2

be more proper to have someone from the US Department of Justice participate in ourdiscussion and also inquiring into this matter

I feel that no one in my government is protecting my rights ndash there is so many disturbingdocuments that are clear violations of the law it is hard to know where to begin And I havebeen threatened by DHCS employees for trying to report this to Local amp State Civil Rightsrepresentatives ndash and this can be corroborated by a witness who actually called the GHPPoffice on my behalf who has an impeccable relationship ndash not the word a ldquoweirdrdquo homelessperson

And sir again no respect ndash the very fact that the ldquoChief Counselrdquo is responding to suchbasic inquiries into the DHCS such as ldquohow to fill out a formrdquo to get access to my PHI isvery disconcerting ndash I do not expect you to say that what I allege is true but I would hopeyou could understand that these feelings are quite rationale I donrsquot believe many Medi-Calshelter applicants get an audience with the Chief counsel from DHCS

I do want to COOPERATRE WITH MY GOVERNMENT in a good faith effort to right something if itis indeed wrong ndash but based on the entirety of my experience there is no evidence to supportldquotrustingrdquo my government ndash and please know that this issue has been looked at by some veryfine attorneyrsquos ndash I was a CFO before my health started to rapidly declinehellipno one (includingthe District Attorney of Santa Clara) has been able to refute the argument ndash but no one wantsto get near it or do anything about ithellip

I look forward to hearing back

Thank you

Joseph Prezioso

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

From Press Douglas (DHCS-EXEC-OLS) [mailtoDouglasPressdhcscagov]Sent Monday June 04 2012 143 PMTo josephpreziosoattnet

3

Subject RE Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill1103 (Chapter 228 Statutes of 2004)Sensitivity Confidential

Hello Mr Prezioso

I have been reviewing your email from last week and from over the weekend and looking intothe matter I have become aware that other staff at DHCS have communicated with you in thepast about the issues below or at least related to them If you would like to come by DHCSto meet and discuss I would find that helpful In your email there is a great deal ofmaterial there but it is difficult for me to get a sense as to where to start

Thanks very much

Douglas Press

From Joseph Prezioso [mailtojosephpreziosoattnet]Sent Thursday May 31 2012 855 PMTo Press Douglas (DHCS-EXEC-OLS)Cc Inspector General Levinson Regional Administrator Sayen Chief of Police Burns ElaineAlquist Case Manager Byrd Chief Trial Counsel Kim Executive Editor Abramson SecretarySebelius Director Rodriguez Regional Manager Leoz Chief Police Seaman AssistantAttorney General Perez Douglas Toby (DHCS-DIR) betsythompsoncmshhsgovSubject Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103(Chapter 228 Statutes of 2004)Importance HighSensitivity Confidential

Chief Counsel Press

California HEALTH AND SAFETY CODE SECTION 124985 states A violation of any of theprovisions of the Hereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

This statue was passed by the legislature branch of our government and approved by theGovernor of our state making it in fact law ndash and more importantly a reflection of the willof ldquoWe the Peoplerdquo of the State of California

4

CMS Information Notice No 03-03 published by the Director of the California Department ofHealth Care Services contained the following seemingly obvious statement

ldquo As you know the general purpose of having regulations is to implement interpret or makespecific the law enforced or administered by itrdquo

Perhaps when it comes to the law stating the obvious sometimes should be considered a goodthing

The ldquofederalizationrdquo of the GHPP and CCS programs under Title XIX of the Social Security Actreclassifying these programs as ldquoMedicaid waiver programrdquo has been effective since September1 2005 with Centers for Medicare amp Medicaid Services approval and Senate Bill 1100legislation (Chapter 226 October 2005)

This ldquofederalizationrdquo was extended via the approval of the State of California Section 1115Medicaid demonstration waiver submitted and signed off by Secretary Douglas CaliforniaDepartment of California Health Care Services on June 3 2010 and subsequently approved bythe US Department of Health and Human Services Agency in a letter dated November 2 2010 andsigned by Donald M Berwick MD Administrator

This waiver

middot NUMBER 11-W-001939

middot TITLE California Bridge to Reform Demonstration

middot AWARDEE California Health and Human Services Agency

middot Under the authority of section 1115(a)(2) of the Social Security Act

This ldquowaiverrdquo Is not just our great statersquos ldquobridge to reformrdquo but I would opine an importantldquobridge to a better futurerdquo for our state and its citizens A very well thought out plan inthe great tradition of the State Of California to lead the way as we have so many times inthe past ndash and set the trend for our great nation In this case working to find a solutionfor providing healthcare access to all our citizens our most important assets and balancethat worthy goal with the very grim realities that our budget constraints and economicconditions have put us in

I salute it and I support it But Chief Counsel Press I believe there is a fatal flaw in ourldquobridgerdquo ndash a flaw so fundamental that if not corrected jeopardizes the entire structure andldquobridge to reformrdquo will turn out to be a true ldquobridge to nowhererdquo

5

Since that day September 1 2005 when our state government with the consent and approval ofour Federal Government ldquoFederalizedrdquo these and other programs three major things I believehad to change

1) Access to Federal Funds to support the goals of these noble programs

2) The ldquoCarving Outrdquo of certain requirements to quite properly allow for experimentationand new delivery care models to take advantage of potential efficiencies and optimize the useof these well deserved Federal dollars

These things have happened

The third requirement

3) Bringing these programs up to Federal standards and compliance with the protectionsunder Title XIX of the Social Security Act as well as full compliance with all otherapplicable federal law such as the Americans with Disabilities Act Protection of basic dueprocess rights including timely and adequate notice and grievance appeal procedures andMedi-Cal State Fair Hearing rights regarding eligibility coverage medical necessityquality of care nondiscrimination and confidentiality

This has not occurred - and that is a fatal flaw

For how can one have ldquodue processrdquo when one does not know what or how to avail themselves ofthat due process And without the benefit of due process how can one have equal protectionOne can only at best have ldquounequal protectionrdquo ndash and I would suggest that is no protection

A basic tenet of the Code of Federal Regulations is that citizens ldquoBe notified of theirrightsrdquo so that they ldquomay exercise those rightsrdquo

So in the attached report to State Senator Leno the ldquoFindingsrdquo regarding State Fair Hearingsstate

ldquoDuring calendar year 2010 there were no fair hearings for denial of medical eligibility ormedical services requested by Medi-Cal beneficiaries who were CCS applicantsrdquo

An impressive record for sure for this program especially when looked at in light of therelatively poor reputation the program had and still has in the eyes of many

6

But perhaps there is an alternate explanation for such a good record one that does require afreedom of information act to confirm Since that day September 1 2005 and continuing untilthis present day every single notice issued to every single applicant or plan beneficiaryhas been ldquodefectiverdquo and not in compliance with Federal Law If one does not know they have aright to request a ldquoMedi-Cal State Fair Hearingrdquo it is not surprising that no one requestsone ndash and I believe that is fundamentally unfair

As an attorney I am sure you are aware of the Supremacy Clause of our wonderful and proudconstitution

Article VI lthttpenwikipediaorgwikiArticle_Six_of_the_United_States_Constitutiongt Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuancethereof and all treaties made or which shall be made under the authority of the UnitedStates shall be the supreme law of the land and the judges in every state shall be boundthereby anything in the constitution or laws of any state to the contrary notwithstandingrdquo

I beleive that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders defacto disabilities as defined by the very statue that enacted the Medical Programs to providetheir care The vast majority are very young children many very poor and born with complexmedical disorders The majority are so young that they are not even aware they are blessed tobe citizens endowed with inalienable rights to life liberty and the pursuit of happiness

But whatever their genetic defects may be and who among us has a perfect geneone they werecreated in the image of their Creator who endowed them with those inalienable rights Theyare full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are entitled tolegal protections that ensure them due process equal opportunity equal protection under thelaw and equal access to the mainstream and all the best of American life

They are entitled to their constitutional rights and all state and local shall recognizethese substantive and procedural rights

How can the California Department of Health Care Services let public servants acting onbehalf of their governmental authority commit acts that deprive any person of rightsprivileges or immunities secured or protected by state or federal law

7

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulatedthree purposes for passage of the statute

middot to override certain kinds of state laws

middot to provide ldquoa remedy where state law was inadequate and

middot to provide ldquoa federal remedy where the state remedy though adequate in theory wasnot available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become apowerful statute for enforcing rights secured by the Fourteenth Amendment First it heldthat actions taken by state governmental officials even if contrary to state law werenevertheless actions taken ldquounder color of lawrdquo Second the Court held that injuredindividuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions alsoviolated state law In short the statute was intended to provide a supplemental remedy Thefederal forum was necessary to vindicate federal rights because according to Congress in1871 state courts could not protect Fourteenth Amendment rights because of their ldquoprejudicepassion neglect [and] intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs mustallege two elements

(1) the action occurred ldquounder color of lawrdquo and

(2) the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens

Our great state has a program that is designed to protect and help citizens that aregenetically disabled ndash and that program in its entirety is in violation of the American withDisabilities Act And the legislature when passing the Hereditary Disorders Act explicitlyprovided a statutory provision that states ldquoA violation of any of the provisions of theHereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I would tell you that there shall be no misdemeanors nor shall anyone be punished ndash becauseIT IS IMPOSSIBLE FOR ANY CITIZEN IN THE STATE OF CALIFORNIA to report this misdemeanor andthe entire law enforcement infrastructure from the California Department of Justice to theDistrict Attorneyrsquos offices down to every local law enforcement department has never heardof or is aware of this law So I believe that in the history of this legislature not a singlereport has ever been filed or anyone punished ndash which much like the ldquoperfectrdquo record of StateFair Hearings is an incredible feat of compliance with the law or more likely due to the lackof knowledge or any enforcement efforts of any kind by the executive branch of government Aldquocriminal actrdquo defined by statute to protect people with disabilities that has no provisions

8

or efforts in place to report investigate or prosecute this misdemeanor that rdquoshall bepunishablerdquo

Six and a half years and counting ndash when will someone have the courage to correct this wrongndash and stand up for these innocent children who are not even aware their rights are beingtrampled upon

Plato hoped that the best men would be good at respecting established laws and he explainedwhy ldquoWhere the law is subject to some other authority and has none of its own the collapseof the state in my view is not far off but if law is the master of the government and thegovernment is its slave then the situation is full of promise and men enjoy all theblessings that the gods shower on a staterdquo

Aristotle went further advocating for the rule of law ldquoIt is more proper that law shouldgovern than any one of the citizensrdquo

But perhaps the Ancient Roman ltfileCwikiAncient_Romegt statesman CiceroltfileCwikiCicerogt said it best We are all servants of the laws in order that we maybe free

Chief Counsel Press I can do nothing ndash I canrsquot even get my own ldquoMedi-Cal State Fair Hearingrdquondash but you can ndash stand up for those children That would an act of great courage and greatcharacter Above all we are a members of we the people and we all have a responsibility todefend the lawhellipbecause the law is the only thing that defends us

Soon I will be meeting with my Congressional Representative Congresswoman Zoe Lofgren As aproud resident of Californiarsquos 16th Congressional District I had the honor of speaking withher last week She could not be more kind or more concerned This issue is bigger than me itaffects many of my fellow citizens ndash and if I am incorrect ndash then please sir ndash just explainit to me

If I am not qualified for this program why not issue me a proper Notice of Action

If I am not qualified for this program why was I issued a fraudulent State of CaliforniaBenefits Identification Card

If I am not qualified for this program why was a fraudulent unsigned application ldquoapprovedrdquofor me

If I am not qualified for this program why was I issued a SAR for medical evaluation at anEndocrine Center when I have a suspected Metabolic Disorder

If I am not qualified for this program why was a SAR issued without a NEW REFERRAL CCSGHPPCLIENT SERVICE AUTHORIZATION REQUEST DHCS 4488 being submitted and signed by a licensedCalifornia Physician

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

3

Subject RE Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill1103 (Chapter 228 Statutes of 2004)Sensitivity Confidential

Hello Mr Prezioso

I have been reviewing your email from last week and from over the weekend and looking intothe matter I have become aware that other staff at DHCS have communicated with you in thepast about the issues below or at least related to them If you would like to come by DHCSto meet and discuss I would find that helpful In your email there is a great deal ofmaterial there but it is difficult for me to get a sense as to where to start

Thanks very much

Douglas Press

From Joseph Prezioso [mailtojosephpreziosoattnet]Sent Thursday May 31 2012 855 PMTo Press Douglas (DHCS-EXEC-OLS)Cc Inspector General Levinson Regional Administrator Sayen Chief of Police Burns ElaineAlquist Case Manager Byrd Chief Trial Counsel Kim Executive Editor Abramson SecretarySebelius Director Rodriguez Regional Manager Leoz Chief Police Seaman AssistantAttorney General Perez Douglas Toby (DHCS-DIR) betsythompsoncmshhsgovSubject Section 1409306 of the Welfare and Institutions Code as amended in Senate Bill 1103(Chapter 228 Statutes of 2004)Importance HighSensitivity Confidential

Chief Counsel Press

California HEALTH AND SAFETY CODE SECTION 124985 states A violation of any of theprovisions of the Hereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

This statue was passed by the legislature branch of our government and approved by theGovernor of our state making it in fact law ndash and more importantly a reflection of the willof ldquoWe the Peoplerdquo of the State of California

4

CMS Information Notice No 03-03 published by the Director of the California Department ofHealth Care Services contained the following seemingly obvious statement

ldquo As you know the general purpose of having regulations is to implement interpret or makespecific the law enforced or administered by itrdquo

Perhaps when it comes to the law stating the obvious sometimes should be considered a goodthing

The ldquofederalizationrdquo of the GHPP and CCS programs under Title XIX of the Social Security Actreclassifying these programs as ldquoMedicaid waiver programrdquo has been effective since September1 2005 with Centers for Medicare amp Medicaid Services approval and Senate Bill 1100legislation (Chapter 226 October 2005)

This ldquofederalizationrdquo was extended via the approval of the State of California Section 1115Medicaid demonstration waiver submitted and signed off by Secretary Douglas CaliforniaDepartment of California Health Care Services on June 3 2010 and subsequently approved bythe US Department of Health and Human Services Agency in a letter dated November 2 2010 andsigned by Donald M Berwick MD Administrator

This waiver

middot NUMBER 11-W-001939

middot TITLE California Bridge to Reform Demonstration

middot AWARDEE California Health and Human Services Agency

middot Under the authority of section 1115(a)(2) of the Social Security Act

This ldquowaiverrdquo Is not just our great statersquos ldquobridge to reformrdquo but I would opine an importantldquobridge to a better futurerdquo for our state and its citizens A very well thought out plan inthe great tradition of the State Of California to lead the way as we have so many times inthe past ndash and set the trend for our great nation In this case working to find a solutionfor providing healthcare access to all our citizens our most important assets and balancethat worthy goal with the very grim realities that our budget constraints and economicconditions have put us in

I salute it and I support it But Chief Counsel Press I believe there is a fatal flaw in ourldquobridgerdquo ndash a flaw so fundamental that if not corrected jeopardizes the entire structure andldquobridge to reformrdquo will turn out to be a true ldquobridge to nowhererdquo

5

Since that day September 1 2005 when our state government with the consent and approval ofour Federal Government ldquoFederalizedrdquo these and other programs three major things I believehad to change

1) Access to Federal Funds to support the goals of these noble programs

2) The ldquoCarving Outrdquo of certain requirements to quite properly allow for experimentationand new delivery care models to take advantage of potential efficiencies and optimize the useof these well deserved Federal dollars

These things have happened

The third requirement

3) Bringing these programs up to Federal standards and compliance with the protectionsunder Title XIX of the Social Security Act as well as full compliance with all otherapplicable federal law such as the Americans with Disabilities Act Protection of basic dueprocess rights including timely and adequate notice and grievance appeal procedures andMedi-Cal State Fair Hearing rights regarding eligibility coverage medical necessityquality of care nondiscrimination and confidentiality

This has not occurred - and that is a fatal flaw

For how can one have ldquodue processrdquo when one does not know what or how to avail themselves ofthat due process And without the benefit of due process how can one have equal protectionOne can only at best have ldquounequal protectionrdquo ndash and I would suggest that is no protection

A basic tenet of the Code of Federal Regulations is that citizens ldquoBe notified of theirrightsrdquo so that they ldquomay exercise those rightsrdquo

So in the attached report to State Senator Leno the ldquoFindingsrdquo regarding State Fair Hearingsstate

ldquoDuring calendar year 2010 there were no fair hearings for denial of medical eligibility ormedical services requested by Medi-Cal beneficiaries who were CCS applicantsrdquo

An impressive record for sure for this program especially when looked at in light of therelatively poor reputation the program had and still has in the eyes of many

6

But perhaps there is an alternate explanation for such a good record one that does require afreedom of information act to confirm Since that day September 1 2005 and continuing untilthis present day every single notice issued to every single applicant or plan beneficiaryhas been ldquodefectiverdquo and not in compliance with Federal Law If one does not know they have aright to request a ldquoMedi-Cal State Fair Hearingrdquo it is not surprising that no one requestsone ndash and I believe that is fundamentally unfair

As an attorney I am sure you are aware of the Supremacy Clause of our wonderful and proudconstitution

Article VI lthttpenwikipediaorgwikiArticle_Six_of_the_United_States_Constitutiongt Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuancethereof and all treaties made or which shall be made under the authority of the UnitedStates shall be the supreme law of the land and the judges in every state shall be boundthereby anything in the constitution or laws of any state to the contrary notwithstandingrdquo

I beleive that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders defacto disabilities as defined by the very statue that enacted the Medical Programs to providetheir care The vast majority are very young children many very poor and born with complexmedical disorders The majority are so young that they are not even aware they are blessed tobe citizens endowed with inalienable rights to life liberty and the pursuit of happiness

But whatever their genetic defects may be and who among us has a perfect geneone they werecreated in the image of their Creator who endowed them with those inalienable rights Theyare full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are entitled tolegal protections that ensure them due process equal opportunity equal protection under thelaw and equal access to the mainstream and all the best of American life

They are entitled to their constitutional rights and all state and local shall recognizethese substantive and procedural rights

How can the California Department of Health Care Services let public servants acting onbehalf of their governmental authority commit acts that deprive any person of rightsprivileges or immunities secured or protected by state or federal law

7

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulatedthree purposes for passage of the statute

middot to override certain kinds of state laws

middot to provide ldquoa remedy where state law was inadequate and

middot to provide ldquoa federal remedy where the state remedy though adequate in theory wasnot available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become apowerful statute for enforcing rights secured by the Fourteenth Amendment First it heldthat actions taken by state governmental officials even if contrary to state law werenevertheless actions taken ldquounder color of lawrdquo Second the Court held that injuredindividuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions alsoviolated state law In short the statute was intended to provide a supplemental remedy Thefederal forum was necessary to vindicate federal rights because according to Congress in1871 state courts could not protect Fourteenth Amendment rights because of their ldquoprejudicepassion neglect [and] intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs mustallege two elements

(1) the action occurred ldquounder color of lawrdquo and

(2) the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens

Our great state has a program that is designed to protect and help citizens that aregenetically disabled ndash and that program in its entirety is in violation of the American withDisabilities Act And the legislature when passing the Hereditary Disorders Act explicitlyprovided a statutory provision that states ldquoA violation of any of the provisions of theHereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I would tell you that there shall be no misdemeanors nor shall anyone be punished ndash becauseIT IS IMPOSSIBLE FOR ANY CITIZEN IN THE STATE OF CALIFORNIA to report this misdemeanor andthe entire law enforcement infrastructure from the California Department of Justice to theDistrict Attorneyrsquos offices down to every local law enforcement department has never heardof or is aware of this law So I believe that in the history of this legislature not a singlereport has ever been filed or anyone punished ndash which much like the ldquoperfectrdquo record of StateFair Hearings is an incredible feat of compliance with the law or more likely due to the lackof knowledge or any enforcement efforts of any kind by the executive branch of government Aldquocriminal actrdquo defined by statute to protect people with disabilities that has no provisions

8

or efforts in place to report investigate or prosecute this misdemeanor that rdquoshall bepunishablerdquo

Six and a half years and counting ndash when will someone have the courage to correct this wrongndash and stand up for these innocent children who are not even aware their rights are beingtrampled upon

Plato hoped that the best men would be good at respecting established laws and he explainedwhy ldquoWhere the law is subject to some other authority and has none of its own the collapseof the state in my view is not far off but if law is the master of the government and thegovernment is its slave then the situation is full of promise and men enjoy all theblessings that the gods shower on a staterdquo

Aristotle went further advocating for the rule of law ldquoIt is more proper that law shouldgovern than any one of the citizensrdquo

But perhaps the Ancient Roman ltfileCwikiAncient_Romegt statesman CiceroltfileCwikiCicerogt said it best We are all servants of the laws in order that we maybe free

Chief Counsel Press I can do nothing ndash I canrsquot even get my own ldquoMedi-Cal State Fair Hearingrdquondash but you can ndash stand up for those children That would an act of great courage and greatcharacter Above all we are a members of we the people and we all have a responsibility todefend the lawhellipbecause the law is the only thing that defends us

Soon I will be meeting with my Congressional Representative Congresswoman Zoe Lofgren As aproud resident of Californiarsquos 16th Congressional District I had the honor of speaking withher last week She could not be more kind or more concerned This issue is bigger than me itaffects many of my fellow citizens ndash and if I am incorrect ndash then please sir ndash just explainit to me

If I am not qualified for this program why not issue me a proper Notice of Action

If I am not qualified for this program why was I issued a fraudulent State of CaliforniaBenefits Identification Card

If I am not qualified for this program why was a fraudulent unsigned application ldquoapprovedrdquofor me

If I am not qualified for this program why was I issued a SAR for medical evaluation at anEndocrine Center when I have a suspected Metabolic Disorder

If I am not qualified for this program why was a SAR issued without a NEW REFERRAL CCSGHPPCLIENT SERVICE AUTHORIZATION REQUEST DHCS 4488 being submitted and signed by a licensedCalifornia Physician

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

4

CMS Information Notice No 03-03 published by the Director of the California Department ofHealth Care Services contained the following seemingly obvious statement

ldquo As you know the general purpose of having regulations is to implement interpret or makespecific the law enforced or administered by itrdquo

Perhaps when it comes to the law stating the obvious sometimes should be considered a goodthing

The ldquofederalizationrdquo of the GHPP and CCS programs under Title XIX of the Social Security Actreclassifying these programs as ldquoMedicaid waiver programrdquo has been effective since September1 2005 with Centers for Medicare amp Medicaid Services approval and Senate Bill 1100legislation (Chapter 226 October 2005)

