kepdavis

Stepping into the world of Social Work

Monthly Archives: March 2012

Ups and Downs

I’ve had an up and down week, with mostly ups at school and a roller coaster at work.

First, I’m very pleased with the grades I’m getting so far in my classes. I just got my Behavior midterm back – I was a little nervous because the midterm in the previous Behavior class was where I stumbled last term (if, of course, you can consider stumbling to be anything less than an A).  So I’m waiting for one other grade in that class (a much smaller assignment that involved an article critique) and will be working with my group on an assignment for the other class. I need to get started on an interview of a senior citizen, and the paper which will result from getting their life story.

In further school news, I’ll be meeting with my advisor regarding my internship placement next year in the middle of the week. I had quite a bit of paperwork to fill out, and also had to crop a couple of 2×2 photos for the purpose. I believe the meeting is to go over the paperwork and any special concerns I have regarding my placement.

At work, I’ve had some goods and bads. The unpleasant situation was a client who, after resisting every suggestion I was trying to make to help him work faster, decided he either wanted another coach or no more coaching. This would have been only mildly troubling, but my boss is one who makes things worse by immediately going for the jugular to try to figure out what I must have done wrong. I fully admit to being a fallible human being, but I also need my boss to understand that some issues are not necessarily caused by an error.

However, at the very next visit that day, I happened to receive copies of another client’s annual reviews by his employer – this year’s, which I just helped the client complete, and last year’s, a couple of months before I started with him. The difference is amazing! Obviously, the client deserves the real praise for making the improvement, but I have to believe that I must have had something to do with it, too.

I also attended a family meeting with the staff responsible for my father’s care. It looks like he is in good hands.

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Even more evidence!

I just came across this from the Family Research Council.

Logo of the Family Research Council.

Logo of the Family Research Council. (Photo credit: Wikipedia)

According to the information on the event:

On March 22nd, 1972, the Supreme Court undermined the boundaries and benefits of marriage. In the decision Eisenstadt v. Baird, the Court struck down a Massachusetts law prohibiting the distribution of contraceptives to unmarried people, and implicitly sanctioned unmarried non-procreative sexual intimacy.

Does this really sound like freedom?

A free society, in my opinion, permits individuals and doctors to make medical decisions based on science and the individual’s moral, ethical, and religious beliefs, not that of the state. I’ll even give the doctor an out from prescribing what he doesn’t approve of, so long as s/he is willing to provide a referral to another doctor, though I would be personally very uncomfortable with the idea of an OB/GYN who refused to prescribe birth control medication.

The “logic” appears to be that the availability of birth control somehow discourages marriage. While I consider marriage a great choice. I don’t see how people are going to decide to get married simply because they can’t get birth control without a marriage license.

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A little evidence we are right to be worried

 

Two articles on the birth control issue caught my eye today, both indicating that reproductive rights advocates are correct in pushing back.

The first is Mitt Romney, stating that he’ll “get rid” of Planned Parenthood. This is very troubling for a number of reasons, but the biggest concern comes from the very arguments of those who are attacking the recent health insurance mandate and even coming up with new legislation allowing ANY employer to opt out for vague conscience reasons. They claim that employers should be able to do this to protect their freedom of religion, and the employee can just go to Planned Parenthood.

Well if these same people had their way, Planned Parenthood wouldn’t even exist! You can’t rely on something in one argument that you are actively seeking to eliminate in another.

Second, an Arizona law requiring that women obtaining birth control prescriptions may be expected to prove to their employer that there is a medical need.  The Huffington Post article does a good job of explaining it. The picture above was going round as a “permission slip for contraception coverage,” which made the concern quite clear. And despite Rachel Larimore’s column on Slate claiming it is insulting and misleading, our fears have turned out to be right on!

It is clear that if we allow the Right to have their way, women will not receive the medical care they need. They are far more concerned about the poor embattled employer having to buck up and provide health care coverage that meets a standard determined by medical and public health experts, rather than religious leaders. Yes, a few exemptions should exist, but they would be for actual churches, not giant universities or hospital chains. Very small employers are also exempt from these mandates, protecting those businesses, as well.

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Next Year’s financial aid

It’s that time again!

USC vs. Syracuse

USC vs. Syracuse (Photo credit: jeffdubyn)

Financial aid decisions and scholarships take time to arrange, so we apparently need to start applying for them about this time. Fortunately, my advisers at USC are very good at ensuring we are aware of deadlines.

