Author Archives: Peter Sanford Kahrmann

Unknown's avatar

About Peter Sanford Kahrmann

Writer, disability rights advocate, civil rights advocate.

Wayne Allyn Root’s missing “gut instinct” found

Posted on by
1

As you are probably aware, former 2008 Libertarian Party vice-presidential nominee Wayne Allyn Root earlier this week released a statement acknowledging that his “gut instinct” is missing.

Mr. Root, who penned a soundly debunked essay claiming President Obama attended Columbia University under the name Barry Soetero, now acknowledges that his “gut instinct” was probably missing when he wrote the essay. Had his “gut instinct” not been missing, Mr. Root explained, he would have been aware that Snopes.com (among others) successfully documented, through what Mr. Root described as the unexpected and highly unusually use of facts, that the 1981 Columbia University ID card purporting to show Mr. Obama as Barry Soetero was, in fact, doctored. A blushing Mr. Root went on to say that if his “gut instinct” had been present and accounted for, he would have had his facts straight, a condition those close to Mr. Root say could well have been a first for the 51-year-old native of Mount Vernon, New York.

Mr. Root has yet to distance himself from Lew Rockwell who, according to several sources, authored the racist passages in Ron Paul’s newsletters, claiming that he will make a decision on whether or not to continue his relationship with Mr. Rockwell once his “gut instinct” (Mr. Root’s, not Mr. Rockwell’s) has been successfully located and returned.

However, Mr. Root did acknowledge there were indeed racist quotes in Mr. Paul’s newsletters. “I mean, hell, how can you not notice racists statements like, “Given the inefficiencies of what DC laughingly calls the criminal justice system, I think we can safely assume that 95 percent of the black males in that city are semi-criminal or entirely criminal,” or “We are constantly told that it is evil to be afraid of black men, it is hardly irrational.””

A December 2011 Atlantic Magazine article examining the issue  makes a salient point when it says racism and conspiracy theories are “marginal causes (that) attract marginal people,” some of them genuinely good and decent people, who are either terribly misguided, misinformed, or both.

Back to Mr. Root’s missing “gut instinct.” Before this missive went to press word came in that a team of FBI experts, archaeologists, sociologists, anthropologists and proctologists have indeed located and successfully recovered Mr. Roots “gut instinct.” 

According to Dr. Ben Dover of the KY Institute of Proctology, Mr. Root’s “gut instinct” was located in the upper reaches of Mr. Root’s rectum. The “gut instinct” was gently extracted, washed, and thoroughly debriefed by a team off psychiatrists, psychologists, and car wash owners. Asked why it had traveled deep into the rectum of its owner, the “gut instinct” offered a heartfelt and refreshingly honest answer: “Well, as a gut instinct I’m embarrassed to admit I had  a track record of getting pretty much every damn thing wrong. And so I wanted to understand why I kept getting things wrong and, once I did, try and make amends. Well,  I am proud to announce that the reason I was way up inside Mr. Root’s rectum… well…let’s just say it’s an emotional day for any of us when at long last we get to see where we were born.”

 

Blue Jeans, Robert Hall & Torture

Posted on by
Reply

I am baffled and awed by anyone who likes to go to the store and try on clothes. To say I’d rather run headlong into a brick wall is only a slight exaggeration. 

When I was a boy I would volunteer to mow the lawn (twice!) and clean every room in the house (including my sisters!) to avoid going to the store to try on clothes.

When I was a boy my mother would take me to Robert Hall’s to buy clothes. Robert Hall Clothes was a reasonably priced and very popular chain of clothing stores that operated from 1937 to 1977. Taking children to Robert Hall’s was also a widely accepted form of child abuse in those days.  Very popular among parents who liked to torture their children by bringing them into what were essentially large cafeterias with racks of clothes as far as the eye could see, parents who enjoyed wiping spittle from their mouths before looking at their young and saying, “And you will try on everything.”

Without question, the worst of all articles of clothing to try on were, and still are, blue jeans. Yes, I love jeans. Why? They virtually last forever because, in case you haven’t noticed, they are made from a combination of cotton and steel.  Most importantly, their durability reduces the number of times I have to go to the store to try the damn things on.

When I was a boy jeans were so hard and durable law enforcement agencies across the country were forever tracking down and arresting builders and contractors who robbed them by the thousands from large clothing stores (when they weren’t hijacking trucks loaded with them). The stolen jeans were used in place of more fragile materials like wood two-by-fours to frame the walls of the houses. I can’t be the only one to notice older houses are a lot more durable and last a helluva lot longer than the newer ones.

