Thursday, September 19, 2013

Embarrassing Disgrace - update

Sometimes being obstinate pays off.

I just got a call from Catawba -- they found some 'discharge assistance money' and a facility with a good track record working with the patients.  No, it's not assisted living, it's a nursing home with stable and trained staff.  I've had other residents there (and an elderly relative who was there many years ago) and have a lot of respect for the owner and staff.

Unfortunately the underlying problem still exists:  Auxiliary Grant is still a cruel joke.  The result I got is in part because I had the power of a court order granting me authority. Many people don't, and don't know how to argue.

Friday, August 16, 2013

An embarrassing disgrace

Embarrassing because I'm a citizen of the Commonwealth of Virginia which perpetuates the disgrace.

A disgrace because of the cruelty Virginia inflicts on its impoverished aged and vulnerable residents.

Everyone is familiar with Nursing Homes - at least the concept of them.  To be in a nursing home you must need assistance and meet the criteria as measured on a "Uniform Assessment Instrument" which you can find here:‎.

But there are people who need help but do not meet the criteria for nursing home level of care. There's an intermediate step called Assisted Living  (AL). People who have money can go to a private pay facility and those are very nice.  And expensive (about 60% of the private pay nursing home rate by my observation).

If you don't have money but only 'qualify' for AL?  Well, Virginia says it'll help, and if $1196.00 per month (eff. 7/1/2013) is "help" then, maybe, it does. For 1197 compensation per month (1375/month in planning district 8 -- 'occupied Virginia' next to DC), an AL agrees to house, supervise, feed, entertain, insure, take to doctor appointments, develop a 'plan of care' individualized to each resident and put it in place, have trained and licensed staff (24/7) to do so, and so on.

It cannot be done. Those properties that have almost only "Aux Grant" residents are horrible - not their fault as they can't afford to do any better. The problem is statewide -- see this Daily Press (Hampton VA) article from October 2012, --here--

I am guardian for a number of individuals. About a year or so ago I began refusing to consent to Assisted Living placement if the individual was in a better place.  Two of the people I am now guardian for are at Catawba Hospital - a psychiatric facility owned and operated by Virginia which charges over $1000.00 a day - more if the room is padded. If the people can't afford to pay (the usual course) the state eats it. So the goal is to get them out as soon as possible. And if they have a guardian, the guardian has to consent to placement.  My two people are ready for discharge - to Assisted Living with Auxiliary Grant.  They're in a better place at Catawba than in ANY AL/AG facility, so I'm not consenting.

Yes, I'm costing Virginia $1000 a day (per person!) because the General Assembly is too damned stupid to recognize the need and increase the Auxiliary Grant to a reasonable level. The Auxiliary Grant has not kept up with the costs of care - especially considering that more and more regulations are piled on the AL facility without any funds to pay for it.  According to the Daily Press article linked above, there were 166 patients in Virginia Mental Health Hospitals with this problem as of October, 2012.

I just got off the phone with someone trying to place one of my Catawba patients.  That person is very competent and very good at her job. I told her my position and I don't care who knows it (thus this blog). I told her she's welcome to tell the upper food chain my position and my pleasure at getting back at Virginia for its disgraceful "Aux Grant" program by costing the state many times what they should pay each month by refusing placement. I dare them to call me.  I dare the Governor to call me.

As a guardian I have to advocate for what's best for my wards.  In my opinion the Auxiliary Grant program is the worst for them - it is instead a Cruel Joke (to borrow a phrase from former Gov. Mills Godwin) and won't happen on my watch. The two individuals are safer and better cared for where they are now than in Assisted Living, and unless Virginia comes up with reasonable money for their care, they're gonna stay there.

Wednesday, June 12, 2013

Lusting . . .

This story goes back nearly 40 years - when Jimmy Carter was running for President of the US.  (as an aside, in my opinion he was probably one of the most honest modern presidents we've had but also one of the most ineffective).  Jimmy had done a "Playboy" interview which was widely discussed.

"Playboy" magazine actually had good cultural content and for a time the "Playboy Interview" enjoyed a remarkably strong reputation. 

Anyhow, in 1976 I was at a lunch table with a bunch of lawyers, judges, business folks, etc. and Jimmy's interview was the animated topic.  In it Jimmy admitted to having "Lusted in his heart" a few times. Just as we were discussing the "Lust" line, a blonde bombshell walked past our table - red dress (short, of course), cleavage, heels, etc. and the talk died down while male eyes watched the spectacle. 

After a few moments of silence, one of the group drawled, "Speaking of Lust:  put me down for two regular and one un-natural".

Wednesday, June 5, 2013

Talkative Worms

Years ago I served as the first citizen member of the Virginia Board of Medicine. (lawyers got citizenship rights that year!) and we had a crazy trying to get his license back.

As part of his "evidence" of what he'd been doing while not practicing his craft he submitted essays (these days they would be blogs) he'd written about various subjects. One of the essays referred to lawyers as "Pedantic Nematodes".

