Poor, pitiful Family Care Homes ramp up their lobbying w/ presentations of octogenarians instead of those w/ MENTAL HEALTH CHALLENGES

Dear Lou Wilson, executive director of the N.C Association, Long Term Care Facilities. & Montie (montieb2@aol.com, who sent me this article:

Adult care homes come up short

by Lou Wilson

http://www.newsobserver.com/opinion/columns/v-print/story/1462567.html#MI_Comments_Link

First of all, most of the residents of family care homes are not poor, decrepid, octogenarians, something which is implied by the above pic in the Raleigh News Observer Comment piece.

I can appreciate that Family Care Homes (this is what I attend to in terms of clients I see who have mental health challenges) don't receive enough money in order to:

1. pay their staff

2. provide nutritious & appealing meals for their residents

3. have well trained Supervisors-in-Charge (SIC) for their houses

4. take their residents to at least some of their medical appointments.

This is why I push the residents I see to go into Section 8 housing as is possible. And that is what made me persona non gratis to WNC Homes where I was seeing my clients w/ mental health challenges.

Oh, but they didn't like me looking in their charts while the resident was sitting by my side (thus obviously a release and as the Supervisor in Charge had given the resident the chart).

Why was it important to look in their charts? To see the medications that had been ordered.

Why was this important? Because I interface w/ the physicians in terms of side effects and benefits of the medications.

Why was it useful for me to see the residents in their homes? Because THEN I could get an accurate view of just how well or how poorly things were going.

What not infrequently happened in this home? strange things happened to the meds as are evident by the non stop firing of the staff.

Do I see my other non Family Care Home residents in THEIR homes? Yes.

What else did I see in looking thru the residents' chart when in the presence of the resident and as per the chart which was given to me by the Supervisor in Charge? The Personal Needs Allowance information and the co-pays which are applied against the $46 or $66 that a resident receives every month after the co-pays have been deducted from the PNA.

Did I start to ask questions and if so, why? Oh yes, I asked questions of Jeff Clifton of WNC Homes and of Mr. Corn of DSS Buncombe, who manages the Special Assistance, the other funds that go into the $1300/ month/ resident/ room & board payment. I asked and asked and asked and asked.

I wondered WHY----if a resident receives a SSDI check of close to $900----which is fairly common amongst the residents-----is that person's PNA the same as the person who receives a $650 SSI disability check. I finally learned that this was so when I met w/ Buncombe DSS.

And so, it appears to me that the residents who receive the larger SSDI checks should certainly try to get to Section 8 housing where they can have MORE of their SSDI check in their pockets.

Just because the Special Assistance is being reduced by Governor Perdue is no reason why I should not look out for the welfare of my clients-----and instead give them a phony line of why it would be in their best interest to keep being warehoused in a place where there is nothing to do but smoke cigarettes and watch TV.

When the clinical psychologist is threatened w/ arrest for rendering therapy to her client in the Family Care Home;

when the clinical psychologist spends her time making written complaint after written complaint on WNC Homes (I'm naming them: they threatened me w/ arrest and a public record was created re: that event which they instigated);

when the clinical psychologist cannot call up her clients during regular business hours and speak to them regarding appointments because the SIC has been told----in blatant disregard of what was agreed upon during a meeting at Buncombe DSS, where the psychological and the WNC administration 'apparently' agreed that the clinical psychologist COULD call her clients up during regular business hours.......

.....well, then that's when THIS clinical psychologist set out to find Section 8 housing for her clients in order that they might rise to the occasion of what NC Mental Health Reform was SUPPOSED to be about, namely the creation of more independence and individual responsibility as per the clients.

So, as far as I am concerned, pretty soon, you won't have to worry about that lack of money for the clients will move into Section 8 housing and be followed by CSS to some extent and their psychologist will even be able to see them in their homes.

Sorry: the Family Care Homes should have MONITORED THEMSELVES instead of allowing the likes of WNC homes to tarnish your good name. If you're smart, you'll figure out how to do this instead of spending your little bit of money as re: lobbying efforts----which is the purpose of this article you have sent me, an Opinion piece by the head of this lobbying effort.

You should have thought a little harder about how to make Community Support Services and mental health care something to be worked WITH not labored AGAINST.

Or were you afraid of losing your cash cows should they become too well educated about their civil rights as associated w/ they being given copies of the Family Care Home law by Dr. Hammond and being forwarded to Disability Rights NC as related to a potential class action lawsuit associated with the interfacing of Family Care Home law and the agenda of NC Mental Health Care Reform?

Oh BTW: here are the two lobbyists who are stated to be associated with North Carolina Association, Long Term Facilities:

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http://www.ncaltcf.com/pages.php?page_id=59

Fred Bone, Bone & AssociatesLobbyistP.O. Box 28586Raleigh, NC 27611Phone: (919) 832-0207

Johnny Tillett, McGuireWoods ConsultingLobbyist434 Fayetteville StreetSuite 2140 Raleigh, NC 27601Phone: (919) 836-4002

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I continue to be amenable to working WITH the Family Care Homes but not at the sacrifice of the clients and frankly, my agenda runs counter to the agenda I have so far been exposed to as re the Family Care Homes and my agenda is to create more independence for them and that is what I intend to do.

If the Family Care Homes wanted to lobby for things like:

1. more independence for the residents, which would mean cooperation w/ mental health providers

2. working w/ mental health providers as per the residents taking their own meds when feasible

3. allowing the residents to participate more in the running of the households

4. hiring reliable and dependable staff members who have no history of drug abuse problems

5. welcoming the larger community into the home in terms of interaction w/ the residents instead of creating a cloister rampant w/ isolation and all the mental health issues that worsen in such an environment....

I'D BE GLAD TO HELP.

Marsha V. Hammond, PhD

GA Depart Hum. Resources taking bids on privatizing mental health hospitals: WE'RE GONNA TELL YOU, 'WE TOLD YOU SO'

Its better to watch a wreck from afar than it is to be the recipient---as a mental health provider. Maybe it will get the Dems back into the Govna's office.

Its as if they lived on the other side of the planet instead of literally next door.

So, GA: here is what we can predict:

1. privatization won't work. Why? Because these are indigent clients and they have no money and therefore there will be no money to be made and therefore they will simply get sicker and sicker, people will get murdered by untreated people, etc.

2. NC only privatized the mental health outpt services but did it in such a way that every citizen was supposed to receive mental health services as associated w/ a term 'state funded client.' Why hasn't that worked better than the state legislature proposed that it would? Because the LME's---the authorizing entity for the state funded mental health and the overseers of Community Support Services (CSS), the people who had been the community mental health centers-----managed the state funded client mental health services in keeping w/ the demands by NC DHHS which continues to create poorly written memos which set up the private providers to crach and burn as they cannot be paid on a reliable basis.

3. NC state psychiatric hospitals have not been privatized. The Centers for Medicaid and Medicare Services (CMS), this being the federal funding that even GA will have to pay attention to----has the matter of the IMD exclusion rule which means that you cannot have more than 14% Medicaid beds in a private, psychiatric, for-profit, free standing hospital. And that is what the GA psychiatric hospitals will be if they are privatized. So, HOW does the GA State legislature think that they are going to get around the IMD exclusion rule?

Read it and laugh (or weep):

http://www.ajc.com/opinion/content/opinion/stories/2008/10/07/mentaled_1007.html

http://www.southernstudies.org/2009/03/georgia-proposes-privatization-of-mental-health-services.html

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"Still, the Georgia Department of Human Resources is pressing forward with a proposal to turn over one of the state’s seven mental hospitals to a private company as early as next year. DHR’s longer-range plan is to close four of the institutions and privatize most of what remains of the state’s mental health services by 2012, according to a report by The Atlanta Journal-Constitution’s Alan Judd and Andy Miller.

....State mental hospitals can hardly be seen as potential profit centers for private companies — one of the reasons there has been so little private or public investment in that market over the last two decades. Patients who are sent to state institutions have usually exhausted all private insurance coverage.

And unlike regular hospitals, there is no way to cost-shift the burden of caring for indigent patients by treating insured patients. Private practice psychiatrists rarely admit insured patients to state institutions. Given this, corporations don’t have many ways to make a profit from running state hospitals. They’ll probably resort to reducing staff and services — the very things that have gotten Georgia in trouble in the first place.

It’s hard to tell whether DHR officials believe privatizing mental health services will really work or whether they have become ideological slaves to the notion that the private sector always delivers higher-quality and lower-cost services than the government can.

“This is the most exciting thing I have seen, conceptually, that helps us get to real, positive change in mental health,” DHR Commissioner B.J. Walker breathlessly announced last month. In an e-mail obtained by the AJC through the Georgia Open Records Act, Walker told a consultant: “I find myself with a strategic opportunity, given budget cuts, to do what is unthinkable here.”

State funded mental health client plan didn't work in NC and neither will HB 212 health Insurance Pool Pilot Program proposed by NC Hse of Represent.

Marsha V. Hammond, PhD: Clinical Licensed Psychologist: Asheville, NC e mail: hammondmv@netzero.com cell: 404 964 5338

re: proposed HB 212, health Insurance Pool Pilot Program

March 27, 2009

Dear Representative Fisher: As you are one of the primary sponsors of this HB 212, I would like to know how this insurance pool pilot program might play out given the massive problems w./ the state funded mental health pool project otherwise known as 'state funded clients.'

I overview below the problems providing care to these people which I am very familiar with as I tried again and again to obtain authorization in order to see them. It sounds like a good idea; but then state funded mental health care sounded like a good idea. And it wasn't.

In western NC these are the specific problems:

1. Smoky Mountain Center LME had an employee retiring spin out of SMC, Joe Ferraro, and he created a company called Meridian Behavioral health Services and they see all the state funded clients and they provide peer support services---which has no professional linked to it except in terms of supervising paperwork and running groups some of the time----not even most of the time. I hammered and hammered on the Utilization Review Department of SMC LME in order to provide me w/ authorization and payment for seeing two state funded clients. I lost thousands of dollars re: my work.

