By Guest Blogger, Mary Ellen Taylor
My name is Mary Ellen Taylor. I am an RN employed by the Mecklenburg County Health Department. I have spent 25 years in the assessment of high risk infants and toddlers under what is currently called the Child Service Coordination Program. I am speaking ONLY as an individual RN who has had a child with the problems described below and who is gravely concerned about measures before our state General Assembly and the Department of Health and Human Services.
The Child Service Coordination Program is offered by our county Health Department. We receive referrals on the birth of all high risk infants under state criteria born in our county. We also receive referrals from a variety of sources on infants and toddlers who are believed to have developmental delays and problems not identified from birth. Our program is free to all county residents, regardless of income. The program is voluntary and is the only such program offered..
My job is, during continual visits, to determine, through observation and assessment whether a child has developmental or other health problems. Continued visits are necessary because the child presents differently as he grows.
When a problem is identified, my job is to educate the parents in the problem guide them through the multi-agency maze of available support and services, and again through contact visits, to determine that the child is progressing toward resolution.
In the last 10-15 years, there has been a staggering expansion in the number of children who require this program to realize their potential. The good news is that the majority of these disorders can be cured or controlled through existing therapy techniques, often without medication. The bad news is that pediatricians and other health care professionals almost never spot these problems before the child enters Kindergarten.
Why is this Bad News?
Because, although the same methods can yield the same results at late discovery, the child is more difficult in therapy and has almost always become a pariah to his peers in his early socialization. Many of our referrals come from teachers and others who noticed the child as an object of ridicule or exclusion by his peers because of behaviors noticeably abnormal for his age group.
At this point, damage to the child’s self-image and the resultant emotional issues and loss of self-esteem frequently induce psychological problems which are often more serious and require more work to resolve than the original problem.
The tragedy is that unidentified and/or untreated, the child will retreat more and more into himself, will never develop his full mental and physical potential – both of which are often in the aggregate HIGHER than the average for his peer group, and will become hostile and defensive, thus creating a circle of disappointment and depression which can follow him throughout life and eventually relegate him to a social status, an income level, and a self-image which he realizes are below his potential, making him an ever more bitter and closed person.
Why have I composed this note?
At the present time the Child Service Coordination Program
-Is under review by the General Assembly for … complete elimination
-Alternatively, is part of an initiative by State Health and Human Services for centralized consolidation.
This initiative would remove all assessment and ongoing home visits by an RN in favor of a minimal screening and referral – almost entirely by phone – to caregivers. The assigned case manager would not personally visit the child, assess his progress and note any new problems or provide detailed guidances and education for the parent.
Doubt this? My caseload is 64-70 cases. A typical case manager in areas previously consolidated under similar initiatives averages a caseload of 2500 clients from an assortment of the program centralized. My performance level today is the result of 20 years of experience and education. Under the initiative, the case manager may not be an RN and may not have experience in this particular area. The primary function would be the standardized referral.
I believe the problems resolved by this program to be the most serious and rapidly expanding threat to our children today.
I believe the elimination of this program constitutes a life sentence for this expanding group of children to underachievement, poverty, and bitter hostility.
I believe many will require public assistance throughout life and many others will spend time in prison.
I believe that the case management initiative is a triumph of form over substance, replacing real help with ineffective, wasteful gesture.
I also believe that this is a little known program whose death or evisceration by consolidation would raise little hue and cry compared to the more visible ones. The decisions on which ox to gore are usually made on the basis of political pain; as opposed to the needs of those they serve.
It is worth noting that the Association of County Health Directors has also condemned this consolidation.
What You Can Do
Listed below are people who can prevent this tragedy. I would ask that if you can you write (emails provided individually & collectively below) as many of these as possible. If you can’t, please write as many as you can in descending order and call the rest. Please encourage any friends or contacts you have to do the same. Please talk to any contacts you have who can lobby General Assembly members, the Governor, and/or the Secretary of Health and Human Services on this matter.
The message is simple:
We vehemently oppose either the elimination of the Child Services Coordination Program or its consolidation into centralized case management under the initiative under way in the Department of Health and Human Services.
We consider the above initiative a grossly inappropriate act which will reduce the present service under the program to an ineffective and useless level.