This ldquofederalizationrdquo was extended via the approval of the State of California Section 1115Medicaid demonstration waiver submitted and signed off by Secretary Douglas CaliforniaDepartment of California Health Care Services on June 3 2010 and subsequently approved bythe US Department of Health and Human Services Agency in a letter dated November 2 2010 andsigned by Donald M Berwick MD Administrator

This waiver

middot NUMBER 11-W-001939

middot TITLE California Bridge to Reform Demonstration

middot AWARDEE California Health and Human Services Agency

middot Under the authority of section 1115(a)(2) of the Social Security Act

This ldquowaiverrdquo Is not just our great statersquos ldquobridge to reformrdquo but I would opine an importantldquobridge to a better futurerdquo for our state and its citizens A very well thought out plan inthe great tradition of the State Of California to lead the way as we have so many times inthe past ndash and set the trend for our great nation In this case working to find a solutionfor providing healthcare access to all our citizens our most important assets and balancethat worthy goal with the very grim realities that our budget constraints and economicconditions have put us in

I salute it and I support it But Chief Counsel Press I believe there is a fatal flaw in ourldquobridgerdquo ndash a flaw so fundamental that if not corrected jeopardizes the entire structure andldquobridge to reformrdquo will turn out to be a true ldquobridge to nowhererdquo

5

Since that day September 1 2005 when our state government with the consent and approval ofour Federal Government ldquoFederalizedrdquo these and other programs three major things I believehad to change

1) Access to Federal Funds to support the goals of these noble programs

2) The ldquoCarving Outrdquo of certain requirements to quite properly allow for experimentationand new delivery care models to take advantage of potential efficiencies and optimize the useof these well deserved Federal dollars

These things have happened

The third requirement

3) Bringing these programs up to Federal standards and compliance with the protectionsunder Title XIX of the Social Security Act as well as full compliance with all otherapplicable federal law such as the Americans with Disabilities Act Protection of basic dueprocess rights including timely and adequate notice and grievance appeal procedures andMedi-Cal State Fair Hearing rights regarding eligibility coverage medical necessityquality of care nondiscrimination and confidentiality

This has not occurred - and that is a fatal flaw

For how can one have ldquodue processrdquo when one does not know what or how to avail themselves ofthat due process And without the benefit of due process how can one have equal protectionOne can only at best have ldquounequal protectionrdquo ndash and I would suggest that is no protection

A basic tenet of the Code of Federal Regulations is that citizens ldquoBe notified of theirrightsrdquo so that they ldquomay exercise those rightsrdquo

So in the attached report to State Senator Leno the ldquoFindingsrdquo regarding State Fair Hearingsstate

ldquoDuring calendar year 2010 there were no fair hearings for denial of medical eligibility ormedical services requested by Medi-Cal beneficiaries who were CCS applicantsrdquo

An impressive record for sure for this program especially when looked at in light of therelatively poor reputation the program had and still has in the eyes of many

6

But perhaps there is an alternate explanation for such a good record one that does require afreedom of information act to confirm Since that day September 1 2005 and continuing untilthis present day every single notice issued to every single applicant or plan beneficiaryhas been ldquodefectiverdquo and not in compliance with Federal Law If one does not know they have aright to request a ldquoMedi-Cal State Fair Hearingrdquo it is not surprising that no one requestsone ndash and I believe that is fundamentally unfair

As an attorney I am sure you are aware of the Supremacy Clause of our wonderful and proudconstitution

Article VI lthttpenwikipediaorgwikiArticle_Six_of_the_United_States_Constitutiongt Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuancethereof and all treaties made or which shall be made under the authority of the UnitedStates shall be the supreme law of the land and the judges in every state shall be boundthereby anything in the constitution or laws of any state to the contrary notwithstandingrdquo

I beleive that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders defacto disabilities as defined by the very statue that enacted the Medical Programs to providetheir care The vast majority are very young children many very poor and born with complexmedical disorders The majority are so young that they are not even aware they are blessed tobe citizens endowed with inalienable rights to life liberty and the pursuit of happiness

But whatever their genetic defects may be and who among us has a perfect geneone they werecreated in the image of their Creator who endowed them with those inalienable rights Theyare full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are entitled tolegal protections that ensure them due process equal opportunity equal protection under thelaw and equal access to the mainstream and all the best of American life

They are entitled to their constitutional rights and all state and local shall recognizethese substantive and procedural rights

How can the California Department of Health Care Services let public servants acting onbehalf of their governmental authority commit acts that deprive any person of rightsprivileges or immunities secured or protected by state or federal law

7

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulatedthree purposes for passage of the statute

middot to override certain kinds of state laws

middot to provide ldquoa remedy where state law was inadequate and

middot to provide ldquoa federal remedy where the state remedy though adequate in theory wasnot available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become apowerful statute for enforcing rights secured by the Fourteenth Amendment First it heldthat actions taken by state governmental officials even if contrary to state law werenevertheless actions taken ldquounder color of lawrdquo Second the Court held that injuredindividuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions alsoviolated state law In short the statute was intended to provide a supplemental remedy Thefederal forum was necessary to vindicate federal rights because according to Congress in1871 state courts could not protect Fourteenth Amendment rights because of their ldquoprejudicepassion neglect [and] intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs mustallege two elements

(1) the action occurred ldquounder color of lawrdquo and

(2) the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens

Our great state has a program that is designed to protect and help citizens that aregenetically disabled ndash and that program in its entirety is in violation of the American withDisabilities Act And the legislature when passing the Hereditary Disorders Act explicitlyprovided a statutory provision that states ldquoA violation of any of the provisions of theHereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I would tell you that there shall be no misdemeanors nor shall anyone be punished ndash becauseIT IS IMPOSSIBLE FOR ANY CITIZEN IN THE STATE OF CALIFORNIA to report this misdemeanor andthe entire law enforcement infrastructure from the California Department of Justice to theDistrict Attorneyrsquos offices down to every local law enforcement department has never heardof or is aware of this law So I believe that in the history of this legislature not a singlereport has ever been filed or anyone punished ndash which much like the ldquoperfectrdquo record of StateFair Hearings is an incredible feat of compliance with the law or more likely due to the lackof knowledge or any enforcement efforts of any kind by the executive branch of government Aldquocriminal actrdquo defined by statute to protect people with disabilities that has no provisions

8

or efforts in place to report investigate or prosecute this misdemeanor that rdquoshall bepunishablerdquo

Six and a half years and counting ndash when will someone have the courage to correct this wrongndash and stand up for these innocent children who are not even aware their rights are beingtrampled upon

Plato hoped that the best men would be good at respecting established laws and he explainedwhy ldquoWhere the law is subject to some other authority and has none of its own the collapseof the state in my view is not far off but if law is the master of the government and thegovernment is its slave then the situation is full of promise and men enjoy all theblessings that the gods shower on a staterdquo

Aristotle went further advocating for the rule of law ldquoIt is more proper that law shouldgovern than any one of the citizensrdquo

But perhaps the Ancient Roman ltfileCwikiAncient_Romegt statesman CiceroltfileCwikiCicerogt said it best We are all servants of the laws in order that we maybe free

Chief Counsel Press I can do nothing ndash I canrsquot even get my own ldquoMedi-Cal State Fair Hearingrdquondash but you can ndash stand up for those children That would an act of great courage and greatcharacter Above all we are a members of we the people and we all have a responsibility todefend the lawhellipbecause the law is the only thing that defends us

Soon I will be meeting with my Congressional Representative Congresswoman Zoe Lofgren As aproud resident of Californiarsquos 16th Congressional District I had the honor of speaking withher last week She could not be more kind or more concerned This issue is bigger than me itaffects many of my fellow citizens ndash and if I am incorrect ndash then please sir ndash just explainit to me

If I am not qualified for this program why not issue me a proper Notice of Action

If I am not qualified for this program why was I issued a fraudulent State of CaliforniaBenefits Identification Card

If I am not qualified for this program why was a fraudulent unsigned application ldquoapprovedrdquofor me

If I am not qualified for this program why was I issued a SAR for medical evaluation at anEndocrine Center when I have a suspected Metabolic Disorder

If I am not qualified for this program why was a SAR issued without a NEW REFERRAL CCSGHPPCLIENT SERVICE AUTHORIZATION REQUEST DHCS 4488 being submitted and signed by a licensedCalifornia Physician

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

5

Since that day September 1 2005 when our state government with the consent and approval ofour Federal Government ldquoFederalizedrdquo these and other programs three major things I believehad to change

1) Access to Federal Funds to support the goals of these noble programs

2) The ldquoCarving Outrdquo of certain requirements to quite properly allow for experimentationand new delivery care models to take advantage of potential efficiencies and optimize the useof these well deserved Federal dollars

These things have happened

The third requirement

3) Bringing these programs up to Federal standards and compliance with the protectionsunder Title XIX of the Social Security Act as well as full compliance with all otherapplicable federal law such as the Americans with Disabilities Act Protection of basic dueprocess rights including timely and adequate notice and grievance appeal procedures andMedi-Cal State Fair Hearing rights regarding eligibility coverage medical necessityquality of care nondiscrimination and confidentiality

This has not occurred - and that is a fatal flaw

For how can one have ldquodue processrdquo when one does not know what or how to avail themselves ofthat due process And without the benefit of due process how can one have equal protectionOne can only at best have ldquounequal protectionrdquo ndash and I would suggest that is no protection

A basic tenet of the Code of Federal Regulations is that citizens ldquoBe notified of theirrightsrdquo so that they ldquomay exercise those rightsrdquo

So in the attached report to State Senator Leno the ldquoFindingsrdquo regarding State Fair Hearingsstate

ldquoDuring calendar year 2010 there were no fair hearings for denial of medical eligibility ormedical services requested by Medi-Cal beneficiaries who were CCS applicantsrdquo

An impressive record for sure for this program especially when looked at in light of therelatively poor reputation the program had and still has in the eyes of many

6

But perhaps there is an alternate explanation for such a good record one that does require afreedom of information act to confirm Since that day September 1 2005 and continuing untilthis present day every single notice issued to every single applicant or plan beneficiaryhas been ldquodefectiverdquo and not in compliance with Federal Law If one does not know they have aright to request a ldquoMedi-Cal State Fair Hearingrdquo it is not surprising that no one requestsone ndash and I believe that is fundamentally unfair

As an attorney I am sure you are aware of the Supremacy Clause of our wonderful and proudconstitution

Article VI lthttpenwikipediaorgwikiArticle_Six_of_the_United_States_Constitutiongt Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuancethereof and all treaties made or which shall be made under the authority of the UnitedStates shall be the supreme law of the land and the judges in every state shall be boundthereby anything in the constitution or laws of any state to the contrary notwithstandingrdquo

I beleive that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders defacto disabilities as defined by the very statue that enacted the Medical Programs to providetheir care The vast majority are very young children many very poor and born with complexmedical disorders The majority are so young that they are not even aware they are blessed tobe citizens endowed with inalienable rights to life liberty and the pursuit of happiness

But whatever their genetic defects may be and who among us has a perfect geneone they werecreated in the image of their Creator who endowed them with those inalienable rights Theyare full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are entitled tolegal protections that ensure them due process equal opportunity equal protection under thelaw and equal access to the mainstream and all the best of American life

They are entitled to their constitutional rights and all state and local shall recognizethese substantive and procedural rights

How can the California Department of Health Care Services let public servants acting onbehalf of their governmental authority commit acts that deprive any person of rightsprivileges or immunities secured or protected by state or federal law

7

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulatedthree purposes for passage of the statute

middot to override certain kinds of state laws

middot to provide ldquoa remedy where state law was inadequate and

middot to provide ldquoa federal remedy where the state remedy though adequate in theory wasnot available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become apowerful statute for enforcing rights secured by the Fourteenth Amendment First it heldthat actions taken by state governmental officials even if contrary to state law werenevertheless actions taken ldquounder color of lawrdquo Second the Court held that injuredindividuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions alsoviolated state law In short the statute was intended to provide a supplemental remedy Thefederal forum was necessary to vindicate federal rights because according to Congress in1871 state courts could not protect Fourteenth Amendment rights because of their ldquoprejudicepassion neglect [and] intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs mustallege two elements

(1) the action occurred ldquounder color of lawrdquo and

(2) the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens

Our great state has a program that is designed to protect and help citizens that aregenetically disabled ndash and that program in its entirety is in violation of the American withDisabilities Act And the legislature when passing the Hereditary Disorders Act explicitlyprovided a statutory provision that states ldquoA violation of any of the provisions of theHereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I would tell you that there shall be no misdemeanors nor shall anyone be punished ndash becauseIT IS IMPOSSIBLE FOR ANY CITIZEN IN THE STATE OF CALIFORNIA to report this misdemeanor andthe entire law enforcement infrastructure from the California Department of Justice to theDistrict Attorneyrsquos offices down to every local law enforcement department has never heardof or is aware of this law So I believe that in the history of this legislature not a singlereport has ever been filed or anyone punished ndash which much like the ldquoperfectrdquo record of StateFair Hearings is an incredible feat of compliance with the law or more likely due to the lackof knowledge or any enforcement efforts of any kind by the executive branch of government Aldquocriminal actrdquo defined by statute to protect people with disabilities that has no provisions

8

or efforts in place to report investigate or prosecute this misdemeanor that rdquoshall bepunishablerdquo

Six and a half years and counting ndash when will someone have the courage to correct this wrongndash and stand up for these innocent children who are not even aware their rights are beingtrampled upon

Plato hoped that the best men would be good at respecting established laws and he explainedwhy ldquoWhere the law is subject to some other authority and has none of its own the collapseof the state in my view is not far off but if law is the master of the government and thegovernment is its slave then the situation is full of promise and men enjoy all theblessings that the gods shower on a staterdquo

Aristotle went further advocating for the rule of law ldquoIt is more proper that law shouldgovern than any one of the citizensrdquo

But perhaps the Ancient Roman ltfileCwikiAncient_Romegt statesman CiceroltfileCwikiCicerogt said it best We are all servants of the laws in order that we maybe free

Chief Counsel Press I can do nothing ndash I canrsquot even get my own ldquoMedi-Cal State Fair Hearingrdquondash but you can ndash stand up for those children That would an act of great courage and greatcharacter Above all we are a members of we the people and we all have a responsibility todefend the lawhellipbecause the law is the only thing that defends us

Soon I will be meeting with my Congressional Representative Congresswoman Zoe Lofgren As aproud resident of Californiarsquos 16th Congressional District I had the honor of speaking withher last week She could not be more kind or more concerned This issue is bigger than me itaffects many of my fellow citizens ndash and if I am incorrect ndash then please sir ndash just explainit to me

If I am not qualified for this program why not issue me a proper Notice of Action

If I am not qualified for this program why was I issued a fraudulent State of CaliforniaBenefits Identification Card

If I am not qualified for this program why was a fraudulent unsigned application ldquoapprovedrdquofor me

If I am not qualified for this program why was I issued a SAR for medical evaluation at anEndocrine Center when I have a suspected Metabolic Disorder

If I am not qualified for this program why was a SAR issued without a NEW REFERRAL CCSGHPPCLIENT SERVICE AUTHORIZATION REQUEST DHCS 4488 being submitted and signed by a licensedCalifornia Physician

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

6

But perhaps there is an alternate explanation for such a good record one that does require afreedom of information act to confirm Since that day September 1 2005 and continuing untilthis present day every single notice issued to every single applicant or plan beneficiaryhas been ldquodefectiverdquo and not in compliance with Federal Law If one does not know they have aright to request a ldquoMedi-Cal State Fair Hearingrdquo it is not surprising that no one requestsone ndash and I believe that is fundamentally unfair

As an attorney I am sure you are aware of the Supremacy Clause of our wonderful and proudconstitution

Article VI lthttpenwikipediaorgwikiArticle_Six_of_the_United_States_Constitutiongt Clause 2

ldquoThis Constitution and the Laws of the United States which shall be made in pursuancethereof and all treaties made or which shall be made under the authority of the UnitedStates shall be the supreme law of the land and the judges in every state shall be boundthereby anything in the constitution or laws of any state to the contrary notwithstandingrdquo

I beleive that SHALL means SHALL

There are over 140000 citizens in the State of California with Hereditary Disorders defacto disabilities as defined by the very statue that enacted the Medical Programs to providetheir care The vast majority are very young children many very poor and born with complexmedical disorders The majority are so young that they are not even aware they are blessed tobe citizens endowed with inalienable rights to life liberty and the pursuit of happiness

But whatever their genetic defects may be and who among us has a perfect geneone they werecreated in the image of their Creator who endowed them with those inalienable rights Theyare full fledge citizens privileged members of ldquoWe The Peoplerdquo and as such are entitled tolegal protections that ensure them due process equal opportunity equal protection under thelaw and equal access to the mainstream and all the best of American life

They are entitled to their constitutional rights and all state and local shall recognizethese substantive and procedural rights

How can the California Department of Health Care Services let public servants acting onbehalf of their governmental authority commit acts that deprive any person of rightsprivileges or immunities secured or protected by state or federal law

7

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulatedthree purposes for passage of the statute

middot to override certain kinds of state laws

middot to provide ldquoa remedy where state law was inadequate and

middot to provide ldquoa federal remedy where the state remedy though adequate in theory wasnot available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become apowerful statute for enforcing rights secured by the Fourteenth Amendment First it heldthat actions taken by state governmental officials even if contrary to state law werenevertheless actions taken ldquounder color of lawrdquo Second the Court held that injuredindividuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions alsoviolated state law In short the statute was intended to provide a supplemental remedy Thefederal forum was necessary to vindicate federal rights because according to Congress in1871 state courts could not protect Fourteenth Amendment rights because of their ldquoprejudicepassion neglect [and] intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs mustallege two elements

(1) the action occurred ldquounder color of lawrdquo and

(2) the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens

Our great state has a program that is designed to protect and help citizens that aregenetically disabled ndash and that program in its entirety is in violation of the American withDisabilities Act And the legislature when passing the Hereditary Disorders Act explicitlyprovided a statutory provision that states ldquoA violation of any of the provisions of theHereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I would tell you that there shall be no misdemeanors nor shall anyone be punished ndash becauseIT IS IMPOSSIBLE FOR ANY CITIZEN IN THE STATE OF CALIFORNIA to report this misdemeanor andthe entire law enforcement infrastructure from the California Department of Justice to theDistrict Attorneyrsquos offices down to every local law enforcement department has never heardof or is aware of this law So I believe that in the history of this legislature not a singlereport has ever been filed or anyone punished ndash which much like the ldquoperfectrdquo record of StateFair Hearings is an incredible feat of compliance with the law or more likely due to the lackof knowledge or any enforcement efforts of any kind by the executive branch of government Aldquocriminal actrdquo defined by statute to protect people with disabilities that has no provisions

8

or efforts in place to report investigate or prosecute this misdemeanor that rdquoshall bepunishablerdquo

Six and a half years and counting ndash when will someone have the courage to correct this wrongndash and stand up for these innocent children who are not even aware their rights are beingtrampled upon

Plato hoped that the best men would be good at respecting established laws and he explainedwhy ldquoWhere the law is subject to some other authority and has none of its own the collapseof the state in my view is not far off but if law is the master of the government and thegovernment is its slave then the situation is full of promise and men enjoy all theblessings that the gods shower on a staterdquo

Aristotle went further advocating for the rule of law ldquoIt is more proper that law shouldgovern than any one of the citizensrdquo

But perhaps the Ancient Roman ltfileCwikiAncient_Romegt statesman CiceroltfileCwikiCicerogt said it best We are all servants of the laws in order that we maybe free

Chief Counsel Press I can do nothing ndash I canrsquot even get my own ldquoMedi-Cal State Fair Hearingrdquondash but you can ndash stand up for those children That would an act of great courage and greatcharacter Above all we are a members of we the people and we all have a responsibility todefend the lawhellipbecause the law is the only thing that defends us

Soon I will be meeting with my Congressional Representative Congresswoman Zoe Lofgren As aproud resident of Californiarsquos 16th Congressional District I had the honor of speaking withher last week She could not be more kind or more concerned This issue is bigger than me itaffects many of my fellow citizens ndash and if I am incorrect ndash then please sir ndash just explainit to me

If I am not qualified for this program why not issue me a proper Notice of Action

If I am not qualified for this program why was I issued a fraudulent State of CaliforniaBenefits Identification Card

If I am not qualified for this program why was a fraudulent unsigned application ldquoapprovedrdquofor me

If I am not qualified for this program why was I issued a SAR for medical evaluation at anEndocrine Center when I have a suspected Metabolic Disorder

If I am not qualified for this program why was a SAR issued without a NEW REFERRAL CCSGHPPCLIENT SERVICE AUTHORIZATION REQUEST DHCS 4488 being submitted and signed by a licensedCalifornia Physician

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

7

Congress passed 42 USC sect 1983 in 1871 The Supreme Court in Monroe v Pape articulatedthree purposes for passage of the statute

middot to override certain kinds of state laws

middot to provide ldquoa remedy where state law was inadequate and

middot to provide ldquoa federal remedy where the state remedy though adequate in theory wasnot available in practicerdquo

The Monroe Court resolved two important issues that allowed 42 USC sect 1983 to become apowerful statute for enforcing rights secured by the Fourteenth Amendment First it heldthat actions taken by state governmental officials even if contrary to state law werenevertheless actions taken ldquounder color of lawrdquo Second the Court held that injuredindividuals have a federal remedy under 42 USC sect 1983 even if the officialsrsquo actions alsoviolated state law In short the statute was intended to provide a supplemental remedy Thefederal forum was necessary to vindicate federal rights because according to Congress in1871 state courts could not protect Fourteenth Amendment rights because of their ldquoprejudicepassion neglect [and] intolerancerdquo

Prima Facie Case To establish a prima facie case under 42 USC sect 1983 plaintiffs mustallege two elements

(1) the action occurred ldquounder color of lawrdquo and

(2) the action is a deprivation of a constitutional right or a federal statutory right

I make these allegations on behalf of all my fellow citizens

Our great state has a program that is designed to protect and help citizens that aregenetically disabled ndash and that program in its entirety is in violation of the American withDisabilities Act And the legislature when passing the Hereditary Disorders Act explicitlyprovided a statutory provision that states ldquoA violation of any of the provisions of theHereditary Disorders Act (Section 27) or any of the

regulations adopted pursuant to that act shall be punishable as a misdemeanor

I would tell you that there shall be no misdemeanors nor shall anyone be punished ndash becauseIT IS IMPOSSIBLE FOR ANY CITIZEN IN THE STATE OF CALIFORNIA to report this misdemeanor andthe entire law enforcement infrastructure from the California Department of Justice to theDistrict Attorneyrsquos offices down to every local law enforcement department has never heardof or is aware of this law So I believe that in the history of this legislature not a singlereport has ever been filed or anyone punished ndash which much like the ldquoperfectrdquo record of StateFair Hearings is an incredible feat of compliance with the law or more likely due to the lackof knowledge or any enforcement efforts of any kind by the executive branch of government Aldquocriminal actrdquo defined by statute to protect people with disabilities that has no provisions

