Tuesday, June 30, 2009

13 Human Rights Organizations sign on to challenge American Psychological Association's torture policies

Dear PsySR Members:
Psychologists for Social Responsibility is pleased to be one of thirteen psychological, health, and human rights organizations that have signed on to today's open letter to the APA Board (see below). We thank Stephen Soldz and other PsySR members for their crucial contributions to the letter and to building the coalition of signatory organizations. The letter is also available in PDF form on our website at www.psysr.org/openletter. Please share this letter with your colleagues. Thank you.

These are the sponsoring groups:

American Friends Service Committee, Pacific Southwest RegionAmnesty International USABill of Rights Defense CommitteeCenter for Constitutional RightsMassachusetts Campaign Against Torture (MACAT)National Lawyers GuildNetwork of Spiritual ProgressivesNew York Campaign Against Torture (NYCAT)Physicians for Human RightsPhysicians for Social Responsibility, Los AngelesProgram for Torture Victims, Los AngelesPsychologists for Social Responsibility

Monday, June 29, 2009

NC Disability Rights legally takes on the NC State Legislature's removal of mental health services

NC Disability Rights is preparing for legal battle re: the removal of mental health services which by law have to be in place pertaining to 'least restrictive' criteria associated w/ disabled citizens.

Here is my letter to Ms. Vicki Smith, the Executive Director of Disability Rights, NC, about specific issues:
June 29, 2009

RE: removal & non-availability of mental health services

Dear Vicki Smith, Executive Director of NC Disability Rights:

Thank you for this announcement indicating that NC Disability Rights is going to 'push back' on the removal of funds as per the NC State Legislature associated w/ mental health services for NC citizens.

I would like to bring up two matters which impact disabled citizens:

1. Family Care Homes provide 'food & board' to disabled citizens in exchange for their disability checks (they are supposed to get a monthly Personal Needs Allowance, or PNA, but this has frequently been abused by the administrations of Family Care Homes). Moreover, these disabled citizens do not have access to mental health care within their homes as indicated by the case of WNC Homes threatening this psychologist with arrest if I continued to see my clients for therapy in their homes. When I spoke to the complaint person last week as associated w/ the Department of Health Service Regulations, the agency within NC DHHS that regulates these homes, I was advised that DHSR has 'nothing to say' about this. I can provide you w/ information pertaining to this matter and perhaps you could include it as re: issues you are going to legally address? The Family Care Homes law simply indicates that the administrations are 'to work' w/ 'case managers' and this, apparently does not cover the rendering of mental health services within the Family Care Home.

2. Community Support Services, or CSS, has been provided to many NC disabled citizens in order to improve their functioning. The recent NC State Legislature budget will severely curtail CSS which is associated w/ expanding the functioning of disabled citizens. Could this be an agenda item which you could take up? I can provide you w/ details pertaining to that matter.


Marsha V. Hammond, PhD: Clinical Psychologist, Asheville, NC
Vicki Smith " vicki.smith@disabilityrightsnc.org>

Executive Director

Disability Rights North Carolina

Phone: (919) 856-2195

E-Mail: vicki.smith@disabilityrightsnc.org
Tuesday, June 23, 2009
DRNC Gears Up for Legal Battles
Raleigh, NC-

On June 19, 2009, the Board of Directors of Disability Rights North Carolina (DRNC) approved the transfer of all available resources to legally challenge specific cuts to services for people with disabilities. In addition, the Board authorized tapping into the agency’s reserves to bring on additional staff in its efforts to protect the rights of adults and children with disabilities in North Carolina.

“Sadly on the 10th anniversary of the landmark Supreme Court decision, Olmstead v. L.C., budget cuts now being considered by the N.C. General Assembly will fracture an already fragile system of community care for people with disabilities,” stated Vicki Smith, Executive Director. “The State of North Carolina is moving in the wrong direction. Lawmakers neglected to factor the federal protections provided to people with disabilities when they made decisions which severely reduce services for adults and children with disabilities.”

President Obama noted in a White House press release that “The Olmstead ruling was a critical step forward for our nation, articulating one of the most fundamental rights of Americans with disabilities: Having the choice to live independently.”

Laws and regulations such as the Americans with Disabilities Act, Individuals with Disabilities Education Act (IDEA) and Medicaid regulations such as Early Periodic Screening Diagnosis and Treatment (EPSDT) mandate certain protections which may be violated by some of the state’s proposed cuts.

“Children cannot be moved to more restrictive environments or denied appropriate services simply because the state has abolished options or severely cut back on an array of services,” Smith stated. “The State is looking at a number of cuts and eliminations to services for children that, in isolation, are troubling, but when taken together, could prove disastrous to our state’s children with disabilities.”

When the State closes residential facilities for children and youth, it cannot neglect their due process rights, their right to the treatment that is medically necessary for them, or their right to a Free and Appropriate Public Education as delineated in their Individual Education Program. Those needs are not dictated by legislation but by individual assessments and often medical necessity.

“The cuts to services in the community are also very troubling,” Smith said. Many people with significant developmental or other disabilities are able to live in the community when they receive appropriate support and services. The elimination of those supports and services for economic reasons does not eliminate their needs or their rights under federal law. “Many people with disabilities fear that as their services are cut, they will be forced to move into more restrictive settings,” Smith explained. “This backward trend is against the intent of the U.S. Supreme Court’s 1999 Olmstead decision. “

Effective immediately, DRNC will focus its resources on the following areas:

Protect the rights of people with disabilities successfully living in community based settings who are at risk of moving to more restrictive settings because their services were significantly reduced or eliminated due to state budget cuts.

Address situations where individuals experience extended stays in an ER (5 days or more) and other 'civil commitment' issues related to waiting for necessary treatment.

Ensure that children with disabilities residing in residential placements receive appropriate discharge planning and placement if their residential facility is eliminated.

Ensure that service needs of people with disabilities who are in the criminal justice system (juvenile justice facilities and prisons) are correctly identified and receive appropriate treatment and services while detained or incarcerated.

DRNC will continue to monitor conditions in facilities licensed by the state’s Division of Health Services Regulation and investigate suspicious deaths in state operated facilities.
# # #
Disability Rights North Carolina is the state’s federally mandated protection and advocacy system for people with disabilities. One of the P&A’s primary federal mandates is to protect and advocate against the abuse and neglect of people with disabilities, including mental illness, in the care of state institutions.

Western Highlands Network LME creates walk-in crisis clinic on Patton Avenue, Asheville 4 mental health needs

First thing I've seen done right in a very long time:

Western Highlands Network LME (WHN) is developing Crisis Walk-In capacity in several areas of the WHN catchment area. The first to open is Western North Carolina Community Health Services, known locally as WNCCHS in Buncombe County at 264 Haywood Road, Asheville, NC, 28806, 828- 285-0622. As other Crisis Walk-In Centers develop in the WHN catchment area, these will be added to Access the Crisis Continuum document on the WHN website.

Western North Carolina Community Health Services (WNCCHS) operating hours are from 9:00 a.m. to 5:00 p.m., Monday through Friday (except on designated State or Federal holidays).

WNCCHS provides psychiatric assessments and stabilization for unassigned consumers discharged from a state hospital or ADATC until their appointment with a primary mental health provider has occurred as well as documentation/follow-up of consumers on Outpatient Commitment for consumers who are activated to WNCCHS and on Outpatient Commitment.

WNCCHS accepts emergent (2 hours) or urgent (48 hours) referrals from a Hospital Emergency Department for unassigned consumers in need of an immediate assessment, MD contact and/or stabilization services. WNCCHS provides assessment and stabilization of urgent referrals from WHN for consumers in need of an immediate assessment, MD contact and/or stabilization services. These referrals may include any consumer, assigned or unassigned, who is deemed by WHN as in need of services because routine care is not available or not adequate to meet the consumer’s needs. WNCCHS provides follow up services as necessary until the consumer has been engaged with their primary mental health provider.

WNCCHS provides crisis walk-in services to urgent and emergent consumers in Buncombe County to include; psychiatric assessment and stabilization interventions. WNCCHS works closely with Mobile Crisis Management (MCM) services and the designated facility transition providers to assure consumers can access and maintain services; medication management; and consumer referral to an appropriate behavioral health provider if unassigned.

WNCCHS refers consumers in need of involuntary commitment to the nearest Hospital Emergency Department, Mobile Crisis Management provider, or law enforcement as deemed necessary by WHN. WNCCHS will assess consumers to determine if the consumer condition may warrant diversion from a psychiatric inpatient admission and will use MCM services to attempt all diversions from psychiatric inpatient admissions where possible.

Providers who wish to access medical/psychiatric services for consumers must contract directly with WNCCHS and not refer consumers through WHN Access Unit. WNCCHS expects all providers with assigned consumers to call ahead and NOT SEND consumers without prior telephone consultation about issues and/or consumer’s condition. Providers should use 1st Responders and MCM services prior to contact with WNCCHS. If WNCCHS agrees to see a consumer assigned to a provider, WNCCHS will provide relevant clinical information to the provider’s attending physician and/or case responsible provider staff, so continuity of care is maintained throughout treatment.

For unassigned consumers who walk-in, follow-up care will be arranged by WHN Access Unit staff.

