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- Could someone check tosee how many of the people listed are coming to this meeting 7 They've all been Ignore invided those with a DianaF. FAMILY OICES Ciro V. Sumaya, M.D., M.P.H.T.M. Administrator Health Resources and Services Administration Rockville, Maryland 20857 Board of Directors Betsy Anderson Massachusetts November 11, 1996 Allan Bergman District of Columbia Kathleen Kirk Bishop Dear Dr. Sumaya: Vermont Gayle Brown Kentucky Your letter from several weeks ago has taken a prominent place on my Connie Garner desk. It reminds me that I must send you a response that reflects my Virginia Pat Hackett-Waters gratitude for your understanding of the dilemma shared by so many families Florida who have children with special health care needs. Your letter also makes it Denny Hoyt Iowa clear that there are many people, not all of them families and front-line Vince Hutchins, MD health professionals, who also worry about the future of our children with Maryland Gail Johnson special health care needs. Clearly, there is a heightened awareness about Maryland these children and the federal policy that guides services, programs, and the Lou Landry allocation of resources on their behalf. Idaho Bev McConnell Michigan It was heartening to read in your letter that HRSA's Maternal and Child John Reiss Florida Health Bureau (MCHB) supports families as partners and believes in the Josie Woll inclusion of our children in MCHB initiatives. We have seen such inclusion Hawaii occurring recently within the MCHB in divisions beyond the Division of Staff Services for Children with Special Health Care Needs (DSCSHCN), where Polly Arango New Mexico such efforts were developed and nurtured over the years. It was also Julianne Beckett heartening to see that the MCHB chose to maintain the presence of the Iowa Trish Thomas DSCSHCN in its reorganization. However, it appears to many of us that as New Mexico the MCHB reorganizes, resources and programs are being taken from the Nora Wells Massachusetts Division and moved into other parts of the MCHB. As that occurs, we wonder how the MCHB will assure us that an adequate focus on children with special Regional Coordinators Cindy Arceneaux health care needs can be maintained and that policies and services for our Southeast children with special health care needs will have the attention and resources Ericka Cade Central they require. Bob Craig Atlantic This may appear to be an arcane issue and one that families have Cassie Johnston West historically not been involved in. If these were ordinary times, we families Sally Maxey Mountains would be more than happy to leave the reshuffling of bureaucracies to others. Heather Bennett McCabe However, on a daily basis, our children with special health care needs and Mid-Atlantic their families face a number of crises. Increasing managed care mandates, Barbara Popper Northeast decreasing employer-based health insurance, Medicaid cuts, Welfare Reform Ceci Shapland restrictions, and state budget cuts all impact our children and present Northern Plains Bill Stumpf families with an almost unbearable onslaught of change. Of all the times Central Plains when we need a distinct, high profile "federal home" that will protect and Trish Thomas Southwest develop good health policy for our children, it is now. A National Grassroots Network of Families and Friends Speaking on Behalf of Children with Special Health Care Needs P.O. Box 769, Algodones, New Mexico 87001 / Tel 505/867-2368 / Fax 505/867-6517 Therefore, it is important for Family Voices and our 10,000 member families to know if the DSCSHCN will continue to have the federal responsibility for providing a permanent, well-defined federal focus on this vulnerable population. And, if so, what assurances do we have that the DSCSHCN will have the resources it requires to fulfill that role? Thank you SO much for caring about our children and understanding why we families must be outspoken in our commitment to our children. By the way, I will be in Rockville on Monday, December 9. Would it be possible to meet with you then? Arango cc: Secretary Donna Shalala Dr. Audrey Nora Ms. Diana Fortuna EXECUTIVE OFFICE OF THE PRESIDENT 20-Nov-1996 11:21am TO: FORTUNA_D FROM: Richard J. Turman CC: Nancy A. Min CC: Barry T. Clendenin CC: Chin-Chin Ip CC: Wm G. White SUBJECT: Re: 2 programs Message Creation Date was at 20-NOV-1996 11:13:00 You had also asked about HRSA's "Division of Services to Children with Special Health Care Needs, which is part of the MCH bureau." Two things: 1) states are required to use at least 30% of whatever they get from HRSA's MCH Block grant on children with special health care needs (Section 505 (a) (3) (B) of the Social Security Act). The state portion of MCH goes up by $58 million under the proposed funding levels, so state funding for these children would go up. 2) as for HRSA's specific program office that consults with states on how states spend their 30% of the MCH block on such children (among other things), we don't have any particular number or proposal. We give HRSA one big number for their administrative operations (we've provided $101 million in FY98, down from $113 million in FY97 to reflect reduced administrative spending on health professions, Healthy Start, and other small HRSA grants), and let them spread it to this Division, as well as to all other Divisions and Bureaus. It would be very rare for us to indicate to HHS how much to give a particular sub-office of administrative types, because this would be intruding in a big way into the management flexibility of the MCH Bureau and of the Administrator of HRSA, Ciro Sumaya. Give us a call with any further q's! I have a 10:00 commitment I'm late for - - : apologize, Children with Special Health Care Needs Meeting--Fri., Dec. 20--9:00-10:00 am--729G Person Position Phone Number Fax Number Polly Arango Family Voices (505) 867-2368 (505) 867-6517 Julie Beckett Family Voices (319) 395-7349 (319) 395-7085 Dr. Phil Lee Asst. Secy. for Health 690-7694 690-6960 Olivia Golden Acting Asst. Secy. for the 401-2337 401-4678 YES Admin. on Children & Families ? (Dr. Ciro Sumaya) Health Resources and (301) 443-2216 (301) 443-1246 NO Douglloyd Doug Services Administrator Dovg Llon 1 Dr. Audrey Nora Director, Maternal and (301) 443-2170 (301) 443-1797 YES Child Health Bureau Dr. Merle Director, Services for (301) 443-2350 (301) 443-1728 YES McPherson Children with Special Health Care Needs Division Mary Beth Donahue Deputy Chief of Staff 690-6133 690-7755 YES Ann Rosewater Deputy Asst. Secy. for 690-7409 690-6562 YES Policy and External Affairs Joan Lombardi Director, Child Care Div. of 401-6947 690-5600 CEPT MSG. Mimi Children's Bureau CEPT Bob Williams Commissioner, Policy, 690-5806 401-9507 MSG. Plans, & Programs Carol Williams Deputy Commissioner, 205-8618 260-9345 CAROL WILL BE OFF; SHE'LL SEND Policy, Plans, & Programs SOMEONE +WILL CALL W/INFO 12/19 Reginald Wells Deputy Commissioner, 690-5806 690-7668 Policy, Plans, & Programs YES Mary Clankson Sally Richardson Deputy Admin., HCFA 690-6726 690-6262 YES Connie Garner DAS- Earl FOX-MOH 205-8124 205-9252 YES Nancy-Ann Min OMB 5-5178 LEFT MS6. Richard Turman OMB 5-4926 LBFT MSC. Boufford +1 Minn- Heth+Diab-HeadStant RuthKatz THE FEDERAL ROLE IN PROTECTING CHILDREN WITH SPECIAL HEALTH CARE NEEDS: A FAMILY PERSPECTIVE The Problem: There is no consensus from the federal government about its role regarding policy, services, and resources for children with special health care needs (children with disabilities and/or chronic health conditions). In fact, the vagaries of federal policy for our children are symbolized by the absence of federal agreement on a working definition of "children with special health care needs". Absent a coher- ent federal policy, this sense of ambiguity about our children results in: confusion about leadership and a champion for these children and their families within the federal bureaucracy; no single program or source of expertise readily accessible to other government agencies or the general public, with a potential loss of research and data for these children; scattered programs that compete for attention, re- sources, expertise, and authority; unjustifiable duplication and overlapping efforts; and muddled messages floating down to state programs that receive federal health dollars for this population.* Without a federal focus that acknowledges and supports children with special health care needs, families will continue their frustrating dia- logues about policy, data, definitions, services, and resources with federal agencies and bureaus that cannot respond appropriately. The bottom line for families is sim- ple: Families want coordinated federal policies that will support them in their efforts to raise their children with special health care needs at home with the help of pro- fessionals and friends and neighbors in their communities. Basic Issues: 1. We must develop a federal policy, based on a philosophy of care, that will even- tually include all persons, of all ages, who have disabilities and chronic health conditions. That philosophy should emphasize decentralization of responsibil- ity to family and community. But let us begin with a developmental approach, with children. 2. The primary purpose of any comprehensive system of services for children with disabilities or chronic health conditions should be to support and supplement what families are doing for their children. While this may seem obvious, moving the family to the center of the system would be revolutionary: the opposite of policies that guide Medicaid, for example. 