ABI Medicaid waiver - Annual Review Doctor’s Team Meeting Minutes

I am a survivor of Traumatic Brain Injury; In the early 1990's I became a member of Connecticut's class action lawsuit working along with the Connecticut Brain Injury Association advocating for Connecticut's Acquired Brain Injury/Traumatic Brain Injury (ABI) Medicaid Waiver.

As you may know I have had a lot of problems with the state o f Connecticut Department of Social Services (DSS) taking advantage of me. It has become very obvious they are also doing it to all others on the ABI wavier. Not only am I a survivor who cares enough to speak up but as a human being I feel I have an obligation to my fellow survivors to speak up and take charge of what is needed.

Because the doctors are not being made aware of Sec. 17b-260a-1J2c and Sec. 17b-260a-1G4 in the ABI waver laws the DSS is making them there “Genie Pigs“ and when it’s brought to light DSS does their best to deny or justify it! Department of Social Service is calling the doctors and telling them that their client’s hours are going to be cut, not being aware of these ‘Sec’ the doctors are singing off on the plain, which is allowing DSS to take advantage of the clients on the wavier.

Sec. 17b-260a-1J2c Responsibilities of the Department of Social Service, The DSS shall assign social work staff to execute the following ABI responsibilities: implement the approved service plan and coordinate services provided to the individual under the waiver.

Furthermore, the Department of Social Service has overstepped its authority; it is the interdisciplinary team that makes determinations about the service plan. This was done without an ABI Waiver team meeting, and in absence of me, my appointed advocate, and a neurophysiologist familiar with me.

Sec. 17b-260a-1G4 the service plan shall be developed by an interdisciplinary team that includes the individual, his or her conservator, if any, the Department of Social Service social worker assigned to coordinate the individual’s service plan, a neurophysiologist who is familiar with the individual, other clinical staff as needed, and any other person(s) of the individual’s choice.

Thank God That I made My Doctor aware of these Sec. :)

Below my ABI Doctor’s team meeting minutes are my staff’s team meeting minutes below that is the letter that I gave to the Connecticut TBI Advisory Committee on Oct 16 2012 My doctor wants to stay above the politics that’s why I am not posting his name


Subject: Dr Notes

Craig Sears’s team meeting 10/24/12

Attendees: Craig Sears, James Dwyer; Stephanie; Clement; Jessica; Dorian Long, and Doctor

Dwyer is requesting a recap of CS last three months CS notes that he has had speaking engagements during the last three months States that he gets calls and emails regarding advocacy on a regular basis It's difficult for CS to describe what he does to the current social worker due to an erosion of trust with this worker

Dwyer is attempting to state that he has not had specific events despite CS explaining to the contrary

Stephanie states that she is working with CS to complete a number of tasks Dorian introduces herself and asks about Stephanie's role on the team What activities he does on a monthly basis: despite details that he manages his blog, website, talk show for brain injury etc...

What specifically does Stephanie do with CS As his staff she provides companion and prevocational services

He does far more than go out to random events. They are conveniently taking advantage of the fact that he is to an accurate reporter

Sarah Jane Brain Project Advisory Board in State of CT

Can you take me through today how did you get through his day -question from Dorian Needs reminders to dress appropriately for weather and occasion States that he gets help with meal preparation from his staff States that he was able to get his oatmeal together in the morning

Being questioned regarding his ADL's ----it is crystal clear that he needs reminders

States that he knows that he would fail without his waiver services CS states that he does not want to go back to not having services

States that he likes structure. Does not believe that he could complete tasks if he did not have his ILST staff

State’s that it would be difficult if he were to have his services taken away. Dwyer states that he has benefitted and grown. Are these guys pushing to say he's made enough progress let's cut your hours? What a joke!

Dorian states that the ABI waiver program is over 42 million dollars in budget

There's an over focus on how his ILST services are implemented When are the ILST services delivered States that his hours in ILST are provided on a daily basis

ILST service hours:

Dwyer States that CS hours cannot be varied and haphazard States that there must be a schedule to implementing the hours It is their job to put structure in place regarding service intervention

Craig Sears

Everyone throws wrenches in his program because it doesn't fit the structure that he wants This is not an issue of improving his service but an attempt to scrutinize

CS is one of the highest functioning individuals on the waiver program per Dorian

My thoughts:

The lack of trust is so problematic He isn't going to be forthcoming in a meeting if he doesn't trust I will make sure that the level of structure is known to Mr. Dwyer

Points I made during the meeting

1. We discuss the service hours at every meeting. Dwyer denies this point

2. Trust on this program has eroded because all we do is discuss his hours

3. Dwyer called me and told me that his hours were going to be cut. I felt this was not a team process. Dwyer denies this point.

4. The focus on his hours leads to him not trusting. We go almost two months after a meeting trying to calm him down. If there is any waste it is the witch hunt that causes him not to trust and leads to months of lost service time.

5. Stated that I imagine that providers do not want to work with him because it's the same witch hunt at every meeting. Dorian stated that she resented my use of the phrase "witch hunt". I don't know how else to characterize what I've seen

6. The level of scrutiny exceeds anything I've ever seen

7. If I were not on his program I would not believe that this is happening. I would write him off as paranoid. I've seen it and it's horrible.

I explained that CS makes sure that he gets every hour out of his program. Of all people to question as to the veracity of their program CS should be the last person. He knows what hours he has and he wants the hours done.

What I did not say: it's a person-centered program. If he wants his hours implemented in a manner that is not traditional I can't see the problem with it. Why does the worker believe that there has to be a schedule that cannot be modified or a schedule that is demanded by DSS? That's not the program. It's not person-centered when it's convenient and then state driven when it's inconvenient. Completely unacceptable in my opinion!

New plan will be signed off in March 2013. The client will be reassessed 6 months afterwards


My thoughts: Connecticut Department of Social Service

Again doctor, thank you very much for being the first person to ever speak up for me on my case, helping make my case an example for others to follow. - CS