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Notes from a Boy @ The Window

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Notes from a Boy @ The Window

Tag Archives: Medicaid

Aside

Sure I’ve Raised Money, But…

27 Monday Jul 2015

Posted by decollins1969 in 1, Boy @ The Window, culture, Eclectic, Mount Vernon New York, Pittsburgh, Politics, Pop Culture, University of Pittsburgh, Work, Youth

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Academy for Educational Development, AED, Bob Beane, Capitalism, Diagnostic and Statistical Manual for Mental Disorders, Exploitation, Fundraising, Grant-seeking, Maximizing Profits, Medicaid, Medicare, Mount Vernon Clinic, Partnerships for College Access and Success, PCAS, Presidential Classroom, Valerie Johnstone, Westchester County Department of Community Mental Health


Man on a hamster wheel gif, like constantly looking for money, July 26, 2015. (http://twitter.com).

Man on a hamster wheel gif, like constantly looking for money, July 26, 2015. (http://twitter.com).

Keep in mind that these are just observations, not me axe-grinding or feeling sorry for myself. My biggest observation is that raising money for others without reaping enough benefit for myself shows that even governmental and nonprofit organizations are just as prone to capitalistic exploitation as Walmart and Apple. And that I am not immune, nor have I ever been immune, to the pride and naiveté of production and exploitation.

Many times during my years in the nonprofit world as a manager or consultant, employers have asked me about my ability to raise money. I’ve done a pretty good job of that over the years. Fifteen minutes of work as an educational “closer” at Presidential Classroom led to a $25,000 grant from State Farm’s civic engagement work (a.k.a. service-learning) in 2000. I worked on a $1 million renewal grant from Lumina Foundation for Education for the college access and success initiative for which I served as deputy director during my last four years at the Academy for Educational Development (AED). I also raised $200,000 from Lumina for data collection for the initiative in 2005.

"I come here looking for money (Got to have it)," lyrics from Pet Shop Boys "What Have I Done To Deserve This" (1988), July 27, 2015. (http://nonprofitquarterly.org/).

“I come here looking for money (Got to have it),” lyrics from Pet Shop Boys “What Have I Done To Deserve This” (1988), July 27, 2015. (http://nonprofitquarterly.org/).

I’ve indirectly raised funds from which I didn’t derive a benefit, either because the amount were too small for AED’s vast overhead and other direct costs (read as paying higher-ups salaries for the privilege of raising money on behalf of the now-defunct organization). Or because others used my curriculum vitae and my work for AED to garner grants that I never worked on. My last year at AED we turned down what would’ve been a $100,000 grant from Carnegie Corporation because it would’ve been too small, especially since we needed to collaborate with a sister organization on K-16 access and success work. We turned down potential smaller grants from other private foundations for similar reasons.

And after nine months of work off-and-on, the wife of a Pulitzer Prize winning-columnist for a Washington newspaper received a $250,000 grant from a corporate foundation in New York, based on my work. Because the AED higher-up in charge of the process worked with her as a personal favor — and didn’t put our proposal and implementation work into a contract — her socialite friend and head of a college fund organization received a grant with no strings attached, for AED or for me. I did get paid for my work, as I did it under the AED banner. But the fruits born from that work went outside the organization, to a person almost as duplicitous as the organization for which I once worked.

But in terms of fundraising, or at least, making money for an organization, absolutely nothing in my work history compares to what I did at nineteen. Yes, nineteen! The summer of ’89, I worked for Westchester County Department of Community Mental Health, out of the Mount Vernon, New York clinic, across the bridge from the Mount Vernon East Metro-North stop. After the previous long summer of unemployment followed by five days of homelessness and two more months of living on financial fumes, I was happy, really happy, to have gained steady employment all through ’89.

So happy that I didn’t notice how productive I was being in the office. I had the rather official title of Summer Intern, and had been told by the Director of Community Mental Health Programs in Bob Beane that he was “counting on me.” I came to the Mount Vernon clinic with Beane’s charge to “get their back-billing in order.” Since 1984, the clinic had regularly had its Medicaid and Medicare billing for psychiatric and psychological services rejected by the state-level health folks in Albany, mostly due to coding errors.

Graphic on DSM editions since 1952 (DSM-V is in its "beta-testing" phase), American Psychiatric Association, 2012. (http://life-surfing.com/).

Graphic on DSM editions since 1952 (DSM-V is in its “beta-testing” phase), American Psychiatric Association, 2012. (http://life-surfing.com/).

Specifically, the clinic staff were putting incorrect codes from the Diagnostic and Statistical Manual for Mental Disorders — in this case, DSM-III and DSM-III-R (with the III-R standing for version number three, revised edition) — on the state billing forms. There were other errors to be sure. Doctor’s names and patients names were often misspelled. Control numbers were incorrect. The proper signature wasn’t obtained. But well over ninety percent of the errors were DSM-III or DSM-III-R codes that staff had entered into a billing form incorrectly.

