Wednesday, October 28, 2009

Tuesday, October 27, 2009

Cost & Prevalence of Chronic Conditions in the United States

Statistics: Chronic Conditions Costs & Prevalence

Please forgive formatting errors: This document was created in 1996 and Blogger did not enter into my formatting plans... This was one of the most difficult posts for me publish because it was written before I incurred the debt of the population I was studying.

This is where I left off... perhaps someone has an idea where I can pick it back up...

Elyssa Durant/eds. October 27, 2009  13 years from the original date of creation... and life goes on ... 








There is no effective system to care for those with chronic conditions in the United States; as a result, much of the care that is available is fragmented, inappropriate, and difficult to obtain. In comparison with acute conditions, chronic conditions call for a


different kind of care: an integrated network of professional expertise. Chronic conditions do not always get worse; the health status of a person with a chronic condition can improve, deteriorate, or shift in either direction. The goal of chronic care is not to cure; rather, it should help individuals with chronic conditions maintain independence and a high level of functioning.






Problems encountered by people with chronic conditions


38% Cannot afford a service


19% Service not available when needed


15% Cannot easily get to a service


13% Quality of service so poor, won’t use it


11% Cannot find needed medical service



SOURCE: Chronic Care in America: A 21st Century Challenge. The Robert Wood Johnson Foundation.




The disproportionate use of health care by those with chronic conditions is consistent across all age groups, as might be expected given their greater health needs. Almost all (96%) of home care visits, 83% of prescription drug use, 66% of physician visits, and 55% of emergency department visits were made by persons with chronic conditions.

Payers: Over 40% of the direct health care costs for persons with chronic conditions were paid through public funds (Medicare, Medicaid, and other state and local medical assistance programs) in 1987. In contrast, public funds paid for less than 20% of the treatment for persons with acute conditions (Figure 2). Among the chronically ill or impaired, private insurance covers about a third of health care, while it covers 45% of the costs of persons with acute conditions.

Using the most recent data source available, we found that 90 million Americans had one or more chronic conditions in 1987. If the same age- and sex-adjusted rates of chronic conditions are applied, we estimate that the number of persons with chronic conditions in 1995 was almost 100 million.

The magnitude of this figure is important for several reasons:


1. First, because the number of persons with disabilities due to chronic conditions is more commonly and regularly reported in the literature, the total prevalence of chronic conditions has perhaps been minimized. The majorities of persons with chronic conditions are not disabled, but are living normal lives. However, they live with the threat of recurrent exacerbations, higher health care costs, more days lost from work than others, and the risk of long-term limitations and disabilities.



2. Second, persons with chronic conditions are at greater risk for being underinsured, particularly those with more than one chronic condition. Short and Banthin estimate 29 million nonelderly people with private health insurance are at risk of being underinsured defined as a function of a family's risk of incurring high out-of-pocket costs for medical services relative to their family income. We found that a disproportionately large majority of all direct health care services, including physician visits, prescription use, and persons with chronic conditions use costly hospitalizations. Their per capita costs are over 3 times higher than those of persons without chronic conditions are. Consequently, they are at greatest risk of unaffordable high out-of-pocket costs.





INSERT RWJF CHART SUMMARY ABOUT HERE

Persons with co morbidities are particularly at risk of finding themselves underinsured; their per capita costs are 2-1/2 times higher than persons with only one chronic condition are. Furthermore, high utilization rates make persons with chronic conditions less attractive to managed care plans that typically cover more services, including preventive care, with less cost sharing. Depending on the adequacy of their health benefits, even middle-income families (for example, a household income of $40,000) could quickly incur out-of-pocket costs in excess of 10% of their incomes if the only expense incurred in a year was to cover their 10% share for a surgery and hospitalization costing $50,000.

Reference:
Chronic Care in America: A 21st Century Challenge. The Robert Wood Johnson Foundation
The Chronic Care Perspective. The Robert Wood Johnson Foundation
[available: http://www.rwjf.org/library/chronic/chrcare/introfact2.htm]

Figure 1. Categories of disabling chronic conditions


Source: Institute of Medicine, 1991



categories of conditions diagnostic condition codes proportion of people

mobility limitations arthritis, paralysis 38%

chronic diseases asthma, cancer, diabetes 32%


sensory limitations blindness, hearing impairment 8%

mental limitations senility, mental retardation 7%


other conditions 15%




Chronic Care in America: A 21st Century Challenge. The Robert Wood Johnson Foundation.


















Figure 2. People with chronic conditions report on their service system.


Source: Unpublished data from The Gallop Organization, 1992.

YES NO DON’T KNOW

Understand services you are eligible for? 47% 47% 5%


Understand how to use the services you are eligible for? 60% 32% 8%


Know who provides what services? 57% 38% 5%

Feel it takes more effort to use these services than they are worth to you? 36% 48% 16%




Using Examinations & Testing to Improve Educational Quality

Examinations: Comparative and International Studies

Heyneman & Ransom discuss the critical role of national examinations in policy implementation and educational reform. Eckstein & Noah discuss why it is important to use national examinations in education. The reasons for using examinations include (1) to identify student strengths and weaknesses; (2) to provide feedback to officials regarding these strengths and weaknesses--within and between schools, districts, and regional areas; (3) to certify mastery of the curriculum; and; (4) as an established selection tool used in identifying the brightest students, thus providing students with an opportunity to obtain advanced degrees. The authors feel the last function of national examinations to be the most influential on individual performances “Selection examinations are the most powerful motivational lever in the education sector. . . The power of using national examinations lies in their ability to allocate life chances.”


In addition to using examinations to gauge students strengths and weaknesses, examinations are also used to compare the educational attainment of students with the changing needs of today’s world and global economy. Examinations are also used to initiate curriculum reform, i.e. by changing the material in national examinations, students must shape their learning in order to perform well on national examinations. The authors also discuss how this approach can fail when it is used as a mechanism to bypass the normal route of gaining public support from parents and communities.

