Showing posts with label news. Show all posts
Showing posts with label news. Show all posts

04 June 2013

The Lost Art of LISTENING.

Before I launch into what will probably be my last post (though don't hold me to it), I want to introduce you to Raleigh Attorney Knicole C. Emanuel with Williams Mullen and her most excellently well written and legally sound Medicaid law blog. In my humble opinion, anyone who can so eloquently and factually draw a strong comparison and contrast between Shakespeare's "MidSummer's Night Dream" and the Medicaid providers' prepayment nightmare is nothing short of a poetic knight in shining armor (yes, chicks can be knights too - why not?)

Now, on with the show...

So, people keep asking where I've gone? Commenting that they've not heard much from me lately... Well, the truth is, that while I have been known to talk to myself on occation, there are some conversations that really need a active partner for successful dialogue. 

Frankly, I'm all talked out at the moment.

American author and journalist, Ernest Hemmingway was quoted as saying, "I like to listen. I have learned a great deal from listening carefully. Most people never listen."

Stephen R. Covey, author of The 7 Habits of Highly Effective People: Lessons in Personal Change said, "Most people do not listen with the intent to understand; they listen with the intent to reply.” 

Therein lies the problem. Nobody's listening.

Everyone has something to say in this Medicaid quagmire - the MCO's and LME's have plenty to say, providers have even more to say, DHHS and DMA have their say, facilities and group homes have something to say, advocacy groups keep trying to have their say, consultants and lobbyists get paid the big bucks to keep saying stuff, and members of the North Carolina General Assembly always seem to have the final say... and don't even get me started on the recipients and their family members that most everyone seems to conveniently forget in all this. 

Nobody can keep the stories straight, not even (and often, especially) the media, becasue it appears the right hand doesn't know what the left hand is doing while everybody's busy with their own personal diatribes and ass-saving.

Everybody's talking but nobody's listening.

Nevermind all of the asinine bureaucratic dynamics at play in the dirty politics of the NC Medicaid system - the inappropriate friendships, roles, relationships, mothers / daughters / board members, ethical conflicts of interest, and who's scratching who's back. Yep, we know about all that.

There are way too many egos on the line here (not to mention the obscene amount of money invested), meanwhile we continue to rearrange the deck chairs on the Titanic while ignoring the real issues of human concious. That's right, I said it again.

I find that this is especially true of the current political climate in North Carolina... For the first time in just over 100 years, the Republican party has finally won back the driver's seat and they seem to be hell-bent on making up for lost time with issues far more "important" than the welfare of our state's most vulnerable citizens, with such utter nonsense as nipples, fracking, abortion / right to choose, ending size limits for K-3 public school classrooms, teaching about abortion risks in public schools while lifting smoking bans on college campuses, imposing rediculous voting restrictions and flat out denying many the right to vote, slashing unemployment benefits, requiring a 2 year waiting period prior to divorce (ironically dubbed the Healthy Marriage Act), vain attempts to negate the first amendment with a state religion, and arresting peaceful protestors, among other idiocy. 

Handbasket anyone?

What with all that debauchery going on, who has time to worry about the threat of homelessness to residents of NC group home facilities (yet again)? Or whether developmentally delayed recipients and their tired-ass exhausted families have the resources to make it through yet another day, or even if they do - if they are actually receiving the services they are entitled through all this slimey red tape? 

I mean really? Who cares? We're such a small minority of the State's population when compared with the number of citizens who have nipples, for Christ's sake.

And speaking of Christ... Conservative politicians love to use the Bible as a platform and foundation for their arguments and justifications and while I've been known to agree with certain positions, it should be noted that countless infamous American psychopaths (Charles Manson, Jim Jones, Fred Phelps, etc.) have also used the good book as sources of inspiration and justification... just sayin'.

My Christ is not wrathful nor boastful, not judgmental nor unknind, and is not dis-compassionate nor cruel toward fellow man nor the world we live in. In the documented lifetime of Jesus, he exhibited love and compassion to all, even those who sought to destroy him and especially for those who could not do for themselves. 

I believe Christ to be alive in the very essence of our collective being, our hearts if you will, a state of mind we all should strive toward. --A perpetual state of love and forgiveness... a state of grace and joy I witness every single day in my own special daughter, Isabel, and her special peers. 

Where the hell are our priorities?

It's way past time for the North Carolina "powers that be" to start listening more to the people, their constituents and voting public, who must live with, and at times suffer from, the repercussions of their actions and decisions. 

You do NOT know what is best for me and mine; that, I can guarantee you. And I'm certainly not in the minority there.

