Tuesday, April 21, 2009

This Is So Kickass!

Welllll, welcome to da struggle, Louisiana

One state official believes the case the first of its kind in Louisiana

A gay New Orleans couple has filed a lawsuit claiming their constitutional rights were violated when they were denied a marriage license

Sunday, April 19, 2009

Spin, Lie, or Fraud?

With Jindal's administration continuing to distort reality and turn truth on its head to convince us to support its misplaced priorities, the latest directives from the governor's office can be aptly described by all of the words in the above title. Their latest attempt to convince us that closing N.O. Adolescent Hospital (NOAH) does not amount to a reduction in services took the form of an editorial yesterday in the Times-Picayune written by DHH Secretary Alan Levine.

It is one of the most dishonest opinion pieces I have ever read.

Levine tries to convince us that because the state spent millions expanding community health care services in N.O. that there is no longer as much of a need for inpatient psychiatric hospitalization (which strikes me as a point DHH wouldn't have to keep pushing if they really felt they were not REDUCING services in the N.O. area -- but that's just my crazy, bizarre opinion). True, assertive mental health services were expanded last year under Nicola's Law, according to this T-P article which also points out that there are little data to support the supposition that such services reduce the need for psychiatric hospitalization.

Such services are partly granted through various "waivers" which provide services like home health care aides who help families care for developmentally delayed individuals and those with severe behavioral and emotional problems. Something Levine conspicuously failed to mention, as he touted the hundreds of children and adults now served by last year's increase in mental health funding, is that there are many more on the waiting lists for these services. One family in our clinic has been waiting 5 years for their waiver (a VERY common wait time), yet DHH is cutting the meager funding for the waivers they provide (see page 14 of linked-to document) while simultaneously rejecting stimulus money to save healthcare from budget cuts. Another thing he left out, when saying "fewer than 15% of the referrals from the mental health Emergency Room at University Hospital are referred to NOAH," was the number of referrals that actually refers to. Also, that percentage has probably plummeted since the state already quietly closed an adult psychiatric unit housed at NOAH 2 months ago.

But back to the issue at hand: NOAH. Secretary Levine's reasoning that NOAH can be safely "moved" (DHH's euphemism) because there are more outpatient services now defies not only logic but also common sense for the same reason that having a primary physician in no way means one will never need hospitalization. Family physicians can no more treat heart attacks, strokes, and traumatic brain injury in their offices than can mental health providers treat psychiatric emergencies on comfortable office couches.

Levine insists: "Our proposal does not reduce the number of mental health beds." He forgot to add in New Orleans at the end of that sentence because when you add those 3 words to this new DHH mantra, it translates into: There will be ZERO publicly funded inpatient psychiatric hospital beds for children and adolescents by the time we get through screwing New Orleans, who by the way did not vote for Gov. Jindal...not that our decisions have anything to do with that fact. If you're a master of subtlety and reading between the lines, you might have picked up the slightly different meaning those 3 little words add.

Yup, I can spin with the best of 'em!

As for fraud, I am sad to say that Secretary Levine has intentionally tried to deceive us when he said: "less than 35 percent of the children treated at NOAH are even from New Orleans." There really is no excuse for trying to slide this piece of misleading info into the mix when just a few weeks ago Arnie Fielkow and Shelly Midura exposed DHH Deputy Secretary Sybil Richard for attempting the same act of deceipt at a city council Subcommittee on Mental Health meeting on March 27. Yes, 35% come from Orleans Parish, followed by another 40% or so from Jefferson Parish. I'm willing to bet the ones that also come from St. Bernard, Plaquemines, St. Charles, St. John the Baptist, Terrebonne, and Lafourche also would not appreciate an even longer drive than they already have to see their hospitalized children.

Honestly, I do not know why the state is putting the entire southshore in such dire straits. I'd ask them, but I doubt they'd tell me the truth anyway.