Friday, February 23, 2007

Calhoun Times: County OKs group for mental health services

My thoughts are with everyone involved as Gordon County, Georgia, takes their next step in providing quality community mental health care for the residents of their county..


County OKs group for mental health services, 02/20/07
Susan Kirkland, Calhoun Times..

Gordon County residents will soon have county mental health services again as the Board of Commissioners voted to approve a contract with Gordon Mental Health and Addictions.

The board also approved a motion allowing Chairman Alvin Long to officially give Highland Rivers 30 days to vacate the county building that has essentially served as storage since the group restructured, eliminating most of its services in the county.

"It's one of those things that we’ve been working on for months," Long said.

The group could be in the county as early as April 1. It is in the application process to receive Department of Human Resource funding for juveniles who qualify for Medicaid and Medicare. The process for funding for adults could take until November.

However, proprietors Beth Brock and Donna Johnson agreed in the contract to take private pay adults and sliding scale fee for those without insurance.

Long told Brock at the work session that what should have been pretty cut and dry as far as approving the contract became more complicated when some members of the community raised questions about the group’s credentials.

Those concerns were unfounded, said Dottie Jarrett, who has been following the mental health issue since Highland Rivers pulled most of its services out of the county.

Friday, February 9, 2007

SteveGoldADA: MFP Rebalancing Benchmarks & 50-50 or Bust..

Hopefully speaking for themselves.. Once again, Steve's is one of the lists that, if you only wish to receive a few advocacy-based emails, this would be a nice addition..

Money Follows the Person "Rebalancing Benchmarks" - Information Bulletin #193.

Two weeks ago, CMS sent out "Money Follows the Person Rebalancing Demonstration Request for Additional Information" letters to 21 states. These are the 21 States that were not awarded "first round" MFP grants of more than $800 million, but are eligible for a "second round" grant. These 21 states have only until February 20 to respond to the CMS questions and concerns.

Whether your State will receive a MFP grant in the "second round" ($700 million remains) depends on how your State responds to CMS' questions and concerns. Based on the CMS letters we have seen, CMS appears serious about requiring "Rebalancing Benchmarks," i.e., how will your State decrease the ratio of institutional to community expenditures? What will your State, in order to receive the enhanced federal match, do to demonstrate its seriousness on the home and community based side of the scale?

CMS suggests one "measurable benchmark" which we think is critical and will demonstrate if your State is really serious about "rebalancing" its Medicaid long term care expenditures. Namely, CMS suggests "A percentage increase in Home and Community Based services versus institutional long-term care expenditures under Medicaid for each year of the demonstration program." CMS is right on the mark!

For the past several springs we have provided by State a comparison of the Medicaid expenditures for institutional versus community-based services. Nationally in FY 2005, for persons who receive "A/D" services, i.e., older Americans and disabled persons, nearly 73% of the funds went to the institutions and 27% went to community-based services.

A true rebalancing benchmark would reduce those ratios so that each year, as one example, the percentages for institutional care would be reduced by 5% and the community-based services expenditures would be increased by 5%. By the end of the five year grant, we would see a true "rebalancing." The same principle applies for MR/DD services.

Congress understood that the primary purpose of MFP was to "rebalance" Medicaid's expenditures from the institution to the community.

Why would a State not want to rebalance and to establish such benchmarks in return for an increase in federal money? How could CMS ever approve an State's proposal that did not establish such benchmarks?

Disability Advocates:

  1. Do you know if your State was one of the 21 that received a request for additional information?
  2. If it was, has your State Medicaid agency shown you the CMS letter?
  3. Are you meeting with your State to discuss these benchmarks and the rebalancing?

50 - 50 or Bust! Money Follows the Person - Information Bulletin # 193A.

A number of folks responded to the "Money Follows the Person "Rebalancing Benchmarks'" Information Bulletin that was issued a few days ago. I suggested that "A true rebalancing benchmark would reduce those ratios [of Medicaid expenditures for the Aged/Disabled] so that each year, as one example, the percentages for institutional care would be reduced by 5% and the community-based services expenditures would be increased by 5%. By the end of the five year grant, we would see a true 'rebalancing.' The same principle applies for MR/DD services."

People were quite upset with only a 5 % rebalancing per year. I was reminded that at least five states (Oregon, Alaska, New Mexico, Washington, and California) were already at the 50% -50% institutional versus community Medicaid expenditures for "Aged/Disabled" long-term care services.

So we were challenged. Why not 50% -50% in "Aged/Disabled" MA expenditures by 2010 for every state?

Outrageous? The Human Services Transition Team for Massachusetts new Governor has proposed a 50/50 balance by 2010. In FY 2005 (the last year for which we have data), Massachusetts spent 77% on institutional Aged/Disabled and 23% for community-based services. Massachusetts' 2010 goal reflects a meaningful rebalancing.

