Wednesday, February 25, 2009

Painting lipstick on the pig: Family Homes to get a rating per NC DHHS for making mental health patients wards of their homes

There is this 'window dressing' remedy which NC DHHS has created in terms of 'rating' the Family Homes; see: Adult care homes receive star ratings in 2009 Release Date: February 20, 2009 Contact: Jim Jones, 919-733-9190

I say, NC DHHS: do you think that the people without the internet connection or the education to use the internet are going to CHECK to see what the '5 start Michelin Guide rating' is as re: the Family Home in which to place their 'loved one'?


Dunno, maybe stink of Family Homes is wafting towards Raleigh.

On Sunday evening I was threatened w/ arrest by Buncombe County Sheriff's Department who sided w/ the owner of WNC Homes, Jeff Clifton, as I sat and tried to have therapy w/ my head injured client with chronic pain (they won't let me see the medical records because they don't want me and the resident to look at the financial records and start asking yet more questions about WHY does the resident get so little back from his social security disability check and why it appears that his funds are comingled---illegally---with their administrative funds).

See the law here: 10A NCAC 13G .1101 Management of Resident's Runds "Residents shall manage their own funds if possible." AND 10A NCAC 13G .1103 "....A resident's personal funds shall not be commingled with facility funds...."

The sheriff's department escorted me off the property using their three parole cars.

The Community Support Service workers last week were told they could not enter certain houses 'or the police will be called', though there were clients in there who had contracted w/ the Endorsed Provider company for services.

I say persue the class action lawsuit. I'm waiting to hear back re: my formal investigation request from DSS Buncombe but I don't have much hope that anything will take place re: that.

Here's the outline of that matter:

Important points:
*90,000 approximately NC impacted citizens; citizens impacted in every state who have mental illnesses and physical illnesses. If WNC Homes is reflective of the usual clients, probably 75% have diagnoseable DSM, psychiatric diagnoses. So that would be approx 60,000 affected citizens.

*42 U.S.C. 1963, I think, Statute (still searching for this; concerning mental illness discrimination and violation of civil rights) gives key to open to door in terms of federal lawsuits e.g., 'suing the government'

*payments to keep mentally ill clients is Medicaid bound which means federal money which means federal court. I am speaking about two stream funding for payment for room & board for Family Homes which comes via: 1. Medicaid 2. DSS funds, which I assume are federal.

*I understand that 4th District Court (I think I have my numbers right) is conservative system. Relatedly, NY lawsuit , specifically, Disability Advocates, Inc.,Plaintiff v.George Pataki, In His Official Capacity As Governor Of The State Of New York, et al was another less conservative district. see:

*class action lawsuit could be referred (not sure about this mechanism) to Justice Department which would be more amenable, perhaps, under Obama, re: these matters. they would argue case and psychologists such as myself would be 'friend of the court', as I understand it.

*only portion of Family Homes law, specifically, Subchapter 13G licensing of family care homes, that has to do w/ people OUTSIDE the home---as interfacing w/ Family Home administration and residents and Supervisors-in-charge of home is the following (save for physicians and there is information around the use and charting of medication): "10A NCAC 13G 0908: "Cooperation with Case Manager: The administrator shall cooperate with and assure the cooperation of facility staff with case managers in their provision of case management services to the appropriate residents." Caveat: I have asked DSS Buncombe to render decision, as per their legal advisor if necessary, if clinical psychologist receives the same 'cooperation' as 'case manager.' I do not know if their legal person can determine this or not. There are no case managers associated with this which leads me to the next matter:

*Community Support Services (CSS), a Service Definition created by NC DHHS, in order to upgrade skills of people like those living in Family Homes, is harnassed to notion of CSS workers being able to work w/ clients which is being blocked by WNC Homes and more or less by all Family Homes in NC in terms of access to financial records/ medical records, etc. In that NC DHHS has a desire to upgrade the skills of these clients----but bearing in mind that the regulatory agency of these Family Homes is a division within NC DHHS, specifically, NC Division of Health Service Regulation (see:

*Only other part of Family Homes Law which seems to allude to civil rights is this: "Resident Rights 10A NCAC 13G .0909: A Family Care homes shall assure that the rights of all residents guaranteed under GS 131D 21, Declaration of Residents Rights, are maintained and may be exercised without hindrance." Checking on GS 131D 21, RE: mental health treatment, the clause, as per the below, seems to be the most pertinent re: mental health treatment, specifically, "(15) To have freedom to participate by choice in accessible community activities and in social, political, medical, and religious resources and to have freedom to refuse such participation."

