Homeless at Home: March 26, 2001

In addition to copies of my medical and financial records, I bring Michael Elliot's book, Why the Homeless Don't Have Homes and What to Do About It

I skim the list of references and I see names I recognize: Jonathan Kozol; Faulkner; Foucault, and I know I am in good company.

I begin my second journey to the Multipurpose Center #54 on Sutphin Boulevard in Jamaica, Queens; I try to prepare myself for the four-to-six hour wait that inevitably lies ahead of me.

It is my hope that buried deep within these pages and Elliot’s years of experience and wisdom, I will find some solution to my problem.

After my first few days in New York City, I quickly learn that the homeless cannot vote nor can we obtain a library card. Knowledge is power. Information challenges the status quo. Books are my friends.

When I browse through Barnes & Noble, I often see titles that catch my eye; and though I know nothing of the content, I am inherently drawn to Night is Dark and I am Far From Home by Kozol, and Tell Them Who I Am by Elliot Liebow.

Today is March 26, 2001; My first journey to Multipurpose Center #54 was January 26, 2001: exactly 2 months ago; After many calls to NYC No-Heat Hotline to complain about the situation, I still have no heat. I have no electricity and no water. My caseworker did not tell me she would be leaving her position with Protective Services for Adults (PSA) and I have not been contacted by any with Health and Human Resources (HRA) since March 5, 2001.

On March 7, 2001, I drove my beat-up 1994 Honda Civic over to the emergency room at NYU. By the time I arrived at East 23rd pulled over and asked two officers in the 3rd precinct to please take my car and help me find my way to the ER since my panic was overwhelming and I had lost touch with my senses and felt I was a danger on the roads; I had now lost my sense of direction both in concrete terms and in the abstract vision I had painted of my life.

Officer Collins and her partner, Officer Gavin did not laugh at me; they did not tell me I was crazy or delusional. They let me catch my breath and miraculously managed to calm my fears and prepare me for the short trip in the ambulance to the ER. Officer Gavin's wife has four cats. Officer Collins was off duty, yet she stayed with me.

In the ER for what seemed like several hours. True to their word, they miraculously got my car out to Long Island where it was placed in a garage safe from the NYC Department of Finance.

I hate cops. Always have. Ever since I found out my Daddy was a Fed. But they were an exception to the rule. There is always an exception to the rule. "Those who say it cannot be done should not interrupt the person doing it" (Chinese proverb)

Yesterday I was grateful for the sunny weather and a place to stay. Today it is snowing. Tomorrow I must return to Multipurpose Center #54 to file another application for Public Assistance. The weather may be nice or it may be cold, but night is coming and I am far from home. And I beg of you, tell them my name. Tell them I have a name. And last but not least, tell them who I am.

Social Services Fails to Prevent Homelessness

Start here. See if you can follow. I am now homeless, because the crazy roommate locked me out and MDHA fucked up big time.

After reporting a shooting and working WITH the cops to help curb the violence and drug activity in my community, they discovered that the maintenance man was a house arrest due to a drug conviction. The same maintenance man who had a key to my apt and would frequently enter without prior notification and on multiple occasions when I was not at home.

After calling the non-emergency police hot line 32 times to report excessive traffic and drug activity in my building without response, the next call I made was to 911 to report gun fire in the apartment directly downstairs. I'm a New Yorker. My dad was a fed.  I Lived through 9/11. I worked as a crisis intervention specialist under contract for Level II and Level III adolescents in state custody (Tennessee Dept of Children's Services)

I am no stranger to violence.

Notified the other day by DHS that I have no tenncare 8/14/09 but state records have me enrolled as active. SSA says I don't, now DHS says I don't but they won't take an appeal because the state says I do! WTF???

Then, they cut my food stamps off because the homeless do not have to pay rent or utilities.

MDHA still hasn't recerted, but they continued to pay rent 4 months after I moved out and sent the renewal papers to my old apt because they were unaware that I was evicted and sued for $4.50.  

Fair housing keeps asking for proof that I made due diligent effort, so tied me with bullshit looking for any and every excuse to blame it on me.

Couldn't find a new apt because it shows up as an eviction.  There's more, and everything is documented.

Oh yeah, my TennCare was terminated on 8/14/2009.  I never an RFI (Request for Information) or reason for this redetermination.  No one calls me back,

State of Tennesee: What's New With TennCare

Sent via BlackBerry from T-Mobile

Health Economics: Free Market for a Public Good?

I have a serious problem with the most recent health reform effort. Asking or expecting the health industry to reduce costs through self-regulation without accountability is simply ridiculous.

Health care is already completely self-regulated and controlled. A person does not have free choice when choosing a provider. Due to an unholy alliance of provider networks, insurance underwriters, pharmaceutical conglomerates and private for profit hospital corporations such as HCA.

By negotiating with providers and developing one-size-fits-all prescription formularies and treatment protocols, we remove the ability for the consumer to make independent informed decisions about the value of various treatment options.