Perhaps if everyone suddenly, miraculously began to listen more, really listen, and made an honest attempt at understanding one another, as I believe the late Steve Jordan had hoped, we wouldn't require knights in shining armor to mitigate such a shameful Comedy of Errors... though sadly, nothing seems to grab attention these days (and further waste taxpayer dollars) quite like a good ole American law suit, eh?

Hang in there folks.

28 February 2013

What's New in January & February?


January and February 2013 news, events, and updates.

February
January

01 December 2012

Weekly Update from Alliance BHC


Here is the link for this week's Alliance newsletter - http://www.alliancebhc.org/wp-content/uploads/November-30-2012.pdf

...and here are a few highlights to note:

1. Alliance Announces MCO Delay
Alliance has submitted a request to NC DHHS for a 30-day delay in its start date as a managed care organization responsible for the implementation of the Medicaid 1915 (b)/(c) waivers. The new start date will be February 1, 2013. To access a press release, click:  http://www.alliancebhc.org/news/alliance-announces-delay-in-managed-care-implementation

Cumberland and Johnston Timetable
Alliance will initiate management of IPRS and locally-funded services for Cumberland County on December 17. The start date for Johnston County has been shifted to January 1.

2.  NC Innovations Individual and Family Guide
The Alliance NC Innovations Individual and Family Guide 2013 is available in English and Spanish on the Alliance website. To access these and other NC Innovations information and resources, click:

3. Innovations Plus Community Forum
Alliance Behavioral Healthcare is working with the NC Department of Health and Human Services to improve the system of services offered to people with intellectual and other developmental disabilities who have CAP-I/DD now and will transition to the NC Innovations 1915(c) waiver in early 2013. The goal of this program is to create a fairer system and to ensure that people get the right amount of supports for their needs.

Thursday, December 13, 2012, 6:00-7:30pm
Alliance Corporate Office, 4600 Emperor Boulevard Room 105, Durham

To learn more about Innovations Plus, please join us at this meeting.  Alliance and DHHS staff will make presentations along with guest speakers from the Human Services Research Institute, which is assisting us with the program. For additional information, contact your I/DD Care Coordinator or Suzanne Goerger at (919) 651-8474.

4. ...and as always, check out the newsletter for calendar dates of Alliance CFAC meetings and are listed below for your convenience, too:

Alliance CFAC Meetings
    Alliance Corporate Office 4600 Emperor Boulevard Durham
    First Monday in February, April, June, August, October and December at 5:30pm

Alliance Durham CFAC Subcommittee Meetings
TROSA 1820 James Street Durham
First Monday in January, March, May, July, September and November at 5:30pm

Alliance Wake CFAC Subcommittee Meetings
401 E. Whitaker Mill Road Raleigh
Second Tuesday in January, March, May, July, September and November at 5:30pm

Hope to see you THIS Monday at Alliance CFAC meeting at 6400 Emperor Blvd in Durham at 5:30pm!

23 October 2012

An Open Letter to Ann Coulter & then some...

Personally, I take no issue with conservatives, generally speaking, nor do I take issue with liberal thinking - everything in moderation as they say. Most of us have sound wisdom and skills worthy of contribution to the world... Just think what we could all accomplish together if we stopped the ridiculous power-plays and political tangos we engage ourselves in tirelessly - time, energy, and resources that, if spent wisely and consciously, could ease the suffering of so many on this earth and in this very country - in our own communities - if we'd just stop trying to force our own ideals, beliefs, and way of life upon others... Though apparently, being self-righteous is a slippery slope - and a long fall off the proverbial turnip truck.

I am rarely a soul of few words and yes I have much I would like to say in response to Ann Coulter's vile remark, "I highly approve of Romney's decision to be kind and gentle to the retard."

Really Ann? You had to go there? Could you think of no sharper dagger to poke into the gentlest hearts of mankind? And you think this strengthens your platform or lends credibility to your cause? I'm pretty sure even your beloved Republicans are sickened by your cruel thoughtlessness too, at least they should be. Because, regardless of what side of the political fence you ride, there is absolutely NO EXCUSE for your hateful comment. It's not the President you hurt with your idiocy. You just spat in the face of millions... Millions who are much stronger than you. 

Millions who love and know love like you only dream of.

Shame, shame on you Ann Coulter.

I could go on... But I could not say anything any better than Mr. John Franklin Stephens.
Thank you Mr. Stephens. You do us proud.

-----------


An Open Letter to Ann Coulter
Posted on October 23, 2012 by Tim Shriver


The following is a guest post in the form of an open letter from Special Olympics athlete and global messenger John Franklin Stephens to Ann Coulter after this tweet during last night’s Presidential debate.

