Showing posts with label human element. Show all posts
Showing posts with label human element. Show all posts

23 September 2012

Day Dreams from an Autistic Mind

Things tend to spread like wildfire on the net, with social networking fanning the flames... sometimes, there are jewels, like this gem from a Facebook page, Day Dreams from an Autistic Mind (click on the image to enlarge):


I loved the way this mom so succinctly summed up the challenges we face from those on the outside looking our way, and more importantly the sole reason we do what we do - for the love of our children.

Because I recognized the images are personal (with the exception of the upper center and cartoon), I contacted the mom to request permission to share her message and inspiration. She kindly obliged and included the following about her family:
"I am a mother of two children, Emma is 4 1/2 and Lukas is 3. He was diagnosed with Autism on November 17, 2011. He is moderately Autistic. He is also nonverbal. As soon as we found out we put him in early intervention that changed our lives. He is very smart and very clever. He is now in an Integrated Preschool using the TEACHH program and he gets OT, PT and ST. He is am amazing little boy and I love him just the way he is."
Thanks to Emma and Lukas's awesome mom for reminding us what it's all about! =)

13 September 2012

10,000 Blog Views! and Counting...

This week, the blog reached 10,000 page views! North Carolinians (and others across the country) are watching - and inquiring minds wanna know...

At the time of the June 16th posting, the blog had reached 5,683 since February of 2012, when first launched. Since that time, the hits have more than doubled from viewers in at least 63 counties across the State of North Carolina and beyond. 

Once more, I'd like to point out that regarding total hits, the number (10,143 as of this posting) reflected to the right of the page (previously located at the bottom) is the correct total of page views since the initial launch of this parent / public information blog back in February of 2012. StatCounter was installed in May, so the data you see compiled via the blog's StatCounter statistics only reflects activity from May onward, mostly because I just haven't bothered to change it. 

Viewers include loads of parents / family members as well as provider agencies and professionals, LME / MCOs, universities and research groups, risk management groups, PR firms, law firms, advocacy organizations, and both state and federal government offices (*although due to the ambiguity of government IP data, it's impossible for a novice like me to know which specific offices nor even agencies are viewing)...

Some of the more interesting regular (and some once or twice) NC viewers include: Duke University, UNC Chapel Hill, UNC Charlotte, the Department of Veteran Affairs, the North Carolina Research and Education Network, Disability Rights NC, The Arc of NC (and various county chapters), NC Justice Center, NC Council of Community Programs, Crossroads Behavioral Healthcare (now Partners Behavioral Health Management), Daymark Recovery Services, Piedmont Behavioral Health, Sandhills Center, Saguaro Management and Accounting Services, Inc. (providing billing, human resources, program development and quality and risk management to human services companies), the Mental Health Association of Forsyth County, Raleigh's Campaign Connections PR firm, and numerous NC Government offices and agencies around the state.

And beyond North Carolina's borders: Kansas Health Institute, Virginia Commonweath University (VCU), Minnesota State Colleges and Universities, University of Georgia, Emory University, DC's American University, FHC Health Systems, Hospice of the Western Reserve in Ohio; Charleston, SC's New Hope Treatment Centers; HMS (a public government and managed-care contracting company); Deloitte, Marsh USA, and Alvarez & Marsal (each being US consulting / risk management firms with varying specialties); Nelson Mullins Riley & Scarborough LLP,  Drinker Biddle, and Hunton and Williams (each are national / multi-state law firms); and yes, even the US Centers for Medicare and Medicaid as well as a few hits from US Government offices in Washington, DC.

Yep, as election season launches into full swing (or sling as is oft the case), the world IS watching to see what North Carolina will do with it's special populations -- even if the usually less-than-enthusiastic main-stream media assignments and focus generally fall short in the real-life, human interest for "those people" and their families - because let's face it, nobody really wants to talk about what they don't understand, especially if it makes them sad... 

The 38th Vice-President of the United States, Hubert H. Humphrey, once said oh-so wisely, "The moral test of government is how it treats those who are in the dawn of life... the children; those who are in the twilight of life... the elderly; and those who are in the shadow of life...  the sick... the needy... and the disabled."

It's one of my favorite quotes and oh-so-fitting... and if you happen to be a quote-y kind of person like me and enjoy wise words, here's another for ya...

"Open your mouth for the mute, For the rights of all the unfortunate. Open your mouth, judge righteously, and defend the rights of the afflicted and needy." --Proverbs 31:8-9

So rest assured North Carolina, Inquiring Minds DO Wanna Know.


And to all the blog followers, the advocates, the exhausted parents, supportive family members; loyal and dedicated direct care staff, Case Managers, and various professionals (our personal community villages) who go above and beyond every day to make our lives possible...  and to all the people of conscious who listen, who care, who try and try again - and who never, ever give up because you know what is right and just and because it's just not in your soul's design to believe that one life is worth less than another... I'd like to take this opportunity to say Thank You!

