A COVID relief rental aid program ends 6/30/22, but there is still time to apply for help

This is from an article in the Detroit Free Press, “Statewide rent aid program will stop taking new applications June 30. What to know.” by Nushrat Rahman, 6/15/22.

“A statewide program to help families catch up on rent payments and avoid eviction will stop taking new applications after the end of the month.“ 

The COVID Emergency Rental Assistance (CERA) will continue to take applications for assistance until 9 p.m. June 30, 2022. 

“The Michigan State Housing Development Authority (MSHDA) — which is responsible for administering the $1.1 billion program that's been in place for a little more than a year — said that it will continue processing applications until all funds are used up. 

“Those who have already completed a CERA application should check their status, but should not apply again because that can slow down the overall processing time, said Julie Schneider, acting director of the city's [Detroit’s] Housing and Revitalization Department.”… 

"The program provides up to 18 months of rental assistance for qualifying applicants who faced economic challenges during the COVID-19 pandemic. It can also be used to help pay for utility bills. Applicants must be below 80% of the area median income. …Applicants must also show proof of financial distress since the pandemic began, such as qualifying for unemployment or having a past due rent notice.“

“…Funds will continue to go out to those who are approved until Sept. 30, or until aid runs out…” 

The article has more information for people living in Detroit and assistance available there.

Abelone Kelley June 16, 2022 0

Review of the 2022 Disability Policy Webinar Series from the ARC Michigan

I have been in semi-hibernation during the COVID pandemic and have not been following state and local disability policy as closely as I should. With regard to policy affecting people with Intellectual and Developmental Disabilities (I/DD) and their families, one way to catch up is to follow the ARC Michigan’s 2022 Disability Public Policy Webinar Series on Zoom. The Webinars are held every Friday in June with each week featuring a different topic and speakers. The Webinars are also archived for viewing later.

I have my differences with the ARC and other large advocacy organizations. Too often they do not represent the spectrum of views held by people with disabilities and their families. Many policy makers find it convenient to accept the views of well-funded advocacy groups as a proxy for individuals with I/DD and their families, thereby avoiding controversy and the unsettling reality of differences of opinion that they would otherwise have to confront. Nevertheless, the ARC policy seminar offers a variety of topics and includes knowledgeable speakers on state and federal issues affecting people with disabilities.

The ARC Michigan 2022 Public Policy Webinar #1: June 3rd, 2022

ThIs is the PDF handout for the first Webinar with Belinda Hawks from the Behavioral Health and Physical Health & Aging Services Administration (BHPHASA), Remi Romanowski-Pfeiffer from TBD Solutions, and Al Jansen, Senior Advisor to Director Hertel, Michigan Department of Health and Human Services (MDHHS)

This is the link to the Youtube video of the Webinar.  

The BHPHASA is new. It is the result of combining agencies under the MDHHS. 

From the Website:

“The Health and Aging Services Administration (HASA) was created under Executive Order 2021-14 combining Aging and Adult Services Agency and Medical Services Administration under one umbrella within MDHHS. Michigan's Medicaid Office is also part of HASA and the designated State Unit on Aging function will be fulfilled by HASA.”

The topics that I was especially interested in include the Direct Care Workers (DCW) crisis and the “Heightened Scrutiny” of settings receiving HCBS (Home and Community-Based Services) funding to assure that they provide access to “the community” based on the wishes and needs of the people living in these settings. There are other issues that will also be of interest to providers, local agencies, and people with disabilities, such as how the state is planning for recovery from the COVID pandemic and various scenarios to consider.

The Direct Care Workers (DCW) crisis - Allen Jansen, Senior to Elizabeth Hertel Allen Jansen, Senior Advisor to Elizabeth Hertel, Director of the MDHHS.

[Allen Jansen’s presentation begins at around 43 minutes on the Youtube video.]

National Data on DCWs (also known as DSPs or Direct Service Providers):

• 4.5 million direct care workers in the U.S.
• 40 to 60% rate of turnover
• 84% have no retirement benefits
• In 2019, 53% were women of color
• 47% qualify for public funded benefits
• In 2020, $20,200 was the median income
• By 2030, the predicted shortage of DCWs will be 151,000.

Michigan has a shortage of 36,000 care workers out of a workforce of approximately 165,000.

A state Direct Care Task Force has been created to establish priorities and make recommendations to the state. 

Also involved in discussions is the Quality Improvement Council (QIC). 

From the Website:

“The Quality Improvement Council directs the development and implementation of the behavioral health managed care programs and serves as the primary point of prioritization and integration of quality improvement activities.

“The Quality Improvement Council includes quality and administrative staff representatives from MDHHS, the PIHPs, CMHSPs, provider organizations, quality vendors and advocacy members.”

There are many job titles that fall under the broadly defined category of Direct Care Worker. Current efforts focus on improving wages and benefits for DCWs. The broad strategy for improvement includes establishing competency standards for the professionalization of the DCW workforce, designing a career pathway, elevating the value of DCWs (specifically identifying them as providing an essential service), and collecting data to demonstrate their impact:

The Governor’s proposed 2023 budget includes funding to stabilize DCW wages. At the time of the Webinar, a supplemental budget that includes additional wages for DCWs was stalled. 

Recommendations for improvement include setting a starting wage at $17 - $18/hour for DCWs and adjusting funding to cover added expenses to providers to pay supervisory personnel.

There is also a proposal to expand “residential models”. Belinda Hawks clarified that this is referring to the need for facilities to house people who are stuck in emergency rooms and hospitals with no place to go or are in nursing homes and want to get out. These would be home environments aligned with a psychiatric treatment facility model. The estimated need for such facilities is 48 beds for adults and 12 for children. 

“Heightened Scrutiny”

Heightened scrutiny is a process to determine whether a setting receiving HCBS funds allows sufficient access to the community to be eligible of funding under the CMS (Centers for Medicare and Medicaid Services) settings rule. 

Michigan does not set limits on the size of a setting. According to Belinda Hawks, no settings so far have been determined to be ineligible. The state is still reviewing settings. Compliance with the settings rule must be complete by March 2023. The Department expects to be finished reviewing settings by August or September 2022 to give providers enough time to make changes to comply or find other arrangements for residents of these settings. 

