Monday, April 28, 2008

MH Workers Refuse to Be Blamed

MH workers refuse to be blamed
David Bracken, Staff Writer
RALEIGH - As a health technician at John Umstead Hospital in Butner, Rosie Hargrove is responsible for admitting mentally ill patients to the state facility.
In recent years, Hargrove says her job has become more dangerous and stressful because, while the number of workers has declined, the patients showing up to be admitted to Umstead has not.
"We need more staff," said Hargrove, 49, as she stood picketing at the entrance to the Dorothea Dix campus Friday. "And we need better pay to keep the staff we have from leaving."
Hargrove was one of about 20 state mental health workers who gathered at Dix to protest what they say are unsafe conditions in the state's psychiatric hospitals. The News & Observer recently reported on 82 avoidable patients' deaths at the hospitals since December 2000, as well as 192 hospital workers being disciplined for abuse of patients.
In addition to demanding increased staffing and better pay, the workers said they were speaking out because they refuse to take the blame for problems caused by the state's attempt to reform North Carolina's mental-health system.
"Injuries have increased among employees and patients," said Larsene Taylor, 58, a health technician at Cherry Hospital in Goldsboro. "We're not going to take the blame for it."
The event was organized by the N.C. Public Service Workers Union, which represents more than 500 employees at the state's four psychiatric hospitals.
James Osberg, who oversees institutions for the state Department of Health and Human Services, said he and other officials share the concerns expressed by workers.
"We think many are underpaid for what the value of their work is," Osberg said. "We certainly think patient care could benefit from additional staffing."
Osberg said an advisory group put together by Dempsey Benton, head of DHHS, has recommended asking for money to pay for 86 new positions in next year's budget.
"Unfortunately, there are more needs than potential dollars," he said.
Steve Hardison, 44, a health technician at Dix, said the low staffing levels have turned workers into baby sitters who have little recourse if a patient acts aggressively toward them.
"We don't have any rights as workers," Hardison said. "The patients have more rights than we do."
Several of Tuesday's picketers held up signs reading "Don't Shut Down Dix." Osberg said the state plans to move most of Dix's patients to a new facility in Butner by July 1.
Hardison said the uncertainty surrounding the future of Dix -- its closing date has been postponed several times -- has made it hard to retain employees at the Raleigh hospital.
"They can't keep people's lives on hold," Hardison said. "They say July 1, but they said that last year."
david.bracken@newsobserver.com or (919) 829-4548

Sunday N&O Editorial

Cut loose
Some patients leave state mental hospitals with skimpy follow-up plans that leave them at risk -- another tangle in 'reform.'

Two days before a North Carolina man, called only "TC" by the advocacy group Disability Rights North Carolina, shot himself to death, he was discharged from an involuntary commitment at the Broughton state mental hospital in Morganton. Doctors sent the dangerously ill man home with an "aftercare plan" that consisted only of his promise to call his family doctor, and despite knowing the following, according to Disability Rights:
"At the time of his release, TC's hospital records contained information that TC had a family history of mental illness; that he was being treated with medication for bi-polar disorder; that he had been involuntarily committed once before following a suicide threat; that the current hospitalization had followed a standoff with police who had to taser TC in order to take him into custody; that he had threatened to shoot any officers who tried to intervene; that he told his family he took 100 Valium; that in talking with family his speech was slurred and he was 'drifting in and out'; that he was intelligent and would try to minimize the event so he would be discharged; that he lost his job the day of the event; that he and his long-time girlfriend, who had a tumultuous relationship, had recently broken up; that he did not have any local support system; that he had anger management issues; that he had been treated for depression with medications for seven years; that he had access to weapons; and that he was aggressive and combative toward hospital staff."
TC is one of three patients profiled in a Disability Rights report who ended up dead after spending just a few days, or hours, in state mental hospitals and with little attention to how they would be cared for on the outside. (TC is Carl Wayne Tournear, identified in a recent series of articles in The N&O about the state's mental health care system. He killed himself on Aug. 3.)
A second patient was a 17-year-old Orange County youth. The third was released to a homeless shelter that actually had been shuttered a few days earlier. According to the report, 1,182 people were released from mental hospitals to homeless shelters last year. That is a disgrace, but not surprising as shelters, jails and prisons increasingly become way stations for the mentally fragile.
The report comes as the state tries to right a seven-year-old reform effort that was to provide more space in the big state hospitals for seriously ill residents but more services in local communities for those whose illnesses were stabilized.
Disability Rights makes sensible suggestions, including hiring more local and hospital staff to coordinate after-care services and setting a statewide policy for local mental health offices. Earlier this month, before the report was released, the state decided on its own to place county liaisons in hospitals to help identify appropriate services for patients returning home -- a welcome step.
Disability Rights has uncovered another hole in the state system that needs to be patched. Until the agency responsible for carrying out reform, the Department of Health and Human Services, gets better control of local and statewide services, troubled North Carolinians are likely to continue falling through the local-state cracks.

Civil Rights Record

CIVIL RIGHTS RECORD:
Democratic gubernatorial candidate Beverly Perdue's record on civil rights again
came under fire Friday, with the campaign of Democratic rival Richard Moore targeting the lieutenant governorfor goods sold at Georgia convenience stores owned by her family and a 1989 legislative move opposed by the Legislative Black Caucus. During a news conference that Moore, the state treasurer, did not attend, Moore's campaign displayed Confederate flag-emblazoned goods purchased from Perdue family stores. "Is this a hat that Bev Perdue would let her campaign staff wear?" said Jay Reiff, Moore's campaign manager, pointing to a
row of three baseball caps with different "Stars and Bars" variations. Perdue's husband, Bob Eaves, owns a chain of "The Right Stuff Food Stores" in Georgia. Until last year, Perdue was an officer in the company. Moore's campaign staff said they purchased the goods at two locations and displayed receipts. They supplied photographs of merchandise in the store. Moore's staff spotlighted the convenience store goods hours after distributing copies of a 1989 newspaper article recounting how Perdue watered down a bill that was the Legislative Black Caucus' top priority that year: making it easier for candidates to avoid a runoff election in a primary.
Rep. Mickey Michaux, D-Durham, at the time said Perdue's move was "a slap in the face of black people." On Friday, Michaux, a Perdue supporter, said her change to the legislation is an exception to an otherwise positive record on civil rights. "She made a couple of mistakes, but that doesn't necessarily undercut the good job she's done particularly when it comes to those matters affecting the minority community," he said. On Thursday Moore's campaign criticized a 1987 vote in which Perdue opposed a bill that made it easier for the State Bureau
of Investigation to investigate hate crimes. Perdue's campaign responded by accusing Moore of using "Jesse Helms" tactics – a claim Perdue spokesman David Kochman reiterated Friday. Kochman said that the most recent attack was "so low that Richard Moore himself wouldn't even attend the press conference announcing it." Kochman said the stores are run by Perdue's stepson and that while her husband retains partial ownership, is not involved in day-to-day management of the company. (THE NEWS & OBSERVER, 4/25/08).

In the news...

MENTAL HEALTH:
Nearly 50 mental health workers gathered on the steps of Dorothea Dix Hospital Friday to protest working conditions at North Carolina's four psychiatric hospitals, saying understaffing, forced overtime and low wages combine to make conditions unsafe. "People are tired," said Larsene Taylor, a health care technician at Cherry Hospital and union chairwoman. "People are burning out, and the ones with the most experience are just leaving." Safety is a real issue, said Donna Earley, a health care technician at Broughton Hospital. "There have been times I've felt unsafe there," Earley said. "Sometimes there just aren't enough people." People who are tending to patients one-on-one are supposed to be relieved every two hours, but that doesn't happen, Earley said. Health care technicians and certified nurse assistants have an average yearly salary of a little more than $20,000, said Laura White, team leader for state hospitals with the N.C. Division of Mental Heath, Developmental Disability and Substance Abuse Services. "We would like to see health care techs make more, but there are a lot of them, and even a small increase would be very expensive," she said.

Friday's protest was organized by the N.C. Public Service Workers Union, which represents the state's public sector workers, including those at state psychiatric hospitals. They plan to hold more rallies across the state to raise awareness about the issue. Representatives from the union met with Gov. Mike Easley on Friday. North Carolina is one of two states where public employees are prohibited by law from collective bargaining, said union organizer Dante Strobino; Virginia is the other. Workers can unionize and hold meetings, but there is no union contract. "We're working to get that changed," Strobino said. (Leslie Boyd, ASHEVILLE CITIZEN-TIMES, 4/26/08).

MENTAL HEALTH AGENCIES:
Currituck County commissioners have adopted a resolution opposing Gov. Mike Easley's proposal to give the state control of the 25 regional mental health agencies across North Carolina. "Everybody's trying to invent a better mousetrap," said Currituck Commissioner Owen Etheridge. "But when you have a successful delivery system, if it ain't broke, don't fix it." Etheridge is Currituck's representative on the board of directors for the Albemarle Mental Health Center, which manages mental health services in 10 counties. Last month, Easley asked lawmakers to give Department of Health and Human Services Secretary Dempsey Benton "clear authority" over the agencies. Easley also wants to consolidate the number of mental health agencies to ensure consistency of care. He said last month that the changes would save money and make the programs more accountable.

A recent report conducted for DHHS recommended consolidating the existing 25 regional mental health agencies into fewer than 10, and transferring control and oversight of mental health services to a centralized agency. According to a grading system used in the report, AMHC would have to merge into a larger regional entity that would likely have its headquarters far from Elizabeth City, where it now is based. If that were to happen, AMHC attorney John Morrison said, the cost to provide mental health care in the region could rise from $1 per capita to as much as $20 per capita. Plus, patients in the 10-county AMHC region would likely have to drive much farther to obtain their services, and there are no guarantees that the quality would be as good, Morrison said.
The resolution that Currituck commissioners approved criticizes Easley's proposal for not "adequately" consulting local officials before it was finalized. It also is critical of other state efforts thus far to reform mental health care. "State-imposed mental health reform to date has adversely impacted the delivery of mental health services and the cost of these services, and therefore has adversely impacted the quality of life of our residents," the resolution states. The resolution Currituck approved hasn't yet been considered by other counties in the region, managers for Camden, Chowan and Pasquotank said last week. (Bob Montgomery, THE DAILY ADVANCE, 4/27/08).

Candidates Answer MH Questions

Survey Answers on Mental Health Questions By The Associated Press Posted:
Apr. 25, 2008
Here are three questions posed by The Associated Press to the eight major-party candidates for governor on the topic of mental health, followed by their unabridged responses. The responses were edited for AP style:

1. In 2001, lawmakers began to overhaul the state's mental health treatment system by shifting more patients from institutional care to community-based treatment by private doctors and services. The reforms have stalled and are widely regarded by critics and advocates of the mentally ill as a failure. As governor, what will you do in your first two years in office to improve the state's mental health care system?

2. Do you support a law - as proposed by a campus safety task force led by Attorney General Roy Cooper - to bar handgun sales to people who have been involuntarily committed to mental hospitals?