This was the summer of ’89, so the form itself was printed on a line printer, and the checking of such forms had to be done manually. It would take two or three weeks to hear from Albany about an incorrect code, a month to receive payment. After five years of coding errors, red tape, and the clinic’s administrative staff badly managed by one Valerie Johnstone, my job was to rectify as many of the old billing errors as I could before the summer came to a close.

In eight weeks’ time, despite all the other menial tasks Johnstone would sometimes have me do, as well as having to share the same billing computer with Beverly (who dealt with current billing, and was probably responsible for the majority of my back-billing work), I got through three cabinets’ worth of billing issues. I left at the end of August, I left for the friendly environs of Pittsburgh and Pitt, vaguely aware of how much money I’d made for the Mount Vernon clinic and for the county.

Screen shot of 100 East 1st Street and South 1st Avenue, where I toiled for Westchester County the summer of 1989 (and 1992), April 2012. (http://maps.google.com).

Screen shot of 100 East 1st Street and South 1st Avenue, where I toiled for Westchester County the summer of 1989 (and 1992), April 2012. (http://maps.google.com).

I found out in September that my work had made them $371,000! I was impressed, but then I quickly became depressed. My salary for Westchester County that summer was $5.90 per hour. Over eight weeks, my net income was $1,610. As an intern, I had no fringe benefits, not even a commuter allowance. In terms of ratios, for every dollar I made between June 26th and August 18th, Westchester County and the Mount Vernon clinic made $230.43!

No wonder the staff at the Mount Vernon clinic looked at me with a combination of bemusement and derision! I had shown them up, unknowingly, and allowed myself to be an exploitable resource. And though I had a guaranteed job for the next three years after that summer with Beane and Westchester County, there was no way I could ever make enough income to make up for that kind of profit-generation. So much for the idea of not-for-profit and government enterprises!

Crooked Fingers

31 Friday Aug 2012

Posted by decollins1969 in 1, Boy @ The Window, culture, Eclectic, Mount Vernon High School, Mount Vernon New York, Politics, race, Work, Youth

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616, 616 East Lincoln Avenue, Benign Tumors, Crooked Fingers, Keloids, Medicaid, Mount Vernon Hospital, Physical Therapy, Poverty, Social Welfare, Welfare, Westchester County Medical Center


My crooked left fingers, August 31, 2012. (Donald Earl Collins).

It’s been a bit more than thirty years since I’ve had surgery on two left fingers in an attempt to straighten them. These fingers are symbolic of what happens when a family slides off a cliff in the Himalayas into deep poverty, of when a nation doesn’t have an adequate social safety net or adequate healthcare for the poor.

At the very end of my glorious summer of ’82, I needed surgery on the ring and pinky fingers of my left hand to remove two benign tumors. The tumors had apparently been there since I was eight and had caused the two fingers to grow crookedly, to the point where I couldn’t use them. After the hospital strike (see my “The Quest For Work, Past and Present” post from earlier this month) and my ordeal with Maurice had ended (see my post “Boy, Interrupted” from July ’12), my mother realized that I needed to see a doctor, and within a week I was at Mount Vernon Hospital in surgery.

They removed the tumors, straightened my fingers, stitched them up and put them in a cast. If all went well, after a month, they’d remove the cast and the stitching. That, and a few checkups to check the progress and scar tissue buildup on my fingers, and I should’ve been good to go. But that happy ending wasn’t to be. After the casts came off in early September, I didn’t see a doctor again until April ’85.

Why? My mother had been downgraded to part-time status at Mount Vernon Hospital by October ’82, and after the birth of my sister Sarai in February ’83, could not work and take care of five kids at the same time. We went on welfare in April ’83, and with that, received Medicaid services. Those services, as anyone who has spent any serious time in America’s worst poverty should already know, are limited in scope, and don’t exactly cover the removal of post-surgery scar tissue.

Choppers and Westchester County Medical Center, Valhalla, NY, August 31, 2012. (http://nymc.edu)

So, a year or so after my tumor removal/finger-straightening surgery, my left ring and pinky fingers went crooked again. By the time me and my mother had schlepped on the old Bee-Line Route 41 bus to Westchester County Medical Center in Valhalla in ’85, my fingers were about half as crooked as they had been before surgery in August ’82. The doctor, of course, misdiagnosed my fingers as having keloids, and offered steroids to shrink them down. Injections, by the way, not covered under Medicaid at the time.

But that wasn’t the only problem. My crooked fingers itched a lot, and made it difficult for me to make one-handed grabs in football tryouts in ’84, not to mention wearing a baseball glove for baseball tryouts in ’86. Some girls at Mount Vernon High School grilled me with questions whenever they noticed them, as if I was a Yeti who decided to visit Western civilization for the first time. One of them told me point-blank, “I can’t go with you — your fingers are too ugly.” A young woman said something to the same effect to me my freshman year at the University of Pittsburgh.

It wasn’t until the fall of ’02 that I finally saw a specialist at Johns Hopkins about my finger, one who confirmed the initial diagnosis of tumors from ’82. Between two doctors and a physical therapist, I gained about two-thirds of my total range of motion in my ring finger, but only five degrees’ worth of motion in my left pinky by the time my son was born in July ’03.

I got to the point where I could finally palm a basketball in my left hand. But ultimately, that was all I could do. It turned out that I’d have to lose a joint in my crooked fingers — to have them fused — in order to straighten them. Otherwise, there was nothing wrong with the bones. It made more sense to leave them crooked.

Maybe this is good thing, though. That no matter my past, present or future successes, that I have them as a reminder of how far I’ve come. They also serve to remind me how many others suffer in the US because of poverty.

For the Love of a Lockout & an Impasse

30 Saturday Jul 2011

Posted by decollins1969 in 1, culture, Eclectic, Politics, Sports

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Tags

2011 Season, Balanced Budget Amendment, Bob Kraft, Boehner, Capitol Hill, Congress, Cutting Taxes, Debt Ceiling, Default, DeMaurice Smith, Football, Great Recession, Great Society, House of Representatives, Jeff Saturday, Media Coverage, Medicaid, Medicare, Military-Industrial Complex, New Deal, NFL, NFL Lockout, Obama, POTUS, President Barack Obama, President Obama, Raising Taxes, Rep. John Boehner, Roger Goodell, Social Safety Net, Social Security, Social Welfare, Spending Cuts, Taxes


DeMaurice Smith watches as Colts player Jeff Saturday gives Patriots owner Bob Kraft a much-needed hug, July 25, 2011. (Source/NESN).

For the past few weeks, we’ve watched an NFL lockout and the political theater of a debt ceiling impasse play out in Washington, DC. Both have captured so much of the media’s attention that when an explosion occurred in Oslo, Norway on July 22, it initially ran as a ticker report on MSNBC and CNN (thank God for the BBC, then). It’s been Goodell v. Smith, POTUS v Boehner for most of May, June and July.

At least until Monday afternoon. When the decertified NFLPA unanimously agreed to continue the practice of compromising away their collective bargaining power to create significantly better employment conditions and even better pay for all of its players in order to make some money now for a chosen few. But none of that mattered. Everyone was giddy over the start of “real football” again. With wall-to-wall coverage on every cable sports channel, as well as not-so-insignificant attention on cable news. Players were hugging owners. And there were reports of a Washington Redskins trainer jumping into the arms of an ESPN 980 beat reporter on Tuesday after their facilities opened. Our long, 133-day national nightmare was over.

Well, not really. Not with the US Government three days away from defaulting on $14.3 trillion in debt

Boehner, Pelosi and President Obama in same room, The White House, December 9, 2009. (Source/Saul Loeb/AFP/Getty Images).

because Rep. John Boehner — another cheap Cincinnati-area, rich White guy — wants a balanced budget amendment and cuts to what remains of our New Deal and Great Society era social safety net.

For many, it appears that President Obama is all but ready to give him many of these cuts in Social Security, Medicare and Medicaid. Provided that there isn’t a balanced budget amendment component in the plan. Even the idea of raising taxes on those who’ve robbed our nation blind and want to keep their riches has been given short shrift by Congress and by our news media.

What makes this situation as shitty as it sounds is the fact that this argument is occurring in what is officially a double-dip Great Recession and the most sluggish recovery in the US since the 1930s. Republicans think they’ve figured out a way to corner the President and the Democrats while simultaneously holding up principles they never had during the ’80s and the ’00s. President Obama’s been stomping around like he has an ace up his sleeve, but refuses to clue the public in on what he plans to do by August 2 if his repeated attempts at so-called bipartisanship fall apart with our struggling economy.

This is a serious situation, and it does have parallels with the NFL lockout. In both cases, billionaires have leadership in their pockets to keep the masses from getting a nanometer of what they need and want. In the case of most NFL players, who get pounded over and over again for a median salary of $325,000 a year, better pay, much better working and safety conditions, and better collective bargaining conditions. In the case of most Americans, some sense of economic stability, government responsibility and affluent Americans and greedy corporations paying their fair share in taxes.

But this is where the similarities end. The fact is, many an American tuned out the stalemate on Capitol Hill the moment Rich Eisen asked, “Are you ready for football?” Monday afternoon on the NFL Network. I mean, who cares that social welfare in this country, fairly meager to begin with, will be slashed severely? While the military-industrial complex and the Pentagon get a budget level that’s higher than over ninety percent of the economies in the world? Who cares that if the federal government doesn’t pay its bill, millions will be out of work, and the unemployment and other monies we all receive will be worth less, and could become worthless?

Herd of sheep, July 30, 2011. (Source/zerohedge.com)

None of that’s important in our world of idiot, imperialistic, and secretly greedy Americans. “Give me football, give me football!,” is our cry. Let’s complain about Kevin Kolb’s contract with the Arizona Cardinals, and not Boehner’s contract on America. Let’s decry a standoff between billionaires v. hundred-thousand-aires. But remain as silent as tranquilized sheep while Congress and the President take our futures into the event horizon of a black hole. Is the mantra of it only takes hard work to become rich in America so strong that people who aren’t don’t know when the shepherd’s about to slit their throats? Yeah, I think so.

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