*There is this 'window dressing' remedy which NC DHHS has created in terms of 'rating' the Family Homes; see: Adult care homes receive star ratings in 2009 Release Date: February 20, 2009 Contact: Jim Jones, 919-733-9190
§ 131D-21. Declaration of residents' rights.
Each facility shall treat its residents in accordance with the provisions of this Article.
Every resident shall have the following rights:
(1) To be treated with respect, consideration, dignity, and full recognition of
his or her individuality and right to privacy.
(2) To receive care and services which are adequate, appropriate, and in
compliance with relevant federal and State laws and rules and
(3) To receive upon admission and during his or her stay a written
statement of the services provided by the facility and the charges for
these services.
(4) To be free of mental and physical abuse, neglect, and exploitation.
(5) Except in emergencies, to be free from chemical and physical restraint
unless authorized for a specified period of time by a physician according
to clear and indicated medical need.
(6) To have his or her personal and medical records kept confidential and
not disclosed without the written consent of the individual or guardian,
which consent shall specify to whom the disclosure may be made,
except as required by applicable State or federal statute or regulation or
by third party contract. It is not the intent of this section to prohibit
access to medical records by the treating physician except when the
individual objects in writing. Records may also be disclosed without the
written consent of the individual to agencies, institutions or individuals
which are providing emergency medical services to the individual.
Disclosure of information shall be limited to that which is necessary to
meet the emergency.
(7) To receive a reasonable response to his or her requests from the facility
administrator and staff.
(8) To associate and communicate privately and without restriction with
people and groups of his or her own choice on his or her own or their
initiative at any reasonable hour.
(9) To have access at any reasonable hour to a telephone where he or she
may speak privately.
(10) To send and receive mail promptly and unopened, unless the resident
requests that someone open and read mail, and to have access at his or
her expense to writing instruments, stationery, and postage.
(11) To be encouraged to exercise his or her rights as a resident and citizen,
and to be permitted to make complaints and suggestions without fear of
coercion or retaliation.
(12) To have and use his or her own possessions where reasonable and have
an accessible, lockable space provided for security of personal
valuables. This space shall be accessible only to the resident, the
administrator, or supervisor-in-charge.
G.S. 131d-21 Page 2
(13) To manage his or her personal needs funds unless such authority has
been delegated to another. If authority to manage personal needs funds
has been delegated to the facility, the resident has the right to examine
the account at any time.
(14) To be notified when the facility is issued a provisional license or notice
of revocation of license by the North Carolina Department of Health and
Human Services and the basis on which the provisional license or notice
of revocation of license was issued. The resident's responsible family
member or guardian shall also be notified.
(15) To have freedom to participate by choice in accessible community
activities and in social, political, medical, and religious resources and to
have freedom to refuse such participation.
(16) To receive upon admission to the facility a copy of this section.
(17) To not be transferred or discharged from a facility except for medical
reasons, the residents' own or other residents' welfare, nonpayment for
the stay, or when the transfer is mandated under State or federal law.
The resident shall be given at least 30 days' advance notice to ensure
orderly transfer or discharge, except in the case of jeopardy to the health
or safety of the resident or others in the home. The resident has the right
to appeal a facility's attempt to transfer or discharge the resident
pursuant to rules adopted by the Medical Care Commission, and the
resident shall be allowed to remain in the facility until resolution of the
appeal unless otherwise provided by law. The Medical Care
Commission shall adopt rules pertaining to the transfer and discharge of
residents that offer at least the same protections to residents as State and
federal rules and regulations governing the transfer or discharge of
residents from nursing homes. (1981, c. 923, s. 1; 1983, c. 824, s. 13;
1983 (Reg. Sess., 1984), c. 1076; 1997-443, s. 11A.118(a); 1999-334, s.
1.6; 2000-111, s. 3.)


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