Here are the States, starting with the most Unbalanced (again FY 2005). We provide the % going to institutional for Aged/Disabled. (This data is from the CMS 64, Office of State Agency Financial Management, as collected and published by Medstat on July 7, 2006.)

These States have a VERY LONG WAY TO GO! It's not too late.

Institutional for Aged/Disabled; % of total long term care expenditures:

  • Tennessee 98.9%, the most unbalanced.
  • Mississippi 96.7%
  • North Dakota 95.0%
  • Indiana 92.3%
  • Pennsylvania 90.5%
  • Utah 90.3%
  • South Dakota 89.7%
  • New Hamp. 89.5%
  • Rhode Is. 89.1%
  • Alabama 88.4%
  • Delaware 87.9%
  • Florida 87.9%
  • Georgia 87.6%
  • Louisiana 84.7%
  • Michigan 84.7%
  • Hawaii 82.7%
  • Maryland 82.6%
  • Kentucky 82.2%
  • S. Carolina 81.9%
  • Wash., DC 81.9%
  • Ohio 81.6%
  • Nebraska 80.6%
  • Wyoming 80.0%
  • Illinois 79.1%
  • Virginia 78.9%
  • New Jersey 78.8%
  • Iowa 78.7%
  • Conn. 78.5%
  • Mass 77.0%
  • Maine 76.9%
  • W. Virginia 76.7%
  • Oklahoma 76.2%
  • Colorado 75.0%
  • Arkansas 74.0%
  • Nevada 72.5%
  • Wisconsin 72.0%
  • Missouri 71.7%
  • Montana 71.3%

What are the Aged/Disabled advocates doing in these States to achieve a 50/50 balance?

Resource: www.SteveGoldADA.com. To subscribe to Steve's list, address a brand new email to majordomo@stevegoldada.com. In the body ONLY place the following:

subscribe stevegoldada

Tuesday, February 6, 2007

(Still) Speaking of Advocacy Ops: Festival of Trees..

Personal experience shouts, "Never too early to start putting together this year's entry for the local Festival of Trees.." :GRIN:

What I'm referring to is the year-end holiday "Festival of Trees" that very often can be found in any given local library branch.. This suggestion, of course, is one of those that is up to individual preference on whether or not it is appropriate for one's message..

If you don't already participate, you could start by asking your librarian 1) if they actually have a Festival of Trees each year in your library and 2) where can you sign up if they do have one..

Bear in mind this is a popular participatory opportunity for many local organizations so you may find yourself on a waiting list, maybe even for next year already.. At least you'll be in the lineup for when your turn finally presents..

The way ours here in Pickens County works, sometime in September of each year, applications are sent out to interested parties.. Based on appropriateness of message, a given number of the completed then returned applications are accepted to actually participate..

To be fair to all, spots are chosen by random drawings for position on a first in to put your tree up, first one to draw for a shot at the prime locations.. Fate has been kind here both years I did displayed a tree locally.. Front and Center by the checkout counter.. Who could ask for anything more.. :WINK:

Decoration-wise, read these fingertips :: Don't sweat it.. Repeat after me: "My tree does not have to be fancy.." That instantly takes a TON of pressure off, trust me..

The sky (and space availability) are the limit with respect to creativity in presenting your message.. Mine was very simple:

  • A 5-foot tall artificial tree bought for about $3.50 after the holidays
  • Tips for advocacy and self-advocacy hand-printed on circular cut unlined index cards
  • Small, clear dollar store ornaments dangling on silver pipe cleaners to hang each index card
  • A silvery, nylon butterfly and big bow on top
  • Pretty white garland to round it out and draw it in together
  • A Word or PowerPoint-generated placard for the base

Total cost comes in probably around $10.00 to $15.00 if you really scrounge around.. Places to check for decorations:

  • Your attic, basement, garage, or woefully overstuffed back closet
  • Your local Freecycle listserv
  • Your area's CraigsList freebies and/or wanted message boards
  • Thrift stores
  • Dollar stores

Some nice examples that come to mind include a big tree FULL of gloves for local children.. That one was bursting by holiday's end.. Others included what I believe was the local volunteer fire department bearing all things fireman-inspired.. Some trees bore names of everyone associated with their program.. Still others gathered banners of related service chapters, charters from throughout the area..

Again, the sky's the limit on this one.. No time like the present to plant the seed with your local library if they happen to present their own Festival of Trees, too..

Advocacy Op: Get "Making A Difference" placed in your local library..

Speaking of the Making A Difference magazine, a great advocacy opportunity resides within and simultaneously is not just limited to the same..