First, having your taxes for the previous year completed is almost a prerequisite. You can do some estimating if there’s a reason you need to delay filing your taxes (perhaps you are having to pay rather than getting a refund) but then you end up having to fix the estimates anyway.

The next step is filing the FAFSA, a federal form about your financial status, that is shared with your school, or in the case of an incoming applicant, all of the schools you are applying to. This year, it even linked to our tax filing, making it only a matter of a few clicks. This was amazingly helpful! This will determine my eligibility for federal loans and work-study.

2010-2011 FAFSA Screenshots

2010-2011 FAFSA Screenshots (Photo credit: Christopher S. Penn)

Then, in the case of USC Social Work, I also had to fill out an application for any funding they have that is specific to our school. This wasn’t difficult either, though I wished they could have allowed for another 200 characters or so in the box where you explained why you need financial aid.

We have also been advised to look for private funding that isn’t directly awarded through our school. I will particularly be looking for scholarships for those intended to benefit hearing impaired students.

The good news is that second year part-time students (as I will be) become eligible for things that were not available to us this year. The other great news is that it is very likely that I will be able to use work study funds for my internship hours. This will help quite a bit, particularly since I’ll need to go part-time at my job starting in September.

More on all of this as I hear. I will still need to be working with the USC financial aid department to provide a variety of documents, including information that my budget will be reduced due to going part time.

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Mid-Semester School Update

Zero Tolerance for Clowns

Zero Tolerance for Clowns (Photo credit: Mike Licht, NotionsCapital.com)

It’s a little more than halfway through the semester, and I realized Ihadn’t written much about my classes recently. Probably not surprising since I’ve been busy writing papers (with the occasional diversion into writing about birth control insurance coverage and Limbaugh’s idiocy).

I have received one paper back, with an excellent grade. This paper was a group effort, with 6 other classmates coming together to write it. The assignment was to choose an issue or law that the NASW has taken a stand on, and the first paper was to be pretty much background.

Our group chose federal legislation ending some funding for abstinence only sex education and moving the funds to a program for comprehensive sex education. Basically, what this means is that some federal funds had been earmarked for sex education programs that would only teach the values of abstinence until marriage, and not about those measures that can be taken to prevent pregnancy or infection. We as a group agree with the National Association of Social Workers that evidence and social work values support comprehensive sex ed.

Our next paper will also be a group project, in which we engage in advocacy on the above issue. Our group has decided our advocacy will be submitting an editorial to some publication on the issue. We have not yet determined which one we will choose.

Our midterm on The Namesake was due a little more than a week ago, that was probably the most challenging task up to this point. Examining a fictional character according to a variety of developmental and psychological theories is interesting but challenging. I believe the biggest issue came from the distinctions within the exam itself. It carefully delineated which theories we could use for each question, but for at least one question none of the obvious theories really fit the situation.

Another paper I had to have in last week was an article review, also done in partnership with a classmate. We chose an article about “Women in the Middle” – middle aged women who are caring for two generations – their children and their aging parents. This paper, and the presentation we will give next week, was much shorter and thus not as difficult as the midterm, and with two of us we were able to move it along fairly well.

Coming up after the break: the final exam for Behavior, in which we interview an acquaintance over 70 years old, then apply what we have learned to that person’s life story.

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About Dad…

I haven’t blogged about it yet, but most people who know me are aware that my father was hospitalized at the beginning of February with a serious illness. Dad is 77, and enjoyed very good health until a shoulder injury some time back and a heart valve replacement a few years ago.

He first reported a number of non-specific symptoms and was hospitalized. I wasn’t notified until almost a week later.  I arrived at the hospital to find Dad looking pretty scary. He was able to talk, however, and was particularly concerned about giving me the passwords to their online services to help my mom with the bills. I believe he felt at the time he had suffered a stroke.

A few days later, I get a call from my mom that Dad had been taken to ICU and placed on a ventilator to “give his lungs a rest.” I was notified a week or so later that they were choosing to do a tracheotomy for the ventilator. What I heard indirectly, and from those discussions I’ve been able to have directly with the doctors, is that he has lymphoma or something in the non-Hodgkins lymphoma, leukemia, or bone marrow cancer family. The most confusing thing is that the most troubling symptoms are not cancer symptoms, rather the neurological symptoms (such as not being able to breathe!). It was another couple of weeks before I really fully understood the true nature of the situation.

