Newsletter 4/2008: A Lot To Say

Long time, no write, y'all. There's a lot to be said in this edition of our Appalachian Counseling Newsletter, so let me get everyone oriented.

Introduction: Word On The Street Is That All Y'all Rock
Chapter One: Interview Your Future Boss
Chapter Two: Transylvania CJPP
Chapter Three: Crystal's Ball
Chapter Four: Follow The Money - Billing Department
Chapter Five: Child and Family Community Support
Chapter Six: Who's doing what, where?
Chapter Seven: Tapestry
Chapter Eight: As Best I Can - Birthdays and Workaversaries
Chapter Nine: Mixed Bag of Goodness
Afterword: Exhortation

INTRODUCTION: WORD ON THE STREET IS THAT ALL Y'ALL ROCK

Rachael gathered up the 48 responses to our App Counseling Satisfaction Surveys and put into this handy internet application:

Click Here To See The Results of the Satisfaction Surveys

Once you're at the Survey site, you can click on "View" buttons to read folks' narrative comments, too!

ONE: INTERVIEW YOUR FUTURE BOSS

We're going to have candidates for our new Practice Administrator position rolling into town over the next several days. Everyone is encouraged to come to one of the events to meet and grill the candidates. Make sure to attend something, and let Rachael Smith know what you're attending. The dinners have limited seating, so it'll be the first folks to RSVP who get to go to those. The dinners aren't paid for.

15th-17th our candidate will be Bob Morris from Ohio
17th-19th our candidate will be Joseph Reap from Atlanta, GA
22nd-24th our candidate will be Denise Adcock from Concord, NC

April 16th - 10 a.m. - Noon Visits to the Brevard locations; 1:30 p.m. - 5 p.m. site visits in HVL and AVL; 7 p.m. Dinner at Carrabas on Airport Road.

April 18th - 1:30 p.m. - 5 p.m. site visits (more info to come); 7 p.m. Dinner at LaPaz in Asheville.

April 23rd - Site visits to be announced; 7 p.m. Dinner at Carrabas on Airport Road

The Practice Administrator will be taking the helm of this agency we call home. If you want to have any input at all into this important selection process, then show up.

TWO: TRANSYLVANIA COUNTY CJPP NEWS

Pat Menser - The Transylvanian Goddess of Substance Abuse Treatment writes:

I have been asked to share some good news about Transylvania CJPP program. At our last CJPP board meeting, Judith West presented some positive statistics on the success of the CJPP program in several categories:

The following are Raleigh 's Goals for CJPP clients in several categories with App Counseling's 2007 stats below:

1. 60 percent of clients will successfully complete treatment Average for state: 42%

Average for App Counseling: 71%

2. 70 percent of clients will not be re-arrested while in treatment. No State Average

Average for App Counseling: 87%

3. 70 percent of clients will not violate probation while in treatment. No State Average

Average for App Counseling: 87%

4. 90% of client's will work full time while in treatment. No State Average.

Average for App Counseling: 91%

Category of those who stay in recovery for this county: 65% clean after three months--50% clean after 6 months and 35% clean after one year. Marie Bartlette, regional director, said these statistics are excellent and praised our county and Appalachian Counseling. In the near future there will be an article in the Transylvania Times about the CJPP program. The CJPP board suggested the county should know what great work App Counseling is doing.



THREE: CRYSTAL'S BALL

Crystal Lance wrote in to let everyone know that some changes in Liaison Land have been happening:

Ashley Sutton's last day will be at the end of April. She is going back to school
Kamilah McKneill moved to the Asheville Office.
Alicia Israel moved to the Asheville Office.
Kate Eastman is working part-time at the Country Club Office.

FOUR: FOLLOW THE MONEY

Bonnie Kain sends this missive from deep within her billing bunker:

"There have been a lot of changes in the Billing Department starting in October with a new software system, Laura retiring, me starting in January and Vicki leaving. I moved here in September, 2007 from Wappinger Falls, New York. I was the Billing Manager for the Dutchess County Department of Mental Hygiene for 3 and a half years there. When I started, the Department had undergone a major software change.