8

or efforts in place to report investigate or prosecute this misdemeanor that rdquoshall bepunishablerdquo

Six and a half years and counting ndash when will someone have the courage to correct this wrongndash and stand up for these innocent children who are not even aware their rights are beingtrampled upon

Plato hoped that the best men would be good at respecting established laws and he explainedwhy ldquoWhere the law is subject to some other authority and has none of its own the collapseof the state in my view is not far off but if law is the master of the government and thegovernment is its slave then the situation is full of promise and men enjoy all theblessings that the gods shower on a staterdquo

Aristotle went further advocating for the rule of law ldquoIt is more proper that law shouldgovern than any one of the citizensrdquo

But perhaps the Ancient Roman ltfileCwikiAncient_Romegt statesman CiceroltfileCwikiCicerogt said it best We are all servants of the laws in order that we maybe free

Chief Counsel Press I can do nothing ndash I canrsquot even get my own ldquoMedi-Cal State Fair Hearingrdquondash but you can ndash stand up for those children That would an act of great courage and greatcharacter Above all we are a members of we the people and we all have a responsibility todefend the lawhellipbecause the law is the only thing that defends us

Soon I will be meeting with my Congressional Representative Congresswoman Zoe Lofgren As aproud resident of Californiarsquos 16th Congressional District I had the honor of speaking withher last week She could not be more kind or more concerned This issue is bigger than me itaffects many of my fellow citizens ndash and if I am incorrect ndash then please sir ndash just explainit to me

If I am not qualified for this program why not issue me a proper Notice of Action

If I am not qualified for this program why was I issued a fraudulent State of CaliforniaBenefits Identification Card

If I am not qualified for this program why was a fraudulent unsigned application ldquoapprovedrdquofor me

If I am not qualified for this program why was I issued a SAR for medical evaluation at anEndocrine Center when I have a suspected Metabolic Disorder

If I am not qualified for this program why was a SAR issued without a NEW REFERRAL CCSGHPPCLIENT SERVICE AUTHORIZATION REQUEST DHCS 4488 being submitted and signed by a licensedCalifornia Physician

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

8

or efforts in place to report investigate or prosecute this misdemeanor that rdquoshall bepunishablerdquo

Six and a half years and counting ndash when will someone have the courage to correct this wrongndash and stand up for these innocent children who are not even aware their rights are beingtrampled upon

Plato hoped that the best men would be good at respecting established laws and he explainedwhy ldquoWhere the law is subject to some other authority and has none of its own the collapseof the state in my view is not far off but if law is the master of the government and thegovernment is its slave then the situation is full of promise and men enjoy all theblessings that the gods shower on a staterdquo

Aristotle went further advocating for the rule of law ldquoIt is more proper that law shouldgovern than any one of the citizensrdquo

But perhaps the Ancient Roman ltfileCwikiAncient_Romegt statesman CiceroltfileCwikiCicerogt said it best We are all servants of the laws in order that we maybe free

Chief Counsel Press I can do nothing ndash I canrsquot even get my own ldquoMedi-Cal State Fair Hearingrdquondash but you can ndash stand up for those children That would an act of great courage and greatcharacter Above all we are a members of we the people and we all have a responsibility todefend the lawhellipbecause the law is the only thing that defends us

Soon I will be meeting with my Congressional Representative Congresswoman Zoe Lofgren As aproud resident of Californiarsquos 16th Congressional District I had the honor of speaking withher last week She could not be more kind or more concerned This issue is bigger than me itaffects many of my fellow citizens ndash and if I am incorrect ndash then please sir ndash just explainit to me

If I am not qualified for this program why not issue me a proper Notice of Action

If I am not qualified for this program why was I issued a fraudulent State of CaliforniaBenefits Identification Card

If I am not qualified for this program why was a fraudulent unsigned application ldquoapprovedrdquofor me

If I am not qualified for this program why was I issued a SAR for medical evaluation at anEndocrine Center when I have a suspected Metabolic Disorder

If I am not qualified for this program why was a SAR issued without a NEW REFERRAL CCSGHPPCLIENT SERVICE AUTHORIZATION REQUEST DHCS 4488 being submitted and signed by a licensedCalifornia Physician

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

9

If I am not qualified for this program why was my Medi-Cal Fee For Service ldquoFair Hearingrdquo onMarch 27 2012 a fraudulent mock hearing

If I am not qualified for this program why I am not allowed to file a civil rights complaintagainst Nina R Elsohn Administrative Law Judge California Department of Social Services

If I am not qualified for this program why was does no one in my state government seem toknow where the ldquotape recordingrdquo mandated by law of my hearing is or how I can access it

If I am not qualified for this program why has my State Hearing Request submitted a viaconfirmed FAX to the State Hearings Division as required on 31 March 2012 not received aresponse or acknowledgement of any form

If I am not qualified for this program why I have I continued to receive threats andretaliation from my state and local government

I believe WELFARE AND INSTITUTIONS CODE SECTION sect10952 requires that hearings should commencewithin 30 working days after the request is filed and at least 10 days prior to the hearingall parties concerned receive written notice of the time and place of the hearing Furthersect10950 states that applicants ldquo be accorded an opportunity for a state hearingrdquo withldquopriority in setting and deciding cases shall be given in those cases in which aid is notbeing provided pending the outcome of the hearing ldquo

I received an Authorization for Diagnostic Evaluation Notice of Action from the Department ofHealth Care Services on 18 November 2011 (SAR 99033765400) and was issued a CaliforniaMedi-Cal Benefits Identification Card on 21 November 2011 (BIC ID No 95486255E41325) withfurther correspondence from Department of Health Care Services stating that I have ldquofullscope Medi-Cal with no share of cost and you are eligible to receive medically necessaryservicesrdquo As of this date I have received no medical aid of any kind

As a Title XIX of the Social Security Act program I believe 42 USC Sec 1396a (a) (8) isquite clear that medical assistance must ldquobe furnished with reasonable promptnessrdquo Irespectfully opine that has not occurred or as Chief Justice Rehnquist more eloquently statedin Jefferson v Hackney 406 US 535545 32 L Ed 2d 285 92 S Ct 1724 (1972) that TitleXIX ldquowas intended to prevent States from denying benefits even temporarilyrdquo I believe thisdelay in providing authorized medical services violates the services violates the ldquoamountduration or scope requirement of the compatibility provisionrdquo of the Medicaid Act

Chief Counsel Press what is your opinion What can I tell Congresswoman Zoe Lofgren thatthe Chief Counsel Office of Legal Services Department of Health Care Servicesrsquo (DHCS) isdoing about this matter

I appreciate your perspective

Joseph A Prezioso

405 N Fourth St B18

San Jose CA 95112

408-883-5446

877-493-2031 fax

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

10

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

877-493-2031 fax

josephpreziosoattnet

US Department of Justice

Civil Rights Division Criminal Section

950 Pennsylvania Avenue NW

Washington DC 20530-0001

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

SUBJECT COLOR OF LAW ABUSES FORMAL CRIMINAL COMPLAINT

REF My Letter to Kathleen Sebelius Secretary US Department Health amp Human Services 6-22-1012

18 USC 241 CONSPIRACY AGAINST RIGHTS

18 USC 242 DEPRIVATION OF RIGHTS UNDER COLOR OF LAW

18 USC 245 FEDERALLY PROTECTED ACTIVITIES

8262012

Dear Chief Kappelhoff

I make these allegations against the California Health and Human Services Agency and Centers for

Medicare and Medicaid Services (CMS) Region IX on behalf of myself and my fellow citizens with

Hereditary Disorders

Specifically I make these allegations under the penalty of perjury against

o Toby Douglas Director California Department of Health Care Services (DCHS)

o David Maxwell-Jolly Undersecretary California Health and Human Services Agency

o David V Banda Chief Statewide Programs Section (SPS) California Department of Health Care Services (DCHS)

o Gloria Nagle PhD MPA Associate Regional Administrator Centers for Medicare amp Medicaid (CMS) Region IX

o Manuel A Romero Chief Administrative Law Judge California Department of Social Services (CDSS)

Who have conspired and continue to conspire to deprive rights under color of law in federally protected activities

and in criminal violation of the CALIFORNIA HEREDITARY DISORDERS ACT (CALIFORNIA HEALTH

amp SAFETY CODE SECTION 124985)

As a citizen of the United States of America I state unequivocally that I recognize there is a reasonable amount of

suspicion supported by circumstances sufficiently strong to justify a prudent and cautious persons belief that

certain facts are probably true to support my allegations and the allegations are prima facie as defined under 42

USC sect 1983

If you are a citizen of California born with a Hereditary Disorder and you are either an applicant or client of the

Department of California Health Care Services (DCHS) CALIFORNIA CHILDRENrsquoS SERVICES

(CCS)GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) programs it is not possible

To be notified of your rights

To be provided a Notice of Action ldquoconsidered adequaterdquo

To exercise your right to a State Fair Hearing

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

JOSEPH A PREZIOSO

2

To be afforded your due process requirements per the Medicaid Act

To be guaranteed your due process rights promised per the United States Constitution

All as provided under state and federal law including the following

o Title XIX of the Social Security Act

o Chapter IV of the Code of Federal Regulations

o Cal Code Regs tit 22

o 42 CFR sectsect 431

o 42 USC sect 1396

o 42 USC sect 1983

o US Constitution 5th Amendment

o US Constitution 14th Amendment

And as promised per the contractual agreement between the California Department of Health Care Services

(DHCS) and US Department of Health amp Human Services (CALIFORNIA BRIDGE TO REFORM

DEMONSTRATION SECTION 1115 WAIVER 11-W-001939 11-2-2010)

In addition the California Department of Health Care Services (DHCS) is in breach of its contractual agreements

under Sec 1115 waivers authorized and approved under the Social Security Act (42 USC 1315) commencing

September 1 2005 for failure to provide the consideration it committed to in the form of promised actions in

exchange for the federal funding that has been provided The California Department of Health Care Services

(DHCS) should be made to return to the US Treasury the federal funding it has received via fraud and breach of

contract commencing September 1 2005

Please inform me as to whom I may provide the substantial direct documentary evidence that is prima facie and

conclusive my corroborating testimonial evidence to substantiate and support my criminal complaint and a list

of witlessness that have direct knowledge of these criminal acts

Thank you

Sincerely

JOSEPH A PREZIOSO

CC Barack Obama President United States of America

Eric H Holder Jr Attorney General of the United States US Department of Justice

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

JOSEPH A PREZIOSO

3

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Daniel R Levinson Inspector General Office of Inspector General US Department Health amp Human Services

Leon Rodriguez Director of the Office for Civil Rights (OCR) US Department of Health and Human Services

Kamala D Harris Attorney General California Department of Justice

Representative John Boehner Speaker United States House of Representatives

Senator Harry Reid Majority Leader United States Senate

Senator Mitch McConnell Minority Leader United States Senate

Jill Abramson Executive Editor The New York Times

Alan Murray Executive Editor The Wall Street Journal

Raju Narisetti Managing Editor The Wall Street Journal

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

Prezioso V DHCS Case s X4544 amp 4913810 State Hearings Division Health and Human Service Agency

1

INTRODUCTION

I respectfully request a fair hearing to be scheduled within 30 days reinstatement of my

program eligibility and be allowed to have services and medical assistance provided while a

decision is pending

ACTIONS I WILL CHALLENGE AT THE FAIR HEARING

bull Refusal and Delay in processing Medi-Cal application

bull Determination that I am no longer eligible for Medi-Cal

bull Inadequate notice

bull An unreasonable delay in receiving services

bull Reduction in services

bull Termination and denial of a Medi-Cal covered services

CONCLUSION

I respectfully request and pray for relief that this Honorable Administrative Court of Law

expeditiously as is possible and as the Court sees as is reasonable grant my hearing reinstate my

Medical eligibility and permit me to be allowed to have needed and mandated support services

and medical assistance while a decision is pending

DATED March 31 2012

Respectfully submitted

JOSEPH A PREZIOSO Citizen United States of America

1

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9

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14

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17

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1

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GENETICALLY HANDICAPPED PERSONS PROGRAM M S 8100 PO Box 997413 Sacramento CA 95899-7413 (800) 639-0597 Original

11182011

Mr Joseph Prezioso Client Name Joseph A Prezioso 119 Carlton Avenue Apt 3 Birth Date 10281961 Los Gatos CA 95032

Case 4913810

County Santa Clara

CIN 95486255E4

GHPP Authorization for Diagnostic Evaiyatiol1

Joseph A Prezioso has been authorized for services necessary to establish a GHPP medically eligible condition Service authorization 99033765400 is effective from 11182011 to 022812012 with the following Special Care Center (SCC) or specialist

Lucile Salter Packard

725 Welch Rd PALO ALTO CA 94304-1601

Please call the above SCOor Specialist at (415) 497-8000 to schedule your appointment bull

Remember to take this letter your Beneficiary Identification Card (BIC) in addition to any other Health Plan Cards to this appointment Please inform the office of your GHPP coverage and authorization for diagnostic evaluaton

This letter will need to be shown to Lucile Salter Packard and any other providers you may be referred to in order to expedite your ability to receive additional medical services

Please call GHPP at (800) 639-0597 if you are referred to any other source for evaluation

All authorizations must be made jn advance by the GHPP office

Sincerely

Genetically Handicapped Persons Program

C-50 - 5352530-2011

(DX Eval Cover Letter)

Page 1 of 2

CONFIDENTIAL SAR 99033765400 GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

M S 8100 PO BOX 997413

SACRAMENTO CA 95899-7413

Authorized SCC LUCILE SALTER PACKARD SCC Number 70924B 725 WELCH RD Telephone (415) 497-8000 PALO ALTOCA 94304-1601

SCC Type ENDOCRINE CENTER

AUTHORIZATION FOR SERVICES Authorization is for services and effective dates indicated below in accordance with GHPP program policies and fee schedule Authorization for additional services not listed below must be requested in advance By providing these authorized services you agree to accept payment from the GHPP program as payment in full If you have a Service Code Grouping (SCG) authorization please check your Medi-Cal manual for services included in the SCG

Client Name Address

Primary Addressee Address

Medical Home Address

County Primary Diagnosis Secondary Diagnosis

GHPP CLIENT INFORMATION JOSEPH A PREZIOSO 119 CARLTON AVENUE APT 3 Client Index Number LOS GATOS CA 95032 Case Number

Date Of Birth MR JOSEPH PREZIOSO Gender 119 CARLTON AVENUE APT 3 Client Telephone LOS GATOS CA 95032 Prim Addressee Tel

VALLEY HEALTH CENTER 2400 MOORPARK AVE

SAN JOSE CA 95128

SANTA CLARA 2701 PHENYLKETONURIA (PKU)

95486255E4 4913810 10281961 MALE (408) 960-5879 (408) 960-5879

AUTHORIZATION INFORMATION Effective Dates 1111Q2011 through 0212812012

Service Code 02

GHPP AUTHORIZED SERVICES Service Description

SPECIAL CARE CENTER

SPECIAL INSTRUCTtONS SAR IS FOR DIAGNOSTIC SERVICES ONLY AS NECESSARY TO ESTABLISH THE PRESENCE OF A PROGRAM MEDICALLY ELIGIBLE CONDITION

PLEASE SEND TO GHPP A COPY OF THE FOLLOWING DOCUMENTS

1 THE LABORATORYGENETIC REPORT CONFIRMING THE DIAGNOSIS

2 A COpy OF THE MEDICAL REPORT EVALUATING THE LABORATORY RESULTS

3 A COMPREHENSIVE MEDICAL EVALUATION REPORT

Please refer to the Medi-cal website wwwmedi-calcagov regarding billing instructions and Provider training related to authorizations Thank you for your continued participation in the Genetically Handicapped Persons Program Program

Issued By HAZELLCAROL( GHPP) Date Authorized 11182011

Page 20f2 Printed On Nov 18 2011 0259PM SAR 99033765400

GENETICALLY HANDICAPPED PERSONS PROGRAM M S 8100 PO Box 997413 Sacramento CA 95899-7413 (800) 639-0597 Original

11182011

Mr Joseph Prezioso Client Name Joseph A Prezioso 119 Carlton Avenue Apt 3 Birth Date 10281961 Los Gatos CA 95032

Case 4913810

County Santa Clara

CIN 95486255E4

GHPP Authorization for Diagnostic Evaiyatiol1

Joseph A Prezioso has been authorized for services necessary to establish a GHPP medically eligible condition Service authorization 99033765400 is effective from 11182011 to 022812012 with the following Special Care Center (SCC) or specialist

Lucile Salter Packard

725 Welch Rd PALO ALTO CA 94304-1601

Please call the above SCOor Specialist at (415) 497-8000 to schedule your appointment bull

Remember to take this letter your Beneficiary Identification Card (BIC) in addition to any other Health Plan Cards to this appointment Please inform the office of your GHPP coverage and authorization for diagnostic evaluaton

This letter will need to be shown to Lucile Salter Packard and any other providers you may be referred to in order to expedite your ability to receive additional medical services

Please call GHPP at (800) 639-0597 if you are referred to any other source for evaluation

All authorizations must be made jn advance by the GHPP office

Sincerely

Genetically Handicapped Persons Program

C-50 - 5352530-2011

(DX Eval Cover Letter)

Page 1 of 2

CONFIDENTIAL SAR 99033765400 GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

M S 8100 PO BOX 997413

SACRAMENTO CA 95899-7413

Authorized SCC LUCILE SALTER PACKARD SCC Number 70924B 725 WELCH RD Telephone (415) 497-8000 PALO ALTOCA 94304-1601

SCC Type ENDOCRINE CENTER

AUTHORIZATION FOR SERVICES Authorization is for services and effective dates indicated below in accordance with GHPP program policies and fee schedule Authorization for additional services not listed below must be requested in advance By providing these authorized services you agree to accept payment from the GHPP program as payment in full If you have a Service Code Grouping (SCG) authorization please check your Medi-Cal manual for services included in the SCG

Client Name Address

Primary Addressee Address

Medical Home Address

County Primary Diagnosis Secondary Diagnosis

GHPP CLIENT INFORMATION JOSEPH A PREZIOSO 119 CARLTON AVENUE APT 3 Client Index Number LOS GATOS CA 95032 Case Number

Date Of Birth MR JOSEPH PREZIOSO Gender 119 CARLTON AVENUE APT 3 Client Telephone LOS GATOS CA 95032 Prim Addressee Tel

VALLEY HEALTH CENTER 2400 MOORPARK AVE

SAN JOSE CA 95128

SANTA CLARA 2701 PHENYLKETONURIA (PKU)

95486255E4 4913810 10281961 MALE (408) 960-5879 (408) 960-5879

AUTHORIZATION INFORMATION Effective Dates 1111Q2011 through 0212812012

Service Code 02

GHPP AUTHORIZED SERVICES Service Description

SPECIAL CARE CENTER

SPECIAL INSTRUCTtONS SAR IS FOR DIAGNOSTIC SERVICES ONLY AS NECESSARY TO ESTABLISH THE PRESENCE OF A PROGRAM MEDICALLY ELIGIBLE CONDITION

PLEASE SEND TO GHPP A COPY OF THE FOLLOWING DOCUMENTS

1 THE LABORATORYGENETIC REPORT CONFIRMING THE DIAGNOSIS

2 A COpy OF THE MEDICAL REPORT EVALUATING THE LABORATORY RESULTS

3 A COMPREHENSIVE MEDICAL EVALUATION REPORT

Please refer to the Medi-cal website wwwmedi-calcagov regarding billing instructions and Provider training related to authorizations Thank you for your continued participation in the Genetically Handicapped Persons Program Program

Issued By HAZELLCAROL( GHPP) Date Authorized 11182011

Page 20f2 Printed On Nov 18 2011 0259PM SAR 99033765400

CONFIDENTIAL SAR 99033765400 GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

M S 8100 PO BOX 997413

SACRAMENTO CA 95899-7413

Authorized SCC LUCILE SALTER PACKARD SCC Number 70924B 725 WELCH RD Telephone (415) 497-8000 PALO ALTOCA 94304-1601

SCC Type ENDOCRINE CENTER

AUTHORIZATION FOR SERVICES Authorization is for services and effective dates indicated below in accordance with GHPP program policies and fee schedule Authorization for additional services not listed below must be requested in advance By providing these authorized services you agree to accept payment from the GHPP program as payment in full If you have a Service Code Grouping (SCG) authorization please check your Medi-Cal manual for services included in the SCG

Client Name Address

Primary Addressee Address

Medical Home Address

County Primary Diagnosis Secondary Diagnosis

GHPP CLIENT INFORMATION JOSEPH A PREZIOSO 119 CARLTON AVENUE APT 3 Client Index Number LOS GATOS CA 95032 Case Number

Date Of Birth MR JOSEPH PREZIOSO Gender 119 CARLTON AVENUE APT 3 Client Telephone LOS GATOS CA 95032 Prim Addressee Tel

VALLEY HEALTH CENTER 2400 MOORPARK AVE

SAN JOSE CA 95128

SANTA CLARA 2701 PHENYLKETONURIA (PKU)

95486255E4 4913810 10281961 MALE (408) 960-5879 (408) 960-5879

AUTHORIZATION INFORMATION Effective Dates 1111Q2011 through 0212812012

Service Code 02

GHPP AUTHORIZED SERVICES Service Description

SPECIAL CARE CENTER

SPECIAL INSTRUCTtONS SAR IS FOR DIAGNOSTIC SERVICES ONLY AS NECESSARY TO ESTABLISH THE PRESENCE OF A PROGRAM MEDICALLY ELIGIBLE CONDITION

PLEASE SEND TO GHPP A COPY OF THE FOLLOWING DOCUMENTS

1 THE LABORATORYGENETIC REPORT CONFIRMING THE DIAGNOSIS

2 A COpy OF THE MEDICAL REPORT EVALUATING THE LABORATORY RESULTS

3 A COMPREHENSIVE MEDICAL EVALUATION REPORT

Please refer to the Medi-cal website wwwmedi-calcagov regarding billing instructions and Provider training related to authorizations Thank you for your continued participation in the Genetically Handicapped Persons Program Program

Issued By HAZELLCAROL( GHPP) Date Authorized 11182011

Page 20f2 Printed On Nov 18 2011 0259PM SAR 99033765400

fr w H C S

Health r Service josephpreziosoattnet

Reply Reply to All

From vdavidbandadhcscagov (Authenticated by dhcscagov) w Valid Signature (Help)

To josephpreziosoattnet

Sent Thu Dec 15 2011 510 PM (6 days ago)

Subject FW Genetically Handicapped Persons Program Case Manager [secure]

Mr Prezioso

The authorization documentation you attached to your e-mail is accurate and self-explanatory Authorizations were properly issued to a qualified provider to permit you to receive the diagnostic evaluation necessary to establish your medical eligibility for GHPP This was necessitated by the fact that you did not provide the medical documentation necessary to establish your medical eligibility despite multiple requests for this information As of earlier today you had not scheduled an appointment for these diagnostic services

Your communication via Lisa Holmes occurred in May of this year I was unable to communicate with her effectively regarding your situation because she did not provide documentation from you that authorized us to discuss your protected health information I attempted to communicate with you but received no return response to my calls

Our system documentation indicates that you currently have full scope Medi-Cal with no share of cost and you are eligible to receive medically necessary services

From the facts evident in your case documentation there is no justification for a fraud or criminal investigation and the suggestion that Carol Hazell or any other GHPP staff member acted criminally is defamatory

GHPP will continue to respond to any properly submitted and appropriate request from you or your health care providers

V David Banda Chief Statewide Programs Section Systems of Care Division (916)327-1706

From Banda VDavid (DHCS-CMS) Sent Thursday December 15 2011 249 PM To josephpreziosoattnet Cc Stop Medical Fraud (DHCS-A8J) Lim Bruce (DHCS-A8J) Mark Geiger DHCS AampI IB Fraud Referrals aforrestlosgatoscagov Howe Neal (DHCS-OHC) Public Inquiry and ResponseDSS Subject RE Genetically Handicapped Persons Program Case Manager

Mr Prezioso

The Genetically Handicapped Persons Programs (GHPP) plays no role in the issuance of the Medi-Cal Beneficiary Identification Card In reviewing this matter I find no indication of any unusual or improper activity by the GHPP staff including Carol Hazell I will reply further to you in an encrypted e-mail

V David Banda Chief Statewide Programs Section Systems of Care Division (916)327-1706

From Joseph Prezioso [mailtojosephpreziosoattnet] Sent Thursday December 15 2011 1206 PM To Banda VDavid (DHCS-CMS) Cc Stop Medical Fraud (DHCS-AampI) Lim Bruce (DHCS-AampI) Mark Geiger DHCS AampI IB Fraud Referrals aforrestlosgatoscagov Howe Neal (DHCS-OHC) Public Inquiry and ResponseDSS Subject RE Genetically Handicapped Persons Program Case Manager

Chief Banda

The attached Diagnostic Approval and SAR Authorization as well as a State of California Benefits Identification Card (ID No 95486255E41325 - Issue Date 11-21-11) came from your department and indicates is was issued by HAZELLCAROL (GHPP)

The BIC Card is being used by my Medi-Cal Providers to bill services

I see no point in calling you as I tried that over 1 year ago at the suggestion of Ms Lisa Holmes Civil Rights Coordinator Santa Clara County and you did not return my calls Since GHPP policy explicitly states you can share my information in fraud and criminal investigations I prefer to communicate with the CC list included as I can only assume that is why you responded now Just as I have to assume that my approval for an application I never submitted and a SAR my PCP never referred arrived unexpectedly with a BIC card when I had come to understand that this was in fact a Medi-Cal program and I sent an inquiry to initiate a State Fair Hearing

And though I am most certainly qualified for the benefits under this program (as I have since my first application submitted over 4 years ago) and I am in desperate need of and entitled to Health Care -1 have good cause to believe my BIC Card and GHPP Authorizations were not properly issued but are attempt to conceal improper criminal activity by state employees within your section by using State and Federal Funds to provide my healthcare benefits in an improper fashion

Though I have suffered greatly because of these criminal violations of my civil rights and desperately need proper healthcare services I cannot in good conscious use this card as I have come to believe is was not issued in accordance with the law I do want my rights but as a citizen I must also live up to my responsibilities and would become complicit to continue receiving Medical Services without a proper explanation and approval from law enforcement that the benefits card is in fact legal

And as my PCP has no knowledge of this SAR HAZELLCAROL (GHPP) is acting in the capacity of a medical doctor without a license to practice medicine (you do not diagnose Metabolic conditions at an

Endocrine Center) which is also a crime that I would like to bring to the attention of the California Medical Review Board

So Chief Banda

- who is HAZELLCAROL (GHPP)

- and could you please go on the record for Deputy Director Lin and Chief Estrada DHCS Medi-Cal Fraud Investigations Branch (DHCS-IB) that my BIC and SAR were legally authorized

Under the watch of their enforcement responsibilities I put my trust that I will not suffer additional retaliatory action - but that trust is badly shaken given the price I paid for just inquiring (not filing a complaint) with my designated County Civil Rights Officer

To me it seems like a simple question not requiring encrypted communications lines It feels as if someone is going to great lengths (including breaching my medical records) to try and conceal the activity relating to how my entire engagement with the GHPP office has been handled

I finally had to go to the Santa Clara County Office of the District Attorney and have an investigator point out to me how irregular all mynotices have been No identifier of who initiated the NOAs and no information regarding a citizens rights of appeal and Request a State Hearing - essentially ex-parte notices making them null and void And as complaints to the Judiciary Branch cannot be ignored or disappear I suspect that is why I finally received a response - but an improper one

I believe that crimes have been committed (ANY VIOLATIONS OF THE HERIDITY DISORDERS ACT SHALL be punishable as a misdemeanor) and that is proper responsibility of Law Enforcement Authorities The HERIDITY DISORDERS ACT is arcane but I want to thank the Los Gatos Police Department (in particular Officer Gregg and Sergeant Langer) for truly living up to the motto to protect and serve They took the time to both try and learn about my rare condition as well as validate that there was good cause that the statue had been violated Neither of us were aware of Chief of Investigations Estrada and that his fraud investigators are sworn law enforcement officers whose authority extends throughout the State or this whole matter would have been resolved long ago

Though arcane I am certain that the Attorney Generals Office will quickly understand not only what wrong has been done to me but the great jeopardy the improper administration of this program has exposed the State of California to at a time when we are in desperate financial condition The California Supreme Court has strongly opined referencing a California District Court case adjudicating the HERIDITY DISORDERS ACT - and the central question of what the legal definition of SHALL is The Justices were quite clear in stating that SHALL means SHALL The GHPP has failed terribly to carry out their minstrel duty

And subsequent to that ruling this program has been Federalized under Title XIX of the Social Security Act - and Federal Courts have ruled clearly that a citizen does not have to exhaust all their remedies despite what state regulations and statues may say - but just need to walk into a Federal Court once a citizen becomes aware their rights are being violated

And I think it bitterly ironic that the Supremacy Clause of our blessed Constitution comes into play -Federal Law (ADA) overrides state law In that short clause the Founders used the word SHALL 3 TIMES Perhaps they were trying to tell us that SHALL means SHALL

Whatever my genetic defects may be - I am a member of WE THE PEOPLE

So I respectfully ask for an explanation and assistance as TIME IS OF THE ESSENCE - I need proper healthcare and social services support that I am entitled to

Thank you kindly

Joseph A Prezioso 2011 Little Orchard St San Jose CA 95125 408-887-2822

From Banda VDavid (DHCS-CMS) [mailtoVDavidBandadhcscagov] Sent Wednesday December 14 2011 520 PM To josephpreziosoattnet Cc Stop Medical Fraud (DHCS-AampI) Lim Bruce (DHCS-AampI) Mark Geiger Subject RE Genetically Handicapped Persons Program Case Manager

Mr Prezioso

I cannot confirm any information regarding your relationship to GHPP in an insecure e-mail Note that various staff members may be involved in the case management of a given GHPP clients case In responding to a concern such as yours it would be important to explore how the SAR may constitute a Medi-Cal fraud (eg was improperly submitted by a provider that claimed for but did not deliver the authorized service)

Please call me directly at (916) 327-1706 If you prefer you can fax written concerns to the GHPP fax line to my attention at (916) 327-1112 or 327-0670

From Joseph Prezioso [mailtoiosephpreziosoattnet] Sent Wednesday December 14 2011 430 PM To Banda VDavid (DHCS-CMS) Cc Stop Medical Fraud (DHCS-AampI) Lim Bruce (DHCS-AampI) Mark Geiger Subject RE Genetically Handicapped Persons Program Case Manager Importance High

Hello Chief Banda

Thank you for your timely reply

1 would like to know the name and contact information of my Case Manager who issued the referenced SAR (SAR 99033765400)

And I think it bitterly ironic that the Supremacy Clause of our blessed Constitution comes into play -Federal Law (ADA) overrides state law In that short clause the Founders used the word SHALL 3 TIMES Perhaps they were trying to tell us that SHALL means SHALL

Whatever my genetic defects may be - I am a member of WE THE PEOPLE

So I respectfully ask for an explanation and assistance as TIME IS OF THE ESSENCE - I need proper healthcare and social services support that I am entitled to

Thank you kindly

Joseph A Prezioso 2011 Little Orchard St San Jose CA 95125 408-887-2822

From Banda VDavid (DHCS-CMS) [mailtoVDavidBandadhcscagov] Sent Wednesday December 14 2011 520 PM To josephpreziosoattnet Cc Stop Medical Fraud (DHCS-AampI) Lim Bruce (DHCS-AampI) Mark Geiger Subject RE Genetically Handicapped Persons Program Case Manager

Mr Prezioso

I cannot confirm any information regarding your relationship to GHPP in an insecure e-mail Note that various staff members may be involved in the case management of a given GHPP clients case In responding to a concern such as yours it would be important to explore how the SAR may constitute a Medi-Cal fraud (eg was improperly submitted by a provider that claimed for but did not deliver the authorized service)

Please call me directly at (916) 327-1706 If you prefer you can fax written concerns to the GHPP fax line to my attention at (916) 327-1112 or 327-0670

From Joseph Prezioso [mailtoiosephpreziosoattnet] Sent Wednesday December 14 2011 430 PM To Banda VDavid (DHCS-CMS) Cc Stop Medical Fraud (DHCS-AampI) Lim Bruce (DHCS-AampI) Mark Geiger Subject RE Genetically Handicapped Persons Program Case Manager Importance High

Hello Chief Banda

Thank you for your timely reply

1 would like to know the name and contact information of my Case Manager who issued the referenced SAR (SAR 99033765400)

I am concerned that this SAR may have been issued improperly as well as my Department of Health Care Services (DHCS) Benefits Identification Card (BIC) and may represent Medi-Cal Fraud amp Abuse as well as violation of several other State (Heredity Disorders Act) and Federal (Americans with Disabilities Act) laws and regulations

Is Carol Hazell still with the GHHP program The letter I received indicates that she issued the SAR dated 11182011 Is Ms Hazell my Case Manager And how do I contact her

Thank you

Joseph A Prezioso 2011 Little Orchard St San Jose CA 95125 408-960-5879 887-371-4043 fax

From Banda VDavid (DHCS-CMS) [mailtoVDavidBandadhcscaqov] Sent Wednesday December 14 2011 324 PM To iosephpreziosoattnet Subject RE Genetically Handicapped Persons Program Case Manager

Mr Prezioso

Gloria is no longer with the program Please let me know what your need is and I will see how we might assist you

From Joseph Prezioso [mailtoiosephpreziosoattnet] Sent Wednesday December 14 2011 306 PM To Padre Gloria (DHCS-CMS) Cc California Department of Social Services Banda VDavid (DHCS-CMS) Lim Bruce (DHCS-AampI) Mark Geiger Subject Genetically Handicapped Persons Program Case Manager Importance High

Hello Ms Padre

Could you kindly provide the name and contact information of my Case Manager

REFERENCE Birth Date 10281961 Case 4913810 County Santa Clara CIN 95486255E4 SAR 99033765400

Thank you kindly

Joseph A Prezioso

2011 Little Orchard St San Jose CA 95125 408-960-5879 887-371-4043 fax

Reply i Reply to All

This message was sent using DHCS SecureMail Learn More

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

COMPLAINT OF DISCRIMINATION

I believe I have been discriminated against on the basis of

n RACE n NATIONAL ORIGIN n RELIGION n MARITAL STATUS

n SEX n COLOR n DISABILITY n AGE(including Gender Identity) (including HIV Status)

n POLITICAL AFFILIATION n DOMESTIC PARTNERSHIP n SEXUAL ORIENTATION n ETHNIC GROUPIDENTIFICATION

NAME OF PERSON WHO DISCRIMINATED TITLE

Describe in your own words what action(s) have happened to lead you to believe you have been discriminated against

Indicate what resolution you are seeking

I understand the above information is true and complete to the best of my knowledge and belief

n I do not give my consent for the release of my name or other personally identifying information I understand that this complaint may notbe investigated as a result of my refusal to give my consent for the release of information

n By signing this complaint I am authorizing the CDSS Civil Rights Bureau (CRB) to reveal my identity and other personal information topersons at the organization or institution under investigation and to other Federal and State agencies in accordance with applicablefederal and state laws and regulations I hereby authorize CRB to receive material and information including but not limited toapplications case files personal records and medical records The material and information shall be used for authorized civil rightscompliance and enforcement activities I understand that I am not required to authorize this release and I do so voluntarily

COMPLAINANTS SIGNATURE

GEN 1179 (209)

DATE

DATE OF OCCURRENCE

PLACE OF OCCURRENCE AND AGENCY

NAME

ADDRESS

AID TYPE

CASE NUMBER

PHONE NUMBER( )

AREA CODE

13 13

$ amp ( ) + amp - 0 - amp ( amp - - ( ( + amp amp ( - 1 amp - ( - amp + 13 0 1 1 2 amp 3 amp amp 4 amp 3 amp 5 2 + 3 1 amp - amp amp ( + - 1 - - amp 6 - - 7 ( 2 1 4 8 - amp 1 + ( 1 - 7 amp - - 8 1 6 9 - + 3 amp 1 1 + 3 1 + 1 1 1 - - amp - 8 1 amp + - + 2 amp amp + + amp 3 1 + 1 amp + 3 - - 4 - - 2 1 3 + 1 1 2 + 8 1 amp 8 amp - 3 9 amp ( - 1 - 3 + amp 1 - 1 3 + 2 + 6 amp - 3 amp amp 6 3 amp - - + amp - + - amp - - amp ( amp 2 - 1 4 + 4 + - - 3 1 1 - - ( + amp - ( - 3 - amp 8 1 - - 1 - - - amp 1 7 1 9 4 2 amp 1 9 1 1 amp + 7

URE

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

888-497-5101 fax

josephpreziosoattnet

California Health amp Human Services Agency (CHHS) 1600 Ninth Street Room 460 Sacramento CA 95814 Diana S Dooley Secretary California Health amp Human Services Agency (CHHS)

SUBJECT Civil Rights Complaint Section Chief Banda State Wide Programs Section (SPS) Department of Health Care Services (DHCS) 6-17-2012

REF My email to Bureau Chief Tashima Civil Rights Bureau (CRB) California Department of Social Services (CDSS) 8-25-2012

9242012

Dear Secretary Dooley

I am requesting the assistance of your office to provide a proper response to a Civil Rights complaint filed with

Bureau Chief Tashima Civil Rights Bureau (CRB) California Department of Social Services (CDSS) on June 17

2012 It would appear to any reasonable person that the California Department of Social Services (CDSS) Civil

Rights Bureau (CRB) and Bureau Chief Tashima do not take civil rights complaints from citizens seriously or even

offer the most basic courtesy and respect of a reply to even acknowledge the filing of such a complaint

The actions of the California Department of Social Services (CDSS) Civil Rights Bureau (CRB) under Bureau Chief

Tashima have been irresponsible regarding this matter and have prejudiced any hope of an impartial and

transparent investigation of these allegations against Section Chief Banda Accordingly I am requesting that you

as Secretary of the California Health amp Human Services Agency (CHHS) refer this matter to the California

Department of Justice Civil Rights Enforcement Section for a proper investigation under the authority of the

Office of the Attorney General

I expect and look forward to a proper and timely response from your office

Sincerely

Joseph A Prezioso

CC Kamala D Harris Attorney General California Department of Justice

Edmund G Brown Jr Governor State of California

Kathleen Sebelius Secretary US Department of Health and Human Services

Leon Rodriguez Director Office of Civil Rights (OCR) US Department of Health and Human Services

Jackie S Garner Medicaid Consortium Administrator Consortium for Medicaid and Childrens Health Operations Centers for Medicare amp Medicaid (CMS)

Eric H Holder Jr Attorney General of the United States US Department of Justice

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Joesph A Prezioso

2

Joel A Moss Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

Barack Obama President United States of America

Roy S Gordet Attorney at Law

Information about user

User chooses to identify himselfherself

First name Joseph

Last name Prezioso

Company

Address (Line 1) 405 N FOUTH ST

Address (Line 2)

City SAN JOSE

State CA

Zip 95112

Phone (408)883-5446

Evening phone (408)883-5446

Email josephpreziosoattnet

Narrative

Joseph Prezioso California Benefits Identification Card Number (Medicaid) 95486255E41325 CA DHCS and LPCH have failed to provide the services required per HHS funding under the California Section 1115 Waiver submitted June 4 2010 Genetically Handicapped Persons Program (GHPP) GHPP provides case management and funding for medically necessary services to people with certain genetic conditions Special Care Centers (SCCs) and hospitals that apply to become CCS-approved must meet specific Criteria for family-centered care (FCC) FCC is assessed by the CMS Branch as part of the ongoing review process of CCS-approved SCCs and hospitals I was diagnosed with PKU on August 28 2009 at Stanford Medical Center (attached) Application was submitted to California DHCS GHPP office on May 10 2010 As of March 4 2012 I am still waiting for urgent medical diagnostic and treatment as required by law including CA Hereditary Disorders Act Ralph Civil Rights Act Unruh Civil Rights Act Business and Professions Code section 1256 and US American with Disabilities Act Title VI of the Civil Rights Act of 1964 42 USC sect 2000d Civil Rights Restoration Act of 1987 20 USC section 1681 et seq 42 USC section 1983 and peace officer misconduct 42 USC 14141 I have made several reports to both my County and State Civil Rights office and have received no response I have been retaliated against and threatened with violence for trying to report this activity I have many additional documents and multiple

witnesses that will corroborate these allegations Please helpI am very ill and desperate

Type of complaint

Grants Fraud

HHS department or program being affected

Medicaid

Information for subject 1

Subject name California Department of Health Care Services

Subject title Statewide Programs Section Chief David V Banda

Subject street address

1515 K Street Suite 400

Subject city or county

Sacramento

Subject state CA

Subject zip code 95184

Subject phone (916)327-1706

Information for subject 2

Subject name Lucile Packard Childrenrsquos Hospital

Subject title Gregory M Enns MD Director Biochemical Genetics

Subject street address

730 Welch Road 2nd Floor

Subject city or county

Palo Alto

Subject state

Subject zip code 94304

Subject phone (650)721-5804

DIANNE FEINSTEIN SELECT COMMITIEE ON CAUFORNIA INTELLIGENCE-CHAIRMAN

COMMITTEE ON APPROPRIATlQNS

COMMfTTEE ON THE JUDICIARY

CQMMfTTEE ON RULES AND tinitro ~tatrs ~tnetr ADMINISTRATION

WASHINGTON DC 20510-0504

httpfe i n ste i n senategov

July 132012

Mr Joseph Prezioso 405 N 4th St B18 San Jose California 95112

Dear Mr Prezioso

ank you for taking the time to write to me I am sorry to hear about your difficulties with the California Department of Social Services I appreciate your trust in me and the opportunity to help in this matter Unfortunately many issues within the State of California are beyond my jurisdiction as a United States Senator

I want to be sure that your concern reaches someone who can help you therefore I suggest you contact the office of Governor Jerry Brown His office is set up to help in matters within the jurisdiction of the Governor of the State of California and I have been assured that his staffwill work hard to heip you in your endeavors You can start by calling his Constituent Affairs office directly at (916) 445-2841 You may also submit an e-mail with an outline of the matter through the Governors website httpgovcagovm contacLphp or mail a signed letter to his office

Office of Governor Jerry Brown Attn Constituent Affairs State Capitol First Floor

Sacramento California 95814

Again thank you for your letter and the opportunity to serve you Please do write to me again if I can be of any assistance to you on a federal government issue

Sincerely

Dianne Feinstein United States Senator

DFdm

FRESNO OFFICE LOS ANGELES OFFICE SAN DIEGO OFFICE SAN FRANCISCO OFFICE 2500 TuUIRE STIIEFI 11111 SAN1A MONICA BOULEVARD 750 B SmEll ONE Posr STREET

SUITE 4290 SUITE 916 SUITE 1030 SUITe 2450 FRESNO CA 93721 LOS ANGELES CA 90025 SAN DIEGO CA 92101 SAN F NClSCO CA 94104

1559) 485-7430 (310) 914--7300 (619) 231 9712 (4151 39J~707

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

COMPLAINT OF DISCRIMINATION

I believe I have been discriminated against on the basis of

n RACE n NATIONAL ORIGIN n RELIGION n MARITAL STATUS

n SEX n COLOR n DISABILITY n AGE(including Gender Identity) (including HIV Status)

n POLITICAL AFFILIATION n DOMESTIC PARTNERSHIP n SEXUAL ORIENTATION n ETHNIC GROUPIDENTIFICATION

NAME OF PERSON WHO DISCRIMINATED TITLE

Describe in your own words what action(s) have happened to lead you to believe you have been discriminated against

Indicate what resolution you are seeking

I understand the above information is true and complete to the best of my knowledge and belief

n I do not give my consent for the release of my name or other personally identifying information I understand that this complaint may notbe investigated as a result of my refusal to give my consent for the release of information

n By signing this complaint I am authorizing the CDSS Civil Rights Bureau (CRB) to reveal my identity and other personal information topersons at the organization or institution under investigation and to other Federal and State agencies in accordance with applicablefederal and state laws and regulations I hereby authorize CRB to receive material and information including but not limited toapplications case files personal records and medical records The material and information shall be used for authorized civil rightscompliance and enforcement activities I understand that I am not required to authorize this release and I do so voluntarily

COMPLAINANTS SIGNATURE

GEN 1179 (209)

DATE

DATE OF OCCURRENCE

PLACE OF OCCURRENCE AND AGENCY

NAME

ADDRESS

AID TYPE

CASE NUMBER

PHONE NUMBER( )

AREA CODE

13 13

$ amp ( ) + amp - 0 - amp ( amp - - ( ( + amp amp ( - 1 amp - ( - amp + 13 0 1 1 2 amp 3 amp amp 4 amp 3 amp 5 2 + 3 1 amp - amp amp ( + - 1 - - amp 6 - - 7 ( 2 1 4 8 - amp 1 + ( 1 - 7 amp - - 8 1 6 9 - + 3 amp 1 1 + 3 1 + 1 1 1 - - amp - 8 1 amp + - + 2 amp amp + + amp 3 1 + 1 amp + 3 - - 4 - - 2 1 3 + 1 1 2 + 8 1 amp 8 amp - 3 9 amp ( - 1 - 3 + amp 1 - 1 3 + 2 + 6 amp - 3 amp amp 6 3 amp - - + amp - + - amp - - amp ( amp 2 - 1 4 + 4 + - - 3 1 1 - - ( + amp - ( - 3 - amp 8 1 - - 1 - - - amp 1 7 1 9 4 2 amp 1 9 1 1 amp + 7

URE

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

888-497-5101 fax

josephpreziosoattnet

California Health amp Human Services Agency (CHHS) 1600 Ninth Street Room 460 Sacramento CA 95814 Diana S Dooley Secretary California Health amp Human Services Agency (CHHS)

SUBJECT Civil Rights Complaint Section Chief Banda State Wide Programs Section (SPS) Department of Health Care Services (DHCS) 6-17-2012

REF My email to Bureau Chief Tashima Civil Rights Bureau (CRB) California Department of Social Services (CDSS) 8-25-2012

9242012

Dear Secretary Dooley

I am requesting the assistance of your office to provide a proper response to a Civil Rights complaint filed with

Bureau Chief Tashima Civil Rights Bureau (CRB) California Department of Social Services (CDSS) on June 17

2012 It would appear to any reasonable person that the California Department of Social Services (CDSS) Civil

Rights Bureau (CRB) and Bureau Chief Tashima do not take civil rights complaints from citizens seriously or even

offer the most basic courtesy and respect of a reply to even acknowledge the filing of such a complaint

The actions of the California Department of Social Services (CDSS) Civil Rights Bureau (CRB) under Bureau Chief

Tashima have been irresponsible regarding this matter and have prejudiced any hope of an impartial and

transparent investigation of these allegations against Section Chief Banda Accordingly I am requesting that you

as Secretary of the California Health amp Human Services Agency (CHHS) refer this matter to the California

Department of Justice Civil Rights Enforcement Section for a proper investigation under the authority of the

Office of the Attorney General

I expect and look forward to a proper and timely response from your office

Sincerely

Joseph A Prezioso

CC Kamala D Harris Attorney General California Department of Justice

Edmund G Brown Jr Governor State of California

Kathleen Sebelius Secretary US Department of Health and Human Services

Leon Rodriguez Director Office of Civil Rights (OCR) US Department of Health and Human Services

Jackie S Garner Medicaid Consortium Administrator Consortium for Medicaid and Childrens Health Operations Centers for Medicare amp Medicaid (CMS)

Eric H Holder Jr Attorney General of the United States US Department of Justice

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Joesph A Prezioso

2

Joel A Moss Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

Barack Obama President United States of America

Roy S Gordet Attorney at Law

Information about user

User chooses to identify himselfherself

First name Joseph

Last name Prezioso

Company

Address (Line 1) 405 N FOUTH ST

Address (Line 2)

City SAN JOSE

State CA

Zip 95112

Phone (408)883-5446

Evening phone (408)883-5446

Email josephpreziosoattnet

Narrative

Joseph Prezioso California Benefits Identification Card Number (Medicaid) 95486255E41325 CA DHCS and LPCH have failed to provide the services required per HHS funding under the California Section 1115 Waiver submitted June 4 2010 Genetically Handicapped Persons Program (GHPP) GHPP provides case management and funding for medically necessary services to people with certain genetic conditions Special Care Centers (SCCs) and hospitals that apply to become CCS-approved must meet specific Criteria for family-centered care (FCC) FCC is assessed by the CMS Branch as part of the ongoing review process of CCS-approved SCCs and hospitals I was diagnosed with PKU on August 28 2009 at Stanford Medical Center (attached) Application was submitted to California DHCS GHPP office on May 10 2010 As of March 4 2012 I am still waiting for urgent medical diagnostic and treatment as required by law including CA Hereditary Disorders Act Ralph Civil Rights Act Unruh Civil Rights Act Business and Professions Code section 1256 and US American with Disabilities Act Title VI of the Civil Rights Act of 1964 42 USC sect 2000d Civil Rights Restoration Act of 1987 20 USC section 1681 et seq 42 USC section 1983 and peace officer misconduct 42 USC 14141 I have made several reports to both my County and State Civil Rights office and have received no response I have been retaliated against and threatened with violence for trying to report this activity I have many additional documents and multiple

witnesses that will corroborate these allegations Please helpI am very ill and desperate

Type of complaint

Grants Fraud

HHS department or program being affected

Medicaid

Information for subject 1

Subject name California Department of Health Care Services

Subject title Statewide Programs Section Chief David V Banda

Subject street address

1515 K Street Suite 400

Subject city or county

Sacramento

Subject state CA

Subject zip code 95184

Subject phone (916)327-1706

Information for subject 2

Subject name Lucile Packard Childrenrsquos Hospital

Subject title Gregory M Enns MD Director Biochemical Genetics

Subject street address

730 Welch Road 2nd Floor

Subject city or county

Palo Alto

Subject state

Subject zip code 94304

Subject phone (650)721-5804

DIANNE FEINSTEIN SELECT COMMITIEE ON CAUFORNIA INTELLIGENCE-CHAIRMAN

COMMITTEE ON APPROPRIATlQNS

COMMfTTEE ON THE JUDICIARY

CQMMfTTEE ON RULES AND tinitro ~tatrs ~tnetr ADMINISTRATION

WASHINGTON DC 20510-0504

httpfe i n ste i n senategov

July 132012

Mr Joseph Prezioso 405 N 4th St B18 San Jose California 95112

Dear Mr Prezioso

ank you for taking the time to write to me I am sorry to hear about your difficulties with the California Department of Social Services I appreciate your trust in me and the opportunity to help in this matter Unfortunately many issues within the State of California are beyond my jurisdiction as a United States Senator

I want to be sure that your concern reaches someone who can help you therefore I suggest you contact the office of Governor Jerry Brown His office is set up to help in matters within the jurisdiction of the Governor of the State of California and I have been assured that his staffwill work hard to heip you in your endeavors You can start by calling his Constituent Affairs office directly at (916) 445-2841 You may also submit an e-mail with an outline of the matter through the Governors website httpgovcagovm contacLphp or mail a signed letter to his office

Office of Governor Jerry Brown Attn Constituent Affairs State Capitol First Floor

Sacramento California 95814

Again thank you for your letter and the opportunity to serve you Please do write to me again if I can be of any assistance to you on a federal government issue

Sincerely

Dianne Feinstein United States Senator

DFdm

FRESNO OFFICE LOS ANGELES OFFICE SAN DIEGO OFFICE SAN FRANCISCO OFFICE 2500 TuUIRE STIIEFI 11111 SAN1A MONICA BOULEVARD 750 B SmEll ONE Posr STREET

SUITE 4290 SUITE 916 SUITE 1030 SUITe 2450 FRESNO CA 93721 LOS ANGELES CA 90025 SAN DIEGO CA 92101 SAN F NClSCO CA 94104

1559) 485-7430 (310) 914--7300 (619) 231 9712 (4151 39J~707

THINKSTRONG JOSEPH A PREZIOSO

358 N MONTGOMERY ST M23

SAN JOSE CA 95110

408-883-5446

888-497-5101 fax

josephpreziosoattnet

California Health amp Human Services Agency (CHHS) 1600 Ninth Street Room 460 Sacramento CA 95814 Diana S Dooley Secretary California Health amp Human Services Agency (CHHS)

SUBJECT Civil Rights Complaint Section Chief Banda State Wide Programs Section (SPS) Department of Health Care Services (DHCS) 6-17-2012

REF My email to Bureau Chief Tashima Civil Rights Bureau (CRB) California Department of Social Services (CDSS) 8-25-2012

9242012

Dear Secretary Dooley

I am requesting the assistance of your office to provide a proper response to a Civil Rights complaint filed with

Bureau Chief Tashima Civil Rights Bureau (CRB) California Department of Social Services (CDSS) on June 17

2012 It would appear to any reasonable person that the California Department of Social Services (CDSS) Civil

Rights Bureau (CRB) and Bureau Chief Tashima do not take civil rights complaints from citizens seriously or even

offer the most basic courtesy and respect of a reply to even acknowledge the filing of such a complaint

The actions of the California Department of Social Services (CDSS) Civil Rights Bureau (CRB) under Bureau Chief

Tashima have been irresponsible regarding this matter and have prejudiced any hope of an impartial and

transparent investigation of these allegations against Section Chief Banda Accordingly I am requesting that you

as Secretary of the California Health amp Human Services Agency (CHHS) refer this matter to the California

Department of Justice Civil Rights Enforcement Section for a proper investigation under the authority of the

Office of the Attorney General

I expect and look forward to a proper and timely response from your office

Sincerely

Joseph A Prezioso

CC Kamala D Harris Attorney General California Department of Justice

Edmund G Brown Jr Governor State of California

Kathleen Sebelius Secretary US Department of Health and Human Services

Leon Rodriguez Director Office of Civil Rights (OCR) US Department of Health and Human Services

Jackie S Garner Medicaid Consortium Administrator Consortium for Medicaid and Childrens Health Operations Centers for Medicare amp Medicaid (CMS)

Eric H Holder Jr Attorney General of the United States US Department of Justice

Robert S Mueller III Director Federal Bureau of Investigation (FBI)

Joesph A Prezioso

2

Joel A Moss Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

Barack Obama President United States of America

Roy S Gordet Attorney at Law

Information about user

User chooses to identify himselfherself

First name Joseph

Last name Prezioso

Company

Address (Line 1) 405 N FOUTH ST

Address (Line 2)

City SAN JOSE

State CA

Zip 95112

Phone (408)883-5446

Evening phone (408)883-5446

Email josephpreziosoattnet

Narrative

Joseph Prezioso California Benefits Identification Card Number (Medicaid) 95486255E41325 CA DHCS and LPCH have failed to provide the services required per HHS funding under the California Section 1115 Waiver submitted June 4 2010 Genetically Handicapped Persons Program (GHPP) GHPP provides case management and funding for medically necessary services to people with certain genetic conditions Special Care Centers (SCCs) and hospitals that apply to become CCS-approved must meet specific Criteria for family-centered care (FCC) FCC is assessed by the CMS Branch as part of the ongoing review process of CCS-approved SCCs and hospitals I was diagnosed with PKU on August 28 2009 at Stanford Medical Center (attached) Application was submitted to California DHCS GHPP office on May 10 2010 As of March 4 2012 I am still waiting for urgent medical diagnostic and treatment as required by law including CA Hereditary Disorders Act Ralph Civil Rights Act Unruh Civil Rights Act Business and Professions Code section 1256 and US American with Disabilities Act Title VI of the Civil Rights Act of 1964 42 USC sect 2000d Civil Rights Restoration Act of 1987 20 USC section 1681 et seq 42 USC section 1983 and peace officer misconduct 42 USC 14141 I have made several reports to both my County and State Civil Rights office and have received no response I have been retaliated against and threatened with violence for trying to report this activity I have many additional documents and multiple

witnesses that will corroborate these allegations Please helpI am very ill and desperate

Type of complaint

Grants Fraud

HHS department or program being affected

Medicaid

Information for subject 1

Subject name California Department of Health Care Services

Subject title Statewide Programs Section Chief David V Banda

Subject street address

1515 K Street Suite 400

Subject city or county

Sacramento

Subject state CA

Subject zip code 95184

Subject phone (916)327-1706

Information for subject 2

Subject name Lucile Packard Childrenrsquos Hospital

Subject title Gregory M Enns MD Director Biochemical Genetics

Subject street address

730 Welch Road 2nd Floor

Subject city or county

Palo Alto

Subject state

Subject zip code 94304

Subject phone (650)721-5804

DIANNE FEINSTEIN SELECT COMMITIEE ON CAUFORNIA INTELLIGENCE-CHAIRMAN

COMMITTEE ON APPROPRIATlQNS

COMMfTTEE ON THE JUDICIARY

CQMMfTTEE ON RULES AND tinitro ~tatrs ~tnetr ADMINISTRATION

WASHINGTON DC 20510-0504

httpfe i n ste i n senategov

July 132012

Mr Joseph Prezioso 405 N 4th St B18 San Jose California 95112

Dear Mr Prezioso

ank you for taking the time to write to me I am sorry to hear about your difficulties with the California Department of Social Services I appreciate your trust in me and the opportunity to help in this matter Unfortunately many issues within the State of California are beyond my jurisdiction as a United States Senator

I want to be sure that your concern reaches someone who can help you therefore I suggest you contact the office of Governor Jerry Brown His office is set up to help in matters within the jurisdiction of the Governor of the State of California and I have been assured that his staffwill work hard to heip you in your endeavors You can start by calling his Constituent Affairs office directly at (916) 445-2841 You may also submit an e-mail with an outline of the matter through the Governors website httpgovcagovm contacLphp or mail a signed letter to his office

Office of Governor Jerry Brown Attn Constituent Affairs State Capitol First Floor

Sacramento California 95814

Again thank you for your letter and the opportunity to serve you Please do write to me again if I can be of any assistance to you on a federal government issue

Sincerely

Dianne Feinstein United States Senator

DFdm

FRESNO OFFICE LOS ANGELES OFFICE SAN DIEGO OFFICE SAN FRANCISCO OFFICE 2500 TuUIRE STIIEFI 11111 SAN1A MONICA BOULEVARD 750 B SmEll ONE Posr STREET

SUITE 4290 SUITE 916 SUITE 1030 SUITe 2450 FRESNO CA 93721 LOS ANGELES CA 90025 SAN DIEGO CA 92101 SAN F NClSCO CA 94104

1559) 485-7430 (310) 914--7300 (619) 231 9712 (4151 39J~707

Joesph A Prezioso

2

Joel A Moss Special Agent in Charge San Francisco Division Federal Bureau of Investigation (FBI)

Thomas E Perez Assistant Attorney General Civil Rights Division US Department of Justice

Mark Kappelhoff Chief Civil Rights Division Criminal Section US Department of Justice

Congresswomen Zoe Lofgren US Representative Californias 16th Congressional District

Senator Barbara Boxer United States Senator State of California

Senator Dianne Feinstein United States Senator State of California

State Senator Elaine Alquist California State Senate

Assembly Member Nora Campos California State Assembly

Barack Obama President United States of America

Roy S Gordet Attorney at Law

Information about user

User chooses to identify himselfherself

First name Joseph

Last name Prezioso

Company

Address (Line 1) 405 N FOUTH ST

Address (Line 2)

City SAN JOSE

State CA

Zip 95112

Phone (408)883-5446

Evening phone (408)883-5446

Email josephpreziosoattnet

Narrative

Joseph Prezioso California Benefits Identification Card Number (Medicaid) 95486255E41325 CA DHCS and LPCH have failed to provide the services required per HHS funding under the California Section 1115 Waiver submitted June 4 2010 Genetically Handicapped Persons Program (GHPP) GHPP provides case management and funding for medically necessary services to people with certain genetic conditions Special Care Centers (SCCs) and hospitals that apply to become CCS-approved must meet specific Criteria for family-centered care (FCC) FCC is assessed by the CMS Branch as part of the ongoing review process of CCS-approved SCCs and hospitals I was diagnosed with PKU on August 28 2009 at Stanford Medical Center (attached) Application was submitted to California DHCS GHPP office on May 10 2010 As of March 4 2012 I am still waiting for urgent medical diagnostic and treatment as required by law including CA Hereditary Disorders Act Ralph Civil Rights Act Unruh Civil Rights Act Business and Professions Code section 1256 and US American with Disabilities Act Title VI of the Civil Rights Act of 1964 42 USC sect 2000d Civil Rights Restoration Act of 1987 20 USC section 1681 et seq 42 USC section 1983 and peace officer misconduct 42 USC 14141 I have made several reports to both my County and State Civil Rights office and have received no response I have been retaliated against and threatened with violence for trying to report this activity I have many additional documents and multiple

witnesses that will corroborate these allegations Please helpI am very ill and desperate

Type of complaint

Grants Fraud

HHS department or program being affected

Medicaid

Information for subject 1

Subject name California Department of Health Care Services

Subject title Statewide Programs Section Chief David V Banda

Subject street address

1515 K Street Suite 400

Subject city or county

Sacramento

Subject state CA

Subject zip code 95184

Subject phone (916)327-1706

Information for subject 2

Subject name Lucile Packard Childrenrsquos Hospital

Subject title Gregory M Enns MD Director Biochemical Genetics

Subject street address

730 Welch Road 2nd Floor

Subject city or county

Palo Alto

Subject state

Subject zip code 94304

Subject phone (650)721-5804

DIANNE FEINSTEIN SELECT COMMITIEE ON CAUFORNIA INTELLIGENCE-CHAIRMAN

COMMITTEE ON APPROPRIATlQNS

COMMfTTEE ON THE JUDICIARY

CQMMfTTEE ON RULES AND tinitro ~tatrs ~tnetr ADMINISTRATION

WASHINGTON DC 20510-0504

httpfe i n ste i n senategov

July 132012

Mr Joseph Prezioso 405 N 4th St B18 San Jose California 95112

Dear Mr Prezioso

ank you for taking the time to write to me I am sorry to hear about your difficulties with the California Department of Social Services I appreciate your trust in me and the opportunity to help in this matter Unfortunately many issues within the State of California are beyond my jurisdiction as a United States Senator

I want to be sure that your concern reaches someone who can help you therefore I suggest you contact the office of Governor Jerry Brown His office is set up to help in matters within the jurisdiction of the Governor of the State of California and I have been assured that his staffwill work hard to heip you in your endeavors You can start by calling his Constituent Affairs office directly at (916) 445-2841 You may also submit an e-mail with an outline of the matter through the Governors website httpgovcagovm contacLphp or mail a signed letter to his office

Office of Governor Jerry Brown Attn Constituent Affairs State Capitol First Floor

Sacramento California 95814

Again thank you for your letter and the opportunity to serve you Please do write to me again if I can be of any assistance to you on a federal government issue

Sincerely

Dianne Feinstein United States Senator

DFdm

FRESNO OFFICE LOS ANGELES OFFICE SAN DIEGO OFFICE SAN FRANCISCO OFFICE 2500 TuUIRE STIIEFI 11111 SAN1A MONICA BOULEVARD 750 B SmEll ONE Posr STREET

SUITE 4290 SUITE 916 SUITE 1030 SUITe 2450 FRESNO CA 93721 LOS ANGELES CA 90025 SAN DIEGO CA 92101 SAN F NClSCO CA 94104

1559) 485-7430 (310) 914--7300 (619) 231 9712 (4151 39J~707

Information about user

User chooses to identify himselfherself

First name Joseph

Last name Prezioso

Company

Address (Line 1) 405 N FOUTH ST

Address (Line 2)

City SAN JOSE

State CA

Zip 95112

Phone (408)883-5446

Evening phone (408)883-5446

Email josephpreziosoattnet

Narrative

Joseph Prezioso California Benefits Identification Card Number (Medicaid) 95486255E41325 CA DHCS and LPCH have failed to provide the services required per HHS funding under the California Section 1115 Waiver submitted June 4 2010 Genetically Handicapped Persons Program (GHPP) GHPP provides case management and funding for medically necessary services to people with certain genetic conditions Special Care Centers (SCCs) and hospitals that apply to become CCS-approved must meet specific Criteria for family-centered care (FCC) FCC is assessed by the CMS Branch as part of the ongoing review process of CCS-approved SCCs and hospitals I was diagnosed with PKU on August 28 2009 at Stanford Medical Center (attached) Application was submitted to California DHCS GHPP office on May 10 2010 As of March 4 2012 I am still waiting for urgent medical diagnostic and treatment as required by law including CA Hereditary Disorders Act Ralph Civil Rights Act Unruh Civil Rights Act Business and Professions Code section 1256 and US American with Disabilities Act Title VI of the Civil Rights Act of 1964 42 USC sect 2000d Civil Rights Restoration Act of 1987 20 USC section 1681 et seq 42 USC section 1983 and peace officer misconduct 42 USC 14141 I have made several reports to both my County and State Civil Rights office and have received no response I have been retaliated against and threatened with violence for trying to report this activity I have many additional documents and multiple

witnesses that will corroborate these allegations Please helpI am very ill and desperate

Type of complaint

Grants Fraud

HHS department or program being affected

Medicaid

Information for subject 1

Subject name California Department of Health Care Services

Subject title Statewide Programs Section Chief David V Banda

Subject street address

1515 K Street Suite 400

Subject city or county

Sacramento

Subject state CA

Subject zip code 95184

Subject phone (916)327-1706

Information for subject 2

Subject name Lucile Packard Childrenrsquos Hospital

Subject title Gregory M Enns MD Director Biochemical Genetics

Subject street address

730 Welch Road 2nd Floor

Subject city or county

Palo Alto

Subject state

Subject zip code 94304

Subject phone (650)721-5804

DIANNE FEINSTEIN SELECT COMMITIEE ON CAUFORNIA INTELLIGENCE-CHAIRMAN

COMMITTEE ON APPROPRIATlQNS

COMMfTTEE ON THE JUDICIARY

CQMMfTTEE ON RULES AND tinitro ~tatrs ~tnetr ADMINISTRATION

WASHINGTON DC 20510-0504

httpfe i n ste i n senategov

July 132012

Mr Joseph Prezioso 405 N 4th St B18 San Jose California 95112

Dear Mr Prezioso

ank you for taking the time to write to me I am sorry to hear about your difficulties with the California Department of Social Services I appreciate your trust in me and the opportunity to help in this matter Unfortunately many issues within the State of California are beyond my jurisdiction as a United States Senator

I want to be sure that your concern reaches someone who can help you therefore I suggest you contact the office of Governor Jerry Brown His office is set up to help in matters within the jurisdiction of the Governor of the State of California and I have been assured that his staffwill work hard to heip you in your endeavors You can start by calling his Constituent Affairs office directly at (916) 445-2841 You may also submit an e-mail with an outline of the matter through the Governors website httpgovcagovm contacLphp or mail a signed letter to his office

Office of Governor Jerry Brown Attn Constituent Affairs State Capitol First Floor

Sacramento California 95814

Again thank you for your letter and the opportunity to serve you Please do write to me again if I can be of any assistance to you on a federal government issue

Sincerely

Dianne Feinstein United States Senator

DFdm

FRESNO OFFICE LOS ANGELES OFFICE SAN DIEGO OFFICE SAN FRANCISCO OFFICE 2500 TuUIRE STIIEFI 11111 SAN1A MONICA BOULEVARD 750 B SmEll ONE Posr STREET

SUITE 4290 SUITE 916 SUITE 1030 SUITe 2450 FRESNO CA 93721 LOS ANGELES CA 90025 SAN DIEGO CA 92101 SAN F NClSCO CA 94104

1559) 485-7430 (310) 914--7300 (619) 231 9712 (4151 39J~707

witnesses that will corroborate these allegations Please helpI am very ill and desperate

Type of complaint

Grants Fraud

HHS department or program being affected

Medicaid

Information for subject 1

Subject name California Department of Health Care Services

Subject title Statewide Programs Section Chief David V Banda

Subject street address

1515 K Street Suite 400

Subject city or county

Sacramento

Subject state CA

Subject zip code 95184

Subject phone (916)327-1706

Information for subject 2

Subject name Lucile Packard Childrenrsquos Hospital

Subject title Gregory M Enns MD Director Biochemical Genetics

Subject street address

730 Welch Road 2nd Floor

Subject city or county

Palo Alto

Subject state

Subject zip code 94304

Subject phone (650)721-5804

DIANNE FEINSTEIN SELECT COMMITIEE ON CAUFORNIA INTELLIGENCE-CHAIRMAN

COMMITTEE ON APPROPRIATlQNS

COMMfTTEE ON THE JUDICIARY

CQMMfTTEE ON RULES AND tinitro ~tatrs ~tnetr ADMINISTRATION

WASHINGTON DC 20510-0504

httpfe i n ste i n senategov

July 132012

Mr Joseph Prezioso 405 N 4th St B18 San Jose California 95112

Dear Mr Prezioso

ank you for taking the time to write to me I am sorry to hear about your difficulties with the California Department of Social Services I appreciate your trust in me and the opportunity to help in this matter Unfortunately many issues within the State of California are beyond my jurisdiction as a United States Senator

I want to be sure that your concern reaches someone who can help you therefore I suggest you contact the office of Governor Jerry Brown His office is set up to help in matters within the jurisdiction of the Governor of the State of California and I have been assured that his staffwill work hard to heip you in your endeavors You can start by calling his Constituent Affairs office directly at (916) 445-2841 You may also submit an e-mail with an outline of the matter through the Governors website httpgovcagovm contacLphp or mail a signed letter to his office

Office of Governor Jerry Brown Attn Constituent Affairs State Capitol First Floor

Sacramento California 95814

Again thank you for your letter and the opportunity to serve you Please do write to me again if I can be of any assistance to you on a federal government issue

Sincerely

Dianne Feinstein United States Senator

DFdm

FRESNO OFFICE LOS ANGELES OFFICE SAN DIEGO OFFICE SAN FRANCISCO OFFICE 2500 TuUIRE STIIEFI 11111 SAN1A MONICA BOULEVARD 750 B SmEll ONE Posr STREET

SUITE 4290 SUITE 916 SUITE 1030 SUITe 2450 FRESNO CA 93721 LOS ANGELES CA 90025 SAN DIEGO CA 92101 SAN F NClSCO CA 94104

1559) 485-7430 (310) 914--7300 (619) 231 9712 (4151 39J~707

DIANNE FEINSTEIN SELECT COMMITIEE ON CAUFORNIA INTELLIGENCE-CHAIRMAN

COMMITTEE ON APPROPRIATlQNS

COMMfTTEE ON THE JUDICIARY

CQMMfTTEE ON RULES AND tinitro ~tatrs ~tnetr ADMINISTRATION

WASHINGTON DC 20510-0504

httpfe i n ste i n senategov

July 132012

Mr Joseph Prezioso 405 N 4th St B18 San Jose California 95112

Dear Mr Prezioso

ank you for taking the time to write to me I am sorry to hear about your difficulties with the California Department of Social Services I appreciate your trust in me and the opportunity to help in this matter Unfortunately many issues within the State of California are beyond my jurisdiction as a United States Senator

I want to be sure that your concern reaches someone who can help you therefore I suggest you contact the office of Governor Jerry Brown His office is set up to help in matters within the jurisdiction of the Governor of the State of California and I have been assured that his staffwill work hard to heip you in your endeavors You can start by calling his Constituent Affairs office directly at (916) 445-2841 You may also submit an e-mail with an outline of the matter through the Governors website httpgovcagovm contacLphp or mail a signed letter to his office

Office of Governor Jerry Brown Attn Constituent Affairs State Capitol First Floor

Sacramento California 95814

Again thank you for your letter and the opportunity to serve you Please do write to me again if I can be of any assistance to you on a federal government issue

Sincerely

Dianne Feinstein United States Senator

DFdm

FRESNO OFFICE LOS ANGELES OFFICE SAN DIEGO OFFICE SAN FRANCISCO OFFICE 2500 TuUIRE STIIEFI 11111 SAN1A MONICA BOULEVARD 750 B SmEll ONE Posr STREET

SUITE 4290 SUITE 916 SUITE 1030 SUITe 2450 FRESNO CA 93721 LOS ANGELES CA 90025 SAN DIEGO CA 92101 SAN F NClSCO CA 94104

1559) 485-7430 (310) 914--7300 (619) 231 9712 (4151 39J~707

1

Joseph A Prezioso

From Novo Don (CMSCMCHO) [DonNovocmshhsgov]Sent Thursday June 21 2012 1103 AMTo josephpreziosolivecomCc CMS ROSFOORA Chief Counsel Press CMS ROSFOMCD Deputy Director Clarkson

Attorney General Harris Sebelius Kathleen (HHSOS) Special Agent in Charge Douglas Subject RE Response to your letter to Secretary Sebelius

Good Morning Mr Prezioso

I want to acknowledge your email and questions In an attempt to properly answer your questions I am going to need toconsult with other CMS colleagues Please afford me the opportunity of a few days to review the information that yousubmitted and respond accordingly to your questions

Thank youDon Novo

Don Novo|Medicaid Program Branch Manager for the Division of Medicaid amp Childrens Health Operations |Region IX|Centers for Medicare amp Medicaid Services|90 Seventh Street Suite 5-300 | San Francisco CA 94103| (415) 744-3674 | (303) 869-9083 | donnovocmshhsgov

From Joseph A Prezioso [mailtojosephpreziosolivecom]Sent Thursday June 21 2012 505 AMTo Novo Don (CMSCMCHO)Cc CMS ROSFOORA Chief Counsel Press CMS ROSFOMCD Deputy Director Clarkson Attorney General Harris SebeliusKathleen (HHSOS) Special Agent in Charge DouglasSubject RE Response to your letter to Secretary SebeliusImportance High

Program Manager Novo

Thank you kindly for your time today and I do appreciate the letter from Regional Administrator Nagle responding to myletter to Secretary Sebelius Please donrsquot misinterpret my questions as I only wish to try and understand the response ndashand if I am wrong that is fine as one cannot learn anything when you are right

I also ask your patience given

- I do have some serious medical issues- for whatever reason my various applications for public assistance (I prefer the more accurate legal definition of makinga claim for a ldquoproperty rightrdquo under the law) have not gone smoothly- I do have Aspergerrsquos Syndrome which a symptom of is ldquoblack or white thinkingrdquo

In my defense I will also add that when it comes to the MEDICAID TITLE XIX OF THE SOCIAL SECURITY ACT

euroThe Social Security Act and its regulations promulgated by the Department of Health and Human Services(HHS) that implements it present as complex a legislative mosaic ascould possibly be conceived by man City of New York v Richardson 473 F2d 923926 (2d Cir 1973)accord Beverly Community Hospital Assn v Belshe 132 F3d 12591266

2

(9th Cir 1997) (finding that clarity is recognized as totally absent from the Medicare and Medicaidstatutes) cert denied 119 S Ct 334 (1998) Rehabilitation Assn of VaInc v Kozlowski 42 F3d 1444 1450 (4th Cir 1994) (characterizing Medicaid as among the mostcompletely impenetrable texts within human experience and densereading of the most tortuous kind)bull

So any difficulty in fully understanding MEDICAID TITLE XIX OF THE SOCIAL SECURITY ACT I do not take personallysbquo I am in good company

1) I agree with Regional Administrator Nagle that Californiarsquos GHPP program is not authorized under TITLE XIX OFTHE SOCIAL SECURITY ACT

2) I agree with Regional Administrator Nagle that constitutional rights and ADA compliance (Supremacy Clause)cannot be ldquowaivedrdquo in a section 1115 demonstration waiver (I was actually shocked when I wrote to the HHSOIG PIAR and the rhetorical nature of my question seemed to be missed and was referred to DHCS for ananswer)

3) I am uncertain about Regional Administrator Naglersquos statement that ldquoGHPP is not a Title XIX programrdquo

Regional Administrator Nagle states explicitly in her letter that ldquothe GHPP program is not a Title XIX programrdquo

But that is contradicted by

1) DHCS 5-3-2007 (A) which states ldquo Effective September 1 2005 with Centers for Medicare amp Medicaid Servicesapproval hellipCCS and GHPP became Title XIX Medicaid waiver programsrdquo

2) 11678 Federal Register Vol 77 No 38 Monday February 27 2012 Rules and Regulations DEPARTMENT OFHEALTH AND HUMAN SERVICES Centers for Medicare amp Medicaid Services 42 CFR Part 431 [CMSsbquo 2325sbquo F] RIN0938sbquo AQ46 Medicaid Program Review and Approval Process for Section 1115 Demonstrations

ldquoThis final rule will implement provisions of section 10201(i) of the Patient Protection and Affordable Care Act of 2010that set forth transparency and public notice procedures for experimental pilot and demonstration projects approvedunder section 1115 of the Social Security Act relating to Medicaidrdquo

3) The CMS Waiver Authority (C) statesAll requirements of the Medicaid program expressed in law regulation and policy statement not expressly waivedin this list shall apply to the Demonstration from the approval date through October 31 2015 unless otherwisespecified

4) The CMS Expenditure Authority statesUnder the authority of section 1115(a)(2) of the Social Security Act (the Act) expenditures made by California for theitems identified below (which explicitly lists the CCS amp GHPP Programs) which are not otherwise included asexpenditures under section 1903 of the Act shall for the period of this Demonstration be regarded as a expendituresunder the Statersquos Title XIX Plan

I believe that what Regional Administrator Nagle states explicitly in her letter ldquothe GHPP program is not a Title XIXprogramrdquo is based on her first point that the GHPP is not authorized under TITLE XIX OF THE SOCIAL SECURITY ACThellipbutthat statement is true for every Medicaid program in every state in the country as all states authorize and establishtheir own state plans ndash by definition there are no programs that are authorized and established under TITLE XIX OF THESOCIAL SECURITY ACT

I believe the more relevant point is the eligibility for Federal Funds versus ldquoState-onlyrdquo funded programs

The question is did something fundamentally change ldquo Effective September 1 2005 with Centers for Medicare ampMedicaid Services approvalrdquo ndash I believe the answer is yes Prior to that date it was a ldquoState-onlyrdquo funded program ndash soCalifornia Law set the standard for appeals and hearing rights within the broader guidelines of Federal Law and USConstitutional Rights

3

I believe prior to September 1 2005 a citizen had to appeal via the California ruleshellipbut once Federal Funding startedthen Title XIX requirements that cannot be waived take precedent A citizen can choose to appeal ndash but the FederalCourts have been quite clear one does not have to ldquoexhaust all their remediesrdquo despite what state regulations andstatues may say ndash one can go direct to a State Medi-Cal Fair Hearing And what is disturbing is I believe that not a singleNotice of Action has been updated since September 1 2005 telling anyone they have a right to a Medi-Cal Fair Hearing

And that is what I found so troubling in the DHCS (B) report to the California Legislature indicating a perfect record of noMedi-Cal Fair Hearings No one knows they have Medi-Cal rights under Title XIX

Title XIX of the Social Security Act is administered by the Centers for Medicare and Medicaid Services Title XIX appearsin the United States Code as sectsect1396ndash1396v subchapter XIX chapter 7 Title 42 Regulations relating to Title XIX arecontained in chapter IV Title 42 and subtitle A Title 45 Code of Federal Regulationsrdquo The question is do these lawsapply to the CCSGHPP programns ndash I believe the answer is yes

As the statue mandates per the DHCS Policy Letter G-01-1200 GHPP shall authorize SCC services for all GHPP clientswho are required by program policy to receive care through the GHPP approved outpatient special care centers ampThese services shall be authorized as GHPP benefits for all eligible GHPP clients and finally ldquoGHPP clients shall bereferred to the appropriate GHPP-approved SCC for diagnosis evaluation medical management and coordination ofcare when the client has or is suspected of having a GHPP medically eligible condition requiring SCC evaluation andfollow-uprdquo

The policy letters and regulations are an extension of the statute per the law Also reference CDHS CMS InformationNotice No 03-03 which says rdquoThis information is being provided as a resource that can be used in conjunction with thelaws for these programs As you know the general purpose of having regulations is to implement interpret or makespecific the law enforced or administered by itrdquo

California Supreme Court Rulings have validated that shall means shall The California Supreme Court found a clear dutywas imposed by law upon the county defendants because a statute unequivocally required a particular actionldquo[Government Code] section 66801 article VII subdivision (a) provides that lsquo[e]ach county in California shall pay the sumallotted to it by the agency from any funds available therefor rsquo [Italics added by Younger]rdquo (People ex rel Younger vCounty of El Dorado supra 5 Cal3d at p 491) Peterson v Superior Court (1995) 10 Cal4th 1185 specifically ratifies theapplication of the doctrine of negligence per se against for failure to comply with applicable statutes and ordinances Id at 1204 note 10

Medicaid agencies must make all rules and policies available to the public and provide copies to legal services offices(42 CFR sect 43118) No one outside of the DCHS has ever been informed that the GHPP and CCS programs wereldquoFederalizedrdquo under Title XIX of the Social Security Act effective September 1 2005 No one at the Legal Aid servicesoffices had even heard of the program

State Medicaid Programs must provide an opportunity for a fair hearing (42 USC sect 1396a(a)(3)) Medicaid applicantsand beneficiaries are entitled to a hearing whenever a service or a request for a service is reduced denied terminatedor not acted upon with reasonable promptness (42 CFR sect 431200 et seq) Goldberg v Kelley 397 US 254 (1970)Public assistance beneficiaries have a constitutional due process right to a hearing prior to the termination of benefitsThis due process right includes adequate and timely notice the opportunity to be heard by an impartial decisionmaker and a decision based upon evidence adduced at the hearing Medicaid regulations governing fair hearings 42CFR sect 431200 et seq provide detailed requirements regarding content and timing of notice hearing procedures andthe content and timing of hearing decisions The due process requirements of the Medicaid Act are enforceable under42 USC sect 1983 All categorically eligible beneficiaries must receive medical assistance that is no less than that providedto other eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must besufficient in amount duration and scope to reasonably achieve its purpose 42 CFR sect 440230(b) The amountduration and scope provisions of the Medicaid Act and implementing regulations provide strong support to challengeexclusions of treatment that fall within the scope of services covered There is a long line of judicial decisions limiting

4

states discretion to exclude medically necessary treatment that falls within the scope of a covered service StateMedicaid programs may not limit services based upon diagnosis type of illness or medical condition 42 CFRsect440230(c) The operation of state Medicaid programs must be based upon reasonable standards 42 USC sect1396a(a)(17) State Medicaid programs must include safeguards to ensure that services will be provided in a mannerconsistent with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19) A Notice ofAction is if the state plan takes an action other than an approval including a denial or a deferral on a providerrsquos requestfor any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate the notice must be inwriting and contain a statement of the intended action as well as the reasons and specific legal support for the action(42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In addition the notice must containan explanation of the individualrsquos hearing rights rights to representation and to continued benefits (42 CFR sectsect431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c))

So I agree with Regional Administrator Nagle that ldquothe GHPP program is not a Title XIX programrdquo It is a California StateMedicaid Program authorized and established by the State of California But CMS approved the Federal Funding ndash sowhere is the ldquoState Medicaid Programs mustrdquo part of the equation

Why has my application languished since May 4 2010 Why can I not have a GHPP State Fair Hearing Has there everbeen a GHPP State Fair Hearing Why am I under attack literally and figuratively for just asking such a question Whywas I dis-enrolled from my LIHP MCE for filing a grievance

I do want to hear Chief Counsel Pressrsquos opinion regarding this question ndash and I do want to go meet with him in myState Capital ndash it is an incredible honor - and I take him at his word that he will get this properly resolvedhellipif I am notqualified then please just give me a proper NOA ndash if I am not entitled to a Medi-Cal State Fair Hearing then please justexplain why And I do care very much about my State ndash and I am concerned that California my state may be subjectto a class action lawsuit ndash and we have enough problems on our plate as it is

But sir with respect this is not just an academic exercise for mehellipI am out on the street terribly ill getting no medicalcare of any kind and scared to even go to an ER as I have been threatened and assaulted at my Federally QualifiedHealth Centers hellipWhere is MY ATTORNEY GENERAL KAMALA HARRIS Why does she ignore me Can the CaliforniaDepartment of Justice not assist me in any way

I was told I had to leave the Emmanuel House because there were threats being made against me My Case Managerwas fired Why for writing letters Can the tired poor and disposed not even be afforded first amendment rights

Please I need some urgent assistancehellipand if I must die out on the street then please at least explain this in a waythat I can understandhellipbecause at this moment I feel somewhat disappointed inSecretary Sebeliusrsquos responsehellipif what I say is true why am I being punished I did not go looking for this ndash if myapplication would have been properly processed if even one time a phone call was returned I would not have out ofdesperation resorted to endless hours in the law library trying to understand thishellip

And at this moment I still believe that 140000 of my fellow citizens ndash children with serious medical conditions ndash arehaving their rights violated as wellhellipand Irsquom counting on you to do something about it because I am utterlypowerlesshellip

I look forward to speaking with you later

Best regards and with appreciationJoseph

From Novo Don (CMSCMCHO) [mailtoDonNovocmshhsgov]Sent Wednesday June 20 2012 424 PM

5

To josephpreziosolivecomSubject Response to your letter to Secretary Sebelius

Good Afternoon Mr Prezioso

Attached is a copy of the letter responding to your questions presented to Secretary Sebelius I will touch base with youby telephone tomorrow at 1230 as we discussed Please let me know if you have any questions or require clarification

Thank youDon Novo

Don Novo|Medicaid Program Branch Manager for the Division of Medicaid amp Childrens Health Operations |Region IX|Centers for Medicare amp Medicaid Services|90 Seventh Street Suite 5-300 | San Francisco CA 94103| (415) 744-3674 | (303) 869-9083 | donnovocmshhsgov

Accept

Joseph Prezioso ltjosephpt522gmailcomgt

Joseph please add me to your LinkedIn network1 message

Travis England via LinkedIn ltmemberlinkedincomgt Tue May 20 2014 at 759 AMReply-To Travis England lttravisenglandgmailcomgtTo Joseph Prezioso ltjosephpt522gmailcomgt

Hi Joseph

Id like to connect with you on LinkedIn

Travis England

Trial Attorney at US Department of Justice

View Profile

You are receiving Invitation emails Unsubscribe

This email w as intended for Joseph Prezioso (Retail Professional) Learn w hy w e included this copy 2014 LinkedIn

Corporation 2029 Stierlin Ct Mountain View CA 94043 USA

2

(9th Cir 1997) (finding that clarity is recognized as totally absent from the Medicare and Medicaidstatutes) cert denied 119 S Ct 334 (1998) Rehabilitation Assn of VaInc v Kozlowski 42 F3d 1444 1450 (4th Cir 1994) (characterizing Medicaid as among the mostcompletely impenetrable texts within human experience and densereading of the most tortuous kind)bull

So any difficulty in fully understanding MEDICAID TITLE XIX OF THE SOCIAL SECURITY ACT I do not take personallysbquo I am in good company

1) I agree with Regional Administrator Nagle that Californiarsquos GHPP program is not authorized under TITLE XIX OFTHE SOCIAL SECURITY ACT

2) I agree with Regional Administrator Nagle that constitutional rights and ADA compliance (Supremacy Clause)cannot be ldquowaivedrdquo in a section 1115 demonstration waiver (I was actually shocked when I wrote to the HHSOIG PIAR and the rhetorical nature of my question seemed to be missed and was referred to DHCS for ananswer)

3) I am uncertain about Regional Administrator Naglersquos statement that ldquoGHPP is not a Title XIX programrdquo

Regional Administrator Nagle states explicitly in her letter that ldquothe GHPP program is not a Title XIX programrdquo

But that is contradicted by

1) DHCS 5-3-2007 (A) which states ldquo Effective September 1 2005 with Centers for Medicare amp Medicaid Servicesapproval hellipCCS and GHPP became Title XIX Medicaid waiver programsrdquo

2) 11678 Federal Register Vol 77 No 38 Monday February 27 2012 Rules and Regulations DEPARTMENT OFHEALTH AND HUMAN SERVICES Centers for Medicare amp Medicaid Services 42 CFR Part 431 [CMSsbquo 2325sbquo F] RIN0938sbquo AQ46 Medicaid Program Review and Approval Process for Section 1115 Demonstrations

ldquoThis final rule will implement provisions of section 10201(i) of the Patient Protection and Affordable Care Act of 2010that set forth transparency and public notice procedures for experimental pilot and demonstration projects approvedunder section 1115 of the Social Security Act relating to Medicaidrdquo

3) The CMS Waiver Authority (C) statesAll requirements of the Medicaid program expressed in law regulation and policy statement not expressly waivedin this list shall apply to the Demonstration from the approval date through October 31 2015 unless otherwisespecified

4) The CMS Expenditure Authority statesUnder the authority of section 1115(a)(2) of the Social Security Act (the Act) expenditures made by California for theitems identified below (which explicitly lists the CCS amp GHPP Programs) which are not otherwise included asexpenditures under section 1903 of the Act shall for the period of this Demonstration be regarded as a expendituresunder the Statersquos Title XIX Plan

I believe that what Regional Administrator Nagle states explicitly in her letter ldquothe GHPP program is not a Title XIXprogramrdquo is based on her first point that the GHPP is not authorized under TITLE XIX OF THE SOCIAL SECURITY ACThellipbutthat statement is true for every Medicaid program in every state in the country as all states authorize and establishtheir own state plans ndash by definition there are no programs that are authorized and established under TITLE XIX OF THESOCIAL SECURITY ACT

I believe the more relevant point is the eligibility for Federal Funds versus ldquoState-onlyrdquo funded programs

The question is did something fundamentally change ldquo Effective September 1 2005 with Centers for Medicare ampMedicaid Services approvalrdquo ndash I believe the answer is yes Prior to that date it was a ldquoState-onlyrdquo funded program ndash soCalifornia Law set the standard for appeals and hearing rights within the broader guidelines of Federal Law and USConstitutional Rights

3

I believe prior to September 1 2005 a citizen had to appeal via the California ruleshellipbut once Federal Funding startedthen Title XIX requirements that cannot be waived take precedent A citizen can choose to appeal ndash but the FederalCourts have been quite clear one does not have to ldquoexhaust all their remediesrdquo despite what state regulations andstatues may say ndash one can go direct to a State Medi-Cal Fair Hearing And what is disturbing is I believe that not a singleNotice of Action has been updated since September 1 2005 telling anyone they have a right to a Medi-Cal Fair Hearing

And that is what I found so troubling in the DHCS (B) report to the California Legislature indicating a perfect record of noMedi-Cal Fair Hearings No one knows they have Medi-Cal rights under Title XIX

Title XIX of the Social Security Act is administered by the Centers for Medicare and Medicaid Services Title XIX appearsin the United States Code as sectsect1396ndash1396v subchapter XIX chapter 7 Title 42 Regulations relating to Title XIX arecontained in chapter IV Title 42 and subtitle A Title 45 Code of Federal Regulationsrdquo The question is do these lawsapply to the CCSGHPP programns ndash I believe the answer is yes

As the statue mandates per the DHCS Policy Letter G-01-1200 GHPP shall authorize SCC services for all GHPP clientswho are required by program policy to receive care through the GHPP approved outpatient special care centers ampThese services shall be authorized as GHPP benefits for all eligible GHPP clients and finally ldquoGHPP clients shall bereferred to the appropriate GHPP-approved SCC for diagnosis evaluation medical management and coordination ofcare when the client has or is suspected of having a GHPP medically eligible condition requiring SCC evaluation andfollow-uprdquo

The policy letters and regulations are an extension of the statute per the law Also reference CDHS CMS InformationNotice No 03-03 which says rdquoThis information is being provided as a resource that can be used in conjunction with thelaws for these programs As you know the general purpose of having regulations is to implement interpret or makespecific the law enforced or administered by itrdquo

California Supreme Court Rulings have validated that shall means shall The California Supreme Court found a clear dutywas imposed by law upon the county defendants because a statute unequivocally required a particular actionldquo[Government Code] section 66801 article VII subdivision (a) provides that lsquo[e]ach county in California shall pay the sumallotted to it by the agency from any funds available therefor rsquo [Italics added by Younger]rdquo (People ex rel Younger vCounty of El Dorado supra 5 Cal3d at p 491) Peterson v Superior Court (1995) 10 Cal4th 1185 specifically ratifies theapplication of the doctrine of negligence per se against for failure to comply with applicable statutes and ordinances Id at 1204 note 10

Medicaid agencies must make all rules and policies available to the public and provide copies to legal services offices(42 CFR sect 43118) No one outside of the DCHS has ever been informed that the GHPP and CCS programs wereldquoFederalizedrdquo under Title XIX of the Social Security Act effective September 1 2005 No one at the Legal Aid servicesoffices had even heard of the program

State Medicaid Programs must provide an opportunity for a fair hearing (42 USC sect 1396a(a)(3)) Medicaid applicantsand beneficiaries are entitled to a hearing whenever a service or a request for a service is reduced denied terminatedor not acted upon with reasonable promptness (42 CFR sect 431200 et seq) Goldberg v Kelley 397 US 254 (1970)Public assistance beneficiaries have a constitutional due process right to a hearing prior to the termination of benefitsThis due process right includes adequate and timely notice the opportunity to be heard by an impartial decisionmaker and a decision based upon evidence adduced at the hearing Medicaid regulations governing fair hearings 42CFR sect 431200 et seq provide detailed requirements regarding content and timing of notice hearing procedures andthe content and timing of hearing decisions The due process requirements of the Medicaid Act are enforceable under42 USC sect 1983 All categorically eligible beneficiaries must receive medical assistance that is no less than that providedto other eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must besufficient in amount duration and scope to reasonably achieve its purpose 42 CFR sect 440230(b) The amountduration and scope provisions of the Medicaid Act and implementing regulations provide strong support to challengeexclusions of treatment that fall within the scope of services covered There is a long line of judicial decisions limiting

4

states discretion to exclude medically necessary treatment that falls within the scope of a covered service StateMedicaid programs may not limit services based upon diagnosis type of illness or medical condition 42 CFRsect440230(c) The operation of state Medicaid programs must be based upon reasonable standards 42 USC sect1396a(a)(17) State Medicaid programs must include safeguards to ensure that services will be provided in a mannerconsistent with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19) A Notice ofAction is if the state plan takes an action other than an approval including a denial or a deferral on a providerrsquos requestfor any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate the notice must be inwriting and contain a statement of the intended action as well as the reasons and specific legal support for the action(42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In addition the notice must containan explanation of the individualrsquos hearing rights rights to representation and to continued benefits (42 CFR sectsect431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c))

So I agree with Regional Administrator Nagle that ldquothe GHPP program is not a Title XIX programrdquo It is a California StateMedicaid Program authorized and established by the State of California But CMS approved the Federal Funding ndash sowhere is the ldquoState Medicaid Programs mustrdquo part of the equation

Why has my application languished since May 4 2010 Why can I not have a GHPP State Fair Hearing Has there everbeen a GHPP State Fair Hearing Why am I under attack literally and figuratively for just asking such a question Whywas I dis-enrolled from my LIHP MCE for filing a grievance

I do want to hear Chief Counsel Pressrsquos opinion regarding this question ndash and I do want to go meet with him in myState Capital ndash it is an incredible honor - and I take him at his word that he will get this properly resolvedhellipif I am notqualified then please just give me a proper NOA ndash if I am not entitled to a Medi-Cal State Fair Hearing then please justexplain why And I do care very much about my State ndash and I am concerned that California my state may be subjectto a class action lawsuit ndash and we have enough problems on our plate as it is

But sir with respect this is not just an academic exercise for mehellipI am out on the street terribly ill getting no medicalcare of any kind and scared to even go to an ER as I have been threatened and assaulted at my Federally QualifiedHealth Centers hellipWhere is MY ATTORNEY GENERAL KAMALA HARRIS Why does she ignore me Can the CaliforniaDepartment of Justice not assist me in any way

I was told I had to leave the Emmanuel House because there were threats being made against me My Case Managerwas fired Why for writing letters Can the tired poor and disposed not even be afforded first amendment rights

Please I need some urgent assistancehellipand if I must die out on the street then please at least explain this in a waythat I can understandhellipbecause at this moment I feel somewhat disappointed inSecretary Sebeliusrsquos responsehellipif what I say is true why am I being punished I did not go looking for this ndash if myapplication would have been properly processed if even one time a phone call was returned I would not have out ofdesperation resorted to endless hours in the law library trying to understand thishellip

And at this moment I still believe that 140000 of my fellow citizens ndash children with serious medical conditions ndash arehaving their rights violated as wellhellipand Irsquom counting on you to do something about it because I am utterlypowerlesshellip

I look forward to speaking with you later

Best regards and with appreciationJoseph

From Novo Don (CMSCMCHO) [mailtoDonNovocmshhsgov]Sent Wednesday June 20 2012 424 PM

5

To josephpreziosolivecomSubject Response to your letter to Secretary Sebelius

Good Afternoon Mr Prezioso

Attached is a copy of the letter responding to your questions presented to Secretary Sebelius I will touch base with youby telephone tomorrow at 1230 as we discussed Please let me know if you have any questions or require clarification

Thank youDon Novo

Don Novo|Medicaid Program Branch Manager for the Division of Medicaid amp Childrens Health Operations |Region IX|Centers for Medicare amp Medicaid Services|90 Seventh Street Suite 5-300 | San Francisco CA 94103| (415) 744-3674 | (303) 869-9083 | donnovocmshhsgov

Accept

Joseph Prezioso ltjosephpt522gmailcomgt

Joseph please add me to your LinkedIn network1 message

Travis England via LinkedIn ltmemberlinkedincomgt Tue May 20 2014 at 759 AMReply-To Travis England lttravisenglandgmailcomgtTo Joseph Prezioso ltjosephpt522gmailcomgt

Hi Joseph

Id like to connect with you on LinkedIn

Travis England

Trial Attorney at US Department of Justice

View Profile

You are receiving Invitation emails Unsubscribe

This email w as intended for Joseph Prezioso (Retail Professional) Learn w hy w e included this copy 2014 LinkedIn

Corporation 2029 Stierlin Ct Mountain View CA 94043 USA

3

I believe prior to September 1 2005 a citizen had to appeal via the California ruleshellipbut once Federal Funding startedthen Title XIX requirements that cannot be waived take precedent A citizen can choose to appeal ndash but the FederalCourts have been quite clear one does not have to ldquoexhaust all their remediesrdquo despite what state regulations andstatues may say ndash one can go direct to a State Medi-Cal Fair Hearing And what is disturbing is I believe that not a singleNotice of Action has been updated since September 1 2005 telling anyone they have a right to a Medi-Cal Fair Hearing

And that is what I found so troubling in the DHCS (B) report to the California Legislature indicating a perfect record of noMedi-Cal Fair Hearings No one knows they have Medi-Cal rights under Title XIX

Title XIX of the Social Security Act is administered by the Centers for Medicare and Medicaid Services Title XIX appearsin the United States Code as sectsect1396ndash1396v subchapter XIX chapter 7 Title 42 Regulations relating to Title XIX arecontained in chapter IV Title 42 and subtitle A Title 45 Code of Federal Regulationsrdquo The question is do these lawsapply to the CCSGHPP programns ndash I believe the answer is yes

As the statue mandates per the DHCS Policy Letter G-01-1200 GHPP shall authorize SCC services for all GHPP clientswho are required by program policy to receive care through the GHPP approved outpatient special care centers ampThese services shall be authorized as GHPP benefits for all eligible GHPP clients and finally ldquoGHPP clients shall bereferred to the appropriate GHPP-approved SCC for diagnosis evaluation medical management and coordination ofcare when the client has or is suspected of having a GHPP medically eligible condition requiring SCC evaluation andfollow-uprdquo

The policy letters and regulations are an extension of the statute per the law Also reference CDHS CMS InformationNotice No 03-03 which says rdquoThis information is being provided as a resource that can be used in conjunction with thelaws for these programs As you know the general purpose of having regulations is to implement interpret or makespecific the law enforced or administered by itrdquo

California Supreme Court Rulings have validated that shall means shall The California Supreme Court found a clear dutywas imposed by law upon the county defendants because a statute unequivocally required a particular actionldquo[Government Code] section 66801 article VII subdivision (a) provides that lsquo[e]ach county in California shall pay the sumallotted to it by the agency from any funds available therefor rsquo [Italics added by Younger]rdquo (People ex rel Younger vCounty of El Dorado supra 5 Cal3d at p 491) Peterson v Superior Court (1995) 10 Cal4th 1185 specifically ratifies theapplication of the doctrine of negligence per se against for failure to comply with applicable statutes and ordinances Id at 1204 note 10

Medicaid agencies must make all rules and policies available to the public and provide copies to legal services offices(42 CFR sect 43118) No one outside of the DCHS has ever been informed that the GHPP and CCS programs wereldquoFederalizedrdquo under Title XIX of the Social Security Act effective September 1 2005 No one at the Legal Aid servicesoffices had even heard of the program

State Medicaid Programs must provide an opportunity for a fair hearing (42 USC sect 1396a(a)(3)) Medicaid applicantsand beneficiaries are entitled to a hearing whenever a service or a request for a service is reduced denied terminatedor not acted upon with reasonable promptness (42 CFR sect 431200 et seq) Goldberg v Kelley 397 US 254 (1970)Public assistance beneficiaries have a constitutional due process right to a hearing prior to the termination of benefitsThis due process right includes adequate and timely notice the opportunity to be heard by an impartial decisionmaker and a decision based upon evidence adduced at the hearing Medicaid regulations governing fair hearings 42CFR sect 431200 et seq provide detailed requirements regarding content and timing of notice hearing procedures andthe content and timing of hearing decisions The due process requirements of the Medicaid Act are enforceable under42 USC sect 1983 All categorically eligible beneficiaries must receive medical assistance that is no less than that providedto other eligible individuals 42 USC sect1396a(a)(10)(B) Each service contained within the Medicaid state plan must besufficient in amount duration and scope to reasonably achieve its purpose 42 CFR sect 440230(b) The amountduration and scope provisions of the Medicaid Act and implementing regulations provide strong support to challengeexclusions of treatment that fall within the scope of services covered There is a long line of judicial decisions limiting

4

states discretion to exclude medically necessary treatment that falls within the scope of a covered service StateMedicaid programs may not limit services based upon diagnosis type of illness or medical condition 42 CFRsect440230(c) The operation of state Medicaid programs must be based upon reasonable standards 42 USC sect1396a(a)(17) State Medicaid programs must include safeguards to ensure that services will be provided in a mannerconsistent with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19) A Notice ofAction is if the state plan takes an action other than an approval including a denial or a deferral on a providerrsquos requestfor any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate the notice must be inwriting and contain a statement of the intended action as well as the reasons and specific legal support for the action(42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In addition the notice must containan explanation of the individualrsquos hearing rights rights to representation and to continued benefits (42 CFR sectsect431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c))

So I agree with Regional Administrator Nagle that ldquothe GHPP program is not a Title XIX programrdquo It is a California StateMedicaid Program authorized and established by the State of California But CMS approved the Federal Funding ndash sowhere is the ldquoState Medicaid Programs mustrdquo part of the equation

Why has my application languished since May 4 2010 Why can I not have a GHPP State Fair Hearing Has there everbeen a GHPP State Fair Hearing Why am I under attack literally and figuratively for just asking such a question Whywas I dis-enrolled from my LIHP MCE for filing a grievance

I do want to hear Chief Counsel Pressrsquos opinion regarding this question ndash and I do want to go meet with him in myState Capital ndash it is an incredible honor - and I take him at his word that he will get this properly resolvedhellipif I am notqualified then please just give me a proper NOA ndash if I am not entitled to a Medi-Cal State Fair Hearing then please justexplain why And I do care very much about my State ndash and I am concerned that California my state may be subjectto a class action lawsuit ndash and we have enough problems on our plate as it is

But sir with respect this is not just an academic exercise for mehellipI am out on the street terribly ill getting no medicalcare of any kind and scared to even go to an ER as I have been threatened and assaulted at my Federally QualifiedHealth Centers hellipWhere is MY ATTORNEY GENERAL KAMALA HARRIS Why does she ignore me Can the CaliforniaDepartment of Justice not assist me in any way

I was told I had to leave the Emmanuel House because there were threats being made against me My Case Managerwas fired Why for writing letters Can the tired poor and disposed not even be afforded first amendment rights

Please I need some urgent assistancehellipand if I must die out on the street then please at least explain this in a waythat I can understandhellipbecause at this moment I feel somewhat disappointed inSecretary Sebeliusrsquos responsehellipif what I say is true why am I being punished I did not go looking for this ndash if myapplication would have been properly processed if even one time a phone call was returned I would not have out ofdesperation resorted to endless hours in the law library trying to understand thishellip

And at this moment I still believe that 140000 of my fellow citizens ndash children with serious medical conditions ndash arehaving their rights violated as wellhellipand Irsquom counting on you to do something about it because I am utterlypowerlesshellip

I look forward to speaking with you later

Best regards and with appreciationJoseph

From Novo Don (CMSCMCHO) [mailtoDonNovocmshhsgov]Sent Wednesday June 20 2012 424 PM

5

To josephpreziosolivecomSubject Response to your letter to Secretary Sebelius

Good Afternoon Mr Prezioso

Attached is a copy of the letter responding to your questions presented to Secretary Sebelius I will touch base with youby telephone tomorrow at 1230 as we discussed Please let me know if you have any questions or require clarification

Thank youDon Novo

Don Novo|Medicaid Program Branch Manager for the Division of Medicaid amp Childrens Health Operations |Region IX|Centers for Medicare amp Medicaid Services|90 Seventh Street Suite 5-300 | San Francisco CA 94103| (415) 744-3674 | (303) 869-9083 | donnovocmshhsgov

Accept

Joseph Prezioso ltjosephpt522gmailcomgt

Joseph please add me to your LinkedIn network1 message

Travis England via LinkedIn ltmemberlinkedincomgt Tue May 20 2014 at 759 AMReply-To Travis England lttravisenglandgmailcomgtTo Joseph Prezioso ltjosephpt522gmailcomgt

Hi Joseph

Id like to connect with you on LinkedIn

Travis England

Trial Attorney at US Department of Justice

View Profile

You are receiving Invitation emails Unsubscribe

This email w as intended for Joseph Prezioso (Retail Professional) Learn w hy w e included this copy 2014 LinkedIn

Corporation 2029 Stierlin Ct Mountain View CA 94043 USA

4

states discretion to exclude medically necessary treatment that falls within the scope of a covered service StateMedicaid programs may not limit services based upon diagnosis type of illness or medical condition 42 CFRsect440230(c) The operation of state Medicaid programs must be based upon reasonable standards 42 USC sect1396a(a)(17) State Medicaid programs must include safeguards to ensure that services will be provided in a mannerconsistent with simplicity of administration and the best interests of the recipients 42 USC sect 1396a(a)(19) A Notice ofAction is if the state plan takes an action other than an approval including a denial or a deferral on a providerrsquos requestfor any medical service (Cal Code Regs tit 22 sect 510141(a)(1)) To be considered adequate the notice must be inwriting and contain a statement of the intended action as well as the reasons and specific legal support for the action(42 CFR sectsect 431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c)) In addition the notice must containan explanation of the individualrsquos hearing rights rights to representation and to continued benefits (42 CFR sectsect431206(b) 431210 Cal Code Regs tit 22 sectsect 50179(c) 510141(c))

So I agree with Regional Administrator Nagle that ldquothe GHPP program is not a Title XIX programrdquo It is a California StateMedicaid Program authorized and established by the State of California But CMS approved the Federal Funding ndash sowhere is the ldquoState Medicaid Programs mustrdquo part of the equation

Why has my application languished since May 4 2010 Why can I not have a GHPP State Fair Hearing Has there everbeen a GHPP State Fair Hearing Why am I under attack literally and figuratively for just asking such a question Whywas I dis-enrolled from my LIHP MCE for filing a grievance

I do want to hear Chief Counsel Pressrsquos opinion regarding this question ndash and I do want to go meet with him in myState Capital ndash it is an incredible honor - and I take him at his word that he will get this properly resolvedhellipif I am notqualified then please just give me a proper NOA ndash if I am not entitled to a Medi-Cal State Fair Hearing then please justexplain why And I do care very much about my State ndash and I am concerned that California my state may be subjectto a class action lawsuit ndash and we have enough problems on our plate as it is

But sir with respect this is not just an academic exercise for mehellipI am out on the street terribly ill getting no medicalcare of any kind and scared to even go to an ER as I have been threatened and assaulted at my Federally QualifiedHealth Centers hellipWhere is MY ATTORNEY GENERAL KAMALA HARRIS Why does she ignore me Can the CaliforniaDepartment of Justice not assist me in any way

I was told I had to leave the Emmanuel House because there were threats being made against me My Case Managerwas fired Why for writing letters Can the tired poor and disposed not even be afforded first amendment rights

Please I need some urgent assistancehellipand if I must die out on the street then please at least explain this in a waythat I can understandhellipbecause at this moment I feel somewhat disappointed inSecretary Sebeliusrsquos responsehellipif what I say is true why am I being punished I did not go looking for this ndash if myapplication would have been properly processed if even one time a phone call was returned I would not have out ofdesperation resorted to endless hours in the law library trying to understand thishellip

And at this moment I still believe that 140000 of my fellow citizens ndash children with serious medical conditions ndash arehaving their rights violated as wellhellipand Irsquom counting on you to do something about it because I am utterlypowerlesshellip

I look forward to speaking with you later

Best regards and with appreciationJoseph

From Novo Don (CMSCMCHO) [mailtoDonNovocmshhsgov]Sent Wednesday June 20 2012 424 PM

5

To josephpreziosolivecomSubject Response to your letter to Secretary Sebelius

Good Afternoon Mr Prezioso

Attached is a copy of the letter responding to your questions presented to Secretary Sebelius I will touch base with youby telephone tomorrow at 1230 as we discussed Please let me know if you have any questions or require clarification

Thank youDon Novo

Don Novo|Medicaid Program Branch Manager for the Division of Medicaid amp Childrens Health Operations |Region IX|Centers for Medicare amp Medicaid Services|90 Seventh Street Suite 5-300 | San Francisco CA 94103| (415) 744-3674 | (303) 869-9083 | donnovocmshhsgov

Accept

Joseph Prezioso ltjosephpt522gmailcomgt

Joseph please add me to your LinkedIn network1 message

Travis England via LinkedIn ltmemberlinkedincomgt Tue May 20 2014 at 759 AMReply-To Travis England lttravisenglandgmailcomgtTo Joseph Prezioso ltjosephpt522gmailcomgt

Hi Joseph

Id like to connect with you on LinkedIn

Travis England

Trial Attorney at US Department of Justice

View Profile

You are receiving Invitation emails Unsubscribe

This email w as intended for Joseph Prezioso (Retail Professional) Learn w hy w e included this copy 2014 LinkedIn

Corporation 2029 Stierlin Ct Mountain View CA 94043 USA

5

To josephpreziosolivecomSubject Response to your letter to Secretary Sebelius

Good Afternoon Mr Prezioso

Attached is a copy of the letter responding to your questions presented to Secretary Sebelius I will touch base with youby telephone tomorrow at 1230 as we discussed Please let me know if you have any questions or require clarification

Thank youDon Novo

Don Novo|Medicaid Program Branch Manager for the Division of Medicaid amp Childrens Health Operations |Region IX|Centers for Medicare amp Medicaid Services|90 Seventh Street Suite 5-300 | San Francisco CA 94103| (415) 744-3674 | (303) 869-9083 | donnovocmshhsgov

Accept

Joseph Prezioso ltjosephpt522gmailcomgt

Joseph please add me to your LinkedIn network1 message

Travis England via LinkedIn ltmemberlinkedincomgt Tue May 20 2014 at 759 AMReply-To Travis England lttravisenglandgmailcomgtTo Joseph Prezioso ltjosephpt522gmailcomgt

Hi Joseph

Id like to connect with you on LinkedIn

Travis England

Trial Attorney at US Department of Justice

View Profile

You are receiving Invitation emails Unsubscribe

This email w as intended for Joseph Prezioso (Retail Professional) Learn w hy w e included this copy 2014 LinkedIn

Corporation 2029 Stierlin Ct Mountain View CA 94043 USA

Accept

Joseph Prezioso ltjosephpt522gmailcomgt

Joseph please add me to your LinkedIn network1 message

Travis England via LinkedIn ltmemberlinkedincomgt Tue May 20 2014 at 759 AMReply-To Travis England lttravisenglandgmailcomgtTo Joseph Prezioso ltjosephpt522gmailcomgt

Hi Joseph

Id like to connect with you on LinkedIn

Travis England

Trial Attorney at US Department of Justice

View Profile

You are receiving Invitation emails Unsubscribe

This email w as intended for Joseph Prezioso (Retail Professional) Learn w hy w e included this copy 2014 LinkedIn

Corporation 2029 Stierlin Ct Mountain View CA 94043 USA

Joseph Prezioso ltjosephpt522gmailcomgt

Senate Bill 1100 legislation (Chapter 226 October 2005)1 message

Joseph Prezioso ltjosephpt522gmailcomgt Wed May 7 2014 at 406 PMTo senatoryeesencagov MarevaBrownsencagov AliciaLewissencagov senatorberryhillsencagovBrentFinkelsencagov senatorliusencagov DarcelSanderssencagov senatoremmersonsencagovTeresaTrujillosencagov senatorevanssencagov Sofiaandradesencagov senatorwrightsencagovStanDiOriosencagov Assemblymemberstoneassemblycagov MyeshaJacksonasmcagovAssemblymemberAmmianoassemblycagov WendyHillasmcagovAssemblymemberMainenscheinassemblycagov ErinDonnetteasmcagovAssemblymemberHallassemblycagov BrianDukeasmcagov AssemblymembercalderonassemblycagovKelsyCastillioasmcagov AssemblymemberGarciaassemblycagov philiphornerasmcagovAssemblymemberGroveassemblycagov KristinaBrownasmcagovCc Joyce Terhaar ltjterhaarsacbeecomgt Kimberly Lewis ltnhelpdchealthlaworggt Laurence Paradisltlparadisdralegalorggt Lisa Porria cHAP ltlisaporriahcahealthcarecomgt Raju Narisettiltrajunarisettiwsjcomgt Shira Wakschlag ltswakschlagdredforggt chadterhunelatimescompatmcmahonlatimescomBcc Travis W England lttravisenglandusdojgovgt Alex G Tse ltalextseusdojgovgt Melinda Haagltmelindahaagusdojgovgt Joann M Swanson ltIladeissusdojgogt Michael T Pyle ltmichaeltpyleusdojgovgtJenniferCCassusdojgov LeifJohnsonusdojgov jocelynsamuelsusdojgov EveHillusdojgov

Effective September 1 2005 with Centers for Medicare amp Medicaid Servicesapproval and Senate Bill 1100 legislation (Chapter 226 October 2005) CCS andGHPP became Title XIX Medicaid waiver programs Both programs will now beregarded as ldquoMedicaidrdquo programs

Since the California State Legislature has passed the subject law NOT A SINGLE CHILDENROLLED IN EITHER THE CCS or GHPP programs has EVER REQUESTED ASTATE FAIR HEARING which they are legally entitled to Doesnt that seem irregular toyou

Who is responsible for Legislative Oversight of DHCS amp CDSS to make sure that thesechildren with very serious and complex medical conditions are not having their civil rightsviolated by the government

Federalization of the GHPP CCS ProgramsTitle XIX hellip

(A) email Secretary Sebelius US HHS 05-27-12 GHHP Fair hellip

Thank you

-- Joseph A Prezioso

80 South Market StreetSan Jose CA 95113408-483-7877855-250-6990 (Fax)THINKSTRONG

ARNOLD SCHWARZENEGGER Governor

State of California-Health and Human Services Agency

Department of Health Services

SANDRA SHEWRY Director

May 3 2007 TO HEMOPHILIA TREATMENT CENTER (HTC) MEDICAL DIRECTORS AND

STAFF SUBJECT GHPP AND CCS BECOME TITLE XIX FEDERAL MEDICAID WAIVER

PROGRAMS The purpose of this letter is to inform HTCs of the ldquofederalizationrdquo of the GHPP and CCS programs under Title XIX Medicaid waiver program Effective September 1 2005 with Centers for Medicare amp Medicaid Services approval and Senate Bill 1100 legislation (Chapter 226 October 2005) CCS and GHPP became Title XIX Medicaid waiver programs Both programs will now be regarded as ldquoMedicaidrdquo programs Under Section 340B of the Public Health Service Act (1992) public hospitals community migrant and homeless health centers HIVAIDS clinics and other safety net providers including HTCs where allowed to purchase outpatient pharmaceuticals including blood and hemophilia factor at discounted rates According to 340B guidelines these entities must bill Medicaid programs at acquisition cost (plus a dispensing fee) for outpatient drugs purchased at 340B discounted prices Beginning September 1 2005 all HTCs must bill acquisition cost (plus dispensing fee) for outpatient drugs including blood and hemophilia factor purchased at 340B prices and not bill usual and customary If you have any questions please contact Edan Lum Pharm D CMS Pharmaceutical Consultant at (916) 324-8906 Sincerely Original Signed by Marian Dalsey MD MPH Marian Dalsey MD MPH Chief Childrenrsquos Medical Services Branch cc See Next Page

1515 K Street Suite 400 MS 8100 PO Box 997413 Sacramento CA 95899-7413 (916) 327-1400

Internet Address httpwwwdhscagovpcfhcms

HEMOPHILIA TREATMENT CENTER (HTC) MEDICAL DIRECTORS AND STAFF Page 2 May 3 2007

cc Judith Baker Regional Administrative Director Federal Hemophilia Treatment Center ProgramRegion IX UCLA-Division of Pediatric HematologyOncology 924 Westwood Boulevard Ste 200 Los Angeles CA 90024 Maurice Robertson Chief Regional Operations Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Joleen Heider-Freeman MS RD Chief Statewide Programs Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Gloria Padre RN MSN Genetically Handicapped Persons Program Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

HEMOPHILIA TREATMENT CENTER (HTC) MEDICAL DIRECTORS AND STAFF Page 2 May 3 2007

cc Judith Baker Regional Administrative Director Federal Hemophilia Treatment Center ProgramRegion IX UCLA-Division of Pediatric HematologyOncology 924 Westwood Boulevard Ste 200 Los Angeles CA 90024 Maurice Robertson Chief Regional Operations Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Joleen Heider-Freeman MS RD Chief Statewide Programs Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Gloria Padre RN MSN Genetically Handicapped Persons Program Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

1

Joseph A Prezioso

From Joseph A Prezioso [josephpreziosolivecom]Sent Sunday May 27 2012 549 PMTo Secretary Sebelius (kathleensebeliushhsgov)Cc Harry Byrd III Jill AbramsonSubject 1115 Demonstration Project WaiversAttachments GHPP STATE FAIR HEARING REQUESTpdf

Importance HighSensitivity Confidential

Follow Up Flag Follow upDue By Friday June 01 2012 1000 AMFlag Status Flagged

Categories Civil Rights

Dear Secretary Sebelius

First of all I want to compliment you for having an email address that all citizens can email their Secretary of the USDepartment Health amp Human Services Itrsquos a pretty important department to all citizens because well we are humansand I know the Supreme Court said the corporation are ldquopersonsrdquo and I guess thatrsquos OK but they are not humans ndash eventhe Supreme Court didnrsquot say that

I have a meeting coming up with my Congresswoman Zoe Lofgren MY CONGRESSWOMEN I even spoke with her on thephone and she couldnrsquot be any nicer See I am in Californiarsquos 16th Congressional District and her office is very close It isvery exciting

I have been having quite a difficult time getting my medical care that I think (but I am not sure) I am entitled to by lawAnd I have been writing to everyone and anyone and I canrsquot seem to get any clear answers (actually pretty much nobodyanswers) Now I know the laws are incredibly complex and I have done by best (we have a great law library in SantaClara County) to try and understand what the problem is I want to be respectful of Congresswoman Lofgrenrsquos timebecause she has a lot of other constituents that need help as well so I am trying to verify and clarify as many things aspossible I was hoping you could answer what is a very important question to me

I have applied for a Medicaid program in the State of California specifically CALIFORNIA MEDICAL ASSISTANCE(MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

The program as I understand it is definitely a Medicaid Program under Title XIX of the Social Security Act and is part ofthe California 1115 Demonstration Project Waiver

The Waiver was approved by the US Department of Health and Human Services Centers for Medicare amp MedicareServices on November 2 2010 The signee was Donald M Berwick MDAdministrator It also says the following individuals are key contacts

Project Officer Steven RubioCenters for Medicare amp Medicaid ServicesCenter for Medicaid CHIP and Survey amp Certification7500 Security BoulevardMailstop S2-01-06Baltimore MD 21244-1850Telephone (410) 786-1782Facsimile (410) 786-8534E-mail stevcnrubiocmshhsgov

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

2

Associate Regional Administrator Gloria NagleDivision of Medicaid and Childrens Health Operations90 Seventh Street Suite 5-300 (5W)San Francisco CA 94103 -6706

It also says that If you have questions regarding this approval please contact

Director Victoria A WachinoFamily and Childrens Health Programs GroupCenter for Medicaid CHIP and Survey amp Certification(410) 786-5647

As I understand some euroMedicaid rulesbull are waived when a state files for a 1115 waiver

My question is this is it possible that certain rights such as those enumerated under Title XIX of the Social Security Actcompliance with and protections afforded under the Americans With Disabilities Act and even such fundamentalthings as ldquodue processrdquo and ldquoequal protectionrdquo rights provided for in the US Constitution can these be ldquowaivedrdquo in aStatersquos 1115 Waiver and then be approved by the US Department of Health and Human Services

I sure hope the answer is no but I thought I should verify this before my meeting with Congresswoman Lofgren I haveasked and written to many local state and federal government officials but no one answers Actually hardly anyoneeven knows that the CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM(GHPP) is a FEDERAL PROGRAM covered under Title XIX of the Social Security Act ndash it has been such for a very longtime Since September 1 2005 with Centers for Medicare amp Medicaid Services approval and California Senate Bill1100 legislation (Chapter 226 October 2005) when both CCS and GHPP became Title XIX Medicaid waiver programs

But the thing is it would seem that no one in the programs was every told this ndash the current information on theprograms from the California Department of Health Care Services website makes no mention of this fact nor suchbasic things as telling applicants and participants that they have the right to file for a Medi-Cal State Fair Hearingreceive proper Notice of Actions etc

And that may explain why I think (I am not certain) that the attached State Fair Hearing Request I filed may be the first inthe almost seven years since the program was ldquoFederalizedrdquo ndash and perhaps that is why I have yet to receive a responseor a scheduled hearing date as required by law ndash and also why a whole bunch of folks seem pretty unhappy with me ndashwhich is quite scary

But if I am correct and I am not sure that I am - donrsquot we have to tell these citizensrsquo this information and inform themof their rights

And I was thinking of sharing with Congresswoman Lofgren the idea that perhaps we should ldquotightenrdquo up the ldquowaiverrdquoapproval process ndash I donrsquot think this is just a one-off case Maybe it would be better in the future to require the AttorneyGeneral as well as the Director of the Department of Health Care Services to sign off on the proposal from the statesand approval should come from both the Department of Health and Human Services and also the United StatesDepartment of Justice Civil Rights Division People tend to be more careful about details when they know that theAttorney General and US DOJ are going to sign off on things

Secretary Sebelius the thing that is a little disappointing is that this program by its very definition is designed for citizenswho are ldquogenetically handicappedrdquo ndash or if you will Americans with Disabilities ndash and it would seem that the entireprogram has been in violation of the American with Disabilities Act since the day it was ldquofederalizedrdquo

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

3

I am certain you know about the ldquoSupremacy Clauserdquo of our Constriction ndash states have their rights but Federal Law isSupremehellipitrsquos a pretty short clause but the Founderrsquos used the word SHALL three times ndash I think they were trying tomake the point very clear ndash SHALL means SHALL

It would be very much appreciated to have your opinion on this matter before I meet with Congresswoman Lofgrenbecause if I am incorrect then there is no point is wasting her valuable time

Thank you

Joseph A Prezioso405 N Fourth St B18San Jose CA 95112408-883-5446877-493-2031 fax

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

State Hearings Division

Joseph A Prezioso 405 N Fourth St San Jose CA 95112 408-883-5446 877-493-2031fax josephpreziosoattnet V

Department of Health Care Services Systems of Care Division Statewide Programs Section PO Box 997413 MS 8102 Sacramento CA 95899-7413 District Office 720 Empey Way San Jose CA 95126 Case Manager Carol Hazell RN PHN (GHPP)

Case Name Joseph A Prezioso Case s X5445 amp 4913810

CIN 95486255E4

BIC ID No 95486255E41325

SAR 99033765400

County of Residence Santa Clara

Birth Date October 28 1961

STATE HEARING REQUEST

I DO NOT AGREE WITH STATE ACTION AND INACTION ABOUT MY APPLICATION FOR CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) CHANGES TO MY CALIFORNIA MEDICAL ASSISTANCE (MEDI-CAL) GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP) ELLIGIBILITY STATUS AND DENIAL OF AUTHORIZED HEALTH BENEFITS

Hearing Request Type IN PERSON Request Submission Date Mar 31 2012 Presiding Chief Administrative Law Judge Manuel A Romero

Address PO Box 944243 Mail Station 9-17-37 Sacramento California 94244

State of California Health and Human Services Agency Department of Social Services

STATE HEARING REQUEST

Prezioso V DHCS Case s X4544 amp 4913810 State Hearings Division Health and Human Service Agency

1

INTRODUCTION

I respectfully request a fair hearing to be scheduled within 30 days reinstatement of my

program eligibility and be allowed to have services and medical assistance provided while a

decision is pending

ACTIONS I WILL CHALLENGE AT THE FAIR HEARING

bull Refusal and Delay in processing Medi-Cal application

bull Determination that I am no longer eligible for Medi-Cal

bull Inadequate notice

bull An unreasonable delay in receiving services

bull Reduction in services

bull Termination and denial of a Medi-Cal covered services

CONCLUSION

I respectfully request and pray for relief that this Honorable Administrative Court of Law

expeditiously as is possible and as the Court sees as is reasonable grant my hearing reinstate my

Medical eligibility and permit me to be allowed to have needed and mandated support services

and medical assistance while a decision is pending

DATED March 31 2012

Respectfully submitted

JOSEPH A PREZIOSO Citizen United States of America

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

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28

ARNOLD SCHWARZENEGGER Governor

State of California-Health and Human Services Agency

Department of Health Services

SANDRA SHEWRY Director

May 3 2007 TO HEMOPHILIA TREATMENT CENTER (HTC) MEDICAL DIRECTORS AND

STAFF SUBJECT GHPP AND CCS BECOME TITLE XIX FEDERAL MEDICAID WAIVER

PROGRAMS The purpose of this letter is to inform HTCs of the ldquofederalizationrdquo of the GHPP and CCS programs under Title XIX Medicaid waiver program Effective September 1 2005 with Centers for Medicare amp Medicaid Services approval and Senate Bill 1100 legislation (Chapter 226 October 2005) CCS and GHPP became Title XIX Medicaid waiver programs Both programs will now be regarded as ldquoMedicaidrdquo programs Under Section 340B of the Public Health Service Act (1992) public hospitals community migrant and homeless health centers HIVAIDS clinics and other safety net providers including HTCs where allowed to purchase outpatient pharmaceuticals including blood and hemophilia factor at discounted rates According to 340B guidelines these entities must bill Medicaid programs at acquisition cost (plus a dispensing fee) for outpatient drugs purchased at 340B discounted prices Beginning September 1 2005 all HTCs must bill acquisition cost (plus dispensing fee) for outpatient drugs including blood and hemophilia factor purchased at 340B prices and not bill usual and customary If you have any questions please contact Edan Lum Pharm D CMS Pharmaceutical Consultant at (916) 324-8906 Sincerely Original Signed by Marian Dalsey MD MPH Marian Dalsey MD MPH Chief Childrenrsquos Medical Services Branch cc See Next Page

1515 K Street Suite 400 MS 8100 PO Box 997413 Sacramento CA 95899-7413 (916) 327-1400

Internet Address httpwwwdhscagovpcfhcms

HEMOPHILIA TREATMENT CENTER (HTC) MEDICAL DIRECTORS AND STAFF Page 2 May 3 2007

cc Judith Baker Regional Administrative Director Federal Hemophilia Treatment Center ProgramRegion IX UCLA-Division of Pediatric HematologyOncology 924 Westwood Boulevard Ste 200 Los Angeles CA 90024 Maurice Robertson Chief Regional Operations Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Joleen Heider-Freeman MS RD Chief Statewide Programs Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Gloria Padre RN MSN Genetically Handicapped Persons Program Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814

1122015 Gmail shy Kamala Harris has just read laquoFW Joseph A Prezioso has shared a document with youraquo

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampq=kamalaharris40dojcagovampqs=trueampsearch=queryampth=14ada19a5847aeb7ampsiml=14adahellip 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Kamala Harris has just read laquoFW Joseph A Prezioso has shared a documentwith youraquo1 message

MailTrack Alerts ltalertsmailtrackiogt Sun Jan 11 2015 at 944 AMReplyshyTo noshyreplymailtrackioTo josephaprezioso14gmailcom

Kamala Harris read your email 1week after it was sent Sent on 2015shy01shy02 at 1128h

Read on 2015shy01shy11 at 0944h

Read using PC (Win7)

View in Gmail

laquoFW Joseph A Prezioso has shared a documraquo sent toKamala Harris ltKamalaHarrisdojcagovgt

Stop receiving alerts for this email

Need help Contact us in feedbackmailtrackio

ARNOLD SCHWARZENEGGER Governor

State of California-Health and Human Services Agency

Department of Health Services

SANDRA SHEWRY Director

May 3 2007 TO HEMOPHILIA TREATMENT CENTER (HTC) MEDICAL DIRECTORS AND

STAFF SUBJECT GHPP AND CCS BECOME TITLE XIX FEDERAL MEDICAID WAIVER

PROGRAMS The purpose of this letter is to inform HTCs of the ldquofederalizationrdquo of the GHPP and CCS programs under Title XIX Medicaid waiver program Effective September 1 2005 with Centers for Medicare amp Medicaid Services approval and Senate Bill 1100 legislation (Chapter 226 October 2005) CCS and GHPP became Title XIX Medicaid waiver programs Both programs will now be regarded as ldquoMedicaidrdquo programs Under Section 340B of the Public Health Service Act (1992) public hospitals community migrant and homeless health centers HIVAIDS clinics and other safety net providers including HTCs where allowed to purchase outpatient pharmaceuticals including blood and hemophilia factor at discounted rates According to 340B guidelines these entities must bill Medicaid programs at acquisition cost (plus a dispensing fee) for outpatient drugs purchased at 340B discounted prices Beginning September 1 2005 all HTCs must bill acquisition cost (plus dispensing fee) for outpatient drugs including blood and hemophilia factor purchased at 340B prices and not bill usual and customary If you have any questions please contact Edan Lum Pharm D CMS Pharmaceutical Consultant at (916) 324-8906 Sincerely Original Signed by Marian Dalsey MD MPH Marian Dalsey MD MPH Chief Childrenrsquos Medical Services Branch cc See Next Page

1515 K Street Suite 400 MS 8100 PO Box 997413 Sacramento CA 95899-7413 (916) 327-1400

Internet Address httpwwwdhscagovpcfhcms

HEMOPHILIA TREATMENT CENTER (HTC) MEDICAL DIRECTORS AND STAFF Page 2 May 3 2007

cc Judith Baker Regional Administrative Director Federal Hemophilia Treatment Center ProgramRegion IX UCLA-Division of Pediatric HematologyOncology 924 Westwood Boulevard Ste 200 Los Angeles CA 90024 Maurice Robertson Chief Regional Operations Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Joleen Heider-Freeman MS RD Chief Statewide Programs Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Gloria Padre RN MSN Genetically Handicapped Persons Program Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814

1122015 Gmail shy Kamala Harris has just read laquoFW Joseph A Prezioso has shared a document with youraquo

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampq=kamalaharris40dojcagovampqs=trueampsearch=queryampth=14ada19a5847aeb7ampsiml=14adahellip 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Kamala Harris has just read laquoFW Joseph A Prezioso has shared a documentwith youraquo1 message

MailTrack Alerts ltalertsmailtrackiogt Sun Jan 11 2015 at 944 AMReplyshyTo noshyreplymailtrackioTo josephaprezioso14gmailcom

Kamala Harris read your email 1week after it was sent Sent on 2015shy01shy02 at 1128h

Read on 2015shy01shy11 at 0944h

Read using PC (Win7)

View in Gmail

laquoFW Joseph A Prezioso has shared a documraquo sent toKamala Harris ltKamalaHarrisdojcagovgt

Stop receiving alerts for this email

Need help Contact us in feedbackmailtrackio

HEMOPHILIA TREATMENT CENTER (HTC) MEDICAL DIRECTORS AND STAFF Page 2 May 3 2007

cc Judith Baker Regional Administrative Director Federal Hemophilia Treatment Center ProgramRegion IX UCLA-Division of Pediatric HematologyOncology 924 Westwood Boulevard Ste 200 Los Angeles CA 90024 Maurice Robertson Chief Regional Operations Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Joleen Heider-Freeman MS RD Chief Statewide Programs Section Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814 Gloria Padre RN MSN Genetically Handicapped Persons Program Childrenrsquos Medical Services Branch 1515 K Street Suite 400 MS 8100 Sacramento CA 95814

1122015 Gmail shy Kamala Harris has just read laquoFW Joseph A Prezioso has shared a document with youraquo

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampq=kamalaharris40dojcagovampqs=trueampsearch=queryampth=14ada19a5847aeb7ampsiml=14adahellip 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Kamala Harris has just read laquoFW Joseph A Prezioso has shared a documentwith youraquo1 message

MailTrack Alerts ltalertsmailtrackiogt Sun Jan 11 2015 at 944 AMReplyshyTo noshyreplymailtrackioTo josephaprezioso14gmailcom

Kamala Harris read your email 1week after it was sent Sent on 2015shy01shy02 at 1128h

Read on 2015shy01shy11 at 0944h

Read using PC (Win7)

View in Gmail

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Stop receiving alerts for this email

Need help Contact us in feedbackmailtrackio

1122015 Gmail shy Kamala Harris has just read laquoFW Joseph A Prezioso has shared a document with youraquo

httpsmailgooglecommailu0ui=2ampik=8be04dc765ampview=ptampq=kamalaharris40dojcagovampqs=trueampsearch=queryampth=14ada19a5847aeb7ampsiml=14adahellip 11

Joseph Prezioso ltjosephaprezioso14gmailcomgt

Kamala Harris has just read laquoFW Joseph A Prezioso has shared a documentwith youraquo1 message

MailTrack Alerts ltalertsmailtrackiogt Sun Jan 11 2015 at 944 AMReplyshyTo noshyreplymailtrackioTo josephaprezioso14gmailcom

Kamala Harris read your email 1week after it was sent Sent on 2015shy01shy02 at 1128h

Read on 2015shy01shy11 at 0944h

Read using PC (Win7)

View in Gmail

laquoFW Joseph A Prezioso has shared a documraquo sent toKamala Harris ltKamalaHarrisdojcagovgt

Stop receiving alerts for this email

Need help Contact us in feedbackmailtrackio