Eckstein & Noah discuss the changing views of testing in American Society, and the controversy surrounding the role of examinations within American Society. They point out the opposing view points regarding the use of rigid, structured examinations in schools as a tool which undermines the foundations of American education: to respond to individual creativity, and make learning attractive to America’s children. The authors also point out the limits to this argument, which fails to accept to testing as an important measurement device. They use China as an example of to demonstrate this point: At one point when China eliminated standardized testing from the curriculum, students assessments were based in large part on Political, Religious, or socioeconomic factors with no way to keep such extraneous variables in check with more objective types of evaluation, allowing for extremely subjective and personal interpretations of student achievement.

The issue at hand becomes not whether or not examinations have a critical role in education, but rather what to measure and how. Seeing how examinations are frequently the strongest indicator as to a child’s future academic success and independent functioning, teachers are under significant pressure to teach those skills which will be measured on such examinations. The authors refer to this as the backwash effect of public expectations, since teachers are often more concerned with a student’s performance on the exam than the relevance of the materials on the exam. When their is a discrepancy in what teachers and students see as useful knowledge, and the skills which are being tested on the exam, this no doubt has a negative effect on what is being taught and what is being learned in schools.

Reference: Examinations: Comparative and International Studies
Max A Eckstein & Harold J. Noah / Eds. Stephen P Heyneman & Angela W Ransom

TIDES OF CHANGE

It seems painfully obvious to me now that the only way out was through….

If had known then what I know, I would not have wasted so much precious time searching for the source of my profound sadness. I have realized that the events leading me into this circle of despair must no longer guide me through life if I am to escape the memories of my past. Now, it is time to focus on the answers and ask a different question…

I have spent years asking myself, “How did I get here?”

Today I am wondering, “Now how the fuck do I get out?”

Monday, October 26, 2009

Blaming the Victim Creates a Culture of Fear & Silence



Dear Mr. Editor:





Next time you plan to alter my work without consent, the least you could do is copy the title Verbatim!





Here's an even better idea: Don't bother printing my words if you intend to do is write them off.







Sexual assault and rape is vastly under-reported on this country. Want to know why? Read the subtitle!






The subtitle alone implies blame, stigma, and creates a level of detachment.  That type of desensitization is what allows people to look the other way and blame the victim.  This creates a culture of silence, fear, and indifference.


Community apathy is what leaves me wondering why I am completely invisible to everyone within a 60 mile radius of my home.  Not a single person seems to hear a word I am saying. 


I know they hear me.  I way too loud for anyone to pretend for second that they don't know who I am or why I am so sad and angry to be trapped in this big little city. 


No one should be invisible, and it concerns to live in a community that has demonstrated a total lack of empathy and compassion.  So yes, once again, my neighbors may hate me, blame me, or just plain pretend I don't exist.  Unless, of course they need something... the simple that I don't have anything to give.


Perhaps you made a profit of the publication of this article, just as the news story I sold for $1.00 a year ago made the publishes 47 times that amount. 


But I need a job.  I am invisible to everyone around me until they are confronted with their own crisis.   


By implying the assault I wrote about in "Good Fences" had anything to do with a mental health diagnosis, you have helped to contribute to stigma so that you could sell papers. 


Thanks, but no thanks. That just convinces me that you are no different from all the other mediawhores who use labels to exploit those who have already been marginalized by society.


more way people are victimized promote that piece in  your publication . It seems to me, that the perpetrator and the witness should have to answer for there actions rather than placing the blame on me, 


Is there anything I could have done to invite such a violent and personal atack in my own home?  Is there anything any woman, man, or child can do that justifies years of trauma, isolation an fear? 


Perhaps you should have commented on what kind of illness allows a man to watch a man use such force to put a woman of 122 lbs against the wall, his hands on a women without even lifting a finger to call 911.



Ever heard of Kitty Genovese? She was murdered as 38 people watched, yet not a single person called the police or did anything to help as she was brutally murdered in the city of New York. This is due to "Bystander Apathy" We often look to others for cues as to how to respond in a crisis.



Having been a both a witness and a victim, I decided that I would never look the other way. It would serve our communities well to adopt the same philosophy. Not only to create a more cohesive community, but a safer one as well.




When was the last time you called the police or filed a police report? We have criminalized and marginalized too many members of society. So where does it end?




I made a decision a long time that it would end with me. But if you were to ask me today, I might have a different answer.





Blaming the victim not only further stigmatized vulnerable populations, prevents witnesses and victims from coming forward to prevent and report criminal activity. It contributes to bystander apathy and prevents people from reporting crimes.



We already have enough problems putting rape victims on trial. As the editor of a publication dedicated to improving the lives of persons diagnosed with mental illness, I can see why you just went out of business. Good Riddance.



Maybe I'll start my own.





Sincerely yours,


Elyssa Durant, Ed.M.
Contributing Author
New York City Voices


[edited 11/17/2009]

The Powers That Tweet: Please Save The Internet


The Internet helped me get through some of the longest nights of my life.  


I am only one voice, and I am only one person, but it helped me feel just a little connected to the human race. During the silent hours in the dead of night, I can always find a voice to keep me company.


When there is no one listening, there is something to read. I found comfort in knowing that I was not completely alone in my krazy world.




There are so many others out who are forced into silence, and I need the Internet to feel connected to this world.  When we live in a society that is completely fragmented and near broken beyond repair, I look toward the web for a place to connect.


The Digital Divide is bad enough. The United States is broken beyond repair. We need to move forward towards this e-volution. Please do not remove the one lifeline I have left to the outside world. There are so many people out there like me deserve to be heard.