WNCCHS may provide services for Buncombe County unassigned consumers who are solely in need of psychiatric medications, as well as those unassigned consumers who are eligible for Basic Benefit and are appropriate for WHNCCHS’ services.

WNCCHS is not to be used for consumers who need long-term, enhanced services. Consumers needing these services are best served by WHN providers who offer Enhanced Benefits.
Please note that the Procedure for Accessing the Crisis Continuum of Care document at http://www.westernhighlands.org/emergency-services.html
has been updated with the WNCCHS' information as well as the list for how to handle diversions for person with ID/DD (Intellectual Disabilities/Developmental Disabilities) and co-occurring Mental Health (MI) issues on page 14 of the same document.

Thursday, June 25, 2009

How to get the public financial records of the LME which oversees mental health care for your multi-county area

Hi Ms. Slusher, Finance Officer of Smoky Mountain Center LME:

I asked you for this:

June 13, 2009

>Hello Ms. Sutton:>>What is the procedure for requesting under FOIA, if necessary, the>following public document?: Public Document of Smoky Mountain Center>LME>"Line Item General Ledger" for 2008."

You stated this:

"Hi Marsha, As the Finance Officer at Smoky Mountain Center, I would be>able to collect any financial information requested of Smoky Mountain>Center. Providing line item detail would be hard to interpret and would>potentially lend itself to being misinterpreted by the reader.>>If you can me a little more specific on what information you are>requesting, we will be glad to gather and provide.>>Sincerely,>>Lisa D. Slusher, BS>Finance Officer>Smoky Mountain Center>828-586-5501 x1216

I am stating this to that:

"Chapter 132.Public Records.§ 132-1. "Public records" defined.(a) "Public record" or "public records" shall mean all documents, papers, letters,maps, books, photographs, films, sound recordings, magnetic or other tapes, electronicdata-processing records, artifacts, or other documentary material, regardless of physicalform or characteristics, made or received pursuant to law or ordinance in connection withthe transaction of public business by any agency of North Carolina government or itssubdivisions. Agency of North Carolina government or its subdivisions shall mean andinclude every public office, public officer or official (State or local, elected or appointed),institution, board, commission, bureau, council, department, authority or other unit ofgovernment of the State or of any county, unit, special district or other politicalsubdivision of government.(b) The public records and public information compiled by the agencies of NorthCarolina government or its subdivisions are the property of the people. Therefore, it is thepolicy of this State that the people may obtain copies of their public records and publicinformation free or at minimal cost unless otherwise specifically provided by law. Asused herein, "minimal cost" shall mean the actual cost of reproducing the public record orpublic information. (1935, c. 265, s. 1; 1975, c. 787, s. 1; 1995, c. 388, s. 1.)"

Please send me the documents. I am certainly willing to pay the 'actual cost' of reproducing the records.

Thank you.
Marsha V. Hammondcc: Defarge blog

Monday, June 22, 2009

Time to unjoin NC Psychological Association: no attention paid to public mental health concerns at any level

Its uncanny how NCPA and APA are enantiomers (mirror images) of each other pertaining to simply pretending that the sky has not been falling for quite some time. Time to UNJOIN and UNSUBSCRIBE and go get some different, activist mental health colleagues.

My letter of 'thanks but no thanks' re: my hundreds of $$ of dues to NCPA:

FROM: Marsha V. Hammond, PhD Licensed Psychologist, NC
E mail: hammondmv@netzero.com cell: 404 964 5338
Fax: 828 254 2013

TO: NC Psychological Association
1004 Dresser Court Suite 106
Raleigh, NC 27609

June 22, 2009

Dear NCPA:

Thank you for the recent materials associated w/ rejoining. However, I will not be re-joining for NCPA has had nothing productive to say about the problems that psychologists and psychological associates have experienced regarding NC Mental Health Reform. And it has nothing to say about health reform except for vague comments regarding parity which are not true----as per the recent NCPA newsletter.

Let me be specific about what would have been useful to take place:

1. The Public Psychology people associated w/ NCPA were said by Sally Cameron to be ‘very busy’, thus, they did not answer my e mails. I work mostly w/ Medicaid & Medicare clients. That is whom they work with. I would have appreciated some communication between myself and psychologists doing similar work. It would have been useful to have an item in the NCPA newsletter regarding public practice.

2. NC Mental Health Parity is a joke for BCBSNC was allowed to opt out. BCBSNC insured over 50% of insured people in NC. The recent article in the NC Psychologist newsletter heralded parity as something whose time has come. Would that this was true.

3. You seemed to think that my concerns re: NC Mental Health Reform were simply a litany of complaints as made clear by assigning Dave Weiner, former NCPA president to ‘address your concerns.’ He did not address my concerns and I was frankly offended that you seemed to think I was a novice intern who had no experience and needed ‘guidance.’

The picture that was painted in the NCPA newsletter has been one of giving out awards and talking about what a swell place NCPA is. Thus, there is little of substance pertaining to the public face presented by NCPA and next to no information about the problems psychologists have practicing in NC.

Oh, there were admonitions to get involved in being a ‘rescue psychologist’ for disasters----something which pays nothing. I am suggesting that NCPA is less of a guild (for guilds concern themselves with protecting the interests and livelihoods of their members) than a good ole boy & girl club where is celebrated----just like w/ APA over the past 10 years-----what a swell bunch of people we are and hey, let me give you a gun so you can shoot at the people outside the circle.

What are some of the specific problems of NC mental health reform?

a. Under NC Mental Health Reform, those w/o Medicare or Medicaid and who need mental health care are defined as ‘state funded clients.’ The LME’s, which administer state funded clients, are completely varied in terms of the criteria necessary to obtain authorization for these services.

There is no standardization anywhere as regards those Utilization Review Departments within the LME’s. The original thinking was assumably associated with ‘every part of NC needs to determine what it needs.’ However, what happened simply was that the paperwork became and is so overwhelming that psychologists are loathe to see state funded clients.

Additionally, as Dick Rumer, PhD, a member of the NCPA board a year or so ago, discovered, in central NC around Charlotte (this is what he stated to me, I believe, during the NCPA board meeting which was held in Asheville, NC about a year or so ago) that an LME he contacted, utilized criteria for state funded clients which was similar to Medicaid.

Contrarily----as I have reiterated many times to Sally Cameron, the Executive Director, and other people associated w/ NCPA----Smoky Mountain Center LME, one of the two LME’s in western NC, utilizes only Meridian Behavioral Services for state funded clients and no individual therapy is provided. Meridian has as CEO a retired employee of SMC LME. To say that they are one and the same is completely true. And so what happened to the private psychologist providers? Their concerns were certainly not addressed by NCPA or even WNCPA. I do realize that WNCPA serves as a point of social contact and I have appreciated this in the past.

Western Highlands Network LME, the other LME in western NC, allows, as per Marsha Ring the Utilization Review Department Manager, authorizes only 8 therapy sessions for state funded clients and they could continue in individual therapy---perhaps----if they could turn up group therapy in DBT format----if anyone knew where that was----as all the pieces of mental health are everywhere & scattered and cannot be found. –

If the purpose of NCPA is to address public concerns vis a vis psychologists, related to mental health, you have not done that and here are the particulars:

b. Medicare ‘Advantage’ Plans (I call them ‘pretend Medicare), specifically, Humana, will only pay for 90806 which is 45-50 min of therapy. That pays me, the doctoral psychologist, $55 for seeing the client in their homes (oh: western NC has no public transportation infrastructure). It has become very obvious that as re: health care reform and national health care, that there needs to be an option for Medicare or government sponsored health care. Medicare does not have the stipulations that Humana has: nothing but 90806; must send in your therapy notes or they will say give us our money back; endless beauocratic difficulties associated w/ the simplest of matters like they registering one’s professional Tax ID. NCPA has had nothing to say about these kinds of difficulties.

c. I am happy to say that MEDICAID works pretty well. If NCPA had anything to do w/ this, I would like to hear about it. What makes NC Medicaid work well is: streamlined & efficient authorizations for therapy and webclaims billing which is a snap.

However, when it comes to Enhanced Benefit Services such as Community Support Services, a valuable service which supplements what psychologists do, particularly for Medicare & Medicaid clients----NCPA has had nothing to say about continuing it as the NC State Legislature has slashed its budget. Not a word.

I have spent hours writing letters of complaint to the Department of Health Service Regulations and the NC DMA Medicaid Investigations people associated w/ improper use of Medicaid funds outside of Medicaid clients’ Person Centered Plan.

d. Many publicly funded clients live in Family Care Homes. There are over 700 of these homes in Buncombe county alone. Across NC, there are tens of thousands of disabled clients who live in these homes.

These are regulated by the Department of Health Service Regulation or DHSR. I have an almost 2 inch thick file now associated w/ complaints associated with my clients who are residents in these homes. These complaints include: 1. not enough food 2. badgering of clients by the administrations 3. administrations colluding with exterior private mental health provider companies and demanding that residents attend Enhanced Benefits programs such as Psychosocial Rehabilition Services rather than what is in their Person Centered Plans as signed off by the psychologist who helps to create medical necessity 4. threatening mental health workers w/ arrest if they do not kowtow to the unreasonable demands of the administration.