Today, jeans are only a tad softer when new. Many have  labels claiming they’ve been pre-washed (a rare admission on the part of big business that there was a problem in the first place). Does the so-called pre-wash make them softer? Somewhat. When I was a boy it was a well-known fact each and every pair of jeans  had to be washed 642 times on average before they’d soften enough so you could bend your knees when you wore them.  A recent study by an independent consumer group, Keep Our Cotton Soft out of Spunky Puddle, Ohio, reveals that today’s jeans are  softer; they only need to be washed 347 times on average before they are soft enough to  bend your knees.

I am writing about all this because today, or maybe tomorrow, I am going to the store to buy jeans which means, God help me, I’ll have to try them on. A friend of mine who knows I am on a mercilessly tight budget was kind enough to send me some money and so, given that colder weather is just around the corner, I am going to buy  two or three pair of jeans.  I figure if I start washing them right away, and wash them daily, I’ll be able to bend my knees by the time winter arrives. One can only hope.

Take a Deep Breath Now

Posted on by
2

 

*

Take a deep breath now and hear me

Don’t turn your lights off no not yet

There’s sunshine lifting on the rise

And betting on the clouds is a losin’ bet

*

Take a deep breath now and see me

Smiling  at you all from the mountain top

Singing life kicks hard at times

But no hard blows should make life stop

*

Take a deep breath now and give me

Some shuck and jive with fingers clicking

Sing out loud you’re glad to be alive

Don’t you think hard on no clock ticking

*

Proposal for NY State Brain Injury Waiver: Elephant #2: NYS Traumatic Brain Injury Services Coordinating Council: the Challenge & Remedy

Posted on by
Reply

The Challenge

Formed in 1994 by an act of the New York State Legislature, The 19-member NY State Traumatic Brain Injury Services Coordinating Council is “charged with recommending to the (NY State) department (of health) long-range objectives, goals and priorities”  for New Yorkers with brain injuries. The record shows it has done this. This is not to say there have not and are not council members who, if afforded the  chance to work with effective leadership, who care.

The problem with the TBISCC rests on two primary fronts. It’s leadership and the ongoing presence of blatant conflict of interest linked to some council members.

First, the leadership. Over its history the council has had two chairs: Charles Wolf, the former head of the Long Island Head Injury Association who left that post in disgrace, and, Michael Kaplen, an attorney whose practice focuses on landing people with brain injuries as clients and is the past president of the Brain Injury Association of NY State. Kaplen was a BIANYS board member during some of his time time as the council’s chair. Judith Avner, the executive director BIANYS has been co-chair for each, and therein lies the tip of the conflict of interest iceberg. BIANYS gets a large grant from the DOH.

A review of council minutes from its inception 18 years ago reveals not one single proposal designed to assist the department of health in developing and improving the state’s Traumatic Brain Injury (TBI) Waiver, established in 1995. Moreover, the fact that anyone from BIANYS or anyone who works for a waiver provider is on the council as a voting member wouldn’t pass the sniff test of even the most poorly written code of ethics. Moreover the council’s by-laws say: “Members shall refrain from participating in voting procedures where a potential conflict of interest may exist as defined under the Public Officers Law.” 

This has not stopped council members from blatantly engaging from conflict of interest even when they were warned not to. According to council’s own minutes for a September 16, 2010 council meeting  ex-officio council member Nick Rose warned Ms. Avner not to violate the Public Officers Law by voting on a proposed trust fund that would be raised from a surcharge on state vehicle registrations because “the Brain Injury Association of NYS ( was to) be contracted (with) to assist with the development”of the trust fund and, it is said, receive a financial percentage of the fund itself. Despite the warning, Mr. Avner and voted for the fund anyway, even though doing was clearly a conflict of interest according to the New York’s Public Officers Law.

BIANYS has a history of hands-off when it comes to the DOH. As a BIANYS member and a former board member it has been made clear to BIANYS staff, by Ms. Avner, that they are not to tamper with DOH related issues, i.e., the waiver. Is just a coincidence that the council offered to constructive proposal to the DOH regarding the waiver?

Left unaddressed,  blatant conflict of interest or the perception of conflict interest undermines the ability of this or any council to do the work it is called upon to do.