Providers have been notified if they under the HS process. The final determination is up to CMS.

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See also:  

DCW commentary from ARC Michigan

Michigan’s mental health system is failing many with severe autism
Thursday, May 16, 2019

Abelone Kelley June 10, 2022 0

The War on Children - May 2022

On Tuesday, May 24, 2022, an 18-year-old boy shot his grandmother and then drove to an elementary school in Uvalde, Texas, where he barricaded himself in a fourth-grade classroom and murdered 19 children and two teachers. Law enforcement were in the building, but, for whatever reason, they waited some forty minutes to enter the room to take out the shooter. During that time, children called 911 and pleaded with the operator to send in the police. The shooter was shot to death when law enforcement finally entered the classroom. 

More will probably come out about the details of this fiasco, but there are many factors that contributed to this tragedy that are coming to light:

The Shooter

The 18-year-old boy reportedly had a troubled home-life. In middle school and junior high, the boy was bullied for having a stutter and a strong lisp. The bullying occurred both at school and on social media. He also made threats to girls in on-line chat rooms but these were never reported to authorities.

The shooter was never identified as needing mental health services, but that doesn’t mean that he might have needed them.

Law Enforcement in Uvalde

This is from The Daily Beast: “More Guns and Cops at Schools Are Not the Answer” by Tana Ganeva, 5/26/22 - It describes the ineffectiveness of law enforcement in preventing the murders of 19 school children :

“As the horror was unfolding in Uvalde, Texas, law enforcement swarmed the area surrounding the school. Many were outfitted in camouflage. They paced around with semi-automatic weapons strapped to their chests and stood next to a Lenco BearCat, an armored vehicle that’s basically a tank.

“Uvalde—an agricultural community dotted with modest houses, is not drowning in excess wealth—yet the police and border control agents have the tools and weapons more befitting of Seal Team 6—thanks to federal grant programs that pass military grade equipment to local police at no cost. 

“Alongside ‘thoughts and prayers,’ pro-gun lawmakers come up with all kinds of explanations to avoid a reckoning on guns in America. It’s violent video games! Rap! Metal! Mental illness! Drugs! Feminists! Fatherlessness! And after the bickering over common sense gun control fades, the solution we seem to settle on is, more cops, more guns, including the ludicrous notion that teachers carry loaded weapons.”

…”Let’s hope this display of law enforcement incompetence nudges Americans towards solutions beyond just simply adding more men with badges and guns into children’s spaces.”

There were a total of 19 officers in the school, before a decision was made to breach the classroom and take out the shooter. Records show the district spent about $200,000 on security and monitoring services in 2017-18 and that figure rose to more than $450,000 in the 2019-20 school year, according to CNN.

The Political response:

This is from ABC News.

"Texas Governor Abbott places shooting blame on mental health, what has Texas done to address it? -The shooter did not have a diagnosed mental health condition, police said."

By Mary Kekatos, May 27, 2022

The Texas Governor Greg Abbot “blamed the mass shooting at an elementary school in Uvalde on mental health issues.”  

"'We as a state, we as a society need to do a better job with mental health,' the Republican governor said Wednesday. 'Anybody who shoots somebody else has a mental health challenge. Period. We as a government need to find a way to target that mental health challenge and to do something about it.'"

The shooter, however, did not have a diagnosed mental health condition. Critics say the state has not done enough to expand mental health services and has in fact recently reduced support for existing services:

“In April, Abbott announced he would be moving nearly $500 million from state agencies to fund Operation Lone Star, a Texas-Mexico border security initiative jointly being conducted by the Texas Department of Public Safety and the Texas Military Department. 

“Of that amount, $210.7 million was from Texas Health & Human Services, which oversees public mental health programs.” 

The state has denied that mental health programs would be negatively affected by the transfer of funds. Nevertheless, in a report from Mental Health America, Texas ranks 51st or last in the nation in access to mental health care. According to the report, “The access measures include access to insurance, access to treatment, quality and cost of insurance, access to special education, and workforce availability.”

There have been efforts to improve services, but overall the state appears to be in bad shape as far as delivering services to the people who need them.

The Weapon:

The shooter, who was later killed by law enforcement, purchased two AR-style rifles and several hundred rounds of ammunition just days after he turned 18, the minimum age under federal law for buying a rifle.

I have gleaned that the AK-47 (Automatic Kalashnikov 1947), is the mother of modern day military-style assault weapons. The AR-15 is a comparable civilian version of a semi automatic assault rifle. If you want to know the fine points of the differences and pros and cons of both weapons, see “How the AK-47 became the ‘weapon of the century” from the Military Times, 2017 and “AR-15 Vs. AK-47: Which is the Best Rifle for the Apocalypse?”. The semi-automatic AR-15, the Uvalde shooter’s weapon of choice, appears to be better than the AK-47 in terms of accuracy. 

From The Military Times: “The AK has secured its place in firearms history not by its performance as a weapon of the conventional war for which it was designed … but by its position as a purely military weapon that broke free of the fetters of armories and official control” and “The AK-47 and its derivatives deserve the title ‘Weapon of the Century,’ at least in the early days of this epoch, because it is quite simply the most effective machine ever manufactured that allows a man, woman or child to kill another human being with the least possible skill, training, effort or expense.”

The shooter’s weapon of choice, the AR-15, is manufactured by Daniel Defense with corporate offices in Black Creek, Georgia. The company pulled out of promoting its products at the National Rifle Association convention May 27 - 29, 2022 in Houston, Texas. They are sad about the Uvalde massacre and send their thoughts and prayers to the victims of this evil act.

The rifles that the shooter purchased, apparently with a debit card, cost around $2,000 each, according to the Daniel Defense website.

Political donations by the gun maker: According to an article in the Washington Post, “Maker of rifle in Texas massacre is deep-pocketed GOP donor - Political contributions by the owners of Georgia-based Daniel Defense show the financial clout of the gun industry, even as NRA spending declines” by Isaac Stanley-Becker, 5/27/22, “The owners of Daniel Defense, the manufacturer of the rifle apparently used in the massacre of 21 people at an elementary school in Uvalde, Tex., are deep-pocketed Republican donors, giving to candidates and committees at the federal and state level aligned against limits on access to assault rifles and other semiautomatic weapons.”

