| The Arlington Voice | |
| The Alliance for the Mentally Ill of Arlington | |
| Affiliated with -- and Supported by -- NAMI of Northern Virginia Families and Consumers Advocating Together that Mental Illnesses are Brain Disorders | |
| Vol. 12, No. 7/8 | March/April 2004 |
|
UPCOMING AMI ADVOCACY MEETINGS ·
NO ADVOCACY MEETING in
March. Traditionally, NAMI-Arlington
advocacy meeting takes March off to give time for members to advocate as they
know best on pending State and County budget issues. ·
Tuesday, April 13 –
Leslie Weisman, manager, Behavioral Healthcare Division Client Entry Services,
will discuss the operations of her newly reorganized unit. The unit includes Client Intake, Emergency
Services, Discharge Planning, Homeless Case Management and the Transition Team. ·
Wednesday, June 9 –
Annual End-of-the-Year Potluck Supper, Clarendon House. NAMI-Arlington joins the members and the
Friends of Clarendon House in celebrating the close of another year of advocacy
and activities. Be sure to mark
the second Tuesday of each month on your calendars for the NAMI-Arlington
advocacy meetings. Advocacy meetings
start at This is a great
way to learn about our |
Seeking information about activities in
|
NAMI-NV SPEAKER’S MEETING HAS NEW TIME NAMI-Northern Virginia is changing the
time for its monthly Speaker’s Meeting to The Speaker’s program for Monday, March
22, features attorney Robert Ward who will discuss estate-planning issues, including
special needs’ trusts. Planning
continues for the April 26 meeting, which, it is hoped, will include
representatives from the regional Community Services Boards who will discuss
how to access community services.
Details will be available on the NAMI-Northern Virginia website at www.naminova.org. All meetings are held at the First
Christian Church, 6165 Leesburg Pike (Route 7), |
Proposed Budget Rejects Residential Funding
for Severely Disabled
Carlee described the budget, which is
about $44.5 million more than voted for this fiscal year (and including
supplemental funding), as maintaining “Arlington’s quality services.”
The Services Board last fall focused on
the need for 24/7 supervised services for 21 individuals, including 10 to 12
children and adults with serious mental illness. The adults are individuals who are ready for
discharge from a state psychiatric facility, but cannot be released for lack of
appropriate housing.
The Services Board has repeatedly
requested such support for the past five years, but the request has never made
it into the Manager’s budget. Previously
allocated Local Public Assistance Cost Allocation Program (LPACAP) dollars
would pay for the bricks-and-mortar costs for the housing.
The Manager’s budget does include $1.9
million in new LPACAP funds. Covered
services that could benefit mental health services include $600,000 for
Supportive Housing Services, $27,000 for emergency needs, including prescription
medications and $381,000 in contingency funds, including assistance to
nonprofit organizations. More than
one-half million would also be spent on upgrading department computers.
NAMI-Arlington, led by its Housing
Committee, has also long advocated for and supported 24/7-supervised housing to
augment
State Budget Battle Focuses on Tax Reform
Debate continues in
As The Arlington Voice goes to press,
anti-tax Republican House members proposed closing a number of corporate tax
loopholes that would raise $512 million in revenues, but still falls short in
meeting proposed state spending, including in the area of mental health
services. Their action followed calls
from U.S. Sen. John Warner (R-Virginia) and members of
An early legislative action saw the House
Appropriations Health and Human Resources Committee unanimously reject
proposals to cut or eliminate state support for funding Medicaid Option Plan
services. These are non-federally
mandated Medicaid services that support community-based mental health services
– including case management, prescription medications, clubhouse and
residential support services.
The Virginia Coalition for Mentally
Disabled Citizens is urging funding of $254 million for services for those with
mental illness and mental retardation and those who abuse substances. The Coalition termed Warner’s budget
proposals, which focus on carrying out the initiatives of the Olmstead Task
Force as only “a start.” “There are
still gaping holes in
“Our Coalition’s message to House and
Senate members is simple: Virginia is
near the bottom in terms of state funding support of services for persons with
mental disabilities and it is time to start fixing the problem,” said Ray
Burmester, Coalition co-chair.