Meg and Kody have been in the Billing Department helping to catch up with the backlog that was created. We have developed a schedule of transmitting claims and posting payments daily. We are keeping up with the current denials and reprocessing claims. We are in the process of identifying patients regarding outstanding balances in the new and old systems.

Year to date for 2008 we billed $2,182,523.57 (gross) and collected $955,330.14 with a collection rate of 84%. We are striving for a collection rate of minimum 96%. This does not include the monies that have been collected in the old system.

Next week Marian Robinson joins our team. Marian comes with 23 years billing experience and a lot of enthusiasm. I am looking forward to working with her.

We still have work to do to get us to a higher collection rate and with your help we can do it. What we need from everyone is that the patient's address, phone number, and insurance information is verified at each visit. The most important thing is to get the necessary authorizations for the services that the patient will be receiving.

The Billing Department's motto is TREAT but DON'T EAT. Which translates: If you treat the patient make sure that the necessary insurance information and authorizations are obtained so that you and Appalachian gets paid. Please feel free to call or e-mail us if you have a question regarding billing."

FIVE: CHILD AND FAMILY COMMUNITY SUPPORT

Kenny McAbee is letting his inner motivational speaker come forth in this update from CS:

"The Child and Family Community Support Team has seen its share of changes over the past year. With state mandated changes, employee change, and many other obstacles that have been thrown our way, we have stuck together and have grown stronger as a team. I am proud to say that we have made a great influence in the Transylvania and Henderson County Schools and we will continue to grow our staff and influence the Buncombe County District.

Currently we have a fourteen member team that is striving to make positive changes in the lives of the clients we serve. Most of our staff have gone beyond the call of duty and have attended and/or become members of local organizations that support children and their families. This has been an avenue that has put Appalachian Counseling's name out in the communities and we have received great applause for the hard work they have done.

Our team members have been challenged to provide better communication within this company and to build bridges into other teams that we work with. It is our desire to see this company, community, and the families we serve be a united force.

Although our job description has set hours that we work, most of the community support workers live and breathe their job 24/7, but yet still find energy to give their best. As we continue to march forward and serve the mental health field, I am proud to say that our team can take any obstacle or change and turn it into an opportunity. Thank you Child and Family Community Support for doing a great job."

SIX: WHO'S DOING WHAT, WHERE?

Erica has lots of news about who's been hired and where they're working:

Welcome new Employees:

Jill Pistel at Kanuga as a QP for CS

Karen Silver at Kanuga as a QP for adult CS

Dana Broach will start on Tuesday as the intake Coordinator for the Hendersonville office, she will be working at the Kanuga office, taking over Megan Fink's position.

Martha "Marty" Thompson at Country Club as the Intake Coordinator for the Brevard office and individual counselor.

Nicole OConnell at Williams street as Medical Records Clerk

Tracey Scott in Brevard as AP for child CS

Meghan Gowland in Hendersonville as QP for Child and Family CS

Sorry to say that Diane Satterfield and Megan Fink are no longer part of the Appalachian team.

Plus - Dental Insurance rates increased to $12.97 per pay period effective 4/1.

SEVEN: TAPESTRY

Tina Nowak's carrier pigeon dropped this into my email box:

"Tapestry has been exceeding the budgeted census since July '07. Since January, we have been at a 5.5 census with many weeks exceeding that with the first step-down clients who have been transitioning into the community. We have been getting excellent feedback on our program and the step down program with insurance companies, families, and clients. Calls come in daily requesting additional outpatient, IOP, and day treatment options. We are currently being approached by two different organizations wanting to discuss investing in expanding Tapestry's programs.