3. The system should serve all children with special health care needs. The vast majority of children with special health care needs will need very little beyond what their families, health practitioners, and teachers are already providing, but the services and programs now available should continue to be protected and provided, with coordination between public and private providers a critical element. At present, we offer a great many services to a small percentage of children with special needs, and do nothing systematic for the majority. It should be noted that the services to these children are inconsistent, varying greatly by state, diagnosis, eligibility criteria, and availability of providers 1 4. The system should keep most of the responsibility for paying for care for chil- dren with special health care needs where it is now: with the private sector, families, and communities. Many government planners' view of systems of services for children with special health care needs is skewed: they focus only on children and families who need lots of expensive services paid for by state or federal funds. Most costs for most children, however, are paid by other sources, such as private health insurance, families, and local schools. Nothing should be done to displace these payers. On the other hand, families who need financial assistance should receive it promptly and without excessive hassle. Policies should clearly delineate who will pay for what, why, and how. 5. Children with special health care needs must be served as early in life as pos- sible. During the transition to a comprehensive system, priority should be given to reaching young children, without reducing services for those youngsters al- ready being served. One group of children, adolescents who must at some point move into adult systems of care, tend to be ignored at all levels and in most programs. 6. We must gather better data about all children with special health care needs, including information about children with mental illness, behavioral problems, and learning disabilities. Once we know who these children are, we must de- cide who will be served, in what ways, and what outcomes we should expect. Outcome-based research can support the identification of effective practices. And then a major effort must be made to disseminate those practices. 7. Improved coordination between schools, health providers, and families can lead to better integration of children with disabilities or chronic health condi- tions into every aspect of ordinary life. Government policy should support and encourage the formation of parent-professional teams, and encourage all ap- propriate agencies to work together to assist the family to raise their child. How to Address the Basic Issues: 1. A broad based group of stakeholders/planners should come together to de- velop, review, or refine models for a comprehensive system of care for children with disabilities or chronic health conditions. They must agree to base their thinking on a family-centered philosophy of care and to participate in a con- sensus model of decision-making. 2. That group will need expert assistance to overcome conventional thinking about systems of care for children with special health care needs, such as: that services must be provided by government; that the institution is the norm; that all kids with disabilities are severely disabled; that only highly trained profes- sionals can provide services; etc. 3. The group should agree on a common definition of children with special health care needs, leading to agreement on how many there are, where they are, what services they require, what those services cost, and who should pay for them. 2 As mentioned earlier, this will require assembling much better information about all children with special health care needs, including those with mental illness, behavioral problems, and learning disabilities. 4. The group should focus on outcomes at critically important milestones during childhood: What do we want for infants with or at risk for special health care needs and their families? What do our children need as they enter school? When they leave school as adults, what skills should they have? Given agree- ment on these issues, and stripped of conventional thinking, we can then begin to construct and understand coordinated, comprehensive, community-based, family-centered models likely to produce the desired outcomes. 5. As the outlines of the models emerge, an effort should be made to identify communities where the models are already in operation. Theoretical models should be modified by actual experience before costs are determined. 6. Costs of the models should then be determined. 7. If the cost is not reasonable, the model should be further modified or dis- carded. The group's work should not be considered done until one or more models have been found that yield the desired outcomes at a reasonable cost. 8. This is a reinventing, not a restructuring, effort. Relatively little time should be invested in figuring out how to make the children's SSI program more effective, or on how to integrate Medicaid and school services. The point is to start with the child, his or her family, the professionals that serve them, and others in their community, and build from there. Starting with existing agencies and programs almost guarantees getting stuck in conventional thinking. 9. Let us repeat: This will require a meeting of stakeholders, with an equal mix of policymakers, families, agency people, providers, and advocates at the federal level. The meeting must be well-designed, well-led, and substantive, sweeping everyone out of their conventional boxes and assuring them that there will be not only long-term vision, but practical outcomes that all stakeholders can use and implement immediately. Note: We acknowledge that there are several strong federal offices fighting for and guiding programs and policies for children with special health care needs. The most veteran office is the Division for Children with Special Health Care Needs (DCSHCN) in the Maternal and Child Health Bureau (MCHB), which has the longest and most specific legislated mandate to serve children with special health care needs. However, we understand that MCHB is undergoing internal structural changes which will have an unknown and perhaps questionable im- pact on the DCSHCN and its history of protecting our children. Polly Arango -8/8/96 Family Voices: system ideas 2 7/25/96 3 Nora-higher levelTAG? 12/20/96 Jan25 + again in March FamV Beekett-eroding - private high care ins. chthatgoes wrong? Arango- pre ICNA what's gd about div cenelusion in VI integration JB- became part of system - no data hunt in heR Connie ? FICC Joan ? -MA Tags Bob who is inchg? Agree it's aproblem. FA Acknowl.that Hits is a place JB: family -Ctrd - vs, familyfocused that 13 not always PA: Model- fame lies tp + ofer McPh- "lo cate + treat complexch "1935 Koop again- tech-dep. HOFA, + Div, ACF(ADD PHS 1989 - Agendai new r He MCH in Goal, 2000 ASPE chilace Chi (4 clace Bur Part H VAP'S Commonvision Focal ptt critical, focus mass FICC Big. - MAISSI, IDEA plus HHS Doug Lloyd - Q -what makes idwic? - state moving Head start gd model Bobw - sitr engths, mustbuild on; when culture 7 HHS, not OSERS Nora - TAG W/ACF + HCFA * higher level TAB Ann - Dom Vidence - Steening Comm - Xidiscovered gap in training Julie - families there FAMILY VOICES Board of Directors Betsy Anderson Massachusetts Allan Bergman District of Columbia Kathleen Kirk Bishop To: Diana Fortuna Vermont Gayle Brown From: Polly Arango DA Kentucky Connie Garner About: Virginia Children with special health care needs Pat Hackett-Waters Florida Date: August 8, 1996 Denny Hoyt Iowa Vince Hutchins, MD Maryland Gail Johnson Here is the paper I promised you so long ago. It is based on the thoughts I shared Maryland with you in written and verbal form in June. What took so long? Family Voices feels Lou Landry Idaho quite a responsibility for speaking on behalf of so many children and families. I Bev McConnell shared my written thoughts, therefore, with several people, primarily the Family Michigan Voices staff, all of whom have different perspectives and experiences than I. They John Reiss Florida helped me make some changes to the body, and then I wrote a problem statement. Josie Woll There are so many changes facing our children and families welfare reform/SSI, Hawaii Kennedy-Kassebaum, Title V/Children with Special Health Care Needs state Staff program modifications, Medicaid cuts, omnipresent managed care. Now is the Polly Arango New Mexico perfect opportunity to get a handle on responsibility and coordination in the federal Julianne Beckett programs meant to serve them. Iowa Trish Thomas New Mexico I hope this is helpful. Julie Beckett and I will be in Washington on August 20-21 Nora Wells for a number of meetings and we would be happy to meet with you at your Massachusetts convenience, Several families will meet with MCHB's Dr. Audrey Nora at 9:00 a.m. Regional Coordinators on August 21, to talk about our concerns about the changing focus on children with Cindy Arceneaux Southeast special health care needs within the bureau. These are interesting times! Ericka Cade Central Thanks for your interest in our children and their future. Bob Craig Atlantic Cassie Johnston West Sally Maxey Mountains Heather Bennett McCabe Mid-Atlantic Barbara Popper Northeast Ceci Shapland Northern Plains Bill Stumpf Central Plains Trish Thomas Southwest A National Grassroots Network of Families and Friends Speaking on Behalf of Children with Special Health Care Needs P.O. Box 769, Algodones, New Mexico 87001 / Tel 505/867-2368 / Fax 505/867-6517 NOV-12-1996 14:05 FAMILY VOICES 505 867 6517 P.02 FAMILY OICES To: Diana Fortuna From: Polly Arango Board of Directors Betsy Anderson About: Meeting about children with special health care needs Massachusetts Allan Bergman District of Columbia Date: November 13, 1996 Kathleen Kirk Bishop Vermont Gayle Brown Kentucky Just a note to make sure I am clear about the meeting in December regarding a Connie Garner Virginia federal focus for children with disabilities and chronic health conditions (children Pat Hackett-Waters Florida with special health care needs). The purpose would be to bring all the federal players Denny Hoyt together with two family leaders (Beckett and Arango) to discuss the problem we lowa have when health policy for children with special needs does not have appropriate Vince Hutchins, MD Maryland placement within the federal government. This would be a one day meeting to state Gail Johnson and understand the problem and perhaps consider some solutions. The ripple effects Maryland lou Landry of this issue have impacts on these children and their families that range from federal Idaho and state policy and allocation of resources to managed care, education, parental Bev McConnell Michigan employment. even media coverage. John Reiss Florida Those