Oh, I mentioned 63 counties; here they are... Clicking on the County links below will take you to the corresponding State representatives page on the North Carolina General Assembly's website.
  1. Alamance County 
  2. Beaufort County 
  3. Bertie County  
  4. Brunswick County 
  5. Buncombe County 
  6. Burke County 
  7. Cabarrus County 
  8. Caldwell County  
  9. Catawba County 
  10. Cherokee County 
  11. Cleveland County 
  12. Cumberland County 
  13. Dare County 
  14. Davidson County  
  15. Duplin County 
  16. Durham County  
  17. Edgecombe County 
  18. Forsyth County  
  19. Franklin County  
  20. Gaston County 
  21. Granville County  
  22. Guilford County  
  23. Halifax County  
  24. Harnett County 
  25. Haywood County  
  26. Henderson County  
  27. Hertford County  
  28. Hoke County  
  29. Iredell County  
  30. Jackson County  
  31. Johnston County  
  32. Jones County  
  33. Lee County  
  34. Lenoir County  
  35. Lincoln County  
  36. Macon County 
  37. McDowell County  
  38. Mecklenburg County 
  39. Monroe County *voter representation falls under Union County
  40. Moore County  
  41. New Hanover County  
  42. Onslow County  
  43. Orange County 
  44. Pasquotank County  
  45. Pender County  
  46. Pitt County  
  47. Polk County  
  48. Randolph County  
  49. Robeson County  
  50. Rockingham County  
  51. Rutherford County  
  52. Sampson County  
  53. Stanly County  
  54. Stokes County  
  55. Transylvania County  
  56. Union County  
  57. Wake County 
  58. Watauga County  
  59. Wayne County 
  60. Wilkes County  
  61. Wilson County  
  62. Union County  
  63. Yancey County  
To find out who your voting representatives are, visit the NC General Assembly search page.
For more on who's involved and how to advocate, see Speak Up!

31 August 2012

What's New in August

August 2012 news, events, and updates.


30 August 2012

DOJ Settlement Good for People with Mental Illness, but May Leave People with I/DD Out

From The Arc of North Carolina

DOJ Settlement Good for People with Mental Illness, but May Leave People with I/DD Out

[ view at ArcNC.org ]

While it is too soon to know what the U.S. Department of Justice (DOJ) Settlement will mean for people with mental illness, now is the time to begin thinking about the effects it will have on our Mental Health/Developmental Disability/Substance Abuse (MH/DD/SA) system.

We appreciate the N.C. Department of Health and Human Services (DHHS) and DOJ finding a way to avoid costly litigation by reaching a settlement. While people can argue about the settlement’s details, there is really no question that NC’s placement of people with mental illness [and people with I/DD] in adult care homes is not appropriate. These settings were designed for people who are elderly, and are not settings where individuals who are young and have a disability will thrive. Spending large amounts of money defending a federal lawsuit would have been a true waste of taxpayer money.

The settlement does several things. The core of it requires the state to create new housing options [defined as slots]. These housing slots will include rental assistance and support services for 3,000 people, 2,000 that currently live in adult care homes, and 1,000 that are in jeopardy of being placed in adult care homes (or rest homes, as they are sometimes called) by 2020. It also requires the state to create, or increase, the availability of community services for people with mental illness including supported employment and additional Assertive Community Treatment Team services. The effort will have an independent monitor who will hold the state accountable. If the state fails to meet timelines, the DOJ can take the State to court.

One of the most disappointing parts of the Settlement is its lack of inclusion of people with developmental disabilities. Though the original complaint was about people with mental illness, there is no doubt that NC continues to rely upon similar institutional settings for people with I/DD. That people with I/DD were leftout of this settlement is concerning. Not only is the state allowed to continue its bias towards institutional settings in placements, community options made available to people with mental illness could come a the cost of community options for those with I/DD, given the State's limited resources.

Creating “scattered-site housing” is a great idea for all people with disabilities. The Arc continues to develop housing options that meet this criteria, but it is a slow process. We are also concerned that policy-makers in Washington and NC are adhering to conflicting policy in terms of housing and people with disabilities. One example is the HUD (US Dept. of Housing and Urban Development) funded properties The Arc manages for people with mental illness. Many of the properties are apartments that will not meet the scattered-site definition, yet have rental assistance vouchers as part of the project. Under the settlement agreement, very few of these properties will be available for people coming out of adult care homes. The changes that would be needed to make them available for these people currently run afoul of federal HUD regulations. We hope the DOJ and HUD will work together so future efforts will not exclude housing options promoted by federal agencies.

While the state has agreed to this promising settlement, we have significant related problems in our service system that must be addressed. One such problem is the crisis that will be created if we do not find a solution to the personal care issue. While the state will be creating community housing options for one group of individuals, others will be losing services and potentially their housing. This is not the way a system should work. While it is impressive that the General Assembly found funds to support the settlement, it should be noted that critical services are being sliced because of budget cuts at the same time.

While this settlement agreement is a step in the right direction, it is far from perfect. It does much for people with mental illness who have faced institutional bias, but at the same time it does nothing for people with I/DD facing a nearly identical problem. This is an opportunity for the leadership of the General Assembly and Administration to proactively take the spirit of this settlement and apply it to other populations. The best possible outcome is a more responsive system for all.

On Wednesday of next week the legislative Blue Ribbon Commission on Transitions to Community Living will hold its first meeting. Hopefully this committee will be the catalyst to create such change.

25 August 2012

Apples, Oranges & Supported Employment

With all the talk of community support, naturally the issue of supported employment for persons with intellectual / developmental disabilities comes up... After all, doesn't everyone need to be needed and have a sense of accomplishment? Does not every life have a purpose?

A while back, I met with NC Representative Bill Current to discuss my concerns surrounding the statewide Medicaid overhaul and the recipients and families who will be affected. Dr. Current, a retired dentist, is a kindly conservative southern gentleman rooted firmly in his strong beliefs of integrity and hard work among other things - and does not hesitate to share his views regardless of yours (much like my late grandfather, a WWII veteran and former magistrate). I liked him immediately.

We chatted briefly about UNC (his alma mater), UNC basketball, and changing times in the field of dentistry before settling down for business. Before I could get started, Dr. Current was quick to share with me his position regarding government handouts and free for alls. I listened quietly as he spoke and then I told him,

"I agree completely."

I highlighted for him my 7 years as a struggling single parent raising a young child with disabilities without child support or much of any other... of undergoing a major back surgery when my child did not walk, going back to school, working and eventually buying my first home on my own - never once receiving government assistance, because I made too much money to qualify and some months, not even enough to live on.