2. Western Highlands Network LME based in Asheville, NC, has only 8 sessions available/ client/ year. this is not even once/ month. Moreover, the CPT code which can be utilized is only 90806 which is 45-50 min of therapy. This really does not work and frankly it would be better NOT to see clients, IMO. As per Marsha Ring, the Utilization Manager of WHN LME, IF the client can find some group therapy oriented in terms of Dialectical Behavioral Therapy (DBT) then MAYB the client will be forwarded to more individual therapy. One cannot even find out where/ when/ IF groups meet in Asheville much less the rest of western NC. Therefore, there are 8 sessions/ 45 minutes long/ client/ year. I would like to know how there are different plans for this proposed pilot.

The last one, I think we can safely say, DIDN'T WORK. Moreover, in perusing the document, this is what I see which is very concerning to me:

http://www.ncleg.net/Sessions/2009/Bills/House/PDF/H212v2.pdf"

43 SECTION 5.(c) The Department of Insurance may adopt rules concerning the44 collection of pertinent data from all insurers covering small and large employer groups in the45 State, whether through a Demonstration Project or through the traditional small and large group46 markets, to conduct the evaluation authorized by this act. Data collected pursuant to this section47 shall be the minimum that the Department deems necessary to perform its evaluation, and data48 collection shall not occur more frequently than on an annual basis during the life of the49 Demonstration Project authority.

What does the above 'say' to me? That there will be created a massive amount of paperwork associated w/ seeing these clients and that means that providers will avoid these citizens....just as providers avoid state funded mental health clients.

Thank you for your response. Marsha V. Hammond, PhD

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sent to me by Representative Fisher's office in Asheville, NC:

"HealthCounties interested in establishing health insurance pilot demonstration projects to provide a model for affordable employer-based health insurance would be authorized to do so under a bill that passed the House this week (HB 212).

The bill will now go on to the Senate. 2009-2010 SessionHealth Insurance Pool Pilot Program.here is link: http://www.ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=2009&BillID=H212

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What might be the problem w/ this pilot program? If its anything like the state funded client matter associated w/ mental health services, this is what can be depended upon to happen:

1. minimal services will be available (for state funded clients it is 8 psychotherapy sessions/ year, of the shorter version, 45 minutes that is available)

2. any Enhanced Services such as Community Support Services (CSS) will be essentially non available; 2/ hrs/ week were available and no company can afford to see someone for less than 1 hour/ week or less given the massive paperwork associated w/ CSS).

3. smart LME's (I guess they're smart; they certainly kept me from seeing my state funded clients) will simply create shadow companies that scoop up all the clients and give them inferior services e.g., peer group support, no professionals present, and get paid a capitated amount for the numbers of lives served.

Yeah: if that's happening w/ this (again), someone better ALERT THE PUBLIC.

Why Mental Health Providers keep sinking like rocks: NC DHHS couples w/ Value Options to write confusing memos: HELLLOOO Secretary Cansler

Medicaid authorizations are not difficult to obtain for a simple service such as therapy rendered by a Licensed Psychologist (LP), such as myself. It entails the filling out of a one page form which is faxed or mailed and usually the therapy is re-authorized after the basic 8 sessions are utilized.

However, this is completely NOT true as related to the Enhanced Services such as Community Support Services.

And let's not forget this fact. Secretary of NC DHHS, Cansler, worked as a private lobbyist to assure that Value Options got the multi-million $$$$$$ gig doing authorizations for NC Medicaid clients. Prior to that, he worked as second in command at NC DHHS from 2000-2006. Now, he's back at NC DHHS and gee, I wonder how it is that Value Options NOW works to limit the $$$$ utilized for Community Support Services.

Is that a coincidence?----this ever diminishing Community Support Services $$ or are there surreptitious intentions here?

Which reminds me, I have not yet heard from Secretary Cansler regarding the 'private' minute meetings associated with the removal of 50 Broughton (Western NC public psychiatric hospital) to be consumed by the private, free-standing, 14% only Medicaid beds psychiatric hospital in Winston Salem being built by Old Vineyard Behavioral Health (OVBH).

OVBH had private meetings starting in early 2008, as per the Centerpoint LME notice put out 2.20.2009 , with Centerpoint LME as well as NC DHHS. IN that memo, Cansler was stated as heralding this creation of cooperation in order to create hospital beds within a facility that could only have 14% Medicaid beds as per the Centers for Medicaid and Medicare Services (CMS) IMD exemption rule. That rule requires that psychiatric hospital beds for Medicaid clients be in general hospitals in keeping with CMS belief that psychiatric patients also much of the time could have or do have physical difficulties that could need attending to.

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So, how does Value Options destabilize Endorsed Provider companies?

Remember: NC Mental Health Reform was supposed to be about: privatizing and making more competitive! mental health services.

However, there are multiple newspaper articles from every newspaper in NC, over the past several years, documenting that mental health providers have dropped like flies leaving consumers w/ no services and the reasons can be pinned directly onto Value Options and how they interpret the confusing memos created by NC DHHS.

Basically, here's the gig: the Endorsed Provider companies operate to some extent on faith in terms of providing Community Support Services to clients who have serious mental health challenges and are attempting to upgrade their skills which is the agenda of CSS.

The Endorsed Provider companies put their necks out in providing CSS to clients. CSS must be re-approved every 90 days. New signatures of the client/ the client's guardian must be re-obtained. Recently NC DHHS created a new "Update/ Revision Signatures' page. However, they were not clear as to WHEN this new signature page had to be used. Additionally, Value Options takes months to provide a written authorization for services. This results in the Endorsed Provider company being squeezed from both ends: they have employees who see their CSS clients and they must be paid but then VO shuffles the cards always in their favor.

You might think that the 'wrong form' is not such a big deal but this would be incorrect. If the wrong form is turned into Value Options, the client can have a 'gap' in services which means that ALL of their services can be cut.

Most importantly, if there is a 'gap in service' , it counts as a NEW APPEAL and the services are not guarantees under Maintenance of Service.

Indeed, it appears that VO employs this 'you turned in the wrong form' as an opportunity to remove CSS Medicaid services.

This is not to even mention the yearly update of the Person Centered Plan (PCP) form and all of its issues.

CSS requires reauthorization every 90 days. If, CSS are cut by VO, the Medicaid client can appeal. The client can continue to receive the same CSS during this period identified with "Maintenance of Service." However, again, the Endorsed Provider company has to put its neck out, assuming that VO will continue the same level of CSS, usually 8 hours/ week/ client.

Unlike what the Endorsed Provider companies and their employees are required to do which is to not allow a gap of services to take place, VO can take months---from the time that the authorization request is submitted by the Endorsed Provider company----to give a written authorization. This means that for that period of time, the Endorsed Provider company is counting on the continuation of services.

This loss of money as related to employing CSS workers and paying them on a regular basis----when the CSS may be cut significantly to 1 or 2 hours/ week (which is now not uncommon)---- discourages companies from providing continuous Community Support Services as they have to go out on a limb in terms of 'having faith' that the CSS will be authorized.

That is one significant reason for a loss of mental health services in NC.

More recently, in 2009, NC DHHS created this new 'Update / Revision Signatures page'

Here is an example of how this has played out recently as pertaining to this new 'Update/ Revision Signatures page':

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Medicaid client living in a Family Care Home (where tens of thousands of mental health challenged clients live in NC) has been in Medicaid appeal for over a year. OVER A YEAR.

This means that the Endorsed Provider company has been operating on faith for OVER A YEAR.

Client has been covered by 'Maintenance of Service' (Medicaid pays for his Community Support Services while it is in appeal). Client had a mediation hearing one month ago; his services were extended for one month at the same rate so that he could obtain a neuropsychological assessment (he has a head injury). He obtained this assessment.

The Endorsed Provider company QP (supervisor) sent in the 'signature page' associated with the Maintenance of Service. VO maintains that the WRONG signature page was sent in which will create a gap in service which means that the Endorsed Provider company will suck wind.

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Here is the NC DHHS memo explaining WHEN to use WHICH signature page:

http://www.dhhs.state.nc.us/mhddsas/servicedefinitions/servdefupdates/iu54/dmadmh2-2-09update54.pdf

NOTE: Implementation Update #51 indicates that, “The revised documents will have an effective implementation date of January 1, 2009; this means that any PCP annual review that is due in January of 2009 will need to be updated on the new forms. Revisions will not be subject to the new forms, only the annual plan.”

• The new documents are now effective March 1, 2009.

• Any Introductory PCP, Complete PCP or PCP annual review that is due in March of 2009 will need to occur using the new format.

• It will also be necessary to use the new Update/Revision form for any reviews taking place in March 2009. The only significant change to this form is the signature page. If a new service is added to a PCP as a result of a review and update/revision to the plan, Part 1, Section A of the Signature Page, with the new check boxes must be used.

PROBLEM: Used old signature page as no new services added on this review (3/17/09) as per Implementation Update #54;

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Was it clear to you WHEN and WHICH form you were supposed to use?

NC DHHS needs to employ some English majors to overview their publications as they appear to not be able to write them clearly----if that is what they are trying to do----which is an assumption in itself.

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Here is the e mail to VO as associated with the turning in of the wrong signature page:

PSDCustomerService (PSDCustomerService@valueoptions.com) : Ryan N. is identified as the VO provider liaison employee:

"We apologize if DMA’s Implementation Update led you to believe that the new PCP signature page was not needed for this review, unfortunately, per DMA any review that takes place after 3.1.09 does need to be performed on the new signature pages. The signature pages included in your request are signed on 3/16 and 3/19 by QP and member and the PCP itself shows the reviewed data as 3/17/09. As per another of DMA’s policies we will only be able to grant authorization as of the date of updated corrected request if received so there will be a gap in services due to this. "

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Basically, VO interprets NC DHHS memos in such a way that mental health services are removed and there is very little that the Endorsed Provider companies can do other than just go broke.