attending will likely include you, Bob Williams, Judy Heumann, Phil Lee, Josie Woll Ciro Sumaya, Merle McPherson, Ann Rosewater, Connie Garner, Joan Lombardi, Howall Carol Williams. These are the dates when Julie and I absolutely cannot be there: Staff December 3,4,6,9 (am and early pm OK), 13. Sorry but those are all speaking Polly Arango New Mexico engagements for one or both of us. Julianne Beckett Iowa Also, you mentioned a later, larger meeting on this topic that would include Trish Thomas New Mexico foundations. Steve Somers of The Robert Wood Johnson Foundation recently hosted Nora Wells a meeting of eight foundations to discuss consumer involvement in health care (or Massachusetts maybe just managed care). I know that representatives from Casey, Packard, Kaiser Regional Coordinators were there ---perhaps Pew. You might want to call Steve at 609/279-0700 to see who Cindy Arceneaux Southeast else attended and if they indicated an interest in children's health issues. Ericka Cade Central One last thing. We are busy trying to find a marked-moderate SSI case not an Bob Craig Atlantic easy task. In making inquiries, I realized another impact of new SSI regulations: The Cassie Johnston SSI eligibility definition is frequently used for eligibility for many, many programs West beyond SSI. For example, in the absence of a better definition, Hawaii is planning to Sally Maxey Mountains use the new SSI eligibility criteria to determine which infants with special needs get Heather Bennett McCabe medical coverage through the carve out in managed care! Mid-Atlantic Barbara Popper Northeast Hope to see you soon. Thanks for your time and concern Ceci Shapland Northern Plains Bill Stumpf Central Plains Trish Thomas Southwest A National Grassroots Network of Families and Friends Speaking on Behalf of Children with Special Health Care Needs P.O. Box 769, Algodones, New Mexico 87001 / Tel 505/867-2368 / Fax 505/867-6517 Merle MeP-,concem-sptfor culture activt focus MCH Bureau andrey Nora HRSA Dr. Dr. Samayo (he) PHS AUG-07-1996 15:39 FAMILY VOICES 505 867 6517 P.01 Key arjel To: Diana Fortuna FYI. From: Polly Arango and Julie Beckett Coyne, Chesser, Date: August 7. 1996 Subject: Family Voices is in contact with a number of organizations interested in ensuring that the changes in the children's SSI program are carried out as smoothly as possible, and that. when the process Is finished. all children who need services continue to receive the services they need. In brief, the approach being discussed is: Negotiations with the Social Security Administration (SSA) to assist them to develop a program for reviewing children's eligibility that will work for both SSA and families. A massive outreach effort to ensure that families who receive an SSA notice understand the situation they face and the steps that they could take prior to their meeting with SSA staff. We have discussed involving a substantial number of AmeriCorps Volunteers in this effort. A group of trained physicians and mental health professionals in each state to consult with the families' treating physicians on documentation issues. Several national medical groups have expressed an interest in participating in this part of the effort. Support to families, particularly between the time the letter is received and the first meeting with SSA, provided by thousands of local parent support organizations. A very large group of volunteer attorneys (100,000 or more) willing to file an appeal for any child found ineligible on the basis of the existing file and/or any new documentation submitted. The attorneys will take each child as far as the CLASP new law permits with the understanding that some children, unfortunately. will be found ineligible. infalking phase A second, much smaller group of physicians and attorneys that will work with each state to ensure that the state is prepared to serve, and in fact serves, any child found ineligible for SSI but still in need of services. The intent is not to challenge the changes, but to ensure that a) families understand and are prepared for whatever may happen when their child's eligibility is reviewed: b) as many children as possible-ideally. all children-are able to avail themselves of their right to a hearing before being dropped from the program: and c) in the end. all children who need services continue to receive them. Further, the intent is to carry out this effort at the community level. using, whenever possible, community-based organizations and volunteers. We'd be happy to provide more information on this effort at your convenience. 8/21/96 SSI - wkg w/Acad Peds - does who work W/CWD - P+A's Bruce Peter 1st Oct wX of ADD Nora t MoPherson(s) Samaya) * HHS/advoc mtg w: ?? justkids?all? *Dr Nork - call re systems mid Sept. & Wha@SA - call Indy to see y she has started Dr Nora - MCHB- long mtg SSA mtg w/ FV Reorg- pull out PedAIDS Nachri - systems dev, - more itent ACCH -bring gps togiDe Rhoda -Wash: mgd care Block grant that works Families @ public health Marty SAMHSA? HRSA? To do - does -legal assistance *2/28-3/2 - non -Dr aps Instrute fn child Heth Policy Eebley-got SSA grant Who @ HHS Krow: Bobw Ruth K