House Panel Unhappy With VA Official’s Answers During Hearing on EHR System

by Joyce Frieden: For Complete Post, click here…

Several House members weren’t very happy with the answers they got Thursday at a hearing on progress with the new electronic health record (EHR) system being implemented at the Department of Veterans Affairs (VA).

“I can appreciate that you inherited a mess, and that you are in the middle of sorting through the morass, but unfortunately your responses to our questions about patient safety really aren’t detailed enough,” Rep. Debbie Wasserman Schultz (D-Fla.), chairwoman of the House Appropriations Subcommittee on Military Construction, Veterans Affairs, and Related Agencies, said to VA deputy secretary Donald Remy, who was confirmed by the Senate in July. “I realize you’re doing the best you can to answer, but we’re just not really getting enough detail in your answers.”

Congress Must Care for Care Workers

BY KARLA J STRAND: For Complete Post, click here…

The U.S. Congress is at a critical juncture in the negotiations on the Build Back Better reconciliation bill. The original proposal was for $3.5 trillion in new spending—paid for by tax increases on corporations and those making more than $400,000 annually—aimed at improving infrastructure. Of this, $450 billion was earmarked for an increase in Medicaid home and community-based services (HCBS). 

These services, such as meal delivery, respite, and other care services, are essential to improving the lives of people with disabilities, those who are aging, and their care providers. But after mostly leaving the fray to moderate and progressive Democrats to battle out a compromise, President Joe Biden unveiled an updated outline for the bill on October 19. Bowing to centrist concerns, Biden’s version of the plan is now down to between $1.75 trillion and $1.9 trillion, and the cuts have caregivers (and receivers) concerned. 

Since February, progressive Democratic legislators have been pushing Biden to make good on his campaign promise to increase Medicaid funding for HCBS. In March, Senators Maggie Hassan, Democrat of New Hampshire; Sherrod Brown, Democrat of Ohio; and Bob Casey, Democrat of Pennsylvania; and Representative Debbie Dingell, Democrat of Michigan, introduced the Home and Community-Based Services Access Act.

Within weeks, Representatives Dingell; Ayanna Pressley, Democrat of Massachusetts; Conor Lamb, Democrat of Pennsylvania; and Pramila Jayapal, Democrat of Washington, sent Biden a letter signed by 107 of their colleagues calling for the $450 billion investment in these service to be added to the Build Back Better infrastructure package.

Following the Senate vote, more than forty-five national disability organizations sent a plea to House and Senate leadership further explaining the imperative of full funding. Unfortunately, last month the House committees with purview over Medicare—Ways & Means and Energy & Commerce—endorsed increasing Medicaid HCBS funding by only $190 billion instead of the $400 billion advocated by caregivers and progressive legislators. 

That proposed $210 billion cut is not inconsequential: It could be the difference between whether more people are able to receive life-saving medical treatment or not.  

News on No-Fault: DIFS Bulletin addressing reimbursement limitations to certain products, services and accommodations

From CPAN: For Complete Post, click here…

On October 11, 2021, the Director of the Department of Insurance and Financial Services (“DIFS”) issued Bulletin 2021-38-INS addressing the applicability of the reimbursement limitations set forth in MCL 500.3157 to certain products, services and accommodations that constitute “[a]llowable expenses” under MCL 500.3107(1)(a).  Specifically, in the Bulletin, DIFS opined that “[p]roducts, services, and accommodations that are not provided by physicians, hospitals, clinics, or other like persons . . .” are not subject to the reimbursement limitations set forth in MCL 500.3157.   In the Bulletin, DIFS also expressed its view that MCL 500.3157 “governs the amount payable to any persons providing attendant care” services to auto accident survivors.

The Bulletin provided examples of several types of products, services, and accommodations that are, in DIFS’ view, exempt from the “fee caps” in MCL 500.3157, including, but not limited to, the following:

  • Services related to guardianship or conservatorship;
  • Vehicle modifications;
  • Home modifications;
  • Computer equipment and supplies;
  • Generators;
  • Non-emergency medical transportation;
  • Non-prescription drugs;
  • Over-the-counter medical supplies; and
  • Certain case management services

Notably, the list of exempted products, services, and accommodations set forth in the Bulletin is not exhaustive, as DIFS itself acknowledged.  Instead, according to DIFS, the proper inquiry for determining whether a particular product, service or accommodation is subject to the reimbursement limitations set forth in MCL 500.3157 is whether it was “provided by physicians, hospitals, clinics, or other like persons.”

Moreover, in the Bulletin, DIFS explicitly directed no-fault insurers who have applied the reimbursement limitations in MCL 500.3157 to products, services, and accommodations that are exempt (including those listed above) to “re-process” the claim immediately, applying only the “reasonable[ness]” requirement set forth in MCL 500.3107(1)(a).  Further, DIFS instructed providers whose bills have been processed improperly to contact the no-fault insurer at issue to request reconsideration.