There has been no attention paid to public health matters by NCPA. As the Obama administration hopefully moves forward---without the support of the Republican Party----a public health option such as Medicare----you might reconsider the knowledge base of your former members who work with the Medicare & Medicaid clients.


Marsha V. Hammond, PhD

How to file a Medicaid complaint: Program Integrity information for people w/ disabilities & mental health concerns needing to formally complain

FROM: Marsha V. Hammond, PhD Licensed Psychologist, NC e mail: hammondmv@netzero.com cell: 404 964 5338 fax: 828 254 2013

TO: Patrick Piggott, Supervisor Department of Medical Assistance, Medicaid Program Integrity 2501 Mail Service Center Raleigh NC 27699-2501

RE: inappropriate use of Psychosocial Rehabilitation Services, an Enhanced Benefits service for WNC Family Care Homes residents w/ Medicaid

June 21, 2009

Dear Patrick Piggott, Supervisor associated w/ NC DMA Program Integrity:

I filed a complaint today w/ ‘Cynthia’ at the DMA Program Integrity telephone number given to me by Mr. Donald Reuss, Director of Provider & Consumer Relations at Western Highlands Network LME in Asheville, NC. Here is the address for that LME: 356 Biltmore Avenue Asheville NC 28801
I outlined the following to Cynthia and the purpose of this letter is to underline the matter. I asked Cynthia when I could expect a response back from you. She stated: ‘it could be two days or two weeks.’ I will therefore be calling you by July 6, 2009, which is two weeks from now.

Here is the issue: my long-term client, -----------------------
Address: WNC Homes (a family care home based in Asheville, NC) --------- has been receiving an Enhanced Benefits Service from Medicaid whose proper name is ‘Community Support Services’ for the past year or two. Recently, the administration of WNC Homes, a Family Care Home, has demanded that the client attend a different Enhanced Benefits Services modality, specifically, Psychosocial Rehabilitation Services (PSR: the name of the company is ‘Health Care Solutions’).

My understanding is that Medicaid cannot pay for more than one Enhanced Benefits Services.

Besides, this point, ---------------- the client's Person Centered Plan does not include PSR; it includes CCS. This is a document which outlines all of ----------------- mental health services. I am the professional provider who signs off on this plan and assists in determining medical necessity. ----------------- has a head injury & cannot focus on verbal information presented in a PSR program. ------ should not be in a PSR program. It is inappropriate and an incorrect use of Medicaid monies----if Health Care Solutions is billing and being paid. Community Support Services is what is in order for -----------------.

Moreover, the Family Care Home has overstepped their boundaries in demanding that this client as well as other residents go to a PSR program when it is not in their Person Centered Plan, which, again, is the document which determines services.

Thank you for letting me know what is taking place re: my client. I will be calling you by July 6, 2009 if I do not hear from you by then.

Marsha V. Hammond, PhD

Sunday, June 21, 2009

American Psychological Association: now it appears they were assisting the CIA & recruiting future torturer psychologists

I feel like I back working in intensive care units at one of the largest hospitals in the US, w/ patients dropping like flies : emergency carts flying and residents bouncing off the walls (I even worked in the ICU w/ the nurse that was sent to jail as associated with euthanizing a bunch of patients w/ boluses of KCl-----I remember him very well, laughing while people were coding: gee, I thought: you are way strange).

I met a marriage and family therapist tonight and I thought: what a breath of fresh air: an activist, a person who stands up to DSS....who doesn't try to just get along because its easier or convenient. I used to hang out w/ those people. I marvelled at the lack of interplay with psychologists.

I don't know what happened here but something bad happened to APA a long time ago, apparently, and its just been growing legs and arms like a monster for years. I don't see any of this changing unless the Division of Military Psychology goes away. And the chances of that are ZIP. Looks like eventually they will just control APA and so it appears that we simply better get on w/ finding some other professional way of interacting.

Everyday its a new piece of hemorrhaging re: APA. Now its Matarazzo's (ex president of the APA) ties w/ the CIA. : http://www.opednews.com/articles/Former-American-Psychologi-by-Stephen-Soldz-090618-554.html#startcomments

"Nathaniel Raymond, of Physicians for Human Rights has posted a piece on the PHR blog discussing Jane Mayer's blockbuster revelation last weekend that former American Psychological Association [APA] President Joseph Matarazzo had a long relationship with the CIA, serving on itsprofessional-standards board. This relationship antedated the creation of the agency's "enhanced interrogations" torture program. This new information helps put in perspective the revelation in an NPR interview by Navy psychologist [and former APA ethics policy-maker] Bryce Lefever that Matarazzo had been recruiting SERE psychologists to "do their duty" to protect the country in the summer of 2001, before 911! The nature of the pre-911 activities for which Matarazzo was recruiting assistance are still secret. We also don't know what was involved in serving on the agency's professional-standards board...."

Saturday, June 20, 2009

Another complaint filed on WNC Homes re: disabled client w/ mental health issues: he is being HOUNDED from his home

I filed yet another round of complaints today w/ DHSR. They reportedly regulate Family Care Homes. They reportedly are 'investigating' WNC Homes re: my previous complaints.

WNC Homes appears to be trying to HOUND one of my clients from his home because he refuses to stop working w/ me and the company providing Community Support Services (CSS).

This is what has taken place over the past six months:

1. he has been told he has to go to Psychosocial Rehabilitation at 'Health Care Solutions' where he must sit for hours in a group therapy format. He has a head injury; he cannot remember things associated w/ this kind of contact/ therapy/ mental health services. This was never recommended by this psychologist in the client's Person Centered Plan which is the guideline for Medicaid services. Thus, Medicaid services are being rendered without approval by Western Highlands Network LME in accord with his Person Centered Plan which is signed off by the professional, namely, this psychologist.

2. in January, 2009, I was threatened with arrest & the Buncombe County Sheriff escorted me off the property of the Family Care Home as I sat and rendered therapy to the client at 1840 one evening, with Jeff Clifton, the administrator for WNC Homes, telling me I could never come back on the property.

3. The SIC of the house, reportedly threw away the client's dentures. He now has no template for his dentures and has been refused services by a Medicaid dentist as associated with an appointment procured for him by the Family Care Home.

4. The SIC of the house, refused the client an additional cheese sandwich on Saturday, June 20, for lunch, stating that the 'other bread is frozen.'

5. The SIC, and the WNC administration, is threatening the client---who is becoming more and more angry about his treatment-----with eviction. According to Family Homes Law, administrations can pretty much do what they want and push the client out.

6. The client did not receive a $250 'stimulus check' which was sent out to disabled clients receiving SSI or SSDI, though every other person in the house received a check with which to purchase clothes. Additionally, as per CSS workers, all the receipts are being demanded of clothes purchases and any remaining money will be intermixed with the funds of the administration.

7. The client is being harassed by the administration.

I guess DHSR will just keep investigating. And I will just keep writing up complaints and logging them on this web page.

Family Care Home demands the disabled clients w/ mental health concerns attend inappropriate rehab program, wolfing down Medicaid $$$

FROM: Marsha V. Hammond, PhD Licensed Psychologist, NC e mail: hammondmv@netzero.com cell: 404 964 5338 fax: 828 254 2013

TO: Donald Reuss, Director of Provider and Consumer Relations Western Highlands Network 356 Biltmore Avenue, Asheville, NC 28801 828 225 2785 x 2969 fax: 828 225 2784 donaldr@westernhighlands.org

RE: WNC Family Care Homes clients being inappropriately demanded to attend Psychosocial Rehabilitation Day Program

June 20, 2009

Dear Mr. Reuss:

Thank you for reading this e mail.

You may be a bit familiar w/ the matter of WNC Family Care Homes and my complaints to the associated regulatory agency, DHSR, Department of Health Services Regulation (see here for a copy of the letter: http://madame-defarge.blogspot.com/2009/06/letter-from-regulatory-agency-dhsr-re.html/). An employee of WHN LME, a gentleman who oversees the family care homes matter, was present at the meeting I had w/ Cheryl Simcox and Cathy Beatty of Buncombe DSS Adult Protective Services in early March, 2009 regarding my concerns about WNC Homes treatment of disabled people having mental health challenges who are my clients.

I am writing to you as I believe the matter I am about to describe concerns the local LME’s activity as associated w/ consumer choice and Medicaid funds.

I am awaiting a response from Congressman Shuler’s office pertaining to the possible illegal mingling of personal funds associated w/ SSDI/ SSI checks clients associated w/ WNC Homes and the non-timely non-payment of some residents’ monthly Personal Needs Allowance (PNA) (see: Sunday May 24, 2009: http://madame-defarge.blogspot.com/2009/05/family-care-home-refuses-to-answer.html)

Residents of WNC Homes (they have over one dozen family care homes in western NC and the specific set of home of which I speak is located in Leicester, NC: ------ Country Time Lane, Leicester, NC) are being demanded and pushed to attend, during the day, a Psychosocial Rehabilitation Program, Monday thru Friday, 8-3. The name of the program is associated with ‘Health Care Solutions’ and I have not yet turned up the corporate head quarters information or location of this program as there are several indicated online. I imagine that as the LME, you may know exactly whom they are.