After a week or two in ICU, he was moved to another ward, and improvement was very limited. My last visit to him at Presbyterian Intercommunity Hospital was rather troubling, as he couldn’t use his voice, but was clearly trying to talk to me. My aunt, who had been able to visit during times where he could cap his ventilator and use his voice, was telling me that he was increasingly less rational in what he did say, for example demanding that she take him home immediately. The nurses confirmed that they were noticing this, too.

Having a professor who is a medical social worker in this situation was amazingly comforting. Dr. Joosten, my Social Welfare instructor, helped me understand that many senior patients exhibit some loss of rationality simply due to the length of stay and the nature of such intense care. Medications, sleep deprivation, lighting and many other factors may have something to do with this, and even has the name of ICU psychosis or ICU syndrome.

In addition, I was finally given a diagnosis beyond the cancer which helped me understand the neurological symptoms. Apparently, whichever cancer he has, or a number of trivial viral conditions he could have caught over the winter,, triggered Guillain-Barre syndrome. GBS is a serious autoimmune condition, in which the body starts attacking parts of the nervous system.

The bad news, of course, is how serious these conditions are. The good news is that neither is an automatic death sentenc

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Day in the life of a job coach

This is a summary of what is a typical day for me as a job coach. This positions serves developmentally disabled adults at their workplaces,  the job coach serves as a supplemental trainer, advocate, and mentor to the clients/consumers. My roster of clients would typically be considered high functioning. Three of my clients are licensed drivers, and while all but two live with family by choice, most of them could live on their own with some level of support if they chose.

Their diagnoses vary between the different types and causes of mental retardation and autism, but my individualist approach generally does not require me to know what some doctor decided 30 years ago. What is important to me is if the person is doing their job to their employer’s standards, and what I can do to help fix any problems. Down Syndrome, autism, Asperger Syndrome, whatever specific reason someone might be receiving my services is less important than where the individual is right now in his/her training and support needs.

8:00 – arrive at first site, a home improvement chain store.  I briefly visit HR manager’s office to say hello.  She has been designated my primary contact at this site, though I also touch base with my clients’ direct supervisors as often as possible. I work with three people at this site but will only be officially visiting one today, as the others are not working.

My client works in Garden, I find her watering plants outside. We exchange a few pleasantries about the past few nights TV offerings. I double-check a few things I’ve been asked to monitor, everything is great. We chat a little further about her work and a minor matter she would like to discuss with her manager. That particular individual is clearly extremely busy this morning, so I suggest postponing that discussion for a later date.

When the consumer takes a break at 9AM, I sit down nearby to do a little of my paperwork. I check that I wrote notes for the previous days visits, adding a sentence or two to a few of them. I also log on to the company computer system as each of my clients to get their schedules for the week after next. I fiddle a bit with the written schedule I’m preparing for my visits the following week, still incomplete until I get the schedule for a client I will be seeing at the end of the day.

I spend some time slowly walking around the garden section some distance from my client. As always, her work is excellent. I observe her helping a customer find what they want and return to her watering.

I visit the HR office one more time to say goodbye and obtain a signature verifying that morning’s visit. I head over to my client to say goodbye and let her know when I will see her again.

10:00 – drive to next site. (Yes, I get paid for drive time and mileage)

This happens to be another site of the same home improvement chain I just visited. I have three clients here as well, and will be spending time with each of them.

10:30 – again, a brief visit to the HR director’s office. I confirm with her that I still have the blank annual reviews she asked me to help each client fill out (this company has the employee state their opinion of their performance on each area in writing, then the manager completes the form with his/her opinion, with an eval meeting afterwards).

I locate all of the clients in their various departments, say hello, and let them know my plan. I bring one of them back to a private room with me, as he indicates it is a relatively good time for him. We spend about half an hour going over the eval. “Work ethic and dependability is being there every day on time, taking breaks and lunch at the right time, and working hard for the whole shift. Do you think you exceed standards, meet standards, or not? Write a couple of sentences why you chose that. I’ll spell that word for you…” I slip in a few reminders of the issues he and I have been asked to work on, but ensure that the answers on the form are his own, not mine.

I finish with that client and send him back to clearing the lot of shopping carts. I spend some time observing another client in Garden, where he is sweeping up. I joke with him a bit and remind him gently about the matters I’ve been asked to work on with him. I tell him I’ll be going to lunch shortly, and need him to find me to do his review when he is done with his own lunch.

