. Pretty good, hard-hitting football game in cold temperatures.
The Pack definitely got a break on the controversial safety call, considering the fact that replays clearly showed offensive holding in the end one. What I don't understand is why the Lions didn't review the play after it was reversed to see if Samkon Gado was down before he got off his "pass".
.........Rough version of my perspective on mental health reform in North Carolina:
So far, mental health reform in North Carolina has not gone smoothly.
A report card recently issued by the North Carolina Psychiatric Association (NCPY
) said that mental health reform “ran into a perfect storm’ of adverse events: unanticipated budget problems, shortfalls in Medicaid, increase in population, more medically indigent (non-Medicaid) consumers needing care, less bridge funding than anticipated, community hospital capacity not increasing (and in fact hundreds of bed being closed over the past decade), and the loss of public sector clinicians (especially psychiatrists).”
In a recent two-part series, the Winston-Salem Journal painted an equally unflattering picture
“The massive overhaul of the state’s $2.3 billion mental-health system began with the best intentions,” the Journal wrote. “But four years into the overhaul, there is little proof that treatment has improved, and there is growing evidence that the state’s complex system of care is worse than ever.”
In January 2001, state legislation was introduced to reform mental healthcare by returning its governance and operations to the counties. But the effort to streamline mental healthcare has only added another layer of bureaucracy.
Many feel the entire legal, financial and service structure of North Carolina’s mental health system is being profoundly altered. Nonprofit agencies that offered mental health services to county residents have now become local managing entities (LMEs). Each agency must submit a local business plan to North Carolina Department
of Health and Human Services Division of Mental Health, Developmental Disabilities and Substance Abuse Services, after which the state recommends different divestiture options.
Many of the state’s 30 LMEs
are in a state of confusion right as they struggle to make sure it’s both economically and clinically feasible to divest themselves. Divestiture of clinical services at LMEs is a complicated affair. LMEs not only have to ensure private contractors are offering services to patients, but also must deal with matters such as asset transfer and annual leave for employees.
LMEs were supposed to receive financial assistance to aid in the process as the state began closing beds in psychiatric hospitals, a move that would save about $50 million, according to the Journal. Hospitals are gradually trying to move away from primary care as more and advances in treatments and drugs are made. People with manic depression who would be hospitalized 20 years ago are now able to function in society.
But according to NCPY, admission of adult patients increased 23 percent since 1999 with a dramatic rise since March 2004. Admissions of child and adolescent patients have increased dramatically in August 2003, nearly doubling between in three-month phases in both 2003 and 2004.
In a memo to LME directors around the state, J. Michael Hennike, the division of mental health’s interim chief of state operated services, let directors know that the spike in hospital admissions would have a profound effect on their budgets.
Based on the increase in admissions, the division said it not be able to close beds until 2006, a modification that not allow funding for an expansion of community mental health systems.
“We are hopeful that as those programs that have already been funded become operational, admissions to the State hospitals will decrease. As this occurs, we will reevaluate our ability to fund additional mental health community expansion proposals,” Hennike wrote.
There’s considerable doubt among many that the new 488,000 square-foot Central Region Psychiatric Hospital, scheduled to be completed in 2007, will have enough beds to satisfy demand.
In the meantime, LMEs and their private spinoff companies are definitely feeling the financial crunch.
In its series, the Winston-Salem Journal reported “ on the fate of HopeRidge Centers for Behavioral Health, the spinoff company of CenterPoint Human Services, the mental-health agency serving Forsyth County and surrounding areas.
In a letter outlining the contractual obligation with Hope Ridge, CenterPoint stated it disagreed with legislation to reform the mental health system because it would “alter the legal, financial and service structure of all area authorities as a reaction, in part, to the failure of some area authorities to meet established performance expectations.”
Still, CenterPoint pressed ahead with its local business plan to contract with Hope Ridge and finalized it in April 2005. In September, HopeRidge was bankrupt.
Another private contractor, Telecare, informed its client, Crossroads Behavioral Healthcare, that it would no longer be able to treat its patients, who live in Surry, Iredell and Yadkin counties.
Officials at Telecare told the Journal it had lost $700,000 treating Crossroads’ clients.
“I guess we’re also hoping that the state and county will be patient with us, because we’re one of the largest providers that’s tried, and if we’re having difficulties perhaps the issue is the system needs to be adjusted,” Anne Bakar, Telecare’s chief executive, told the Journal.
On top of all this the recent budgeting process was kind to LMEs The Health and Human Services department wants to reduce the number of LMEs to 20, meaning treatment will be further regionalized. Until that goal is achieved, LME budgets will have to tighten to the tune of $28 million.
When advocacy groups such as theMental Health Association in North Carolina
(MHA/NC) voiced their opposition, the department backpedaled, saying it find the $28 million somewhere else.
MHA/NC says that for true mental healthcare reform to be a reality, both hospitals and community programs still need adequate funding.
“Reform proponents have known from the start that both systems would need funding during the transition; the freeze on shifting funds is yet another barrier to having a mental health system that meets people’s needs in their community,” the association wrote in a recent public policy update.