NAMI-Virginia stressed
“Too many people are in jails, prisons or
juvenile correctional facilities because our public mental health centers,
known as community service boards (CSBs), serve less than 12 percent of all
citizens with serious mental illness in the state.” Marsh said fiscal 2002 and 2003 budget cuts
of 15 percent have resulted in a 313 percent increase in NAMI-Virginia helpline
calls relating to criminal justice issues.
“Adults and children are going to jail and
juvenile detention centers because they cannot access community treatment,” she
said.
NAMI-Virginia is supporting Warner’s
proposed $$42.5 million for individuals with mental illness. This covers money for three new Programs for
Assertive Community Treatment (PACT) and $9 million to bring 77 individuals in
NAMI-Virginia is also supporting:
·
Increasing eligibility for Medicaid services to 100
percent of Federal poverty levels (FPL), from
·
Ensuring the Medicaid Preferred Drug List includes all psychiatric medications. Cost-cutting measures often limit access to
psychiatric medications.
·
Adding $21.7 million to ensure reinvestment – the
downsizing of state psychiatric facilities by moving care and treatment of
individuals to their communities. Marsh
said, “It is not possible to restructure the mental health system on a
cost-neutral basis,” which uses “saved” funds from facility care to cover
community-based expenses.
Both NAMI-Virginia and the Coalition call
on advocates to contact their state lawmakers in support of issues.
How to Contact Our County Board Members
Advocates and advocacy are needed to
support the Arlington Community Services Board request for $1.6 million for the
urgently required 24/7 supervised housing.
Members of the Arlington County Board may be contacted by telephone
(703/228-3130), by email (countyboard@co.arlington.va.us) or by regular mail (
The
Honorable Barbara Favola, Chair
The
Honorable Jay Fisette, Vice chair
The
Honorable Paul Ferguson
The
Honorable Walter Tejada
The
Honorable Chris Zimmerman
The Virginia General Assembly will
consider a $42.5 million Warner Administration plan to respond to the 1999 U.S.
Supreme Court decision that said individuals with disabilities have the right
to live in the most integrated setting possible.
NAMI-Virginia is supporting this
initiative that carries out a report developed by an Olmstead planning group
last year. It includes:
·
Developing a Medicaid “buy-in” program for disabled
individuals.
·
Funding 77 discharge plans so that individuals in
state psychiatric facilities may move to and stay in more integrated settings.
·
Funding 160 additional Medicaid waiver slots to
allow more individuals with mental retardation to live in more integrated
settings.
·
Funding for three new Programs of Assertive
Community Treatment (PACT) teams.
The 1999 Court decision arose from a
The Court said that community treatment is
required when treatment professionals indicate community placement is
appropriate, when the transfer is not opposed by the individual and when such
placement can be “reasonably accommodated,” which takes into account available
resources and the needs of others.
Alexandra Stewart of the
Stewart said the Court ruled that Title II
of the
The concepts of “reasonable accommodation”
and “fundamental alteration” are still being litigated. Under “reasonable accommodation” a court may
order changes in program administration.
A “fundamental alteration” is deemed a part of the political process and
beyond the purview of a court’s ability to change, Stewart said.
But, lower courts have started to define
what is meant by “reasonable pace.”
Courts have said that individuals eligible for community placement as
outlined in the state plan must receive them within a reasonable length of
time, Stewart said. Courts have rejected
“inadequate funding” as a valid reason for delay – particularly when Medicaid’s
cost-neutrality requirement is met.
Enforcement of the Olmstead decision falls
under the Federal Office of Civil Rights, which is not planning any action
until states have had the time to act. A
state is considered in compliance with the decision if it has developed a
comprehensive, effective working plan for placing individuals with disabilities
in less restrictive settings. A state is
also deemed in compliance if it has a waiting list that is moving at a
reasonable pace and is not controlled by efforts to keep institutions
populated.