Elyssa Durant

Nashville, Tennessee

The Powers That Beat



Also available at:

Saturday, October 17, 2009

Reform Requires Regulation: ERISA, COBRA & Federal Law

For anyone who would like to know why I feel so strongly that any reform that does not address the issue of regulation, oversight and enforcement... perhaps my experience will serve as an example of how the judicial system fails to protect those who so desperately need help to fight injustice, inequity and corruption in the United States of America.



At twenty-two…





At 22 I was diagnosed with a degenerative spinal condition. Yes, there are times when the pain is so terrible, I cannot lifet myself out pf ed or tie my shoes. But far worse is having the knowledge that the level of damage to my spinal cord could have been stopped had I received adequate health care.



Yes, I had insurance. But who was there to make them pay???


14 years later, I finally received surgical intervention, and can feel my hands again-- and as a writer, that has been a miraculous gift.


Through the toughest times in my life, no one told me I was wasting my time and money on an education I would never be able to use.


After all I just wanted a diversion.


Even more disturbing than the damage to my spinal cord, is the realization that I missed mosre than 14 years of my life. So not only did I waste my time and money on an education I will never be able to use, I wasted a window of opportunity. A moment in time when I almost had a world the world at my fingertips.


Without any real place to go after college, I felt I had no other choice than to become a professional student of sorts—you know, the ones who stay in school forever to take advantage of cheap housing, health insurance, and student loans.

Unfortunately, I wandered aimlessly through the system acquiring useless knowledge and letters after my name that do not mean jack in the real world. But it distracted mye from the fact that my spinal cord continued to worsen my physical and emotional health.

So with no prosepects on the horizon-- and so thrilled thto feel my hands today, that the one thing I can do is write. So for now, I write, maybe tomorrow I'll read, but if there is any justice left in this world, maybe someday I will actually live.



http://my.barackobama.com/page/community/post/elyssadurant/gGxh4R/commentary




Despite having four individual insurance policies including a major plan with Blue Cross Blue Shield for $1,000,000; I still wound up on Medicaid, and eventually welfare and social security with a total income of under $6,000 / year.


The insurance investigators ultimately ruled in my favor, however I was unable to collect any damages for two reasons: Although mandatory federal fines in the amount of $560,000 would require legal assistance and complicated civil litigation that would be timely, costly, and emotionally traumatic. Second, under federal law, grants immunity to ERISA plans: a type of group insurance that is totally untouchable due to federal preemption of state law that leaves the beneficiary without recourse or the ability to collect punitive damages under federal law,


Unfortunately, this was a very complicated case that involved unscrupulous attorneys that involved tax and insurance fraud, and has yet to be resolved despite the overwhelming evidence of fraud and the favorable ruling from the insurance department. It should also be notes that no criminal charges were ever brought against any of the participants, which s even more disturbing if you knew the history of the parties involved, some were arrested for RICO conspiracy, Tax Evasion, Embezzlement, Extortion, and wire fraud. One man actually shot himself in the head one month after the Insurance Dept. opened the investigation.


So one is dead, one got off on a technicality, one was acquitted, and several others were never prosecuted. I however, pay a price for their crimes every day of my life, I now live in a prison of sorts: a prison of poverty, and despair with no real expectation of change on the horizon.






SO HERE ARE THE FACTS:



I recently learned that for the last 14 years, my parents used my social security number and that I was claimed as dependent on a NY State tax return. 

To complicate matters, I sit with the reality that I was screwed for life at the tender age of 22 and must somehow balance that knowledge with the ignorance and incompetence that surrounds me in my daily life. 


The country continues to fight a battle that can't be won without people like me who are willing to come forward, call their bluff, and say enough is enough.  Unforunately the country continues to self destruct and the citizens of the world are watching as the all mighty American dream is noting more than myth created by ignorance, propoganda, and elitist politicos that want nothing more than my silence and your ignorance.  Well fuck that, because I'm still here, and this ost will go straight to DC the moment I hit send.  So you can take it down, you can intercept my signal, but the truth is out there and I will not be intimidated or marginalized by the Powers That Beat.  So here we go... again... for the record (if one exists...)  [edd/eds 10.25.2009]

I live with the effects due to federal law (1) As a covered beneficiary under an ERISA plan, I will never be able to access; (2) being claimed as a dependent on my mother's NY State tax return for so many years it is near impossible impossible to go back and set the record straight.  This little factoid made it legally impossible to file taxes, obtain insurance, disability benefits, or student financial aid, and neither parent is willing to compromise.

They will NEVER release a copy of their returns. [edd/eds 10.25.2009]

For historical purposes, let take a trip back to 1995 where I spent most of my time in a state of confusion and completely in the dark about the damage I was to do as an unwilling participant of fraud and abuse in the health care industry... CONTENT WARNING read only if you are prepared to deal with the facts... I invite you to share this truth with whomever you like.  I have no where to run to, no where to hide.  But I will move forward for the sake of my sanity... I know things too... but it is not how well you know the law, iit how well you know the Judge. 

Try to bare with me as my mind is contantly in overdrive and my thought patterns have been altered through years of trauma, accute and chronic stress... so take your time, question authority, question me,  but don't be surprised if I I stfu for as I prepare for the fall out...

But remember this, if what I am saying is true, it is serious.  But even if I am making it all up...  it is still pretty fucking serious!  I can't remove the documents that were already posted, so I can not be held in contempt for something I did in good faith.  So they are probably out there somewhere waiting to reveal this web of deception that can only exist in a corrupt society through a pattern of judicial failure and social injustice:



1995: I filed a complaint with the Pennsylvania Insurance Department in 1995, and received response six months after the policy had expired. Despite the considerable evidence I provided to the Insurance Dept. and Pennsylvania Blue Shield, I was told that despite the overwhelming evidence that I provided, the Insurance Dept. Did not have the authority to override the terms of the contract.
