DEMOCRATS
RICHARD MOORE
When reading The News & Observer's series on mental health I was struck by Professor Joseph Morrissey's summary of the problem: "Solving these systemic problems will require the capacity to analyze proposed solutions, check out their costs and benefits in advance, monitor policy and program implementation, and assess outcomes on an ongoing basis. No multibillion-dollar enterprise in corporate America operates without this type of intelligence function."
As the only candidate for governor that has run two state agencies, I am very familiar with the challenges of operating vast bureaucracies with silo-funding streams and have experience in breaking down those barriers to change and improvement. I will bring a decade of public managerial experience to bear on our mental health system.
First, I will finish any of the outstanding initiatives Secretary Benton began, but remain incomplete, in order to ensure a smooth transition. This includes gaining approval from Centers for Medicaid and Medicare Services to end the blended payment rates. My budget will include funding for an internal inspection team to ensure we do not forfeit millions in Medicaid/Medicare payments because our hospitals are not in compliance with federal rules. And I will ensure we are filling key positions related to our mental health system with the most highly qualified individuals by offering sufficient salaries to attract them.
Concurrently, I will begin my own improvements starting in our institutions. I will develop an interagency team that will be dispatched immediately to investigate all deaths that occur in our mental hospitals. The team will include investigative personnel from the Department of Crime Control and Public Safety and will be required to file timely reports with the hospital, the DHHS Secretary, the medical examiner/pathologists, and the family. It will also be forwarded to the district attorney if there is any suspicion of wrong doing by anyone in the facility.
Second, to increase the quality of care our patients are receiving in state hospitals, we will seek to institute a career ladder of sorts for the medical and patient technicians working directly with patients in our hospitals. To advance on the ladder and earn a higher salary, the staff will achieve more advanced levels of certification. We will ask the community colleges, universities, and medical hospitals to design continuing education courses that will be offered during the work day. Much like we have done in our schools and in child care, we will raise the wages of our employees by raising the quality of care they provide.
Because more than 20 percent of the patients admitted to our mental hospitals last year were dependent on alcohol or drugs and because our psychiatric hospitals admitted more drug addicts than schizophrenics last year, I will commit more resources to substance abuse treatment programs.
As governor I will seek to further our knowledge base on mental health issues and develop improvements by working with our research institutions to convene regular task forces of experts to study these complex mental health issues and develop workable solutions on an ongoing basis. Currently, Secretary Benton has a number of working groups meeting regularly to develop solutions, but I want to institutionalize the dialogue and grow the state's knowledge base on mental health issues.
From those groups we will 1) seek to create meaningful, clear objective criteria for the local management entities, 2) design effective clinical and fiscal competencies with incentives for those exceeding the criteria and penalties for those who fail, 3) develop standard protocols for mental health care to ensure consistency of treatment between providers, 4) develop a system of statewide case management through health care community networks, or a "medical home" system and 5) develop a funding mechanism to ensure our low wealth counties have the resources they need to attract high quality providers so all patients can have access to high quality care.


2. Yes. --- DENNIS NIELSEN
1. We must first define the exact problem and then work towards real solutions. Hoping will not work we need real definitions of problems and then together set real goals and milestones to implement the fixes. This is a complex issue and one that requires strong leadership to define and fix. We also need to separate those that need help; citizens with mental illnesses, disabilities and those with substance abuse need different programs, we must do away with a one size fits all approach.
2. Handgun sales: I don't like a law that is so broad so I would have to see the actual legislation to see if I would or would not support it.

--- BEVERLY PERDUE
We need to get serious about the goal of quality health care for all North Carolinians - and that must include mental health care.
My background in health care tells me that it makes no sense to separate mental from physical health care. The best research confirms that many patients have mixed mental and physical health issues. Thus I am proud that my plans for expanding health care coverage to all children and more low-wage working parents have been praised by such leading advocates as Adam Searing of the North Carolina Health Access Coalition for containing "the most significant changes in health care access in North Carolina in, quite literally, decades." To read more, go to http://bevperdue.com/healthcare.
As North Carolina's next governor, I also want to establish the national model for an integrated approach to behavioral and primary health services for patients with mental health, development disability, and substance abuse problems. It will be one of my top goals to break down the barriers to the coordination of mental and physical health care.
North Carolina's Medicaid program has recently moved to the forefront in emphasizing the importance of a "medical home" for the primary care of adults and children. Our Community Care of North Carolina has developed a very cost-effective and quality-driven model of statewide case management through health care community networks. We need to extend this kind of collaboration and community network to the delivery of mental health services.
In my view, the concept of a medical home should play a major role in helping to revitalize our badly tattered mental health system within and outside of Medicaid. Patients with severe mental illness need the security of a medical home as well as strong inpatient professional service. We should also strive to define a basic level of mental health services to which needy patients should have access.
Recent events have made us all too painfully aware of what can happen to those who fall through the gaping holes in our mental health care system. While in the long-term my focus is on closing those holes, it would be irresponsible not to take what steps we can in the short-term to avert tragedy. The Campus Safety Task Force led by Attorney General Cooper has proposed a law to bar handgun sales to people involuntarily committed to mental hospitals. We should take such a sensible step in the interests of the safety of our students and of our communities.
I know that improving our mental health system is easier said than done. Yet we cannot stop until we have a system where the local and state levels work in a coordinated fashion to assure access to appropriate services for all North Carolinians. We will need to adopt a disciplined approach with lots of two-way learning between government officials and the mental health community.
That will require sound leadership and coordination throughout state government. We need stability, a shared vision, and a focus on quality outcomes for all those who depend on our mental health, developmental disability, and substance abuse services. I will be the kind of dedicated, hands-on governor who can provide this needed leadership on health care generally and mental health in particular.

--- REPUBLICANS

BILL GRAHAM
. The first step I will take is to bring all interested parties involved to the table to discuss the failure of our current system as well as any successes. We have some of our nation's premier experts on mental health in our state, yet we have failed to use them. Our mental health professionals understand what needs to be done, we need a governor who will listen to them. I would immediately increase funding for our mental hospitals and for other programs that offer treatment to those who are considered high risk or critical.
After the initial steps, I will work with our mental health professionals and experts to devise a plan that will meet the needs of our mentally ill citizens. We will begin with pilot programs so that we can quickly identify any problems. Once I am satisfied that we have a workable system that will fully meet our needs, I will then launch the new mental health system statewide.
2. Yes. ---

PAT MCCRORY
1. It is no secret that North Carolina has people who suffer some form of mental illness and need state help. It is also no secret that the last eight years have seen escalating waste, fraud, institutional ineptitude, bureaucratic bungling, and now, finger pointing as to who is to blame for this sorry state of affairs. Responsibility for mental health care falls under the broad mandate of the governor and his secretary of Health and Human Services. Now the governor is trying to "pass the buck" to the Legislature, which approved privatizing many mental health care services without, apparently, having appropriate service levels defined and without having clear guidelines of responsibility and supervision in place. Such lapses could explain other puzzling proposals as the one recently where HHS planned to close two mental health hospitals without having enough beds in place to replace them.
Parceling out treatments to private sector facilities located closer to the patients themselves makes sense. The existing plan needs considerable redrafting in terms of quality, costs, patient care, oversight, and state follow up but can be salvaged. The new governor first needs to take responsibility for fixing the problem and actually begin fixing it ... putting policies and procedures in place to make sure the patients who are depending on the state for help get the help they need. Those actions will be my starting point for mental health reform. The governor's office is responsible and accountable for mental health in North Carolina. If the legislature is making that job harder, the governor needs to let us know and then he needs to step up to the plate and do his job.
2. Yes. ---

BOB ORR
1. We must have leadership, the right concept of care, the appropriate resources, and a rigorous oversight process. Administration officials have admitted that they have been aware of the problems in mental health, yet have taken no action to fix them. The next governor must be ready to take on the challenge of addressing our broken mental health care system from the first day in office. Among the reforms needed, we must determine where privatization is a viable business model, implement a fair and efficient reimbursement process that pays for actual care, fully fund the Mental Health Trust Fund, and ensure that the state has a secure, long term supply of mental health care providers. Please visit my web site at http://www.Orr2008.com for my full proposal.
2. Yes. ---

ELBIE POWERS
. Apparently, lawmakers may not have the best answers or solutions. I will replace some agency directors with knowledgeable and efficient people in their proper fields, removing ones placed by favoritism or the buddy-buddy system. Who are these inefficient agency directors? To find out, I go down the ladder in each department to the working people. The following statement from an individual who is a worker within the mental health system. "The state passed the buck to private providers. Now the private providers are collecting money for services that they are not necessarily providing. Also, they appear as they don't care about the individual. All they are worried about is collecting the money. The dollar has become what's important. Also there are approximately 800 private providers now that are fighting to offer services. Another issue that concerns me is that we have had individuals that have worked on their own for years, now all of a sudden they need a one on one worker. What this means is the facility draws down huge dollars for this individual to have a baby sitter for several hours a day."
2. Definitely, yes on this question unless a unique situation reveals it to show otherwise. ---

FRED SMITH
1. It is important that we move forward with reform that creates a structure of clarity, certainty, and confidence, providing appropriate leadership and a plan that more clearly identifies the roles and responsibilities of the State, the Local Management Entities (LME's), and the care providers. To accomplish this we must:
- place clear responsibility on the state for providing care for the long-term and more difficult chronic cases of mental illness and disabilities that cannot be appropriately served in the community and require the expertise and services provided through our state psychiatric hospitals and facilities for the developmentally disabled.
- develop the community capacity for short-term acute psychiatric care by working with our LME's, community hospitals, and other providers to establish and reinforce our abilities to serve consumers in crisis, providing a hub around which to build community services while reducing dependency on the State's psychiatric hospitals.
- develop the community capacity to provide individuals with mental illness, developmental disabilities, and substance abuse with appropriate ongoing assistance and services necessary to provide the greatest opportunity to live a productive and quality life.
Building a strong system of community based mental health services is not going to happen as a result of increased and constantly changing state rules and regulations coupled with poorly developed and sometimes inadequate provider reimbursement policies. Building community access and choice is going to require leadership focused on understanding the needs and identifying and addressing the barriers to success. This requires a willingness and devotion to working closely with our community hospitals and other care providers, the LME's and local governments, consumers, families, and advocates to find solutions.
2. Yes.

Help This Triad Group Get Funding!

Good Morning,

We submitted a grant proposal that was selected to be featured on the Million Step March website as a part of the Step it Up! philanthropic campaign provide by Blue Cross Blue Shield of NC. Proposals are being voted for online. Voting ends May 19th. The winner will be determined by the proposal that has the most number of votes. Voting is allowed from the same email address once per day. You are allowed and encouraged to vote daily.The winner will be announced (maybe publicly) at a venue to be determined. The details will be shared with the organization at a later date.

Help us win. The proposal submitted will fund an evidence base exercised program for older adults with lower extremity osteoarthritis in our region.

The link below will take you to our proposal. Click vote now. This will take you to a page that asks for your email address and a text to type. Once you submit you will then receive an email confirming your email address. Your vote counts once you confirm your email address.

http://walk.millionstepmarch.com/step-it-up/ptcg-fitandstrong/


Please pass this to all your staff, seniors and anyone that will help us win.

Thanks!

Legislative Alert

Dear CSWA Members, As you know from previous posts, the Clinical Social Work Association is supporting H.R. 5447 and S. 2858, bills which would create a commission to study social work practice, salaries, and funding. These bills have 57 and 5 sponsors respectively, with prime sponsors Rep. Edolphus Townes (D-NY) and Sen. Barbara Mikulski (D-MD), respectively.