“The owners of the Georgia-based company have donated more than $70,000 directly to GOP candidates for federal office this election cycle… Daniel Defense itself gave $100,000 last year to a PAC backing incumbent Republican senators.” The owners put another $20,000 into a PAC “whose largest beneficiaries are Reps. Kevin McCarthy (R-Calif.) and Steve Scalise (R-La.), the No. 1 and No. 2 House Republicans.”

Beneficiaries of the owners’ contributions include Hershel Walker who won the Republican primary in Georgia for the US Senate race, Republican Senator Joni Ernst of Iowa, Senator Tim Scott of South Carolina, Senator John Kennedy from Louisiana, and Eric Schmitt, the Attorney General of Missouri and Republican candidate for U.S. Senate.

None of the contributions have gone to Democrats.

Yes, guns are part of the problem and the 2nd amendment does not preclude reasonable regulation of gun sales and ownership:

The right to bear arms is not absolute. 

“Like most rights, the right secured by the Second Amendment is not unlimited. [It is] not a right to keep and carry any weapon whatsoever in any manner whatsoever and for whatever purpose.”

Justice Antonin Scalia

District of Columbia V. HELLER, 2008

Abelone Kelley May 31, 2022 0

From the Washtenaw Intermediate School District:

Join us next week on May 19 from 5:30-7:00 pm for a community-wide Open House for our renovated High Point School!

Come see this beautiful gem: take a tour, check out the brand new fully accessible playground, and see how High Point benefits our community!

This unique school facility is home to WISD's High Point program, which serves students ages 3-26 with severe and multiple disabilities from across Washtenaw, along with WISD's Deaf & Hard of Hearing program, Honey Creek Community School, and Gretchen's House.

The renovated school was made possible thanks to voters.

Washtenaw Intermediate School District
May 19th, 2022
5:30 - 7:00 PM
1735 Wagner Road
Ann Arbor, MI 48103

Abelone Kelley May 15, 2022 0

Biden program offers discounted internet to low income households

This is from an Associated Press article on discounted internet service for low income households. People with disabilities often fall into this category making life more difficult with less ability to receive information available to most of the public. This affects many people living in rural areas as well as people in more populated areas who struggled to find internet service for their children to participate in on-line schooling.

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Biden announces program offering discounted internet service
By AAMER MADHANI and WILL WEISSERT, 5/9/22

"WASHINGTON (AP) — President Joe Biden announced Monday that 20 internet companies have agreed to provide discounted service to people with low incomes, a program that could effectively make tens of millions of households eligible for free service through an already existing federal subsidy..."

..."The $1 trillion infrastructure package passed by Congress last year included $14.2 billion funding for the Affordable Connectivity Program, which provides $30 monthly subsidies ($75 in tribal areas) on internet service for millions of lower-income households.

"With the new commitment from the internet providers, some 48 million households will be eligible for $30 monthly plans for 100 megabits per second, or higher speed, service — making internet service fully paid for with government assistance if they sign up with one of the providers participating in the program."

..."Biden noted that families of four earning about $55,000 annually — or those including someone eligible for Medicaid — will get a $30 monthly credit, meaning about 40 percent of Americans will qualify."

..."The participating providers are Allo Communications, AltaFiber (and Hawaiian Telecom), Altice USA (Optimum and Suddenlink), Astound, AT&T, Breezeline, Comcast, Comporium, Frontier, IdeaTek, Cox Communications, Jackson Energy Authority, MediaCom, MLGC, Spectrum (Charter Communications), Starry, Verizon (Fios only), Vermont Telephone Co., Vexus Fiber and Wow! Internet, Cable, and TV.
American households are eligible for subsidies through the Affordable Connectivity Program if their income is at or below 200% of the federal poverty level, or if a member of their family participates in one of several programs, including the Supplemental Nutrition Assistance Program (SNAP), Federal Public Housing Assistance (FPHA) and Veterans Pension and Survivors Benefit."

Abelone Kelley May 10, 2022 0

Budget Alert from the Michigan Assisted Living Association (MALA)

This is from the Michigan Assisted Living Association (MALA) on increasing wages for direct care workers who provide services to people with developmental disabilities as well as those who are aging or have mental illness or physical disabilities. 

The only thing I would change about this appeal is to make sure it applies to direct care workers regardless of where the individual served lives. Workers in group homes, nursing homes, and other settings are as vital to the care of people with disabilities as those who are hired to work in the individual's own home.

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MALA Budget Alert - Your Action is Needed Now!

Your advocacy is urgently needed as the Michigan Legislature works on the state budget for the fiscal year beginning October 1, 2022. Please see the message and link below for you to communicate with your state legislators.

The behavioral health coalition, of which MALA is a member, is urging the Michigan Legislature to appropriate an additional $127.0 million in General Fund dollars. This funding equates to an approximate $4.00 per hour wage increase which would be in addition to the $2.35 per hour wage increase.

We expect the $2.35 per hour wage increase to be funded in the next fiscal year’s state budget. However, the potential exists for an additional wage increase particularly if the state revenue estimates released later this month are positive.

Please take a few minutes to contact your state legislators to urge their support for the additional funding referenced in the message below. An additional $4.00 per hour wage increase would result in an estimated average starting wage rate state-wide of $18.00 per hour for direct support staff. 

Please feel free to contact us if you have any questions related to this MALA Budget Alert.

ROBERT L. STEIN

General Counsel
, 734-525-2400,
rstein@miassistedliving.org
 

KATHLEEN M. MURPHY

General Counsel
, 734-525-2401,
kmurphy@miassistedliving.org

BRENDA L. ROBERTS

Director of Quality Assurance and Education,
734-525-2407,
broberts@miassistedliving.org

Please Support Michigan’s Direct Care Workers

When a Michigan resident experiences a mental illness or developmental disability, they should be able to hire the help they need to ensure their safety and wellbeing. But right now, they can’t.