Since ERISA mandates that all beneficiaries (including insured dependents) be given a copy of the policy (among other forms of insurance identification, e.g., EOBs, Insurance Identification Card; a hard copy of the policy) all requests for ERISA mandated materials were repeatedly denied until the Jason Manne from the Dept. of Public Welfare sent a letter to my insurance carrier to inform them that they in accordance with federal law, they must honor my request for a copy of the insurance policy.


The insurance Department came to the same conclusion: that my rights under federal law had been violated, but because this situation was unprecedented in the state of Pennsylvania, it took approximately 9 months before BCBS decided to send me the necessary documentation. In addition, my plan had expired, and BCBS refused to honor my request for COBRA continuation (which would have been extended from 18  to 36 months since I was disabled at the time of the qualifying event plan supporting my initial request for federally mandated information in accordance with ERISA 4236. 

The Health Insurance Portability Act of 1996 was no help (NY State Public Law Enacted in 1996) and each policy passed me off to the next. Without EOBS or proof of comparable coverage, primary and secondary coverage could not be established and I began a 14 year journey into hell. Being forced to produce paperwork I could not obtain, my dissent into madness took hold of my life, each day a new request feeding my OCD with Ten Day letters, federal mandates and court ordered repetition.

Each company trieds to subrogate the next, and I watched my life: my dreams, my aspirations, my goals get sucked into the vortex of chaos and hell. I will never be free from the madness. The memories are burned into my memory like and I eat, sleep, dream, and search for solutions that never seem to arrive.  

My life is a constant battle to balance the reality of what is, and the hope for a judicial system that could enforce what should be.  The truth is out there in black and white, and I refuse to be silenced by people who simply refuse to take responsibility for their role in creating or feeding the Powers That Beat. Public Record, fucktards. So deal with it or go away. [edd/eds 10.25.2009]





Blue Shield refused to honor my request for COBRA continuation and / or a reassignment of benefits so those providers could be reimbursed directly. According to their attorney, Tija Hilton-Phillips, they had no obligation to provide me with any information about COBRA continuation and shifted the burden of responsibility onto the plan administrator and/or fiduciary. In addition to having the terms of my policy falsified in writing, I was unable to identify the plan administrator of fiduciary. Since federal law requires that all plans be filed with the Dept. of Labor, I contacted them on multiple occasions and wrote several letters requesting a copy of claims made under the policy, the plan fiduciary, administrator, and the specific type of ERISA plan (e.g., self-insured) that was on filed in accordance with federal law. Again, my verbal requests were denied. I then sent a written request to the regional office in Philadelphia but again, received no response.


Washington requests in Washington in accordance with federal law. , e.g., self-insured, their assistance in obtaining accurate information through the FOIA and the Pennsylvania Right To Know Act. 

Furthermore, the Dept. of Labor requesting this information were never answered. I never found out the name of the plan administrator or the fiduciary, and was never offered COBRA continuation, and then BCBS refused to let me continue under COBRA, claiming they were not obligated to offer it to... so who is ultimately held accountable in these situations.


When I first filed my complaint against Independence Blue Cross Blue Shield, I had no idea what I was about to uncover.  Each agency denied responsibility despite the overwhelming evidence of fraud that I had provided. I started to receive calls that puzzled me...  and it was only a few years ago that a psychiatrist finally took the time to investigate the facts.  My diagnosis was changed that same day, and never again will I allow "crazy" to be an excuse for any of the guilty parties involved. I don't have to.  I may be crazy, but that does not change the simple truth or the facts of my case. I am not delusional, though I often wish that I were.  I will never wake up to find that this clusterfuck was just a dream or a figment of my imagination.  There is no pill to erase the facts or to drag me out of this rabbit hole.  I am Alice in Blunderland. And we all pay the price.  Red pill or blue pill, the facts remain. So do what you please... but don't blame systemic failure on my state of mind.  Blame it on the state of affairs and social injustice and the lack of enforcement for all things holy in the US of A. [edd/eds 10.25.2009]

Although I was only 22 at the time, I spent my days and nights reading up on insurance, labor and employment law, and subsequently came to believe that aside from violating my natural rights, I had been denied due process protections and requested legal assistance from advocacy organizations in New York, Pennsylvania and Tennessee. I was unable to find anyone who would take my claims seriously, and could not find anyone to take my case pro-bono or on contingency. Eventually, I moved to Nashville, TN and tried to recover from the physical injuries and the new emotional scars that left me cynical and bitter about a judicial system that consistently fails to enforce natural and human rights.



Everyone I spoken to thus far reiterates the same statement-- practically verbatim, "I sympathize with your dilemma, yet, as you know, our office does not have the jurisdiction to assist you in this matter."


I sought the assistance of an attorney at Shnaeder Harrison years ago (regarding Pennsylvania Act 62) and Jason Manne in the Dept. of Public Welfare.


Although I may be biased, I believe this case has substantial social merit and long standing implications for children in the state of Pennsylvania. I am a reputable witness, and have 5 years of doctoral studies under my belt in the field of social policy.


I have been unsuccessful in my search for a competent litigator (unfortunately, this is an unprecedented case that touches on all the hot issues before the 3rd circuit including ERISA and the State's interest in Equal Educational Opportunity and due process protections for children (and adults) who are "victimized twice... first by their parents, and then, again by a judicial system who fails to protect them" (it's been a while, but I believe that is a paraphrase of the dissenting opinion from Justice Montemuro in Curtis v. Klein.


In many ways, I feel it is too late for me to recover what I lost due to a snag in the law and a few loopholes in the system. I have collected evidence for over 14 years because I used to believe that justice might prevail.


If she has an interest in looking bold into the face of police corruption, I would like to share my story (and the documents) to be sure no other child in the Commonwealth of Pennsylvania falls victim to such heinous crimes due to legal technicalities from an outdated piece of legislation. It has been 14 years since my case was “abandoned” by the state judicial system in the Philadelphia Court of Common Pleas. It is time to have these loop holes closed for good and ensure equal protection under the law for all children—not just those who are lucky enough to have a fair hearing or be heard before they reach the age of majority.