CSWA is working with NASW toward inclusion of clinical social work more specifically in the bills and on the commission they would create. Anyone interested in reading the bills can find them at http://thomas.loc.gov/cgi-bin/query/z?c110:H.R.5447 and http:// thomas.loc.gov/cgi-bin/query/z?c110:S.2858 .
While these bills, like most bills, are not perfect, CSWA sees them as an opportunity to enhance the awareness and overall understanding of clinical social work practice in several arenas. CSWA also believes that the dialogue with NASW in progress on the way this bill could move forward the interests of clinical social work is productive. As you know, Kevin Host, CSWA President and I recently had a useful discussion with NASW's Executive Director, Elizabeth Clark,receiving a commitment to make the bills stronger for clinical social workers. I am using a new system for identifying email addresses of your legislators to send messages.
Please click on http://www.visi.com/juan/congress/ .
You will find a map where you can click on your state and all the legislators and email addresses will come up. Please send the following message to your representative:
“I am a constituent and a member of the Clinical Social Work Association. Please sign on to H.R. 5447 which will create a commission to study the crucial work being conducted by social workers and the social work needs which are quickly emerging. Thanks for your consideration. Sincerely,____________, LCSW/LICSW”
If your representative is on the list of co-sponsors below, please send the following message: “I am a constituent and a member of the Clinical Social Work Association. Thanks you for signing on to H.R. 5447 which will create a commission to study the crucial work being conducted by social workers and the social work needs which are quickly emerging. I appreciate your support for the social work profession. Sincerely,____________, LCSW/LICSW”
Rep Abercrombie, Neil [HI-1] - 4/9/2008
Rep Allen, Thomas H. [ME-1] - 3/31/2008
Rep Baldwin, Tammy [WI-2] - 4/10/2008
Rep Berman, Howard L. [CA-28] - 4/15/2008
Rep Bishop, Sanford D., Jr. [G A-2] - 4/15/2008
Rep Blumenauer, Earl [OR-3] - 4/15/2008
Rep Bordallo, Madeleine Z. [GU] - 4/8/2008
Rep Braley, Bruce L. [IA-1] - 4/15/2008
Rep Brown, Corrine [FL-3] - 3/3/2008
Rep Clay, Wm. Lacy [MO-1] - 3/12/2008
Rep Conyers, John, Jr. [MI-14] - 3/12/2008
Rep Davis, Danny K. [IL-7] - 3/3/2008
Rep Davis, Lincoln [TN-4] - 4/15/2008
Rep Davis, Susan A. [CA-53] - 2/14/2008
Rep DeLauro, Rosa L. [CT-3] - 4/22/2008
Rep Ellison, Keith [MN-5] - 3/31/2008
Rep English, Phil [PA-3] - 3/4/2008
Rep Etheridge, Bob [NC-2] - 4/10/2008
Rep Filner, Bob [CA-51] - 3/31/2008
Rep Gutierrez, Luis V. [IL-4] - 2/14/2008
Rep Hare, Phil [IL-17] - 4/22/2008
Rep Hinojosa, Ruben [TX-15] - 4/15/2008
Rep Honda, Michael M. [CA-15] - 4/15/2008
Rep Israel, Steve [NY-2] - 4/9/2008
Rep Jackson-Lee, Sheila [TX-18] - 3/31/2008
Rep Johnson, Eddie Bernice [TX-30] - 4/9/2008
Rep Johnson, Henry C. "Hank," Jr. [GA-4] - 3/4/2008
Rep J ones, Stephanie Tubbs [OH-11] - 2/14/2008
Rep Kennedy, Patrick J. [RI-1] - 4/10/2008
Rep Kildee, Dale E. [MI-5] - 4/9/2008
Rep Kilpatrick, Carolyn C. [MI-13] - 4/8/2008
Rep Lee, Barbara [CA-9] - 2/14/2008
Rep Lewis, John [GA-5] - 3/6/2008
Rep Maloney, Carolyn B. [NY-14] - 4/15/2008
Rep Marshall, Jim [GA-8] - 3/6/2008
Rep McGovern, James P. [MA-3] - 4/9/2008
Rep McIntyre, Mike [NC-7] - 4/22/2008
Rep Moore, Dennis [KS-3] - 3/3/2008
Rep Moran, James P. [VA-8] - 4/22/2008
Rep Norton, Eleanor Holmes [DC] - 3/4/2008
Rep Pastor, Ed [AZ-4] - 3/4/2008
Rep Payne, Donald M. [NJ-10] - 3/6/2008
Rep Rodriguez, Ciro D. [TX-23] - 2/14/2008
Rep Ross, Mike [AR-4] - 3/31/2008
Rep Rothman, Steven R. [NJ-9] - 3/31/2008
Rep Ruppersberger, C. A. Dutch [MD-2] - 4/8/2008
Rep Rush, Bobby L. [IL-1] - 3/3/2008
Rep Sanchez, Linda T. [CA-39] - 4/10/2008
Rep Sarbanes, John P. [MD-3] - 4/10/2008
Rep Schakowsky, Janice D. [IL-9 ] - 4/10/2008
Rep Schiff, Adam B. [CA-29] - 4/22/2008
Rep Schwartz, Allyson Y. [PA-13] - 4/15/2008
Rep Shays, Christopher [CT-4] - 2/14/2008
Rep Shea-Porter, Carol [NH-1] - 3/3/2008
Rep Sutton, Betty [OH-13] - 4/9/2008
Rep Townes, Edolphus [NY-10] - 2/14/08
Rep Watson, Diane E. [CA-33] - 4/22/2008
Rep Woolsey, Lynn C. [CA-6] - 3/4/2008
Please send the following message to your senators: “I am a constituent and a member of the Clinical Social Work Association. Please sign on to S. 2858 which will create a commission to study the crucial work being conducted by social workers and the social work needs which are quickly emerging. Thanks for your consideration. Sincerely,____________, LCSW/LICSW”
If your Senator is on the list below, please send the following message: “
I am a constituent and a member of the Clinical Social Work Association. Thank you for signing on to S. 2858 which will create a commission to study the crucial work being conducted by social workers and the social work needs which are quickly emerging. I appreciate your support for the social work profession. Sincerely,____________, LCSW/LICSW”
Sen Boxer, Barbara [CA] - 4/22/2008
Sen Inouye, Daniel K. [HI] - 4/15/2008
Sen Levin, Carl [MI] - 4/16/2008
Sen Mikulski, Barbara [MD] – 4/15/08
Sen Smith, Gordon H. [OR] - 4/15/2008
Sen Stabenow, Debbie [MI] - 4/15/2008
As always, please let me know when you have sent your messages and if you receive any responses from your legislators.
Thanks for your help,
Laura Groshong, LICSW, CSWA
Director, Government Relations
4/26/08

Wednesday, April 23, 2008

Message from Zach Ambrose, Campaign Manager for Bev Perdue




Bev Perdue is fed up with the politics of destruction. And after hearing from so many voters who feel the same way, she decided to do something about it – she decided to run a positive campaign that stays focused on the issues that matter most to you.And the response has been overwhelming. We have received hundreds of positive emails from voters like you and the latest poll from Public Policy Polling puts Bev ahead by 10 points, 41% to 31%.But it won’t work without your support.


Here’s what you can do to make a difference:

Spread the Word:Tell your friends about Bev Perdue's positive campaign. Forward this email on to five, ten, or fifteen others… print this flyer (PDF) and pass it out or post it on other blogs or websites for others to see.


Volunteer: Early voting has already started and Election Day is only 18 days away, and we need your help to make sure every one of our supporters makes it to the polls to vote.


Click here to volunteer for Bev’s positive campaign.


Learn More: Visit http://images.myngp.com/LinkTracker.aspx?crypt=IVi0ax2%2b6UBSinc%2fCPYaKbAtnknTdaMM064gngb3ARIMNC1OrcF3oj%2fyX0VblJwGxXsXMQatZxQ8JWa68Uqp1z77XbrrjgF3tCBCvf9B3xU%3d to read more about Bev's positive campaign for better health care, education and jobs in North Carolina.


Vote!: Vote Bev Perdue for Governor on May 6th.


Click here to find an early voting location near you.


Bev's Positive about US, so let's make sure everyone in North Carolina knows! Tell your friends, family, coworkers and neighbors why you support Bev Perdue and why they should too!


Sincerely, Zach Ambrose, Campaign Manager
Coalition on Human Needs
Towards Shared Recovery
People and Communities are Hurting.How Helping Them is Not Only Right --It's the Best Way to Boost the Economy
Webinar: Friday, April 25 at 3:00 p.m. eastern time (noon Pacific time)
Click here to register: www.bostonconferencing.com/chn

Please join us to learn about proposals before Congress to respond to the recession, and about a growing effort by advocates to support the most effective forms of aid: extending unemployment benefits, help with the high cost of food and home energy, funds to prevent cuts to Medicaid, child support, and other services, and school repair. (For more information, see Towards Shared Recovery, at http://www.chn.org/pdf/2008/stimulus4142008.pdf)

This 60-minute webinar will feature a Member of Congress (details coming soon), Jared Bernstein, Director of the Living Standards program at the Economic Policy Institute, a prominent, engaging, jargon-free economist, and Deborah Weinstein, Executive Director of the Coalition on Human Needs, to explain how putting more money in the hands of people and communities who need it is the best way to reverse the recession, as well as one of the best prospects this year for federal help to those in need. Ellen Teller of the Food Research and Action Center will moderate. It's a great way to get answers to your questions about the recession and to learn about easy steps to take to make sure Congress knows this assistance is urgently needed.

Sign up today - and forward this message to let others know. It's free, thanks to the generous support of the Annie E. Casey Foundation. The webinar and related materials will be available on the Coalition on Human Needs' website after the live presentation. Please sign up to be sure you get the links to all the information we will make available.

This webinar is sponsored by the Coalition on Human Needs in partnership with: ACORN; AFSCME; American Friends Service Committee; Center for Law and Social Policy; Community Action Partnership; Emergency Campaign for America's Priorities; Food Research and Action Center; Jewish Council for Public Affairs; National Association for State Community Services Program; National Association of Social Workers; National Head Start Association; National Research Center for Women & Families; National WIC Association; National Women's Law Center; NETWORK, A National Catholic Social Justice Lobby; OMB Watch; Public Education Network; RESULTS; SEIU; USAction; Voices for America's Children; Wider Opportunities for Women; YWCA USA.