Dear Ann Coulter,

Come on Ms. Coulter, you aren’t dumb and you aren’t shallow. So why are you continually using a word like the R-word as an insult?

I’m a 30 year old man with Down syndrome who has struggled with the public’s perception that an intellectual disability means that I am dumb and shallow. I am not either of those things, but I do process information more slowly than the rest of you. In fact it has taken me all day to figure out how to respond to your use of the R-word last night.

I thought first of asking whether you meant to describe the President as someone who was bullied as a child by people like you, but rose above it to find a way to succeed in life as many of my fellow Special Olympians have.

Then I wondered if you meant to describe him as someone who has to struggle to be thoughtful about everything he says, as everyone else races from one snarkey sound bite to the next.

Finally, I wondered if you meant to degrade him as someone who is likely to receive bad health care, live in low grade housing with very little income and still manages to see life as a wonderful gift.

Because, Ms. Coulter, that is who we are – and much, much more.

After I saw your tweet, I realized you just wanted to belittle the President by linking him to people like me. You assumed that people would understand and accept that being linked to someone like me is an insult and you assumed you could get away with it and still appear on TV.

I have to wonder if you considered other hateful words but recoiled from the backlash.

Well, Ms. Coulter, you, and society, need to learn that being compared to people like me should be considered a badge of honor.

No one overcomes more than we do and still loves life so much.

Come join us someday at Special Olympics. See if you can walk away with your heart unchanged.

A friend you haven’t made yet, John Franklin Stephens
Global Messenger
Special Olympics Virginia

EDITOR’S NOTE: John has previously written powerful opinion pieces on the R-word. Read one here.

31 August 2012

What's New in August

August 2012 news, events, and updates.


23 August 2012

NC DHHS, US DOJ Reach Agreement on Community Based Care for Only Citizens with Serious Mental Illness

From The Arc of North Carolina

Breaking: NC DHHS, US DOJ Reach Agreement on Community Based Care for Only Citizens with Serious Mental Illness

[ view release at arcnc.org ]

Press Release from NC Dept. of Health & Human Services:

Raleigh — The North Carolina Department of Health and Human Services and the United States Department of Justice today reached an agreement on the state’s plan to offer more choices of where and how citizens with serious mental illness receive care and supportive services.

The plan, which was announced last month, will create housing slots in the community to offer the choice of community-based care for many adults with serious mental illness. It will also invest in job training and employment assistance for those citizens and will set up a comprehensive, 24/7 crisis care program for people with a serious mental illness.

This agreement will modernize our mental health system and ensure that North Carolina is providing the best possible treatment for adults diagnosed with severe mental illness. It will also provide the opportunity for many of these individuals to live in community settings if they choose to do so, and ensure that North Carolina is fully complying with the Americans with Disabilities Act and other federal laws.

This agreement is similar to ones signed by governors of a number of other states including, among others, the governors of Virginia and Georgia.

DHHS Secretary Al Delia agrees that more should be done to ensure access to community-based treatment for those with mental illness. “North Carolinians who have a serious mental illness have a right to choose the very best care environment to meet their personal needs,” he said. “That choice – whether they live in the community or in an adult care home – will be supported with access to mental health and other support services that will be available in part due to this agreement. Moving forward with a solution to help them identify and access those choices is the right thing to do,” he said.

“Disability Rights NC applauds the Governor and Secretary Delia for their leadership on this matter. They have not only done the right thing to protect the rights of people with disabilities, they have helped the state avoid costly litigation and destabilizing uncertainty,” said Vicki Smith, executive director of Disability Rights NC.

The agreement outlines DHHS’s plan of action to provide community-based services to people with mental illness. The budget the General Assembly passed in July expressly contemplated a settlement and appropriated funding to make this agreement possible. The timeline for completing the plan is eight years; this transition period will enable people who want to move to community-based settings to do so on a workable timetable and will allow sufficient time for North Carolina’s mental health infrastructure to implement this agreement.

# # #

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.


26 July 2012

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.

news : Adult care home plan for NC under way

APNewsBreak: Adult care home plan for NC under way
By GARY D. ROBERTSON - Associated Press

[ read at News and Observer ]

RALEIGH, N.C. --

North Carolina's state health agency is moving ahead with the first step of a multi-year plan to help move potentially thousands of mentally ill residents from adult care homes to affordable housing and less restrictive living conditions.

The state Department of Health and Human Services publicized Thursday the action plan, which responds to allegations made a year ago by the U.S. Department of Justice that the state was failing to comply with the Americans with Disabilities Act. The government threatened to sue unless improvements were made.

