Backburner

Backburner
Photo: Graur Codrin (click photo to link)

Sunday, March 22, 2015

PROPOSAL 1: And where does the road repair come in?

Source: Muskegon Chronicle File Photo

A friend of mine has started a monthly "salon" where we discuss policy issues. The membership is still in flux, and we have many pet projects, so the discussions tend to be about pretty much everything about which we "lefties" might have a thing or two to say.  I volunteered to research Proposal 1 because I wondered how road repair, school funding, and the earned income tax credit could all be "mushed" into a constitutional amendment...and why?

After much discussion of the 7 items encompassed by the constitutional amendment (Proposal 1), we came to the conclusion that it didn’t really address road repair at all. What it does is create the groundwork for the passage of ten (10) bills by the legislature to accomplish the road repairs and other items opened up by the change in the constitution (if it passes).  We agreed that it was a complicated path to school funding, revenue sharing, restructure of the gas surcharge, and sales tax, with the incentive for progressives being the reinstatement of the Earned Income Tax Credit, and a possible incentive for the right in the removal of sales tax from gasoline and diesel fuel.  We were left wondering what the 10 bills were going to be, and what chances they had of passing?  

The lines are somewhat shakily drawn.  There is bi-partisan support for the amendment, but U.S. Sen. Peters (D) questions the proposal for its’ complexity, and wonders how a layperson is going to understand the proposal well enough to vote yea or nay.  Bill Schuette (R) our current attorney general (and potential gubernatorial candidate), has been accused of being against it to curry favor with the right wing/Tea Party camp (which he denies).  However, polls seem to indicate that votes for and against are running neck and neck with a large percentage of voters undecided.

If you want to read more, here are the links that I found to be most informative:






If you want to know what happens next (assuming the constitutional amendment passes), contact your state legislators and get some information about what the legislature would need to do to finally rearrange the puzzle pieces and get a start on the actual road repairs. If you have a yearning to write a letter or two to the editors of the Free Press, MLive, Detroit News, the Lansing State Journal or other publications, now is the time to start doing it. Or, just post something on social media to your friends, and their kids, to encourage them to get informed and make the best of choices…whatever that might be.

Sunday, March 01, 2015

WHEN DID THIS BECOME HEALTH CARE?

February 28, 2015

 Daniel J. Loepp

President and Chief Executive Officer
Blue Cross Blue Shield of Michigan
MPSERS — Mail Code X521
Blue Cross Blue Shield of Michigan
600 E. Lafayette Blvd.
Detroit, MI 48226-2998

Dear Mr. Loepp:

I am writing to express my frustration with Blue Cross Blue Shield PPO’s practice of contracting a different mail order pharmacy annually. BCBS PPO is my medical insurer as part of the Michigan Public School Employees Retirement System.


On December 18th I spent over an hour online, on the phone, and in the drugstore trying to get a prescription for Bystolic 10 mg. refilled. Bystolic is a medication that I have taken for over a year for high blood pressure. The mail order service, Express Script, contracted by BCBS PPO lost my prescription. First they told me that they couldn't authorize a duplicate order because they had to wait 30 days to make sure it was really lost. Although I had ordered a refill in plenty of time, at this point I had no pills left and they said they would expedite a duplicate order. I let the customer service representative know that my doctor had called in a prescription at my local pharmacy to tide me over for the next 2 weeks. When I arrived at the pharmacist’s, he couldn't fill it because my mail order pharmacy wouldn't authorize payment, claiming I had filled it at a Walmart in Arkansas. I have never been to Arkansas nor do I shop at Walmart. My name is not a common name and when the pharmacist called the Arkansas Walmart, they had no patient with my name. Having reached an impasse with the mail order pharmacy, my local pharmacist gave me enough pills to make it through the next day and a half until I could call Express Script so my pharmacist could be reimbursed for the prescription to tide me over until Express Script sorted out the problem.


On December 19th, I spent another 2 hours trying to resolve this issue. I called the automated line for Express Script. The automated service routed me to the wrong department and issued the recorded message "Due to unusual caller volume, your wait may be longer than anticipated. Please consider using the contact portal on our website..." I re-tried and was connected with a customer service employee to whom I told the story of my lost mail-order prescription and asked to have permission for my local pharmacy to be paid for pills to tide me over. She said, "I'm very sorry but your prescription was already paid for on December 12th." Since it was clear that this employee was neither informed nor empowered to solve my problem, I asked to be connected to the supervisor who could not authorize my local pharmacy, because she only worked with mail order operations. She called another company to get authorization. Not wanting to leave anything to chance, I got a phone number for this other company, and called my pharmacy to verify that the prescription was authorized and ready for pick up. Believing that this was an anomaly, I put this experience behind me.