Happened for me accidentally a year or so ago when I took a copy in to the Pickens County Library to share with the librarians.. Next thing I knew, they had their own subscription, and it is now prominently displayed on the front side of the magazine racks in the same library..

For those outside the realm of the "Making A Difference" locale, your own Governor's Council on Disability must surely put out some kind of regular publication.. Even if it is not quite magazine rack quality, ask that it be placed in a community area.. If there isn't a community area, looks like an opportunity to advocate for one to these fingertips.. Grin..

Another opportunity many local library systems offer is for the posting of meetings and events of interest.. Among other forms of communication, these can be found in the form of high trafficked bulletin boards.. My local library additionally has a loose leaf notebook containing community calendar information front and center on the main checkout counter..

Best suggestion coming to mind just this second is to ask what's available in your own library and adapt your communication to be displayed in the same.. You could also present your services regularly to create multiple formats of information such as this for those who may need, for example, large print or voice..

P.S. While you're at it, this additionally presents the opportunity to follow up and make sure that assistive technology is available and operable should anyone come in and wish to use the same..

RFP: Design, Publish "Making A Difference" Magazine..

An interesting RFP (request for proposals) from the GCDD (Georgia Governor's Council on Developmental Disabilities)..

If you would like to see a hard copy of previous issues, feel free to pop into disABILITY LINK in Decatur (755 Commerce Drive).. You don't actually enter the building, but instead use the door just to the right of Building 755's front doors.. Let them know why you were asking, and feel free to drop my name as having sent you by.. :WINK:

Good luck to anyone who gives this unusual opportunity a shot..


RFP: Design, Publish "Making A Difference" Magazine..
Original RFP #42700-901-0000003250 at Georgia Procurement Registry.
Any questions should be directed to the Contracting Officer via electronic mail at: mpavonsuriel@dhr.state.ga.us.

Description:

The Department of Human Resources, Governor's Council on Developmental Disabilities (GCDD) is requesting proposals from individuals or organizations to produce a quarterly magazine, known as, "Making A Difference Magazine". The objective of this procurement is to obtain the services of a qualified firm to design, publish, print, and distribute a quarterly magazine, which is reader-friendly and contains timely articles and features that are on the cutting-edge of technology, supports and services for persons with developmental disabilities.

Resource: Member post at Advocates' Roundtable.

Sunday, February 4, 2007

EndeavorFreedom.TV: A Chance to Share Your Story

Had been meaning to post about Endeavor Freedom for a while now.. This makes for the perfect opportunity to pass along a tad of their message.. If any of it proves of interest, drop a note and/or your resume to:

ZenGarcia@alltel.net.

On June 22 of last year during brutal heat and sweltering sun, Georgia Advocates celebrated the sixth anniversary of the landmark Supreme Court Decision Olmstead v. LC & EW; in which all people with disabilities won The right to lives integrated in community with long term care services Delivered at home instead of an institutional setting.

In 1995, 47 year old, Elaine Wilson, characterized with a mild mental Disability and personality disorder, joined in a lawsuit filed by fellow Patient 31 year old, Lois Curtis. Curtis, who having been diagnosed With a mild mental disability and schizophrenia, had been Institutionalized for three years at Georgia Regional Hospital, a mental Health facility, before Atlanta Legal Aid lawyer Sue Jamieson, filed a Brief in federal court in Atlanta on their behalf. The case took on Immediate precedence as State’s lined up to oppose the right of people With disabilities to receive government long term care assistance to Remain in the community and receive services in our own homes. The Government and then Director of the Department of Human Resources in Atlanta, Tommy Olmstead claimed that the nursing home and institutional Facilities that the States have provided for end of life care and long Term disability placement were ‘sufficient’ environments to sustain People whom had acquired permanent life impairing disabilities even Though most were in no threat of imminent death because of their Disabilities.

On June 22, 1999, the spotlight shone on the Supreme Court as disability Advocates waited what was to become milestone decision – "To people with Disabilities, this case is as significant as /Brown v. Board of Education/ was to people of color," said Mark Johnson, advocacy Coordinator for the Shepherd Center in Atlanta. "When the ADA was Passed, it was a mandate for integration. Now we've got our state Challenging our right to integration." Cheers echoed through the nation As the U.S. Supreme Court sided with advocates, saying that to force Persons with disabilities into nursing homes -- or any institution -- Without creating alternatives, "constitutes a form of discrimination Based on disability prohibited by Title II of the Americans with Disabilities Act."