WNC Family Care Homes and ‘Health Care Solutions’ appear to have colluded to stop Community Support Services, which the clients have asked for, and have demanded that they get on the bus and go to this PSR. As I understand it, Medicaid does not, nor should it, pay for both Community Support Services and Psychosocial Rehabilitation Services. These demands are not concerned w/ just this one client who live at WNC Homes.

The specific client of my concern, ----- (I am back-channel securely e mailing to you his Medicaid information), Hse -----, WNC Homes, Leicester, NC, has a diagnosis associated w/ a head injury and going and listening to group therapy topics for 7 hours/ day is not appropriate for him; is not helpful for him; and, it is a mis-use of Medicaid dollars.

I am asking you to investigate this matter as I understand that you are about to, or are, managing public Medicaid monies pertaining to these kinds of services. The service is not appropriate for this client, it is not what he wants to do, and it is being demanded by WNC Homes. Moreover, it appears that other clients at the Leicester, NC WNC Homes are being pushed to engage in Psychosocial Rehabilitation Services that may, or may not, be appropriate for them.

Here is the contact information that I have in my files for WNC Homes: WNC Homes: -----------------

If possible, I would like to hear from you about this matter by: July 6, 2009, two weeks from now. I am cc’ing DHSR contacts with whom I have spoken over the past six months re: issues at WNC Homes as well as disability attorneys with whom I have conversed concerning these pressing issues, over the past couple of years.

Thank you.

Marsha V. Hammond, PhD
Licensed Psychologist, NC


Kayce Cowan, DHSR contact Buncombe county: Kayce.Cowan@ncmail.net 670-3391
Barbara Ryan, DHSR, Raleigh: 919 855 3784: Barbara.Ryan@ncmail.net
Doug Barrick, Policy Coordinator, DHSR, Raleigh: Doug.Barrick@ncmail.net
Lou Morton, DHSR, Raleigh: Lou.Morton@ncmail.net
"Cathy Beatty, Adult Protec Serv dir " Cathie.Beatty@buncombecounty.org
"Cheryl Simcox, APS, Buncombe DSS " cheryl.simcox@buncombecounty.org
John Rittelmeyer, Director of Legal Services, Disability Rights NC : "John Rittelmeyer"
Douglas Sea: Lead Attorney, Central Piedmont Legal Services, "Douglas Sea" dougs@lssp.org
Madame Defarge blogspot (removal of information associated w/ client)


Marsha V. Hammond, PhD

Letter from Regulatory Agency, DHSR, re: WNC Homes managing of disabled people w/ mental health concerns personal funds, etc.


TO: Marsha Hammond, PhD

FROM: Doug Barrick, Policy Coordinator <Doug.Barrick@ncmail.net> (DHSR: Department of Health Services Regulation, within NC DHHS)

DATE: June 10, 2009

RE: Complaints Against WNC Family Care Homes

In response to your issues with WNC Family Care Homes, let me first clarify that I am not a legislative liaison as Lou Morton indicated. I do, however, concur with you that a change in law is not at issue based on the complaints you have reported.

There are rules, as you have pointed out, that apply to resident funds, mail and cooperation with case mangers. Residents are to have available their monthly personal needs allowance according to Rule 10A NCAC 13G .1104 and G.S. 131D-21(13). Mail is confidential and not to be opened except as authorized by the resident according to Rule 10A NCAC 13G .0906(b) and G.S. 131D-21(10). In addition, Rule 10A NCAC 13G .0906(f) addresses visitation in the home and states that visitation is to be at “reasonable” hours with at least 10 hours per day allowed for visitation and “arranged through the mutual prior understanding of the residents and administrator.” The information you provided does indicate possible violations of rules related to personal funds and mail. The rule on visitation in the home also needs consideration, depending on the nature of the visit, given that the administrator does have a role in determining visitation schedule and restrictions.

Rule 13G .0908 addressing cooperation with case managers requires further clarification regarding the “case manager” designation. “Case manager”, for the purposes of this rule, is a designation applied to those monitoring and managing areas of care as defined by an agency such as the Division of Medical Assistance (DMA) which requires case management services for residents receiving enhanced personal care services. It does not apply to those providing therapeutic services or treatment exclusively.

Complaints are normally investigated by the county departments of social services, but the State can be involved in investigations if there are problems or there is a request for State involvement. County staff are not under our direct authority as the State regulatory agency, but we do have oversight authority as specified in G.S. 131D-2(b)(1a)(b,c). An investigation related to your allegations and concerns is currently underway. You will be informed of the results of the investigation.


Letter to the American Psychological Association President regarding mental health association's inability to function ethically

Marsha V. Hammond, PhD: Clinical Psychologist, Asheville, NC APA Member/ Member Division 32, 42 e mail: hammondmv@netzero.com cell: 404 964 5338 NC Mental Health Reform blogspot: http://madame-defarge.blogspot.com/

June 20, 2009

Dear Dr. James Bray, President of the American Psychological Association:

Thank you for reading my e mail, Dr. Bray and thank you for your work for the APA.

I would like to underline and support ethicist Dr. Steven Miles' points with which you are undoubtedly familiar and which are being circulated amongst psychologists throughout APA.

It is too late to put out the brush fires, Dr. Bray. The barn is burning and the horses have left. All APA can attempt to do is salvage what they can. Many psychologists have resigned or are withholding their dues: (see: http://groups.yahoo.com/group/withholdapadues/ ).

Here is Dr. Miles letter: http://psychoanalystsopposewar.org/blog/2009/06/18/bioethicist-steven-miles-responds-to-latest-american-psychological-association-board-letter-on-interrogations-policy/

I would like to second that unfortunately Stephen Behnke, PhD, JD, head of the APA Ethics Office, must go. However, this will not be a suitable sacrifice, if this even takes place, the reason being that the APA Board of Directors and by default the APA Council has taken most every opportunity to look at their feet if not openly though coyly stepping aside when it came to directly addressing the APA Code of Ethics.

I have personally found Dr. Behnke to be a helpful man but this does not negate what he has done. He could always have quit his job in protest, much as Colin Powell could have quit prior to making his 'yellow cake' presentation to the UN so many years ago----ending us in Iraq.

Both are credible figures and they both quite frankly screwed up. Pillorying them is not particularly satisfying, either.

How APA mis-stepped is quite well outlined in the following video made by a psychologist and circulating amongst the APA divisions: http://www.youtube.com/watch?v=o84RE-9023U>

I want to know, as also iterated by Dr. Miles, what is the status of any ethical charges made on the psychologists mentioned in the video, if not other psychologists?

Given the lack of trust between the APA Board/ APA Council and this member, I assume that there was a calculated reason for the release of the APA Board statement on June 18, 2009 and this indeed has been noted by Psychologists for Social Responsibility:

Did APA IN FACT TIME the release of its statement for a reason?:" At issue is whether the the Statute of Limitations (5 years for non-members, 4 years for members) has expired for offenses committed during the 2002-2004 and prior period. Whether the delays that occurred in the release of APA memo until this time were a function of the SOL period remains unknown. Only BOA members can speak to this issue. ..."

This was stated by: Psychologists for Social Responsibility: From: Anthony Marsella Sender: psysr-announce@yahoogroups.com : http://www.psysr.org/ PsySR is an independent organization of psychologists and others committed to promoting peace and social justice.

And while I'm at it, it is not acceptable that clinicians are listed third as pertaining to APA's recent mini-convention on health care priorities: "Note that in the APA document clinicians are listed THIRD after researchers and educators."

So, in summary: three matters need to be addressed and they are frankly overlapping:

1. we need leadership with integrity, not 'go-to' people.

2. we want to know about ethics' charges much as many of us want to see the photos of what US service-people were up to (sorry: it doesn't wash that the release of the photos will harm same said people; this is just flimsy excuse making).

3. we want clinicians, who are very familiar with duties pertaining to ethics, to be put into key positions within APA. For it seems that some of the military psychologists and enough academic members of the APA have simply plotted to cut out the important clauses in the APA Code of Ethics so that they could function within the parameters of the law and attempt to direct out attentions to 'Look at that over there.'

We're tired of this. Please fix it.

Please feel free to give this to anyone you like. I have also published it on my blog which concerns itself w/ the horrors of NC Mental Health Reform----which APA and its subsidiary, the NC Psychological Association-----has also ignored..

That address is: http://madame-defarge.blogspot.com/

Sincerely and respectfully, Marsha V. Hammond,

30 US Lawmakers have Millions of $$ personally invested in health care industry : another way to wreck your mental health

The work just never stopsand we are so screwed re: getting access to government sponsored medical health insurance:

Lawmakers Reveal Health-Care Investments: Key Players Have Stakes in Industry

By Paul Kane Washington Post Staff Writer Saturday, June 13, 2009

".....freshman Sen. Kay Hagan (D-N.C.), who holds at least $180,000 in investments in more than 20 health-care companies. ...

The hearings will be led by Sen. Christopher J. Dodd (D-Conn.), who is filling in for Sen. Edward M. Kennedy (D-Mass.), the committee chairman, who is battling brain cancer. Dodd's wife, Jackie Clegg Dodd, serves on the boards of four health-care companies, receiving more than $200,000 in salary and stock from her service in 2008, according to the Associated Press....

