Showing posts with label special needs. Show all posts
Showing posts with label special needs. 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! =)

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!


Saturday Humor for Special Parents

Hard to imagine a world without Facebook isn't it? A life our children will never know. I mean, where ever would we get our latest news and entertainment without it? 

We've all seen these smart aleck little ecards swimming around our inboxes, Facebook and Pinterst and while they often make me chuckle, I just had to share this one for the parents out there who, like me, have received loads of unsolicited and painfully unhelpful parenting advice from usually well-meaning strangers and even experts over the years... This one I can truly appreciate. =)


06 August 2012

Program Coordinator Needed for Lifetime Connections

FIF Lifetime Connections Program Seeks Program Coordinator

Program Coordinator for Lifetime Connections program; full-time, possible part-time options; generous benefits. Position is located in Durham at headquarters of statewide non-profit providing innovative supports and services to people with disabilities and their families. The Coordinator: recruits and maintains relationships with members, community connector staff and volunteers, ensures quality of services and support for member families, coordinates workshops, and manages budget. Seeking person interested in and experienced with disability issues and family support concepts, Community Development expertise, membership and volunteer recruitment, and budgeting. Applicant should have strong communication, organizational skills, be flexible to travel for some night and weekend meetings, and have use of car. 

First In Families of NC is an Equal Opportunity Employer. Review our website before applying: www.fifnc.org. Apply in writing to Human Resources; First In Families of NC; 3109 University Dr Suite 100, Durham NC 27707 or email betsym@fifnc.org. No calls or unscheduled visits please.

Betsy MacMichael
State Director
First In Families of North Carolina
3109 University Drive; suite 100
Durham, NC 27707
(919) 251-8368 X100
Fax: (919) 400-4846


Believe, Achieve, Give Back




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

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.

13 July 2012

DRNC : Request for Public Input

Survey from Disability rights NC regarding target / focus areas in the new fiscal year.

Disability Rights North Carolina is our State's protection and advocacy system for its citizens with disabilities. We provide individual and systems advocacy, including legal representation, to people with disabilities when their legal rights are violated. We uphold the provisions of the Americans with Disabilities Act and other federal and state laws.

Each year, we establish Targets that guide how we spend our resources for the coming year. These Targets drive the work that we do. They influence the work we do and the cases we take.

In fiscal year 2011 (October 1, 2010 - September 30, 2011), we received more than 2,300 calls for assistance but had the resources to provide direct advocacy for only 852 callers.

On June 15, 2012, the Board of Directors of Disability Rights NC tentatively approved its Targets for 2013 which are now out for public comment through the middle of August. The Board will carefully consider all public input received before finalizing the 2013 Targets at its September Board meeting. We do this to make sure that we are spending our resources the way the disability community feels is important.

Our proposed 2013 Targets continue to focus on the impact of the state budget cuts to services for people with disabilities. They also reflect the requirements of our federal funders.

Please let us know what you think about the proposed 2013 Targets by responding to this survey. It should take about 15 minutes but that time will help us make better decisions about how to spend our limited resources next year.

Please share the link to this survey with your friends, family and anyone who cares about people with disabilities.

If you need assistance in completing this survey, contact Haydee Martinez at 919-856-2195.

Si necesitas ayuda o traducción en español para completar esta encuesta por favor llame a Haydee Martinez al 1-877-235-4210 or 919-856-2195 or haydee.martinez@disabilityrightsnc.org.

26 June 2012

DMA 8M Public Comment on CAP-I/DD 270

Note: Below is a Public Comment submitted to DMA regarding the 8M Clinical Coverage Policy proposal for CAP-I/DD during the 15 day comment period from July 28 - August 11, 2011. This exert was pulled from it's original source, a public record, and is posted exactly as it appeared save the removal of the submitter's personal contact information and abbreviation of last name.

[ More on DMA Public Comments. ]

Comment 270

To: Webmedpolicy, Dma
Cc: R&T Gmail account
Subject: 8M-CAP-I-DD
Sent: Thursday, August 11, 2011 4:43 PM

To whom it may concern,
I am extremely concerned by the proposed changes to the CAP waiver. Please consider the following before you make any changes.

Twenty hours of habilitative care per week during the school year is not sufficient for our autistic son. The improvements in behavior, language and social skills we have seen as a result of the hab techs hard work with our son have been a blessing and are truly invaluable. A decrease in hours would be devastating to all the effort put forth by our family and his workers. I know that we are not the only family that feels this way and this strongly about this proposed change. Please do not cut these hours!!!!!

Do not remove home supports either! Our son is not yet 18, but we know other families that are relying heavily on these services for their kids. I would hope and pray home supports would be available when he is 18 to give him a chance at a better life.

I know each one of you cares about the population supported by CAP. I would hope you would not be in this job otherwise. It took our family six long years from our initial application date until our son received his waiver. It was a devastating time financially for our family from which we have not recovered as we tried to do what we could without any support. I know that these are desperate financial times for everyone in this state and in this country, but this population of people and their families are already deeply in debt and desperately need the invaluable assistance provided by the CAP waiver. I beg you not to make a stressful and difficult situation worse. The autistic population in this state had no choice when it came to being autistic. You can make a choice to support them by not changing the CAP waiver. Thank you for your consideration of our ideas on this matter

DMA 8M Public Comment on CAP-I/DD 293

Note: Below is a Public Comment submitted to DMA regarding the 8M Clinical Coverage Policy proposal for CAP-I/DD during the 15 day comment period from July 28 - August 11, 2011. This exert was pulled from it's original source, a public record, and is posted exactly as it appeared save the removal of the submitter's personal contact information and abbreviation of last name.