On December 30, 2014, I was notified by email that the mail order prescription service would be changed to Catamaran Rx in January 2015. I had difficulty using the link in the email to register a user name and password on their website and later used their contact portal to notify them of the problem. I received no response. 


At the end of January or early in February, I tried to order a refill of Bystolic 10 mg., but when I finally got online to order it, I discovered that my prescriptions had not transferred over from Express Script. By then, I was getting dangerously low on this medication, and asked my doctor to call in a two week prescription at my local pharmacy to tide me over, and to send a complete list of my prescriptions to Catamaran Rx so I could order refills when I was running low on them. I picked up the “tide-over” prescription and on February 16th called Catamaran to send the 90-day refill as soon as possible. They claimed that they couldn’t send it until February 27th because it was too soon. They asked me to get a 30-day prescription at my local pharmacy and said that then they'd send my medication out. Of course, this begged the question: if they had to wait until I was out of medication to send my refill, wouldn’t I need to get another prescription from my local pharmacy to tide me over...triggering another delay in the mail order? None of the customer service representatives seemed to be able to understand that they were not solving, but rather creating, a snowballing problem. 

It is now February 28th, and I have one weeks’ worth of Bystolic 10 mg. left. Today, I received a robo-call from Catamaran Rx telling me that they were about to ship a prescription but that it exceeded cost. I got connected with a customer service person who explained that the medication was in the formulary but was considered part of “step-therapy”—I would have to have taken another medication and have it be ineffective in order to take Bystolic! There were only two solutions to the problem: my doctor could call the mail order clinical services to get the name(s) of some substitutes for Bystolic, or he could “initiate a prior authorization for Bystolic” but some penalties for cost might apply. At that point she said that I had been notified by letter that there were some policy changes that Catamaran had implemented.  I asked her to re-send the letter by both postal mail and e-mail since I had not received such a letter.


I took down all of this information, acknowledged that the customer service person was neither empowered to override this problem, nor did she have any expertise to inform me of acceptable generic substitutes for Bystolic and that, since it was a Saturday, the only thing I could do was wait until Monday to speak with a knowledgeable and empowered pharmacist who could provide me with enough information to refill my prescription by the time I again ran out (on March 7th). Of course, I pointed out to her, this would probably necessitate another temporary “tide over” refill at my local pharmacy which is frowned upon by BCBS PPO and its’ contractor Catamaran Rx. I expressed my disappointment in Catamaran for having more concern for its bottom line and for a rigid adherence to irrational rules that prevent the timely refilling of established prescriptions, and informed her that my only recourse was to send letters of complaint, in the hope that BCBS, MPSERS, and Catamaran would re-think this kind of business plan, that operates without regard for the welfare of its customers.

I don’t imagine that I am alone in this complaint, but I have no way of verifying that others have also experienced such disregard. I can only hope that someone who receives this letter is able to gather such data and encourage a more responsive approach to health care service.

Sincerely,


N. Kathleen Kosobud


Copies mailed to:

State Representative Jeff Irwin
Michigan House of Representatives
S-987 House Office Building
P.O. Box 30014
Lansing, MI 48909-7514

Senator Rebekah Warren
Michigan Senate
PO BOX 30036
Lansing, MI 48909

Phil Stoddard, Executive Secretary
MPSERS Board of Directors
Office of Retirement Services
PO Box 30171
Lansing, MI 48909-7671

Judy Foster, President
MEA-Retired
1216 Kendale Blvd
East Lansing, MI, 48826-2573

Joel Saban
Executive Vice President, Pharmacy Operations
Catamaran Rx
1600 McConnor Parkway

Schaumburg, IL 60173-6801

Saturday, March 22, 2014

TALES FROM THE FIELD



This has been a particularly fertile month for some "Really?" moments in advocacy.  Just a sampling:

  • A student with hearing impairments is assigned an interpreter who, among other things, signs "pee" for "Palestine".  Check those credentials!
  • A substitute teacher tries to send an ASL interpreter out of the class because the sub says that the student with hearing impairments doesn't need an interpreter--she speaks perfectly well.  The sub apparently thinks that the interpreter is there to translate what the student says--for the benefit of the teacher!! The student actually needs the interpreter to sign and explain teacher lectures.
  • I file an OCR complaint because a district won't allow a student to participate in athletics. The county program for students with emotional impairments is not included in the MHSAA list of qualifying alternative schools for the district.  The district responds by making all of the needed changes...and then the student is disqualified because of his GPA. (Do I feel like a chump? No--because now students from this school will be able to play for their home school teams.)
  • A student with physical impairments transfers districts and requires a specialized chair in order to participate in school.  His chair makes it to the new district one week before he does.  The district refuses to provide portal to portal transportation for the student, but he is physically unable to make it to the nearest bus stop. Portal to portal transportation is finally in place.
Life is good...especially when you can laugh as you're making things better for students!