Before continuing the past program of piecemeal reduction/privatization/outsourcing of present public health functions, we strongly urge the Secretary of Health and Human Services to address on a comprehensive basis this question as relates to all Public Health Functions, to properly publicize the proposal, to require approval by the General Assembly of the overall plan which, after public hearing, would be executed in a known fashion over a suitable timeframe.
A vote is up soon, so please act today to help! We are dealing with the only assistance available to a fragile and little recognized group of children. The “little known” is important…a program, however vital, often becomes a candidate for downsizing or elimination based up the relative public silence with which it can be done. We need to make our (Smarty) voices heard and NOW, not after these plans have the force of law.
Thank you all so very much for your support and help in saving our precious children!
Mary Ellen
Health and Human Services
Mr. Lanier M. Cansler
Secretary, Department of Health and Human Services
2001 Mail Service Center
Raleigh NC 27669-2001
919-733-4534
919-715-4645
Lanier.Cansler@ncmail.net
Dr. Jeffrey P. Engel
Director, Division of Public Health and State Health Director
1931 Mail Service Center
Raleigh NC 27699-1931
919-704-5000
919-870-4829 Fax
Jeffrey.Engel@ncmail.net
The General Assembly: Chairmen of the Committees on Funding of Health and Human Services and on Health Care
Sen. Stan Brigham
NC Senate
300 N. Salisbury St. Rm. 625
Raleigh NC 27603-5925
919-276-7328
Stan.Bingham@ncleg.net
Sen. William R. Purcell
NC Senate
15 W. Jones St. Rm. 1118
Raleigh NC 27601-2808
919-733-5665
William.Purcell@ncleg.net
Mr. Doug Berger
NC Senate
300 N. Salisbury St. Rm. 526
Raleigh NC 27603-5925
919-715-8363
Doug.Berger@ncleg.net
The General Assembly: Chairmen of the House Committees on Funding Health and Human Services and on Health
Representative Beverly M. Earle
NC House of Representatives
300 N. Salisbury St. Rm. 634
Raleigh NC 27603-5925
919-715-2530
Beverly.Earle@ncleg.net
Representative Bob England
NC House of Representatives
300 N. Salisbury St. Rm. 634
Raleigh NC 27603-5925
919-733-5749
Bob.England@ncleg.net
Representative Verla Insko
NC House of Representatives
300 N. Salisbury St. Rm. 634
Raleigh NC 27603-5925
919-929-6115
Verna.Insko@ncleg.net
The Governor, who has stated the health and well-being of the state’s children as her first priority
Governor Bev Perdue
Office of the Governor
20301 Mail Service Center
Raleigh NC 27699-4240
919-733-4240
919-733-2120 Fax
Bev.Perdue@ncmail.net
Mecklenburg’s State Senators
Senator Daniel G. Clodfelter
NC Senate
300 N. Salisbury St. Rm. 408
Raleigh NC 27603-5925
919-715-8331
Daniel.Clodfelter@ncleg.net
Senator Charlie Smith Danelly
NC Senate
16 W. Jones St. Rm. 2010
Raleigh NC 27601-2808
919-733-5955
Charlie.Danelly@ncleg.net
Senator Malcolm Graham
NC Senate
300 N. Salisbury St. Rm. 620
Raleigh NC 27603-5925
919-733-5650
Malcolm.Graham@ncleg.net
Senator W. Edward Goodall
NC Senate
300 N. Salisbury St. Rm. 332
Raleigh NC 27603-5925
919-733-7659
Eddie.Goodall@ncleg.net
Senator Bob Rucho
NC Senate
15 W. Jones St. Rm. 1118
Raleigh NC 27601-2808
919-733-5655
Bob.Rucho@ncleg.net
North Carolina National Senators
Senator Richard Burr
217 Russell Senate Office Bldg
Washington DC 20510
202-224-3154
Senator Kay R. Hagan
521 Dirksen Senate Office Bldg
Washington DC 20510
202-224-6342
Senator_Hagan@hagan.senate.gov
Mecklenburg County Manager
Harry Jones, County Manager, Mecklenburg County
600 E. 4th Street
Charlotte NC 28202
704-336-2472
Harry.Jones@mecklenburgcountync.gov
Michelle Lancaster-Sandlin, General County Manager for Community Health and Safety
600 E. 4th Street
Charlotte NC 28202
Michelle.Lancaster@mecklenburgcountync.gov
Mecklenburg State Representatives
Representative Martha B. Alexander
16 W. Jones St. Rm. 2208
Raleigh NC 27601-1096
919-733-5807
Martha.Alexander@ncleg.net
Representative Kelly M. Alexander
NC House of Representatives