In today’s tight labor market, it is difficult to find a Direct Care Worker, whether you are looking for care for yourself, a loved one, or hiring an employee for your agency. This leaves our state’s most vulnerable residents at risk.

Our coalition proposes a General Fund appropriation of $127.0 million in FY 23 which would increase the average starting wage rate in the behavioral health system to approximately $18.00 per hour. That’s what many entry-level jobs pay across the state right now and is the least we can do to compensate our Direct Care workforce.

With significant amounts of GF dollars and pandemic-related federal funding available to the state right now, Michigan has a once-in-a-lifetime opportunity to address the long-standing direct care workforce crisis in a meaningful and sustained manner.

Let’s reach out and make it happen.
 

Click Here

Abelone Kelley May 06, 2022 0

Michigan: Whitmer announces additional assistance to lower the cost of food

Most people with disabilities who qualify for SSI (Supplemental Security Income through the US Social Security Administration) also qualify for food assistance benefits. In a recent press release, Governor Whitmer announced additional help with food costs:

Whitmer Announces Michiganders to Receive Additional Assistance to Lower the Cost of Groceries
April 19, 2022                      
 
"LANSING, Mich. – Governor Whitmer today announced all Michigan families who are eligible for food assistance benefits will continue to receive at least an additional $95 monthly payment in April to help lower the cost of groceries and ensure Michiganders can keep more of their hard-earned money. The additional assistance will help approximately 1.31 million Michiganders in more than 700,000 households.

"'Michiganders will receive additional assistance to put food on the table in April as we continue growing our economy,' said Governor Whitmer. 'This relief ensures that families can thrive and help us build on our economic momentum. We will continue collaborating with our federal partners to get things done by lowering out-of-pocket food costs and put money in people's pockets with our proposals to roll back the retirement tax, triple the Earned Income Tax Credit, and lower the cost of gas.'
 
"In April 2020, some Michigan residents began receiving additional food assistance under this program. In May 2021, all eligible households began getting extra monthly benefits. Federal approval is necessary every month.
 
"Eligible clients will see additional food assistance benefits on their Bridge Card from April 16 - 25. These benefits will be loaded onto Bridge Cards as a separate payment from the assistance that is provided earlier in the month.
 
"All households eligible for the Supplemental Nutrition Assistance Program (SNAP) receive an increase of at least $95 monthly, even if they are already receiving the maximum payment or are close to that amount. Households that received over $95 to bring them to the maximum payment for their group size will continue to receive that larger amount."...

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For additional information on accessing benefits and future plans to help people on fixed incomes with rising costs, see the press release...

Abelone Kelley April 26, 2022 0

Severe Autism Awareness: An Interview with Isaac

April is Autism Awareness Month. 

Severe autism takes many forms, but lets be honest, it makes many people uncomfortable. It is not well understood by the general public. Even families that have been living with severe autism for decades and can tell you exactly how it affects their family member, are almost as clueless as everyone else as to its cause and how to treat it effectively. Sometimes there is a reluctance to speak about it because it contradicts the rosy picture that is painted by advocates for people with autism who are not intellectually disabled and have average or above average abilities. It is as if using the autism label for people who are not performing at this level will reflect badly on people who are. 

In this video, Irene Tanzman introduces her son. She projects their affection for each other, but without needing to wear rose-colored glasses to see severe autism clearly.

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An Interview with Isaac, Diagnosed with Severe Autism

Apr 1, 2022

Irene Tanzman

This is my interview with my son, Isaac, an adult diagnosed with severe autism. I filmed this video in April 2022, Autism Awareness Month. Most often, the autism you hear about is not the type of autism that my son and many others have. It seems to me that Autism Awareness for this type of autism seems at its lowest point since my son was diagnosed. The kind of autism that the public is aware of is not the autism that Isaac has. Individuals like Isaac need quality disability specific programming and instruction to lead productive and fulfilling lives. They need therapies such as behavioral, speech, and occupational therapies. This type of help is nearly impossible to obtain. While Isaac is quite loveable and endearing, the idea that he will work in competitive employment is not realistic. He needs the type of services that the National Council on Severe Autism advocates for. Please be aware that this type of autism exists, and that people like this need help and services. Thank you for watching my video.

Visit my website at: https://irenetanzman.com/ . 

Follow me on Twitter: https://twitter.com/itanzman . 

Visit the National Council on Severe Autism: https://www.ncsautism.org/

Abelone Kelley April 06, 2022 0

The War in Ukraine

The invasion of Ukraine has lasted for over a month now. On March 2, the BBC reported on the ongoing battles for Kharkiv, Kherson and Kyiv: the chaos, the rubble, the dispair of peaceful Ukrainians in the bomb shelters, the tears of refugee families parting into exile...  This distressing report, which is introduced by Clive Myrie, an experienced BBC foreign correspondent and TV presenter, is suitable for B2 students and above.  

You will come across interesting expressions like: "in broad daylight, to leave a trail of destruction, the aftermath of a deadly missile attack, the target [is] an airbase, in the rubble, to keep myself together, shooting, to have captured, sirens wail, [deserted streets] echo fear and dread, [the children made] pistols [to kill the enemy], as war closes in, to put on a brave face in, the national anthem, hit by sustained rocket fire, airborne troops, [planes] shot down, distressing images, [calm] in the wreckage [of people's homes], to hide in basements and bunkers, made a dash, to make it onto a train, to go back and forth, to refuse to be cowed, shoving forward, chaos, desperate to get on board, to swear at [all those who have caused the suffering], to flee abroad, to break down".

In the next BBC News report (29/03/22), Iryna Babich, a refugee English teacher,  explains how she has found peace of mind in a Romanian monastery "Only here, at the monastery, I stopped hating.  Last Sunday, I even prayed for Putin", Iryna says while she sadly misses her husband who is delivering fuel back in the besieged city of Kharkiv. This short interview can be followed by B1 students and above and you will find expressions like: "a place of retreat, prayer, meditation, my [lovely] van, just to smell [my husband, my house], stayed behind [...] delivering fuel, [a city] under Russian siege, [they can stay] as long as they wish, [I wished Putin] to become wiser, to feel sympathy to Russian troops, sunflowers in the yard, to breathe [this beautiful mountain air], they fled Ukraine, they might be home by Easter, their best hope is by summer".