Kaiser Daily Health Policy Report

Kaiser Daily Health Policy Report
Coverage & Access Depression, Post-Traumatic Stress Disorder Among Service Members Will Cost U.S. up to $6.2B Over Two Years, According to Report
[Apr 18, 2008]


Nearly one in five, or about 300,000, soldiers who has served in Iraq or Afghanistan has post-traumatic stress disorder or major depression -- illnesses that could cost the U.S. as much as $6.2 billion over two years in care, lost productivity and lost lives through suicide, according to a RAND report released on Thursday, the Washington Post reports (Scott Tyson, Washington Post, 4/18). The study was based on telephone interviews conducted from August 2007 to January with 1,965 soldiers who have served in Iraq or Afghanistan, in some cases more than once. The soldiers interviewed live in 24 communities with high concentrations of service members, reservists and veterans. Researchers also conducted focus groups. About 1.6 million people have served in Iraq or Afghanistan in the past five years (Alvarez, New York Times, 4/18).In total, 31% of Iraq and Afghanistan soldiers have experienced a brain injury, stress disorder, or both, the report found. The study found that 19.5% of service members experienced a concussion or other traumatic brain injury during their service (Barnes, Los Angeles Times, 4/18). Of soldiers who reported having a traumatic brain injury, 43% were evaluated by a physician. The report also found that about 7% of soldiers surveyed have a probable brain injury and currently have PTSD. PTSD and major depression were most prevalent in women and reservists, according to the report (Jelinek, AP/Miami Herald, 4/18). The treatment costs for brain injuries have not been determined, but according to the report, based on the number of traumatic brain injury cases diagnosed through June 2007, the cost is expected to be between $600 million and $900 million. According to the report, the stress of war has resulted in a disproportionately high psychological toll compared with physical injuries. The report warns of "long-term, cascading consequences" for the U.S. if the mental health problems are not treated. Consequences include higher rates of drug use, suicide and unemployment, and increased marital problems (Washington Post, 4/18). The study was funded by a grant from the Iraq Afghanistan Deployment Impact Fund at the California Community Foundation (Carter, Washington Times, 4/18).
Treatment The report also found "serious gaps in mental health care," according to the Post. According to the report, 53% of service members with PTSD or depression had sought treatment from a provider in the past year, about half of whom received "minimally adequate" treatment. To care for all of the service members, thousands more certified mental health professionals are needed in both military and civilian sectors, as some veterans are seeking care outside of the Department of Veterans Affairs system because of stigma attached to mental illness, according to the report (Washington Post, 4/18). Terri Tanielian, one of the study's authors, said, "When we asked folks what was limiting them from getting the help that they need, among the top barriers that were reported were really negative career repercussions." While the treatment costs might seem high to government officials, failure to treat mental illness could cost the government billions of dollars, according to Lisa Jaycox, another one of the study's authors. She said, "We make the case that investing in treatment early would prevent some of the negative consequences from unfolding and save money."
Recommendations The study recommended allowing service members to receive mental health care "off the record," to avoid any possible stigma. Researchers also recommended that fitness-for-duty reports for redeployment not be based on a soldier's decision to seek mental health care (Los Angeles Times, 4/18). According to Jaycox, Department of Defense Secretary Robert Gates is considering removing a question from security clearance questionnaires about soldiers' health care history. Col. Loree Sutton, head of the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury, said removing the question would be a "big step forward to help our service members understand that seeking care, in fact, is a sign of strength" (New York Times, 4/18).Gerald Cross, the VA's principal deputy undersecretary for health, said VA was increasing outreach to veterans, regardless of whether they reported mental illness. Ira Katz, the VA's mental health chief, said the VA budget for mental disorders increased from $2 billion in 2001 to $4 billion next year. However, Paul Sullivan, executive director of Veterans for Common Sense, said, "The VA is completely unprepared for the tidal wave," adding, "Unless the VA gets a massive amount of money (and) a set of new strong pro-veteran leaders, the situation will collapse" (Los Angeles Times, 4/18).

The report is available online.CBS' "Evening News" on Thursday reported on the study. The segment includes comments from Carissa Picard of Military Spouses for Changes, Col. Casper Jones and a soldier diagnosed with PTSD (Dozier, "Evening News," CBS, 4/18). Video of the segment and expanded CBS News coverage are available online. NBC's "Nightly News" on Thursday also reported on the study. The segment includes comments from Tanielian and Sutton (Miklaszewski, "Nightly News," NBC, 4/17). Video of the segment is available online.

Proposed Federal Rules Expand Disclosure of Student Information

Proposed Federal Rules Expand Disclosure of Student Information
April 15, 2008--T he U.S. Department of Education (DOE) has published
new
regulations enforcing the Family Educational Rights and Privacy Act
(FERPA),
which governs disclosures from students' records by educational
institutions.
The proposed rules were published in the Federal Register on March 24
and are
available at http://www.bazelon.org/pdf/ED-2008-OPEPD-0002.pdf . They
address
the disclosure of information to parents and others and set a new
standard for
DOE's review of disclosures.
DOE has acted responsibly in the past to safeguard student privacy.
The
proposed regulation may herald a new hands-off approach that will
weaken FERPA
enforcement, erode privacy, and place at risk the confidentiality of
students'
mental health information.
The rules allow for a public comment period (ending at 5 p.m. on May
8, 2008).
The Bazelon Center will post its comments online in advance for use as
a
model.
For details and instructions for commenting, visit:
http://www.bazelon.org/issues/education/takeaction/4-08FERPAregs.htm
For more information:
* the Bazelon Center's campus mental health policy guide,
Supporting Students: A Model Policy for Colleges and Universities:
http://www.bazelon.org/newsroom/2007/STUDENTMENTALPOLICY051607.htm
* the October 2007 Department of Education guide entitled,
"Balancing Student
Privacy and School Safety: A Guide to the Family Educational Rights
and
Privacy Act for Colleges and Universities,"
http://www.ed.gov/policy/gen/guid/fpco/brochures/postsec.html.

News from around the state (with thanks to Diane Bauknight)

The Daily Tar Heel
Unhealthy system

Withheld funding apt response to mental health failures

Just as citizens have a responsibility to faithfully pay their taxes each spring, governments have a responsibility to ensure that tax money is spent wisely and usefully.North Carolina's state government has obliterated its end of this unwritten pact by wasting at least $400 million on mental health reform since 2001.Knowing that, the federal government's Centers for Medicare and Medicaid Services did well to punish the state by withholding $175 million in federal funding from community support programs during the last three months of 2007.We wish the state had gotten a warning before the money disappeared because reforming the system will likely require money. But the punishment is justified.We just hope the loss of federal funding will incite state officials to revamp a mental health program suffering from innumerable ailments.In 2001 evidence indicated the N.C. state government leaned too heavily on state psychiatric hospitals, and legislators responded by enacting reforms to treat more mental health patients in their own communities rather than the state's four overcrowded hospitals.Under the new system, private health care providers replaced local governments in the delivery of mental health services.The community support program, intended to cost the state less than $5 million per month, soon cost more than $50 million because of bloated private health care bills, money-hungry providers and a government that seemed to ignore it all.Shockingly, many of the health care workers employed by private companies to provide services to the community had little or no experience in the field and no college diploma.Regardless, the state paid these workers as much as $61 per hour for services deemed "unnecessary" 89 percent of the time by a Department of Health and Human Services review.Rather than delivering useful services to patients in need, providers often took clients shopping or to the movies, all at the expense of N.C. taxpayers.While private health care providers cashed in on this faulty system, the state's 210,000 residents who seek state help each year received worse service.From March 2006 to January 2008, the government spent $1.4 billion on the wasteful community support programs and only $78 million on services statistically more effective at decreasing the chances of hospitalization.Luckily, the federal funding is being taken from the community programs. In this case, less is probably more.

Asheville Citizen Times
State to replace juvenile centers
by
Jordan Schrader
published April 19, 2008 12:15 am

RALEIGH – Unlike its larger and more violent neighbor in Swannanoa, Buncombe Regional Juvenile Detention Center doesn't tend to make headlines.
But like Swannanoa Valley Youth Development Center, state officials say, the short-term youth lockup on Asheville's Lee's Creek Road is old and unsafe.
"It's been a maintenance nightmare forever," said Sen. Martin Nesbitt, D-Buncombe.
It's time to bulldoze the facility, juvenile justice officials told lawmakers this week. They want to spend more than $13 million to tear down and rebuild three of the state's nine Detention Centers, temporary holding places for youth facing criminal sanction.
An updated facility could help prevent incidents such as a December attack on two staff members.
A counselor facing a violent juvenile Dec. 14 reported taking a hit to the mouth and an elbow to the eye, while another employee helping wrap up the youth was struck in the face and back. Within an hour of being shackled, the boy had broken free of his leg irons and was shouting from his room threats to kill the counselor.
The counselor watched the boy's fury for nearly three more hours until deputy sheriffs arrived to take him to the adult jail, the kind with cells, guards and career criminals.
"When kids come to detention, they're more unpredictable" because they haven't undergone mental health assessments that are available at other state facilities, Buncombe director Debby Burchfield said.
"They come in off the streets, essentially."
Triple-bunking, lack of technology
The Buncombe jail was built in 1953 as a sanctuary for runaways and today holds just 14 juveniles. The state wants to replace it with a 24-bed unit.
A state report envisions 24 rooms separated by living areas encircled by security fences. It would have three classrooms, a room for family visits and space for appointments with mental health care professionals, social workers and court counselors — all watched over by cameras.
It would be a far cry from the current design of the jail, which makes it hard to keep a close eye on the young but often dangerous inmates.
The building's seven bedrooms are perpetually double-bunked and occasionally triple-bunked, Burchfield said. Youth must be taken from their rooms to use the bathroom. The wooden doors lack electronic locks.
There is a perimeter fence, but no security cameras, and an intercom needs replacing.
The new building would probably go up on the same site, said Michael Bryant, director of juvenile detention services.
Statewide overhaul
The Buncombe site is in the worst condition of the detention centers, but those serving the Wilmington and Fayetteville areas also need to be rebuilt, according to the report.
Cumberland Regional Juvenile Detention Center should relocate to a less crowded area, Bryant said.
Sports fans drop by hoping to pick up tickets to watch the Fayetteville FireAntz play hockey or the Fayetteville Guard play arena football. They're told they want the building next door, Crown Coliseum.
If lawmakers agree, the projects would join a lengthy plan for new juvenile lockups whose construction will long outlast the Easley administration.
State officials Thursday dedicated the first of the state's new Youth Development Centers, in Chatham County. Three more open in May.
Another is in the works, and legislators will be asked in the session starting next month to fund four more, an overhaul that began with a 2003 state audit sparked by violence at Swannanoa that found the youth prisons had substandard buildings.
"Money's going to be tight," said budget co-chairman and Rep. Mickey Michaux, D-Durham, on prospects for new buildings. "We're just going to have to take a close look."
It will be up to Gov. Mike Easley's successor to pursue construction of a promised 32-bed unit to replace the Swannanoa center, whose old property on Old U.S. 70 is being turned over in stages to an adult women's prison.