[ More on DMA Public Comments. ]

Comment 293

To: Webmedpolicy, Dma; Office of the Governor; kpowell@arcnc.org; Michael Cooper; admiral ballard; opinion@charlotteobserver.com
Subject: 8M-CAP-I/DD
Sent: Thursday, August 11, 2011 9:59 PM

To Whom it may concern:

I am writing to share my thoughts on the waiver changes proposed by DHHS/DMA for Community Alternatives Program for Individuals with Intellectual/Developmental Disabilities. I do not understand the details and technical terms as well as I should but I understand enough to know vital services are proposed to be cut. I worked outside the home for the first 18 years of my daughter's life to provide for her and was lucky to have parents to help me with childcare. When Jordan turned 18 I was able to stay home and provide Home Supports through CAP for her which resulted in an amazing improvement in our lives. I was no longer so exhausted from working all day and taking care of her all night that we actually began to enjoy our life rather than getting by.

If Home Support hours are cut I will be forced to work an outside job again to pay our bills. If other support services are cut then who will care for Jordan while I work this other job? My parents have retired, moved and are unable to help me now that they're older. I have never even thought of a group home or institution until now. If I can't care for her and she was to go to a group home or institution then the government would be paying for that. Why would you take my income and give it to a group home or institution when my sole purpose in life is to love and care for her. I would personally live in my car if that's what it took to keep Jordan with me but I would hope it would never come to that. I have worked from the age of 16, paid my taxes, never had government assistance and never plan on it. I don't want food stamps or welfare or my daughter placed outside our home. I want to be paid for the job I am doing which is to provide 24/7 care for Jordan. I love her, want to care for her and grow old with her.

I would hope you wouldn't make these changes so the families of people with disabilities can stay together and have the lives they deserve. I thought that was the purpose of Home Supports and other support services. Stop giving more money to drug addiction programs, released convict programs, etc. and let us keep what our children deserve and need.

Sincerely,

Donna C.
Pineville, NC


22 June 2012

DMA 8M Public Comment on CAP-I/DD 266


Note: Below is a Public Comment submitted to DMA regarding the 8M Clinical Coverage Policy proposal for CAP-I/DD during the 15 day comment period from July 28 - August 11, 2011. This exert was pulled from it's original source, a public record, and is posted exactly as it appeared save the removal of the submitter's personal contact information and abbreviation of last name.


[ More on DMA Public Comments. ]


Comment 266

To: Webmedpolicy, Dma
Subject: Home Support Program
Sent: Thursday, August 11, 2011 3:28 PM

To Whom It May Concern:

I am writing to voice my support of keeping the Home Support Program as it is. I have read the draft proposal, and am not pleased
with it.

My son is 21, he will be 22 in November. I started on the Home Support Program April 1, 2011. It has been a godsend. I finally knew
I could be at home with my son and provide him one-on-one care. Because of his goals, there is work involved. It is not like just keeping
him at home. I must now be his mom, his teacher, and his therapist.

I quit a job to do this for my son, for myself, for my family. I am a single mother. Now I might have to try to re-enter the workforce. How?
I would have to take whatever you give me, lose my car, lose my credit that I've just spent 2 1/2 years re-building, because when can I interview? Take him with me? Collect unemployment? Again, how? He will be at home, I can't leave him by himself. Or should I give up and let the
government provide inadequate care for him that will cost at least 5 times what I'm getting paid?

When my son was diagnosed with Dandy-Walker Cyst Syndrome almost 20 years ago, very little was known about it. (In fact, I still have only met
1 person who has a child with it. Now web-sites have been established for support.) Because I have been a single parent, and Randy has been on Medicaid since 1994, I had to remain poor to keep him on it. I couldn't get a raise, overtime, married, have anyone live with me, and when my older children turned 16, they couldn't get their 1st jobs. We all have suffered. Putting him in a home probably would've been easier, it probably still
would be easier, however having children is not about doing what's easier for you, it's what's best for them.

The worst part was, and is, knowing that at least one of my children will not survive me. He is under 5' tall, he barely weighs a hundred pounds, he
doesn't talk, doesn't walk by himself, is tube-fed, wears diapers and takes 3 anti-seizure drugs twice a day. The seizures started almost 4 years ago.
I believe that was the beginning of the end.

All I wanted was to be able to stay at home and take care of him, to not have to put him in a state run home. I want him to be cared for one-on-one, I want him cared for by someone who truly loves him, I want him to be happy every day. There's only one way that can happen, if he remains home
with me. And there's only one way for that to happen, keep paying me $500/wk, I can't afford anything less. It's still below the poverty line, it still saves the state over $100,000/yr per "client".

I don't understand the issue. This program should be expanded, not eliminated or reduced, and that's what this proposal does. It eliminates the Program that saves the state, what over $1 million, maybe billion per year, and incorporates it into another program that pays less. When the other
program should be modified to fit into the Home Support Program. If you get Home Support, you should not get any other services except Respite. Respite hours could be reduced from 576 hours per year to 416 hours per year, which would save the state the same amount of money as changing the Home Support Program.

Please, let me keep my son at home where he is happy, and healthy.

Thank you,

Judi H.