Across NC, people are beginning to see the light re: the warehousing of citizens w/ mental health issues living in Family Care Homes

From the FayObserver with a statement from a member of NAMI Moore county pertaining to her schizophrenic son who lives in a Family Care Home:

http://www.fayobserver.com/article?id=321925

"In addition, many mental health patients are being lumped into facilities with the elderly or people with developmental disabilities, said Laura Gingerich, a board member of NAMI-Moore County.Gingerich’s son, who suffers from schizophrenia, is in an assisted-living home, where most of the patients are elderly. Fran Stark, also a board member and pastor for two churches in the county, said it’s a common problem. Stark, who has begun an outreach program for the mentally ill, said several members of the program are mentally ill and living in assisted-living or nursing homes. “Assisted living was designed for geriatric care,” she said. “That’s what the staff is trained for.” Lancaster agreed that mentally ill patients traditionally have been placed in adult-care homes because of a lack of housing. "

NC DHHS sees that 50 Broughton PUBLIC MEDICAID psychiatric beds go to OLD VINEYARD PRIVATE FREE STANDING 14% Medicaid beds psychiatric hospital

I think this is tragic. Public psychiatric medicaid beds are beds ' for the people'----not the private-enterprise, free standing, psychiatric hospitals who can only have 14% medicaid beds (bearing in mind that most people who have Severe Persistent Mental Illness have Medicaid: their medicaid will be no good in this hospital once the 14% threshold is passed).

Here is my comment to the announcement that Old Vineyard will get its way in terms of having a 14% Medicaid bed psychiatric hospital as per 3.20.2009 meeting today, as associated w/ the Department of Health Service Regulation meeting today in Winston Salem, 1 pm, with public comment:

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"McCartney (CEO Old Vineyard) said that Old Vineyard will serve all patients to the point of being stabilized regardless of their ability to pay. We will not turn people away when they cross our threshold. If we have to do charity care, we will do that."

I personally will keeping an eye on your promise, Mr. McCartney, via the mental health advocates in your area. When you surpass that magical '14% medicaid beds only' mark, if you turn away clients, I am quite sure that the mental health advocates will catch wind of this.

I think you have just foisted some magical thinking upon the public, the sheriff included, who transport the clients. I think that any psychiatric unit should be able to accept ANY PSYCHIATRIC PATIENT.

And I do not believe that Old Vinehard Behavioral Health will take a loss.

I believe that you will quickly transfer the patient to some other psychiatric unit.

And I am still waiting for the release of the public oriented records discussing the creation of this hospital and the related transfer of 50 PUBLIC MEDICAID western NC Broughton beds.

Marsha V. Hammond, PhD: Clinical Licensed Psychologisthttp://madame-defarge.blogspot.com/

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Here is the article:

http://www2.journalnow.com/comments/posted/?c=50:79234

"Two local law-enforcement officers said yesterday that they support the creation of a local 24-hour psychiatric-emergency department for professional and economic reasons.
Capt. Patricia Murray of the Winston-Salem Police Department and Capt. Robert Settles of the Forsyth County Sheriff's Office spoke at a hearing for a certificate of need for a proposed $13.8 million center being pursued by Old Vineyard Behavioral Health Services.
If the center is approved, Triad residents dealing with a mental-health crisis would have a new option for treatment in a 50-bed center by January 2011.
When law-enforcement officers pick up someone having a mental-health crisis, they are responsible for the person until he is admitted to a health-care provider, no matter how long it takes.

75 Psychiatric Beds leaving western NC with years of planning necessary to create community mental health beds in hospitals

It took more than two years---from my very limited perspective as an outside observer---to get the 16 adult psychiatric bed unit up and going in Haywood Regional Medical Center in Clyde (next to Waynesville) NC. I'm guessing that there were years of planning work prior to that.

In order for Medicare/ Medicaid beds to be created within general / community hospitals, a great deal of planning has to take place. You do not simply open a unit and declare you are ready to see patients.

In order to carefully attend to matters associated with CMS (Centers for Medicare & Medicaid Services) and preserve the beds for possible Medicaid patients' admissions (most people w/ severe and persistent mental illness, SMPI have Medicaid) , the IMD exclusion rule is taken into account.

I assume that this is why there are few to no private free standing psychiatric hospitals and assumably why Asheville lost psychiatric beds that were here 20+ years ago e.g., Charter Hospital & Appalachian Hall in Asheville, NC

Governor Perdue is taking away 75 of Broughton's beds. I understand that no adult wants to be hospitalized at Broughton (I have heard differently about the child and adolescent units) but there is no in-the-works community / general hospital psychiatric beds in the works----that I know of. Yes, its a good idea to keep people w/ mental health challenges in their communities.

No, its not a good idea to rely on the already fractured 'community support' systems which are composed of limping-along Endorsed Provider companies----which is what NC Mental Health Reform was supposed to be about in the first place. However, that, apparently is what is intended as per this Associated Press (AP) article:

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"North Carolina's proposed state budget would reduce the size of two state mental hospitals to save more than $6 million a year. The plan would rely on community treatment for those patients."
http://wake.mync.com/site/wake/news/story/29974/

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I sure hope that the state legislature gets a jump on this which is stated in the Raleigh News & Observer article:

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"Perdue's budget would shut down 50 beds in state psychiatric hospitals -- 25 at Cherry Hospital in Goldsboro and 25 at Broughton Hospital in Morganton -- saving more than $6 million a year. ......The budget adds $12 million to contract 111 additional local hospital beds for mentally ill patients, a priority for legislators interested in mental health policy."

http://www.newsobserver.com/news/story/1449062.html

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Here is my comment to the Raleigh News & Observer article outlining the additional loss of the 25 beds at Broughton:

" 75 PSYCHIATRIC HOSPITAL BEDS ARE LEAVING WESTERN NC: Adding these 25 Broughton beds to the already proposed loss of 50 more PUBLIC MEDICAID Broughton beds= 75 lost psychiatric beds in western NC. The 50 beds are to be transferred to a PRIVATE FREE STANDING ONLY 14% Medicaid (IMD exclusion rule per CMS) beds endeavor put together by Centerpoint LME/ NC DHHS/ and Old Vineyard Behavioral Health. I have asked for a release of the documents associated with those closed doors meeting (HEY, Gov Perdue: where's that transparency?) which was indicated in a 2.20.2009 memo put out by Centerpoint LME. Here's MY question: Was Cansler the lobbyist, during his revolving door career, who advanced this project BEFORE he was Secretary of NC DHHS? May have to evoke FOIA via Electronic Frontier Foundation in order to hack thru shrubbery blockading the real view. Marsha Hammond, PhD: http://madame-defarge.blogspot.com/"

Formal complaint filed w/ DHSR re: opening of Family Care Home resident's mail: people w/ mental health challenges w/o civil rights

I have sent off paperwork today re: filing a complaint associated with the following statement within the NC Family Care law:

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http://ncrules.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2013%20-%20nc%20medical%20care%20commission/subchapter%20g/subchapter%20g%20rules.html

10A NCAC 13G .0906 OTHER resident SERVICES

(1) Residents shall receive their mail promptly and it must be unopened unless there is a written, witnessed request authorizing management staff to open and read mail to the resident. This request must be recorded on Form DSS‑1865, the Resident Register or the equivalent;

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I had a client living in WNC Family Care Homes, Asheville, NC 28801, whose mail was intercepted by Jeff Clifton as he paraded the letter at DSS Buncombe meeting on March 16, 2009. Heckuva job, Jeff, giving yourself away like that.

Onto the HIPAA violations tribunal.

The letter had been sent to the client in order to present it to Pisgah Legal Services. I was asking Pisgah Legal Services to assist him in terms of he petitioning the court to become his own legal guardian.

As per that Release of INformation form, Pisgah Legal Services is the ONLY 'to obtain from' entity listed on the Release of INformation form signed by the client & myself.

I suppose that DHSR and DSS Buncombe will go over there; ask the client did you receive your letter; he will state no but Dr. Hammond handed me a copy; and they will do WHAT?

Well, so sorry, Dr. Hammond, we couldn't verify that anything took place.

(HELLOOOO Jeff Clifton and other Family Care Home administrators and your lobbying group reading me e mails which I am purposefully putting on my blog).

cc: DisabilityRights NC: Lead attorney: "John Rittelmeyer attny disabili rights " <john.rittelmeyer@disabilityrightsnc.org>

NC Depart.of Hlth Service Regulations & what they have to say about my complaints on a Family Care Home:nothing useful to those w/ mental health probl

It certainly seems to be true what mental health providers and Endorsed Provider companies have 'understood' in terms of not tangling with the Family Care Homes. You do what we say and we'll let you work with our warehoused residents. Just so we know who's in charge here.

There are tens of thousands of disabled people being warehoused in these Family Care Homes across NC. The county Department of Social Services, Adult Protective Services, is whom is supposed to be 'spotting the problems' but gee, I'd like to know how are you going to do that by even a 'surprise visit' when they know who you are? Gosh, I think I'll act like the jerk I was to that psychologist when I told her she couldn't speak to our (warehoused) resident. Or maybe I'll call the sheriff on the DSS lady.

Most of the residents of Family Care Homes need to all get Section 8 housing. Or most of these residents, anyway. IN a humane world, that is what would happen. HEY! Maybe that will happen as Governor Perdue has indicated she is going to cut the Special Assistance which is the other stream of funding keeping people in these Family Care Homes.

NAH: their lobby will see that this doesn't happen. Nothing like a good bunch of complaints to drag out the lobbyists. See here: its in the news how swell they're doing:

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N.C. Adult Care Homes Receive High Ratings From State Inspectors
Fri Feb 20, 2009 8:30am EST

Introducing Friends of Adult Care HomesFriends of Adult Care Homes is a new advocacy organization established by theN.C. Association of Long Term Care Facilities to raise awareness of issuesthat affect adult care in North Carolina and promote needed reforms. It is acoalition of North Carolinians who are committed to ensuring that residents ofadult care homes and assisted living facilities receive competent,compassionate and quality care. Friends of Adult Care Homes represent residents and family members, employeeswho work in the adult care industry and others who want to improve the levelof care that our state's oldest residents receive. To join, or learn moreabout this organization, visit www.friendsofadultcare.com.SOURCE Friends of Adult Care HomesLou Wilson, Executive Director of the N.C. Association of Long Term CareFacilities, +1-919-787-3560, lou@ncaltcf.com; or Robert Brown,+1-919-810-1901, robert@rbpr.com

http://www.reuters.com/article/pressRelease/idUS151478+20-Feb-2009+PRN20090220

Boy, I wonder how much money you have to have to create a Reuter's Press Release.

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Now that this is out of the way.......I'll just keep filing complaints and see if anything at all shows up on the NC Department of Health Service Regulations website or if, as I suspected, this site is just all fluff: no information about why a Family Care Home has its rating. Simply put: we make the rating and you believe it.