We rely upon one the ratings of physicians who have self-interest in controlling access and information to accurate information through their reliance upon Certification and Licensing Boards. By limiting access into the profession, health care costs are inflated and it is near impossible for the consumer to determine the fair value of a health care service.

Second, the consumer is far removed from the negotiating process, so we do not have a good sense of the fair, free market value of one particular service in comparison to another. All you need to do is look at any EOB (explanation of benefits) report for your last trip to the hospital.

Billing codes are used and assigned through various service departments and the insurance carrier then decides which services are covered and at what rate. They use the terms like “Reasonable and Customary Rates” and then choose to pay 80% of that. Therefore, by definition, that 20% must be built in to the billing rates to adjust for the actual (and expected) rate of reimbursement.

Such complicated billing procedures and methods are so complicated and technical that the end recipient of services (the consumer) really has no idea if an X-ray costs $90 or $73. Add into that a separate fee for the radiologist, and sometimes a charge just to use the facility, and even smart people find it difficult to understand.

The bills are then processed by an insurance adjuster who must determine primary and secondary (supplemental) plans and determine who is responsible for what, the end cost and intricate design is truly “priceless.”

Good luck to those people who actually purchased supplemental plans they saw advertised on TV, you have been duped. Giving people (especially the infirm and the elderly) a false sense of security is unfair and unjust.

Without regulation, intervention and enforcement, many people will continue to believe they are prepared and protected from that ultimate for “just in case” scenario that results in major, catastrophic medical loss.

The administrative cost alone on the part of the “Responsible Party” is probably more costly than the initial service they received at whatever hospital for whatever condition.

You cannot apply basic economic theory and free market principles to health care. Health care is fundamentally different and should be considered a public good.

Elyssa Durant, Ed.M.

Nashville, Tennessee

Health Economics 101: What Most Don't Know

You cannot apply basic economic theory and free market principles to health care. Health care is fundamentally different and should be considered a public good.

First, health care is completely self-regulated and controlled. A person does not have free choice when choosing a provider. Due to an unholy alliance of provider networks, insurance underwriters, pharmaceutical conglomerates and private for profit hospital corporations such as HCA.

By negotiating with providers and developing one-size-fits-all prescription formularies and treatment protocols, we remove the ability for the consumer to make independent informed decisions about the value of various treatment options.

We rely upon one the ratings of physicians who have a self-interest in controlling access and information to accurate information through their reliance upon Certification and Licensing Boards. By limiting access into the profession, health care costs are inflated and it is near impossible for the consumer to determine the fair value of a health care service.

Second, the consumer is far removed from the negotiating process, so we do not have a good sense of the fair, free market value of one particular service in comparison to another. All you need to do is look at any EOB (explanation of benefits) report for your last trip to the hospital.

Billing codes are used and assigned through various service departments and the insurance carrier then decides which services are covered and at what rate. They use the terms like "Reasonable and Customary Rates" and then choose to pay 80% of that. So by definition, that 20% must be built in to the billing rates to adjust for the actual (and expected) rate of reimbursement.

Such complicated billing procedures and methods are so complicated and technical that the end recipient of services (the consumer) really has no idea if an X-ray costs $90 or $73. Add into that a separate fee for the radiologist, and sometimes a charge just to use the facility, and even smart people find it difficult to understand.

The bills are then processed by an insurance adjuster who must determine primary and secondary (supplemental) plans and determine who is responsible for what, the end cost and intricate design is truly "priceless."

A false sense of security is unfair and unjust. I would rather have nothing than false expectations and disappointment.

Without regulation, intervention and enforcement, many people will continue to believe they are prepared and protected from that ultimate for "just in case" scenario that results in major, catastrophic medical loss.

Yeah, right. The administrative cost alone on the part of the "Responsible Party" is probably more costly than the initial service they received at whatever hospital for whatever condition.

The bottom line is this, we can pass laws, we can file injunctive, pass symbolic legislation, and spew feel good if oration about public programs that fall short if their promise to assist those in crisis. However, unless we demand accountability from state and federal agencies (1) demanding a timely response; (2) create and external entity to do an independent audit to ensure compliance, (3) enforce those laws through whatever means necessary; we have no recourse.

As more and more people continue to lose their benefits, and their unemployment benefits run out... the state will continue to be overburdened, and people in crisis can only go so long without before it is too late. Social Security and DHS MUST be held accountable, and we must pressure our legislators to create a separate entity to conduct external reviews IMMEDIATELY.

I would write more, but I have some forms that MUST be filed out and faxed immediately to appeal the termination of my benefits. Since the Dept of Human Services only have 20 days to appeal, they should be required to respond in a timely fashion.

It is on us to see that this happens. Regardless of whether we chose a public or private option, without regulation, accountability and strict enforcement... we have no recourse. Please fix it. I can't do this alone!



Elyssa Durant, Ed.M.
Nashville, Tennessee

Government Fuckuppery!