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Something to Think About!

on the Psychiatric Nurses hired out of Health & Social Service.

Tue, 24 Aug 1999 11:14:32 -0800
"Bernie Janzen" <bj@pobox.alaska.net>
"Disanto, Diane" <Diane_Disanto@health.state.ak.us>


You are always open for information. It is one of the things I like about

It's not that I don't think that it will work. Who it works for is my

#1 What I heard consumer groups saying was, we have kids OOS because we
lack resources to keep them here.....community based individualized
services. (This is not news to us, maybe to the department, but not to us)
We know there are too many kids being sent out because there are not
alternative or qualified persons to run the type of services we need here.
These nurses positions do not help develop community programs, they do not
help research what is needed to keep kids in our state. The sad part I see
is, this position only addresses 5% of the position's energy into community
based programs. While the nurses will have a good idea why kids are going
out, after probably 3-6 months, they will not serve families in developing
programs here. (a very small amount of time is focused on working with
families) The question was risen of , "How many kids are OOS", because some
in the division did not think there were many kids OOS. This was not the
consumers primary concern. Again, we knew there were a lot of kids OOS. It
was the department that did not know this was a problem. The consumers
attempted to help the division understand that yes, indeed, we had a lot of
kids OOS, because we do not have the resources in AK. The division may have
focused on data collecting verses developing resources in State.

#2 When consumer groups decided to educate the division about how many kids
where OOS, the information was not readily available, it changed from one
person to another you talked, and it was never precise. (Anywhere from 48-
68 kids) It appears a position was created because of pressure to know
statistics and not because it would solve the problem of not having the
resources in Alaska to keep kids from going OOS. (This is a high paid
position for collecting data.) This is something that should be done because
it is the division's job to know this information. (My guess is it will be
supported by Medicaid only and therefore, less helpful to families due to
greater restrictions in Medicaid) Consumer groups heard about these
positions "after the fact". (The "fact": information was not readily
available) It appears the division got nervous about not having this
information and forgot the consumers initial concern. If these positions
were necessary the consumer should have had input into these positions and
how they would be developed. We, the members of the AK. MHB subcommittee
Children's Work Group, were asked to help develop a list for data
collecting. (I think this was a great step forward in the division including
consumers. I hope for more of this is the future) We were not told that
Psych. Nurses were going to be hired to perform this data collecting, until
after it was a done deal. I still am having difficulty understanding why
these nurses are out of the family services area instead of DMHDD. Is
this information available?

#3 Also, I am concerned that the "nurses" have to much power to say, "NO",
to OOS placement due to pressure put on them by DFYS to keep kids here when
there are no services available. (Although the job description says they
will work with IDT and RPC it has not been my experience, as a parent, that
these teams are well educated to community based services) If kids stay
in-state without the community support the communities will suffer. This is
a set-up for families with difficult kids and for communities. If we cannot
get services here than families should have the opportunity to seek services
somewhere else, while resources here, in Alaska, are being developed. (I do
believe we are making progress, slowly but surely, in this matter)

#4 This is another layer of "hoops" families must jump through.
"Authorizes Medicaid reimbursement when medical criteria is met" is
something a psychiatrist has already done. "Provides medical expertise and
guidance to these teams and committees", is a slap in the face to doctors
who have already made their recommendation; they know the kids.......the
nurses will not meet these kids till they return from OOS. And, while all
these people are making the decision for the kid and family the child is
probably setting in a high priced hospital, not getting appropriate
treatment, for an even longer time because their is no "safe place" for the
child to be released in Alaska.

So, Diane, it is not that I don't think this will work. Who it works for is
my concern. Whose needs it meets is my concern. These positions added
layers to an already cumbersome process, added power to the division
(instead of the consumer), did not address our primary concern for community
based services, and made well qualified professional nurses data collectors.
And mostly, we the consumers, were not totally included.

Thanks for listening to my concerns. I know this is not malicious it is a
matter of communication and education. I will do my best to keep asking
the questions and keep listening and learning. I will do my best to help
families in Alaska receive appropriate, efficient & effective services which
are family focused services.

Thanks, Bernie

-----Original Message-----
From: Disanto, Diane [mailto:Diane_Disanto@health.state.ak.us]
Sent: Tuesday, August 24, 1999 8:38 AM
To: 'Bernie Janzen'

Bernie, what is it that you don't think would work?

> -----Original Message-----
> From: Bernie Janzen [SMTP:bj@pobox.alaska.net]
> Sent: Monday, August 23, 1999 5:38 PM
> To: Aileen McInnis
> I was able to obtain a copy of the operating job description for the
> Psychiatric Nurses hired out of Health & Social Services. (This is public
> information) These were positions (3 1/2) Health & Social Services asked
> the AK. Mental Health Trust to financially support through a grant. I
> have
> concerns for families of children with mental health disabilities and
> those
> kids who have no family (custody kids) and how this job description does
> or
> does not meet those families needs. Please call 465- 3633 and ask for
> Dave
> Cote to get a copy of this job description. Make your own decision as to
> how these positions will support families. If you, also, decide you have
> concerns please call or write the AK. Mental Health Trust Authority and
> discuss these concerns with Mary Elizabeth Rider or Jeff Jesse: AMHTA-550
> W.
> 7th Ave., Suite 1820, Anchorage, AK. 99501
> (907) 269-7960
> (907) 269-7966
> www.mhtrust.org
> Good Health,
> Bernadine Janzen,
> Ak. Attachment & Bonding Associates (AABA), Co-Director


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