I told him I knew exactly what he was talking about, that I could fill up a page on his legal pad with names of people I knew on welfare or capable persons receiving disability who have made a career mooching off the system, residing in supplemented housing and living and eating far better than my own family and driving brand new SUVs - and my husband and I work our butts off.

"But let's separate the apples from the oranges. I'm talking about a population of people who would do absolutely anything to be able to work, give back, and have a sense of independence, pride and accomplishment. People who desperately want to have just a taste of what the rest us us take for granted every day..."

So, today when I saw this image from The Arc of San Francisco, promoting supported employment through their We Can Do It program, I could not help but smile all the way through! It is absolutely, positively AWESOME and I LOVE IT!


09 August 2012

From The Arc NC: Lessons from the Western Highlands Network overruns

From The Arc of North Carolina

Lessons from the Western Highlands Network overruns

[ view original posting ]

The cost overruns at Western Highlands Network (WHN), the first LME to become an MCO under a new law, are a serious issue. The solution to these overruns that the state and WHN has come up with is clear: further service cuts. Hopefully, these overruns are just a bump in the road and not the light of an oncoming train, indicative of a system-wide underestimation of managed care cost. Most likely it will be somewhere in the middle.

We can only hope that people with disabilities will not be harmed further by these overruns than they already have been by the shift to managed care. The Arc hopes WHN survives these problems and succeeds for the sake of the individuals they are in the business of supporting.

Regardless of the reasons for the problem, the State, meaning both the Administration and the Legislature, should be paying close attention. Though we do not yet know the specifics that led to these overruns, several things should be perfectly clear:
  1. We need a real examination of the process. Regardless of why, no MCO should have such significant funding issues six months into operation. Some are understandably questioning the leadership of former CEO Arthor Carder, but it’s hard to believe anyone would question his commitment to the people WHN served, or the commitment of WHN’s staff. The fact that this MCO was allowed to go live without the tools to succeed is not only a mark on WHN, but more importantly a significant mark on the DHHS processes that deemed them ready.
  2. We should not only examine the process that led to these overruns, but the 1915(b)(c) waiver model as a whole. It is no secret that The Arc does not believe this model is appropriate for people with IDD. The issues with WHN should cause public officials to question the model as well. As WHN looks for places to cut Medicaid rates, it becomes clear that the system prevents them from even considering state operated facilities [state institutions] for reductions comparable to community services. Managed Care was sold to legislators, and the public, on the assumption of MCOs’ ability to effectively manage all public resources. Clearly, that was not true then, nor is it now. This disconnect makes the state’s difficult transition to a new model of care even more difficult. If the 1915(b)(c) managed care model works for community-based services it should also work for state-managed facilities. This issue is just one of many model design questions that must be questioned.
  3. State officials told the WHN Board that they should expect no additional state funds to make up for overruns. This begs the question: is the stated goal of “better access to services” just spin? When rate reductions, utilization reductions, and Medicaid paybacks are the primary tools used to eliminate deficits, it is difficult to take seriously that better access is a real goal. Better service access would more likely be achieved if the state were willing to adjust the capitation rate or infuse some money while WHN becomes better prepared to “manage.”

Though not enough details have been released yet to determine the specifics of the WHN overruns, we do know:
  1. The only way “savings” will be achieved through this managed care model is through cuts. That should be clear as we review the differences in what WHN was paid and what they have said they needed to provide services. We know that Medicaid cost must be controlled but an honest discussion of how managed care achieves this is critical if people will have faith in this system.
  2. The way “at risk” is used in this model is insulting to families, consumers and the people who provide the supports for them. Public MCO’s are not really “at risk” entities. They have raised no capital to fund their organizations; they receive generous administrative allocations separate from services funds, and have the ability to cut rates and services to consumers if they exceed budgets. Providers of services are the ones really at risk. With subjective decision making, constant rate reductions, no guaranteed “administrative” funds or excise payments to fund a MCO’s “risk” reserves, many providers will likely go out of business. Most importantly, people with disabilities and their families are the most at risk…at risk for another failed effort at reform jeopardizing their ability to live successful lives in the community.

06 August 2012

WRAL re NC MH Reform & Parent Info.

WRAL report re Managed Care and IDD, etc.
1 message


MaryKShort@aol.com <MaryKShort@aol.com>Sun, Aug 5, 2012 at 11:15 AM
To: MaryKShort@aol.com

FYI ... very well written and researched article by Mark Binker at WRAL.com.  I can see that there are a lot of good talking points to use when you contact your elected representatives to express your concerns or your experiences. 


In the article, a Ms. Laurie Haley is quoted:  Laurie Haley has seen ups and downs as North Carolina has slogged through mental health reform efforts over the past decade. For a three-year period from 2005 through 2008, she said, reform seemed to have worked for her daughter, Alissa. Other times, dealing with local and state mental health bureaucrats was more fraught.

That period of time covers the pre-Home Supports service definitions.  I happen to agree totally with her EXCEPT for the fact that it was at the end of 2007 and into early 2008 when the state first tried to implement the 40-hour limit!  I don't know if she was impacted by that at the time or if she even knows it is part of the Innovations waiver.  I have written the reporter to ask.

Mary K. Short
828-632-5888 or 704-451-4144 (cell)


Posted: 7:09 p.m. Friday (August 3, 2012) Updated: 12:11 a.m. yesterday

Patients, advocates wary as NC again reforms mental health system

By MARK BINKER, WRAL.com Multimedia Reporter


Raleigh, N.C. — North Carolina is in the midst of an effort to remake the state's public safety net for those with mental health, substance abuse and developmental disabilities.