As part of the Governor’s program, a
15-member Oversight Advisory Committee was created and appointed.
Individuals with mental disabilities are
among the target population for the County’s assisted living facility under a
policy adopted unanimously in January by the Arlington Community Services
Board.
In addition, individuals with dementia –
who also have either depression or psychosis – are included in the eligibility
criteria for the Arlington Assisted Living Residence (ALR), due to open at
year’s end in
All
individuals will be low income and elderly, although discretion is allowed for
individuals who meet the eligibility criteria and who may be younger.
The Services Board also passed, again
unanimously, a policy opposing discrimination against eligible individuals due
either to level of functioning or ability to pay. This policy seeks to guard against admitting
preferences to individuals who have a higher level of functioning – and who
would need less assistance in their care – or who are not able to contribute
funds toward their care at the ALR.
Eligible individuals would also need
support in at least one Activity of Daily Living (ADL), described as bathing,
dressing, toileting, getting from one place to another and eating or feeding. The policy calls for admitting individuals to
the facility who need assistance with ADLs up to a level that requires skilled
nursing care.
Eligible individuals may also need support
with one or more Instrumental Activity of Daily Living. These include meal preparation, housekeeping,
money management, laundry, transportation, shopping and using a telephone. Assistance with medication management is
another criterion.
Mental disabilities cover those with
mental retardation and those suffering from mental illness as defined as the
priority population served by community services boards across the
Commonwealth.
NAMI-Arlington has been around
NAMI-Virginia and the Virginia Coalition for
Mentally Disabled Citizens both offer email services that keep respondents
up-to-date on legislative happenings in
How to Contact Our Arlington Sate Lawmakers
STATE SENATORS:
The Honorable Patricia S. Ticer
City Hall -- Room 2007
(703) 549-5770
Email: patsy@tidalwave.net
The Honorable Mary Margaret Whipple
(703) 538-4097
Email:
mmwhipple@erols.com
Legislative address in
Virginia Senate
Mail Room FAX (804) 786-4640
Toll-free number is 1/800/889-0229
STATE DELEGATES:
The Honorable Robert Brink
(703) 243-5778
Email: www.bobbrink.org
The Honorable Adam Ebbin
Post Office Box 41827
(703) 549-8253
Email: info@adamebbin.com
The Honorable Albert (Al) Eisenberg
Post Office Box 1511
(703) 276-9414
Email: www.aleisenberg.com
Legislative address in
Post Office Box 406
Mail room FAX (804) 786-6310
Toll-free number is 1/800/889-0229
Medications Unit Focuses on Holistic Approach
Following cutting-edge and “best
practices” in psychiatric care, Arlington’s Behavioral Healthcare Division is
embracing a holistic approach in integrating medical care in its treatment of
consumers, according to Marcy Bartolovic, the Division’s lead psychiatric
nurse.
Bartolovic, who works closely with
Arlington Medical Director and Chief Psychiatrist Mildred Osborne, described
the new initiatives under way. For one,
integration is the current watchword in the division’s handling of consumers’
needs. Integration for the Medications
Unit translates to a biopsychosocial approach in consumers’ care. The new Dual Diagnosis Unit integrates mental
health and substance abuse treatments for those who are mentally ill and who
also abuse substances.
Other initiatives now have the Division’s
eight psychiatric nurses, involved on the Outpatient Teams and clinics,
reporting to Osborne, along with the psychiatrists who serve the Center. The eight nurses include three who serve on
In addition, the unit has hired a
part-time pharmacist to assist them.