19 June 2012

NC DHHS Press Release

From:  Titus, Trina Tue, Jun 19, 2012 at 4:51 PM

N.C. Department of Health and Human Services
For Immediate Release

June 19, 2012

Contact: Chrissy Pearson
919-855-4835 or Chrissy.pearson@dhhs.nc.gov

Secretary Delia Announces Reorganization of State Medicaid, DHHS Leadership Team

State Medicaid office will now report directly to Secretary



Raleigh– North Carolina Department of Health and Human Services (DHHS) Secretary Al Delia today announced that he is reorganizing the leadership teams that oversee the state’s Medicaid division.

The changes come after careful evaluation of the Department’s management, said Delia, who was named acting secretary in February.

Michael Watson, DHHS chief deputy secretary, will become the new head of the state’s Medicaid office, the Division of Medical Assistance (DMA). That position will be elevated to serve on the Secretary’s executive leadership team. Watson joined the Department in 2009 as an assistant secretary. He is the former CEO for Sandhills Center for MH/DD/SAS, with more than 20 years of experience and leadership in developing and operating mental health, developmental disabilities and substance abuse services on a local and regional level. His salary remains $160,000.

Watson replaces Dr. Craigan Gray, who served as director of DMA since April 2009 at a salary of $270,000.

Beth Melcher, assistant secretary for mental health, developmental disabilities, and substance abuse services development since August 2010, will become chief deputy secretary. Melcher, a licensed psychologist, is the former president of Recovery Innovations North Carolina. She was clinical director of The Durham Center, and also worked with the National Alliance on Mental Illness North Carolina as its executive director and as public policy director. Her salary will be $141,797.

John Dervin, the secretary’s senior policy adviser since March 2012, will step into a newly created role as chief of staff. Dervin previously served as policy adviser for health and human services for Governor Perdue. His salary will remain $84,000.

“After nearly six months in this role, my first priority for strengthening our management team is to elevate the state Medicaid office to play a more prominent role in the Department’s decision-making process,” said Secretary Delia. “Medicaid is not a stand-alone division. It touches not only multiple DHHS divisions but also plays a huge part in shaping the state budget. We need better communications and stronger oversight of this $12 billion program. I believe these changes will accomplish that.”

These staff changes are effective immediately.

###

12 June 2012

Sign Arc NC's Online Petition!



In 2011, the NC General Assembly passed House Bill 916 (now SL 2011-246). It mandates that North Carolina’s Mental Health, Developmental Disability, and Substance Abuse (MHDDSA) system of care convert to a Managed Care System by January of 2013. The shift happens in stages, with many areas of our state already affected. While The Arc has concerns about managed care for people with intellectual and developmental disabilities, we understand the state will convert to this system.

A major issue with the new design is the replacement of independent Case Management with Care Coordination provided by the Managed Care Organization (MCO). Though we understand that Case Management as it currently exists will not be available in Managed Care sites, we believe individuals should have someone not working for the MCO responsible for writing their person centered plan and to assist them in finding the appropriate service providers. Otherwise, a conflict of interest exists.

In addition to the need for independent care coordination,

In an effort to make NC’s system more responsive, The Arc is recommending a modest set of changes to members of the General Assembly. These changes would establish independent care coordinators not working for the MCO to assist in writing Person Centered Plans and to help find the appropriate services providers. Additionally, it would require that Innovations Medicaid Waiver Slots be portable, and that where a person first received Medicaid not become a barrier for services.

These changes will have no impact on the budget that the NC House and Senate are currently working on and will not cause cost increases in future years. MCOs may have to change the way they organize Care Coordination, but with careful planning that involves qualified agencies, families, and consumers, we believe the cost to MCOs will be minimal.

It is important to note that our proposal does not restore Case Management, but rather builds upon the option that is already available in the law- Care Coordination. Our proposal requires MCOs to contract these functions for people not on the Innovations Medicaid Waiver and assures that people on Innovations have the option for an Independent Care Coordinator.

Many members of the General Assembly want to help with this plan but they need to hear from their constituents.

Please sign our petition today!

07 June 2012

Legislative Correspondence to Re. Tim Moffitt

Thu, May 31, 2012 at 3:37 PM

From: Crystal J. De la Cruz
To: Representative Tim Moffitt 

Re: DMA 2011 Public Comment Documents on CAP I/DD



Thank you for allowing me the opportunity to say hello and quickly introduce myself today; you were most kind given the chaos and time constraints at the General Assembly today. I do look forward to sitting down for a more comprehensive discussion regarding the 1915(b)(c) Medicaid Waiver and the impact upon recipients and families, as well as the countless dedicated professionals, staff and small business owners whose livelihoods will be be affected - many who may be forced to leave a field that they love for self-preservation.

I am forwarding with this mail, an email sent to Representative Current yesterday with attachments to include the 2011 Public Comments to DMA regarding both phases of 8M Clinical Policy proposals for CAP I/DD services and supports. The first 8M proposal was posted for 46 days, while the second, with more drastic cuts was posted for only 15 days. I'm not certain by whom these were reviewed but certainly not by the appropriate persons in my humble opinion. They are quite lengthy documents, described in more detail in my mail to Dr. Current below, but given that as I meet with members I continually hear that they're not hearing from many parents, I do believe it is worth a scan. These are the missing voices. 

For everyone's convenience, I plan to try to break down the the comments and highlight the significant feedback, suggestions, testimonials and desperate pleas.

I have further included with this mail the detailed email and attachments sent to Governor Perdue and members of the General Assembly in February of this year. 