Here is the public information on the DHSR site w/ comments about the site which I had most of the complaints about, including being threatened w/ arrest. http://www.ncdhhs.gov/dhsr/acls/star/worksheet.asp?id=8

Do you see any indication of complaints there? Not me.

Gosh, get over it, lady.

And, apparently, I'm not going to get anywhere by filing complaints against Family Care Homes as regards their regulatory people----at least at the local level. Probably not at the state level either. Not even at the level of any information on the NC Department of Health Service Regulations. Why, there's not even any information about any complaints BEING filed.

There is no info there. Nothing indicating why there is a score of '3' re: WNC Homes, Leicester, NC. In fact the homes are even mis-named on the DHSR site, thus removing the stigma away from WNC Homes, instead pinning it to the previous owners who called it 'Lee's Evergreen.'

I have received six letters associated with the following complaints, some of which were stated over the phone by me and some which were written in letters by me.

Here are the numbers of the complaints and here are the general statements regarding these following matters which grossly are the complaints:

1. Supervisor in Charge refused to let me talk to my clients.

2. Client stated he had been told by WNC administration not to see me anymore.

3. WNC homes called the Buncombe County Sheriff on me as I was rendering therapy at 6:30 pm, a Sunday evening, 4 weeks ago and accused me of trespassing 'their' property. A report number was created, thus initiating a public dialogue about the public figure reporting this, myself, and Jeff Clifton of WNC Homes.

4. WNC Homes refused to transport a client with an agreed upon rendezvous so he could join the YMCA. They left me waiting for an hour wondering what was going on.

5. WNC Homes refused to answer US Mail letters written by myself and residents pertaining to attempting to get an explanation about PNA, Personal Needs Allowances, not paid, and no explanation available as per clients being taken by Community Support Services workers to the Social Security Administration in Asheville.

6. WNC Homes intercepted a US Mail letter intended for a client at its Asheville homes location and took it to the Buncombe DSS meeting on March 12, 2009, 2-4 pm and attempted to use the intercepted letter to indicate that the resident had no right to petition the court in order to reconsider he being his own legal guardian and thus able to be issued his own disability check instead of having WNC Homes be the payor and he left wondering where his PNA check was.

7. I do not believe that WNC Homes can violate the civil rights of the residents and forbid the psychologist from seeing them at their residence when the physician and physician's assistants and psychiatrist see the residents at their family care home.

But heck, what do I know? Gee, I guess when DSS and DHSR made their 'unannounced visits' they still identified themselves as being from DSS and DHSR. What would have happened if they had said they were working w/ Dr. Hammond? "Sorry, you cannot see that client."

I guess I am going to have to figure out I can obtain Deep Throated type information identifying what is taking place. I always did want to be a cloak and dagger spy.

These are the Complaint investigation numbers included in the six letters dated March 12 and March 10, 2009:

Licensure Number: FCL-011-243
Licensure Number: FCL-011-280
Licensure Number: FCL-011-254
Licensure Number: FCL-011-256
Intake number: NC00054112
Intake Number: NC00054122

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This is the letter associated with the 'intake number' complaint:

"thank you for contacting Division of Health Service Regulation with regards to your concerns about the care and services residents received at WNC Family Care Home ---------(number of home or homes----just to muddy the waters so you don't what exactly they are referring to). We regret the care provided by this facility has not been satisfactory to you.

Your concerns have been referred by theComplaint Intake Unit to the Buncombe County Department of Social Services for investigation. Ms. Cheryl Simcox, Adult Services Supervisor, with Buncombe County Department of Social Services has been requested to assign an Adult Home Specialist to investigate your concerns and provide you with a written report of the findings. Should you have addiditonal questoins about this investigation, please contact Ms. Simcox by telephone at 828 250 5870.

Your request for state involvement in this investigation will be forwarded to Mr. Joan Cross, Assistant Chief, Adult Care Licensure Section, Division of Health Service Regulation, for approval. If approved, Ms. Cross will assign a state consultant to provide oversight and technical assistance to Ms. Simcox and her staff with this investigation. Ms. Cross or other staff in the Adult Care Licensure Section will inform you if your request if approved. Should you have additional questions about this investigation, please contact Ms. Simcox by telephone at 828 250 5870 or Ms. Cross at 828 670 3391.

If you have any questions, please feel free to contact us. Whenever you contact our agency in the future, please reference the intake number at the bottom of this page. Sincerely,
(signature of Rita C. Horton, fea?) but typed with Johnnie H. Lawson, RN, Complaint Intake Unit.

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Intake Number NC00054122: REPEAT THE ABOVE
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Here's what they send you as associated with the Licensure Number complaints: (it's not entirely clear to me why you these two different tiers of complaints' assigned numbers):

"This letter is in reference to the Adult Care Licensure Section and the Buncbome County Department of Social Services investigation of your complaint about WNC Family Care Home ----(a specific number this time!) in Asheville, NC. Staff with the Adult Care Licensure Section and the Buncombe County Department of Social Services made an unannounced visit to this facility on March 6, 2009 for the purpose of invetigating your concerns. As with all investigations, the determination regarding your allegations is whether the facility is in compliance (unsubstantiated) or not in compliance (substantiated) with the statute or rule governing the event reported by you.

The visit included observations of residents; interviews with residents and staff; and review of resident and facility records.

Based on the evidence collected, the allegations regarding 10A NCAC 13G 0909 Residents' Rights, 10A NCAC 13G 0906 Other Residents' Services and 10A NCAC 13G 0902 (d)(1) Health Care were not substantiated. the fact tha tthe allegations were not substantiated does not mean, of course, that they were not valid. It simply means that based on the information available the allegations were unable to be verified at the time of the investigation.

Thank you for reporting your concerns about the facility. If you have any questions concerning this investigation, please do not hesitate to contact our office at 828 670 3391. Sincerely, Fran Conn, Licensure Consultant Adult Care Licensure Section.

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FCL 011 254: REPEAT THE ABOVE
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FCL 011 280: REPEAT THE ABOVE
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FCL 011 243: REPEAT THE ABOVE
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How to make enemies amongst the mental health advocates in NC : boundary issues & how NC DHHS/ Centerpoint LME stands to profit

Dear Mental Health Advocates and Mental Health Association folks in eastern NC:

NC DHHS is counting on us falling into a heaping, blistering mass of 'he said, she said.' So is the NC State Legislature. So is the Centerpoint LME. So is the Forsyth Medical Center. So is Old Vinehard Behavioral Health. So is Smoky Mountain Center LME.

The only LME with which I am familiar that I would venture has some scruples is Western Highlands Network LME who has people at the top who don't smile at you : they let you know that they are the regulatory agency. Don't send us candy at Christmas; we'll send it back. Don't send us get-well cards; we don't want them. You stay over there and we'll stay over here.
Boundary issues.

I salute the Forsyth MHA effort re: trying to discover if there were changes regarding providers and consumers, as per their surveys from 2006 to 2008 . However, effort does not equate to good work. And if you are being looked to in order to provide accurate information, that's one thing. If you are being looked to, with the assumption that you are attempting to put a salve on things and make things better, that is another thing.

From my viewpoint, the MHA-Forsyth 2008 report served the purpose of making it OK that the Centerpoint LME, whom the mental health advocates have labored to call to task, continue to try and get a little better every year. I expect there will be another report in 2010 which will echo something similar: we made a little progress, not much (oops: don't look at the data points please).

And so, here is where I stand pertaining to my assessment of anyone or anything's work: WHO IS SPEAKING?, vis a vis Michele Foucault, a French philosopher. Who are the powers that stand to gain? Who is speaking?

I will not engage in this 'he said/ she said.' Let us be adults and let us consider that we all could benefit from healthy boundaries.

It may be that the Forsyth County MHA is the 'best in NC.' We all work hard given the limits of what we can do. I believe that almost 100% of people who work in the arena of mental health have a desire to help people. It IS important to keep that in mind.

However ----all of us, and I include myself----make efforts that run amuck for various reasons: you don't have the time to do the task; you want to get along with others whom you perceive to protect your back; you over- or under-state what you know; you grow giddy with power.

I believe that the biggest barrier to moving mental health care ahead in NC---or any other state or country in the world----is associated with the keen desire to get along with others. This is true about any difficult agenda. You make coalitions, you create dyads----and in this way you perceive that you slowly move things ahead. Not as far as you would like to move them but slowly.

Such affiliations, while many may perceive them as being necessary, there is a role for the person who stands outside the circle and maintains boundaries that are not permeable on the basis of 'gee, let's get along.'

This is how state legislators create dyads of power: you watch my back, I'll watch yours. This is how mental health advocates create groups that have a common agenda. Again, while these coalitions may serve to alert the public to some pressing public health issues, too much of the time such coalitions fall prey to cozy relations that eschew frank comments.

To suit, from what I can tell, NAMI NC, has such an agenda. They were perfectly willing to use the 'D' that was apparently rendered by NAMI National in order to speak to the continuing problems associated w/ NC mental health. But I'll be damned if NAMI NC aren't the people who have done more to allow this train wreck to cascade into one long blistering eyesore and mental headache.

Multiply by 10 that responsibility that fell on the shoulders of the NC Psychological Association and the NC Psychiatric Association----the professionals who threw their hands up in the air and ran away. Actually, they didn't run away. They just put up gigantic fences so that nothing could get in and nothing could get out, much like Plato's allegory: gee, these shadows are reality-----AREN'T THEY?

All these groups could have held state legislators feet to the fire and yet they went along, hoping for some spot at the table. But people wanted to get along more than they wanted to speak the truth.

I submit that one of the reasons that professionals do not participate in NC mental health reform is because they are not eager to take on the irritation of the mental health advocate community.
I am very clearly attempting to make a comment about boundaries here. The mental health advocate community has an opportunity to critique what I have critiqued. Bring out your best statisticians; let's hear from your creators of surveys and psychologically oriented instruments. Let's have the data and information from the 2006 survey you did, MHA-Forsyth.
Or are you going to boo hoo and resubmerge yourselves into a collective that evades standing up and asking for what you want and desire? Are you going to ask for good reports based on sound data collection that substantiates you as significant players to be dealt with?