Lawmakers, administrators and taxpayers want to see if the change to a "managed care" model can really save millions of dollars and avoid the over-spending debacles that marked the first system remake a decade ago.

At stake is how the North Carolina manages more than $2.4 billion in state and federal mental health dollars that flow through local mental health agencies, and how individuals with mental illness will live their lives every day.

"All I want to do is keep my daughter at home," said Laurie Haley.

For her, reforms success or failure will be measured by how it affects her daughter, Alissa. The 27-year-old woman has severe developmental disabilities and also suffers from seizures. Alissa needs help dressing, eating and taking care of other needs. Those who help her need to be able to administer medicine and prepared to act in case a seizure makes her fall in the shower or comes on her in public.

Haley says that she has, for now, ensured that the transition to managed care won't mean fewer services for her daughter. But she said other families making the switch are still encountering problems.

"What I'm hearing is that they're still trying to reduce services for people," Haley said.

That small-scale skepticism of the new system was amplified this summer when a blistering report said that one of the first local mental health authorities given permission to make the transition was not ready for the switch to managed care.

State and local mental health administrators say that one experience should not color the entire transition effort and that the system is on the road to improvement. Advocates, some who work providing services to clients and even some lawmakers say the process may be moving too fast. They worry that counties such as Wake and Durham, which have just begun the move toward managed care, could encounter the same mistakes and problems seen elsewhere.

...

[ There's much more... Read the Full Story on WRAL.com ]

And while statewide success will be measured in millions of dollars, Haley and others like her will measure it in terms of what it means for their loved ones.

"My daughter is not a disability, she's a human being with a disability," Haley said. "If I have the right to live at home and you have the right to live at home, she should too."

----------- more from Mary Short...

EXTRA:  Mercer Report link
2ND EXTRA:  Federal Report link and quote from that report

C. Health, Safety and Quality

Abuse, neglect, exploitation, the use of mechanical and chemical restraints, unexplained injuries and denial of services are far too prevalent in our current long-term system of services. CMS has made significant strides in holding states accountable for addressing health and safety issues in the 1915(c) Medicaid Home and Community Based Waiver program; but requirements governing program design, state monitoring and reporting to CMS have not been mandated for managed care programs approved under Section 1115 demonstration waivers or under the dual eligible pilot demonstrations.
3rd EXTRA:  Other news reports from Raleigh sources regarding other budget cuts and budget overruns

http://projects.newsobserver.com/under_the_dome/mental_health_office_needs_lots_of_work_consultant_says#storylink=cpy
Submitted  by lbonner on 2012-07-26 14:37
Under the Dome | mental health | N.C.  Department of Health and
Human Services | Western Highlands  Network

Last week, we wrote about a local mental health office that  covers
western North Carolina counties losing $3 million since switching  to
managed care in January.

A consultant's report issued this week  describes problems at Western
Highlands Network, one of the first local  mental heath offices to
convert to a managed care system.

Among other  things, the report says that the information Western
Highlands leaders  receive about services, use and costs is inadequate,
and that it is not  keeping good track of Medicaid claims.

The report goes on for nine pages.  In short, it says Western Highlands
needs lots of improvements, and the  consultant recommends close
monitoring by the state Department of Health and  Human Services.

Under managed care, the local mental health office gets a  set amount
of money to treat mentally ill patients who rely on Medicaid or  state
funds.

Western Highlands Network became a managed care  organization in
January. By next January, managed care organizations  for
government-paid mental health services will cover the entire  state.
And ... news article re WHN & Mercer Report is in it and easy to read!

31 July 2012

What's New in July

July 2012 Events and Updates.


30 July 2012

Labels are for Jars.

Received a mail recently from a dear ole friend of mine, Joe Genera, and thought it appropriate to share his wisdom regarding labels and the human experience... but first, a bit about Joe:

I first met Joe in biology class as a student at Wake Tech, way back before marriage, before Isabel, in a time when I was "young, wild and free" as they say... As my "right brain" has consistently proven to be far more developed than my left, I quickly aligned myself with a sciency-minded study partner, who happened to be Joe. Not only was he (and remains to be) among the most down-to-earth, likable  fellows I've ever met, he's also wise beyond his years and exceptionally intelligent (which made for an excellent choice in lab partners). We became fast friends, sharing many experiences and countless laughs together. I sometimes camped at his house as he was one of the only people I knew back in the days of floppy drives to own a personal computer; I hammered out many a Criminal Justice term paper in his home office in the wee hours of the morning. And he took me to my first theatrical performance - Cats - and opened my eyes (and soul) to a new way of thinking about the poetry of life...

Joe was a slightly older-than-me single dad back then of a beautiful, young active girl who most days drove a sporty teal-blue convertible Corvette - on other days, he drove a custom van outfitted with a lift.

You see, once upon a time Joe was a young ramble-rouser with an affinity for restoring old hot rods... One day, the unimaginable happened when a car slipped from the garage lift pinning Joe beneath and crushing his spine - forever changing life as he knew it. And yet he finished school, worked, raised a daughter, and is a successful business owner, fierce disability advocate and a soon-to-be published author.

(If you want to know anything else, you'll have to read the book, "Arrested Youth" for it's not my tale to tell.)

These days though, back in Connecticut, it is no surprise that he still uses his powers for good, operating an autobody repair shop and program called Team-MuscleCar, LLC: "'TEACHING TEENS - ONE HOT ROD AT A TIME' tm Mentoring to keep kids in school by having them use their hands and minds, and expanding their life skills."

----------- from Joe...

Crystal - just saw your post about labels - thought this might hit a cord with you. An Op-ED piece I did last month.