We have added a part-time Registered Dietician to the program who provides individual, nutrition groups, meal planning, and grocery shopping with the clients. This was a much needed addition to the program that has shown great success. In addition, we have added a Licensed Exercise Physiologist who assists the clients with learning healthy limits around exercise and strength training with healthy limits. Many of these ladies have lost all muscle tone which leads to many physical problems who need this type of training. On the other extreme, many clients are athletes who include mountain bikers, marathon runners, and dancers who need training on when to recognize and how to manage the desire to exceed their bodies limitations. We have also transitioned our Equine Therapy to Brevard which has lifted the burden of traveling and hour and a half each way. Harry Taub took over as Medical Director in December, he is also providing client and staff education on a weekly basis.

Improvements to the site include having the driveway paved and striped to comply with City Regulations, converting the cottage into a Transitional Home, and landscape improvements.

Kelly Brown, Clinical Director is persuing her CEDS Certification and EMDR licensure. She is currently licensed and providing Imago and Energy work with the clients. Heidi Houser completed and received her LCAS, we are so proud of her. She is doing a wonderful job providing individual, music, and body work groups. Thalia Brennan is in the process of persuing her licensure and is doing a wonderful job providing individual and body works groups. Elizabeth Hazelwood is currently out on maternity leave following the birth of her beautiful boy and will be doing contract work as a Trager Practitioner until she is able to work more hours. Susan Link and Melissa McGill are doing great work with the clients with providing counseling, activities therapy, and support to the clients. Michelle Pitcavage has expaned her role as Admin. Assistant and has been posting billing, accounts payable, and will be doing payroll when Tapestry becomes a separate LLC which is currently in process.

Tapestry has a team of providers second to none and provide the most comprehensive, caring treatment that is offered in the Eating Disorder Field. Our staff are not here to merely make a paycheck, they are passionate and believe in their clients and what they do."

The Tapestry website is up and looking good - check it out by clicking here.

EIGHT: BIRTHDAYS AND WORKAVERSARIES

Because of the comings and goings, I don't have a comprehensive B-day and Workaversary list any more. Please send me your date(s), or leave them in the comments at the end of this post. To all of you whose special days fell in the fallow months of this Newsletter, my apologies. Here are the April/May celebrants!

Birthdays:

Catherine Myton - April 8
Michael Smith - April 13
Kenny McAbee - April 20
Mary Pitcavage - April 23
Thalia Brennan - April 26
April Banks - April 27
Karen Stewart - May 8
Richard Johnson - May 10
Kristin Doyne - May 23
Paulina Goodfellow - May 24
Linda Spencer - May 26
Jim Anderson - May 26

Workaversaries:

Teresa Drevar, April 9 celebrated one year.
Cindy Willis' first year will end on April 30.
Ruth Hobson will celebrate two years on May 9.
Kody Kinsley will be a two-year old on May 16.

NINE: MIXED BAG OF GOODNESS

Asheville: "This is a free lunch and learn about mediation and collaborative law and how it may work for your clients. It takes place at 34 Wall Street (Public Service Building or Self Help Building), Suite 401. Date and time: Tuesday, April 22, 12:00 - 1:30 pm. The sponsors are the Mediation and Collaborative Law Offices of Barbara Davis, Sarah Corley, Aleece Hiller and Kathy Marth. RSVPs to Kathy Marth have been extended to Wednesday, April 16 [kathymarth@mindspring.com]."

Laura Zabodyn says: "Just a reminder that if you want to meet with Jane or have her somewhere that you need to contact me or she might not be there. My phone at the office is 885-8255, email is lzabodyn@appcounseling.com"

Cindy Jordan is in the vacation rental business and wants y'all to know about her cute'z'hell chalet:

"Come experience life on a working, organic farm with all the comforts of home. Our vacation cabin rental is located at the base of Mt. Pisgah, down one of the prettiest drives in the North Carolina mountains. We're only 4 miles from the incredible hikes and gorgeous scenery of the Blue Ridge Parkway, and only 15 minutes from nightlife, culture, and charm found in Asheville, NC.

*Amenities include linens, feather pillows, towels, cable TV, wireless internet, coffee maker, full kitchen, CD player, DVD, local telephone.

*Laundry facilities on site.

*Pets ok with deposit. Some restrictions apply.

*Large rock fire circle, hiking and biking opportunities abound, picturesque fish pond, unspoiled views of Pisgah National Forest right outside your door.

