Friday, May 13, 2016

Why we need an ombudsman.

I want to take the time to explain something to the public, due to comments I have received because of a comment left by one of the volunteers.

When a person in Michigan gets their rights and freedom taken away from them, via Judicial due process, and they get sent to Jail, they have an Ombudsman to represent them in disputes with government officials.

At the Veterans Home, when a State Guardian is imposed on a veteran, usually after a different form of judicial due process, there is NO ONE to represent the veteran in disputes with government officials or the guardian. The Veteran becomes a virtual prisoner to the will of the guardian.

2 cases here, clearly show the reason we need an Ombudsman for the Veterans.

Case 1, Ron Stowitts. He and his wife Cathy are active on the face book page. Let me tell you about Ron's case.  Ron would come down to the pavilion in his wheel chair, and sit there quietly reading a book, having a smoke. Rons family has a medical history of a condition that can be treated with drugs, but Ron was NOT showing any signs of having this condition. Yet the home insisted he take a drug he did not need, as a preventative action. The drug made Ron feel weird and out of touch, so he quit taking them and then refused to do so. The home got upset and tried to impose a guardian on Ron so they could force him to take the unneeded medication. Tears came to his eyes as Ron told me the home had tried to get his wife Cathy to sign off on getting him a guardian against his will. He told me twice he had to go to mental competency hearings where he had to prove to an administrative judge that he was fully capable of making his own health care decisions. Both times Ron came out the winner. It upset him that the home was trying to take away his freedom and force him to take a drug he did not need. And we should all question why did the home try to force Ron to take an expensive drug that he did not need?

Soon after, due to an accident, Ron managed to "escape" the nightmare of the home, and is now living free and doing better from what I hear.

The next case was not so lucky. The home killed my friend Richard Ware by forcing him to take Depakote when he did not need it, and had proven he did not need it.  Richard stop taking the drug without informing his care givers. He would spit the pill out after he made them think he took it. This went on for a period of time, 3 to 6 months. The staff said he was improving greatly at the time. They had no clue he had stopped taking the drug  - one that he did NOT need.  Well, a trip to the local hospital for tummy flu or something and the blood work showed he was NOT taking his drug. The caregivers at the home found out and they Forced him to take it,  and threatened to take away his power scooter if he refused.  That too is wrong.

In other words they were abusing Richard by threatening to take his personal own property from him, if he refused to obey them. THIS was not right.  But Richard had no choice. He was property, owned by Cynthia Thornberry, the state imposed guardian (at the request of Richards counselor Karen Fugi.)
He died less than 45 days after being forced to take the drug he did not need.  A drug prescribed by a doctor who I am told, at the time did not even have a proper state license to prescribe such drugs.

In both cases, the Veteran had no one to assist them. No one to speak for them, No one to help them.

Changing the administration is NOT the solution. Changing the administration may lead to some improvements but it is just part of the over all solution to providing the care these veterans deserve.

Only by giving these veterans a voice, will things change the way they need to. And that change must be made to happen via an ombudsman.

Thursday, May 5, 2016

Ombudsman for the Veterans – we need to be specific to the legislature as to what we are asking for.

What you are about to read is a collection of parts of conversations that have happened in recent days. Some of this is cut and paste from emails, some of it is what I have written from the conversations I had on the phone.  

I am posting this here, so that folks can see what is happening and why we need to move CAREFULLY and be sure of what it is we are asking the State Legislature for. My comments, the Blog author comments are in [ ]’s.  This is parts of several conversations.

OK want to update you on some conversations I have had re an ombudsman.  Someone said something about prison ombudsmen that got me thinking and making calls.  Like, let's stop wondering how that works and ask!  Well apparently a few people have done this, including members of the legislature, trying to get ideas. The Prison ombudsmen people welcomed the inquiries.

During the hearings, American Legion said it would cost $250,000 to $500,000 for an ombudsman -- that seemed a tad high.  Meanwhile, Winnie Brinks told me yesterday that the House asked for $150,000 for that in the pending budget going to the Senate.  That is a big difference.

So, several folks have talked with legislators and ombudsman organizations to figure why the difference and what we should be asking for. Bottom line, I now believe it is in the best interests of the Home residents to ask for more and be part of an ombudsman organization that already exists.  

Would appreciate your opinions.  Following are the reasons and considerations used to come to that conclusion.  