Abelone Kelley April 03, 2022 0

Michigan: The Washtenaw County CMH Recipient Rights Advisory Committee seeks new members

"Every person who receives public mental health services has certain rights. The Michigan Mental Health Code protects some rights. Some of your rights include:

The right to be free from abuse and neglect

 
The right to confidentiality

 
The right to be treated with dignity and respect

 
The right to treatment suited to condition..."

This notice is from the Washtenaw County Community Mental Health Recipient Rights Advisory Committee (RRAC):

WE NEED YOU…to join the Recipient Rights Advisory Committee!

What we do:

• Meet in person four times a year to review recipient rights complaint data.
• Protect the Rights Office from pressures that could interfere with the impartial, even-handed, and thorough investigations.
• Receive trainings on WCCMH programs and policies.
  
• Act as the appeals committee for any accepted rights appeals.  
• Receive a $25 stipend for every meeting attended!
  

Call the Office of Recipient Rights at 734-219-8519 or email Leah Raehtz raehtzl@washtenaw.org for more details!

Abelone Kelley March 16, 2022 0

Marina Ovsyannikova Interrogated for 14 Hours

Russian Journalist Marina Ovsyannikova has been released after being interrogated for 14 hours without a lawyer, for two consecutive sleepless nights, and after paying a fine of €250.  She was detained for disrupting a major Russian TV news programme with a placard that read "Stop the war, don't believe the propaganda, they're lying to you", BBC News reports.

Previously, she had recorded a video with a statement explaining her protest, which can be seen below, thanks to The Guardian.

Some interesting words you can find in this story are: to be fined, to be released, a live TV news programme, the set, to plead not guilty, a charge, to call on [the Russian people] to protest, to be prosecuted, to ban, the court hearing, to be denied access [to a lawyer], to stress, to come up with an idea, the courthouse, her whereabouts, the placard, to be ashamed, the television screen, this inhumane regime, a blog run by former BBC journalist, to praise her for telling the truth, to launch an effort, hooliganism. This text is suitable for B2 students.

Abelone Kelley March 15, 2022 0

Michigan: Part-time workers were eligible for pandemic unemployment benefits, even when told they were not...

This is according to an article in the Detroit Free Press, "Whitmer signs bill clarifying eligibility for pandemic unemployment benefits" by Adrienne Roberts, 2/28/22:

Governor Whitmer has signed a bill into law that clarifies that part-time workers were eligible for federal pandemic unemployment benefits.

The new law affects PUA (Pandemic Unemployment Assistance) claims filed after March 1, 2020, for those who had issues due to only being available for part-time work. The PUA program ended in September 2021. People with disabilities and part-time caregivers were among those who were denied benefits that they should have received.

The new law makes it clear that part-time workers were eligible for  federal unemployment benefits. Many were denied these benefits because of the way the forms were worded, making it appear that only those who could claim to be “able and available” for full-time work could claim benefits. 

State Sen. Jeff Irwin, D-Ann Arbor, is quoted in the article:

"To me, this was just a perfect example of putting the box-checking and bureaucratic needs above the needs of the citizens and the true intent of the law," state Sen. Jeff Irwin, D-Ann Arbor, who sponsored the bill, said about the discrepancy.

"…Between this new law and recent guidance from the federal government for applying blanket waivers for overpayments when the claimant is not at fault, Irwin said many of the pieces should be in place to "sweep away these fights with the agency that are unnecessary, unproductive and that we shouldn't be having."

Abelone Kelley March 02, 2022 0

Emergency department care and hospitalization: It’s not just COVID that is the problem…

The term Emergency Room (ER) has been replaced with the term Emergency Department (ED) at Michigan Medicine. I use both terms interchangeably.

These are personal experiences I have had involving my sons’ care at the University of Michigan hospital in Ann Arbor. To be sure, my sons have received outstanding and sometimes life-saving care through Michigan Medicine, but in a large institutional setting like the University of Michigan Hospital, there are pitfalls and gaps in care that can make a visit to the ER or hospitalization excruciating for patients and their families. Improvements in care rely on acknowledging the flaws as well as successes in treating patients, especially those with extraordinary medical needs.

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The COVID pandemic has affected routine medical care, especially at an institution as large as the University of Michigan’s Michigan Medicine, in almost every aspect of care. But some problems with emergency care and hospitalization are long-standing, at least from a patient-perspective.

My son Danny is a complicated person: He is 45 years old and has severe Cerebral Palsy, profound intellectual disabilities, severe visual impairment, a rare seizure disorder, severe reflux, a history of gastric bleeds and numerous other problems, most of which are related, directly or indirectly, to his original diagnosis of severe brain damage soon after birth. A doctor who has not seen him before has a lot of catching up to do before he or she can start making treatment decisions. This is one reason why I almost always accompany him to the emergency room when the group home calls to tell me that his seizures are getting out of control or something else out of the ordinary merits a trip to the our local Emergency Department.

Out-patient medical procedures and hospitalization have their problems also, especially for a person like Danny who baffles doctors under normal circumstances. I’m too old to do overnights at the hospital anymore, which makes it all the more important  for me to get in on the early stages of assessing Danny soon after he arrives at the hospital. For instance, if he is having seizures, the ER nurses want to know if he is flinging his right arm around because of a seizure or if that is just normal activity for him? It’s “normal”, but they may be missing the more subtle signs of ten-second seizures that make him look startled, smile, or laugh.

Whoops! The ambulance takes Danny to the wrong hospital

Not long ago, Danny had another run to the ER. We found out later he had a urinary tract infection, but that diagnosis took awhile to determine. His group home is within twenty minutes of two hospitals; Michigan Medicine has all his medical records and contacts for his doctors within the same medical system. The other hospital does not. The usually safe assumption by the group home staff is that the ambulance will take him to the right hospital, but this time that did not happen. When more than 30 minutes had passed since an ambulance had left to take Danny to the ER and he had not arrived at the U of M, the group home called the other hospital and determined that Danny was there without enough information to figure out why he was there or who could make medical decisions for him. I drove over there while they arranged for him to be transported back to the correct hospital.

