From the Iroquois attorney to the judge, interspersed with my responses [WordPress will not maintain indentations or changes in type face; basically the Iroquois attorney alternates with me. I’m sorry–I don’t know how to make it clearer. Quoted paragraphs are the attorney.]:
“Gentiva: Screened at Crouse. Concerned about MH issues. Gentiva is continuing to follow for home care services in the home.”
Gentiva: Gentiva may have screened the records at Crouse but they have not screened me; no one from Gentiva has interviewed me. Gentiva’s concern “about MH issues” might be ameliorated if the Iroquois brought into the record their consultation report from Dr. Ghaly stating that, other than a mood disorder, I have no psychiatric disorder, and Dr. Lewis’ letter stating that my only problem is depression.
“TLS: Received copy of Anne’s SPOA application from TLS. Spoke with Susan, Program Supervisor, for TLS residential services. Confirmed that referral for Anne is for a TLS treatment apartment, which is a TLS run apartment where staff would see Anne daily. TLS requested further information/ documentation on Anne’s medical conditions, ADLs, nursing notes. TLS States that Anne’s scooter will limit where they can put her. And they indicate they are concerned about her behaviors.”
TLS: TLS stands for Transitional Living Services; primarily and historically its function is to transition people from inpatient psychiatric hospitalization to independence in the community. It is not a medical services agency. A “TLS treatment apartment” is designed for psychiatric treatment. I know because I was in a TLS treatment apartment several decades ago.
N.B. Could you please learn to use the correct language? I do not have a “scooter”; I have a power wheelchair. Under Medicare/Medicaid, a scooter is defined as a three-wheeled electric mobility device, which M/M deems unstable and therefore will not fund. They only will fund a power wheelchair, which they consider to have four wheels. Fact: it has two large power wheels and four small balance wheels.
“Susan Parker attempted to meet with Anne last night (10/7/13) to obtain release to submit requested information for SPOA application in order to submit requested information to TLS. Susan Parker was also attempting to meet with Anne to discuss Health Home and to obtain release for this referral. Anne refused to speak with Susan. Anne refused to discuss referrals or to sign releases. Per Susan, Anne kicked her out of the room. Anne indicated that she was unwilling to accept any services that have a mental health treatment component.”
Susan Parker did not attempt to meet with me “last night.” She came in the afternoon, which I considered odd since she enjoys full-time employment working days as a program manager at Syracuse Behavioral Center. I did not refuse to talk to Parker; we talked, and I could not understand what she was talking about. I see by this report that she was talking about both TLS and Health Home, which I did not understand. I have a POA precisely because I get confused when people do not talk to me clearly and straightforwardly. I told Parker to talk to my POA, which she did not do.
Further, I did not refuse to discuss anything with a “mental health component”; I refused to discuss anything that is primarily a mental health program. I have critical physical illnesses, e.g., chronic hyperglycemia, chronic kidney disease, nephrogenic diabetes insipidus, etc. I am perfectly willing to have a major medical treatment program that has a minor mental health component. I cannot fathom why Iroquois Nursing Home is not seeking a medical management program for me.
And I “kicked [Parker] out of the room” because she continued to engage in deceptive and deceitful reconstructions regarding the termination of our working relationship.
“10/8/13 I approached Dr. Wechsler during his visit to Iroquois’ business office today. He was aware that Susan Parker had attempted to meet with Anne last night. I explained the status of the SPOA application, its purpose, and that a release was needed from Anne in order to submit the information TLS was requesting. Notified him that Susan Parker had attempted to meet with Anne to obtain this release last night and Anne refused. I also discussed Health Home with Dr. Wechsler, the application process, and went over the Health Home application. Explained that the basis of the application for Health Home would be related to Anne’s chronic conditions, not a serious mental illness. Notified him that Anne would need to sign a release for this referral as well. Notified him that Anne had refused to discuss this with Susan Parker. Steve indicated that he would discuss both the SPOA release and the Health Home program/ application/ release with Anne. Provided him a copy of the SPOA release and Anne’s Health Home application and release. Steve indicated that he may discuss the Health Home program further with discharge planners at Crouse.”
“. . . The basis of the application for Health Home would be related to Anne’s chronic conditions, not a serious mental illness.” Both agencies—Onondaga Case Management and St. Joseph’s Hospital Behavioral Unit—that operate Health Home in Onondaga County are primarily psychiatric agencies. It would be disastrous to put “chronic conditions” through psychiatric agencies wherein the decisions are made by psychiatric case managers without any medical training much beyond CPR.
10/10/13: On Thursday, there was an extensive and intensive discussion between myself, Dr. Wechsler, and Ms Barbara Drapola, director of Care Coordination at Crouse Hospital. Subjects included Gentiva, TLS, Health Home, Nursing Home Transition and Diversion, and PACE.
“Onondaga County Long Term Resource Center: Mia spoke with Patricia. Maureen Calsta oversaw Anne’s case. Anne was closed on 9/16/13. A note in her chart stated Anne was to call if in the future she needed LTC services. Mia was given number for supervisor (Marge Owens) 435-5600 X 146. She left a message, requesting a return call, to make a referral. Indicated that the process took 2-3 weeks after referral was made.”
Onondaga County Long Term Resource Center: I have been receiving services from them for perhaps a decade or more; I have never heard of Patricia or Maureen Calsta. I have worked extensively with Marge Owens. The service was not being used primarily because Crouse Hospital’s discharge people did not think it offered appropriate and necessary services.