Carolina Journal Article on Executions

4.17.08 - Ruling may not led to resumed executions

Updates from the NC Housing Coalition (Chris Estes)

Executive Director’s Notes
Dear Jack,
I am writing this from sunny New Bern where I am attending the Blue Cross Blue Shield Healthy Community Institute with NCHC Board Chair Helen McInnis and CHIN Director Hunter Thompson. It is a great event focusing on helping nonprofits with strategic planning, board development, financial management, and fundraising. I counted ten other organizations we work with in attendance, and we are looking forward to networking with them on local housing issues in their communities tonight at the reception.We are proud to announce that the Blue Cross Blue Shield Foundation has chosen the NC Housing Coalition as its CommuniTies Award Recipient! This grant is unrestricted support to us to recognize our work as a coalition. We in turn will make three $10,000 unrestricted awards to member organizations of the Housing Coalition in recognition of their great work at the Annual Housing Conference in October. More details on this to come in a few weeks.North Carolina Housing NewsCongratulations again to all of the folks working with Congregations for Social Justice in Raleigh. As I noted two weeks ago, this group packed the Raleigh City Council chambers with over 175 people in support of having the Council approve an Affordable Housing Task Force in conjunction with the city’s Comprehensive Plan implementation. This week, the Council approved the creation of such a Task Force and we are excited to work with CSJ as they continue their advocacy for affordable housing in Raleigh by monitoring the Task Force’s formation and work.Also, congratulations to Amy Powell, Chatham Habitat for Humanity, Gregg Warren, DHIC, and the other members of the Chatham Co. Housing Task Force for their highly successful Housing Summit in Siler City last Friday. I moderated a terrific panel that included Beth McKee Huger, Greensboro Housing Coalition; Dawn Blobaum, Town of Davidson Planning; Joe Durham, Wake County Planning; Scott Dedman, Mountain Housing Opportunities; and Sally Green, Chapel Hill Town Council. The best part of the day was having the 100 or so attendees break into eight groups to identify top priorities for moving affordable housing forward in the County. These were then woven together to form four recommendations for the Task Force to present to the Chatham County Commissioners. We look forward to working with the Task Force and Chatham Housing Coalition as they push for more funding and policy changes in their county.Foreclosure Scam AlertThere are many stories of owners facing foreclosure being taken advantage of by various foreclosure scams. If you or your organizations comes across anyone who has experienced such scams, please contact Al Ripley at the NC Justice Center (al(at)ncjustice.org or 919-856-2573). The Justice Center is interested in working on policy solutions to this problem and would like to get more information to better inform what changes are needed.Campaign for Housing CarolinaWe have had meetings with various state legislative leaders in the past two weeks in preparation for the upcoming legislative session, asking for their support for the NC Housing Trust Fund. So far our group includes Paul Stock, NC Bankers Association; Jill Cox, United Way of NC; Julia Leggett, Arc-NC; Bill Rowe, NC Justice Center; Rick Zechini, NC Realtors Association, along with Bob Kucab and other representatives from the NC Housing Finance Agency. Thanks to all of these folks for their work in support of getting more resources for affordable housing finance and production in NC.Our message has centered on the critical need for an expansion of recurring funding for the Housing Trust Fund as we face a national recession, a growing foreclosure crisis, and a mental health crisis that has left our most vulnerable residents without adequate housing. The reception has been very positive – though cautious about the amount of funding that will be available. I look forward to further meetings in the coming weeks. Of utmost importance to the success of the Campaign will be the contact you have with your legislator in support of the Housing Trust Fund as a local constituent. Find out who your legislators are and how to contact them here. Federal Housing NewsThere is mixed news to report regarding Senate Bill 2636, which passed the Senate last week. The bill included the income targeting we advocated for: 25% of CDBG funds allocated (to buy and rehab already foreclosed properties) will be targeted to households at 30% and below area median income. However, the Senate rejected the proposal to let bankruptcy judges modify mortgages on primary residences to help financially distressed homeowners. As expected, the bankruptcy proposal was the most controversial in a series of amendments to the larger housing measure.Also, the Center for Responsible Lending let us know that when the Senate passed the Foreclosure Prevention Act of 2008 it was as House Bill H 3221, not S 2636. We do not why this was done. This bill provides some help, but not enough. It also has some less desirable provisions, but at least it is a continued platform for discussion. As Senator Dodd said yesterday, “…But this legislation falls short of its lofty title. It does not do enough to help the millions of American families facing foreclosure.”
Other Federal Housing News is available here from NLIHC and HAC on rural housing issues.
To read the full Housing Update, click here. This will open an Adobe PDF document on our website.

Thanks again for being a member of the NC Housing Coalition,
Chris EstesExecutive Director

Hendersonville News re: Mental Health Patients

Hendersonville News

Local sheriff's deputies can spend hours handling involuntary committals instead of patrolling the streets. The time-consuming process can create problems for law enforcement, hospitals, people who suffer mental illness and the community. This issue and more will be explored in an upcoming meeting hosted by the Four Seasons chapter of the National Alliance on Mental Illness. The meeting is at 11:30 a.m. Saturday at the Pardee Education Center in the Blue Ridge Mall. The public is invited. "This is an information session to inform people of the need for a crisis intervention team and what it is so that we can hopefully get it started," said Nancy Moreland, the education program chair for Four Seasons NAMI.Crisis intervention teams are community collaborations between mental health providers, law enforcement officers and consumer advocates. The teams are geared toward improving the outcomes of law enforcement interaction with people with mental illness. The meeting will include members of Four Seasons NAMI, the Henderson County Sheriff's Office and the Western North Carolina and Wake County chapters of NAMI.

For more on this story, read Thursday's Times-News

---------------

http://wral.com/news/local/video/2740481/

http://wunc.org/programs/news/archive/NRH041608MNTL_HEALTH.mp3/view


DISCHARGED PATIENTS:North Carolina risks lives and violates federal rules by discharging patients from its state mental hospitals without adequate plans for community care, the advocacy group Disability Rights North Carolina said Tuesday. A report by the group focused on the deaths of three people within two weeks of their discharges from state hospitals last year. Executive Director Vicki Smith said the group's investigation found a "pattern of dangerously inadequate discharge planning practices" and a system "rife with ambiguity and without accountability." Poor planning for community care leads to increased hospital use by patients who return over and over, and it leads to deaths, Smith said.
One of the patients focused on in the report, Drew Thames, who had twice attempted suicide, was discharged in November from John Umstead Hospital in Butner after a five-day stay. The 16-year-old boy slipped away from his Orange County home in December and was later found dead in a Wilmington hotel. Another patient, Bryan Lowery, was sent from Dorothea Dix Hospital in Raleigh to a homeless shelter that had been shut down two days before his discharge. He died in a motel room of an overdose two days before he was to check into a drug treatment center. And another patient, who wasn't identified by name in the group's report, bought a gun the day after his Aug. 1 release from Broughton Hospital in Morganton and shot himself in the head Aug. 3. A recent News & Observer report identified him as Carl Wayne Tournear of Mooresville.
James Osberg, the Department of Health and Human Services administrator who oversees state institutions, said patients are not discharged before doctors determine they are no longer a danger to themselves or others. Discharge plans vary in quality, he said. He would not comment on the cases Disability Rights identified, but he said it would be wrong to assume that an inadequate discharge plan resulted in a death. Hospitals don't have time to do thorough discharge plans for most patients in the hospitals only a few days, he said. And in some cases, Osberg said, community services that patients need are not available.
(Lynn Bonner, THE NEWS & OBSERVER, 4/16/08).

ETV and NC Reach

Scholarships for Former Foster Children

Education Training Vouchers

Youth who were adopted from foster care after the age of 16 or who were in foster care on or after their 17th birthday are eligible for Education Training Vouchers, which are worth up to $5000 per year toward the cost of attendance at most colleges, community colleges, or vocational schools. Students apply directly on line at www.statevoucher.org. This website contains a wealth of information regarding other sources of aid, North Carolina colleges, community colleges, and vocational schools, and other information useful to any student.

Education Training Vouchers were established in 2003 and are funded by the same money that funds the NC LINKS program. For this academic year, as of April 9, 2008, we have 165 students currently receiving funding, and 40 more students have been approved for funding. For the life of the ETV program, 968 students have received funding for one or more years.
NC Child Welfare Postsecondary Education Support Scholarships

The 2007 North Carolina Legislature approved funding for a scholarship program for young adults through age 25 who either aged out of NC foster care or were adopted from NC foster care on or after their 12th birthday. Eligible students under the age of 18 must have completed their high school or GED requirements. This scholarship program is called NC Reach. The website is www.NCReach.org and students apply on line. The Division has selected Orphan Foundation of America to manage the program and provide case management services to all scholarship recipients.

The scholarships will pay for the remaining the costs of attendance, as defined by the Higher Education Act of 1965, at any branch of the University of North Carolina or any of the North Carolina Community Colleges. Federal grants, including the Education Training Voucher and Pell grants, will be applied to the costs of attendance first. Legitimate student loans incurred by students after July 31, 2007 may be eligible for repayment through this program, up to the determined cost of attendance after that date.

Students will be eligible for up to eight semesters of assistance, so long as they make satisfactory progress toward the completion of their academic program. Students will remain eligible for assistance until their 26th birthday.

For information about the UNC constituent universities, go to http://www.northcarolina.edu/content.php/campus/campusmap.htm

For information about North Carolina community colleges, go to http://www.ncccs.cc.nc.us/colleges_map.htm

Students who were in North Carolina DSS custody but were placed out of state and aged out of care in another state are eligible for these scholarships.

The following students are not eligible for NC Reach scholarships:
Students who were in the custody of other states and were placed in North Carolina on an interstate agreement;
Youth adopted from other states’ custody, even if their adoptive parents live in North Carolina.
Youth who were adopted through international adoptions or private adoptions;
Undocumented youth who aged out of North Carolina foster care or were adopted on or after their 12th birthday. Such students may become eligible once they have established legal residence.

Case Management Services to be provided to NC Reach students

The Division of Social Services is contracting with Orphan Foundation of America to provide intensive Case Management Services to all students who receive the NC Reach scholarships. Services will include:
An annual assessment of strengths and needs
Surveys to identify ongoing concerns
Workshops on a variety of topics promoting academic achievement
Students matched with a screened, trained and monitored “virtual” mentor who will maintain contact with them through e-mail and who have made a two year commitment
Provide opportunities for internships for rising juniors and seniors in major metropolitan areas of North Carolina
Provide emergency case management 24/7; and
Send 3 “care packages” per school year.

The web site for NC Reach went live in mid March.

NC Reach Press Release

FOR IMMEDIATE RELEASE
CONTACTS:
Doug Sprei, Director of Communications
Ann Rebeck, NCReach Program Manager
Orphan Foundation of America 1- 800-585-6112
(703) 581-2498 1-866-283-0223 (fax)
dsprei@orphan.org ncreach@orphan.org
www.orphan.org
www.ncreach.org

NEW PROGRAM OFFERS COLLEGE ACCESS WITHOUT DEBT FOR NC ADOPTEES AND FORMER FOSTER YOUTH

RALEIGH, NC, APRIL 15, 2008 – NC REACH is a new scholarship program created to benefit students who were in public foster care, assuring that they can complete their undergraduate education without incurring student loans.
The NC Reach scholarship provides significant financial assistance to pay for the costs of attendance at North Carolina public universities and community colleges. Costs of attendance, which are predetermined by the college, include tuition, fees, room and board, supplies, transportation to school, and other costs specifically required to complete the educational program.
In addition to financial assistance, students are provided services like virtual mentoring, care packages, and internships to enhance their educational program. Eligible students are those who have completed their secondary education and who were in NC DSS foster care on their 18th birthday, or who were adopted from North Carolina public foster care on or after their 12th birthday. Students may qualify for the scholarship through age 25.
"North Carolina has made a significant investment in the future by implementing the NC Reach scholarship program. The State will benefit as many more young people complete their education and make a successful transition to the workforce and adult life," said Eileen McCaffrey, executive director of the Orphan Foundation of America, which is administering the new program.