In a nutshell I was told:  the $150,000 would get us one person.  That amount would cover salary, benefits, office, supplies, travel, investigations......   the ombudsman does the talking, does investigative work, works to resolve the issues, stays on top of legislation and laws impacting the area covered...  And, in this case, the person would need to knowledgeable in health care, veteran issues/rights, food service, guardianships, and more.....a lot areas for one person to be experienced in, manage ongoing training (since the field is constantly changing) and do the job.  That person would also have to do all the investigative work -- which can be time consuming -- alone.  There would be no backup during vacations, illness, meetings......

The higher amount ($250,000+) would get us an ombudsman and one or two analysts.  Was told also getting analysts is critical.  An analyst would cost about $45,000 but that amount is then doubled to cover benefits, training, expenses.....  I was told analysts are critical because they do the investigations and time consuming work - freeing the ombudsman to work directly with clients/patients, negotiate and get results.  They can also keep projects going while the ombudsman is out (for whatever reason).  They also free up an ombudsman to do things like more investigations.  Like s/he could investigate at least one area a week and follow-up as opposed to one quarterly or yearly investigation.

This also raised more questions we need to consider:  is one person sufficient for the needs at the Home?  Would we better asking for a team (ombudsman with analysts)?  And should this person or persons work with already established ombudsman agencies?  
A Volunteer mom asked an interesting question to the effect "what do the prisoners get?" (Good question!)  So....yesterday I reached out and had a long, wonderful, informative conversation with a prisoner ombudsman.  VERY eye opening.  He already knew who we are and what we are doing.  Seemed very eager to work with us. (This should not surprise anyone, they are probably wondering what has taken us so long? LOL).

I learned there are seven ombudsmen for the Michigan prison system and a team of analysts. [Remember, there are over 100 Prison facilities, and only 2 Veterans facilities at this time, so that might put a damper on what the legislature is willing to give us.]
The Prisoner ombudsman budget is $714,000, I was told by the person who does their budget process.  He said by having a team, the costs are spread out and not one big hit.  He talked about the costs we need to consider in addition to salary and benefits:  travel expenses, supplies, office, equipment, ongoing training......

He also talked about the critical need to bring in people who have PROVEN and DEMONSTRATED experience already, as opposed to a person coming in new.  In other words, that person MUST have experience in multiple disciplines as mentioned above.  Failure to do that will waste a lot of our time and not be as productive as we need that person or persons to be.

[ I think we all got a taste of what its like to hire someone UN-Qualified, with no experience; her name was Sara Dunn. That is why this step is critical and I agree, it must be someone who has already worked in the field, and has shown they have the skills to do the job.] 

He did say the prison system has been contacted by and is already working with top legislators on the issues at the Home, including the Speakers of the House/Senate.  Because many of those who are incarcerated are veterans, that system is already trained and aware of their issues/rights....many mirroring Home residents' issues/rights.  While our current Home ombudsman team consists of some good people, they also appear to have a higher ratio of ombudsman to constituents than the prison system.  ( We need to confirm if that is fact or just his opinion.) And, while knowledgeable, he felt the prison ombudsman system may be better qualified for what Home residents need.  [What ombudsman? Do you mean Lino Pretto, the board of managers’ member whom the board president Earnest Meyers appointed to do that job?]

[If the Prison Ombudsman is better qualified, lets hire them then, or better yet, get one of them assigned to both vets homes and the vets in the prison system, making that person a veterans specialist Ombudsman. That sounds like a better idea.] 

He said he studied all the proposed ombudsman bills. Both are ok and well-intended.  However, he said while they seem alike, they are very different. He advised us to do the same as he did, study them and decided which serves us best.  
He stated he believes McGregor took the prison ombudsman legislation, cut, pasted and created his version to mirror that.  So, McGregor's proposed bill address a longer term set of needs, a bigger picture. He said he believes Brinks put together what we asked for:  one ombudsman to fill immediate consideration for analysts, etc.  It shows she listened to us then acted, but maybe we need to ask for more? He said both have a place and purpose.  Advised us to look at the differences carefully and rethink what we need.  He did not believe one ombudsman is going to be enough to fix issues at the Home.  He advises us to also ask for analysts or a team.

We also need to pay extremely close attention to the accountability of whomever we get, he stated.  As an example, it may be harder to hold accountable one person given strong range, as opposed to a team that keeps each other in check and is mandated by law to be more accountable.  He also stressed current ombudsman organizations have high accountability by law. 