I leave the store to get some lunch. I choose fast food, and spend most of my lunch reading a novel on my Kindle Fire.

I station myself in the training room after my lunch until my client clocks back in, checking schedules on the computer and adding a note or two to various forms for a few minutes. He comes in right on time and we go through the same process as before, though this client prefers that I do the writing. This particular client is an immigrant from south Asia, and his English is somewhat limited.

We finish up, the client goes back to his work in garden and I go look for the third client. He is busy stocking in the Seasonal section, so I spend some time with him chatting and observing until he has reached the point he can come and go through the same process as the other two.

In this case, it’s a little more challenging to get privacy, as managers are gathering in the training room for an afternoon meeting, and the other two private rooms in the general area are also in use. The HR manager figures it out for us, though – she has my client bring a light table into a network server room nearby.

When we’re done, it’s time for his lunch, and very near the end of my visit, so I spend a few minutes wrapping up my visit with managers, saying goodbye to the clients, and writing a few sentences as notes for each client.

2:30 – drive to last site

I then drive to my last site for the day, a supermarket, where my client is a courtesy clerk. She is doing a fantastic job overall, so much so that she doesn’t really want me there. In fact, most of the time I get the silent treatment. She’s busy bagging when I get there, so I just say hello and head to the back room to get her schedule for the next week. I come back out and observe her from a distance, to avoid distracting her or confusing customers.

I try to engage her in a little bit of conversation when she’s not too busy.  She tells me she is unhappy with the schedule she has received. I talk to her about why she doesn’t like it, and suggest that we talk with the manager who writes the schedule so he is aware of her preferences. She mentions a point in the past where she had apparently already done this, and names an individual I do not know (I’m not sure if it’s a previous job coach or job developer from my agency, or a case manager from one of our funding agencies). She seems rather put out that I don’t know this person.

I remind her that scheduling preferences like that can get lost or forgotten over time, and confirm with a lead cashier that I had the right manager in mind to discuss the matter with. The client then says “never mind” and appears very annoyed with me. I’m not sure if it’s because I don’t know who the person is she referred to earlier, that I’m not equally outraged that her preferences have been forgotten, or that I’m expecting her to be part of the process (that I don’t just talk to the manager without her).

Particularly at her level of competence, it is very important that I do everything I can to facilitate her independence on these matters. If I just slip upstairs and get her schedule changed for her, that gives her and everyone else the wrong message. My role, in my opinion, is to model and instruct her in the best way of handling these things, encouraging her to handle them on her own when possible, rather than taking them on myself.  I also remind myself that the schedule difference is fairly minor and not an absolute (such as if there would be no transportation home for her, or a conflict with some personal commitment).

The last few minutes, I find a place to sit down where I can still see the client bagging groceries, and complete my planned schedule for the next week and the last remaining notes, as well as my time sheet and mileage for the day. I get a final signature for this visit and say goodbye to the client and the managers.

 

4:30 – I head home to relax. 🙂

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Freedom of religion and the employer

I’ve been following the birth control debate pretty closely, as can

Rush Limbaugh - Caricature

Rush Limbaugh - Caricature (Photo credit: DonkeyHotey)

probably be shown by my having devoted two whole posts to it, and am considering another about Rush Limbaugh’s ridiculous rants and attacks on a woman, a Georgetown law student who intended to testify on the issue.

We all have the right to our own religious views. However, our rights can be somewhat limited by time and place, as well as the rights of other people. For example, employees can be limited in their speech (including religious) during their paid hours, if that behavior conflicts with the interests of the employer. My co-workers’ right to peace and my employers expectation of productivity do create limits to my hypothetical right to evangelize at work.

An employer, according to US law, also has to accept certain boundaries relative to their religion and employees. Most businesses cannot refuse to hire someone who does not happen to attend the same church as the owner. A few exceptions to that are actual places of worship, possibly very small businesses, and I’m sure a few others are recognized.

So the idea of a “conscience exception” for businesses that are not actively religious in nature is inherently wrong. An employer has no religious rights over his/her employees. A shop owner who didn’t believe in blood transfusions would be considered laughable if they attempted to remove that particular medical treatment in a health insurance plan. So why is birth control fair game? If it were hearing aids or blood pressure medication, the discussion would be much saner (I would hope).