Let's not critique each other at the level of, 'well, don't you want to get along with us?'

Not if it means I shut up and give special favors to someone's study. This is a boundary issue. This is where you differentiate yourself from me. And to my mind, boundary issues are the biggest, most disavowed and ignored issue in mental health. Boundary issues implies respect for what the other has said. You may completely disagree and if so, state how.

People who work in academia, as I do, take no survivors. I have seen colleagues make blistering comments on someone I might assume they value and like. It is true that this can turn into oneupmanship but on the other hand there is a freedom to critique that is revered and is not associated with, "I'd rather get along with you."

There is a German tale (where the really old universities are) associated with how a dissertation is defended. Yes, that is the term: a dissertation is defended by the person who did and wrote the research. The tale outlines that you leave the knives and swords at the door for you are about to engage in a task that may make you want to kill someone else.

When I lamblasted the 2008 MHA-Forsyth report, I used my moderate amount of knowledge as associated with how surveys are created; how data is utilized; how do you compare sets of data; what you can say from your data.

I believe that what I had to say about the Mental Health Association of Forsyth county, as related to their report evaluating consumers and providers in 2006 and 2008 is, to the best of my knowledge, accurate in terms of the 2008 data information which I was given. I believe it is public information but I may be wrong. I know that advocates around Forsyth county worked long and hard to get the results.

Limitations may be in the form of : lack of funding; lack of education; lack of expertise; lack of Its all well and good to want to do right and make things better. I think that all of us who work in mental health have that as a primary initiative. And I salute the Forsyth MHA effort re: trying to discover if there were changes .

However, effort does not equate to good work. This is like a child asking that the teacher give you a good grade because you 'tried really hard.' The teachers that caught my attention and made me sit up were the ones who gave me F's. MAN: I'd better see if I can understand what you are talking about.

And if you are being looked to in order to provide accurate information, that's one thing. If you are being looked to, with the assumption that you are attempting to put a salve on things and make things better, that is another thing.

This ain't no time to sing Kumbaya, my friends.

Lies, Damned Lies, & Statistics: Mental Health Association-Forsyth blew its money on an moth eaten report funded by the United Way

What a mess this report is. So how much money did we spend on this? United Way, you blew your money. How much public money went into this?

Here is a statement about the presumed results of the MHA-Forsyth report:

"...What do the survey results show?
Some areas in the delivery of publicly-funded mental health services still need attention."

http://www.forsythunitedway.org/pilotFiles/bulletinBoard/files/2009%20MHA%20IN%20FORSYTH'S%20SURVEY%20PRESENTATION%20%20%20%20%20.pdf

Gosh. Really? No you cannot even say that. Indeed, you can't say much of anything for the gaping holes associated with the data collection.

I do not see the entire report online anywhere. If you want a copy of the pdf as forwarded to me by a mental health advocate, come to me back channel and I will send it to you: hammondmv@netzero.com

Save us from the reports. Or at least save us from these endless mental health reports that are of poor quality. If this had been a doctoral dissertation I was marking up, I would have punted it back to you and told you to recollect your data----so many holes are there in terms of unanswered questions. No conclusions can be made on the basis of the data set which is spelled out here:

Moreover, where's this blog so I can put my statements on it?: : 'The MHA has suggested as a result of the data collected through this survey, additional recommendations from the February 23rd presentation audience included creating a blog for fielding comments from the community, "

The biggest need, stated by consumers, was individual therapy, however only 50 of the 220 participants receive it. And if you're a state funded consumer, you get 8 sessions and THAT'S IT for many of the LME's across NC. Specifically, in western NC, associated w/ Smoky Mountain Center LME, state funded consumers get NO individual therapy. As associated with Western Highlands Network LME, you get 8 sessions and then you have to harass Marsha Ring, the Utilization Review manager to get anymore (which you won't as she believes that most people don't want more than this-----something she stated to me on a phone call about a year ago).

The study implies that it is a longitudinal study of mental health providers and consumers associated with the Winston Salem area of NC. Since the 2006 data set is not associated w/ the 2008 data set information, there is no way to verify that this is true or false.

There are lots of problems, in terms of clarity of the data and their presumed findings based on data problems as per the long-awaited , "ONGOING IMPACT OF NC MENTAL HEALTH REFORM ON CONSUMERS AND STAFF/PROVIDERS IN FORSYTH COUNTY conducted by The Mental Health Association in Forsyth County, Inc. "

The Mental Health Association of Forsyth County (MHA-Forsyth county) appears to want to declare that changes re: mental health care has 'stabilized' or at least not gotten worse but their statements cannot be corroborated as per their data which is listed. This is what MHA-Forsyth stated as a conclusion (well, they have encrypted it so you cannot cut and paste: how clever and how indicative it is that they do not want people to utilize their document):

"...the 2008 survey indicates that there have been very minimal improvements for consumers and staff...."

I don't think they can state that AT ALL. I think they have a flawed report and these are the reasons why I think that:

1. the 2008 MHA-Forsyth is being compared to 2006 MHA-Forsyth. Where is the 2006 data? The n or number of consumers =220. What was the number of 2006 participants as associated w/ comparing? Were the consumers more or less matched in terms of being 'similar' as associated with demographic and any other salient characteristics that could have been speculated to skew the data----or not?

2. On p. 19 of the report, there are 50 consumer participants that are not identified as being from any agency. Where did they find them?

3. 3/4 of the consumers surveyed had been receiving services for less than a year. So, were the participants/ subjects matched in terms of demographic and other salient data in order to compare them? (again, where is the 2006 data).


4. This below table is most problematic because the numbers do not add up in terms of If n= 220, how can you have 74 uninsured and 207 w/ Medicaid? You either have one or the other.

5. Its not clear how many providers were surveyed. The n or number of participants, associated with the various questions ranged from a few dozen to 135. And, how many providers were surveyed in 2006 and where are those survey questions? They're not in the appendix.

6. There were only 5 provider companies surveyed. How did the five separate companies get CHOSEN as associated with Centerpoint divesting its clinical arm?: "HopeRidge provided clinical services from July 1, 2004 until August 31, 2005 when it went out of business and most of its services were divested to five separate private companies. " Who chose the companies? Are they same ones that were surveyed on 2006? How many of the same providers responded? For what reason? What were the politics associated with that? Why only five companies?

7. pretty darn important matter not to have collected data on: "Although we did not collect data on the refusal rate, we estimate that the refusal rate was approximately 25% across agencies." Which agencies? and which agencies participated or can't you say as re: anonymity or was the anonymity at the level of INDIVIDUALS within the agencies or as per the agencies themselves? Again, an important point.

8. The MHA- Forsyth report stated: "In addition to the questions adapted from the state survey, we added demographic questions and some open-ended questions that allowed staff and consumers to provide additional information about their experiences and opinions. " What did you do w/ the additional demographic data gathered, apparently, only in 2008? What did you do w/ the open ended questions?

9. The MHA-Forsyth report stated: "Quantitative data were analyzed using standard descriptive statistical methods with Excel 2003. To analyze qualitative data from open-ended survey questions, we developed a standardized, explicit coding system using content analysis. " So, you utilized a mixed methods analysis. EXCEL is simply an organizing tool. And so how did you compare 2006 to 2008?

10. This is very problematic, this statement, to my mind as you have mixed Basic Level Services with Enhanced Benefits services: "In regards to service needs, case management, community support, and individual therapy/counseling were all services that approximately 20% of consumers surveyed stated they needed, but did not currently receive. " So, your statement indicates that case management is grouped, in terms of NC mental health reform and Service Definitions, with Community Support Services. These are termed ' Enhanced Services' and there is very very little of this available to state funded/ IPRS consumers and less and less available to Medicaid or Medicaid/ Medicare dual eligibility consumers. Basic level services, which is essentially individual therapy, for state funded clients is available in many of the LME's for 8 sessions. That's IT unless the provider wants to go to a great deal of trouble to obtain more. Medicaid consumers gets as much individual therapy as they want, for the most part. And so you have mixed services that have a huge range in terms of availability.

Therefore, I do not know what use this statement serves: "20% of consumers surveyed stated they needed, but did not currently receive.' Wre these Medicaid clients? State funded/ IPRS clients? what?

11. You stated: "Staff/provider data overall indicated that overall satisfaction rates with service provision and availability for consumers remained quite low and had dropped a bit when compared to the data collected from the MHA 2006 survey ..." Was this a statisically SIGNIFICANT difference? 'dropped a little' has no meaning when comparing two different samples that may or may not be matched in terms of demographic or other characteristics which matter.

12. This statement is attempting to link apples and oranges: "And although 65.9% of staff were in agreement with the statement “I give clients a choice of providers” only 28.9% agreed with the statement “I have been pleased with the consistency of the providers I have seen or referred clients to”. " What does 'choice' have to do w/ 'consistency of providers'?

13. The MHA-Forsyth report stated: "In regards to overall systems changes, we saw a very small rise in staff satisfaction when compared to our 2006 survey (please see MHA 2006 survey report for full details, the MHA survey PowerPoint presentation also has some comparisons listed). " Was this a STATISTICALLY SIGNIFICANT DIFFERENCE? 'small rise' has no meaning. You have to know the n of the 2006 data and you have to know if the participants/ subjects were matched across the variables that might be inferred to affect that matching.

14. How can you compare Virginia when you have given us no information as to the comparability of that sample to the ones you obtained?":The comparisons to the satisfaction scores from Virginia were made to give us all a view of a comparable system and to give us a benchmark for a comparable state. "

15. Let's all have a big hurrah for this---as it really does not matter except as associated w/ 'perception' : "Although the presentation presented findings that showed little improvement in regards to satisfaction scores in our community, it was stated, on a very positive note, that “the release of the survey results didn't come with the usual finger-pointing that has slowed progress on mental-health delivery” in our area. "

16. Consumers numbered 220. As regards a question attempting to solicit whether consumers believes there were improvements or not in terms of mental health care, 40 of those 220 did not answer the question. Therefore you cannot say anything because you did not collect more complete data. And there is also no information about the 2006 data set.

Where is information re: rating the Family Care Homes where thousands of people w/ mental health challenges live....as promised by Governor Perdue?

Where are the promised records & ratings on the Family Care Homes where tens of thousands of disabled NC citizens w/ mental health challenges live?