With the support and inspiration, I received from some very kind and brilliant professors in sociology and social policy, plan to submit a book proposal to document the sequence of events that still astound me and curious onlookers who take a quick peek as they casually pass in and out of my life. You see, it is much like a traffic accident-- people like to take comfort in seeing the tragedy of a broken man and his family demonstrating the social injustices and inequity resulting from a stratified society where only "violent" criminals or those who commit acts that violate or impede the natural rights of others are not taken seriously by the judicial system or the public at large. Unaware of the consequences that arise from dual standards in the worst of academic snobbery and intellectual elitism -- living a lifestyle they might otherwise envy.


I would appreciate assistance in restoring my social security number and account so that I do not have live in constant fear. If that means either relocating to another country and/or having my name and social security number changed or restored, it is probably well worth the inconvenience if it means there is still hope for living a peaceful existence.

Funding Grant Received to Transition Homeless

I am happy to report that I am no longer tweeting from my TwackBerry (in part because it is broken) and that Spotty and I are now in our very own apartment!


I am to thrilled to have a place to plant butt on the floor (no bed yet) but to watch Spotty curled up next me in the morning, purring as if nothing ever happened, I hardly notice how hard the floor is beneath the single top sheet that I have been sleeping on.


This brings me incredible relief. I thought she was broken. I thought she would be scarred for life. But Spotty has adapted better than expected. She is miraculously calm and almost unaware of how close we were to being.... how close she was to not being saved at all. Sadly no one came forward to Please Dave Spotty. I must find a place to balance my anger and disgust for all who poked fun at my campaign to save Spotty. http://darknightdurant.blogspot.com/2009/04/please-save-spotty.html



To be perfectly honest, I had given up hope that I this moment would come. The simple joy in having a place to call home. So yes, I can breathe. I can love. I can express joy. And relief, and should feel some sense of “pride” that it was me who did it. Against all odds, and should feel empowered that despite the barrage of the added stress fixing errors that I did not make; ultimately I was the one who has to find some oasis in this complete and total government fuckuppery. Complicated further by unforeseen, unforgiving, complications from my past, I did what I needed to do to set myself free. Did it work? Yes and no. Do I feel free? Yes and no. Do I feel a sense of pride and dignity? Yes and no. Will I ever feel safe and truly at home? Probably not. http://thepowersthatbeat.blogspot.com/2009/07/greatest-gift-greatest-grtief.html

But I will pretend for now that none of this matters. I will pretend the fraud and abuse is gone for the time being, so I can try to make it through the hour with a sense of ownership, self-efficacy and hope that for one day, my life is not interrupted by uninvited guests or complications so I can take a few hours to feel some relief as together we move towards a sense of stability.... http://thepowersthatbeat.blogspot.com/2009/08/identity-theft-its-personal.html

Unfortunately, I can still feel the wolves circling outside the door. As I try to lift myself up from the darkest depths of despair, I am racing against the clock to collect pieces of myself lost along the way. Of critical importance is recovering all the documents that will allow me to stay here-- as I am under review for social security, DHS, social services, and of course, the MDHA (Metro Development Housing Agency) for Section 8. This requires proof of income, identity, and countless other forms and documentation that are difficult to keep track of when you don't have an address or a place to keep them safe in an unsafe environment. http://darknightdurant.blogspot.com/2009/07/housing-crisis-in-nashville-tennessee.html

A few days ago, I found out that all of my belongings had been were placed into garbage bags, and thrown into the very same flooded garage outside the house I had rented from a CMHA (Community Mental Health Agency) that was funded, in part by SAMHSA (the Substance Abuse and Mental Health Services Administration) HUD (Housing and Urban Development) and special funds under the Recovery Act of 2009. I used to work as for SAMSHA, and I know enough about the law to realize that the lack of supervision and intervention at the house I rented is not only against the rules, but should be considered a crime against humanity. http://article.wn.com/view/2009/09/10/Centerstone_receives_grant_from_city_to_assist_homeless/

The "landlord" did nothing to prevent or intervene and actually encouraged such behavior as he knew it would force me out of the house that was clearly a threat to my safety and well being. The three women who should be jailed for the countless times they complicated the situation by locking me out, unplugging my phone, disconnecting my computer cables, and destroying my property "just for fun." http://thepowersthatbeat.blogspot.com/2009/08/today-again.html

What he did take issue with was the very fact that I was writing about my circumstances, especially the more disturbing times when I was when I watched the other residents become violent, and dangerous towards each other, and in time towards me. One nearly assaulted with me with waffle iron; One locked during a tornado warning, and one was simply too intoxicated to make a telephone call when five shots were fired down the street. To prevent from calling mobile crisis to intervene, me personal telephone was disconnected, the electric cables and power cords were unplugged and ultimately broken, and when I needed to call 911 even the house phone had disconnected by the woman who claims ownership by proxy of the entire household. Yeah, I’m the problem.