300 N. Salisbury St. Rm. 632
Raleigh NC 27603-5925
919-733-5778
Kelly.Alexander@ncleg.net
Representative Becky Carney
NC House of Representatives
16 W. Jones St. Rm. 1010
Raleigh NC 27601-1096
919-723-5827
Becky.Carney@ncleg.net
Representative Tricia Ann Cotham
NC House of Representatives
16 W. Jones St. Rm. 1010
Raleigh NC 27601-1096
919-733-5606
Tricia.Cotham@ncleg.net
Representative Ric Killian
NC House of Representatives
16 W. Jones St. Rm. 1010
Raleigh NC 27601-1096
919-733-5886
Ric.Killian@ncleg.net
Representative Nick Mackey
NC House of Representatives
300 N. Salisbury St. Rm. 403
Raleigh NC 27603-5925
919-733-5606
Nick.Mackey@ncleg.net
Charlotte Mayor
Mayor Patrick L. McCrory
600 E. 4th Street
Charlotte NC 28202
704-336-2472
mayor@ci.charlotte.nc.us
All email addresses to copy/paste into line of email:
Lanier.Cansler@ncmail.net; Jeffrey.Engel@ncmail.net; Stan.Bingham@ncleg.net; William.Purcell@ncleg.net; Doug.Berger@ncleg.net; Beverly.Earle@ncleg.net; Bob.England@ncleg.net; Verna.Insko@ncleg.net; Bev.Perdue@ncmail.net; Daniel.Clodfelter@ncleg.net; Charlie.Danelly@ncleg.net; Malcolm.Graham@ncleg.net; Eddie.Goodall@ncleg.net; Bob.Rucho@ncleg.net; Senator_Hagan@hagan.senate.gov; Harry.Jones@mecklenburgcountync.gov; Michelle.Lancaster@mecklenburgcountync.gov; Martha.Alexander@ncleg.net; Kelly.Alexander@ncleg.net; Becky.Carney@ncleg.net; Tricia.Cotham@ncleg.net; Ric.Killian@ncleg.net; Nick.Mackey@ncleg.net; mayor@ci.charlotte.nc.us
8 comments
Thanks for the information. EARLY INTERVENTION is Key!
As a family that sees the services she has received from Early Interventions critical to her boys development… i will be writing all on this list!! Thank you for this information!
Great idea! You never know if your child will be the one who needs these wervices.
As an update to this blog, I have reviewed the present Conference Budget now before the general assembly. There are clear provisions (see "changes in Medicaid" under this bill at the General Assembly website) (1) the consolidation/reduction of this program under (2) CCNC, a private organization which will manage Medicaid services.There is a budget line item for savings from this consolidation of $53 million. It will move forward without action to reverse.The result will be as indicated in the blog. PLEASE NOTE: The term "Medicaid" may be causing some confusion. This program, unlike its fellows, has separate state funding to extend its services to ALL eligible children. Finding no provision for continuation of this funding, I can only assume it vanishes.If you wish to see firsthand what is happening, go the the Division of Medical Assistance on the state Department of Health and Human services website. Click on budget initiatives and click on the"see more" tab under Medicaid case management. And please note that, despite project language which permits a number of outcomes, the legislative provision for management under CCNC of all Medicaid programs dictates the end result.I urge you to continue writing our delegations in the general assembly as well as others noted in the blog to gather support for retaining this program.I have said to the governor and others that I should beprefer to see it elinated completely rather than reduced to an expensive, ineffective shell which offers little to parents and children in need of effective intervention but permits government to say "But we didn't eliminate the service."In DMA's own words, the purpose of the consolidation, beyong anything else, is reduction in service level and cost.I again ask for your support.Mary Ellen Taylo
I wish you were my children's coordinator! We are enrolled in the program, but have only heard from our coordinator twice in the past 7 months…I will be writing all on this list as well!
Thank you for sharing the information. We used this service when we had a 28 week preemie and found it very helpful and loved our coordinators. I am passing on to all our NICU friends and nurses.
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