 To the amusement of the rest of the Board and staff, (and going way over the head of the still-unlicensed individual) I immediately put the initials "PN" at the end of my nameplate.

Thursday, May 2, 2013

Appendicits (2001 replay)

Twelve years ago I got hit with major appendicitis and had to have it removed.  After it was over, I decided to "sue" the weasly thing, and got my good friend Hoot-N-Owl to represent me.  In going through stuff I found a copy of the complaint and here it is. I've edited it to disguise somewhat the real names of  a bunch of individuals who chipped in to help.  Those that recognize yourselves, thank you again!


V I R G I N I A:





COMES NOW Ross C. Hart, by Hoot N. Owl, counsel, and represents as follows:

1) On, about, or within nine months of MMDDYY, Ross C. Hart and his appendix were joined together, and remained together in apparently harmonious relationship for over 50 years.
2) During the early years of the relationship Ross C. Hart did the usual thing for his age: attended school, went to the principals' office, annoyed his parents, and so forth. The appendix, as a vestigial organ of undetermined value did nothing to interfere with those functions.
3) During Ross' second decade, as he discovered the fairer half of the species and made crude attempts to impress them, the appendix continued to stand by.
4) The appendix similarly kept to itself during the next three decades not even getting involved at the time Ross' right kidney, in an inexcusable fit of rage, stoned Ross.
5) At no time during this relationship did Ross abuse, coerce, hinder, constrain or interfere with the appendix in any way; in fact Ross went to great effort to ensure that it was well fed and enjoyed various beverages supplied in appropriate (by Ross’ standards) moderation.
6) The foregoing relationship ended abruptly in the City of Salem, Virginia, on the morning of April 18, 2001, when the aforesaid appendix, with malice aforethought, intentionally began interfering with the normal functions of the remaining organs of Ross C. Hart. More specifically, the appendix:
a) Began causing pain around 4:00 AM, but disguised the pain as a pulled muscle
b) Increased the amount of pain such that at 6:30 AM Ross C. Hart was forced to awaken his sleeping wife (the pain of awakening her then being less severe than the pain then being caused by the appendix)
7) The aforesaid wife having excellent medical skills honed as an Emergency Medical Technician, began an examination of Ross C. Hart, which examination, as loving and gentle as it could be, caused increased pain.
8) Said wife then called Dr. K, Ross' primary care physician (being formerly known as "Dr. Quinn") who immediately scheduled an office visit for later that same morning.
9) During said office visit, Medicine Woman performed various tests, some causing additional pain, and announced that a blood test had an extremely high white cell count of 17000, and (realizing Ross hadn't cracked a single joke in over 45 minutes) stated that Ross "had all the 'good' signs of appendicitis" ('good' later changed to 'classic' as there are no 'good' signs of appendicitis)
10) Ross was immediately dispatched to the emergency room, and Dr. K called ahead so that they would be expecting him. Unfortunately, Dr. K called Roanoke Memorial, and his wife thought the doctor had said Lewis Gale.
11) Ross and his wife then arrived at the Lewis Gale ER which was not expecting them, and they looked up with blank stares when the supposed call was referred to.
12) Nevertheless, upon being given a summary of the office visit, the Lewis Gale ER accepted Ross as a patient, made him put on the too small uniform patients are required to endure, and which have too much air hitting the posterior. Ross was then placed in a cold room to wait. And Wait.
13) A surgeon was contacted and a Dr. Al appeared and described himself to be the 'quack on call'.
14) At some time during this, Trigon Blue Cross BS (ever notice the last two initials of Blue Cross is “BS”?) was contacted and did confirm appropriate insurance coverage.
15) Dr. Al and the nice, kind, anesthesiologist (with those drugs, the name is forgotten!) discussed the various ways Ross could die during the "routine" operation, and then obtained his consent for the operation.
16) The next thing Ross remembers is awakening several hours later without the pain experienced earlier in the day, but with other pains and some interesting scars on his belly (interesting only if you're a Steven King fan)
17) Dr. Al later advised that the surgery was laproscopic, in which neat little tubes are inserted through several incisions in the belly, air is pumped into the wall, and the tubes moved to the appendix. The appendix was found to be gangrenous and really nasty, and was therefore removed immediately. Upon closing the various incisions, an incidental repair was made to a hernia in the area of the 'belly button'.
18) During the night after the operation nurses kept entering the room Ross was given to give medicine to help him sleep, to control his pain, and to take temperature and blood pressure every half hour. Therefore Ross did not sleep well that night.
19) At breakfast time Ross was greeted with bullion and a popsicle (isn't ice cream for tonsils?) but fortunately the meals got better as the day progressed.
20) Ross was then discharged from the hospital around noon, April 20, 2001, and after a short rest at home with some abdominal discomfort (similar to doing about 1000 sit-ups at one time), low grade fever, and some pretty good drugs, he returned to his office to continue whatever the hell he does.
WHEREFORE, Ross C. Hart, by counsel, moves that this Court--
A. Condemn the appendix t an eternity in the theological place of eternal punishment with all other bad appendices;
B. Thank all those who helped out, visited, or otherwise expressed their concern, to wit:
1 A& J and then DF for keeping the kids the first day, PQ for picking them up and bringing them to the hospital and A and H for taking time from their spring break to watch them the second day.
2 Donna Jarrells, Ross' legal assistant, who rose to the occasion and made various arrangements to deal with Ross' schedule and generally ran the office more efficiently than if Ross were there.
3 The Rev. T.V. who, being informed of the situation (and having some other folks from the parish in the hospital) gave up a vacation day and showed up at the hospital in his uniform. Also MO, St. Paul's Parish missioner, who visited and called.
4 PQ, again, for jumping in to a rezoning hearing not having done one before, and obtaining a unanimous vote in favor of the rezoning, then visiting to describe how it went.
5 JM for covering those matters on Friday that could not be put off, and in particular for helping Donna deal with the payees.
6 Dr. Al for doing a wonderful job, having an excellent bedside manner and sense of humor, and being able to put the patient at ease and explain things so even a lawyer could understand them.
7 The nurses and staff at Lewis Gale Hospital for their excellent care.
8 The Business Office at Lewis Gale Hospital AND Lewis Gale Clinic for NOT messing up the bill.
9 The kids for behaving incredibly well with those who watched over them during the ordeal.
C. Take such other action as appropriate.