Monday, March 11, 2013

AN OPEN LETTER TO THE MICHIGAN BOARD OF ED FORUM


To: Members, Michigan State Board of Education
Date:  March 11, 2013

My name is Kathleen Kosobud.  I am a “temporarily retired” special educator working on my dissertation, and offering technical support and advocacy to parents of students receiving special education all over the state. I am here today to speak to you about the impact of “school reform” and the ever more rigid standards that affect these children.  

Almost two years ago (May 26, 2011), I addressed members of the Board about the effects of withholding a Personal Curriculum option from students with disabilities, until their senior years. Since then, I have had two more years working with students who have experienced exclusion—in the name of “improving education”.  Some of these actions are against Federal and Michigan law, some are merely immoral:

  • I heard from a student’s parent in an EAA school who is trapped in the school where he is being bullied because his IEP is not current, and his new public school won’t accept him without a current IEP. 
  • I was contacted by a parent whose child was suspended from school for three months on a disciplinary issue, and is not being allowed back until the parent has him evaluated for emotional/behavioral problems.
  • I have been called by parents who can’t keep their children in charter schools, because their children’s needs don’t fit the services at the charters.
  • I represented a child in foster care who had been suspended for a year, placed in a virtual high school, and had been stripped of the other services that his IEP called for because the virtual school claimed that they didn’t offer those services.
  • I have represented several children whose parents have requested evaluations, only to be told that they must wait for a “response to intervention” program before they could be evaluated…even though their children are failing academically, or have behaviors that are so severe and frequent that they are missing countless days of school. 
  • And finally, after leaving school, I was contacted by an adult who was told by the local adult literacy organization that his entry test scores made him unsuitable for literacy instruction—he was unlikely to make enough progress to support the literacy organization’s funding.

I am worried, and I think that I have a right to be worried that school reform is nothing more than code for “reform school” for these children and adults—who are destined to leave school because they are not supported—by dropping out, or being pushed out through a steady diet of “we don’t serve people like you”.

Having recently read The New Jim Crow: Mass Incarceration in the Age of Colorblindness, I am left to wonder if our weak Michigan economy is being bolstered by feeding the School-to-Prison Pipeline, a growing economy that starts with the alienation of disempowered youth.  And what more disempowered group than students with learning and behavioral disabilities, left unattended by our schools?

-----
About N Kathleen Kosobud:  Kathleen Kosobud is completing her dissertation at Michigan State University focusing on family-school relationships in special education.  Kathleen has blogged for LDA of Michigan at http://ldamiexchange.blogspot.com/, and for her own amusement at http://backburner-nkk.blogspot.com/.  She was one of the contributors to restructuring of the teacher education program at Michigan State University’s School of Education through a project to infuse inclusive content into all teacher education courses for the preparation of new teachers, under the guidance of Susan J. Peters, Ph.D. After achieving National Board Certification as an Early Adolescence/Generalist as a teacher of middle school mathematics in a special education resource classroom, she served as a teacher-in-residence for Assessment Development at the National Board for Professional Teaching Standards.  She is the parent of two adult children with learning disabilities, and identifies as a person with learning disabilities, herself.  You can reach her by e-mail.

Tuesday, August 07, 2012

What Kind of Teachers Do We Want?

On Diane Ravitch's blog today: The Future of National Board Certification, a guest posting by Nancy Flanagan.  She says:
Here’s what I worry about: NBPTS has now been taken over by Pearson. The teacher-led, teacher-developed goals of the original founders’ mission–using teacher expertise to shape education reform–are so far from what we’re doing now it’s frightening. And–the US Dept Of Ed decided not to put the National Board in their last budget. They gave $$ to Teach for America instead.
I, too, am a National Board Certified Teacher. Like Nancy, I also took time away from the classroom to work for the National Board in assessment development, and then returned to teaching. I was one of the first 87 teachers in the country to earn the distinction of being board certified, at a time when there was NO context for such an attainment–one had to make one’s own. I continued to teach and found myself more articulate about my teaching decisions, and more observant about how my students learned. And I agree with Nancy’s comment:
NB Certification has nothing to do with credentialing–largely because credentialing has little to do with increasing student learning…NB Certification is all about what happens in the classroom; advanced degrees focus on other issues and knowledge.
My greatest hope for education reform was that the interesting work of teachers would take center stage, and that many more teachers would be engaged in sharing their practices with future generations of teachers. Instead, teachers have been shoved to the margins, and operations like Pearson have grown into giant ed-factories, bending to political influence and financial expedience.
What is central to my concern is what gets funded, and who gets funded–Teach for America, and the Common Core. We march ever forward, reducing education to a technical exercise, measuring accountability with machine-scored tests, and staffing the neediest schools with fewer and fewer committed, career-minded educators. Once schools lose the trust of their family community, the project of dismantling public education becomes easy to sell–parent triggers, emergency manager takeovers, and farming out the business of public education to for-profit charter operators.