This follows the putting into place a Refill Telephone Line that allows
consumers to obtain a prescription refill with a simple telephone call. There has been positive consumer feedback on
the line, said Bartolovic, who came to
There is a “Nurse of the Day” initiative
which designates a nurse to handle walk-in cases and staff questions. The nurses have developed medical education
sheets, describing 30 to 40 medications, their side effects and who to call if
there are difficulties. “It helps
consumers understand the medications,” Bartolovic said, adding it builds onto
the unit’s philosophy that the “more information and education a consumer has,
the more power the consumer has in his/her care.”
There is closer monitoring of consumers’
medical condition. The unit’s two
Clozaril clinics have long included monitoring of blood counts. The unit’s Injection Clinic is increasing the
monitoring of the 30 to 40 individuals it serves – especially for symptoms of
Tardive Dyskinesia, a negative side effect of Parkinsonian-like involuntary
movements.
The nurses have started a Health
Management group to educate consumers about mental illnesses with the goal of
helping them better manage their symptoms.
“We want to help consumers recognize the symptoms of their illness, and
when they have these symptoms, how to cope.
We want to educate them on the side effects of their medication,”
Bartolovic said.
“Mental health is more than
medication. We are increasing the
emphasis on wellness and how to stay well.
We want the consumers adopting a healthy lifestyle.
“Treatment is more than a pill,” she said.
Bartolovic said medical monitoring is
needed because more chronic medical issues – heart, respiratory and diabetes –
are seen. “We want to see if we can
catch these issues early,” Bartolovic said.
Consumers’ vital signs – blood pressure, weight, temperature, pulse and
respiration – are checked to identify those who may be a high risk for
diabetes. “We are tracking if something
is not normal.” The monitoring enables
the unit to have the consumer seen by a treating primary physician sooner. A small intervention can make a difference in
a consumer’s life, she said.
Taking the pulse of one consumer,
Bartolovic felt an irregular pulse, which prompted a blood-pressure check. The individual is now on blood-pressure
medication. “Two fingers on her arm
helped us catch something. We want to be
proactive,” the nurse said.
The nurses are targeting individuals who
are overweight, educating them on meal and diet plans. She noted there is an interest among
consumers for a weight-watching group.
“It is exciting to watch consumers respond
to our initiatives,” she said.
Any positive change in the way one views
the use of substances is considered progress when working with individuals who
have co-occurring substance dependency and mental illness, according to staff
members of
Marilyn Schmal, manager, and Tiffany
Kelsey discussed the new program that has five and one-half full-time employees
and is about to hire a sixth full-time professional. The unit will focus on individuals diagnosed
with severe mental illness and substance dependency. One staff member speaks Spanish and will also
work eight hours weekly in the
“Outcomes [for individuals with the
co-occurring disorders] are the same—40 percent – as for individuals who only
abuse substances,” Schmal said.
Abstinence is not the benchmark.
A positive outcome is “any positive change.”
“Acknowledging and recognizing the problem
is often very important,” she said, adding that it usually takes three months
to see such change.
The Dual Diagnosis Unit will handle only
the most serious cases. Other individuals
who have a substance dependence complicated by a psychiatric diagnosis will be
treated by
“More than 50 percent of individuals with
mental illness have a co-occurring substance abuse disorder,” said Schmal, who
since 1989 has been practicing cutting-edge Dual Diagnosis practices. It has been known since the late 1970s that
integrated mental health and substance abuse treatment was needed, but it was
difficult to get a handle on how to achieve this, Schmal said.
Using nearly $300,000 in on-going federal
Local Public Assistance Cost Allocation Program dollars, Arlington is creating
the new six-member core unit that will offer four hours daily of programs and
activities. These include educational
classes on health issues, such as diet and exercise. Therapy groups are also scheduled.
Family support groups open to all
Arlingtonians are also offered. These
groups are an eight-week course that meets Monday evenings from
Schmal and Kelsey said the Unit’s program
design is to reduce stress to help in recovery.
Schmal said individuals are often more aware of symptoms of one disorder
than the other. The Unit plans to
present information on both disorders that may persuade an individual that the
other disorder “maybe does pertain to me.”
It is information to motivate, Schmal said.
