Client, therapist lament end of reimbursement for telephone counseling
By RICK KARLIN, Capitol bureau
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First published: Monday, May 8, 2006
ALBANY — Peter Kahrmann will never forget the faint sound he heard before his life irrevocably changed almost 22 years ago on a dark Brooklyn street, as he headed for his 5 a.m. shift as a cabdriver.
“I heard what sounded like the jingle of a key chain,” he said. “I turned around toward the noise. I’m looking at a teenager who puts a gun to my head.”
There was a crack of gunfire. Hours later, doctors stopped the bleeding but left part of a .22 slug in his head.
Today, along with the bullet, Kahrmann still carries a deep fear of leaving his home in rural Berne. He keeps the terror at bay with the help of antidepressants and weekly counseling with the social worker who helped him leave his New York City apartment, where he had locked himself up for a year after the shooting.
“There is no such thing as leaving my home when it’s not scary,” he said.
And he’s fighting more than fear these days, because he’s engaged in a struggle with New York’s bureaucracy.
The state’s Crime Victims Compensation Board, which has been paying for Kahrmann’s weekly therapy sessions since the 1980s, recently decided it won’t pay for phone counseling anymore.
“We both felt that it was a real low blow, like pulling the plug,” said William Buse, the social worker who has counseled Kahrmann since 1984, shortly after he was shot.
The decision to cut off reimbursement for phone counseling was made informally about three years ago but finalized in the last several months, said Everett Mayhew, the board’s general counsel. Kahrmann first received written notice of the new policy in the mail Aug. 24, the same date he was shot in 1984.
“The board felt that in-person counseling was more effective,” said Mayhew.
The board, Mayhew said, paid out approximately $2.7 million for 1,068 claims last year. He did not know how many phone counseling sessions that included, but said it wasn’t more than a handful.
The decision to stop reimbursement also was made after looking at what other states, such as California and Texas, were doing, said Mayhew.
Such decisions aren’t unusual, said Lori Drummer, public affairs director for the American Legislative Exchange Council, a Washington, D.C., organization that, among other things, tracks the way states make bureaucratic decisions.
“It comes down to, a lot of times, the major trends,” she said.
Few private insurers pay for phone therapy, although that policy is generally viewed as a way to limit the amount of claims that are paid out, said Sara Gray Long, a psychologist in Norwich who has worked with patients with post-traumatic stress disorder.
Kahrmann, 52, is quick to make light of his injury, joking that, no, the bullet in his head doesn’t set off metal detectors. Despite his humor, he still recalls those days when he locked himself in his Lower East Side apartment, relying on friends to bring groceries, spending his time reading biographies and listening to Bruce Springsteen records. He was in the grip of severe post-traumatic stress disorder as well as suffering what would turn out to be permanent damage to his brain’s frontal lobes.
Eventually, neighbors and friends convinced Kahrmann to call Buse, a clinical social worker who had counseled him during a divorce years earlier.