Danny has not had a lot of luck in his life, but at this particular moment he lucked out with a nurse who had a family member with cerebral palsy. She got the transfer to the other hospital going, knowing exactly why I would want him moved to be close to his doctors and medical records, and Danny was as happy and content as he could be with a festering UTI and waiting for his second ambulance ride of the morning.

In praise of the other hospital: A few years ago, we suspected that Danny had aspiration pneumonia and his oxygen levels were declining rapidly. Because the other hospital was a few minutes closer, it made sense to get him there as quickly as possible. He spent a day in intensive care where they got him stabilized and on antibiotics and a few more days weaning him off of oxygen so that he could go home. They gave him excellent care. As a a smaller hospital (though large by most standards in rural areas) it was less of a rat race than the U of M hospital. For instance, the ER has its own free parking lot, so that visitors do not have to wait for valet parking or park in a huge parking garage where it might take fifteen minutes or more to make it down to the hospital Emergency Department.

Hurry up and wait! Pre-COVID days in the ER were not much better

Many years ago when Danny was still in school, he rolled off a changing table and hit his forehead on the floor. This was a dramatic bloody event, but did not do any permanent damage. The ER was full that night. One of the people waiting to be seen was a young woman in a wheelchair who, like Danny, was a frequent flyer in the ER. She was in her element, chatting with other patients about her ailments and high-fiving the staff who seemed to know her well. Others occupied themselves patiently chatting, reading, or watching TV or moaning, depending on how ill they were. Danny and I waited for hours - we watched a full episode of ER on TV while in the actual ER. A triage nurse had stopped the bleeding from Danny’s forehead and put a butterfly bandage on the wound. It took so long to get in to see a doctor, that the wound had begun to heal and we were sent home without further treatment.

At another ER run with Danny, we sat for hours with a waiting room full of miserable sick people, one of whom finally stood up and said, “If I’m going to die, I want to die at home, rather in this waiting room!”. She stood up and left along with a number of other people who had also come to the end of their collective ropes.

First-come, first-serve is not always the best way to deal with all ER patients

Danny has a feeding tube. The outer part of the feeding tube can easily be replaced by the group home staff, but on one occasion they were unable to do this successfully. A nurse at his primary care doctor’s office could have handled this in less than 15 minutes, but it was after hours and the ER was the only alternative. Without the feeding tube working, he could not get food, water, or his seizure medications.

At the ER, Danny waited his turn. It was not until 3:30 in the morning when someone could attend to him. By that time he was having seizures with increasing frequency and needed his emergency seizure meds that stop seizures in their tracks. If the ER staff had taken him first, regardless of what seems fair to other people, he could have been out of there in twenty minutes, instead of occupying time and space needed for other patients, not to mention the expense. Instead, he missed a feeding and his seizure meds that evening and spiraled into a completely avoidable major seizure event.

This has also occurred while he was in the hospital waiting for a test to determine the cause of a gastric bleed. He was not allowed food and water so that he could be safely anesthetized, but because of delay after delay in administering the test, he ended up going for days without nourishment, except when we insisted that they give him a feeding in the evening before another scheduled test. That hospital stay also included a bout of uncontrolled seizures. I also think that being thrown so far off of his schedule for feeding and seizure medications, it took extra days for him to recover. After he got home, he started having seizures again a day or two later.

People with extraordinary medical needs, especially those who are seen frequently in the ER, cannot afford to wait their turn. One partial solution is available through a local ambulance service. They will send paramedics to the home to assess the condition of the person needing care and give advice as to whether a trip to the ER is recommended and then take the person there if it is.

Michigan has closed all its publicly operated Intermediate Care Facilities that in other states serve people with the most significant medical and behavioral needs. An ICF, funded by Medicaid, is usually equipped with the medical expertise to take care of a person like Danny, but the ideology of the day considers these facilities too “’institutional”, assuring the public that they are unnecessary. What often happens is that one “institution” (an ICF or nursing home) is traded for another, a hospital, for instance, and overuse of the ER for what is routine care for a person with extraordinary medical needs. The criminal justice system for a person whose behaviors are out of control often replaces the expertise available at an ICF to react to these events.

The way the hospital handles complaints is important

In another case of an ER visit going badly, my other son, Ian, was brought to the ER with a swollen knee. [Ian also has CP and a number of the same problems that Danny has. He is a good-natured fellow who endures medical emergencies more easily than Danny].

The group home noticed that Ian’s knee was swollen. It was after regular office hours at his doctor’s office. We did not know if  this was a serious problem - Ian has no ways to communicate how he feels or what happened to him. We arrived at the ER around 6:30 pm with an aide from the group home. We waited about an hour, when he was called in to have an X-ray of his knee. Then we waited for him to be seen by a doctor. Not wanting to be too pushy and having endured many hours-long waits to see a doctor when the ER waiting room was full, I waited until after 11 p.m. to ask at the reception area how much longer it was going to take. The nurse looked into it and finally said that Ian had discharged himself from the ER at 7:30 pm. A man who has never talked or had any reliable mode of communication and is unable to tell you how he feels discharged himself from the ER?

While Ian was getting his knee X-rayed, someone had called his name to be seen in the ER. He did not respond and we did not hear the call, so the assumption was that he just left.

By the time we found that Ian had been dismissed from the ER, he had already missed dinner and his evening seizure meds, so we decided that he should go home and be seen by his doctor the next day. We found out later that Ian had a fractured knee-cap. If he had been mobile and was putting weight on it, it would have been painful and might have eventually needed surgery. He is not mobile and the best thing to do at the time was to wait and see if it would heal on its own. As far as we know, it healed well and has not bothered him or caused any further trouble.

The way this had been handled by the ER, especially the fact that they did not seem to know that Ian had already gone to Xray was egregious, but without serious consequences. At the time, the University of Michigan had come to the conclusion that sometimes it was better to fess up to mistakes and fix whatever caused the problem in the first place. The U of M also had some evidence that handling mistakes in this way was actually preventing some lawsuits against the University.