"LABELS ARE FOR JARS – NOT PEOPLE." – Joseph P. Genera

In the thirty years since a car slipped off a lift, falling six feet through the air before breaking my back as it crushed my spinal cord, I have gone through many life changes. Some, like adapting to a world from a suddenly shorter stature and navigating a bumpy world via a wheelchair, took some getting used to. Other changes, like how the world saw me, or more pointedly - labeled me as, has been one of the more challenging aspects to get used to.

In the three decades since my world so abruptly changed, I have gone from being a ‘cripple’ to a 'person with a disability', with about ten other labels in between. Not because I myself had made any significant changes, or had some miraculous healing come my way. No, the different labels arose from our American society deciding that one name was better, or more ‘politically-correct’, than another. And as with other minority groups, I was personally never asked myself what I would like to be called.

In my own lifetime, I have seen the currently 'P.C.' African-American named population referred to as colored, black, people of color, evolving to today's accepted 'African-Americans.' But, I don't remember there ever being a vote taken of that population, asking them what they as a people, would prefer.

In the case of the 55 million 'persons with disabilities’ in America, there has never been a caucus of any kind that has asked, "What would you like to be called?"

And yet, in the last thirty years I have been dubbed everything from crippled, infirm, afflicted, handicapped, handi-capable and differently-abled. I have been wheelchair-bound, as if I never leave the chair to bathe, sleep or love. One of my least favorite of all is to be branded as an ’invalid,’ which suggests that portions of society thinks that people such as myself are not considered valid members of our world.

Today, the favored phrase seems to be 'person with a disability.' If there has to be a label, this one is probably the least offensive, in that it at least puts the person before whatever condition or impairment that affects his or her life. While positive in nature, who knows how long this current term will be in favor before our polite world decides that I need to be called yet another unasked-for label. In fact, the ‘new and improved’ title that the national media seems to be trying to adapt today is the instantly dependent sounding label: ‘special needs population.’

No, no, no! People with disabilities do not want to be seen as special – they want to be seen as people, period. And they/we certainly do not want to be perceived as needy. As disability can affect any one of us at any time, with little consideration as to race, sex, religion or socioeconomic status, those who come up with these ‘titles’ should ask themselves – ‘If I were hit by a bus tomorrow and became paralyzed, would I want to be immediately affixed with the label ‘special needs person?’

In this country, much time, thought and energy go into defining what is politically correct, what words are best to use to ensure that the majority of a specific population is not offended, and so that the rest of society feels good for having come up with the next ‘right thing.’ Even within the ranks of the various disability groups, there is constant in-fighting as to what their own monikers should be. Energies and resources are wasted on such pursuits, when the time could be better used to improve the very real physical and psychological barriers that people with disabilities face every day.

No one wants to be offended, and most people with good sense do not want to offend. That’s the reason why everyone from the average person to the national media struggles with the question "What do we call 'those' people?"

I know exactly what I would say if I were ever polled, or had to vote for the very best label for the world to bestow upon me.

Just call me Joe. Thanks.

----------- my reply...

Dearest Joe, as long as I've known you - a lifetime it seems (I bought my first legal 6-pack with you if you recall [and much to my 21-year-old disappointment, was not even carded]), even back in pre-Isabel days when life for me was oh-so-much-easier though exceptionally less profound - I have never, ever thought of you as "disabled"... You??? LOL Not able to do something - outside of say a running long jump (which if this two of us were competing, you'd probably win truth be told) - preposterous! Pfft... And you know I am not saying this out of some misplaced need to defend myself regarding what I assume you to believe I think; I know you know me... My point is, you are among the most able and capable, intelligent and AMAZING human beings I have ever been blessed to know - who has yet once again, smacked my sensibilities upside the aha... reminding me of the absolute profundity of it all: human connection.

It's really all the same isn't it? There is not a one born among without purpose and no purpose is without importance, nor is one purpose greater than another... regardless of perceived 'ability', color spectrum, belief, education nor status. "Normalcy" indeed is a manmade definition to corral ourselves within our comfort zone. --Until we each recognize these truths within ourselves and step outside of our own limitations, we are doomed to remain ourselves "disabled."

I never imagined I would have another child after Isabel. When Liam came along, it was like being a first time parent all over again; a whole different ballgame! --As he grew and began to become aware of his world, talk and ask questions (OMG, does he talk!), he would ask me why sissy didn't speak or why she does things that she does... I tried to explain to him once that Isabel was "special"... I thought that explanation was a pretty good one and seemed to quiet his curiosities (I should have known better). The next days he came to me crying and told me that he wanted to be "special" too. --From the mouths of babes! Oh, talk about breaking your heart! ...So we had a long talk about purpose and God and how Isabel is as God intended for her to be; that while we may never know her intended purpose for this world, the fact that she does not speak verbally and doesn't think the same way we do was part of her purpose and that purpose was very important... That just maybe her purpose was to teach us to be better people and understand how to love everyone the same?

I have always made a conscious effort to never describe someone by their abilities, ethnicity, etc. because I did not want to plant the seed in his thinking that these things were a measure of an individual. --About a year ago, when Liam was four, it came home to me in such a profound way when he came home from preschool telling us about his new friend, "Johnny"... Who is Johnny we asked, trying to put a face with a name? You know, he said, the boy with the super-hero eyes - and then he put his fingers on each temple by his eyes and pulled back the skin to show us... (Johnny's parent's are of asian decent.) To Liam, his new friend was nothing short of a rock star. =)

Joe: In this world, in this life, we tend to get stuck so often in the gravity of ourselves, our own lives, problems, issues and goings on; I am no less guilty. Though I try to make certain that those sacred souls in my life always know how much I love them, that they have mattered to me in magical ways, and I could not have made it this far without them... You are one of those sacred souls - I know I don't say it often enough... so, just to reiterate: Not only have you shaped me in ways you will probably never know in all the years, but I love you dearly.

Thank you for your words dear one...