I am familiar w/ this family care home, previously known as Evergreen, Country Time Place, Leicester, NC. It is no longer and has not been Evergreen since August, 2008. Yet, it is named by its old name, Evergreen, as associated with the date of this inspection: Annual Inspection Date: 08-Jan-09 which is online.

Here is the supposed rating information. Where is it? There's nothing there online:
see: http://www.ncdhhs.gov/dhsr/acls/star/worksheet.asp?id=8

What is the rating of '3' referring to? There is no information.

It has 40+ residents in very rural western NC.

The rating site associated w/ NC DHHS, specifically, DHSR, indicates it has a '3' (out of a max of '5') but there is no information as to how a '3' was derived.

Under the old owners, 'Evergreen', the Supervisors in Charge of the various houses were dismissed repeatedly for stealing the residents' medications. The residents went without food. The garbage didn't get picked up.

Then the management changed to WNC Homes who has banned this psychologist from being able to provide professional services to the residents at their home which is in isolated western NC.

The reason for calling the Buncombe county sherriff on me when I was in the middle of a therapy session? Because I was working w/ the client to see where their PNA, Personal Needs Allowance, the whopping $40 left over from the 98% usage of their disability checks for room/ board/ some occasional transportation----disappeared to.

I have filed multiple formal complaints to the Complaint Intake Unit and have no information back on that matter.

I sat thru a 2 hour meeting at DSS Buncombe (they reportedly are supposed to enforce matters re: the family care home law) this past Monday, March 16, 2009, only to see the Family Care Home Buncombe DHSR regulatory people sit on their hands, not saying a word about the clinical psychologist being banned from rendering professional services.

There was nothing regulatory about their behavior.

Marsha V. Hammond, PhD: Clinical Licensed Psychologist, Asheville, NC
see regulatory information that is supposedly in place:

http://madame-defarge.blogspot.com/2009/02/painting-lipstick-on-pig-family-homes.html

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N.C. public records on Internet, study says, but some hard to find

THE ASSOCIATED PRESS
Published: March 15, 2009

RALEIGH - North Carolina is among the best states at posting public records on the Internet, but some information is often hard to find, infrequently updated or not entirely available, according to an analysis by The Associated Press released today.........

http://www2.journalnow.com/content/2009/mar/15/nc-public-records-on-internet-study-says-but-some-/#comments

Why shouldn't people w/ mental health challenges be allowed to manage their own disability check funds? Family Care Homes BLOCK IT

These are some of the items associated with a continuing series of complaints I have filed on WNC Homes, a Family Care Home, whose administration attempted to have me arrested at 7 pm, 4 weeks ago, when I was rendering therapy to a resident as pertaining to their previous demand that I not see clients after 6 pm.

I was informed by Kayce Cowan, of the state DHSR regulatory agency over the Family Care Homes in Buncombe county (kayce.cowan@ncmail.net) that a report would be available for the public very soon.

As regards WNC Homes and what I perceive to be confusion that fosters dependence by the people/ residents mostly with mental health challenges who live there-----WNC Homes had no rules posted outlining the visiting hours by family members and professionals. As far as I was concerned their demand was arbitrarily stated to me as I had been trying to get to the bottom of why some of the residents indicated they had not received their Personal Needs Allowance, the less than 2% of their disability checks left over after their room & board and medication co-pays are utilized. This sum is commonly $46/ month/ resident. That is their spending money for the entire month.

One of the results of the session that I had at DSS Buncombe on March 16, 2009, was to have resulted in a public posting of the 'times for visitation' within the WNC Homes.

I am still banned from coming onto the property of WNC Homes, however while physicians and physicians' assistants may do so. I will be following this up w/ another complaint to DHSR.

I would venture to say that most of the people who have SPMI, Severe Persistent Mental Illness, in NC are living in Family Care Homes and thus this one residents' concerns are potentially the concerns of ALL OF THEM----tens of thousands of them----who were re-warehoused subsequent to Wyatt v Stickney which released people with mental health challenges back into the communities----only to be re-warehoused by the Family Care Homes.

To make a formal complaint on a Family Care Home, go here:
Division Contact: Rita Horton
Complaint Hotline: 1-800-624-3004 (within N.C.) or 919-855-4500
Complaint Hotline Hours: 8:30 a.m. - 4:00 p.m. weekdays, except holidays.
Fax: 919-715-7724
Mail: 2711 Mail Service Center, Raleigh, NC 27699-2711
You can also file the complaint via this form, found online:
http://www.dhhs.state.nc.us/dhsr/ciu/doc/complaint_form.doc

THESE COMPLAINT REPORTS ARE PUBLIC INFORMATION AND NC DHHS, TO THEIR CREDIT, HAS SET UP A GRADING TOOL WHICH CITIZENS MAY USE IN ORDER TO EVALUATE FAMILY CARE HOMES. This was instituted 1.1.2009 and certainly this is to Governor Beverly Perdue's credit.

I have not assigned details to this matter as there was a 'confidentiality statement' signed by everyone in that room that day, March 16, 2009.

********************************

What happened?: An administrator for WNC Homes in Asheville, NC, a Family Care Home, improperly intercepted personal & confidential US Mail letter addressed to --------- Asheville, NC 28801 during the month of February, 2009. The resident never received his letter, as per his statements to me who was acting as his psychologist. I did give him a copy of his letter at a later therapy appointment on February 16, 2009; he reportedly took this letter to Pisgah Legal Services; I have had no contact from them. The matter is important because it concerned my statement to Pisgah Legal Services asking that --------------- ability to be his own guardian, and his own social security disability check payee, be reconsidered by the court system. At the present time, WNC Homes is the payor for ---------------- disability check.

A caveat: Here is the Family Care Homes law in NC:

http://ncrules.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter% 2013%20-%20nc%20medical%20care%20commission/subchapter%20g/subchapter%20g%20rules.html

The law states: (chapter 13G-Licensing of Family Care Homes: 10A NCAC 13G.1101 Management of Residents Funds):"Residents shall manage their own funds if possible."

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Was the incident reported to the staff: The incident was reported to Kayce Cowan and Cheryl Simcox, of DSS Buncombe, via e mail, on Monday, March 16th, subsequent to the meeting at DSS Buncombe when I realized that in fact the letter intended for (the resident) had been intercepted by the administrator of WNC Homes as evidenced by his displaying of the letter intending to bring my judgment into question as associated with this client with a severe and persistent mental illness. I believe that whether he is capable of being his own guardian and thus the recipient of his disability check is a question for the courts to resolve.

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How has the negative outcome affected the resident’s functioning? : I do not know. I do believe that the client merits having the court system reconsider he being his own guardian and recipient of his disabilty check given that the purpose of NC Mental Health Reform as associated with Community Support Services, which he apparently receives, is to encourage independence and an improvement of skills associated with increasing independence and responsibility.

NC DHHS transferred their own inefficiency when they created mental health reform: workers go thru medication training 4 no reason

Remember that NAMI report that came out yesterday giving NC's mental health system a D?

One of the domains surveyed had to do with this:

Financing & Core Treatment/Recovery Services: C 45% of Total Grade :A variety of financing measures, such as whether Medicaid reimburses providers for all, or part of evidence-based practices; and more.

I'd give NC a "D", NAMI. You are not looking at the mess that the providers have to deal with.

None of the trainings that Endorsed Provider companies are demanded to create and attend are reimburseable. NONE OF THEM.

This, in fact, was the reason that I was not able to work with state funded clients----as a clinician-----as per Smoky Mountain Center LME. I was not willing to sit thru hours and hours of unpaid, unnecessary training in order to do what my license states I can do. They would not budge.

Hours and hours every year Endorsed Provider company employees (the private companies: privatization is supposed to be more efficient...remember?) sit thru trainings that are non reimburseable as associated with the demands of NC DHHS and CARF (Commission on Accreditation of Rehabilitation Facilities) accreditation. The Endorsed Provider companies have no choice about this; this is DEMANDED by NC DHHS.

The owners of the companies don't get reimbursed; the workers get paid minimum wage in order to drive hours in order to obtain the trainings.

Basically, when NC Mental Health Reform was created, there was some kind of magical thinking that somehow the business models which were in existence, specifically, the heavily beauracratic model of NC DHHS, would surely somehow work for smaller companies which were supposed to be competitive. Right?

Wrong. You can't take a business model associated with a heavily beauracratic entity and create a competitive company that can stay alive.

Go ahead: let's review yet again why it is that Endorsed Provider mental health companies are collapsing.

NC DHHS, when it assisted the NC State Legislature in creating mental health reform in conjunction with the NC State Legislature, could have utilized business models which are associated with efficiency. Instead, this massive NC beaurocracy transferred----in lump sum----ALL of its inefficiency to the Endorsed Provider companies which is bit by bit taking them all down.You should have entertained a different business model----as in PRIVATE----business model, NC DHHS and NC State Legislature.

Will NC DHHS Sec Cansler get his $180K raise as Perdue cuts $49 million out from NC citizens w/ mental health needs?

You can sign the petition here which would be an attempt to ask Perdue to do something different: http://www.petitiononline.com/MHDDSA/petition.html

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I guess its a good idea that Rep Verla Insko asked that NC DHHS Secretary Cansler get his $180K raise BEFORE Perdue told NC citizens that she felt she had to cut $49 MILLION from under NC citizens with mental health challenges.

Does anyone know if he got his raise?

He had to keep up w/ Dr. Lancaster at the Department of Mental Health, a child psychiatrist, who weighs in with a salary of $280K.

Didn't Cansler make enough money to tide him over when he was the lobbyist for Value Options? Of course, there's no conflict of interest. What a silly question.

Raleigh News Observer:http://projects.newsobserver.com/under_the_dome/cansler_appointed_to_head_dhhs

"Cansler was the registered lobbyist for Computer Sciences Corporation, a Virginia company that won a $265.2 million contract a few weeks ago to build and run a Medicaid bill-paying system for the state."

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These are the cuts that will affect---in particular----western NC:

**Eliminate psychiatric loan repayment which allows rural areas in particular to recruit psychiatrists $248,000.

(my comment: This is a small mount of money compared to the benefit of this. This being said, however, the psychiatric nurse practitioners seem like a better deal to me, frankly; you can have more for less money; additionally the physicians seem to be fleeing into private practice & are dumping their Medicaid clients).