The plan is a calculated risk for state officials because federal attorneys haven't told them whether it's enough to avoid litigation. That could require a judge-approved agreement with the federal government that may be more rigorous and expensive to carry out.

Government lawyers said in July 2011 that thousands of people with mental illness were segregated from society in adult care homes that had essentially become mental health treatment centers without giving them access to community treatment.

The plan, which will cost $10.3 million this fiscal year, will begin moving at least 100 residents with severe mental illness outside the homes to other community housing. Based on their income and ability to function, the displaced residents also will get help with paying rent, job training and potential employment.

The eight-year plan, which could cost a total of $67 million, would work to create 3,000 "slots" for people seeking a full slate of community services, acting HHS Secretary Al Delia said. The number of people that move could be much more because not everyone will need all of the offered services, Delia said.

Those who want to stay in adult care homes can remain there, he told The Associated Press.

"People will have choice," Delia said in an interview. "They will not be required to live in any one place, whether it's in a facility or in the community."


The General Assembly set aside money in this year's budget to begin the transition, which has been the subject of months of talks with the Department of Justice. Delia described HHS and the federal government agreeing largely on the improvements being made.

HHS is "moving forward on implementation because we believe that it's the right policy," Delia said.

Vicki Smith with Disability Rights North Carolina, the group that leveled the 2010 complaint, said the plan sounds good on the surface but lacks a method to require the state to carry out the plan completely. Smith pointed out there's less than six months before Gov. Beverly Perdue leaves office and another administration arrives.

"Many of the people who are issuing these promises will not be around even at the end of the first year to ensure implementation," said Smith, adding that the state has fallen short of expectations in the past when it comes to mental health treatment.

"I just don't think people with mental illness can recover from another failed promise," Smith said.

The department said it still doesn't have an accurate count of the number of mentally ill residents in homes. DOJ wrote in July 2011 that 5,800 people with mental illness live at 288 adult care homes with at least 20 beds where people with mental illness comprise at least 10 percent of the population.

The action plan is one solution to deal with intertwined legal and government challenges involving North Carolina's adult care homes, whose residents include people with chronic health problems, Alzheimer's disease or mental illness. The homes don't have medically intensive services that are found in nursing homes.

The state budget also set aside another $40 million in part to provide assistance to adult care homes that aren't expected to receive some Medicaid reimbursements when a streamlined policy for personal care services goes into effect soon.

The plan's unveiling came on the 22nd anniversary of the signing of the Americans with Disabilities Act. The 2010 complaint by Disability Rights North Carolina also was filed on Thursday's date.

19 July 2012

N&O: LME Money Woes

Money woes snag mental-health center

Published Wed, Jul 18, 2012 09:38 PM
By Lynn Bonner - lbonner@newsobserver.com
The News and Observer

[ original article ]

The state’s latest plan for community mental health services has gotten off to a bad start with the first local mental health office to become a managed-care agency falling into a $3 million financial hole in its first six months of operation.

Western Highlands Network, which covers eight counties including Buncombe and Rutherford, is working with the state Department of Health and Human Services on a plan to correct the money problems that started the first day it became a managed-care agency in January.

The changes may involve reducing some mental health treatments the office believes are excessive, telling service providers to return money for services that were not approved, and enforcing rules for providers filing payment claims.

The experiences in the west are significant because, under a new state law, all government-paid mental health services in the state will be handled the way they are in Western Highlands. Advocates for people with disabilities are skeptical that the new system will work, and they worry consumers will be the losers.

Last year, the legislature passed a law that requires all local mental health offices to convert to managed-care agencies by January 2013, copying a system started in the state in 2005 by Piedmont Behavioral Health, a local mental health office now called PBH.

As managed-care agencies, the local mental health offices’ relationships with the state, mentally ill people in their coverage areas, and providers will change significantly. Each local office will be given a set amount of Medicaid and state money to treat patients. If they spend too much, they have to cover the costs. Local offices that save money can spend it on more Medicaid mental-health services.

Though the local offices take on financial risks, they also have more control. Under managed care, they will say which providers will treat patients in the region and what kinds of treatment – and how much government-paid mental-health treatment patients receive.

Choice and uniformity

This is the biggest change to mental-health services in the state in more than a decade. In 2001, the state told local offices to stop offering treatment in favor of having patients seek out private providers. The intent was to give patients more choice and foster uniformity across the state.

That 2001 reform was an expensive failure. Patients were left waiting for beds in state psychiatric hospitals while the state spent millions on low-level services for people who didn’t need treatment. A legislative report from 2009 said the state spent up to $635.3 million too much for community mental-health services between April 2006 and February 2009.