Health care is not the only industry that is both heavily regulated by Congress and heavily invested in by lawmakers. As The Washington Post reported Thursday, more than 20 members of the House leadership and the House Financial Services Committee hold investments in companies that received more than $200 billion in federal bailouts. ...."


June 16, 2009
Top of the morning
Posted at 6:50 AM by Chris Fitzsimon

North Carolina Senator Kay Hagan made the Washington Post this weekend as one of 30 lawmakers playing a key role in health care reform who have significant investments in the health care industry.

Hagan is a member of the Senate’s Health, Education, Labor, and Pension Committee that will begin its health care debate today on Capitol Hill. The Post says Hagan owns at least $180,000 in investments in health care companies.

The 30 members of Congress who will draft the reform proposal combined have between $11 million and $27 million of personal investments in the industry that will be directly affected by what Congress decides.

It is not against the law or Congressional rules for lawmakers to have large financial interests in the industries they regulate.

But it doesn’t inspire a lot of confidence.

Friday, June 19, 2009

American Psychological Association : undermining the mental health of professional providers as well as those w/ chronic mental health challenges

APA made hard times more difficult

by Marsha V. Hammond, PhD, Licensed Psychologist NC

I have been documenting the profound difficulties experienced by NC mental health practitioners and recipients of public mental health care, as associated with mental health reform, which was enacted in 2001 in NC, via my blog, ,http://madame-defarge.blogspot.com/, for the past two years. I have had the satisfaction of participating with others---ALL non-psychologists----- across the state as we attempted to round up the usual suspects and document to hell and back matters pertinent to health care in NC.

Related to those time consuming efforts, instead of assistance from APA and the NC Psychological Association, an arm of APA, what I have received and noted are deaf ears and isolation. Members of the NCPA Public Psychology committee have refused to contact me; I got 'assigned' to a former NCPA president because of my deep concern with the state of public mental health care in NC. I was assumed to be a renegade nut who needed professional supervision from someone who had nothing but shutting me up as an agenda.

On top of this, I felt a 'duty to warn' re: psychologists roles within the military as pertaining to the use of their expertise to HARM instead of HELP.

Instead of assistance and comraderie, what I have experienced is a monkey-see-no-evil mindset which is absolutely maddening. Except for the groundswell of individual psychologists over the past 5 years, a tiny bit of acknowledged noise from the divisions within APA concerned w/ social justice, and the more recently big pile on as associated with frankly shoving the APA Board of Directors into saying something----- the last 8 professional years has been one long , lonely inability to bring little attention, save for the APA yearly meeting w/ its scattered meetings about the PENS committee results, leaving me with a sense of inability to participate in these two professional organizations which make such a very big deal about the advantages of membership.

According to the NYT, the American Medical Association only has as members 20% of the physicians in the US.

Relatedly, US Representative Patrick Kennedy, speaking at the Boston APA meeting last year, made the excellent point that the reason that universal health care reform did not move along 30 yrs ago can be credited mostly to the AMA's refusal to allow 'socialized medicine' into their little world. I might imagine that physicians who were concerned w/ the welfare of their patients found less and less a reason to be a member of such an authoritarian organization.

I wonder what the membership numbers are re: APA and NCPA and I question what will happen as time goes on.

What is the point of being tortured by one's professional mental health organizations? Ducking and diving continues to be the preferred behavior of professional organizations who have lost their way related to their membership except for members who like to see the award plaques and their own pictures, standing with the latest edition of the big kahuna,on their office walls and in the thin newsletters full of nothing but 'good news everyone!' scenarios.

Here is the letter from the American Psychological Association's Board of Directors which flew outta D.C. at the speed of light as associated with a (pretty obvious) reaction to heavy hitter Bryant Welch, PhD, JD, resignation and statement about 'just who's been cooking in the kitchen w/ Dinah' : (see here: http://www.huffingtonpost.com/bryant-welch/torture-psychology-and-da_b_215612.html : Torture, Psychology, and Daniel Inouye: The True Story Behind Psychology's Role in Torture

June 18, 2009
An Open Letter from the Board of Directors

Dear Colleague,

As a psychologist and member of the American Psychological Association
(APA), you no doubt share our serious concerns about reports regarding
the involvement of psychologists in torture and abusive interrogations
as part of the Bush administration's "war on terror." We recognize that
the issue of psychologist involvement in national security-related
investigations has been an extremely difficult and divisive one for our
association. We also understand that some of our members continue to be
disappointed and others angered by the association's actions in this
regard. Although APA has had a longstanding policy against psychologist
involvement in torture, many members wanted the association to take a
strong stand against any involvement of psychologists in national
security interrogations during the Bush administration.

Information has emerged in the public record confirming that, as
committed as some psychologists were to ensuring that interrogations
were conducted in a safe and ethical manner, other psychologists were
not. Although there are countless psychologists in the military and
intelligence community who acted ethically and responsibly during the
post-9/11 era, it is now clear that some psychologists did not abide by
their ethical obligations to never engage in torture or other forms of
cruel, inhuman, or degrading treatment. The involvement of
psychologists, no matter how small the number, in the torture of
detainees is reprehensible and casts a shadow over our entire
profession. APA expresses its profound regret that any psychologist has
been involved in the abuse of detainees.

This has been a painful time for the association and one that offers an
opportunity to reflect and learn from our experiences over the last five
years. APA will continue to speak forcefully in further communicating
our policies against torture and other cruel, inhuman, or degrading
treatment or punishment to our members, the Obama administration,
Congress, and the general public. In so doing, we will continue to
highlight our 2008 petition resolution policy, Psychologists and
Unlawful Detention Settings with a Focus on National Security. APA will
ensure that association communications convey clearly that the petition
resolution is official association policy and must be central to
psychologists' assessment of the appropriateness of their roles in
specific work settings related to national security. Our association's
governing body, the Council of Representatives, will soon be receiving
guidance from various governance groups regarding further steps to
implement this resolution. The history of APA positions and actions
related to detainee welfare and professional ethics can be found at

On a closely related matter, the Ethics Committee and APA governance as
a whole are focused intently on Ethics Code Standards 1.02 and 1.03,
which address conflicts between ethics and law and between ethics and
organizational demands, respectively. In light of Bush administration
interrogation policies and uncertainty among our membership, the Ethics
Committee has issued the attached statement, "No defense to torture
under the APA Ethics Code" (http://www.apa.org/releases/ethicsstatement-
torture.pdf ).

Invoking language from the U.N. Convention Against
Torture, this statement clarifies that the Ethics Committee "will not
accept any defense to torture in its adjudication of ethics complaints."
APA will continue to monitor material in official reports related to
psychologist mistreatment of national security detainees, will
investigate reports of unethical conduct by APA members, and will
adjudicate cases in keeping with our Code of Ethics. The association's
focus on these ethical standards is consistent with its position that no
psychologist involved in detainee abuse should escape accountability.
In conclusion, as part of APA's elected leadership, we have an
obligation to protect and further psychology's longstanding commitment
to the highest standards of professional ethics--including, and
especially, the protection of human welfare.


American Psychological Association 2009 Board of Directors
James H. Bray, PhD
Carol D. Goodheart, EdD
Alan E. Kazdin, Ph.D.
Barry S. Anton, PhD
Paul L. Craig, PhD
Norman B. Anderson, PhD
Rosie Phillips Bingham, PhD
Jean A. Carter, PhD
Armand R. Cerbone, PhD
Suzanne Bennett Johnson, PhD
Melba J.T. Vasquez, PhD
Michael Wertheimer, PhD
Konjit V. Page, MS

Here is a video associated w/ the APA trajectory pertaining to these matters:

Roy Eidelson, Ph.D., is a licensed clinical psychologist, associate
director of the Solomon Asch Center at Bryn Mawr College, president-
elect of Psychologists for Social Responsibility, and associate member
of the University of Pennsylvania's Program in Ethnic Conflict.
He has created a remarkable 10-minute video "No Place to Hide: Torture,
Psychologists, and the APA."
The video takes the viewer through a time-line, showing the evolution of
APA's policies governing psychologists' participation in detainee
The video includes documentary footage and direct quotations from
international treaties, APA documents including the APA ethics code,
U.S. government documents, etc.
The video is online at YouTube:
It is also online at other sources, such as the Psychologists for Social
Responsibility web site:

Did APA IN FACT TIME the release of its statement for a reason?:

"Enclosed is the APA Committee Statement - this was unavailable when accessed via the APA release. At issue is whether the the Statute of Limitations (5 years for non-members, 4 years for members) has expired for offenses committed during the 2002-2004 and prior period. Whether the delays that occurred in the release of APA memo until this time were a function of the SOL period remains unknown. Only BOA members can speak to this issue. ..."

Psychologists for Social Responsibility: From: Anthony Marsella Sender: psysr-announce@yahoogroups.com : www.psysr.org PsySR is an independent organization of psychologists and others committed to promoting peace and social justice
What is the problem w/ the Letter of the APA Board:

ethicist Steven Miles, MD, Professor of Medicine & Bioethics at the University of Minnesota Medical School in Minneapolis. He is an Affiliate Faculty for the Center for Holocaust and Genocide Studies and for the Law School's Concentration in Health Law and Bioethics.