I filed a complaint and got a letter back from Patient Relations after an investigation of the matter. They agreed with me that none of this should have happened and had met with staff to make sure that such a simple avoidable mistake did not happen again. The hospital did the right thing, made the staff aware of a really stupid mistake, and maybe improved the situation for other patients. I think this affects everyone’s morale. It is easier to take care of a mistake immediately with a little honesty and de-escalation techniques that leave room for a successful resolution of any dispute.

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For complaints at Michigan Medicine, contact Patient Relations.

Phone: 734-936-4330
or toll-free at 877-285-7788
Monday-Friday 8 a.m. - 4 p.m.
Walk-in: During the COVID-19 pandemic many Patient Relations staff are working remotely to help minimize the number of people in our hospitals and health centers. Please call our office to speak with a Patient Relations staff member directly or to schedule a future appointment at 734-936-4330, Monday through Friday, 8 a.m. to 4 p.m.
Online: Concern form (secure and confidential)(link is external)
Download the Patient Relations Brochure(link is external)
Please have the following information ready when you contact Patient Relations:
    •    Patients MRN or Date of Birth
    •    Date the concern occurred
    •    Name of the Department Involved
    •    Name of the people involved
    •    Concise explanation of the concern

Abelone Kelley March 01, 2022 0

20 Best Movies of 2021

BBC Culture  publishes the list of the 20 Best Movies of 2021, which includes Almodovar's first film in English, "The Human Voice". 

In this dense article, which is full of simple and composed adjectives and adverbs you will find interesting words and expressions for C1 students like: "[a] suspenseful, action-filled [film], wiliness, the film's themes [...] resonate profoundly with social justice movements today,  to feature, damsels in distress, [a] dreamlike film, a callow knight, to behead, to stroll, to gasp, bewildering, a smart-mouthed comic sidekick, swirl, stunningly shot, to blur the boundaries between fact and fiction, to reel back, to capture [the novel's] nuance, an entrancing work of art, over-the-top entertainment, giddy,  to mess up, a spellbinding drama, endless grievances and yearnings, grief, barrage, bone-crunching violence, grip, to boast, strait-laced, brooding, creepy, sprightly, chilling, a grief-racked, a pared-down drama, a stunner, haunting, a heart-wrenching scenario, a run-down prison, griots, roaming free, to veer into myth, chatty, a heart-rending film, a visually dazzling film, the film is loosely based, from defiant pride to pleading to resilience, a glamourous vermilion gown, outrageous, an uproarious celebration, a piquant warning, subtlety". 

If you prefer to hear the flow of oral English, you can listen to NPR's list of the 10 Best Movies of 2021 which includes Almodovar's "Parallel Mothers". The audio comes with a script, which can be helpful for C1 students. 

Abelone Kelley January 06, 2022 0

An anonymous $550 million gift to Western Michigan University will help fund tuition-free education and low-cost housing

This is not specifically relevant to news about developmental disabilities, but it is the sort of thing everyone should know about and pass on to friends who might benefit from this.The dog at left is the late Lucy Barker, not to be confused with our current dog, Polly Barker.

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An anonymous $550 million gift to Western Michigan University in Kalamazoo, Michigan, will help fund “tuition-free education, low-cost housing, a new innovative Living Learning Community and internship stipends for students attending the Kalamazoo school”, according to an article in the Detroit Free Press by David Jesse, 12/9/21. “It is the largest single gift ever given to any public university in the nation.”

According to the article, the University will launch several programs to help students:

• “The first, the new Bronco Promise will provide a tuition-free WMU education for up to five years for first-year students who come from Michigan families earning an adjusted gross income of $50,000 or less who have net assets under $50,000, the school said in a news release. University officials plan to hand out the scholarships to 340 students in the 2022-23 academic year and a projected 600 students each year after.
• “Western will also create a program to give up to $6,000 in housing and dining scholarships to 110 incoming students for their first year. That will cover about half of living expenses for a year, the school said. It will also create a new Living Learning Community for the students. They will live together in double occupancy rooms in a section of one of Western's residence halls. 
• “Students who attend Kalamazoo Public Schools or have a Detroit or Grand Rapids address will get preference for the need-based scholarships, but all Michigan residents are eligible to apply. Applications are due Feb. 15, and decisions will be released in March.
• “Western is also creating a program that will subsidize up to $3,600 in wages for up to 100 students each year with competitive, need-based stipends. The internships will be for students working with private and nonprofit organizations, the university said.”
• “The school will also give 800 upper-level students each year a need-based award up to $1,000 that can be applied to tuition and fees to help students complete their degrees.”

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From Wikipedia: “Western Michigan University (WMU) is a public research university in Kalamazoo, Michigan. It was established in 1903 by Dwight B. Waldo. Its enrollment, as of the Fall 2019 semester, was 21,470... It is classified among 'R2: Doctoral Universities – High research activity'...

Abelone Kelley December 10, 2021 0

Thinking differently about COVID outbreaks with widespread vaccination and a better understanding of the virus

In an article in the San Francisco Chronicle,  "We need to start thinking differently about COVID outbreaks, says UCSF's Monica Gandhi", 11/11/21, Gandhi is critical of recent decisions that she believes are too restrictive, now that there are areas of the country with high rates of vaccination and evidence that some venues are not conducive to spread of the COVID virus. 

Monica Gandhi is an infectious diseases specialist and professor of medicine at the University of California San Francisco. I heard her on a podcast about a month ago speaking about the COVID pandemic with more nuance and less hysteria than what you hear from most non-experts and political commentators.  Many commentators flail around spouting numbers and terms that most people do not understand (including the speakers themselves) and irresponsibly interpret their misunderstandings to further one skewed political belief or another. I imagine some of Gandhi's thinking is controversial among fellow infectious disease experts, but that is as it should be. Discussion about uncertainties among experts about a contagious disease is what leads to better understanding and better evidence-based public policy decisions.

Her article is well-sourced for anyone wanting to learn more and to follow her reasoning.

My own interest in this is in keeping my sons, who have multiple disabilities, and other residents of their group home from contracting COVID. None of them need or deserve the consequences of sloppy thinking and excessive risk-taking that could lead to the preventable transmission of the virus. The so-called "Dignity of Risk" where many disability advocates see risk as a virtue, does not apply in this situation. 

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Excerpts from "We need to start thinking differently about COVID outbreaks, says UCSF's Monica Gandhi" by Monica Gandhi, 11/11/21

Gandhi takes issue with the recent cancellation of the University of California/USC football game after 44 students and staff tested positive for COVID despite a 99% vaccination rate: 

"...the cancellation of a highly anticipated game like this one due to COVID-19 has led to online speculation — fueled by scary headlines — about the dwindling efficacy of vaccination and a return to the conditions that led to last year’s deadly winter surge..."

High vaccination rates means that some restrictions can be lifted:

 "But, in truth, clusters of mostly asymptomatic cases among the vaccinated, like what we’re seeing at Cal, are neither cause for concern, nor unexpected with a virus that will become endemic. They are an emerging part of our new normal. And we need to start recognizing — and more importantly — speaking about them as such."

..."Prior to the availability of the vaccines, we employed a variety of techniques to control the virus...But things have changed. In areas of high vaccination, mass asymptomatic testing no longer needs to done for those who are vaccinated, according to Centers for Disease Control and Prevention guidelines. Even testing for coronavirus exposure should be confined to individuals who were in close contact of a symptomatic person."

Vaccines reduce transmission:

"...A study of symptomatic delta variant breakthroughs from Singapore showed that the viral load by a value on the PCR test (cycle threshold, a test that should not be used to make clinical decisions) may start as high, but quickly comes down in the vaccinated (compared to the unvaccinated). This makes sense, since the immune response in the vaccinated can take a moment to kick in and fight the virus..."

"It’s essential to remember that we only need to take emergency medical or public health measures if there are clinical implications in play...if vaccines reduce the chance of being infected (vaccinated people are 13 times less likely to be infected than unvaccinated) an asymptomatic vaccinated person should not be tested without a direct exposure from someone who is ill."

Different metrics should be used in determining restrictions:

"[Using asymptomatic case counts] public health officials in the Bay Area (except for Marin County) appear to be using this metric to determine the necessity of restrictions such as masks, instead of a more appropriate index like COVID hospitalizations...Young people have been restricted during the pandemic in the United States...to protect others. We owe it to them to return their lives to normal, especially when that was the promise of public health officials in the context of vaccine mandates at many colleges and universities. Football (an outside activity) was shown to be safe and lead to no transmissions in a study from last year, prior to vaccinations and in areas of high community transmission. It is too late for this Cal-USC football game, but we need to think of outbreaks differently from now on in the context of the vaccines and live our lives accordingly." 

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See the original article for complete references. 

Abelone Kelley November 15, 2021 0

Another attempt to further privatize the Michigan Community Mental Health system

This is from the Community Mental Health Association of Michigan (CMHAM). From the Website - "The Community Mental Health Association of Michigan (CMHA) is the state association representing the state’s public Community Mental Health (CMH) centers, the public Prepaid Inpatient Health Plans (PIHP) public health plans formed and governed by the CMH centers and the providers within the CMH and PIHP provider networks." Michigan CMH agencies serve people with developmental disabilities, as well as individuals with mental illness and other disabilities.

Despite the flaws in the Michigan CMH system, and there are many, I agree with this statement - "This approach is nothing more than a [Medicaid] health plan money grab, these bills will not improve care for Michigan’s most vulnerable citizens, it will eliminate local decision making and only put more money into the pockets of insurance companies – this is BAD public policy." These are the same policies that the legislature, with the help of private Medicaid Health Plans, has been trying to impose on Michigan for at least the last 10 years.

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As you may know, [the CMHAM has been sending out alerts about the proposed legislation for months] the Senate Government Operations Committee has held three hearings on Senator Shirkey’s 2-bill integration package (9/14, 9/21 & 9/28). We believe as soon as Sen. Shirkey has the votes to move these bills in the Senate, he will vote them out of committee.

In recent media interviews, Sen. Shirkey has described his integration proposal as his top priority for his remaining time in the Michigan Senate. Given the fact that he chairs the committee and being Senate Majority Leader, he holds a tremendous amount of power and control over the day to day business in the Michigan Senate, we believe it is very likely these bills will move out of committee in the next couple of weeks.

Senate Bills 597 & 598 much like the 298 process from a couple years ago, would shift the Medicaid financing and managed care functions from the public PIHP system to private Medicaid Health Plans. We once again have significant concerns with this type of proposal and will be launching a series of action alerts to combat this harmful public policy initiative. This action alert will focus on local control & local decision making.

Make no mistake, SBs 597 & 598 eliminate local control and local decision making by the CMH and give it to for-profit insurance companies who are only accountable to non-elected bureaucrats in Lansing via contracts. Additionally, the bills will gut the local CMH system by allowing health plans to contract around CMHs and inserts specialty integrated plan (SIP) language into SB 598 which would allow health plans to remove CMHs from their local safety net role as community convener and collaborator.

REQUEST FOR ACTION: We are asking you to reach out to your legislators (House & Senate) and the Governor and URGE them to reject these bills when they come before them for a vote. We need to get as many Senators to oppose SBs 597 & 598 as possible. This approach is nothing more than a health plan money grab, these bills will not improve care for Michigan’s most vulnerable citizens, it will eliminate local decision making and only put more money into the pockets of insurance companies – this is BAD public policy.

**Please feel free to customize your response as you see fit**

We also need you to ask that the members of your Board of Directors, your staff, and your community partners make those same contacts – SIMPLY FORWARD THIS EMAIL TO THEM. This will not be the last action alert we send out on this topic, but it is critical that lawmakers hear from us – there has been tremendous turnover in the Michigan Legislature since 2016 (when 298 first appeared) this will be the first time many lawmakers are hearing about this issue.

Thank you in advance for your support and tireless advocacy on this important topic.

 
Click the link below to log in and send your message:
https://www.votervoice.net/BroadcastLinks/P5oQ02bJjoQ9w3Me_-yxiQ

Abelone Kelley October 27, 2021 0