To add insult to injury, the day after my belongings were moved into the flooded garage, I learned that the agency received a grant to help transition the homeless. I'm not quite sure what to do... but I think there needs to be a stop gap measure somewhere, and if that makes me a "rat" so be it, but no one, and I mean NO ONE should ever be subjected to the things I witnessed over the last six months while I paid rent, yet lost everything as I was locked outside by the residents, while disposed of my food, kept from my medicine and destroyed property by repeatedly moving into areas of the property that were known to have flooding. The originals are destroyed; the ink from the notarized copies bleeds into the paper and can no longer feed through the scanner without getting caught in the feed. http://thepowersthatbeat.blogspot.com/2009/08/metro-govt-fuckuppery.html

Centerstone should probably know exactly how the “landlord” is doing business, and SAMHSA may be interested to see exactly how that grant money to help transition from homeless is being spent. http://article.wn.com/view/2009/09/10/Centerstone_receives_grant_from_city_to_assist_homeless/

I hope to pick the remaining items sometime son, and can only hope that I have what I need to move forward, and find the piece of myself that used to care enough to volunteer at the family shelter; go one more round in the fight for social justice; explain the need for equitable funding and share facts and research with those who need it… I encourage others to support social welfare programs to empower youth and the disenfranchised... I encourage others because I’m not sure I have what it takes any more. Not the skills, the passion. The drive. http://thepowersthatbeat.blogspot.com/2009/08/is-poverty-crime.html

Maybe I will. Maybe I won't. I guess the bottom line is that maybe I can't.

Perhaps the significant loss was the faith I had in human decency and kindness. I also lost considerable respect for nearly every person I know as they watched from a far (or a near) and failed to do anything to "stop the madness" I must confront the fact that so many things got lost in the 6 months it took to get here.

There were so many along the way that provided golden opportunities for someone to step up and be a hero. Not for the publicity or to grand stand, simply to be a hero to one woman who was caught in the vortex in a vicious downward spiral: homeless, helpless, hopeless.

So many faces, most of them of them strangers, would pass me by not knowing g of my story, my fear, or my sadness and isolation. They would chat me up at the park, the library, some place I could use Wi Fi for free, and I would feel almost human for a few hours. http://darknightdurant.blogspot.com/2009/07/writing-through-dark.html

Several hours later, I would find myself sitting in the parking lot hours after losing, tweeting my ass off in the pouring rain with nowhere to run to and no place to hide. Only then could you see the broken dreams of a woman marginalized into the shell of a person I had become. Broken. Completely broken.

To be continued….

Wednesday, October 14, 2009

Is Self Sufficiency Possible for Social Security Recipients


I composed my thoughts a little more, and will schedule with my pcp asap. My father sent me a text yesterday threatening to have me committed unless I just get over it already. He doesn't get it. If I refuse just "get over it" to try to get my benefits back, he will withhold my "allowance" even longer.

The material and financial loss resulting from the Centerstone situation is totally irrelevant to him, since I don't bother telling him that I had dropped down to 94 pounds when he left the country for two months and I ran out of food because he didn't send any money while he was gone.



He still has not paid my electric, rent, or other utilities, and I paid my medical and phone myself, electric reconnect myself since he never bothered to have it turned off when I got evicted over the $4.50 late fee.


All I need is the form to reverse the rep payee decision from SSA. I'm pretty sure a judge would remove him immediately if they the correspondence, but then I would have no one to represent me at all.


I have heard the rumors, and I know that several lawyers in town called him to tell him that I was "embarrassing myself by things I said on FaceBook."

He's on FaceBook, and he knows all about the poverty and gunfire I reported. Adam Dread told me to go the airport and he would call my father to try and "talk things out" the way lawyers do.  Well, fuck you, Adam! When you told me to "go home to the city I where I was born" and  went through the trouble of making sure there was no "conflict of interest for you to try have a "man-to-man" discussion with my pops?

I had no idea don't what on earth made me trust the sob, but hind sight is 20-20, and trust me... you are NO super lawyer... [more details and direct quotes to follow.... i gotta hit the welfare office] 

.... but he told me return to the city I was born, while he worked it out that I could get paid from the event I did for the Inaugural Ball. Obviously, that never happened so after 3 hrs, the police showed up.





They took me to mobile crisis where I placed in a room by myself for 20 minutes in handcuffs on the floor. They would not even get me a glass of water or juice and since I had been in my car for almost 36 hrs since the shooting, I was quite dehydrated.



Also, received a letter from DHS yesterday recognizing their mistake, however my father told me he does times my conversations to under 2 minutes.


Emails must be 100 words or less. We all know that not possible for me.


I finally picked up my medication and cut stretched my script for 2.5 months since it cost $59.99 out of pocket. Because my father places limits on how much I can spend on medication, I can't even tell you what a slap in the face it is to finally purchase my medication only to find my account overdrawn since I didn't realize I wouls now be resposbible for additional late fees on top of all the other fucked up crap I've had to deal with. 


I dont argue with about the money, but I do take issue with my being paid late so that I become responsible for the late or reactivation fees.

 

I have the name of a therapist two specialists in this type of trauma. One MD, one PsyD who has a masters. Neither accept TennCare. 

 

Maslow's Heirarchy of Needs

 

I need to fill out and fax forms and my printers sat in the rain at Dabbs for days.  It costs $2.50 /pg at kinkos and I already spent my entire monthly allowance on food gas and medicine.



Any suggestions?



EDITORIAL NOTE: 11/21/2009

I STILL NOT RECEIVED A CENT OF THE DISABILITY PAYMENT DEPOSITED INTO A BUSINESS [IOTOLA] ACCOUNT LISTED UNDER THE NAME DURANT & DURANT.


I HAVE NO "STUFF."  AS PROMISED, MY MY FATHER DID NOT MOVE AN INCH OR A CENT TO HELP ME REGARDLESS OF HIS CONTRACTUAL OBLGATION TO ACT IN MY BEST INTERESTS TO PROTECT MY HEALTH AND FINANCIAL STABILITY.  


I HAVE $O DOLLARS IN MY BANK ACCOUNT, HAVE NOT THIS MONTHS RENT, ELECTRIC,  OR PHONE. I HAVE $2 IN FOOD STAMPS AND $7.00 CASH TO LAST THE MONTH.  ONE AGAIN, HE MANAGED TO SHOW ME WHO IS BOSS AT THE HOLIDAYS.


FOOL ME ONCE... 