"APA Board of Directors
>Re: Your Open Letter to APA Membership of June 18, 2009 on
>Psychologists and Torture
>Dear Board,
>I have been extensively involved in studying the issue of health
>professional involvement in abusive interrogations in the war on terror
>Your June 18, 2009 letter to the APA membership is a welcome but
>incomplete shift of APA policy.
>It is welcome because it states that the APA has retreated from its
>untenable insistence that no psychologists were involved in torture or
>other forms of cruel, inhuman, or degrading treatment.
>This official acknowledgment is new but the fact of these abuses has
>been established for several years.
>[end excerpt of Miles letter]
>Here's another excerpt:
>[begin excerpt]
>The APA Board's letter was also welcome because, it states that the
>2008 petition, Psychologists and Unlawful Detention Settings with a
>Focus on National Security, would be fully integrated into APA policy.
>That resolution was openly opposed by the Defense Department operating
>those same detention centers.
>After passage by the membership who voted in accordance with APA by-
>laws, APA governance gave that position second class status by
>asserting that since it did not pass through the conventional internal
>ethics policy making process, it could not serve as a standard for
>assessing the conduct of APA members.
>The current Board's position, as outlined in the June 18 letter,
>remains incomplete.
>1. It lays out a process for incorporating the 2008 referendum
into APA >policy but it does not give a timeline.
>2. Its newly passed "No defense to torture under the APA ethics
code" >statement (http://www.apa.org/releases/ethics-statement-torture.pdf) is
>a hastily written statement that does not define torture; ignores the
>concept of cruel, inhuman, and degrading treatment; does not address
>the duty to report observing such abuse and so on.
>3. It does not acknowledge the failure of the APA to manage the
>conflicts of interest in membership and process of the PENS Task Force.
>These failures stained the reputation of APA, divided APA's membership,
>separated APA from the larger community of health oriented
>professionals and produced a report that was tailor made to the design,
>policies, and operation of previous United States system of abusive
>4. It states the APA will monitor and will investigate reports of
>ethical misconduct by APA members but it does not address the status of
>previously filed allegations.
>[end excerpt]
>Again, as with all excerpts that I circulate, I strongly urge those
>interested to read the complete document rather than rely on a few
>The letter is online at:


Wednesday, June 17, 2009

NC Senator Kay Hagen is opposed to Public Option/ Medicare accessibility: affects mental health also

Some people might think that not having access to Medicare does not affect mental health but you'd be dead wrong.

What does Medicare do that is useful?

*provides for expanded CPT billing by Mental health care providers (Humana, sneaking around and re-naming itself, it appears, as 'Lifesynch', only pays for 90806 or 45-50 minutes of psychotherapy: the problem with this is that interaction w/ medical providers for the many mental health clients who have impacting physical illnesses is not billable)

*does not ask for all the session notes (yes, Willis, Humana does that and will ask for their money back if you do not send in those confidential notes)

*Medicare has an efficient administrative system in place as well as electronic billing (Humana, for instance does not).

*Medicare automatically wraps around to Medicaid if the client is dually eligible; Medicare also wraps around to AARP's complementary insurance (Humana does not)

Yet, here is the DEMOCRATIC party senator Kay Hagen who is in a key position on the Seante Health, Education, Labor & Pensions (HELP) Committee who is opposing the public option which would allow people to opt for Medicare.

Here is some information sent via Democratic Party channels: Democrats.com Local Announcement List.

".....Sen. Ted Kennedy is being treated for cancer so he cannot vote on health care bills before the committee he chairs, the Senate Health, Education, Labor & Pensions (HELP) Committee.
That makes Sen. Kay Hagan's vote crucial. But she secretly OPPOSES the public option that Sen. Kennedy and President Obama are working so hard to pass. She is so ashamed she won't even admit it publicly.

Call Sen. Hagan's offices with a simple message:

Support a Full Public Option - Medicare For Anyone.

DC 202-224-6342, Greensboro 336-333-5311, Raleigh 919-856-4630.

Be sure to provide your North Carolina voting address."

ALL the monsters fall out of APA's closet: Insider reveals gameset behind APA supporting psychologists mapping torture creating mental health problems

comments on Bryant Welch's (heavy hitter in the American Psychological Association for over two decades until he recently resigned re: APA's continued manipulation of making it OK for psychologists to be the 'go to' people to map out how to torture people and make them mentally ill.

This article as associated w/ his resignation from APA. The article & comments are like opening the closet door and all the monsters pop out and its scarier than the mother of all horror movies, The Exorcist.

Man alive: with colleagues like this, who needs enemies?

Extended comments on the fluff as re: the NC Psychological Association. (yes, I am currently a member of NCPA)

This year's APA should be a revolutionary meeting in Toronto:

Bryant Welch:

Torture, Psychology, and Daniel Inouye: The True Story Behind Psychology's Role in Torture

"The result was that much of the activity of the APA Council of Representatives, the legislative group with ultimate authority in the APA governance, turned away from substantive matters into an odd system of fawning over one another. Many members appeared to simply bathe in the good feeling that came from "working together." The bath was characterized by grandiose self-referents and shared lofty opinions of one another. As it became more and more detached from reality, the organizational dysfunction became more pronounced, but this was ignored and obscured by the self-congratulatory organizational style."

Welch got his article into The Huffington Post:


and these are a particularly vivid set of comments to Welch article:

".....Psychologists are not---should not be---guardians of the status quo, but, on the other hand, they do have to help people "adjust to reality." The modern therapies, cognitive, reality-based, behavioral, all have as their starting point, "reality," and all seem to view the creative process of inventing oneself, following one's instincts, as irrelevant, a sign of pathology. Cognitive therapy is part and parcel of the growing concreteness and shallowness of the American mind and it is no wonder that the APA, which endorses it, has drifted into collusion with Bush.
Reply Favorite Flag as abusive Posted 08:53 AM on 06/17/2009
- kellysmalltowngirl I'm a Fan of kellysmalltowngirl I'm a fan of this user permalink

Yes, that reflects my observation of the profession over the last 20 years.

Reply Favorite Flag as abusive Posted 09:57 AM on 06/17/2009

- OkieIntellectual I'm a Fan of OkieIntellectual I'm a fan of this user permalink

I blame the rise and popularity of CBT on the HMO / PPO culture of US healthcare. CBT is proven in study after study to provide fast, lasting results in the treatment of specific behavioral issues. Insurance companies like this because it is cheap. However, the approach almost completely ignores the complexity and interconnectedness of the human psyche. CBT is great for treating phobias, substance abuse, anger outbursts... its great for treating behavior, but it does not address the underlying issues that motivated the behavior in the first place. And you're very correct in saying that it contributes to a culture of rigid behavioral "standards" that in the end are not particularly realistic or helpful.
Case in point re: NC Psychological Association whopopee! polly-anna attitude which is reflected in every single newsletter: everything is great! there's no problems w/ NC mental health reform! Just positively think yourself out of your troubles! When life gives you lemons, make lemonade! Let's hand out some more awards!

NC Psychologist May/ June 2009

lead story:
National Award Winners—Dr. Antonio Puente, left, poses with APA Chief Executive Officer Dr. Norman Anderson just before receiving the APA 2009 State Leadership Award. Both Dr. Puente and Dr. Anderson are NCPA members. Rep. Martha Alexander from Charlotte received the 2009 Legislator of the Year Award from APA.Story and more photos
story from NCPA current president: FROM THE PRESIDENT Annete Perot , Ph.D. : NCPA leadership: the easiest job you'll ever love!
another article: NC Wins Three National Awards!
another article: Investing in the Future of Psychology!
another article: NCPF President's Award!
whoopee! Earn 25 NCPA bucks for recruiting a new member!
another article: Online Disaster Training! (you aren't paid for this work, I assume; its because we're such swell people that we give it away)
a little note & my very favorite: The DIPP Directory (Madame Defarge made an unwholesome comment on that some time ago:

Wednesday, June 04, 2008

NC Psychological Association: a hit dog yelps

June 5, 2008Dear NCPA/ Sally Cameron, Executive Director of NCPsychological Association:...... You told me, via e mail, that the Public Sector psychologists were 'busy people.' A hit dog yelps and NCPA appears to be trying to defend its non-assistance to NC psychologists and by default, NC citizens needing mental health care. There are other psychologists on this listserv who also back channel criticize NCPA.

You stated, Sally: "DIPP’s role within NCPA is to work on issues related to the private practice of psychology including problems with reimbursement, managed care, the State Health Plan, and other practice issues including risk management and practice management. Because NCPA is not a single issue organization, DIPP has taken very little action regarding MH reform, allowing the Public Sector Committee, Legislative Committee and other committees to address this important issue. "

1. The 'other' committee within NCPA, specifically, the Public Sector Committee, has never answered any of my e mails re: reimbursement/ public sector e.g., Medicare, Medicaid issues.

