Michigan Disability Resistance

CHILDREN IN THE for-profit foster care system are dying at alarming rates, but the deaths are not being investigated, and autopsies are not even being attached to the now-closed case files, a two-year investigation has found.

The investigation, conducted and released in rare bipartisan fashion by the Senate Finance Committee, looked closely at one of the largest private providers of foster care services, the MENTOR Network.

The companies and agencies charged with keeping foster children safe often failed to provide the most basic protections or take steps to prevent tragedies, the investigation found.

Used to be hedge funds, now it's health systems....

https://goo.gl/vE5dyK

The nursing home can afford these multimillion-dollar improvements partly because it has, for the past five years, been collecting significantly higher reimbursement rates from Medicaid, the state-federal health insurance program for the poor. About half of its residents are covered by the program.

In 2012, the nursing facility was leased to Hancock Regional Hospital, a county-owned hospital 15 miles away. The lease lets it take advantage of a wrinkle in Medicaid’s complex funding formula that gives Indiana nursing homes owned or leased by city or county governments a funding boost. For Indiana, that translates to 30 percent more federal dollars per Medicaid resident. But that money is sent to the hospitals, which negotiate with the nursing homes on how to divide the funding.

Nearly 90 percent of the state’s 554 nursing homes have been leased or sold to county hospitals, state records show, bringing in hundreds of millions in extra federal payments to the state.

Even though Indiana’s nursing home population has remained steady at about 39,000 people over the past five years, Medicaid spending for the homes has increased by $900 million, in large part because of the extra federal dollars, according to state data. Total spending on Indiana nursing homes was $2.2 billion in 2016.

The funding enhancements were pioneered in Indiana, but hospitals in several other states, including Pennsylvania and Michigan, have also used the process. Advocates say it has been a key factor in helping to keep Indiana’s city and county hospitals economically vital at a time when many rural hospitals nationwide are facing serious financial difficulties.

US society seems stuck in an era of “happy talk.” When a fireman pulls a child from a swimming pool, it seems appropriate to call it “saving a life.” But how many times have you seen the newspaper headline touting a new drug or device that will “save X thousands of lives,” when, at best, it will delay the dying of very sick and usually elderly people by some months before something else causes death? That may be a good thing, but it is illusory to claim that it is “saving lives.” Advocacy organizations around each eventually fatal illness promote prevention and cure, but none say what would be a better way to come to the end of life. Influential authors tout odd claims such as “Toward a State of Complete Well-Being,” which persuasively argues for investments in prevention and social determinants of health but does not give voice to the limitations imposed by illnesses associated with aging. Public policy falls into the same pattern, with enthusiasm for supporting development of a costly drug that will delay the progression of heart failure, but inattention to issues such as the struggles of family caregivers, the waiting lists for home-delivered meals, and the misfit of available housing with disabilities.

My mother now lives through the peculiar torment of progressive disability from frailty in a “care system” that is not designed for her situation: losing nearly half of her weight, barely able to get up from a chair, having a plethora of symptoms with no treatable etiology, and yet having enough heart, lungs, kidney, and liver functions to go on for a while. There will be no letter from a neighbor who is startled when she dies; neighbors will be astonished that she lived so long with such severe disabilities. Hospital care is readily available and paid for, but medications after hours are not available, and she must pay out of pocket for personal care. Hospitals, physicians, pharmacists, and civic leaders have not made plans as to how to serve large numbers of elderly people living in the community with serious and worsening disabilities.

Making workable plans would require adopting some novel perspectives and taking account of some salient facts that are often set aside. First, the life possibilities of an elderly person with increasing disabilities is profoundly dependent upon the surrounding community. Is housing accessible? Can you readily get help with minor home repairs, such as changing a light or fixing a gutter? Can you get food delivered, and can you get prepared meals delivered? Can you stay engaged with other people—family, neighbors, and church or club members? Are you considered an embarrassment when out in public with a walker or wheelchair—or an adult diaper? Are walk lights lit long enough for you to cross the street? Are there personal care aides trained to deal with disabilities and challenging behaviors at home, and can elders in need afford them? Are there physicians attuned to your physiology and preferences who will, when needed, come to your home?

Wonder what other states have similar secret plans......

https://goo.gl/2mB67z

After Julie Rodriguez enrolled her 10-year-old autistic son at a public school on Chicago’s Southwest Side last year, she found herself navigating a maze of paperwork that she said seemed designed to prevent her son from getting the special education services he needed.

Rodriguez had just moved to the city from the suburbs, and she brought with her a legally binding special education plan for her son from his suburban public school. She also had a thick binder detailing his behavioral and academic problems, including a detailed analysis from some of the most highly respected doctors in Chicago.

In addition to autism, he suffers from attention deficit disorder, speech delays, and oppositional behavior disorder.

But it took six disastrous weeks for Chicago Public Schools and the staff at Peck Elementary to determine what she already knew — that her son needed an aide by his side all the time and a laundry list of other services.

“The security guards were calling me every day,” Rodriguez said of that six-week period. “They have a police officer on staff — that person was calling me. ... Everybody had all these complaints. And I am like, ‘He needs all of these other services that he is not getting.’”

Little did she know that she came to Chicago just as the school system was attempting a major overhaul of its special education program, which serves more than 52,000 students and consumes about $900 million of CPS’ $5.7 billion operating budget each year.

A WBEZ investigation into that 2016 overhaul found officials relied on a set of guidelines — developed behind closed doors and initially kept secret — that resulted in limiting services for special education students, services like busing, one-on-one aides, and summer school. This overhaul was orchestrated by outside auditors with deep ties to CPS CEO Forrest Claypool. They had no expertise in special education.

In addition to interviews with parents of special-needs children, WBEZ analyzed school financial records and discovered a pattern where students did not receive services last year that they had previously counted on, raising questions about whether the rules violated federal laws aimed at protecting special-needs children. For example, the time children spent with specialists dropped by about 12 percent last year, WBEZ found.

Well, that didn't last long.....

https://goo.gl/jM5Z2h

Yet another last-ditch effort to tackle the nation’s health-care system stalled within hours of its release by a bipartisan pair of senators Tuesday, with President Trump sending mixed signals and Republicans either declining to endorse the proposal or outright opposing it.

The week began on Capitol Hill with a renewed sense of urgency to craft legislation following Trump’s decision last week to end key payments to health insurers that help millions of lower-income Americans afford coverage but that the president argued were illegal under the Affordable Care Act.

The compromise offered by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) on Tuesday proposes authorizing those payments for two years in exchange for granting states greater flexibility to regulate health coverage under the ACA. Those payments help offset deductibles and other out-of-pocket costs for low-income consumers who obtain insurance through the law; critics of Trump’s decision said eliminating the subsidies would cause insurers to back out of marketplaces across the country.