The man I spoke was really informative and most helpful -- eager to work with us.  He is a lot like me and his career seems to parallel mine.  Specifically, like me, he is not a veteran.  He has worked closely with national and state level Vietnam Veterans of America and other veteran groups over the years, he claims.  However, he said he began noticing a lot of veterans coming into the system after Korea and more so after Nam.  Now, the younger vets have even different responses and needs.  Years ago, he recognized most incarcerated veterans seemed to have different triggers, needs and backgrounds than the general prisoners.  So, he took it upon himself to educate himself on the unique needs of veterans and has been dedicated to creating special programs for them.

Again, he did advise he is already working with major legislators on many different committees (even some we are not already working with -- which I find fascinating) to structure a sound ombudsman system for the Home.  He said there is intense interest in this in Lansing and intent to do something this time around.

Now, I also talked at length with the current ombudsman group.  This one mirrored many of his thoughts.  However, this one seems more experienced on patient care, aging patients. Like him, they stated we would highly benefit by working with an experienced team -- for pretty much the same reasons.

As he and they stated, we need to consider who currently has the higher load and what are our exact expectations? In other words, what is are the different ratios of ombudsman/analysts to clients/patients?  I recall the ombudsman before Kay said he had to cover 19 facilities -- that left him little time to do enough.  What specifically do we expect this person or persons to do for us?  How often?

The prison guy said there is already serious dialog in Lansing about the Home partnering with the prisoner system -- renaming it to serve both populations.  The main question there -- is that best for the residents?  I felt it may be a good thing.  Yet, the other side, would there be a problem doing so?  Some would say veterans served with honor while prisoners are the opposite. Yet others would recognize many prisoners are vets who did not get proper care or help. [Another good point]
After discussing all this with legislators, current ombudsmen and ombudsman groups, this appears to be a much bigger and more complex situation than it appears on the surface.    Am interested in your opinions and thoughts on this.  But, one thing for certain, we need to address this quickly and then push the legislators one way or the other.  IMHO.

[Agreed this is much bigger than we first thought. The guy just wanted a voice for veterans but we have to do this the right way or it will just be a waste of time and money. And we cannot let up the pressure on the legislature. Already I am seeing signs they want us to back off, to let things ‘slide” for a while, I think so that they can sweep it under the rug. I made it clear to them, we are not backing down and if anything, we will be ramping things up if we do not see timely results.]

Monday, May 2, 2016

New Idea, same problem, but no real solution?

After talking with several people in Lansing, it has come to be my own opinion, that the only real solution to the lack of enough properly trained caregivers, will be to reduce the population at the Vets home and open another smaller one on the east side of the state so that healthcare workers can be drawn from that area to provide services to the vets home to be built there.

Currently Michigans 2 Vets homes draw on qualified people from the 2 metro areas they are in, which means there will be a limit to the number of qualified people available, due to the fact that the home has to compete for these people with private nursing homes, and retirement communities.

Research of some of the other 49 states show that dispersing the veteran population into smaller homes, gives the veterans a higher standard of quality care. Better food services, better administration and better health care.

Warehousing them into one big facility may have worked in the past, when veterans themselves helped to maintain the buildings, and grounds, and kitchens, but that is no longer the standard. Todays standard is the fact that even qualified vets in the Dorm unit who could help out, are not allowed to, except for minor jobs such as sweeping up the outside side walks, or pushing a cart of material from one place to another. These vets are not allowed to help maintain the grounds or do other such kind of labor which would benefit them and the home.

The current proposal from Lansing is to have 3 care giver services working at the home, with each one assigned to various units. For example, one would specialize in providing care for people in the lock down units such as the Alzheimer units, and court yard.  Another would be responsible for nursing units in the McLiesh building and Rankin 1.  And a 3rd would be responsible for the nursing units in the Mann building. Ranking 2 and 3, which is the Dorm unit would continue to have a state employed nurse (probably Cathy) and one other to be assigned to a 2nd shift position, as there is no need for care givers to be on that unit.

That might be a good idea, removing some of the responsibility from J2S, but it does not address the problem of lack of the number of available qualified employees to draw from, from the Greater Grand Rapids and Kent county areas.  Only reducing the population and thus the need for greater numbers of qualified employees, would address that problem, thus the need to open a 3rd home on the east side of the state near the Detroit Metro area. 

One glaring fact remains: The veterans homes have been Underfunded for too long. The home in Grand Rapids needs a budget twice as big as the current one to make up for short falls from previous years, so that badly needed maintenance can be completed, food service and living conditions improved.