I understand this is a great deal of information; I've probably read shorter books. As I mentioned, there really is no way to put it in a nutshell. My goal, while we struggle to salvage the State's fiscal integrity, is to make certain no one forgets the human element in all this - the most vulnerable and least responsible of our citizens. The train may have left the station already, though I firmly believe there can be a better destination.

Thank you in advance for your time, attention and compassion toward our special populations and the families who love them.

If I can be of assistance in any way whatsoever, please do not hesitate to contact me at any time. 


Warm regards,

-- 
Crystal J. De la Cruz - Hopper
Mother, Advocate & Concerned Citizen

When we allow the value of human life to be determined by capital gain, when we sacrifice the well-being of the most innocent among us to compensate our own shortcomings, and when we judge the worth of our most fragile, not by their character nor intention, but rather their abilities – We Are in Crisis.

http://no2nchb916.blogspot.com/

"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." 
--Hubert H. Humphrey 




3 attachments
20110512-0626 NC-DHHS-DMA Public Comments 8M CAPIDD.doc [598K]
20110728-0811 NC-DHHS-DMA Public Comments 8M CAPIDD.doc [2786K]

Legislative Correspondence to Sen. Tommy Tucker

Wed, May 30, 2012 at 4:48 PM

From: Crystal J. De la Cruz

To: Tommy.Tucker@ncleg.net
Re: DMA 2011 Public Comment Documents on CAP I/DD


My sincere apologies for the delay in following up after our May 15th visit. I'm sure you can appreciate the sentiment when I say I've been "running around like a chicken with my head cut off."

I greatly appreciate your time and attention in meeting with [name stricken] and I regarding Medicaid Waiver concerns for the DD populations, their families and the wonderful providers who have kept us all afloat throughout this rocky journey. I recognize that this is not an easy time for NC and I do not envy your job as a Senator, so it means a great deal that you are open to having a dialogue. I sincerely believe that you want to see this baby put to bed and sleeping safely and soundly, so to speak, and I do admire your unwillingness to compromise your character... and that is why I sought to meet with you.

No, it's not an easy life raising a child with profound special needs - in fact, unimaginable to most, but I can tell you one thing with the utmost certainty: at the end of the day, it's our special folks who keep it real and truly put life in perspective. That is why I do what I do because I am the mother Isabel needs me to be. I firmly believe special people were not born to be tested, rather to serve as litmus to the rest of us. 

And that's why I maintain that there's so much more to these issues than fiscal accountability; besides Merriam-Webster defines accountability as: "the quality or state of being accountable; especially : an obligation or willingness to accept responsibility or to account for one's actions" Who among us are least accountable, least responsible for this mess than our special populations? 

Several members have expressed that they haven't heard from many parents. I keep pointing out that it is not an easy feat for many of these folks to pack up their kids with all their meds, supplies, sensory items, and equipment and travel hours away for a 30 minute - an hour meeting and well, most don't have the time nor vacation time because they use it all going to appointments with doctors and specialists. --Most of us do the very best we can with what we got and sometimes there's no extra left over. And sometimes when we do let the laundry or dishes go or forgo a shower to take the time to sit down and write a letter, send an email - pleading for help, it falls on deaf ears. 

Families need a little more acknowledgment than a pat on the head. Some of us are quite knowledgable, some are professionals in the field, some of us have really great ideas and we've been navigating system after system after new-and-improved system - but we are each experts in what we know. We need and deserve the respect of being heard by our Governor, the General Assembly and the administrators of entities entrusted to assure order and means in the survival of those they serve.

I am polishing up additional materials for you that I hope to send later today regarding our prior visit and conversation, though meanwhile I wanted to share with you the attached documents forwarded to me by fellow parent Mary K. Short who finally received them yesterday from Brad Dean at the DHHS Office of Public Affairs. Attached are the Public Comment response records from 2011 regarding the 8M CAP I/DD Clinical Policy proposals posted from 5/12 thru 6/26 and from 7/28 thru 8/11 -- a total of 540 comments; 618 pages. Pretty interesting reading. And this is what's missing - the human element.

Comments were made from across North Carolina by many parents and caregivers sharing heartfelt details of their lives as well as professionals, providers, and advocates in the DD field who know well the devastating impact such changes and service cuts would have not only on the recipients and families they serve and care for, but on their small businesses, their livelihood and the lives of staff they employ as well.

My sincerest hope that our elected officials - our Governor and members of the North Carolina Senate and House of Representatives - aspiring candidates, policy-makers, Health and Human Services administrators, LME's, MCO's, and other stakeholders and powers that be take the time now to hear that voice as our lives are in your hands... not merely the quality of our lives but rather our ability to live.

I know I'm asking a lot of you to sit down and skim through a 'book' like this but I also believe you want to assure this thing is done right; currently it's not. There's far more at stake than our State's broken-back budget - A budget crisis which cannot be rectified by plugging the dike with our finger and hoping for the best. Hoping there's not another crack - if we cement this model as it, the levee will break.

Thank you again for your time and attention and thank you in in advance for your considerations and efforts toward improving our State and our lives.