Ross C. Hart
By: Hoot N. Owl, Esquire pq (Mill Mtn Bar # 3)
Third Cage on the Left
Mill Mountain Zoo
Roanoke, Virginia

Monday, February 18, 2013

How to Help the Post Ofice

Just received more junk mail.  Actually I get a LOT of junk mail given my estate/guardianship work and the fact that I have a lot of decedents'/wards' mail forwarded to my office. Usually we just toss it.

However one caught my eye, even more so given that they had a 'postage paid business reply thing' enclosed. 

As I understand it, the post office charges more for Business Reply mail than usual because of their extra handling.

And the Post Office has serious financial problems, due in part to the stupid Congress. (Aren't "Stupid" and "Congress" are redundant terms?) and due in part to a lot more email instead of snail mail. 

So to help the Post Office we need to send more snail mail.

And business reply envelopes are snail mail.

So I helped the Post Office revenues.  And even put a note on the envelope thanking the sender for helping the Post Office in it's fiscal difficulties.

If we all did this . . . .

Sunday, January 20, 2013

More Borg fun

Ya gotta be a StarTrek - The Next Generation fan to understand this one . . .

I'm a member of a group of lawyers who use a "Listserv" which is an email blast to others who choose to subscribe. I am - probably - overactive on the listserv.

I used the term "Borg" to refer to WellsFargo and Bank of America (who have an unfortunately large presence in Virginia).

It seems to have caught on. 

It started with my question:
I've got to go get info from one of the Borg and am anticipating the usual crap. 
and I continued with a suggestion of how I might annoy and try to get the attention of the Borg and invited comments. [I'm not including the suggestion here as it involves lawyer-client privilege]
One of the founders of our group said:
Since we’re using ST TNG vernacular, I say “make it so!"   to my suggestion. 

Another member chimed in with 
I don't know Ross, you might need to start with President and CEO of Borg Bank, N.A. and then require that the Bank provide you with appropriate organizational documents verifying which Borg officers in Virginia have authority to speak on the collective's behalf.  Until they provide you with that information, you can tell them that only the President and CEO can talk to you.
which I think is a good tactic . . .

Another member -- responding to the seriousness of the problem -- mentioned a fairly high up contact or two she has at WellsBorgo (did I just coin another phrase?  is that like "Borg of America"? ) and suggested a meeting with the state chapter to discuss communication problems with that collective. 

There were a number of comments very supportive of a meeting and one is in the process of being organized. We've even picked a spokesperson/moderator for the meeting; and one of the comments about picking an  emissary was: 

I think [Irving] would be a great representative for the Federation, if he's willing . 

Irving is willing.  With that news, our group's leader said:

Thanks Irving -- I guess that makes you the leader of the landing party into the BORG hive.  The rest of us will back you up with our phasers set to stun.   Unfortunately, if you remember the actual landing parties that entered a BORG hive ship, they were completely ignored by the Collective as irrelevant unless and until a member of the landing party started vaporizing the BORG drones.  I am afraid that we will be treated the same – ignored unless and until we start doing some real damage to the bank.

I still think, as I thought years ago, that the only way to get the attention of the BORG is to organize and publicize a formal boycott of the bank, where every member of [our group] advised every one of our respective clients to avoid using the BORG bank and we put out a press release to this effect and actually try to get some real publicity (such as TV and radio coverage around the state) of how bad the BORG is.  Only then, I think, is there any chance that they will actually care about what we say.

My response to the group's leader:
You're a real Trekkie!  Perfect analogy and I agree totally.     
(doing Picard's finger thing . . . ) "Engage!"
Of course, for years I've been discouraging my clients and friends and readers from opening or keeping an account at WellsBorgo [and Borg of America]. And withdrawn every penny I could.