Saturday, December 10, 2005
......John Feinstein sells out to the man.......N.Y. Times review
of Next Man Up
, Feinstein's chronicle of the 2004 Baltimore Ravens:
"Feinstein's willingness to see things the way management does may be inevitable. As we grow older, we tend to identify with our peers, and Feinstein's peers nowadays are the people running the teams rather than the ones playing for them. This is not that different from the evolution of another Washington Post writer, Bob Woodward, who began his career knocking on the doors of secretaries and now talks directly to presidents and cabinet officials — and conveys their version of events (empathetically, of course)."
Would that be the case if Art Modell still owned the Ravens?
......How incredible is it that Grimsley's run to the state championship game features the sideline drama of the injured starting quarterback, a plot line that runs throughout football history?
Josh Stewart and Robert Lane join the likes of John Unitas and Earl Morrall
, Bart Starr and Zeke Bratkowski
, Bob Griese and Earl Morrall
(again) and, most recently, Tom Brady and Drew Bledsoe
Friday, December 09, 2005
....The theme running through last night's discussion at Fisher's: sports announcers and drinking.
Brent Musburger cited for open container in a motor vehicle
Wellington Mara's favorite Giants moment
, framed forever in his office: Pat Summerall
kicking a long field goal in heavy snow at Yankee Stadium to beat Cleveland at the end of the 1958 season.
Thursday, December 08, 2005
......Sorry for the extended blank space. My time has been occupied with matters that require practical, as opposed to abstract, thinking: drying out a wet basement, sawing up a metal swing set, learning to use the mouse with my left hand, buying a Christmas tree.
I've also been doing research for an article on our state's mental health reform. Writing such an article is going to be tough, because the Winston-Salem Journal
did an excellent job of covering the subject in this two-part article
"The massive overhaul of the state's $2.3 billion mental-health system began with the best intentions. State officials hoped to improve the treatment of more than 358,000 North Carolina residents by moving patients from the state psychiatric hospitals to community programs.
"Better yet, the plan woud get government out of the business. Care for indigent patients wouls still be paid for by the state, but most treatment would be done by private agencies that would bill the state for their services."
Bottom line: the General Assembly mandated a reduction in psychiatric hospital beds and more streamlined adminstrative functions, with the savings going toward setting up local managing entities (LMEs).
But they're two problems: the money's not there (as it seemingly never is) and there's been a spike in psychiatric hospital stays. But there's one catch, in my view: many patients checking into psychiatric hospitals have substance abuse issues which could be managed through counseling services at the local level. So the trick is to direct those patients toward the LMEs, which is where officials want to direct the money.
It's an interesting problem. As one background source told me:
"We're not going to be able to do everything for everybody. The state just doesn't have the resources."
Wednesday, December 07, 2005
.....Very, very busy lately......barely enough time to.........well, you know the old expression.....
Saturday, December 03, 2005
.....Am I the only one who found it interesting that the N&R ran an editorial endorsing the city's plan to purchase Bill Agapion's Cedar Street property alngside a straight news story that says "demand for downtown living has not outstripped supply" ?
Granted, the N&R editorial does concede that the deal would play into Agapion's hands. Yeah, I'd say making somebody richer by $1.6 million plays into their hands. But I find it odd that the paper — which has done everything in its power to get rid of Agapion — would suddenly concede. I guess the fact that it's our tax dollars on the line makes the decision a little easier.
I vote no. This is one for the private sector to work out.
.....A full day of college football conference championship games.......What if
"A Texas loss immediately opens the door for Joe Paterno to take the Nittany Lions, third in the last BCS standings, to the Rose Bowl."
An old-fashioned Pac-10-Big Ten Rose Bowl matchup for the national championship. I like it.
But what if Texas and USC lose:
"Let's just say the BCS will have a really bad day."
We can hope for chaos, although I have the feeling the BCS ranking wouldn't budge should both Texas and USC go down.
Friday, December 02, 2005
......Roberto Heras tests positive for EPO
, the second
former Lance Armstrong teammate to be busted for doping in a year.
So do these guys get from under Armstong's wing and start doping, or...........
Thursday, December 01, 2005
....I'm trying to make sense of New Hampshire abortion case that was the Supreme Court heard yesterday. NPR
broke it the story down pretty well, but I was still a bit confused. This N.Y.Times account
waits until it's three-quarters through before breaking down the case's key issue:
"Of the 43 states that require parental involvement in a teenager's abortion decision, New Hampshire is one of only five not to include an explicit health exception in the text of the statute. All the laws do make exceptions for life-threatening emergencies."
So the New Hampshire law makes exceptions for the life of the mother, not the health of the mother. But is it not reasonable to assume that if your life is in danger, then your health is also in danger?
"As much musing as questioning," Justice Steven Breyer dug into the issue:
"All you're looking to is the state of mind of the physician. Now, the problem that I think we'd see with that is you'd be writing into the law the broadest definition of what that health exception means."
The truly ironic thing is, via the NPR report, is the hypothetical medical emergencies presented by ACLU attorney Jennifer Dalvern concerned the mother's future reproductive health.
The Bush administration argued there was "literally a one-in-a-thousand chance there's going to be an emergency," and the court should not invalidate a statute with 999 valid applications.Guarino says
"...Modern obstetrics has progressed to the point that it can manage the worrisome complications that women faces decades ago. How often do we truly hear that a woman had to have an abortion because her life was in danger, or her physical health was jeopardized in a major way? It does not occur very often, because these situations are managed medically."
.....I'm certainly not suggesting that Gregory Peck wasn't a great actor
, but of all the stars on Hollywood's Walk of Fame