Sincere regards,

-- 
Crystal J. De la Cruz - Hopper
Mother, Advocate & Concerned Citizen

When we allow the value of human life to be determined by capital gain, when we sacrifice the well-being of the most innocent among us to compensate our own shortcomings, and when we judge the worth of our most fragile, not by their character nor intention, but rather their abilities – We Are in Crisis.

http://no2nchb916.blogspot.com/

"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." 
--Hubert H. Humphrey

2 attachments
20110512-0626 NC-DHHS-DMA Public Comments 8M CAPIDD.doc [598K]
20110728-0811 NC-DHHS-DMA Public Comments 8M CAPIDD.doc [2786K]

Legislative Correspondence to Rep. Bill Current


Wed, May 30, 2012 at 3:51 PM
From: Crystal J. De la Cruz  


Dear Dr. Current,

My sincere apologies for the delay in following up after our May 15th visit. It was a great pleasure meeting you and getting to know a bit about you as a person; I'm so glad the time afforded us a chance to chit-chat. Both [name stricken] and I were moved by your deeply-rooted integrity and moral compass. I dare say the world could use more people like you Dr. Current and your family is very lucky to have you. 

I greatly appreciate your time and attention in meeting with [name stricken] and I regarding Medicaid Waiver concerns for the DD populations, their families and the wonderful providers who have kept us all afloat throughout this rocky journey. 

No, it's not an easy life raising a child with profound special needs - in fact, unimaginable to most, but I can tell you one thing with the utmost certainty: at the end of the day, it's our special folks who keep it real and truly put life in perspective. That is why I do what I do because I am the mother Isabel needs me to be. I firmly believe special people were not born to be tested, rather to serve as litmus to the rest of us. 

Several members have expressed that they haven't heard from many parents. I keep pointing out that it is not an easy feat for many of these folks to pack up their kids with all their meds, supplies, sensory items, and equipment and travel hours away for a 30 minute - an hour meeting and well, most don't have the time nor vacation time because they use it all going to appointments with doctors and specialists. Most of us do the very best we can with what we got and sometimes there's no extra left over. And sometimes when we do let the laundry or dishes go or forgo a shower to take the time to sit down and write a letter, send an email - pleading for help, it falls on deaf ears.

I am polishing up additional materials for you that I hope to send later today regarding our prior visit and conversation, though meanwhile I wanted to share with you the attached documents forwarded to me by fellow parent Mary K. Short who finally received them yesterday from Brad Dean at the DHHS Office of Public Affairs. These are the Public Comment response records from 2011 regarding the 8M CAP I/DD Clinical Policy proposals posted from 5/12 thru 6/26 and from 7/28 thru 8/11 -- a total of 540 comments; 618 pages. Pretty interesting reading. And this is what's missing.

Comments were made from across North Carolina by many parents and caregivers sharing heartfelt details of their lives as well as professionals, providers, and advocates in the DD field who know well the devastating impact such changes and service cuts would have not only on the recipients and families they serve and care for, but on their small businesses, their livelihood and the lives of staff they employ as well.

My sincerest hope that our elected officials - our Governor and members of the North Carolina Senate and House of Representatives - aspiring candidates, policy-makers, Health and Human Services administrators, LME's, MCO's, and other stakeholders and powers that be take the time now to hear that voice as our lives are in your hands... not merely the quality of our lives but rather our ability to live.

I know I'm asking a lot of you to sit down with a book like this but I also know you understand the importance of the messages inside. Thank you again for your time and attention and thank you in in advance for your considerations.

Kind regards,

-- 
Crystal J. De la Cruz - Hopper
Mother, Advocate & Concerned Citizen

When we allow the value of human life to be determined by capital gain, when we sacrifice the well-being of the most innocent among us to compensate our own shortcomings, and when we judge the worth of our most fragile, not by their character nor intention, but rather their abilities – We Are in Crisis.

http://no2nchb916.blogspot.com/

"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." 
--Hubert H. Humphrey

2 attachments
20110512-0626 NC-DHHS-DMA Public Comments 8M CAPIDD.doc [598K]
20110728-0811 NC-DHHS-DMA Public Comments 8M CAPIDD.doc [2786K]

24 May 2012

Parent Legislative Correspondence

Colleen is the parent a 12-year-old son and CAP recipient with multiple diagnosis and special needs including an auto immune disease and Traumatic Brain Injury (TBI) attributing to many medical, developmental and behavioral issues. She also has another child with needs who is not being served. Posted with parent permission.


Colleen is in NC House District 36, Senate District 17 and will fall under Alliance Behavioral Health Care LME (formerly the Durham Center) upon implementation.

Legislative Correspondence 

from another Parent Perspective


From: COLLEEN  Thu, May 24, 2012 at 11:12 AM

To:  Senator Richard Stevens <Richard.Stevens@ncleg.net>, 
Representative Nelson Dollar <Nelson.Dollar@ncleg.net>, 
House Speaker Thom Tillis <Thom.Tillis@ncleg.net>, 
Office of NC Governor <governor.office@nc.gov>, 
Representative Justin P. Burr <Justin.Burr@ncleg.net>,
US HHS Commissioner Sharon Lewis <sharon.lewis@acf.hhs.gov>, 
Joint Caucus Leader Marilyn Avila <Marilyn.Avila@ncleg.net>, 
Representative William A. Current, Sr. <Bill.Current@ncleg.net>, 
Senator Fletcher L. Hartsell, Jr. <Fletcher.Hartsell@ncleg.net>, 
Senator Tommy Tucker <Tommy.Tucker@ncleg.net>


Dear Representatives:


As a constituent, I am asking you to reconsider the move forward with the current HB 916 until there is a restoration of Independent Case Management, establishment of a third party unbiased binding conflict resolution entity and an unbiased SIS evaluator not employed directly by the MCO. There are more issues that are relevant to this Waiver that are concerns to families like mine as well. Habilitative services is needed to ensure individuals the ability to provide some independent level of care if not complete independence, later on. Enhanced Personal Care is also imperative to families that have children with more involved personal care needs involving GI problems, medication administration, and intense behavior supports to name a few. Eliminating these services will create a bias against these more involved children as staff will not work and pick up cases that require much more effort and unpleasant things to deal with when there is no incentive to do so. The necessity of CAP services to enable families to function and allow siblings to have some normalcy, is imperative to allow for a system that is not burdened down the road with institutionalized adults and broken families. Lastly, appropriate CAP level services in place provides the support families need to just be a family. I will close with a personal example of how these services are needed to just allow families to deal with every day things that happen in all our lives, but can become a crisis without support from CAP:

CAP services are imperative for families like mine. We have more than one child with special needs, but only one with CAP. When my husband's father just recently passed away, we would have been in a tailspin without our CAP workers. One of us would have had to miss all the planning, viewing, hanging out grieving with family and seeing family members that live out of State who we hadn't seen in many years, if it weren't for the supports we had. My son could not handle all the noise, chaos and environment of funeral planning and the viewing. His CAP workers and I brainstormed how to help him handle the loss of his grandfather and explain this to him. We came up with a wonderful concrete picture that he grasped. The CAP workers kept him with them at home while we traveled to another town in NC. They continued his programs/routine as we went about the various duties and family commitments involved in this type of loss. We decided it was best for him to not attend the viewing as it might confuse him. We explained to him that he would go to a "Funeral" and it was a place we would say goodbye to Grandpa and see his casket, which was a "car" that you ride to heaven in and we wouldn't see him again till we moved there too. He then came to the funeral with his CAP worker and she was able to keep him quiet and help him participate in this aspect of it all. She did various sensory strategies to keep him sitting still and attending, bringing along little hand toys, sensory brushes etc. to help him remain there. He did! To our amazement and thankfulness to his 10 year CAP worker who knows him so well, she had just the right strategies to enable him to do this. We all stood together as the casket was placed into the hurst and we said together "there goes Grandpa in his casket, he's riding to heaven". He understood. He hasn't asked for Grandpa again which is unusual since he saw him every Sunday and looked forward to his "tickles" and cuddling in the rocking chair. So we know he got it and is at peace with it. We are so thankful for our CAP workers and how they rallied behind our family and provided the supports that were necessary to enable us to spend long days with family, grieve and have this time together with extended family.

That is just one example of what CAP does for families like mine and that's not addressing all they have done habilitatively for my son, which I could also write personal examples of such as his ability to now toilet, feed and bath independently - we are so thankful for CAP.

Thank you for your continued commitment to do what is right and to forge a plan that makes sense for our voiceless children caught up in fiscal difficulties that are not their faults and should not balanced on their already burdened backs.

Respectfully,

Colleen


13 May 2012

Mother's Day Tribute to Special Moms

In honor of all the special moms out there, I wanted to post something special for Mother's Day and could think of nothing more fitting than Lori Borgman's column, "Some Mothers Get Babies with Something More." Though I came across this years ago, it still brings tears to my eyes each time I reread it, and each time I am humbled. I think most moms (and dads too) probably feel the same way I do in that, I don't consider myself an extraordinary person simply because I love, parent and care for a child with special needs and fight for her rights... I'm just a mom doing what any parent would do to protect and provide for their baby; at least, I'd like to think so.

It's who we are. It's what we do. It's why our children chose us.

Yes, we get tired. We get frustrated. We get hurt and angry. We feel guilty, overwhelmed, and saddened. And tired (did I mentioned tired?) Often we forget the dreams and ambitions we once had, long ago in another life when things made sense; we forget ourselves. And yes, there are times we seek refuge in a locked bathroom for a five-minute tear-fest just so we can let it out, regroup and return to the trenches as we dare not let our precious children see us cry...

Because you see, at the end of the day when all is said and done, despite everything, our children somehow always seem to put life in perspective for us, keep it real, and remind us as only they can, that every day is a celebration.

Happy Mother's Day!

Some Mothers Get Babies with Something More (Mothers Lie)
Lori Borgman | Monday, May 12, 2002

My friend is expecting her first child. People keep asking what she wants. She smiles demurely, shakes her head and gives the answer mothers have given throughout the ages of time. She says it doesn't matter whether it's a boy or a girl. She just wants it to have ten fingers and ten toes. Of course, that's what she says. That's what mothers have always said. 

Mothers lie.

Truth be told, every mother wants a whole lot more. Every mother wants a perfectly healthy baby with a round head, rosebud lips, button nose, beautiful eyes and satin skin.

Every mother wants a baby so gorgeous that people will pity the Gerber baby for being flat-out ugly. Every mother wants a baby that will roll over, sit up and take those first steps right on schedule (according to the baby development chart on page 57, column two).

Every mother wants a baby that can see, hear, run, jump and fire neurons by the billions. She wants a kid that can smack the ball out of the park and do toe points that are the envy of the entire ballet class. Call it greed if you want, but we mothers want what we want. 

Some mothers get babies with something more.

Some mothers get babies with conditions they can't pronounce, a spine that didn't fuse, a missing chromosome or a palette that didn't close. Most of those mothers can remember the time, the place, the shoes they were wearing and the color of the walls in the small, suffocating room where the doctor uttered the words that took their breath away. It felt like recess in the fourth grade when you didn't see the kick ball coming and it knocked the wind clean out of you.