I DON'T KNOW WHAT I "DID" TO MY PARENTS TO MAKE THEM TREAT ME WITH SUCH INDIFFERENCE, SO PLEASE DON'T BOTHER TO ASK. BUT IF YOU CAN TELL ME WHAT I DID, I WOULD LIKE TO KNOW... 


THAT'S ALL FOR NOW FOLKS. MY HANDS ARE ICE COLD, AND SLEEPING IN MY CAR OR ON THIS STUPID AIR MATTRESS HAS DEFINITELY TAKEN IT'S TOLL. THE PAIN IS BACK.  I SUPPOSE IN THE GRAND SCHEME OF THINGS, IT IS MY HEART, MY FAITH, AND MY HOPE THAT WILL HURT THE MOST.


HAPPY THANKSGIVING.

I AM REMINDED ALL TOO WELL OF THE DAY I STARTED THIS BLOG... TWO YEARS AGO TO THE DAY.  WHEN I DECIDED TO STOP BEING A VICTIM...

AFTER BEING LEFT AT THE AIRPORT ONN THANKSGIVING DAY.


"I FEEL LIKE I'M LIVING THE WORST DAY OVER AND OVER. AND EVERY IS THE WORST DAY  EVER... 

EVERY DAY IS THE WORST DAY EVER.


THE WORST DAY EVER."


WHAT A FUCKING NIGHTMARE.  AND IT NEVER EVER ENDS...






"I got no pace to go, I've got no where to run.

I'm sick of this waiting, so go on and take your shot. You can sit there and judge me... say what you want to.

I'm a nightmare, a disaster. That's what they always said, but I'll make it on my own.

I'm a lost cause, not a hero. But I'll make it on my own.

I've got to prove them wrong.

It's me against the world."

Monday, October 12, 2009

Drop Dread Part II

Enclave: Drop Dread

Since so many people have asked why Adam Dread is, and why on earth he would call my father to complain about my blog... well, here's what I know...

I received a text message at 4:58pm on Friday afternoon as I was leaving Summit Medical Center. A local attorney called my father asking him to have me remove his name from my blog. Seriously!

I will be 37 years old in two weeks. If Mr. Dread had either the courtesy or even the balls to ask me himself, I may have even taken it into consideration. However, after 8 or 9 months of trying to contact him directly, he never once returned a single telephone call or e-mail. There is a very fine line between being unethical and being an asshole.

What at did he expect? That my daddy would ground me mentioning his name online? Unlikely. I think I'll let him sue me.

Clearly, Mr. Dread has some other reason for wanting to build an alliance with my father... perhaps he hoping to resurrect his career by returning to Pittsburgh roots of big money and the Heinz family fortune.

Get over yourself, Adam. You are no Superlawyer. And until I hear otherwise, it is still a free country. Nothing I said was untrue, and therefore I see no reason to make any modifications.

This is still America, and I have the freedom to say whatever I want. You are actually kind of lucky that the post went up via mobile blogger.

I'm sure you would not appreciate the formal report submitteed to the State. That one has details.

Now go play with your snuggie buddies and and maybe if you are lucky, someone will take a shot at me and all of mycharacter flaws. Oh, wait... you did that already.

Whatever... you know how us Dems can be. At least you’ll always have Friday's and your buddy AC.

#fucktard

A Formal Apology Upon Request

The problem statement: You tell me!


So basically, when a case mgr leaves, your file does not get transferred; it is simply closed or abandoned?

This also happened to me at OCA (according to Willis Farris, Legal Aid, MDHA, Metro AFS/Crisis Homeless Prevention, Crisis Intervention, MHC MANY TIMES, DHS and the DLAC (when it was still TPA)

No wonder nothing gets resolved. Heard on appeal, or resolved. Social Security, TennCare Appeals Unit, the DLAC all did the same exact thing.

There is a serious problem in this state with case file management.

I used to work for DCS. Those files weren’t lost! Neither were quite a few of the children who were suddenly MIA as they approached the age of majority. I personally reported to the location of several “missing” children, however, the Supervisors never bothered to return any calls or find go to meet the children. However, the state simply found it too inconvenient to be bothered with the time and expenses involved with coordinating post-custody services.

This problem was most obvious within populations at risk were those in transitioning out of custody. Expense involved transitional services several of the clients

Transitioning into ANY system of care has to be well designed, implemented. Evaluation is a critical component throughout the entire process and does not end after the program is implemented. We must constantly assess the quality of services.

The word “seamless” has no relevance here. Instead, we find road blocks to access transitional services.

No follow up, no appeal, no re-application option, no closure, no resolution appeals, or follow up. No wonder I'm spinning my wheels. I would like to know why my case cannot be transferred to another advocate, or transferred to another agency. Of course it makes more sense to keep it within the same agency, to maintain consistency and avoid time delays with appeals, releases and authorizations; but instead files are simply closed.

And I am always the last to know.

I realized that Ms. Duncan WAS my coordinating communications with MDHA since I have found it difficult to get a response. Even worse, it is NOT an MDHA issue. It makes things more complicated or me since they now have informal, incorrect information assessment from my old landlord and the three crazy ladies who I was forced to share an address with. Furthermore, I still don't have any more information about my finances and benefits because Social Security and my advocate also dropped the ball.

The woman, who sent this email, deserves a big, FUVM. MDHA has already disputed my eligibility since I simply don't have what I need to fill out their paperwork within the Ten Days permitted. They very well may close my file today.

I contacted Liz at Legal Aid, and she told my father has to mail me money to hire a lawyer. She actually refused to make a referral for pro-bono or other legal advocates for people with disabilities. She never even sent me a denial letter, or an appeal options. In fact, they neglected to read their own policy regarding open cases.

I never heard back from Erik Cole, John Wood, or Adult and Family Services, Crisis Intervention, Metro Homeless Prevention, or anyone at the ADA hotline. I hear nothing from anyone about anything. Why bother creating programs if no one is there to run them.