----------- from Joe...

Absolutely! And please know that was in no way a rebuke of any kind to you ...at all! I just love reading your posts, personal and the NC ones and thought it might fit... And it does, cuz of who you are!

I am so glad you came and asked about my motorcycle 20 years ago. I love you too Crystal

P.S. And of course you can post!

27 July 2012

I/DD Budget Cuts May Be Worse than Expected

From The Arc of North Carolina

I/DD Budget Cuts May Be Worse than Expected

[ original post here ]

In what is being described as a mistake, a budget transfer intended to move Guardianship funding from one division to another has created an additional 4.3 million dollar cut primarily to community services for people with I/DD.

Department officials and legislative leadership agreed to transfer $4.3 million in the Social Services block grant from the Division of MHDDSA to the Division of Social Services. The money was to be used by either Corporate Guardians or local DSS to provide guardianship services. The transfer was needed because, as LMEs transfer to MCOs, they will no longer be allowed to be guardian for individuals in their catchment areas.

Somehow the transfer of funding happened twice causing an additional cut of 4.3 million dollars to MHDDSA community services funding. Department officials tell us that this was never the intent and discussions with legislative staff point to a mistake, although we have no official confirmation. Unfortunately, the reduction has been included in the allocations to LME/MCO’s and several are taking immediate action to cut services. We are hearing reports that some programs face 20% reductions effective August 1st.

The Arc is calling on the DHHS to ask LME/MCO’s to hold off on implementing this reduction until all possibilities of fixing the problem have been exhausted. This reduction to an already fragile system is unwarranted and will harm individuals with I/DD.

The Arc is also concerned about how LME/MCO’s are implementing the one time $20 million reduction to community services. This cut is an extension of a reduction taken last year. While LME/MCO’s were encouraged to use fund balances to offset this reduction last year, we do not believe most did so. We are seeing a disturbing trend that has LME/ MCO’s passing on this entire cut to people with disabilities and their families. We believe a more responsive approach would be for LME/MCO’s to use fund balances to offset this reduction since it is a non-recurring cut. It does not seem appropriate for the Management Entities, who are charged with ensuring individuals have services, to use fund balances to become MCOs while the people they are created to serve lose services.

We will be tracking these reductions and will continue to encourage the State and LME/MCO’s to find alternatives to wholesale reductions for people with disabilities and their families.

Once we determine what steps the DHHS plans on taking, we will issue an action alert describing what actions people with disabilities and their families should take, if any, to influence these changes.

Related : 

26 July 2012

First LME to become MCO Facing Budget Overruns

From The Arc of North Carolina

First LME to become MCO Facing Budget Overruns

[ view original article ]

Western Highlands Network (WHN), the Managed Care Organization (MCO) that provides state funded services to people with intellectual and developmental disabilities (I/DD) in several western counties, recently reported that they are running a monthly defecit of $500,000 since they became a managed care organization in January 2012. WHN officials indicate they feel the State’s original capitation (reimbursemnt) rate was insufficient to cover the Medicaid cost of their program.

When questioned by members of the Disability Waiver Advisory Committee on July 24th, State officials responded that the budget deficit had been uncovered in a routine monitoring visit and that they would be attending the upcoming WHN board meeting. They offered no further explanation.

Apparently the State, along with the Mercer consulting firm, reviewed WHN in mid -July to determine what was causing the cost overruns. At this time, we do not have the results of this review, but we will report as we find more details.

The revelation of these cost overruns is concerning on many levels. Most importantly, we are concerned WHN will be forced to make significant cuts to services in an area that already has significant numbers of people with I/DD waiting for services. To correct this deficit, WHN plans to evaluate rates paid to providers and the amount of service provided to consumers. If this problem results in service reductions, it will be further evidence that Managed Care “savings” are really just another name for “cuts.”

If the capitation rate is too low, as WHN claims, and the state adjust it upwards, it will erode the “savings” North Carolina hopes to gain from the implementation of the Managed Care Waiver. Such a development would call into question why we would make such a massive change for little gain.

Another concern is how the state deems a MCO ready to proceed. According to state officials, all pending MCOs pass rigorous tests to assure that they are ready to go “live” as a managed care entity. The State contracts with Mercer to engage in this process, as do state officials charged with implementing the Waiver. If WHN was really ready to go “live” in January, it is hard to believe they could be losing money at such a pace.

The Arc believes the WHN staff and DHHS staff are sincerely attempting to find solutions to this serious problem. We hope that this issue is only temporary and that services will not be disrupted to the people this complicated system is intended to serve. However, we do believe this issue should prompt the DHHS and the General Assembly to truly examine the model and pace of this implementation. In an at risk Managed Care system, the only people truly at risk are the people it is intended to serve.

This is What it's ALL About Folks... from Tampa Bay Times

Twins bond in the gift of the other: Hailey is there for Olivia, born with epilepsy and cerebral palsy

By Rebecca Catalanello, Times Staff Writer
Published Friday, July 13, 2012

[ see original Tampa Bay Times article & video clip ]

CLEARWATER

It was just after the 2 p.m. opening time and already Hailey Scheinman's lemonade stand had attracted a crowd.

The 7-year-old turned around to brush the sleep from her twin sister's eye. Olivia sat quietly in a hot pink wheelchair that was decorated with flowers and butterflies.

Hailey's best friend arrived to help, and the pair jumped up and down at the end of the driveway.

"Lemonade! Lemonade!"

Hailey's friend said goodbye a couple of hours later, and Hailey stood at the edge of the driveway watching the girl's car disappear down the street.

Hailey retreated to the front porch and counted the profits: $142.65, all for her sister's physical therapy.

What makes a good sister?