Legislators talked for years about giving more local offices more power and passed a law last year requiring it. Western Highlands was the first regional office to convert. Two more offices have followed. All 11 local offices will be managed-care agencies by January 2013. The office covering Durham and Wake counties will be in the last group converting.

The local offices do extensive prep work before they convert and a consulting firm assesses their readiness to switch.

Outdated figures


Western Highlands has been losing money all year. One of the problems, said CEO Arthur D. Carder, is that the lump-sum payment the office received to care for patients was based on outdated information from 2009 that did not take into account increased costs in 2010 and 2011.

Al Delia, the state Department of Health and Human Services acting secretary, said the office has been closely monitoring Western Highlands and is talking about taking another look at whether the $9.7 million a month the office receives to pay for patient treatment is enough.

Delia was in the western counties Wednesday, meeting with members of the office’s governing board.
“There’s going to be some adjustment in culture and attitudes and mindset in leadership of all these organizations in making these transitions,” Delia said.

Skeptics question whether managed care is the best system for all consumers.

“I think we’ve rushed to judgment on this,” said Dave Richard, executive director of The Arc of North Carolina. Parents of children with developmental disabilities and the agencies that provide services to the disabled have been among the most vocal skeptics of managed care, questioning conversion to a system they say isn’t designed to meet their needs.

“If you’re going to give up the system where people had a lot of choice to one where choice is limited and is controlled by one entity, you’d hope to see better outcomes,” Richard said. “We haven’t seen that with folks with developmental disabilities.”

Lawsuit under way

State officials and legislators have looked to PBH as an example for years, but not everyone is a fan.
Disability Rights North Carolina, an advocacy group, is suing PBH in federal court over allegations that it did not give residents proper notice of changes in their services or let them know how they could appeal.

Western Highland’s problems show that the office wasn’t ready to become a managed-care agency, said Vicki Smith, Disability Rights’ executive director.

“It would almost be too simple to say this was predictable,” she said.

Legislators are convinced that managed care is the path to follow for mental-health care. The legislature is committed to a new system where government does more than just pay the bills, said Rep. Nelson Dollar, a Cary Republican.

“We want to manage the care and the individuals receiving the care, and manage the costs and how we’re allocating scarce taxpayer resources,” he said.

Legislators have been working with DHHS since winter on Western Highland’s financial problems, Dollar said. A new law that adds members with experience in managed-care finances, insurance and health care administration to local governing boards is meant to strengthen oversight of Western Highlands and other managed-care operations.

“We’re going to be working with the department to straighten out issues like the ones that are being encountered in Western Highlands and making sure what lessons are learned there are being incorporated in the conversions in other areas of the state,” he said.

13 July 2012

NC DHHS Press Release re Jim Jarrad

N.C. Department of Health and Human Services
For Immediate Release
July 13, 2012
Contact: Julie Henry, 919-855-4840
julie.henry@dhhs.nc.gov

Secretary Delia Selects Jarrard to Lead Division of Mental Health

RALEIGH - N.C. Department of Health and Human Services (DHHS) Secretary Al Delia has announced the appointment of Jim Jarrard as acting director of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (MH/DD/SAS), effective immediately. Jarrard has been deputy director of the division since October 2010 and worked closely with Division Director Steve Jordan, who was killed last week in a bicycle crash.

“The Department suffered a devastating loss with Steve’s death and we will miss his energy and passion for mental health services and the people we serve,” Delia said. “Jim Jarrard is a knowledgeable and respected leader who I am confident will continue to lead the Division in a positive direction.”

Jarrard has been with the Division of MH/DD/SAS since 1994, serving in a variety of roles. Prior to becoming deputy director, Jarrard was chief of the Resource and Regulatory Management Section, which is responsible for fiscal monitoring, accountability, and regulatory compliance, support of information technology and contracts management. He also served as a team lead for Accountability. Jarrard holds a doctorate in theology and was a pastoral counselor and parish minister before joining the Division.

“Our division is a great model of resiliency for the consumers we serve,” Jarrard said. “We have a duty to keep the focus on our mission to protect the health, safety and well-being of all North Carolinians. I look forward to continuing our positive and productive relationships with community advocates, partners and providers.”

The Division of Mental Health, Developmental Disabilities and Substance Abuse Services (MH/DD/SAS) provides leadership and support to community partners, providers and local management entities/managed care organizations to deliver prevention, treatment, and rehabilitation programs for persons with mental illness, developmental disabilities, and substance abuse disorders in North Carolina.