For more information
Call: 1-800-585-6112
e-mail: ncreach@orphan.org
Online application at www.ncreach.org

The North Carolina Reach Program is administered by the Orphan Foundation of America 21351 Gentry Drive, Suite 130 Sterling, VA 20166 (571) 203-0270 www.orphan.org

National Medicaid Issue

We have a few updates on waivers and DRA state plan activity to report:

Rhode Island: At the end of March, the state submitted a far-reaching concept paper to CMS for "The Rhode Island Global Consumer Choice Compact" waiver. The waiver would put a global cap on both acute and long-term services, putting the state at risk for both unanticipated growth in health care costs and enrollment. There are limited changes in benefits and increased cost-sharing for children and families, but extensive changes in the way long-term services would be provided. While the goals of the waiver include expanding community-based services and limiting institutional care, the capped funding creates significant risks for all beneficiaries, providers as well as the state. As in Vermont, the state would establish 3 levels of need for long-term services: highest, high and preventive. Only those beneficiaries who meet the criteria highest level of need would have an entitlement to services; others would be subject to the availability of funding -- a risk compounded by the capped federal funds. The criteria are not described in the waiver. There is also no information regarding the details of the financing of the waiver such as trend rates the state is seeking. We have been in touch with advocates and providers in Rhode Island who will be working on this, so let me or Joan know if you want more information regarding efforts there. We will update you as we learn more about these plans as well as the progress of this waiver. The concept paper is at http://www.eohhs.ri.gov/reports/documents/RIGlobalConsumerChoiceCompactWaiverFinal3-26-08toCMSmodified.pdf

Florida: Plans to expand Florida's waiver to additional counties have been hotly debated in the state's legislature and the outcome is still up in the air. The House budget bill would expand the waiver to 9 additional counties, including Miami-Dade in September 2010. The Senate bill does not include any aurhority for further expansion of the waiver. So it does appear that expansion will not be happening in the near future. Unfortunately the legislature is also considering significant cuts to the state's Medicaid program. (The Center's paper on state budget cuts was updated today and includes detailed information on the cuts being considered in Florida as well as other states. http://www.cbpp.org/3-13-08sfp.htm )

West Virginia: Some light has finally been shed on the impact of the state's Medicaid Redesign on children and adults needing mental health services. See the article from the April 7 Charleston Gazette reprinted below. What is especially disturbing is that only 7 percent of beneficiaries affected by the program are enrolled in the enhanced plan leaving the vast majority of beneficiaries in the basic plan with limits on prescription drugs and mental health services. (In order to get into the enhanced plan, beneficiaries must see their primary care provider and enter into a member agreement for the year. If this is not done within 90 days of the approval of an application or renewal of coverage, the beneficiary stays in the basic plan with limits on benefits for the year.) According to mental health providers, many of their patients have had problems scheduling appointments and getting their paperwork done and having the state put them in the enhanced plan in a timely manner. Since the plan went statewide last November, the problems have grown as described below. The state's responses regarding EPSDT are particularly troublesome. What they have said is that a child in the basic plan could get necessary mental health care services if they are determined necessary during a well-child visit. Some of the children affected have been approved for intensive behavioral health services by the state's own utilization review contractor, but services are not being provided because the child is in the basic plan and the services were not prescribed by the child's pediatrician or other primary care provider.

Let us know if you have any questions or any thoughts on any of this.

Judy and Joan

April 7, 2008
Medicaid fails mentally ill, group says
Changes force more people into mental hospitals, jails
By Eric Eyre
Staff writer
West Virginia's revamped Medicaid health insurance program for the poor has failed people with mental illness, according to behavioral health center executives from across the state.
The administrators predict thousands of low-income West Virginians with severe mental problems will be without services, forcing them into state mental hospitals and jails, or out onto the street - unless the state Medicaid office overhauls the program.
"You're talking about the people who are the most quickly dangerous," said John Russell, director of the West Virginia Behavioral Health Association.
The state has stopped reimbursing behavioral health centers for crisis services provided to the bulk of their Medicaid clients.
"They're implementing a program that will eliminate payment for crucial services for thousands of West Virginians," Russell said. "As a result, the only choice the state will have is to lock these individuals up in jails or state facilities. The more likely outcome will be to leave them to suffer on the street."
Three other behavior health center chiefs also spoke to the Gazette, but requested anonymity because they feared retribution from state Medicaid officials.
Medicaid spokeswoman Shannon Riley Landrum said the health administrators have overstated the impact of the program changes.
"They're presenting a worst-case scenario," Landrum said. "Information presented to us simply doesn't indicate this is happening."
Landrum said behavioral health centers could tap a special "uncompensated care" fund through the state Bureau of Behavioral Health and Health Facilities to pay for mental health services not reimbursed by Medicaid.
Also, the Medicaid office tweaked the program Tuesday, allowing behavioral health facilities to be paid for less-intensive mental health services typically provided by psychologists and psychiatrists, Landrum said.
"During a crisis, no one should be turned away from services," she said. "We have not heard of that happening. We have a lot of people worrying that will happen."
Last year, Medicaid recipients started switching over to a redesigned program called Mountain Health Choices.
They're given the choice to sign up for a bare-bones "basic" plan or an "enhanced" plan, which comes with more benefits but also stipulations, such as keeping doctor's appointments and staying away from hospital emergency rooms for minor illnesses.
Until last week's change, the basic plan for adults included no mental health services provided by behavioral health centers. Children on the basic plan are limited to "26 units" of service - an allotment that could be used up in two or three days, mental health group administrators say.
Landrum said that cap would be lifted if a child's doctor determines mental health treatment is "medically necessary" during an annual screening. Medicaid's enhanced plan provides a full range of mental health services. But only 6 percent of Medicaid recipients who require mental health help have signed up for the basic plan, according to a recent survey of all behavioral health centers in West Virginia.
Some Medicaid mentally ill patients simply don't have the mental capacity to know they should enroll in the expanded plan, the executives said. Others were automatically transferred from the traditional Medicaid program, which provided mental health services, to the basic plan because they didn't fill out the required form.
The Medicaid program started in three counties - Lincoln, Clay and Upshur - last year. The program has expanded to 49 of West Virginia's 55 counties.
"The pilot was a failure," Russell said. "It's been an administrative nightmare. There's never been an independent review."
Landrum said it was too early to call the redesigned Medicaid program a failure. Less than half of Medicaid recipients have switched over to Mountain Health Choices.
Of those, about 7 percent - 5,288 out of 73,257 - signed up for the enhanced plan, according to Medicaid enrollment data.
The behavioral health centers continue to provide services to mentally ill patients, racking up hundreds of thousands of dollars in bills that the state has refused to pay - even though the state contracted with a claims management company that approved the services, the health center administrators say.
The executives said their nonprofit agencies are no longer willing to shoulder the cost of the program's failure and will have to refuse to treat Medicaid recipients. People with Medicaid insurance make up about 40 percent of behavioral heath center patients - those with mental health and substance abuse problems - across the state.
"We're moving from a community system to an institutional system," said Tom Susman, a consultant for the mental health centers. "We're moving back in the direction of warehousing. The centers can no longer afford to take care of these patients, and they'll end up in state hospitals."
West Virginia has two psychiatric hospitals: Mildred Mitchell-Bateman Hospital in Huntington and William R. Sharpe Jr. Hospital in Weston. Both facilities are at full capacity, forcing them to divert dozens of patients to private psychiatric hospitals.
Russell said it's much cheaper for the state to treat mental patients in residential programs than in mental hospitals and jails. The state receives 3-to-1 matching funds from the federal government for Medicaid recipients who use behavioral health centers. State taxpayers pick up the entire cost of a patient's medical care once they're committed to a state mental hospital, he said.
The health center administrators plan to talk to lawmakers and advocacy groups in the coming weeks.
Medicaid officials said they've been meeting with behavioral health leaders since the new program's inception and will continue to do so.
"There are some individuals impacted by the changes in the program, and we're continually monitoring the issue," Landrum said. This is about our members receiving the right care at the right place at the right time. No member should be going without medically necessary services."
To contact staff writer Eric Eyre, use e-mail or call 348-4869.

Monday, April 21, 2008

Unhealthy System: JJ Centers to be Replaced

The Daily Tar Heel

Unhealthy system

Withheld funding apt response to mental health failures
Just as citizens have a responsibility to faithfully pay their taxes each spring, governments have a responsibility to ensure that tax money is spent wisely and usefully.North Carolina's state government has obliterated its end of this unwritten pact by wasting at least $400 million on mental health reform since 2001.Knowing that, the federal government's Centers for Medicare and Medicaid Services did well to punish the state by withholding $175 million in federal funding from community support programs during the last three months of 2007.We wish the state had gotten a warning before the money disappeared because reforming the system will likely require money. But the punishment is justified.We just hope the loss of federal funding will incite state officials to revamp a mental health program suffering from innumerable ailments.In 2001 evidence indicated the N.C. state government leaned too heavily on state psychiatric hospitals, and legislators responded by enacting reforms to treat more mental health patients in their own communities rather than the state's four overcrowded hospitals.Under the new system, private health care providers replaced local governments in the delivery of mental health services.The community support program, intended to cost the state less than $5 million per month, soon cost more than $50 million because of bloated private health care bills, money-hungry providers and a government that seemed to ignore it all.Shockingly, many of the health care workers employed by private companies to provide services to the community had little or no experience in the field and no college diploma.Regardless, the state paid these workers as much as $61 per hour for services deemed "unnecessary" 89 percent of the time by a Department of Health and Human Services review.Rather than delivering useful services to patients in need, providers often took clients shopping or to the movies, all at the expense of N.C. taxpayers.While private health care providers cashed in on this faulty system, the state's 210,000 residents who seek state help each year received worse service.From March 2006 to January 2008, the government spent $1.4 billion on the wasteful community support programs and only $78 million on services statistically more effective at decreasing the chances of hospitalization.Luckily, the federal funding is being taken from the community programs. In this case, less is probably more.