*Gazebo, benches, meditation areas, flower and vegetable gardens.

*Cottage is furnished with local arts and crafts, most of which are available for sale."

AFTERWORD - EXHORTATION

To anyone who's read this far, give yourself a pat on the back. This agency has gotten bigger than a deer tick on a bag of plasma, and it can be hard to keep up with all the goings-on. Feel free to send me information at any time for the Newsletter. I "star" it in my Gmail and put it up when it comes time to post another edition. You can also use the Comments feature beneath this post to add anything I may have missed.

My hat is off to everyone who's been toughing it out over this period of rapid growth and consequent stability problems. It looks like we're out of the woods, and the new Practice Administrator will be laying a solid foundation for what we will become. I'm proud to be a part of this unlikely agency.

Newsletter 12-3-07: Notes between the gobbles and the ho, ho, ho

Hello again Appalachian Counseling. Rachael and I traveled to the strange land of Florida, where we picked oranges, cavorted with swans, saw the latest Coen Brothers' movie, and got trapped in UF vs. FSU football traffic on I-75. Here's hoping your Thanksgiving was gut bustingly grand.

It looks like we're almost out of the woods in our transition to NueMD. While there will be kinks in any system, we surely didn't need it to be as kinky as all that. The teams that have worked to correct and fine tune the NueMD/billing/paycheck thing deserve your pats on their backs.

And now Christmas, Hanukkah, Kwanzaa, winter solstice, and the new year are coming. Whichever holidays you're celebrating, make sure you adjust your schedule well ahead of time to prevent any problems. Holidays can be difficult times for many of those we serve, so help them plan for the best while giving them supportive Plans B as well.

Polly Penland sends a quote that might help us through the holidays:

An elder Cherokee Native American was teaching his grandchildren about life. He said to them, "A fight is going on inside me. It is a terrible fight, and it is between two wolves. One wolf represents fear, anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, pride, and superiority. The other wolf stands for joy, peace, love, hope, sharing, serenity, humility, kindness, benevolence, friendship, empathy, generosity, truth, compassion, and faith. This same fight is going on inside of you and every other person too." The children thought about it for a minute and then one child asked his grandfather, "Which wolf will win?"



The old Cherokee simply replied: "The one I feed."

Someone with some serious organizational talent created an awesome AppCoun provider directory here. Check it out and make corrections/updates as needed. You can use it to make internal referrals and also figure out who's who.

Rachael Smith: "I've gotten a provider directory together of therapists to start. We can add CS workers and their specialties and Doctors. At this point, therapist info. was most in demand. I'm allowing everyone to be collaborators which means you can add and edit your own info. Just make sure if you are clicking on a text box, that you double click before you start editing. If you single click and start typing everything already in that box will disappear. Some people did not send me any info, so those people might want to complete their own info."

The Child and Family Community Support staff is planning a fantastic Christmas party. The invitation is here. Be sure to let Kenny McAbee know how many of you are coming and how many folks you're bringing. I can't wait. This is my favorite party of the year.

Attention all employees, adult family members, and guests!!!!

This year’s theme is: An Ugly Christmas Sweater. Prizes will be awarded for the most outrageous Christmas sweater. All other dress attire will be casual.

This fun-filled event will take place on Thursday, December 20, 2007 at 6:30 p.m. and will be hosted by Jubilee Community Church located on 46 Wall Street in downtown Asheville.

This year we will be having a potluck dinner and will be asking each location to provide a certain dish. All beverages will be provided. Please look at the following list for what each location is responsible for.

Johnson Street- Soups and Sides
Alliance/Asheville – Desserts
Williams Street – Main Dishes
5th St/Kanuga – Salads
Tapestry/Country Club - Appetizers

Please contact Kenny McAbee (kmcabee@appcounseling.com) with the dish you wish to bring and number of guests, no later than December 17th..

This is an evening that is promised to bring much joy, laughter, and memories for months to come. This will be a casual party for all to relax and to have a great time.