The fact BIANYS has voting members on the TBISCC is particularly disturbing. I doubt it is a coincidence that both groups, BIANYS and the TBISCC, were stone silent when New Yorkers with brain injuries were and still are going through some tough times. Neither group said anything when the DOH decided waiver providers could not support waiver participants at Medicaid Fair Hearings. Neither made an iota of effort to make sure waiver participants were informed of the results of complaints they filed. It was only last year that the DOH, to its credit, changed this policy. The point is, BIANYS members have had a role in the TBISCC and, more specifically, the TBISCC’s leadership virtually from the council’s beginning. As noted earlier, Ms. Avner was co-chair under both council chairs and Mr. Kaplen is past BIANYS president.

Does anyone with any degree of common sense in their possession think it is merely a coincidence that neither BIANYS or council says word one to the DOH about the waiver?

It is also worth noting that, until this blog exposed it, Ms. Avner’s and Mr. Kaplen’s terms on the council had expired eight and seven years ago respectfully. Apparently, Mr. Kaplen has been reappointed by a, one would hope, misinformed Speaker of the New York State Assembly, Sheldon Silver. I am not sure about Ms. Avner’s status. I am sure there terms as chair and co-chair ended a long time ago.

The bottom line is this. The TBISCC can be a positive and constructive force in the lives of New Yorkers with brain injuries. Mr. Kaplen should remove himself from the council. Barring that, he should certainly refrain from seeking the chair or co-chair position. Mr. Kaplen’s history strongly indicates that unless he can be the center of attention, his participation in council activities will rapidly decline. And,  his behavior reflects an individual who has no business being on a council like this. His disdain for individuals with brain injuries and, on more than one occasion, his colleagues on the council ought to send him packing.  I remember attending a council meeting some time ago when Mr. Kaplen responded to a series of utterly reasonable questions posed to him by Mary Ann Anglin, the DOH Director of the Division of Home & Community Based Care Services, with a level of nasty defensiveness that ought to have embarrassed him and, it must be said, did nothing to ruffle or intimidate Ms. Anglin.

In must be said too that under Mr. Kaplen’s leadership, council committees have all but ceased to exist, and executive sessions, rarely, if ever, happen. Mr. Kaplen’s rather self-absorbed dictatorial streak has run both off the road, and, as co-chair, Ms. Avner has either supported this or been ineffective in doing anything about it.

Kaplen should go. I’ve heard first hand reports of how he has yelled at people in person and on the phone, sometimes leaving them in tears, and, as this blog reported, I was present at a BIANYS board meeting when he threatened everyone to embarrass everyone at the table.

However, Ms. Avner and the presence of BIANYS, whose presence on the council needs tweaking,  should not be sent packing.

 

The Remedy

The relationship between the TBISCC and the DOH does not have to be adversarial. The TBISCC is there to recommend “to the (NY State) department (of health) long-range objectives, goals and priorities” for New Yorkers with brain injuries. Then do so!

The DOH has plenty on its plate as it is. One would think it would appreciate a sincere effort by the council to develop and propose objectives, goals and priorities. Everyone with any semblance of knowledge about the state’s TBI Waiver has known for years the lack of training in the brain is a real problem, yet the TBISCC has done nothing? Not a single idea presented? Waiver providers throughout the state have made it clear – and made it clear to the TBISCC – that the requirements for billing for services and other rules are not uniform throughout the state. There is one set of rules in one region, another set of rules in another. The council has offered nothing.

The problems with the  council are not because it is absent members – voting and non-voting – who care. It is, in my view, because the only two council chairs, Messrs.’ Kaplen and Wolf were all about Messrs.’ Kaplen and Wolf, and because of the blatant areas of conflict of interest just described.

Several things must happen in order for the TBISCC to be effective. If they do, the TBISCC can be a truly healthy influence on the lives of New Yorkers with brain injuries and a well-deserved support for the state’s DOH.

1) All areas of conflict of interest must be immediately addressed and remedied. No member of BIANYS and no one working for a TBI Waiver Program should be voting members of the council. However, both BIANYS and the providers, represented, for example, by the Providers Alliance and other such groups, should, like various state agencies, OASAS (Office of Alcohol and Substance Abuse Services) and the CQC (Commission on the Quality of Care for People with Disabilities) to name two, should have a seat at the table as non-voting members. Advocacy groups should be at the table as well. All have important and relevant knowledge to share.

2) Even if only symbolic in nature, the council should vote to uphold its own by-laws.

3) The council would be well-served to consider itself a working committee and discuss matters at hand during their meetings rather than have each meeting as a platform for presentation from outside groups who are not relevant to what is going on with, for example, the TBI Waiver.