In 2004, Kate Gainer, organized the first ever Long Road Home, a 5^th Anniversary Celebration of the Olmstead decision to assess the ‘Integration mandate’ in Georgia as President Clinton had ordered all State Medicaid programs to draw up plans to comply with the Supreme Court decision. 5 years after the initial ruling Georgia remained in 45^th place out of the 50 in providing community-based services to its Long term care recipients. Georgia ADAPT has honored this landmark Decision every year since by organizing and marching for the annual "Long Road Home" campaign which demands our State comply with the Olmstead decision.

Last year we ended our campaign with a press conference at Kenny’s alley At the Underground in downtown Atlanta. The only problem was - none of The mainstream news channels or media sources showed up to be in Attendance to relay the importance of our story and why we were Celebrating this event. Lois Clark was even in attendance to address The crowd in support. That was when Valerie Suber, the media director For the Governor’s Council on Developmental Disabilities asked loudly, “Where is the media and why do they continuously ignore our issues?” In That moment I conceived a thought, why continuously struggle to get Coverage from the mainstream news outlets when they mostly never show up To profile our issues, would it not be easier to create an independent Media site for people with disabilities, empowered by people with Disabilities with news stories and media specifically targeted for our Community.

It seemed to me that it would be an easier task to create an independent Media site than to convince corporate news outlets that our issues are Important. We as a group, as a community of people living on the Fringes of society, in the shadows of mainstream culture are largely Ignored, told that our lives are not worthy of equality, that there is No quality in living with a disability, and that we would be better off Dead. We know they are dead wrong and have been banging our heads Against the wall just to get some one to notice that we have things to Say; we feel, we hurt, we bleed!! We are human and we want our equal Rights no matter what your professional opinion thinks about our lives.

As advocates we spend so much time attempting to convince the mainstream Media that our issues affect everybody and are relevant to be reported On and yet even when they do cover our stories it is usually done in a Way that slants public opinion against us. So instead of spending all That time and effort into persuading corporate media to cover our Issues, I wrote a grant to the Governor’s Council on Developmental Disabilities to start an independent media organization for people with Disabilities run by people with disabilities to be called EndeavorFreedom.tv.

Having had the grant approved, we are now on the cutting edge of moving into and creating something which can really benefit people with disabilities as a community whole and give us a mode for expression that is not controlled by minds and opinions that do not understand and even belittle our lives. It’s bad enough that we have to struggle to hold onto our individuality and our dignity when hard pressed by a historical legacy of warehousing people with disabilities and segregating us from mainstream society just because we function differently than most.

People with disabilities make-up 20% of the population and yet disability news, stories, and events make up less than 3% of what the corporate media reports on. If you happen to be in a minority with a disability you are represented even less, and if you are poor and a minority with a disability, then truly nothing in mainstream culture reflect your/our everyday experience of life. EndeavorFreedom.tv wants to change all that. We want to capture and relay the everyday stories of everyday struggle by everyday people with disabilities just trying to manage the American dream here in the land of the free and the home of the brave. We want you to be the hero, the star, the story and we want you to share with us the stories that you consider news, issues which are important to you, that are rarely if ever seen on corporate news.

All of us are touched at some point and in some way by disability. Share with us how it is that disability affects you or some one you know. In order for us to make this project a success we are seeking the active participation of the entire disability community abroad. This will be your chance to write, shoot, direct, and edit your story and share it with us so that we can in turn share it with the world. Like the newly launched Current.tv or YouTube.com, we are empowering all people with disabilities to be the producer, editor, film director. Create, capture, and shoot the story that is important to you; share it with us and we’ll share it with the world.

EndeavorFreedom.tv also represents an opportunity for people with disabilities to become involved in media vocations which we as a community have been largely locked out of up until this point. We do have paid staff positions available to website developers, radio hosts, film editors, journalist, and camera personnel. We are also seeking creators of disability unique content and will pay accordingly. We envision expanding EndeavorFreedom.tv into the central hub for the disability community. If you are interested in being part of our project please contact me at the email above. We’ll start where we can and expand into all directions as time and space allows. We need the whole gamut of personnel with technical expertise on media, engineering, editing, filming, reporting, and hosting to make this project work. We are especially interested in bilingual personnel so that we can extend our reach to all communities of minorities with disabilities. We especially are seeking website developers with experience adapting websites to accommodate all accessibility issues as we want to insure the site for people with every kind of disability.

So, if you are or know of anybody that might be a good candidate for any of these positions, please invite them to submit their resume to ZenGarcia@alltel.net. We will be in contact soon and may invite you or them to join our staff. Even with our grant, initially we will focus on keeping paid staff to those areas of dire need, utilizing volunteer staff where we can to get things started. We will employ more paid staff positions as the site grows. As soon as the site is generating enough viewer interaction to solicit paid advertisers to site, we will further increase paid staff positions. Please consider joining us in this endeavor, we need your participation to make this a success.