No one ever directed me to the Legislative Committee and I have no hope that they would be any more helpful that DIPP or Public Sector Committee members.2. If NCPA has been working with matters associated with mental health reform, then why are the most basic matters not addressed?................
**********************************************************************************************DIPP another article from the latest NCPA newsletter:

Four Parities in Search of Implementation!: "You could say that the straightforward part is accomplished. Now to work on the sequels. 2007 was a great year for the Mental Health of North Carolina citizens.! (nevermind that BCBSNC, insuring over 50% of people w/ health insurance in NC was allowed to OPT OUT of mental health parity; BCBSNC is 'overseen' by the NC STate Legislature: (continuing):

'Parity is the legislative ratification of a truth we have been promulgating for many years—that psyche and soma are one and need to be thought of and treated as one.'!

Sunday, June 14, 2009

Seroquel: Big Pharma makes more money off those w/ mental health concerns than do the mental health providers: AMAZING

St. Petersburg Times
Seroquel maker wants to seal info from you, "for" youBy Kris HundleyIn Print: Sunday, February 15, 2009

"....Dr. David Egilman, facing possible criminal charges, admitted in writing that he violated a court order to keep Lilly documents secret.

"They don't want anybody to know about the side effects of their drug, and they're keeping secret the results of studies from patients, their doctors and the FDA,'' said Dr. David Egilman, clinical associate professor at Brown University's Department of Community Health.
"Saying they're protecting the patient is a self-serving, fraudulent argument."• • •

Though Egilman is merely an observer of the Seroquel proceedings, he knows the power of sealed documents in drug liability cases. He played a key role when similar lawsuits were lodged against another mega-selling antipsychotic, Eli Lilly's drug Zyprexa. As in the Seroquel cases, thousands upon thousands of patients claimed Zyprexa caused weight gain and diabetes...."

Philadelphia InquirerRuling near on privacy issues in Seroquel caseBy Miriam Hill
Feb. 25, 2009

Source: http://www.philly.com/inquirer/breaking/business_breaking/20090225_

And what about details of sexual relationships between Wayne Macfadden, AstraZeneca's former U.S. medical director for Seroquel, and two women who researched and wrote papers supporting the drug's safety and efficacy?

A federal judge in Orlando may answer those questions as soon as tomorrow in a case stemming from personal-injury claims by 15,000 people that Seroquel triggered weight gain, diabetes, and other health problems.

Plaintiffs' attorneys and Bloomberg News, the news organization, have sued to force London-based AstraZeneca P.L.C. to make public documents discovered in the litigation. AstraZeneca's U.S. headquarters are in Wilmington."This is, first and foremost, a public-safety issue," said Howard Nations, chairman of the Seroquel litigation group of the American Association for Justice (formerly the Association of Trial Lawyers of America).Patients, Nations said, have the right to know about safety concerns raised in discussions between AstraZeneca and the U.S. Food and Drug Administration or in unpublished research on the drug.Seroquel belongs to a class of drugs known as atypical antipsychotics.

The drug is approved to treat bipolar disorder and schizophrenia, but doctors have been prescribing it and similar drugs for conditions including attention-deficit disorder and sleeplessness.Seroquel is now one of AstraZeneca's best-selling drugs, with $4.5 billion in sales last year...."
Comments: 15

TheHammer (aka Marsha V. Hammond, PhD: comment to the Charlotte Observer documenting how the NC State Legislature can't find its way to make Big Pharma more responsible):

wrote on 06/14/2009

Good ole Seroquel: very common to see in my clients 50-100 pounds of weight gain, commonly leading to diabetes. STUN drug.

Fortunately, psychiatrists seem to be returning to some of the older medications (OOPS: no money in those drugs who have gone out from under their patent after 7 years) even if there is a risk of tardive dyskenisia.

What a mess mental health is: from A to Z.


"Such a move would be opposed by the drug industry, which prefers voluntary measures such as having state officials encourage doctors to prescribe more generics.

Officials at GlaxoSmithKline declined to be interviewed for this story, but a spokeswoman for North Carolina's largest drugmaker issued a statement saying preferred drug lists interfere with the individual relationship between a doctor and a patient.

GSK employs about 5,000 people in Research Triangle Park. Besides being the state's largest pharmaceutical employer, the company is the largest political contributor among N.C. drug companies. Between 2004 and 2008, Glaxo's political action committee and executives contributed at least $218,940 to state candidates. Other drug company PACs and executives contributed at least $456,205 in the same period.

Drug companies are a formidable presence at the General Assembly.

“They are like tobacco companies,” said Rep. Verla Insko, an Orange County Democrat and budget writer. “They are a major part of our industrial base.”

Insko said there was scant support for a preferred drug list until last week, when budget writers learned they had to trim an additional $254million from Medicaid. ..."

Tuesday, June 09, 2009

Who to write in the NC State Legislature re: slashing Mental Health services

Dear Appropriations Chairs & Mr. Hackney, Speaker of the NC House:(Mickey.Michaux@ncleg.net, Alma.Adams@ncleg.net , Martha.Alexander@ncleg.net , Jim.Crawford@ncleg.net , Phillip.Haire@ncleg.net , Maggie.Jeffus@ncleg.net , Joe.Tolson@ncleg.net , Douglas.Yongue@ncleg.net , Joe.Hackney@ncleg.net

As you well know, your duty is to appropriate money for expenditures concerning citizens of NC. It is undoubtedly a very difficult job. Moreover, it is currently more difficult than usual. And we realize that there is an election coming up in two years. However, please bear in mind that the country is experiencing a wave of Democratic candidates in office. Besides this, ‘doing the right thing’ should, I hope, be more important than getting re-elected-----if that is your fear.

As a clinical psychologist, I work mostly with Medicare & Medicaid clients in western NC. To say that my clients are indigent would be a vast understatement.

I would like to speak specifically to the usefulness of Community Support Services for my Medicaid clients. This psychologist utilizes time w/ my clients to deal with intrapsychic issues which impede their ability to improve.

If you remove CSS, what we will then have to deal with will be an endless list of things like: 1. how to get to the doctor’s appointments 2. how to get food on the table 3. how to get a part time job.

I cannot do it all. I ask you to consider very carefully the impact of CSS service cuts on this population.

Sincerely, Marsha V. Hammond, PhD

Wednesday, June 03, 2009

HUFFINGTON POST: TEN Suicide attempts in one night admitted to Carolinas Medical Center

Dear Arthur at Huffington Post:

Thanks to you and Adrianna Huffington for your comments. Love seeing her on Colbert.

Here's what is taking place in NC: since 2001, NC Mental Health Reform has been in place. What does this mean?

'Privatization' and 'competition' was viewed by the Dem controlled NC State Legislature (yes, I am a Dem, far to the left) as necessary to create a more efficient, better public mental health care system. The mental health centers were morphed into administrative centers.

Private providers came on board (this gave me an opportunity for a job as an independently practicing psychologist).

However, problems rather quickly evidenced re: this innovative mental health reform.

No one can make much of a profit re: mental health care. Why? Because people w/ mental health challenges don't have any money. What they do have is Medicare & Medicaid. So, what happened is that these Severe Persistent Mentally Ill (SPMI: a descriptor associated w/ this population) with Medicaid, utilized Community Support Services (CSS). These citizens w/ mental health challenges also received access to therapy and medication, as needed.

CSS provides weekly face-to-face support from CSS workers who work w/ the client to increase their skill level and to augment difficulties w/ creating better mental health---such as making mental health appointments, etc. (It does not help that there is not a transportation infrastructure in NC).

What were the other problems that created barriers to mental health?

For over five years, Carmen Hooker Odom, the Director of the Department of Health & Human Services (DHHS NC) was in place. She put out confusing memos that confounded the system. She was let go in 2007.

Some of the morphed community mental health centers put into place their 'favorite people' to create the mental health services.

The citizens advisory boards within the morphed community mental health centers were dissed and thrown out on the street---when they were supposed to---by law---have an advisory capacity.

As you surmise, there was a big scramble for control.

This brings us to where we are now: the NC House has just submitted a proposal to lob off 25% of the human services budget. They say its because they have to. However, this is in the face of:

*10 suicide attempt citizens being admitted to the hospital in your report this past week (there is a decrease in mental health services, particularly as BCBSNC was allowed by the State Legislature to OPT OUT of mental health reform)

*two incidents in the past two weeks where in NC citizens w/ mental health challenges were chained to hospital beds for 5 days and 8 days in the local ER's because there were no acute level beds ANYWHERE in NC

*thousands of hours of sheriffs' time tied up w/ people who are admitted to ER's and there are no inpatient beds ANYWHERE in NC

*if CSS are cut as proposed by the NC House, most of the private providers which came into play as associated w/ mental health reform will go under, thus exacerbating the already dire situation

I think you get the picture.

Marsha V. Hammond, PhD


".....ten patients attempted suicide in a single night in March, a doctor at the Carolinas Medical Center, said, "I can't believe it's not related to the economy."

The story raises questions for the rest of the country: Is this happening everywhere? And do more people kill themselves when the economy contracts?

Hard to know. The latest national data on suicides, released in April by the Centers for Disease Control and Prevention, ends in 2006, when 33,300 people committed suicide nationwide.

That's 11.2 suicides per 100,000 people, a rate increase of .2 percent over the previous year.
"Our data aren't really current enough to be able to say anything about this particular downturn," said Bob Anderson, chief of mortality statistics with the CDC's National Center for Health Statistics, in an interview with the Huffington Post.