In short, DIFS’ Bulletin 2021-38-INS may be used by providers other than “physicians, hospitals, clinics, or other like persons” to assert that the “fee caps” set forth in MCL 500.3157 should not be applied to limit reimbursement by no-fault insurers for the products, services, or accommodations that those providers  render to auto accident survivors.

The National Council of Dementia Minds

From NCDM: For Complete Post, click here…

The National Council of Dementia Minds (NCDM) is a not-for-profit organization led by persons living with dementia whose vision is to transform the worldview of living with a Neurocognitive Disorder (NCD).

Since May of 2019, NCDM has been proud to be a model of equity and inclusion as we are governed by a board of directors who are living with various types of dementia.

We are a group of individuals who are committed to living our best lives and sharing this experience with others. We advocate for inclusion and equity for persons living with dementia in all aspects of private and public life. We embrace the diversity of persons affected by NCD as well as the multiple types of dementia. Together we promote our strategies to enhance our well-being and refute the misconceptions of living with dementia.

To achieve our vision, we develop and support Dementia Minds groups (persons living with dementia) who create opportunities for dialogue and education for persons living with dementia, licensed health care professionals, researchers, families, care partners, policymakers, and communities at large about strategies to live well with Neurocognitive Disorders. The National Council of Dementia Minds is proud to report that we have provided educational opportunities for over 3,000 people in four countries.

Lethal, highly addictive methamphetamine again stalking rural Michigan

By Ted Roelofs: For Complete Post, click here…

ngd-I have been watching meth/stimulant surges since the late ’60s-some kind of cycle that destroys people. goes away and comes back…

n an Upper Peninsula courtroom, Circuit Court Judge Brian Rahilly leafed through the pages of his Sept. 22 criminal docket in Alger County. The defendants scheduled to appear before him fit a familiar pattern.

Nine of 20 cases that day involved charges tied to methamphetamine ─ from possession to delivery or manufacture of the drug, including one case that also charged an assault.

“Just off the cuff,” the judge said, “I would say most days half of my criminal docket is meth and it’s probably higher than that.”

Rahilly has been on the bench since January, following his election last year to the circuit court, which spans four rural counties. 

“For every 10 cases involving meth, I might get one involving another substance; it’s not even close,” he said. 

Disability Rights Toolkit for Advocacy Against Legalization of Assisted Suicide

From Not Dead Yet: For Complete Post, click here…

“If this bill passes, some people’s lives will be ended without their consent, through mistakes and abuse. No safeguards have ever been enacted or proposed that can prevent this outcome, which can never be undone.”

– Marilyn Golden, Disability Rights Education & Defense Fund

The purpose of this Toolkit is to give disability rights advocates an organized set of resources to assist in defeating proposals to legalize assisted suicide in state legislatures.  The Toolkit is divided into seven brief sections, each consisting of basic information and links to related resources with more information.  The seven sections are:

  1. Why disability advocacy groups oppose legalizing assisted suicide
  2. Educating and organizing disability opposition
  3. Meeting with legislators and policy leaders
  4. Testifying at hearings
  5. Working with the media
  6. Conducting direct actions – leafleting, rallying
  7. Working in coalition

All of the major national disability groups that have taken a position on assisted suicide oppose bills to legalize the practice as a matter of public policy.  The disability role in defeating these bills has increased in visibility and importance in the last few years as both media and various stakeholders have acknowledged our effectiveness.  It is critical that our voice be heard wherever assisted suicide bills are introduced and considered.

New auto insurance law forcing severely injured people to scramble for scarcer and scarcer care

By Tracy Samilton: For Complete Post, click here…

The first thing you notice about Jake Veeder is his horrific injuries. The second thing you notice is his absolutely killer smile, the kind that lights up his whole face.

His mother is Tricia Smith. She has the same smile.

People mistake the two for brother and sister, or worse, girlfriend and boyfriend, all the time.

“I hate it,” the 23-year-old Veeder said, with just a tiny hint of that killer smile.

I met mother and son, along with Melanie Olson, Veeder’s medical case manager, outside his new home, Maple Manor in Novi. Veeder has some speech difficulties from a brain injury, so I asked Smith to tell me what happened to him.

Like practically everyone with a story about a catastrophic car accident, she started it the same way. With the date.

“It was on November 17, 2018,” said Smith. “He was the passenger in a vehicle that lost control, and they ended up flying off the road. The car flipped over, and Jake was pinned inside for about 40 minutes. It was on fire, so a lot of his injuries came from him burning.”

Smith said no one ever thinks it’s going to happen to them — going suddenly from a normal life, to living in a nightmare. His injuries were extensive. Closed head injury. Burns over 40% of his body. A broken orbital bone. A dissected carotid artery. The list goes on.

Veeder was 20 at the time of the accident. Like everyone in Michigan in 2018, he had lifetime medical on his car insurance policy. The cost of his care has been jaw dropping.

First, there was the three months in the hospital burn unit.

“Just his bill at Hurley alone was $2.98 million,” Smith said.