Schmal said other plans call for increased
coordination with ASPAN, the nonprofit Arlington Street Peoples’ Assistance
Network that works with homeless individuals, greater outreach to clients in
the community and, lastly, to determine how to use funding for substance abuse
residential treatment. “We are going to
be intensively involved with individuals with dual diagnosis,” Schmal said.
Schmal acknowledged that dual diagnosis
training is an issue. “It is not taught
in schools. It is on-the-job training,”
she said. The
Three seats on the Arlington Community
Services Board open up this July as terms of three current members – all of
whom coincidentally serve on the Mental Health Committee – expire.
Workshop Weighs Early Onset Mental Illness in Adolescents
A special workshop to highlight mental
illness in children and adolescents will be held on Monday, March 22, at
NAMI-Arlington is joining with Arlington
Public Schools and the Arlington Special Education in sponsoring the free
workshop titled, “Parents and Teachers as Allies: Recognizing Early-Onset Mental Illness in
Children and Adolescents.”
Dr. Edith Wiggs, a neuropsychologist, will
present at the workshop, which will also include testimony from an individual
diagnosed with mental illness as a schoolchild and a parent of such an
individual.
Common behaviors arising from attention
deficit, hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD),
bipolar disorder, depression and schizophrenia are among the topics that will
be discussed.
For more information, contact the
Support Clarendon House’s
Annual Car Wash
Saturday, May 10
from 9 a.m. to 1 p.m.
3141 N. 10th St., Arlington
Annual NAMI-National Convention
NAMI-National celebrates its 25th
Anniversary this year at its annual convention,
We in the greater Washington-area are
fortunate that NAMI holds its convention in our capital city every three years,
giving us the opportunity to hear about, among other things, the latest
research and the latest state-of-the-art programming. It is also a terrific time to network and to
meet other families from across the
It is well worth taking time off from
otherwise busy schedules for the five-day convention and to celebrate NAMI’s 25
years of advocacy, education and support.
Special sessions on research, “Ask the Doctors” breakout sessions and
workshops on mental health services and programs are featured. It is all worth taking time from busy
schedules to attend.
For more complete information and to
register, check the NAMI website at www.nami.org/convention. NAMI members in the greater Washington-area
are also able to attend at reduced fees by volunteering to work at the
Convention. Check the website for more
information.
NAMI-Arlington thanks the many who
responded to our appeal for contributions to support the printing and mailing
costs of The Arlington Voice. It
is our way to help NAMI-Northern Virginia, which has generously supported our
Taste of Arlington Set for May
The 16th Annual Taste of
Arlington, the major fundraiser for CR, formerly Community Residences Inc., is
set for Sunday afternoon, May 16,
The Arlington Voice is the product
of many hands. For their help and
support, thanks go to:
Editor: Betsy Greer
Proofreaders: Wayne Bert, Bob Jack, Tom Quinn
Formatting: Christina Kozyn
Mailing: Barb Keish
NAMI-Arlington Committee News
NAMI-Arlington has three committees that
support its advocacy work, and it invites interested individuals to become actively
involved in one of these committees. The
Committees are: Criminal Justice
Committee under Wayne Bert (wbert@cs.net), which is working to improve the way
that Arlington handles those with mental illness who become involved in the
criminal justice system; Housing
Committee under Kathy Donovan (kdonovan7@comcast.net), which is ensuring
NAMI-Arlington’s voice is heard in the continuing work to obtain housing for
those who suffer mental illness; and Budget Committee (vacant chair) to
formulate NAMI-Arlington positions – and make sure these positions are voiced –
on state and local expenditures for programs that serve those with mental
illness.
