On a good day, parenting will test the integrity of your character. On a bad day, parenting will test your will to live. Parenting children with trauma histories will cause you to test the integrity of everything and everyone you thought you knew, for the rest of your life.
~J. Skrobisz

Wednesday, February 23, 2011

Politics and Mental Health Part II

Did i drop a bomb shell on you yesterday? Sorry. If you're just tuning in, go HERE first.

Same as yesterday, I'll speak in generalizations. I can take the time to research what I'm saying to substantiate my claims but I'm kind of busy lately taking care of two challenged children whose issues may or may not be linked to some experimental vaccinations for medicaid infants in our state. Or it could just be shoddy DNA, environmental factors and dumb luck. Who knows?

A former governor of our state is very good pals with a former republican president of our country. When i say "good pals" I mean these two were tight, thick as thieves, chums, they go "way back." In other words, it can be speculated that these two republican spearheads of state and federal government would do just about anything for one another. Might they have created special-interest legislature together? Ah, but then I'd be a conspiracy theorist again and as I said yesterday, that's not really my cup of tea. My only claim is that I pay close attention and that I don't speak unless I have some degree of certainty.

Let's presume then that our former governor and former president did act with singular intent. What might that special interest legislation look like for our state and then federal government as it pertains to mental health services dictated by politics? Gaze into my looking glass and let's have a looksee, shall we?

Said governor, we'll call him "Chicken" as in *CENSOR*-oven-stuffer-roaster-chicken and said president, we'll call him "Short Tree", came to an understanding about the state of affairs of mental health in our pitiful, poverty stricken state. Currently our state is 8th in the nation for poorest in addition to having a statistically disparagingly high incidence of mental health and developmental delay residents. Of course, issues may have been exacerbated by some potentially harmful experimental vaccinations that Chicken's state agreed to do (probably because Short Tree's Dad, the "other short tree" suggested it.) Compounding the state's concerns is the high number of rural residents that have very little if no access at all to medical services. Short Tree would have recognized in the federal budget that a large amount of Social Security Disability Dollars was being siphoned to Chicken's state. Chicken would have mentioned the statistics and thus a dialogue may have begun about how to amend both the state's woes and the SSDI and medicaidbudget.

What if Chicken's state became the model state for the new governmental regime about how to manage mental health on the state level? What if Short Tree could grandfather some legislation that guaranteed Chicken's state would get priority in federal grants provided that Chicken would guarantee that Short Tree's model was followed within the state agencies? What if?

Indeed, this can be tracked and substantiated. I've heard if for myself in parent forums, from professionals in mental health and in medicine and from CEOs of local hospitals. Chicken's state is currently the model state in the union for how to manage mental health. Heralded as "the first state in the union to have ..." xyz. Pick something pertaining to mental health or developmental delay. Chicken's state is the model for it, the state after which other states have made their models. Indeed, federal grant money can be tracked to Chicken's state, even after Short Tree has left office and his predecessor "Half-Brown Bear" stepped in. It might be said that Chicken's state has a direct line to federal grant money for all things related to mental health.

What does this model look like, you ask? The state has decided children under 13 don't belong in institutions. The state has decided psychiatrists aren't credentialed to write PRTFs for RTC placement. In fact, pdocs have very little jurisdiction over their patients beyond being told if they want to get paid for their medicaid patients, they need to keep all appointments to 15 minutes and only write scripts for and/or recommend drugs that are covered without prior authorization (PA). Doctors that have too many scripts requiring PAs get audited. Doctors that have appointment times running too long get penalized and black listed. Without warning, doctors that don't follow the state rules can have their medicaid patients stripped from their rosters. This of course sends those patients scrambling to whatever doctor WILL pony up and obey and usually those doctors are overwhelmed and inundated and almost always have to keep their practices governed by the state hospitals because they can't afford to do otherwise. That would be, state hospitals backed by federal dollars.

What else? Agencies. Ah yes, the in-the-dirt-with-the-patients agencies. Well, our state restructured a few years back, stripping my region of agencies and dollars at the same time making my region the largest in the state. We have only one agency now that can staff and treat patients like my kids with the proviso that if the patients get an autism spectral diagnosis including PDD-NOS, those children are no longer serviceable because the agency is not credentialed to provide that level of care. However, PDD-NOS gets us Social security disability and medicaid (and if you missed it in yesterday's post - if they stay on medicaid's roster, the progression of mental health and development can continued to be flagged and monitored.)

There is only one hospital in the state that is doing research on pediatric ASDs and it's here, 30 minutes away. There is only one hospital in the state that is doing research on pediatric bipolar disorders and it's here, 30 minutes away. When I try to get help from that hospital, I'm told to go back to the local agency that is staffing my children's cases. But of course, that agency is not credentialed to serve my kids.

We had another agency here. It began as a privatized institution that eventually required state assistance. It was shut down in November. Budget.

We had another state hospital here for mentally ill and developmentally challenged adults. Shut down. Budget.

Talks of building an RTC in this region have stalled out. Budget.

I've been told I could move to one of the two greater metropolitan areas and have access to a wealth of resources for my children. But of course, I'd have to MOVE. Moving challenged kids is THE.MOST.EVASIVE.THING.I.COULD.DO.TO.THEM. Not by any means, the most helpful. And then I'd get on waiting lists which begin at 6 month wait times.

Let's go back to dollars. CBAY waiver? Federal grant money. Our state's parent support network? Federal grant money. The interagency that is my backdoor entrance to all of the agencies that turn me away when I call them directly? Federal Grant money. The RTCs that are accepting kids? Federal Grant money. The group homes that don't ask you to relinquish your child's rights? Federal Grant money. But of course the bank-rolled RTCs and group homes are following the not-under-13 mandate.

LOTS of federal grant money being siphoned into my state. Lots of higher-ups telling Capital Hill that our state has the federally approved model for how to manage mental health in today's medical world. Lots of other states feeling pressure to model our state's model because the federal government is saying, "hey, they're one of the worst states in the union for statistics for mental health and one of the poorest. we've got grant money for your state too if ... you can model their model in your state." Essentially, this "successful" model is based on how much money it takes to support and not on how useful it is in rehabilitating patients long term. Where is the voice of the medical professionals in how to create a useful model for mental health? Oddly silent. And no one is cluing in to that fact. Doctors and Therapists no longer have a say in how to treat their patients. Government, Budgets, Legislators (that don't know shit about mental health) and, *ahem* PHARMACEUTICAL COMPANIES, do.

except this model isn't working. Clearly.

Talked to a professional recently. All coy and inquisitive, curious and non argumentative-like (i'm good at that, btw. one of my hidden talents) Said, "hey. here's the thing. you're saying my kid can't get services in your hospital. you say she doesn't qualify. i say I can't handle her. you say go to my local agency. i say my local agency can't help her, she doesn't qualify. you say that's what I'm supposed to do because that's what you're telling me you're told to say to parents. I'm telling you right back - we just fell through the cracks ... again." Professional sat there looking at me with a confused look. Then said, "well, that's how it works. Just keep trying, eventually it will work."


Current state of affairs thanks to Chicken and Short Tree:
1. no PDD-NOS Dx and I get no SSD or medicaid
2. with PDD-NOS Dx I get no local agency
3. no local agency, i get no PRTF for RTC
4. PDOC can't help, his hands are tied. In fact, he's HOG tied. he can't even write the PRTF!
5. no PRTF for RTC = my state can tell the union on capital hill that they're obeying the federal government's model of eliminating the need for institutions for children under 13 (but failing to mention that they have set it up so that it's impossible to get my kid to qualify even though RTC is exactly what she needs)
6. if my state can tell the union on capital hill that they're obeying the model, they'll keep getting federal grant money
7. if my state keeps getting federal grant money, the federal government can keep telling the other states in the union that this model works - and then convince the other states to follow our model so they'll get the same grant money
8. if more states get the grant money and follow this bogus model for mental health, eventually SSDI and medicaid dollars decrease
9. if SSDI and medicaid dollars decrease the federal government can tell the union "hey, we're reducing the budget! we're getting healthier! we know how to manage mental health! hip hip hooray, vote for us again!!! We're working FOR you AMERICA!!!!"

but wait. where does this grant money come from? So glad you asked. Say it with me, pharmaceutical companies. And maybe some schmoozed and schmaltzed rich whities that got sold a bill of goods: hey, all your money is being taxed to fund medicaid and disability. why not make your money do something GOOD and support mental health directly? and seriously ya'll. Do you REALLY think all of those charitable contribution dollars actually go TO THE CHARITABLE CONTRIBUTIONS?!?! seriously, if you believe THAT, then you just need to grab a blankie and go suck your thumb in a corner some where.

Anyone still want to say the pledge of allegiance?

heh heh.
just kidding.
i'm messin' with ya.
I'm actually just trying to see how much interest there might be for a sci-fi novel. I'm hoping it will get a movie deal so I can ... FRIGGIN' PAY FOR PRIVATIZED MENTAL HEALTH SUPPORT FOR MY FRIGGIN' CHALLENGED KIDS THAT MY FRIGGIN' STATE WON'T HELP AND THAT MY FRIGGIN' STATE MAY HAVE CAUSED IN THE FIRST PLACE WITH THEIR FRIGGIN' VACCINE TRIALS!!!!!

got a little crazy there at the end.
sorry about that.

and... oh darn. My crystal ball just fell off the table and shattered into a million pieces. Thanks for playing! Have a nice day.


Sammie said...

If living with EXTREMELY challenging kids without help won't drive you crazy, then dealing with a broken system surely will : ( I don't need tell you how much I feel for you, you know. You are such a warm and caring person despite all of this crap. Big HUGS.

Dimmie said...

If I were you I'm pretty sure I would have gone berserk by now and shaken someone/run up and down the halls waving my hands over my head and letting out some strange and undulating cry.

Healthcare in the US is something I don't understand at all. I don't understand how a country that wants the people in it to be happy has such screwed up healthcare.

On institutionalisation: I am one of those people that believes all other avenues should be exhausted before institutionalised because obviously we don't want anyone, particularly children, to become institutionalised and end up in the system forever. However, once all those avenues are exhausted institutionalisation should be an option and someone should be there to help you with that option.

Oh, and is it just me or is it like none of the different people, agencies and offices you speak to ever have any communication?

Integrity Singer said...

@ dimmie - LMAO about none of these agencies communicating. I can't count how many times I've had to cc: them all just to get them all on the same damn page!