Some mothers leave the hospital with a healthy bundle, then, months, even years later, take him in for a routine visit, or schedule her for a well check, and crash head first into a brick wall as they bear the brunt of devastating news. It can't be possible! That doesn't run in our family. Can this really be happening in our lifetime? 

I am a woman who watches the Olympics for the sheer thrill of seeing finely sculpted bodies. It's not a lust thing; it's a wondrous thing. The athletes appear as specimens without flaw - rippling muscles with nary an ounce of flab or fat, virtual powerhouses of strength with lungs and limbs working in perfect harmony. Then the athlete walks over to a tote bag, rustles through the contents and pulls out an inhaler. As I've told my own kids, be it on the way to physical therapy after a third knee surgery, or on a trip home from an echo cardiogram, there's no such thing as a perfect body.

Everybody will bear something at some time or another.

Maybe the affliction will be apparent to curious eyes, or maybe it will be unseen, quietly treated with trips to the doctor, medication or surgery. The health problems our children have experienced have been minimal and manageable, so I watch with keen interest and great admiration the mothers of children with serious disabilities, and wonder how they do it. Frankly, sometimes you mothers scare me. How you lift that child in and out of a wheelchair 20 times a day. How you monitor tests, track medications, regulate diet and serve as the gatekeeper to a hundred specialists hammering in your ear.

I wonder how you endure the clichés and the platitudes, well-intentioned souls explaining how God is at work when you've occasionally questioned if God is on strike. I even wonder how you endure schmaltzy pieces like this one -- saluting you, painting you as hero and saint, when you know you're ordinary. You snap, you bark, you bite.

You didn't volunteer for this. You didn't jump up and down in the motherhood line yelling, "Choose me, God! Choose me! I've got what it takes." You're a woman who doesn't have time to step back and put things in perspective, so, please, let me do it for you.

From where I sit, you're way ahead of the pack. You've developed the strength of a draft horse while holding onto the delicacy of a daffodil. You have a heart that melts like chocolate in a glove box in July, carefully counter-balanced against the stubbornness of an Ozark mule.

You can be warm and tender one minute, and when circumstances require intense and aggressive the next. You are the mother, advocate and protector of a child with a disability. You're a neighbor, a friend, a stranger I pass at the mall. You're the woman I sit next to at church, my cousin and my sister-in-law.

You're a woman who wanted ten fingers and ten toes, and got something more. 

You're a wonder.

12 May 2012

Family Story: NC Creates Dilemma for the Grahams

Real Faces in North Carolina

It's not the mere idea of "change" that frightens North Carolina parents regarding the State's new Medicaid Waiver reform. We aren't afraid of change; our lives are change and adaptation - a carefully balanced juggling act that most cannot imagine, unless you live it.

No, what we are afraid of is failure. We are afraid of failing the precious children we love and care for. And without proper supports, services and assistance for our children's unique needs and circumstances, many families will be forced to make the unfathomable choice of giving their loved one up to an State operated institutional setting. 

Such a failure would be the failure of the State of North Carolina.


See NC Creates a Dilemma for the Grahams on North Carolina Health News.
Video and article by Lydia Wilson.
Lydia's Medicaid Waiver focused website: www.ncmentalhealthreform.com

09 May 2012

Federal Government changes re Long Term Care

May 9, 2012
From: Mary K. Short [MaryKShort@aol.com]
Subject: Federal Government changes re Long Term Care

I would like you all to read the information below. I have been following the changes that are talked about. I have been sending you all some information about what is happening at the federal level ... even The Arc put the information about the new Administration on Community Living (ACL) in their Action Alert. On April 17th I sent an email with the press release about the new ACL to Rep. Dollar and Rep. Avila asking them to use that information as a basis for stopping the further implementation of this move to Managed Care! I asked for them to consider the idea of moving IDD to Dept. of Aging or Dept. of Long Term Care because that is the direction the feds are taking. (http://www.hhs.gov/news/press/2012pres/04/20120416a.html.)

The information is from Steve Gold, an ADA attorney in PA, http://www.stevegoldada.com, is clear. Please use this information when you contact your Legislators! This is about NOT moving us to a capitated managed care system.
828-632-5888 or 704-451-4144 (cell)

From: ncadvocacy@yahoogroups.com
Reply-to: notify-dg-ncadvocacy@yahoogroups.com
To: ncadvocacy@yahoogroups.com
Sent: 5/9/2012 6:22:25 A.M. Eastern Daylight Time
Subj: [ncadvocacy] Digest Number 2011

Messages
________________________________________________________________________
1. Fw: [NYAPRS Enews] Gold Urges States to Adopt Community First Choice
    Posted by: "lauriecoker" 
    Date: Tue May 8, 2012 7:18 am ((PDT))

The Centers for Medicare and Medicaid announced this funding program, the "Community First Choice" option, just last week. It is a funding option that would specifically impact our citizens who could live independently with some services rather than being housed in large facility settings such as many of our adult care homes or "assisted living" facilities. It aims to impact states like ours, New York, and others that have become dependent on the convenience of placing people in "homes" -- some of which have 100 plus beds!

New York, which has had a similar ruling by the DOJ to ours about the institutional bias and limiting rightful choices for citizens, is planning to use this to change their behavior.

We could use this to help us in the very near future, but we have to advocate for it!