4) The council would be wise to begin its own blog – free of cost at blogger.com – and use that format to announce meetings, publish proposals, and report on the response to those proposals.

5) The council would be wise to invite neuropsychologists and neurologists and physiatrists, not to mention people with brain injuries and their friends and families,  to get there input so council proposals would be better informed.

6) Last, and not least, and perhaps most obvious, the council is lacking in members who have brain injuries and family members who have people in their families with brain injuries.

 

Please distribute to all interested parties

 

Next: Elephant #3 Lack of effective oversight of  TBI Waiver

A proposal for NY State’s TBI Waiver: Elephant #1: Lack of knowledge about the brain: a Remedy

Posted on by
Reply

We have thus far identified the four parts of this proposal. In short they are the three elephants in the room and a summation with final thoughts.

Part 1:  Elephant #1: Lack of knowledge about the brain

Part 2:  New York State Traumatic Brain Injury Services Coordinating Council

Part 3: Elephant #3: Lack of effective oversight of those providing services to those on the waiver, a problem which is severely exacerbated by Elephant #1

Part 4: Summation and final thoughts

The proposal format for Elephant #1 is being published in two parts. The first part, the outlining of the problem or challenge, was published yesterday, and this is the second part, a proposed remedy to the issues outlined in part 1. I had thought elephants #2 and #3 would need to be addressed in two parts, but they may be able to be successfully addressed in one part. We’ll see.

Let me say that not for a minute do I think the remedy, as set forth here, is in any way perfect nor am I claiming that it can’t be improved on. It can, and it should be. What I believe is that the remedy I am about to describe here is a solid step in the right direction and, if it is applied, it will, in addition to dramatically benefitting the lives of those men and women with brain injuries currently on New Yorks TBI (Traumatic Brain Injury) Waiver and the lives of future waiver participants, save Medicaid dollars, a lot of them, to put it mildly.

Thus far I have, I hope, successfully outlined some salient points. First, as the current waiver molds into its new form, decision makers must be very careful not to discard the plethora of waiver staff and others (RRDCs) who have, over time, developed an understanding of the brain and brain injury that is rare in general and rare in the over-worked folds of managed care companies. Second, anyone providing and or monitoring/regulating waiver services must be trained and deserves to be trained to a level of expertise that is currently sorely lacking. Third, there can be no doubt that truly well-trained waiver staff, RRDCs and DOH staff, will create a program and delivery of services that will result far more positive outcomes and save money to boot. Brain Injury 101, which is offered by the Brain Injury Association of New York State (BIANYS) free of charge, is excellent for those seeking a cursory overview of the brain, but it does not provide the level of knowledge needed and deserved by those providing waiver services nor those overseeing and regulating them.

However, BIANYS has staff qualified to train individuals to become a CBIS (Certified Brain Injury Specialist) or a CBIST (Certified Brain Injury Specialist Trainer). The CBIST is qualified to train people to the CBIS level of expertise. Both CBIS and CBIST are offerings linked to ACBIS, the Academy of Certified Brain Injury Specialists.

Now, I am anything but oblivious to the fact that Medicaid dollars, any dollars for that matter, are in short supply. There is a fee for each person sent for CBIS or CBIST training, something in the neighborhood of $300 per individual. Even if a reimbursement rate for staff training is instituted, and it must be if this program is ever to reach its full potential and save money in the process, $300 per individual is far too costly for providers. So, here is what I propose.

  • Identify some key staff members who meet the criteria for becoming CBISTs as set forth by ACBIS, and send them for the training.
  • Once they are CBISTs, they are then able to train staff to a CBIS level of expertise. No, ACBIS will not be issuing certificates because no fees were paid, but yes, staff will be at a significantly higher level of expertise and, to my knowledge, there is nothing preventing providers or the RRDCs or the DOH from issuing certificates of achievement to those staff members who have reached the CBIS level of expertise.

Were this proposal to be enacted, waiver programs would operate at a markedly higher level of expertise, waiver participants would benefit greatly, and, in the long run, would require less services to maintain and increase their independence, which is, after all, the point of the waiver in the first place.

Now, I think at some point the DOH must make this level of training mandatory, but not until one of two things happen. There is either a reimbursement rate instituted for staff training that, I have neglected to say until now, must be relevant to those who live with brain injuries, or, there is a higher reimbursement rate awarded for waiver services once the training is successfully completed.

 

Please distribute to all interested parties

 

Next: Elephant #2: New York State Traumatic Brain Injury Services Coordinating Council