***********************
This is an eye-opener and it has to do, I believe, with the legacy of the Bush administration which refused to allow Medicaid/ Medicare to bargain and obtain lower cost medications. The meds that people w/ mental health challenges take can be extremely expensive.

**Implement preferred drug list atypical psychotropic drugs> $12.672 M

*************
Here is another important item and it has to do w/ housing:

**Reduce state county special assistance $5.38 M

(my comment : Special Assistance, as admnistered by the county Departments of Social Service is the other funding stream, besides their disability checks, which allows the warehousing of people with mental health challenges in the Family Care Homes. This being said, many of them would be homeless without the Family Care Homes. Currently, in NC, Family Care Homes get paid approximately $1300 / month/ resident which includes room and board and some transportation to medical appointments. For SSI clients, or those who did not vest into social security with about a year of full-time work----the Special Assistance makes up about half that money. For SSDI clients, who get larger checks, Special Assistance, commonly, only makes up $200-300/ month of the total amount. Why not get the SSDI clients out of the Family Care Homes and into Section 8 Housing which is more federally mandated and thus save the state money and create more satisfaction for the Family Home residents who receive SSDI?)

**************

These are the cuts that Perdue is considering (and really a done deal unless she gets a lot of heat, I suppose):

Some of the proposed cuts which add up to ~ $50 Million> include:>

Reduce community services $25.9 M>

Consolidate LME system mgmt $8.9 M>

Reduce Operating expenses - Central admin $250,000>

Close two 25 adult bed units at Broughton, Cherry > $6.02 M>

ATB ADATC (Alcohol and Drug Abuse Treatment Center) cuts > $l.86 M>

ATB Central and Western Regional > $l M>

Close Wright and Whitaker Schools $5.77 M>

Total: $49,774,659 million, 200 positions> > These cuts alone are dreadful, but the Summary of Reduction> Options for FY 2009-10 indicates that the $50 M is not the> only thing that will affect our families and people living> with mental illness. It cuts across the services also> offered in rural health, aging, child development, public> health, social services, Medical Assistance, Vocational> Rehab, and Corrections, in addition to reduction in payment> rates and elimination of cost of living increases for> providers.> > Examples of the cuts that will affect us that are not> included in the above $49.7 Million: (meaning the impact is> more than just $50 M)> Eliminate psychiatric loan repayment which allows rural> areas in particular to recruit psychiatrists $248,000> Reduce state county special assistance $5.38 M> Implement preferred drug list atypical psychotropic drugs> $12.672 M> Reduce funds to NC housing finance agency $485,000> Eliminate contract with drug and substance abuse facility> for male inmates $2.52 M> Eliminate criminal Justice Partnership Program $9.76 M

National NAMI gives NC a 'D' in 'Mental Health': 65 criteria

Well, the National NAMI grade certainly reflects my own experience as a mental health provider. What would I say the worst problems are?

1. Community Integration and Social Inclusion: NAMI gave this a "C": I'd give it an "D":

Time consuming, non paying difficulty in trying to get agencies to work together would be my personal comment. If you are a mental health provider, what you see from 'up here', in overviewing the landscape, are all the bits and pieces associated w/ mental health care lying around on the ground. As proof, I offer the matter featured in last week's newspaper article in the Citizen Times which documented the collapse of yet another mental health provider, this one internal to Mission Hospital in Asheville, NC. Relatedly, I have a client in a Family Care Home who has asked repeatedly to be able to go to a Dual Diagnosis program in Asheville which he knew of which USED TO BE within Mission Hospital. I learned two weeks ago that this dual diagnosis program had 'closed because things kept disappearing' (inferring that people who came to the group somehow ripped off the place' to which I thought: well, then, why didn't you take things that could be ripped off out of the room?

This also include efficient communication with the local Western Highlands Network LME whom, I assume, is vastly overworked. However, I REALLY do need to know, Brad Owen of Western Highlands Network LME, as per the meeting we had the other day as to whether there has been follow up of that psychotic client who was stated to have been magically switched to another provider when I have no one asking me about records for this psychotic resident of a Family Care Home.


2. Consumer & Family Empowerment: F 15% of Total Grade : I'd give it an "F" also:

This is also in keeping with my complete frustration on trying to provide mental health services to clients of mine who reside in Family Care Homes and the incessant reporting to their regulatory agency concerning: denied being able to talk to my clients on the phone to set up appointments; denial of being able to provide therapy at their residence; harassment by the Family Care Home administration; threats by the Family Care Home administration; threat of arrest by the Family Care Home administration for rendering therapy services on the premises of the Family Care Home. How much can one provider do in terms of throwing up a flare: HEY! HEY! THERE'S REAL PROBLEMS HERE! LISTEN UP!

***********************************

http://www.nami.org/gtsTemplate09.cfm?Section=North_Carolina_Grades09&template=/contentmanagement/contentdisplay.cfm&contentID=75314

Here is the NAMI report for NC:

"....The report card is based on 65 criteria, including access to medication, housing, family education and support to National Guard members. It includes policy recommendations for federal and state leaders. State governments provided most of the information on which the grades are based."

In the previous report, North Carolina received a grade of D. This year it is one of 23 states that saw no change. The national average is D, remaining stagnant from three years ago. Six states received Bs. Six received Fs. No state got an A.See www.nami.org/grades2009 for the full report.

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Details of report:

Grading the States 2009 Report Card: North Carolina

In 2006, North Carolina’s mental health system received a grade of D. Three years later, the grade remains the same, but does not even begin to convey the chaos that now pervades the state’s mental health care system. Full narrative (PDF).

Grades by Category Detailed Score Card (PDF)

Health Promotion and Measurement: D 25% of Total Grade :
Basic measures, such as the number of programs delivering evidence-based practices, emergency room wait-times, and the quantity of psychiatric beds by setting.

****************

Financing & Core Treatment/Recovery Services: C 45% of Total Grade :
A variety of financing measures, such as whether Medicaid reimburses providers for all, or part of evidence-based practices; and more.

*************

Consumer & Family Empowerment: F 15% of Total Grade
Includes measures such as consumer and family access to essential information from the state, promotion of consumer-run programs, and family and peer education and support.

****************

Community Integration and Social Inclusion: C 15% of Total Grade
Includes activities that require collaboration among state mental health agencies and other state agencies and systems.

****************

Mental Health challenges: what can one blog about in terms of malfeasant Family Care Homes' behaviors: tempting arrest can have its advantages

Today I was asked by WNC Homes, a Family Care Home in western NC----scratch that-----today I was DEMANDED to remove IMMEDIATELY from my blog any reference to WNC Homes as I sat in the DSS Buncombe meeting in order to 'resolve' some 'misunderstandings' about why I believe I have a right to see my clients at their residences in their Family Care Home.

WNC Homes called the Buncombe County sheriff on me three weeks ago because I refused to stop having therapy w/ my client in the client's residence. That action created a sheriff's report. Jeff Clifton of WNC Family Homes told me to NEVER come back on 'his' property (I mean the property that is completely supported by the social security check payments of the disabled people who live there some of whom are my clients).

That means that WNC Homes has created a 'public' incident. And that means that you, Jeff Clifton, are now a public figure.

NAH. I'm not taking off anything.

And since you're reading this, Jeff Clifton of WNC Homes, know that I figured out that you intercepted the letter that I sent to my client who complained and complained that he never received it. Can you say MAIL FRAUD? Can you imagine HIPAA VIOLATION? The dead giveaway was in the Release of Information form that you included in your 'packet' you handed out at DSS today: the release of information had ONLY the name of the legal firm to whom the information was intended.

I suggest you back far, far away from me.

Check out the wonderful and only EFF, Electronic Frontier Foundation: http://www.eff.org/issues/bloggers/legal/liability/defamation

"Is there a difference between reporting on public and private figures?

Yes. A private figure claiming defamation—your neighbor, your roommate, the guy who walks his dog by your favorite coffee shop—only has to prove you acted negligently, which is to say that a "reasonable person" would not have published the defamatory statement.
A public figure must show "actual malice"—that you published with either knowledge of falsity or in reckless disregard for the truth. This is a difficult standard for a plaintiff to meet.

Who is a public figure?

A public figure is someone who has actively sought, in a given matter of public interest, to influence the resolution of the matter.

What is a "fair and true report"?

A report is "fair and true" if it captures the substance, gist, or sting of the proceeding. The report need not track verbatim the underlying proceeding, but should not deviate so far as to produce a different effect on the reader.

What if I want to report on a public controversy?

Many jurisdictions recognize a "neutral reportage" privilege, which protects "accurate and disinterested reporting" about potentially libelous accusations arising in public controversies. As one court put it, "The public interest in being fully informed about controversies that often rage around sensitive issues demands that the press be afforded the freedom to report such charges without assuming responsibility for them."

DSS Buncombe Family Care Homes meeting: no privacy 4 clients w/ mental health concerns; no ability to see them in their homes;they must be in by 5 pm

(in response to lead attorney, John Rittelmeyer, Disability Rights, NC re: 3.9.09 2 -4 pm meeting at DSS Buncombe attended by: :

Marsha V. Hammond, PhD: clinical licensed psychologist, NC
e mail: hammondmv@netzero.com cell: 404 964 5338

March 9, 2009

Thanks, Mr. Rittelmeyer:

I certainly can value you creating confidentiality w/ the resident who spoke to Anthony at your office last week re: WNC Homes.

No, I would not say that much of anything has been settled. I am forbidden from seeing my clients at their Family Care Home, WNC Homes, while the physician and his PA can see their patients there. DSS Haywood was not willing to take this up and indeed, that is a big topic that the likes of Disability Rights could tackle. As you probably know, the Family Home Law does not have much to say about the interface of residents with the outside world. I would hope that some entity like Disability Rights could tackle this, particularly in light of NC mental health reform.

The only success I had today, on behalf of disabled clients, was an agreement from WNC Homes that there would be posted on the wall, in plain view, information about visitation hours. Given that many of them take psychotropic medications, opiates, anxiolytics, and some have head injuries-----I assume that they need this in order to be able to remind themselves of what the rules are. Treated like children, they are supposed to be in the house by 5 pm.