Then, a transfer to Mary Free Bed, a pediatric rehab hospital. Then, a transfer to Origami Rehabilitation, a comprehensive residential rehab facility.

“Last I checked we were just over $10 million,” she said. She glances at her son in a way that somehow combines humor, sorrow, and affection. “Yeah, he’s the $10 million man.”

Melanie Olson is Veeder’s medical case manager. Case managers help people with complex medical conditions get the care they need.

Olson said Origami offers one-on-one care, a brain injury rehab program, adaptive equipment to become more independent. A social life.

“He was doing phenomenal at Origami, in Lansing, weren’t you, Jake? He was making so much progress,” she said.

But in July 2021, insurance companies began paying providers less than their actual costs. The new law lets them do that. Veeder’s insurance company, Progressive, told Olson that he had to find someplace cheaper.

David Seymour’s collateral damage

By Emily Writes: For Complete Post, click here…

There was a period of almost a year when our eldest son wasn’t “vulnerable”. He’d recovered well from the latest surgery, his fourth or fifth since he was born, and he had managed to struggle through a common cold without hospitalisation. Life, had finally become normal for us.

He went to school. He loved it. He built an enormous group of friends, discovered a love of cross-country, started learning to surf, and began swimming. He had his birthday party at the pool – that would have been unthinkable the year before.

He had playdates and his first sleepover. He was six. For the first time in a long time we didn’t have to hold our breath.

Then he caught a tummy bug. Then he fell into a coma. He spent three weeks in hospital and was diagnosed with type one diabetes. He did not return to school for two months. When he did – it was for half-days.

David Seymour has a plan for Covid 19 apparently. He says: “We can’t keep living with the uncertainty that we could be locked down again at any moment.” This is a bitterly funny comment to parents and caregivers who constantly live in uncertainty. (I started a new job and two days later, my son was in hospital for weeks).

It won’t surprise you that Seymour’s plan involves the isolation of the “medically vulnerable”. It involves pushing children like Eddie back inside, into an endless bubble from which they can never escape from, because their mental health and their worth is apparently of little value.

“Children are anxious about missing school”, Seymour says, apparently discounting the hundreds of thousands of disabled and medically fragile children who would be removed from school completely if we were to only isolate the medically vulnerable.

“Medical operations are being deferred”, he says, without considering how we are meant to cope when we take our medically fragile children to hospital and ICU beds are full. Will my child be worthy of an ICU bed? Will his life be worth saving?

To Study Zika, They Offered Their Kids. Then They Were Forgotten.

BY MARIANA LENHARO: For Complete Post, click here…

Years after agreeing to take part in research, families of children with congenital Zika syndrome are feeling abandoned.

ROCHELLE DOS SANTOS LEARNED that her daughter would probably be born with microcephaly — a condition where a baby’s head is much smaller than expected — when she was seven months pregnant. It was 2016 and Brazil was going through an unprecedented microcephaly outbreak associated with the mosquito-borne virus Zika. After the baby was born and the diagnosis of congenital Zika syndrome was confirmed, several researchers approached dos Santos to see if she’d join relevant clinical studies. Eager to understand her daughter’s condition, she agreed.

Dos Santos says she was surprised to learn through a social media post last year that an international study that she participated in had been published in the journal Brain & Development. The study took over a year to be completed, and dos Santos had taken her daughter multiple times to the hospital for evaluations. As the head of an association for families of children affected by Zika in Goiás state in midwest Brazil, dos Santos wanted to share the findings with the other caregivers. She says she had to reach out directly to Hélio van der Linden, a neurologist at the Dr. Henrique Santillo State Center for Rehabilitation and Readaptation who authored the study in partnership with researchers in Brazil and the United States, to ask that a copy be shared with her. But she says he told her there was no point because it was written in English.

“Of course, we get upset,” she recalled in her native Portuguese. “We want to have this feedback and better understand this situation that is new for everyone.” Dos Santos — who noted that while she speaks only a little English, her husband reads and speaks English capably — said she feels used and that many other families share the same sentiment. “We know that Covid is now the priority,” dos Santos adds, “but our children are still here, they still have needs.”

The Hospital Occupation
That Changed Public Health Care

By Emma Francis-Snyder: For Complete Post, click here…

On July 14, 1970, members of the Young Lords occupied Lincoln Hospital in the South Bronx — known locally as the “Butcher Shop.” A group of activists, many of them in their late teens and 20s, barricaded themselves inside the facility, demanding safer and more accessible health care for the community.

Originally a Chicago-based street gang, the Young Lords turned to community activism, inspired by the Black Panthers and by student movements in Puerto Rico. A Young Lords chapter in New York soon formed, agitating for community control of institutions and land, as well as self-determination for Puerto Rico. Their tactics included direct action and occupations that highlighted institutional failures.

Through archival footage, re-enactments and contemporary interviews, the documentary above shines a light on the Young Lords’ resistance movement and their fight for human rights. The dramatic takeover of Lincoln Hospital produced one of the first Patient’s Bill of Rights, changing patients’ relationship with hospitals and doctors nationwide.