In the womb, Olivia and Hailey Scheinman formed to the thump of the same heartbeat. Cells divided and organs sprouted, skin and hair knitted together while fluids swirled. Their mother rocked them with her every step.

For reasons no one knows, something didn't proceed normally for Olivia. During the first trimester, her brain didn't form the way it should, the way her twin sister's did.

Her body shook with seizures shortly after birth. At first, doctors diagnosed her with Ohtahara Syndrome, a neurological condition that comes with a high incidence of infantile death. Later, they reassessed, calling what she has multifocal partial epilepsy and cerebral palsy. She has undergone two major brain surgeries and takes a laundry list of drugs to control what Hailey calls "the shakies."

For seven years, life has relentlessly pulled Hailey and Olivia apart — milestone by milestone.

Hailey walked at 11 months, talked at 15 months, kicked her first soccer ball at 5. At 7, Olivia cannot stand and struggles to hold her head up. She smiles when she's happy, but she cannot say it. For years, Olivia's progress has been measured hour by hour, with each letter "S" her mother scribbles on calendars when she has a seizure.

It wouldn't be hard to imagine a scenario in which the trajectory of the sisters' lives simply continues to diverge. But something in Hailey has resisted that. She seems determined not to lose her grip on the being to whom she is closest in the world. Her mom thinks that because of Hailey's efforts, the sisters are closer now than ever.

What makes a good sister?

Hailey Scheinman doesn't have the answer. She's 7.

Hailey Scheinman is the answer.

• • •

It was the week before Mother's Day at Leila Davis Elementary, and the first-graders fidgeted and laughed, many of them sitting "crisscross" on the floor as their teacher had instructed. Hailey was one of them.

Two little girls in wheelchairs appeared on a video screen.

"Hi, Livy!" Hailey waved to the screen. Her teacher called on Hailey to read the first few pages of My Mom to Olivia's class at Paul B. Stephens Exceptional Student Education Center via Skype.

"She's nice, my mom," Hailey read aloud, her head tucked into the hardbound library book. "My mom's a fantastic cook. And a brilliant juggler."

She turned the book toward the videocamera so her sister could see the illustrations.

Ms. Davis called on someone else to read. Hailey took her seat among the other students.

On the screen, a teacher's aide fed Livy PediaSure through a tube connected to her stomach.

• • •

Two rooms. One lavender-painted wall separating them.

On one side, dolls and miniature furniture fill a three-story dollhouse. Children's books cram a bookshelf. Figurines pose around a Harry Potter Lego castle. Family photos, soccer trophies and achievement medals sit on tables and hang on walls. Fairy stickers and butterflies are everywhere.

On the other side of the wall, a red-wheeled mechanical lift is positioned beside a massage table turned changing table. A video baby monitor hangs above the comfy full-sized bed, which is pushed into a corner for safety.

Butterflies adorn this room, too, including a butterfly-shaped pinata from one of the girls' birthday parties. Two plaques from Lampert's Therapy Group hanging above the changing table describe Livy as a "brave child" for her hard work completing two rounds of three-week-long intensive therapy.

One night in March, Allison Scheinman dressed her daughter Livy in soft cotton pajamas that read "Sweet Dreams" across the top. She leaned across the massage table to squeeze a stuffed glow worm that lit up and played Hush, Little Baby. She brushed her daughter's hair, wet from the bath, then lifted her to a sitting position. Livy smiled.

Hailey flitted in and out, wearing a lavender nightgown. When her mom asked her to fetch the "good stuff," Hailey ran to the bathroom to get her sister's toothbrush and toothpaste.

If it were up to Hailey, these two rooms would be one. They'd have sleepovers every night.

But Livy doesn't sleep well through the night, so her parents have told Hailey no. "Maybe one day," her mom has said.

Allison deposited Livy on Hailey's bed. Hailey sat at the edge and searched for her journal.

"Hailey, what are you going to write about?" Allison asked on her way out.

"You'll see," Hailey answered.

In the quiet of the dimly lit room, Hailey hunched over her paper.

After a few minutes of silence, she leaned back to lie next to her sister and raised her journal for Livy to see.

"I just wrote this in cursive for you," Hailey said.

You are the best Livy, it said. Love, Hailey

"And I wrote it in cursive."

Earlier that day, Allison, 37, steered her silver Chrysler Town & Country minivan up U.S. 19 toward her in-laws' vacation home in Clearwater to pick up Hailey.

Livy was strapped in the back of the van, worn out after a therapy session, from moving her body in ways her mom once doubted she ever could.

"I've always wanted to stop things with Livy," Allison said.

Meanwhile, her sister is charging forward into life. "With Hailey, we're like, 'Where's your stop button?' "

"With Livy," Allison said, "I don't want to see the future just yet because I don't know what to expect with it. With Hailey, I want to see her grow and go on to college and get married and have kids. I don't ever want to stop and think about Livy's future. She's not going to grow up and get married. She's not going to have children. We just have to imagine her the way she is."

• • •

Hailey Madison Scheinman was born at Bayfront Medical Center in St. Petersburg on Dec. 15, 2004, weighing 6 pounds 5 ounces, after 12 hours of labor. Nurses showed her to her parents — Allison, a graphic artist with a love of books and theater, and Jon, a lifelong soccer player who worked in finance at HSN — then ushered her to the nursery while her mother labored another hour more.

Four hours later, Olivia Hope Scheinman, 6 pounds 11 ounces, looked up at her father from a crib in the Neonatal Intensive Care Unit at All Children's Hospital in St. Petersburg.

He watched her body shake in her first documented grand mal seizure.

• • •

Twenty-two days later, at home with Olivia for the first time, Jon wanted to be excited. But his videocamera was still.

No one spoke.

Cradled in her grandmother's arms, Olivia's body curled in an infant-sized abdominal crunch.