Asheville Citizen Times
State to replace juvenile centers
by Jordan Schrader
published April 19, 2008 12:15 am

RALEIGH – Unlike its larger and more violent neighbor in Swannanoa, Buncombe Regional Juvenile Detention Center doesn't tend to make headlines.
But like Swannanoa Valley Youth Development Center, state officials say, the short-term youth lockup on Asheville's Lee's Creek Road is old and unsafe.
"It's been a maintenance nightmare forever," said Sen. Martin Nesbitt, D-Buncombe.
It's time to bulldoze the facility, juvenile justice officials told lawmakers this week. They want to spend more than $13 million to tear down and rebuild three of the state's nine Detention Centers, temporary holding places for youth facing criminal sanction.
An updated facility could help prevent incidents such as a December attack on two staff members.
A counselor facing a violent juvenile Dec. 14 reported taking a hit to the mouth and an elbow to the eye, while another employee helping wrap up the youth was struck in the face and back. Within an hour of being shackled, the boy had broken free of his leg irons and was shouting from his room threats to kill the counselor.
The counselor watched the boy's fury for nearly three more hours until deputy sheriffs arrived to take him to the adult jail, the kind with cells, guards and career criminals.
"When kids come to detention, they're more unpredictable" because they haven't undergone mental health assessments that are available at other state facilities, Buncombe director Debby Burchfield said.
"They come in off the streets, essentially."
Triple-bunking, lack of technology
The Buncombe jail was built in 1953 as a sanctuary for runaways and today holds just 14 juveniles. The state wants to replace it with a 24-bed unit.
A state report envisions 24 rooms separated by living areas encircled by security fences. It would have three classrooms, a room for family visits and space for appointments with mental health care professionals, social workers and court counselors — all watched over by cameras.
It would be a far cry from the current design of the jail, which makes it hard to keep a close eye on the young but often dangerous inmates.
The building's seven bedrooms are perpetually double-bunked and occasionally triple-bunked, Burchfield said. Youth must be taken from their rooms to use the bathroom. The wooden doors lack electronic locks.
There is a perimeter fence, but no security cameras, and an intercom needs replacing.
The new building would probably go up on the same site, said Michael Bryant, director of juvenile detention services.
Statewide overhaul
The Buncombe site is in the worst condition of the detention centers, but those serving the Wilmington and Fayetteville areas also need to be rebuilt, according to the report.
Cumberland Regional Juvenile Detention Center should relocate to a less crowded area, Bryant said.
Sports fans drop by hoping to pick up tickets to watch the Fayetteville FireAntz play hockey or the Fayetteville Guard play arena football. They're told they want the building next door, Crown Coliseum.
If lawmakers agree, the projects would join a lengthy plan for new juvenile lockups whose construction will long outlast the Easley administration.
State officials Thursday dedicated the first of the state's new Youth Development Centers, in Chatham County. Three more open in May.
Another is in the works, and legislators will be asked in the session starting next month to fund four more, an overhaul that began with a 2003 state audit sparked by violence at Swannanoa that found the youth prisons had substandard buildings.
"Money's going to be tight," said budget co-chairman and Rep. Mickey Michaux, D-Durham, on prospects for new buildings. "We're just going to have to take a close look."
It will be up to Gov. Mike Easley's successor to pursue construction of a promised 32-bed unit to replace the Swannanoa center, whose old property on Old U.S. 70 is being turned over in stages to an adult women's prison.

Action for NC Children Updates

Greetings,
Below are summaries of articles related to child well-being in North Carolina. Also provided are links to each article's full text.
GENERAL NEWS & INFORMATIONHEALTHSAFETYEARLY CAREEDUCATIONCHILD MALTREATMENT
GENERAL NEWS & INFORMATION
Last chance to register! Register now for Action for Children's "Research Brain Development Research & Implications for Public Policy" lunch forum on Tuesday, April 22, 2008, at One Eleven Place in Cary. Visit http://www.ncchild.org for more information and registration instructions.-------------------------------

HEALTHUNC Daily Tar Heel
http://media.www.dailytarheel.com/media/storage/paper885/news/2008/04/17/StateNational/N.c-Health.Care.fragmented-3330871.shtml
"N.C. health care 'fragmented'"By Ariel Zirulnick, Assistant State & National EditorIssues of mental health might have dominated North Carolina's media recently, but the state health care system has a host of other problems to face."We have a fragmented health care system that has not been adequately invested in over the years," said Marcus Plescia, chief of chronic disease and injury for the N.C. Division of Public Health. "It's hard to get resources for these vulnerable populations."The agency's 2008 task force report cites five focuses: basic public health services, chronic disease, children and family health, communicable disease and funding issues.The state's mental health system is also struggling. "The incoming governor is going to have to sort out issues with the North Carolina mental health system," Plescia said. "The system still seems to not be working as well as it should."The new governor might also have to grapple with gaps in insurance coverage. The State Children's Health Insurance Program, a federal initiative to cover uninsured children, faces a potential funding cut."With SCHIP being up in the air states are scrambling to make up for that," Plescia said.--------------

Chapel Hill News
http://www.chapelhillnews.com/front/story/13909.html
"System failure looming"
By Mark Sullivan
Eight years into mental health reform, North Carolina has thus far dodged a bullet. Much of the postmortem on the origins and unfolding of the reform effort has been done. But how much worse can things get, and what will it take to bring about real and meaningful change?If recent developments do not mark a turning point in reform, the turning point will be marked by tragedy on a massive scale.Consider that after all of this time, just three of 24 (12.5 percent) local management entities (the organizations charged with ensuring needed services are available) in North Carolina are meeting minimum standards for routine care. Just 45 percent are meeting minimum standards for urgent care. How bad must things get before we are willing to re-think the fundamental assumptions that the new system was founded on?North Carolina ranks near the bottom in the nation in per-capita funding for mental health care at $16.80, compared to the national average of $91.12. Yet our problem is much bigger and more complex than under-funding. After the first six months of the fiscal year, the Division of Mental Health, Substance Abuse and Developmental Disabilities reported that only 30 percent of mental health funds and 20 percent of substance abuse funds that had been budgeted had been expended. On the surface it might look like the system is over-funded, but what these numbers signal is that needed services are not being provided because they are unavailable.A core problem with the new system is that it was built upon a fundamentally flawed assumption that the private sector will always outperform anything run publicly. It is a wildly popular notion and a key reason why this particular plan was able to gain support in North Carolina.The private sector is far superior in many arenas, but not necessarily when it comes to protecting the poorest and most vulnerable members of society. Private providers pick and choose which services they will provide based on what will best meet the needs of the agency, as opposed to public entities whose first responsibility is to meet the needs of the citizenry. Departments of social service, child protective services and health departments are county-run, why not mental health? --------------
Goldsboro News-Argus
http://www.newsargus.com/news/archives/2008/04/13/two_new_shots_required_for_school_this_fall/index.shtml
"Two new shots required for school this fall"
Changes to the state's immunization rules will require a number of children and teens to be vaccinated before the start of the next school year.A booster dose of Tdap -- tetanus/diphtheria/pertussis -- vaccine will be required for three age groups: Students entering sixth grade in the fall, or who are 12 years old on or before Aug. 1, provided five or more years have passed since their last tetanus/diphtheria vaccine, and individuals enrolling college for the first time on or after July 1, if the vaccine has not been received within the last 10 years.The change also impacts the mumps vaccine, with a second dose required before enrolling in school, college or university for the first time. However, any child entering school prior to July 1 is exempt from the requirement.School officials and health care providers' biggest concern at this point is getting the word out and avoiding a last-minute rush to get the vaccine over the summer.Allison Pridgen, director of student support services for Wayne County Public Schools, said the district is working closely with Goldsboro Pediatrics and the Health Department to publicize the changes."We're kind of batting around some different ideas of what might work to get the information home to parents," she said.As a district, officials are also discussing what the ramifications and consequences will be for those who don't comply.Ideally, Mrs. Pridgen said, area pediatricians would like to see the bulk of the vaccines given before the summer months, when kindergarten assessments consume a lot of appointments at doctors' offices.The Health Department is also making sure the vaccine is available for anyone who needs it, said Health Director James Roosen. -------------------------------

SAFETYDaily Southerner
http://www.dailysoutherner.com/local/local_story_101110840.html
"Doctor: Hug, don’t shake children"
By Bob Benedetti, Staff Writer
If the saying "life is fragile" holds true, then the life of a baby is extremely delicate. That's why babies need gentle care – and can't afford to be shaken.It's part of a message from experts at the University of North Carolina at Chapel Hill Injury Prevention Research Center and School of Medicine who is taking on a statewide shaken baby prevention project.Health care professionals in Edgecombe County take the message that seriously, too.Dr. Ada Williams-Wooten, a Tarboro pediatrician of 22 years, has served thousands of young children, including babies, during her tenure. She realizes how important it is to "protect them from head trauma" due to being rattled about.According to lead investigator Dr. Heather T. Keenan, research assistant professor of social medicine at the UNC School of Medicine, it is one of the leading causes of death due to child abuse in the state. The UNC-Chapel Hill study found that an estimated 2.6 percent of children in the North Carolina were reported to have been shaken at some point before the age of 2.Shaken baby syndrome (SBS) refers to injuries found in babies or young children who have been shaken. Subdural hematomas (bleeding on the brain) and retinal hemorrhages (bleeding behind the eyes) are the two main factors for determining whether or not a child suffers from SBS.Williams-Wooten gave a chilling explanation of the child abuse that occurs in more severe cases; rib fractures or long-bone arm fractures may also be found. In some very severe cases, shaking "is sometimes accompanied by throwing the infant onto a hard surface."This is called Shaken Impact Syndrome (SIS) and indicated by skull fractures in addition to other damage. Facial bruising or bruising on other grip-point parts of the body can occur with SBS/SIS depending on the severity and duration of the shaking.--------------

Kinston.com
http://www.kinston.com/articles/child_45718___article.html/safety_babyproofing.html
"Protect babies from your home"
Babyproofing should be done before an infant begins to crawl - about 6 months old - and continue until a child reaches an age that a parent can trust him to follow commands.Children are fast and often it is very difficult to anticipate what a child is going to do next. Babyproofing is only designed to slow babies down and give moms and dads a few minutes to figure out what the baby is doing.Putting gates up at the top of stairs, for example, could prevent a catastrophic tumble during those seconds when a toddler scampers away after a parent is distracted. Securing cabinets where a toilet cleaner, rubbing alcohol or other toxic solutions are stored will keep the child from getting into it after he or she has somehow eluded adult supervision.Unused electrical outlets should be covered with safety plugs approved by Underwriter's Laboratories, a nonprofit consumer safety organization. Place the plugs where outlets are accessible to babies, particularly in family rooms, kitchens, dens and the baby's own room. It is recommended that swimming pools have 4-foot-high fences completely surrounding the perimeter. There should be no direct access to a pool from the home's rear door.Parents need to be ready to jump up and physically intervene if necessary on a moment's notice. -------------------------------

EARLY CAREGaston Gazette
http://www.gastongazette.com/news/skills_19235___article.html/kindergarten_students.html
"Preschool provides strong foundation: Tips on choosing a quality preschool or day care center"
By Amanda Millard
Today's kindergartners learn what used to be first-grade skills.That makes establishing routines and boundaries before coming to kindergarten important so the focus can be on teaching skills."Without a good foundation, they're not going to be ready for school," said Linda Bennett, director of the Cline Learning Center in Dallas.A stronger foundation early in life also means more success later on, said Eileen Yantz, early childhood program coordinator at Gaston College."They tend to learn to read easier and quicker," Yantz said.Preschool can also build social skills along with motor skills."One of the main things we see here is the socialization," Bennett said. "A lot of children have not had a lot of interaction with other children."Early childhood education can be a stepping stone to kindergarten."Some students will be fine. Some students will be able to walk into kindergarten and be able to develop on par with their peers," Yantz said. "Sometimes they can flounder in kindergarten."Students who struggle in kindergarten may find school less appealing and view school as a chore, Yantz said.No Child Left Behind rose accountability standards when testing began in third grade. That brings a focus to the beginning grades so students develop the skills they need to be successful in third grade.North Carolina has a star-rated child care system. But parents shouldn't rely solely on the star rating system to make a decision."Don't ever judge it by just the stars. Always go in and tour," Bennett said. "You should be able to go into a day care any time."--------------