Discrimination in Metro must address all of Metro. Constituents, programs, employment and private religious charities. Even the Jewish Federation turned me down for counseling. They spent three months verifying their primary criteria for eligibility. They had two questions, one: are you Jewish, and, two: can you prove it? Seems like funding the JCC with benefits to the #homeless was not best idea Councilman Briley ever had. But I sure wish his Wi-Fi Bill had passed.

Homeless Prevention Programs must realize how difficult it is to maintain any stability. Especially a mailing address. All I have a website, and I can't even buy the domain. Regarding the official reason services are being denied appears to be more a social judgment from what I've seen, observed, and read online. To deny services based upon my parents income is absurd and ridiculous.

Perhaps they need a refresher course in Family Law and Benefits. Perhaps professor Rubenstein or the Employee Benefits Research Association to explain how these things work.

Can they actually refuse to furnish me with an application as they deny services, without a formal application? At least allowing me to apply or appeal since the fine print on their contract states they will represent me in any future disputes (the same case was thrown out in 2006) since the current dispute is result from the same case, Liz deserves a very enthusiastic FYVM as well.

A CLE course in Labor & Employment law is definitely in order, so Ms. Liz, keeper of all pro bono lists, referrals, and the only person I was told makes decisions regarding intake should be a little more embarrassed than she made me feel. That is why people hate lawyers: they are so damn arrogant.

So if "Liz," director, gatekeeper, and arrogant bitch, ever responds to my request made via Councilman Cole and TALS to find out the official grounds for denying my request for Legal Aid Services, I would be happy to go over there and tell her straight up what I think.

Any public interest lawyer who doesn't get the concept of the buzz words such as Termination of Parental Rights, clearly needs a lesson from a welfare little brat like me. There are very few reasons child custody files get sealed in what should be public record. Support orders don't get terminated before the age of majority except under extraordinary circumstances.

The fact that I am will be 37 in 3 weeks, and even I can't get a copy, gives you some idea of what is so bad, that even now the courts will not give ME a copy of my own custody file.

Yes, Harvard Lawyers have secrets. Federally appointed judges, sometimes go to extremes to hide them. It may be funny to all you fucktards who make jokes about the Jewish on welfare, but it is unprofessional to say it on a conference call.

Yes, terminated at August 15, 1988. So anyone who thinks I'm the sweet little girl Daddy loves to spoil, think again. If you want money from my parents, you will have asked them yourself.

Please don't push me on this. I've been on my own financially since I started working full time the summer before my 14th birthday. Locked out and discarded the summer my mother started dating a man who just happened to live on W72nd & CPW. Yes, the Rock -n-roll roll style was a hell of a lot more interesting than having a 14 year old who smoked the pot my mother was growing on the balcony.

So I worked full time to so I could eat at work (The Barge had really good lobster!) pay for clothing, because mom couldn't afford to buy me any. And when I needed to go on birth control, I paid for it myself. When I fractured my ankle, my father refused to take me to the doctor.

He told me straight out that unlike my mother, he will never tell me he can't afford it; he simply didn't think it was spending money on. I guess the $20 dollar co-pay was too much.

Years later dragged my own ass down to the ER for a fracture that happened when I was about 12. At 20, it finally chipped into my tendons since left untreated; I wound up in surgery and finally learned that I did have health insurance after all. Two years after that, I developed an extremely rare spinal condition that baffled the some of the neurologists and orthopedists in the country.

I applied as a clinic case to access to the National Spine Network for free. I lived in constant severe and disabling physical pain for most of my adult life. I developed severe OCD and PTSD after spending so many years under public and government investigations into MY financial records. The personal attacks were completely inappropriate, and many people simply assumed I must be delusional or psychotic for making up such a crazy story about such a well respected Harvard Lawyer.

After being homeless or the last 6 months because he refused to disburse my SSI income in a timely fashion, I decided to Tweet my way to freedom.

I want due process. I want due diligence, and I hope somebody out there might actually DO DILIGENCE for me and help me find a way to support myself and have HIM removed from as my financial representative through Social Security. Please help if you can. I deserve a chance to be free. I deserve a chance to be m.e.

It is October 7th. My deadline was May 8, 2008. I am requesting any all legal and social service workers to PLEASE come forward TODAY! I can't be homeless. I already feel homeless at home.
Btw... I now have a criminal record, as of yesterday. TYVM for adding that expired registration ticket onto my otherwise clean criminal background. I need transportation, printer, fax or internet access, and a decent CALM person to do the impossible. Let me live have a place to call home.

I can work if I can get through this, I want a job. I deserve a chance to use my experience to help get someone, anyone, the type of crisis & cm services needed to navigate this disconnected network of “services" Please help me with anything! Just please don't ignore me. This can be managed before it becomes a crisis!

I HAVE AUTO INSURANCE! Unfortunately, now I have expired tags. I need to update my voter registration, DL, and DHS files, and apparently my SSA since my fad never bothered to change my address after he told me it was done last month. I have no printer since the Dabbs people managed to leave all three outside in the pouring rain. Internet, fax, *signed letters of support* on my behalf.

PLEASE FWD ANY LETTERS OF SUPPORT TO:


I can't drive, now that my tags are overdue and my license was suspended yesterday since I could not print out proof of insurance.

It was emailed to the Dabbs computer. The landlord decided to unplug MY router. All were mailed to the wrong address (including my recertification for SSI, TennCare subrogation notices, MDHA app, and my DHS letter cutting off my benefits including food stamps & TennCare Someone do something, PLEASE! How many times must I say, "My name is Elyssa. I live in Nashville, TN. Please make a note of it"

Let me give back the taxpayers something more than additional fees to care for my sorry ass excuse a life. They have to pay all of it no matter how you look at it. Unless you help me get a job...
#justsayin


Elyssa Durant
Homeless at Home