See some of Steve Gold's strategy suggestions re: this opportunity, below. It may be time to build a cross-disability coalition to bring change.

Please talk to decision-makers about using dollars for services in real community settings so that individuals can envision personal lives with goals and hopes. It costs less to the taxpayer, and surely less to the person who wishes to live differently than in a facility based setting.

Laurie Coker
Director, NC CANSO
North Carolina Consumer Advocacy, Networking, and Support Organization
Citizen self-advocacy and empowerment - State-wide from Winston-Salem

There is no more blessed bondage than to be a prisoner of hope.     --R .Z. Kemp

----- Forwarded Message ----
Sent: Tue, May 8, 2012 7:50:39 AM
Subject: [NYAPRS Enews] Gold Urges States to Adopt Community First Choice Programs

NYAPRS Note: New York State officials have already committed to adopting the CFC program, which will also apply to those at risk for residing in what’s called an IMD (institute for mental disease) that includes facilities over 16 beds.

Community First Choice Regulations Published.
Steve Gold  May 2012  Information Bulletin # 357

Let's hear the trumpets and the Halleluiahs chorus.

Finally, the Department of Health and Human Services / Centers for Medicare & Medicaid Services issued the final regulations for the Community First Choice option. The regulations state that CFC's scope is designed to make available home and community-based attendant services and supports to eligible individuals, as needed, to assist in accomplishing activities of daily living, instrumental activities of daily living, and health-related tasks through hands-on assistance, supervision, or cueing.

CMS listed CFC's Total Benefits as providing States with additional flexibility to finance home and community-based services and attendant services and supports. The regulations state that CFC will increase State and local accessibility to services that augment the quality of life for individuals through a person-centered plan of services and various quality assurances. CMS further noted that CFC reduces the financial strain on States and Medicaid participants.

CFC is a win-win for States to save money and for people who need community-based and attendant services to stay in their homes and apartments.

For many years, the Community First Choice was strongly supported and initiated by ADAPT, a national grass roots organization of people with disabilities of all ages and all disabilities. ADAPT organized large numbers of supporters, testified before Congressional committees, and last week demonstrated in front of HHS's Washington offices demanding CMS release CFC's regulations.

Now that the federal regulations have been released, the struggle shifts to you disability and aging advocates in each State - to make sure this program is implemented in your State. Nothing happens automatically. Unless advocates demand CFC state-by-state, it will not happen. Yes, another local effort but quire worth the effort.

Here's why your State should amend its Medicaid Plan to include the CFC the federal government will pay an additional 6 percentages to your State's Federal Medical Assistance percentages. (Go to http://aspe.hhs.gov/health/fmap.htm to see what the FMAP is now WITHOUT the additional six points.) That translates into a LOT of federal money!

Another reason: yes, your State can save a lot of State funds while at the same time complying with the ADA/Olmstead requirements to prevent unnecessary isolation and institutionalization of people with disabilities.

Here's a brief summary of the final regulations:
  1. CFC provides home and community-based attendant care services and supports to persons with disabilities.
  2. Such services must assist the individual with activities of daily living, instrumental activities of daily living (e.g., shopping cleaning) and health-related tasks.
  3. States can provide, at the State's option, transition costs (rent and utility deposits, first months rent/utilities, basic kitchen/bedding needs).
  4. Individual eligibility requires that the person with a disability meets your State's institutional level of care criteria. The person need not be in the institution nor packing their bags or at risk of being imminently institutionalized. If the person meets the level of care for the institution, the CFC services can be provided.
  5. Individual financial eligibility is the same as what your State has established for the institution.
  6. Under the CFC, States must use a person-centered service plan and the services must be self-directed, either with a self-directed service budget or an agency-provider model.
  7. This plan must be in writing and agreed to by the individual and must be based on a functional needs assessment. The regulations state that the person-centered service plan must reflect the services and supports that are important for the individual to meet the needs identified through an assessment of functional need.
  8. These plans must be reviewed, and revised upon reassessment of functional needs, at least every 12 months, when the individual's circumstances or needs change significantly, and at the request of the individual.
What advocates must do:
  1. Your State Medicaid Plan must be amended to include the CFC. Advocates should be at the table to ensure the services meet your needs.
  2. You need a statewide, multi-disability coalition and strategy to ensure your State amends its Medicaid plan to include the CFC. If your State does not already have such a coalition, the CFC presents an opportunity to develop one.
  3. If your State has such a coalition, convene it!
  4. You need to show your Governor why s/he should amend your State's Medicaid plan to provide CFC services. This will require real live people who want and need CFC services. They must be ready to speak out. CFC is a critical opportunity to end waiting lists.
  5. You should get to your media and explain how this program will save your State money, while bringing into your State additional Federal funds.
Steve Gold, The Disability Odyssey continues

Back issues of other Information Bulletins are available online at http://www.stevegoldada.com.
FYI:  This is the link to the actual regulation (45 pages!)  It is still open for public comment and if you click on the link, there is a section that explains how to make public comment. This is about multiple populations ... elderly, other adult disabled, and IDD. This relates with the federal move to an "Administration on Community Living" department that was created.


DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 430, 431, 435, 436, 440,
441, and 447
[CMS–2249–P2]
RIN 0938–AO53
Medicaid Program; State Plan Home
and Community-Based Services,
5-Year Period for Waivers, Provider
Payment Reassignment, and Setting
Requirements for Community First
Choice
AGENCY: Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Proposed rule.