Pearson, formerly Harcourt, used to run the operations side of National Board Certification–booking the needed rooms for training and running the scoring operations, making sure that assessments were properly logged in and distributed to scoring sites, handling applications and so on. Other organizations ran the assessment development portion of the work of the National Board–Educational Testing Service, Educational Development Center, WestEd, etc. Each of these organizations brought their most knowledgeable resources to the table to create assessments that were authentic representations of the essential elements of teaching practices in each field. I think that it is wise to be concerned when all aspects of an operation such as National Board Certification are under one roof. One might reasonably speculate that such an arrangement might lead Pearson to revise National Board Certification processes with profit and power, rather than student development and growth, in mind.

My first grandchild enters kindergarten this fall. I hope that his early years in school will mark the beginning of a turnaround where all children, not just my grandson, will experience the joyfulness of being “known” by committed teachers in healthy environments where learning provokes awe.
I saw that in many of the National Board Certified Teachers whom I met after becoming one myself. Too bad that we aren’t about funding that kind of effect.

Wednesday, June 20, 2012

SOME OF US ARE MORE EQUAL...

The Michigan House of Representatives has been pretty busy lately. First, they passed this bill (HB 5040 of 2012) which makes it okay for students in counselor training programs to engage in discriminatory practices against LBGT clients, by refusing to counsel them. Then they passed House Bill 5711 of 2012 which places draconian restrictions on facilities that offer abortion as part of their services. And, in response to the word ("vagina") used by Democratic state Rep. Lisa Brown in speaking out against HB 5711, HB 5712, and HB 5713, the Republican Majority Floor Leader  banned her from speaking the next day.

It seems to me that these actions aren't about decorum or conscience or manners--they're about Power--who is entitled to wield it, and who is not. This quote from Animal Farm is apt in describing the situation: "All animals are equal, but some are more equal than others"- George Orwell, Ch. 10. The latest targets are women, but the "Freedom of Conscience Act" troubles me because, although it targets LGBT people, there is nothing to prevent other vulnerable groups from the "equal opportunity" of discrimination.

I really waffle about this "Freedom of Conscience Act".
 

Would I want someone who is so clearly biased counseling me? What if my being overweight or having red hair set off a gag reflex in some counseling intern and (s)he decided to tell me that I made them sick, it was against their religious principles to treat fat redheads, and I'd have to go to someone else?  

Would I be hurt? You bet! 

Would I argue over their reaction to me?  No--but I might say something pretty choice to their supervising instructors. 

Would I be likely to seek counseling from another intern in the program? Not very...

Isn't this like allowing a doctor to refuse to treat a (name your persecuted minority) patient?  Yes, it is.  We cringe in horror when we recall the shunning that patients with leprosy, tuberculosis, and later AIDs were treated.  We fight to close the institutions for the disabled because they are inhumane.  And yet, our legislature thinks it's okay to hide behind (Christian) religious beliefs to refuse to give counsel?

Of course, then it occurs to me that no amount of counselor training is likely to make a difference. Maybe it's a losing proposition to try to open such a closed mind.  Maybe it's okay to discriminate, as screwed up as that sounds?



Now, this Act only singles out students in counseling programs.  But what if we take it another step further?  What if our legislature decides that this "protection" should be extended to teaching interns?  What happens when the legislature extends its' attack to teacher education (e.g. I only teach (name your privileged class)? This is wrong, wrong, wrong. 


But then, I guess that "Some of us are more equal than others".

Monday, March 12, 2012

On the death of laptops

Quick rant:

Once again, I have worn out a laptop. I hate when this happens.  First of all, it's never at a convenient time.  Second, it invariably means that I also have to figure out what software has been lost in the data transfer...and then either re-load it or replace it.  Both are expensive--one in time, and the other in actual dollars...and time. And finally, it means learning the new hardware, system software, and customizing it all to my idiosyncratic need for same-ness in spite of the advances in technology that force me to learn new things.

This time is no different.  Sigh.