Recognizing an Arlingtonian who Works for Better Community Services
It’s that time when we in NAMI-Arlington pause to honor those in our
community who have worked to ensure that
We
are calling on you to help us identify the individual or individuals. We are talking about NAMI members, members of
Clarendon House, members of other nonprofit organizations, a member of the
Arlington Mental Health Bureau – anyone and everyone who has contributed to the
objective of making sure
Past honorees were:
·
In 2001 – Former Arlington Community Services Board Chair Judy
Connally, Services Board Executive Director Cynthia Kemp (acting Mental Health
Chief at the time) and Clarendon House member Joe Morgan.
·
In 2002 – The Arlington Partnership for Affordable Housing for its
development of Project HOPE, a supported affordable housing model.
·
In 2003 – David Leibson, vice chair of the Arlington Housing
Commission, Alice Biby of the Friends of Clarendon House, Marikay Crangle,
Behavioral Healthcare Residential Coordinator, and Clarendon House member Kevin
O’Brien.
Mary Montgomery is pulling together a
committee to select an honoree or honorees.
We are looking for your nominations to guide them. Submit a name or names and your reasons why
you believe a specific individual or individuals should be recognized, and send
your nominations to Mary Montgomery, 2205 South Buchanan Street, Arlington, Virginia
22206. Then come to our annual June
potluck supper at Clarendon House to join in honoring him, her or them.
The
deadline is May 15. So, put your
thinking caps on now!
NAMI-ARLINGTON RECOGNITION AWARD(S)
Name of
Nominee______________________________________
What is/was the activity (or
activities) that merits recognition?___________________________________________
_______________________________________________
____________________________________________
_______________________________________________
Arlington Emergency Services recently
resumed training for the police, conducting a three-hour class for police
recruits.
On December 30 Peter Frecknall of
Arlington Emergency Services talked to approximately 20 recruits on how to deal
with people with mental illness. He
talked about the nature of various mental illnesses, how such illness affects
behavior and what the mentally ill person experiences. He also discussed how the police should react
to various situations to ensure public safety while still treating consumers
and their families in a way that provides the special attention and treatment
they require.
The police recruits also had a chance to
use an auditory device that simulates a hallucinatory state and the feelings
consumers would have when hearing voices.
Wayne Bert, representing NAMI-Arlington at
the class, talked to the police from the perspective of a family member in a
situation where the police are called because a consumer has become or
threatens to become dangerous because of mental illness.
The recruits seemed particularly curious
about the experiences of a family member who deals with a mentally ill
relative.
NAMI-Arlington’s Criminal Justice
Committee has worked to increase the training that
The Criminal Justice Committee continues
its work with the Arlington Community Services Board on ways to improve the
civil commitment process, to investigate the feasibility of a mental health
court in
Clarendon House Plans Special Spring Event
A Maryland-based subsidiary of the Sheppard and Enoch Pratt Foundation is offering short-term care for pre-teens and adolescents who suffer from serious mental illness.
Way Station Camp Journey Respite House in Frederick, Maryland, provides preventive therapeutic respite services for up to eight individuals, aged 11 to 17. The program offers a planned daylong schedule, recreational activities or schoolwork supervision. Medication therapy is also provided and monitored. The program permits pre-registration of a child in advance of actually using it.
Way Station Camp, which costs $155 daily (and may be covered by private insurance), can be used for respite or for therapeutic breaks for the child and the rest of the family.
For more information, contact 301/662-0099, extension 1702, or toll-free, 1/888/549-0629.
Borderline Personality Disorder Group Formed
A Greater Washington-area education and
support group has formed for family members whose relative has been diagnosed
with Borderline Personality Disorder.
The group has been holding support group meetings, alternating between
Special Report
Remember – The Friends of Clarendon House next
monthly meetings are
Wednesday, March 17 and April 21, at
Be sure to come.
Wednesday, June 9,
CLARENDON HOUSE PLANS SPECIAL SPRING EVENT
Clarendon House members are planning a
special spring event for Wednesday, May 12,
MANY RESPOND TO ANNUAL FRIENDS’ APPEAL
The Friends of Clarendon House, Inc. gained a strong response to its annual holiday fund-raising drive. We thank these individuals who contributed to its success: