I am posting this at the Snelling Ave Dunn Bros. Coffee shop. Unfortunately, there were no available tables with outlets close by. Actually, every table was taken. So, I am sitting out back, which is great today, considering it is 60 degrees right now, but also lacks outlets. Anyway, work was quick, with only one consult. But it did require an assessment, and a DHS one at that.
DHS is Department of Human Services. In Minnesota, for publicly funded patients, we have to fill out a particular form, which is 18 pages long. Most of the Minnesota care HMOs (there are four of them that manage health care for Minnesota) require it to be completed, even if they are not going to get state funding for treatment.
See, many, many years ago, something called Rule 25 was created to help under-insured people get funding for treatment. These people could be employed, have health insurance, but not have substance abuse benefits, But, as in all things deemed welfare, the financial requirements became so strict, the original target population was restricted from receiving aid, and only the poor got the funding. Get a job, and you lose your funding.
Anyway, the funding was a combination of Federal grants with a certain level of matching state funds. From what I understand, Minnesota was better than most states at getting the money out there for treatment. Wisconsin, at least when I first sobered up in the mid 80s, was not so good at it.
As seems to be the case these days, in an effort to prove government inefficient, a re-write by the state (controlled by republicans, I deem, though can not prove) was done on Rule 25 recently, and they created a bloated assessment tool that goes above and beyond any reasonable effort at assessing for abuse or dependence. In my opinion, it was created with the mind-set that we had to discover a lifetime of issues in 40 to 60 minutes.
A psychiatrist that works for one of the county mental health services complained the assessment was a complete waste of time; that it attempted to be a tool for developing an actual treatment plan - instead of it's original function - which was simply to determine the necessary level of care for a person.
One of the biggest problems with my field is that it is very politicized, especially in the last decade, as Christian organizations attempt to insert their ideology into treatment services. I came across a little flier that was clearly written to coop the original intent of AA, and in direct opposition to one of the traditions, which clearly states attraction rather than promotion. This flier was describing the means to evangelize the 12 step concept.
In all things both conservative and Christian, it is a return to shaming the drunks and drug addicts. Considering Bill W. spent the first 8 months of his sobriety attempting that path, and failing, I suspect we will not really hear of any statistical success from this move. Prior to AA's creation, there really was not documented success at dealing with addiction.
In the end, I have to say I grow tired of my field. It seems more mired in bureaucracy then at any time in my 19 year career. All I want to do is help people find their way out of the hell that is addiction. Instead, it has turned into another battle ground for which ideology is the best.
DHS is Department of Human Services. In Minnesota, for publicly funded patients, we have to fill out a particular form, which is 18 pages long. Most of the Minnesota care HMOs (there are four of them that manage health care for Minnesota) require it to be completed, even if they are not going to get state funding for treatment.
See, many, many years ago, something called Rule 25 was created to help under-insured people get funding for treatment. These people could be employed, have health insurance, but not have substance abuse benefits, But, as in all things deemed welfare, the financial requirements became so strict, the original target population was restricted from receiving aid, and only the poor got the funding. Get a job, and you lose your funding.
Anyway, the funding was a combination of Federal grants with a certain level of matching state funds. From what I understand, Minnesota was better than most states at getting the money out there for treatment. Wisconsin, at least when I first sobered up in the mid 80s, was not so good at it.
As seems to be the case these days, in an effort to prove government inefficient, a re-write by the state (controlled by republicans, I deem, though can not prove) was done on Rule 25 recently, and they created a bloated assessment tool that goes above and beyond any reasonable effort at assessing for abuse or dependence. In my opinion, it was created with the mind-set that we had to discover a lifetime of issues in 40 to 60 minutes.
A psychiatrist that works for one of the county mental health services complained the assessment was a complete waste of time; that it attempted to be a tool for developing an actual treatment plan - instead of it's original function - which was simply to determine the necessary level of care for a person.
One of the biggest problems with my field is that it is very politicized, especially in the last decade, as Christian organizations attempt to insert their ideology into treatment services. I came across a little flier that was clearly written to coop the original intent of AA, and in direct opposition to one of the traditions, which clearly states attraction rather than promotion. This flier was describing the means to evangelize the 12 step concept.
In all things both conservative and Christian, it is a return to shaming the drunks and drug addicts. Considering Bill W. spent the first 8 months of his sobriety attempting that path, and failing, I suspect we will not really hear of any statistical success from this move. Prior to AA's creation, there really was not documented success at dealing with addiction.
In the end, I have to say I grow tired of my field. It seems more mired in bureaucracy then at any time in my 19 year career. All I want to do is help people find their way out of the hell that is addiction. Instead, it has turned into another battle ground for which ideology is the best.
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