Winston-Salem Journal
http://www.journalnow.com/servlet/Satellite?pagename=WSJ%2FMGArticle%2FWSJ_BasicArticle&c=MGArticle&cid=1173355248551&path=%21living&s=1037645509005
"ANGER: Parents should talk to children about it"
By Melissa Kossler Dutton, The Associated Press
Even little children can be full of big anger.That's the lesson parents should take from the third-graders suspended from a Georgia elementary school after being accused of an elaborate plot to restrain and attack their teacher, childhood-behavior experts say.Third grade may seem awfully early for children to harbor such thoughts (and some experts say they doubt that these children would have gone through with it), but a child who doesn’t know how to properly channel anger may be susceptible to such behavior, say anger-management experts who deal with children.Parents need to help their children manage their anger, talk about right and wrong and monitor their children’s behavior, the experts said - even at a very early age."Say, 'It's OK to have feelings of anger, but it’s not OK to hurt people,'" said Lea deFrancisci of the Child Study Center at New York University.If a child says he wants to hit his teacher, a parent should follow up with questions and a lesson on proper behavior, she said.Parents shouldn't worry that talking with their young children about negative feelings will have a negative impact, deFrancisci said. "You're never putting an idea in your kid’s head by asking about it," she said. "Parents can't be afraid to talk about taboo topics."During the conversation, parents need to stress the differences between right and wrong, said Lisa Pion-Berlin, the president of Parents Anonymous in Los Angeles."Hitting someone is not going solve any problems. It's not going to make you feel better, and there will be consequences, too," she said.Then the parent needs to offer a workable solution that lets the child know that his or her feelings will be addressed, she said.And remember, teaching kids how to manage emotions is an ongoing process; it’s not about just one Big Talk."Parents need to tune into their kids' emotional state," Pion-Berlin added.Don’t dismiss a child’s embarrassment over an incident at school, worries about a test grade or fight with a friend, added Andy Reitz, a child consultant with the Child Welfare League of America in Boston."When kids do get angry, adults have to take them seriously," he said.-------------------------------

EDUCATIONThe Times News
http://www.thetimesnews.com/news/school_5290___article.html/punishment_corporal.html
"Alamance schools eye ban on spanking, paddling"
By Mike Wilder, Times News
Superintendent Randy Bridges is asking members of the Alamance-Burlington Board of Education to ban spanking and paddling from Alamance County schools.Bridges and school board members briefly discussed the proposed corporal punishment ban during a meeting on Monday night.The proposed policy reads, “Believing that other forms of discipline are more appropriate with children of all ages, the Alamance-Burlington Board of Education prohibits the use of corporal punishment.”The policy defines corporal punishment as “including, but not limited to, spanking, paddling or slapping.”The proposed policy allows “reasonable force to control behavior or to remove a person from the scene” in various situations. Those include “a disturbance threatening injury to others,” to obtain weapons or other dangerous objects, for self-defense, to protect school property or other people, or to maintain order on school property or at a school-related activity.Current policy allows corporal punishment if certain conditions are met. Those include notifying parents and giving sufficient warning that misconduct could result in spanking or paddling.Bridges said corporal punishment is rarely used. Earlier this year, Charles Monroe, the system’s assistant superintendent for administration, said corporal punishment was used nine times in the school system in 2005-06. Each time was at Altamahaw-Ossipee Elementary School, he said.After Monday night’s meeting, Bridges said he thinks the school system has more to lose than gain in allowing corporal punishment. --------------

Raleigh News & Observer
http://www.newsobserver.com/print/thursday/opinion/story/1039983.html
the truth: More classroom money needed. Segregation hurts"
By William J. Barber II, president of the state chapter of the NAACP
Let's be blunt. North Carolina high schools are not serving our poor and minority students well. Only about half of black, Hispanic, Native American and poor students are able to perform at grade level in English, mathematics, science, history and social studies.In 2006, Gov. Mike Easley commissioned a High School Resource Allocation Study by education specialists Gary Henry of UNC-Chapel Hill and Charles Thompson of East Carolina University, asking them whether North Carolina could improve student achievement in its low-performing high schools by spending education dollars more efficiently.Ever since the state Supreme Court issued its Leandro decision in 2004, state officials have known that the schools they are responsible for are in violation of Articles I and IX of the state constitution. These articles mandate that the state provide every student with a sound, basic public school education......Forty years ago, on his last night with us, the Rev. Martin Luther King Jr. reminded us that when fighting for justice nothing would be more tragic than to turn back now. The Leandro ruling is one example that this is true. Its creation of a fundamental right to an effective education bears out another of Dr. King's prophesies, that the moral arc of the universe bends inexorably toward justice.For the past two years, the N.C. NAACP's almost 20,000 members from 100 local branches have organized, marched and lobbied all over North Carolina for well-funded, high-quality, diverse schools for all children. The Henry-Thompson findings, while not surprising, provide hard evidence for our position.Leandro is a matter of justice. The NAACP, joined by many other good people, will agitate, litigate and legislate to bring justice to our children, every one of them precious.--------------

Rocky Mount Telegram
http://www.rockymounttelegram.com/news/content/news/stories/2008/04/13/electioneducation.html
"Education influences ballot box: Candidates offer plans"
By Carolyn Casey, Rocky Mount Telegram
The concerns topping the N.C. General Assembly candidates' list for education don't veer far from one of the larger problems school administrations are trying to tackle.Those vying for positions during the May primary unanimously said the dropout rate needs urgent attention.The question is: What is the solution?N.C. House District 25More funding, parent involvement and vocational skills might hold the key to decreasing the number of students leaving high school, the two Democratic candidates said.If schools offered more vocational and technical skills there might be fewer dropouts, Carnell Taylor said. The idea would not only decrease the number of dropouts but also would reach a wider range of student interest and prepare high schoolers for a more realistic workforce because not every student is going to be a doctor or lawyer, he said.Taylor's opponent, Randy Stewart, said the state's designation this year of $7 million for dropout prevention programs is a good start and follows a path of funding he would like to continue. In response to the Twin Counties receiving little funding from the state initiative, one of his goals would be to help local school districts become more competitive with grant writing.A solution to the problem also lies within creating more in and out of school programs and strengthening the curriculum to increase student interest, he said.N.C. House District 7Both incumbent N.C. Rep. Angela Bryant, D-Nash, and her opponent Jean Reaves said curriculums need to be amended and more services need to be available.There needs to more programs that target at-risk students, said Bryant, who sits on the Joint Legislative Commission on Dropout Prevention and High School Graduation. In order for intervention to happen, the schools and public and private sectors must work together.To better understand what happens to teens once they drop out, Bryant would like to see a uniform database between the school systems, social services, juvenile justice and various agencies to track students, she said. Once a student drops out, the N.C. Department of Instruction doesn't know whether or not they end up at a community college or in jail, she said.In school, a varied curriculum that uses more technology and special programing like the performing arts and technical education needs to be added, Bryant said."Children are saying they're bored," she said.Along similar lines, Reaves said the dropout rate needs to be addressed with long term and permanent solutions because special projects haven't been as effective."If we're going to allocate dollars to education we need to look seriously at allocating dollars to correct the problem and not just the special programs," she said.Programs like the cultural arts need to be implemented because they expand upon creativity, learning and self esteem, she said."I truly believe we have taken the arts and character education out of elementary school," Reaves said, which are the grade levels that need to be targeted for early intervention.--------------

Rocky Mount Telegram
http://www.rockymounttelegram.com/news/content/news/stories/2008/04/15/funding.html
"Legislators pledge to seek more school funding"
By Tom Murphy, Rocky Mount Telegram
State legislators and area leaders called for unity to help find and provide the resources to fund the needs and opportunities to launch all children as lifelong learners during a State of the Child Briefing Monday.The event, held at the Down East Partnership for Children, also focused on building the future work force for the 21st Century.N.C. Sen. A.B. Swindell, D-Nash, who was joined at the event by N.C. Reps. Joe Tolson, D-Edgecombe, Jean Farmer-Butterfield, D-Wilson, and Angela Bryant, D-Nash, said Nash and Edgecombe counties have a good legislative delegation that works hard in the education area."We communicate often," Swindell said. "If we don't work hard to see where we really are, it's hard to tell where we're going."We are on track in North Carolina to do greater things for children."Legislators realize that more money is needed to educate children and are looking at increasing funding, Swindell said."The General Assembly recognizes we have work to do and are trying to target money to do that," he said. "Even with all the ills we have (in the education arena), North Carolina is looked at nationally as a real leader, especially when it comes to early childhood education."Just as the price of food has increased significantly in the last three years, so has the cost of education, Swindell said. More money is needed to fund programs for disadvantaged and poor students and for agencies like the Down East Partnership for Children that serves those children, he said."We do believe we're doing the right things," Swindell said. "You need to stay in touch and let us know how you feel because it's so important to involve the total community if we are going to improve the life of children in Nash and Edgecombe counties."Bryant said more funding is needed to address the high school dropout issue, to provide more child care and to assist teen mothers.An upcoming vote on a sales tax increase in the Twin Counties is an opportunity to raise money for education, Bryant said.-------------------------------

CHILD MALTREATMENT
Asheville Citizen-Times
http://www.citizen-times.com/apps/pbcs.dll/article?AID=/20080413/OPINION03/80410105/1006/opinion
"To reduce sexual assault, we must do much more to prevent child abuse"
By Dr. Stephen Snow
April is a difficult month for memories. It is for some, as T.S. Eliot noted, the cruelest month.It is recognized as both Child Abuse Awareness Month and Sexual Assault Awareness Month. And although these two terrible crimes have in common that they are assault-based, they have something even more disturbing at their nexus:Males.Men commit most of the sexual assaults in this country, and those men were most likely abused as children. This is not an opinion. This is based on solid research. I say it not to excuse behavior but to understand it better. Understanding can lead to treatment, which can lead to change and prevention, and less repeated crime.Gender differencesThe research suggests although women (mothers, mainly) commit the majority of child abuse, young girls are not as likely to commit sexual assaults. Abused boys, however, are much more likely to abuse and sexually assault if they have been abused as children. Both are more likely to be traumatized as adults if they were abused as children.If we want to reduce sexual assault, then we must be far more aggressive in preventing child abuse. This is true not just in the United States, but around the world."Child abuse is one of the fastest-growing and most serious problems facing mental health practitioners in contemporary Japan," said psychologist Junichi Shoji in The Japan Times recently. The government is moving way too slowly, he said. "We sense very little progress in policy."Statistics vary, but child abuse is clearly an international epidemic. One of the least-addressed emotional difficulties is the pervasive, persistent impact of this chronic psychological trauma — the result of a daily, even hourly, experience of fear and terror that comes from being in terrible, abusive living situations.--------------

Hickory Record
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"Children in trouble need advocates"
There are children among us who desperately need advocates. We see the need routinely in the news - across the nation or right here at home.The Guardian ad Litem program is one way to stand up for children who can’t stand up for themselves.The program is an all-volunteer extension of the court system. While adults have legal representation, children do not have the wherewithal to retain counsel.That’s where the Guardian ad Litem program comes in. The “guardian” represents the child in abuse and neglect proceedings. The volunteer representative has standing in court. In fact, they are appointed officers of the court.They must work within the law, but volunteers’ only obligations are to the children they represent.Gov. Mike Easley has proclaimed April as N.C. Guardian ad Litem Child Advocate Month in recognition of the program’s 25th anniversary.According to the governor’s office, volunteer advocates have donated nearly 900,000 hours of service to children in all 100 counties, but more volunteers are needed.The need for child advocacy is greater today than when the guardian program began.Statewide, 64 offices, approximately 100 attorneys, and more than 4,614 volunteer Guardians ad Litem work as a team to represent 17,701 children.Folks, that’s simply not enough to adequately represent all children who need help.

Thank you,
Action for Children North Carolina