Crunch. Crunch. Crunch.

Within hours, Olivia was readmitted to All Children's with infantile spasms.

• • •

Eleven-month-old Hailey wobbled excitedly across the living room floor toward her daddy, her hands raised in the air, her mouth open in glee.

Jon's camera captured the steps, then he panned to Livy resting across his lap. Her eyes flickered uncontrollably in what family calls her "blinkies."

• • •

First Christian Preschool teacher Cherryl Sonnenberg couldn't help but overhear the lunch table conversation between two 5-year-olds.

"Does your brother walk?" Hailey asked.

"No," the boy replied. "He doesn't walk."

"I have a sister, Livy, who can't walk. But she rides in a chair," Hailey said. "Does your brother ride in a chair?"

"Yes," the boy said.

"Does your brother eat by himself?"

"No."

"My sister doesn't either."

• • •

Every day before she went to preschool, Hailey slurped down PediaSure in a cup.

She called it her "Livy Shake."

• • •

The kindergartener glued herself to the kitchen stool, repeatedly clicking "refresh" on her parents' laptop computer.

Click. Click. Click.

Her painting had to sell.

Two pink flowers. Two pink ladybugs. One ant hill. One butterfly.

Hailey had titled it Spring Is Coming, and now she was trying to sell it on eBay.

Click. Nothing. Click. Nothing.

Allison and Jon stood by, unsure what to do.

Click.

Five dollars.

Five dollars! Hailey went berserk.

Three days later, Spring Is Coming sold for $66.

Hailey gave the money to her parents to help with Livy's physical therapy bills.

• • •

On a Saturday morning early this year, Livy started having a seizure while napping on the couch.

"Mom," Hailey said as her parents approached, "I can take care of this."

The little girl knelt beside her sister's outstretched body, looked into her face, stroked her forehead with her thumb and held Livy's hand.

Three days later, the Pinellas County School Board had been meeting for 50 minutes before someone nudged Hailey. She left her sister's side, walked to the lectern and stood beside her principal.

"Hailey truly loves her twin sister Olivia," a school district employee told the board. "That is evident in the compassion and pride that she shows in introducing Olivia, who is a special needs child attending Paul B. Stephens School."

Hailey reached up to shake seven hands, School Board members happy to recognize her as a "Young Hero," an award given to students who inspire others.

• • •

Allison pushed Livy's wheelchair through the grass toward Hailey's soccer game. A shamrock garland wound around Livy's chair glimmered in the sunlight — a remnant of the St. Patrick's Day parade teachers held at her school that day.

Hailey saw her best friend, Ainsley Walling, with the rest of their team and ran toward them.

Jon squeezed into a sideline spot among the other parents and set up Livy's blue and white bath chair, which she sometimes uses instead of her wheelchair. For years, Hailey and Livy bathed together, Hailey tucking her legs underneath this very chair. But Livy's legs are longer now, and there's no room left for Hailey.

"Go, Hailey!" Ainsley's mom, Tracey Walling, called from the sidelines as Hailey ran the ball up the field.

Ainsley and Hailey had spent all day in class together and now they were going to spend all night playing together — first on the soccer field, and then at Hailey's house for her first official sleepover.

The two red-faced girls hugged when the game ended. They held hands on the way to the Scheinmans' van, with Livy, Allison and Jon following behind. They laughed as Ainsley shuffled up and down the handicapped ramp after Livy was loaded in.

"Before Jon slid the van door closed, a giggling Ainsley called out from the backseat.

"Can me and Hailey get in the shower together?"

"No," Jon said with a laugh. "I think you'll be taking separate showers."

• • •

In June, Hailey stood beside Livy at an Orlando conference for families of children with disabilities.

"No," Hailey said, holding a microphone in one hand and her note cards in another. "I don't remember what it was like with Livy when I was little. But I can tell you how it is now. First, Livy and I like to cuddle together on the couch. It seems like she is trying to push me off because her arm is pushing against me. I don't think she means it though . . .

"And I would like to tell you about how I feel about having a sister with disabilities. I like to spend a lot of time at home with my sister. We've never had a fight over toys or clothes or anything else. She's always nice to me. I know this because she always smiles at me.

"Sometimes, she tickles me by accident. She always listens to me and she likes my singing . . .

"If Livy didn't have disabilities, I wouldn't be here speaking to you now. I wouldn't know anything about disabilities, and neither would my friends . . .

"She has taught me that everyone should be treated equally and with respect. The only thing she sees in the world is good and so do I. She has taught me how to have more empathy to others. She has taught me how to be a better person."

• • •

In late February, shortly after Hailey won the award from the School Board, Jon got the girls together and read Hailey a thank-you note he'd written for the family's blog, one he imagined Livy might give her sister if she could speak or write.

"To my sister, my best friend, and my biggest supporter . . . you amaze me. You protect me, comfort me and love me like no other. You include me in all that you do and look past my disabilities. You are so proud of me and are not afraid to tell others my story . . .

"You visit me in the hospital when I am sick. You are not afraid of the medical equipment and procedures I have to go through. You console me when I am upset or in pain. When my body doesn't work like it should, you are there to assist me . . .

"I couldn't do this without you. I may never be able to walk or talk, but you make me feel like I can do anything. You frequently tell me I am the best sister in the world. But it is I who could not imagine a better sister than you."

When her father had finished reading, Hailey wrapped her arms around Livy.

"You are the best sister in the world," she said.

Rebecca Catalanello can be reached at rcatalanello@tampabay.com or (727) 893-8707.


To learn more about twins Olivia and Hailey Scheinman, visit links.tampabay.com to view an audio slide show and family videos. Also see the family's website, livyshope.com, to learn more about Hailey's artwork, jewelry and lemonade stands to benefit her sister's therapy costs.