Patient privacy was also a big agenda item for me. I do not know how a resident is supposed to maintain privacy particularly when I discovered today that my psychotic client's mail had been intercepted, opened, and reported by WNC Homes as something that they 'received----and indeed Mr. Clifton of WNC homes attempted to use this information against me until I gathered up my papers and walked around the block until the Western Highlands Network LME representative arrived, specifically Doug Owen. I will be filing yet another complaint on the violation of the resident's privacy re: his mail about which he informed me: "I still haven't gotten that letter." He finally got the letter as I made a copy of it and put it in his hand.

I also had questions after the meeting w/ DSS Buncombe re: no indication on the Personal Finances forms bought to the meeting by WNC Homes indicating that there was money, the PNA, Personal Needs Allowance, to the clients-----but there is no indication it was ever given to them and thus I continue to try and assist them----along w/ Community Support Services----in encouraging them to be more independent and skillful at managing their lives----when there is a dark hole of non-information causing me to be the constant interlocuter.

Additionally, I remain very disturbed by this fact: all clients----regardless of whether they receive SSI or SSDI----receive the same amount of money back---their PNA----minus their co-pays. This means that residents who receive SSDI, as they vested regarding working-----with their checks usually being around $890 checks/ month----receive the same PNA back as those who receive SSI checks, which are approximately $680.

I will be working with other mental health providers to find them Section 8 housing so that they have more disposable income. I believe this in keeping with the notions of NC Mental Health Reform.

I find the current law inadequate in assuring the civil rights of disabled clients who have mental health challenges. I trust that you will advise me if you are able to take up these issues which could benefit tens of thousands of citizens across NC.

I will continue to follow these matters up personally.

Marsha V. Hammond, PhD

cc: NC NAMI; NC DHSR; madame defarge blogspot; mental health advocates

Secretary Cansler: request 4 public records assoc. with Center Pointe LME (mental health LME in eastern NC) assoc w/ creation of 14% Medicaid bed hosp

Marsha V. Hammond, PhD: Clinical Licensed Psychologist, NC
---------------------Asheville, NC 28806
E mail: hammondmv@netzero.com cell: 404 964 5338
Fax: 828 -------------

March 9, 2009

RE: release of public documents

Dear Secretary of NC DHHS, Mr. Cansler:

The purpose of this letter is to request a release of public information as pertaining to three sets of information (see below). I understand that there may be some copying charges and I am glad to pay for this if you would advise me. My cell phone is above as is my address. I ask for the release of these records as pertaining to this matter:

GS 132 (b) The public records and public information compiled by the agencies of North Carolina government or its subdivisions are the property of the people. Therefore, it is the policy of this State that the people may obtain copies of their public records and public information free or at minimal cost unless otherwise specifically provided by law.

These are the public records I would like released.

Item 1: Center Pointe LME CFAC minutes prior to 8.2.07 and after 6.12.08.

Specific to the minutes of the Center Pointe LME CFAC meetings, it seems to me that they need to be online available to citizens of NC. As per Leza Wainwright’s e mail to me 1.2.2008 (see below), it seems that I should contact Ann Remington. However, when I call NC DHHS and try to obtain her name via the Directory, after hours, Ann Remington is not listed and therefore I assume she no longer works at NC DHHS. I am, nevertheless, sending her an e mail at the e mail address suggested by Leza Wainwright.

Additionally, I am wondering if obtaining the CFAC minutes PIOR to 8.2.07 (see CFAC dates/ minutes below as pertaining to Center Pointe LME CFAC website (http://www.cphs.org/CFAC/CFAC_minutes.html) could be problematic in that Leza Wainwright stated in her 1.2.08 e mail letter to me the following: “As you know, CFACs are by state statute designed to be a "self- governing and a self-directed organization" (G. S. 122C-170 (a)) so the decision to post the minutes on the Internet had to be made by the CFAC.”

I wanted to circumvent any conversation that might go along with the matter that the earlier CFAC was completely dismissed by the LME regarding disagreements and therefore I bring up that information in order to make a suggestion.

In that the first CFAC was dismissed by the LME----in its entirety, apparently----it would appear that the previous CFAC should ‘meet’ somehow in order to have the minutes released. Or, maybe the current CFAC should have the previous CFAC-----all with completely different members-----release the older minutes. Or, perhaps, as the Secretary, you can cut to the chase and obtain the minutes. I would ask the CEO of Center Pointe LME, Betty Taylor, but given the history of the LME vis a vis the previous CFAC, I do not believe Ms. Taylor will bring forward the minutes. In case the previous CFAC’s minutes cannot be ‘found’ I am forwarding this e mail to previous members of that CFAC which was dismissed due to their disagreements w/ Center Pointe LME, and I am betting that the Secretary, assumably the appointed note taker, will have that CFAC’s minutes. Can we have those CFAC minutes placed on the CFAC website associated w/ the LME that the CFAC was attached to please?

Here is a previous e mail letter from Leza Wainwright to me re: my request for CFAC minutes from the Smoky Mountain Center LME CFAC. I am happy to say that the public was given these CFAC minutes---at the SMC LME online website----for all citizens to read:

***************************

Date: Wed, 02 Jan 2008 13:53:03 -0500 From: Leza Wainwright User-Agent: Thunderbird 1.5.0.7 (Windows/20060909) MIME-Version: 1.0 To: hammondmv@netzero.com CC: Dempsey Benton , Mike Moseley , Ann Remington Subject: Smoky Mountain CFAC Content-Type: text/plain; charset=ISO-8859-1; format=flowed Content-Transfer-Encoding: 7bit X-ContentStamp: 13:6:1880312345 X-MAIL-INFO:496f6fbf6702bf0e028f2ea78f43832ec3d7e7b3fbd7eeebee6f7ab367fe6f0fe70aced76f8ffe8f131b8fbfaa430afb3b4b2bba9b3a8f438f1f4a1f77ef X-UNTD-Peer-Info: 149.168.220.196relay1.ncmail.netrelay1.ncmail.netLeza.Wainwright@ncmail.net X-UNTD-UBE:-1
Dr. Hammond:

Secretary Benton requested that I respond to your inquiry to him regarding the Smoky Mountain Consumer and Family Advisory Committee (CFAC). Your correspondence with Secretary Benton indicated concerns that the Smoky Mountain CFAC minutes were not available on the web and that Smoky Mountain staff had not given you contact information for two CFAC members, as you requested.

I am pleased to tell you that the Smoky Mountain CFAC has now chosen to have the minutes of their meetings posted on the Smoky Mountain Center website. The minutes are available at http://www.smokymountaincenter.com/partners/cfac.asp by clicking on the hyperlink labeled "meeting notes" on the right hand side of the page.
Minutes for all meetings thus far this state fiscal year have been posted and future minutes will also be posted. As you know, CFACs are by state statute designed to be a "self- governing and a self-directed organization" (G. S. 122C-170 (a)) so the decision to post the minutes on the Internet had to be made by the CFAC.

As for your request to be given contact information for specific Smoky Mountain CFAC members, I am told that the membership of the Smoky Mountain CFAC have decided that they do not want their individual contact information distributed. Instead, there is a dedicated e-mail address at The Smoky Mountain Center (smcfac@smokymountaincenter.com) that can be used to contact CFAC members. Of course, employees of The Smoky Mountain Center cannot compel volunteer CFAC members to respond to inquiries, but I have been assured that any inquiries received are passed along to the appropriate CFAC members.

I hope this information is helpful. If you have further questions regarding the roles and responsibilities of CFACs or any specific CFAC, please contact Ann Remington in the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services central office. Ann is the team leader for a team of state employees who provide support to CFACs statewide. Ann can be reached at Ann.Remington@ncmail.net or via telephone at 919-715-3197.

Leza Wainwright
Deputy Director
Division of MH/DD/SAS

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Specifically, Secretary Cansler, I would like the minutes of the CFAC prior to 8.2.07 and subsequent to 6.12.08. Moreover, as Governor Perdue has an agenda of increased transparency, I would hope that the minutes would be put on the Center Pointe LME CFAC website.

Again, I am requesting Center Pointe LME CFAC records prior to these dates and subsequent to these dates. Here is what is currently available on the Center Pointe LME CFAC site, in terms of minutes:

Meeting Minutes 08/02/07

Meeting Minutes 08/16/07

Meeting Minutes 09/13/07

Meeting Minutes 10/11/07

Meeting Minutes 02/11/08

Meeting Minutes 03/10/08

Meeting Minutes 03/13/08

Meeting Minutes 04/10/08

Meeting Minutes 04/14/08

Meeting Minutes 06/09/08

Meeting Minutes 06/12/08


Item 2: All minutes associated with meetings pertaining to construction of free standing psychiatric hospital as organized by NC DHHS; Old Vineyard Behavioral Health; and, Center Pointe LME. In particular, where are the minutes associated with the statement on 2.20.09 by you, Mr. Cansler, outlining the following agreement which appears to have been struck by the above mentioned parties prior to this 2.20.09 announcement which indeed indicated that meetings have been taking place since 'early 2008.' Therefore, I am requesting all the minutes associated with those meetings held since early 2008 regarding plans for this free standing, private psychiatric hospital.

More specifically, I am speaking about meetings and minutes associated with events that took place prior to this 2.20.09 announcement put out by Center Pointe LME: “24/7 Psychiatric Emergency Department, Additional Hospoital Beds Coming : DHHS Secretary Commends Local Partnership” (contact Michael Cottingham, Marketing & Public Relations Officer, Center Pointe LME)

Item 3: Can the Center Pointe LME make available to the public---on its website----information about the meeting to be held, assumably, at the March 20, 1 pm, Winston Salem library regarding this newly proposed, free standing, private psychiatric hospital that will take only 14% Medicaid patients?

I would like to ask why there is no information about anything----at all----- taking place in 2008 under ‘News’ at the Center Pointe LME website. See here for yourself what I am talking about. These are the most recent items under ‘News’ on the Center Pointe LME website: http://www.cphs.org/News/NewsInfo.html

Sincerely,


Marsha V. Hammond, PhD, Clinical Licensed Psychologist, NC

cc: Governor Beverly Perdue; mental health advocates in eastern NC; Madame Defarge blogspot: http://madame-defarge.blogspot.com/; NAMI NC