Anderson said that the CDC is hampered in its reporting because it has to wait for each state to process death certificates, which can take up to a year. "We can only be as fast as our slowest state," Anderson said.

....Clayton stressed that 90 percent of the people who commit suicide suffer from a psychiatric disorder. However, she added, job loss can exacerbate persistent feelings of anxiety and hopelessness, which are warning signs of suicide.

There is a precedent for connecting economic trends to suicide trends, Clayton said. "If you go back to the Great Depression and you look at suicides from 1927 to 1932 there does seem to be a rise."

Even without statistics, there are clues to what might be happening. Calls to the National Suicide Prevention Lifeline, the only national 24/7 suicide prevention hotline, have increased steadily every month since April 2007, when 38,114 people called the hotline. In April 2009 the hotline received 51,465 calls......"

Family Care Homes mental health residents have a critical link to Community Support Services WHICH ARE TO BE CUT OUT

".....Community Support Services was supposed to address this issue of fostering independence. Now, however, the state Department of Health and Human Services is clearly abandoning CSS. And the managers of these family-care homes have a vested interest in keeping their cash cows in their place...."



Carolina’s forgotten residents"Family care homes" deny treatment to mentally ill residentsby

Marsha V. Hammond in Vol. 15 / Iss. 45 on 06/03/2009

Most citizens, even concerned ones, don’t understand where people with mental-health challenges go—as in live, manage their lives, hang out. Why, of course, they live with their families, right? Nope: Many don’t. Neither do they vaporize when the sun goes down.

In North Carolina, most adults with severe and persistent mental illness are not homeless but rather live in privately owned “family care homes.” According to the state Division of Health Service Regulation, there are about 750 adult-care-home beds in Buncombe County, and they’re mostly filled.But statistics don’t begin to convey these residents’ everyday experience. Mostly they share a bedroom with two or three other people; to get a single-person room, you have to travel far, far out into rural N.C.—miles away from any buses. So if you want to go anywhere at all, you are plainly stuck.

Mostly what happens in the family-care homes is that the residents are forgotten. Lacking transportation, they are isolated, and like the patients of the large mental hospitals of bygone days, they clean toilets, mop floors and endlessly rearrange their small number of personal items while watching TVs linked to cable systems (aka the “activities director”: State law requires TV to be available at least 14 hours a week.)

In the mid-1970s, the famous Wyatt v. Stickney case determined that people with mental illnesses couldn’t be kept without appropriate treatment that could enable them to become more independent. Subsequently, North Carolina’s family-care-homes law was passed—just in time to snare the folks now being released by the state hospitals’ psychiatric wards. Thus, people with mental-health challenges were sprung from the hospitals only to be devoured by the family-care homes (lest we ordinary folks be overrun by homeless people).

Created by the state’s ill-fated 2001 mental-health reform, Community Support Services was supposed to address this issue of fostering independence. Now, however, the state Department of Health and Human Services is clearly abandoning CSS. And the managers of these family-care homes have a vested interest in keeping their cash cows in their place.

The county departments of social services, meanwhile, are supposed to enforce state law, but if you file a complaint, you’ll get a letter from the Division of Health Service Regulation indicating that they “found no evidence” when they arrived in their official cars, wearing their official badges, to investigate.

This is not a workable system, and we obviously need to revisit Wyatt v. Sitckney as it pertains to North Carolina’s family-care homes.Residents receive disability checks in varying amounts, depending on which Social Security account they’re linked to.

If the disability started at age 19, it could be the father’s account. Or it could be the now-disabled person’s own Social Security account, which they vested by working for decades—just like you—before filing for disability.

The law concerning family-care homes is detailed to the point of specifying how much protein should be part of residents’ daily diet; who can take them where; who gets their toenails clipped and under what conditions; what are the visiting hours—and what happens to their spending money. But the departments of social services see only what they’re allowed to see, and they are, after all, part of the system.

Residents, meanwhile, don’t generally complain, because they’re vulnerable to angry retribution by the management—which often illegally mixes the patients’ money with the institution’s own funds.

Some family homes are cleaner than others, and some have better food. According to the law, patients are supposed to be in control of what food is put in front of them, and menus are supposed to be posted a week ahead of time. They never are. Sometimes the food runs out entirely, and the residents eat cereal—or nothing—for several days.

The diabetics suffer the worst. Most seasoned residents learn to stash food in their rooms to get them through these lean times. Meanwhile, outside, the trash sometimes spills out onto the road, because the trash pickup is private, and one is told that “the money ran out.”

I’ve always wondered how that could be, if—as per the “personal finances” page in every resident’s chart—they’ve signed over their dependably mailed disability checks to the family-home management. Along with the remaining funds promptly delivered by the local department of social services, those checks are designed to cover the approximately $1,280 per month, per resident, cost of housing and food and occasional transportation.

But then I tend to ask an awful lot of questions, such as what happened to the “spending money” that should be coming back to the residents—which represents their ability to interface with the larger world.

Absent that ability, the residents appear to be right back where they were in the wards of the old psychiatric hospitals: They have no rights.

[Asheville resident Marsha V. Hammond, a licensed psychologist, writes about N.C. mental-health reform on her blog, ]http://madame-defarge.blogspot.com.]

Monday, June 01, 2009

Why there will be no Mental Health Parity associated with a 'for profit'/ non-government sponsored health insurance industry

In the Fall of 2008, NC passed a mental health parity law. Didn't matter. BCBSNC was allowed to opt out of it. BCBSNC insures over 50% of all people paying for insurance in NC.

So, here are some reasons why the notion of mental health parity doesn't matter AT ALL if we are caught up in a for-profit health insurance industry scenario.

Remember: Medicare has overhead administrative costs below 5%. BCBS has administrative costs close to 20%.

First item was put forward by Dr. Gordon Herz, psychologist, from the Division 42 (Independent Practice) of the American Psychological Association (Gordon@DrHerz.us Madison, WI).

"...Imagine -- bear with me, I know this is a fantasy -- you are a grossly
overcompensated CEO a health insurance company, trying to make as much of
your 7 figure performance bonus you can, and to make as much forstockholders
as you can.

Read the description of the parity law and its "requirements."

How many ways can you devise to circumvent it, make mental health patients'
and the doctors who take care of them miserable? ...

If I wanted to continue my profit-making for me and my company I'd simply
define as 'noncovered,' in the policy language, well, pretty much any
condition I didn't want to pay for. ....

If the terms of the plan are that psychotherapy requires preauthorization and maybe even reauthorization in writing by the doctor every visit or so, but hip surgeries require no
authorization, that is, as I understand it, completely acceptable under the
"parity" legislation.

Paraphrasing APAPO's summary of the parity legislation
<http://www.apapractice.org/apo/in_the_news/parity_summary.html#>, the law
applies to "...all financial requirements, including deductibles,
copayments, coinsurance, and out-of-pocket expenses, and to all treatment
limitations, including frequency of treatment, number of visits, days of
coverage, or other similar limits."

Note: there is nothing in there that requires parity in any other way of
managing benefits.

Bryant Welch, J.D., Ph.D., is a clinical psychologist and attorney living in Hilton Head Island, S.C. He designed and built the APA Practice Directorate which he ran from 1986 until 1993.

From the spring, 2009, National Psychologist: The following article appears in the May/June 2009 issue of The National Psychologist on Page 14.

Parity: Future of an Illusion

"....There was, however, a serious problem with parity. According to most of the proposals, parity provisions addressed a reimbursement system that no longer existed. Under parity, insurance plans had to provide the same co-pay and the same deductibles for mental health care that they did for other forms of health service.

If it was at 20 percent co-pay for outpatient services in medical care, it would be at 20 percent co-pay in outpatient mental health services. That;s parity as it has typically been defined. The problem is that insurance companies have not relied on co-pays and deductibles for cost control for a long time now.

Managed health care controls based on the concept of 'medical necessity' shape the amount of resources that will be allocated to any particular health care problem. Parity does not even address these mechanisms.

Under managed health care insurers can articulate any benefit they want and they can order businesses to make that same benefit available to people seeking psychological services. The real question this does not address, however, is how will 'medical necessity' be determined by the insurance company in administering the program.

One can have all the mental health care that is 'medically necessary' under an 80-20 payment plan with no maximum limit on visits and still wind up with exactly zero mental health treatment if the insurance company determines the care is not medically necessary.

In short parity closes the barn door after the horse has already been stolen.

But the problem with most parity bills runs even deeper. Typically, given everyone's presumption that parity is going to lead to more money being spent on mental health care, businesses and insurance companies are able to make a successful plea that they must have some protection from runaway spending, something that did occur in the mental health field when the for-profit psychiatric hospitals were given special exemptions from Medicare regulations, which made investments in mental health facilities more lucrative and more attractive to venture capitalists in the late 1980s.

Thus, provisions were put in many parity bills that limited the cash outlay businesses had to pay under the parity bill. If they did not provide any mental health benefit, they did not have to conform to the parity provisions at all. It was only if the company provided mental health care that it had to meet the parity standards.

In short, the loud cries of victory coming from representatives of the mental health community every time a parity measure has been passed have on many occasions been very hollow victories, indeed. ..."