Some would say that it’s the employer’s choice and you don’t have to take or keep the job if the benefits are not sufficient. That is a possible course of action, but I have yet to have an employer give me the details of their insurance plan ahead of time, so it isn’t like the information is available during salary negotiations. Some (most?) employers even require you to work 3 or 6 months before you become eligible, making you put in real time, perhaps only to learn that an important part of your compensation does not meet your needs. So the “free market” does not solve this problem.

We have a major problem with health care in this country. The only solution our legislature was able to get through was a modest plan to increase the percentage of people with insurance coverage. The only way this will help is if we also allow experts (medical and public health experts, not bishops or rabbis) to define what a basic, comprehensive plan looks like.

It is clear that people who speak from a “moral” or a political point of view are deliberately lying and confusing the issue.

  • Sandra Fluke, telling the story  of a roommate whose ovarian condition required surgery due to a lack of coverage for the proper medication, somehow becomes a slut (when her own choices were not even under discussion). Her history of belief in reproductive rights somehow makes her a “plant” as opposed to the positive terms they’d use for those who are devoted to conservative causes.
  •  The co-pays or full prices for prescription medication that must be taken daily somehow add up to “a lot of sex,” deliberately confusing prescription costs with the costs of other “per use” methods such as condoms.
  • Males with no medical training pontificate that birth control pills serve no medical purpose. This is quite easily debunked.
  • Coverage under an insurance policy is deliberately confused with entitlement and government handouts
  • The fact that Georgetown students pay every dollar for their insurance (if it’s like USC, where I attend, it is mandatory unless you have evidence of other acceptable coverage) is not mentioned. That fact alone should indicate that nobody’s religious rights are infringed by bringing insurance policies into the 21st century
  • The fact that 28 states already have laws requiring such coverage with no problems is also ignored
  • The fact that some Catholic universities already have comprehensive plans because there was no way to separate medical necessity from personal preference is also ignored
These are very similar distortions and outright lies to the kinds of things that were said about Obama as a candidate, or even as current president, and health care reform when it was in the formative stages. Death panels, anyone? Obama a secret Muslim? It is clear that the Right cannot be trusted to say anything factual. They will say or do anything to win.

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An open letter to Rush Limbaugh

Dear Mr. Limbaugh,

I hate to waste space and time to you on my blog, but I just had to say my piece about your ridiculous comments on birth control and the recent hearings.

First, the issue is not about giving anyone money. It is about insurance covering FDA approved medications that are legally prescribed by a doctor. Covering any of these medications should be no more controversial than covering those for erectile dysfunction.

It is also not about what we have to pay for as taxpayers. It is about what a “comprehensive medical insurance package” looks like. If employers do not provide this, they are increasing the risk that you and  I will indeed end up paying for medical care that could have been avoided through good preventative coverage. For example, not covering cholesterol medications now will lead to expensive heart procedures later.

This isn’t an entitlement issue. University students pay for their medical insurance along with their tuition (I can provide the evidence – my own bills from USC if you like).  Employees typically receive their insurance as part of their compensation package, with their “contribution” deducted from their salary). I don’t see the taxpayer involved anywhere here.

It isn’t even about supposedly promiscuous college students. Contraceptive medication is medically indicated for many medical issues, including painful ovarian and menstrual conditions. These same medications would be prescribed even if the woman were a cloistered nun. They must be taken daily to work properly, whether the woman is sexually active or celibate, unlike those for erectile dysfunction. Perhaps your familiarity with Viagra and similar medications is why you jumped to the conclusion that $3000 of medications over 3 years indicates “a lot of sex.”

You indicated that a particular woman’s family should be ashamed of her for her testimony. I submit they should be exceedingly proud. She was standing up for a friend and roommate who required a medical treatment the university was denying, even though the condition and the treatment are typically taboo.

Further, it is not about freedom of religion. Employers do not have the right to dictate their religious views to their employees. There are limited exceptions such as churches, but the idea is this: simply because an organization has some connection to a church does not make it exempt from labor laws. Do we allow employers to object “morally” to laws regarding rest and lunch breaks? Can they say their religion forbids them to pay overtime or a minimum wage? Can they ignore occupational health and safety regulations?

The important point is this: the patient, due to the university’s refusal to cover an FDA approved medication, required painful and expensive SURGERY.  Medically and economically, this was an unacceptable outcome. This is what health care reform is about; recognizing that an ounce of prevention is worth a pound of cure.

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