Your entertainment guest and drama team for the night will be the Child Community Support Team, also known as "The Smurf Team""

And now it's time for that favorite newsletter feature: Birthdays and Workaversaries! I think it's great that so many of you keep tabs on each others' important dates.

Jen Worthen has her first A.C. workaversary on Dec. 14.
Vicki Gaddy is celebrating two years with A.C. on Dec. 14.
Richard Johnson had his two-year-versary on Dec. 1.
Shirley Nicholson is out in front of them by a year, celebrating three on Dec. 1.

Elizabeth Hazelwood blows out her birthday candles on Dec. 5.
Jay Joslin and Kambra Meyer can birthday together on Dec. 7.
Kathy Parris is our Christmas baby on Dec. 25.
Alicia McCrary has hers on Dec. 29.

Vicki asked me to pass this along, "I guess we should let providers that Monica Curbeam decided to leave. Currently there is just myself, Carol, & Teresa on finance team."

The Operations Team wants to let you know that there are a lot of plans cooking:

"- Be on the lookout for new PTO policy that will be much easier to keep up with.

- Looking at beginning client satisfaction surveys

- Working on figuring out reporting for various divisions to make sure nothing falls through the cracks- to assure communication/feedback/and accountability

- Planning to begin accreditation process with CARF in January. When our program is CARF accredited, it means that AC has passed an in-depth review and that we meet rigourous guidelines for service and quality- a qualified endorsement that we conform to nationally and internationally recognized service standards and that we are focused on delivering the most favorable results for the people we serve. The process begins with acquiring the standards manual and beginning the work of making the changes necessary to meet those standards. The benefits are business improvement, risk management, funding access, positive visibility, accountability, and a peer network.

- Reporting on collections/AR: Contractors be on lookout for email explaining things.

- Rebecca Norton, PsyD is now with us at Country Club. She is available to take testing referrals for children and adults. Currently she is only accepting self-pay until we can get her on some panels. Please welcome her and send her referrals!"

Vicki is offering up a couple vehicles for that special someone on your Christmas list:

"I would like to sell my 1997 Gold Infiniti QX4 for $6,000.
And my 2003 Blue Mazda Protege 5 for $9,600."

Lastly, Psychology Today has a list of newly discovered holiday disorders. Click here to read the whole thing:

"Angoraphobia (AP): A chronic fear that cousin Harriet from Omaha sent you another homemade sweater for Christmas."

"Calendar Countdown Condition (CCC): An unyielding obsession with how many shopping days are left until Christmas. Constantly reaching for Palm Pilots and notepads, CCC sufferers feel a pressing need to absorb and retain a daunting litany of time zones, store hours and driving mileage in support of their shop-or-drop obsession. "It's amazing," notes Harvard University's Arnold Belfry, who has studied CCC. "Some of these people can't even balance their checkbooks. But can they number-crunch the time it takes to get to the Radio Shack on Route 40? Down to the millisecond." CCC is most commonly found among former math majors, chronic coupon-clippers and old ladies who still use tiny change purses."

"North-Polar Disorder (NPD): The chronic fear that someone is on the roof."

"OCD-AAA: A variation on obsessive-compulsive disorder, in which sufferers are constantly on the verge of panic for fear that they forgot to buy triple-A batteries for their kid's Game Boy."

"Semitic Phlegm Syndrome (SPS): The inability to make the guttural, Hebraic ch sound when pronouncing the word chanukah. Primarily afflicting children, gentiles and seriously lapsed Jews, SPS sufferers become paralyzed with fear that a passing remark about chanukah at the dinner table will cause them to launch unexpected throat projectiles into the mashed potatoes."

Thanks to everyone who sent in submissions to the newsletter. If I left anything out, please click on comments below and leave it there.

I look forward to seeing all of you (and your loved ones!) at the Christmas Party on the 20th.

Newsletter 11-5-07: It's Been Too Long!

Good Lord, has a month passed? Thanks to everyone who's sent Newsletter items, and thanks for your patience as I work feverishly to get my act together. If I waited too long and made your newsletter submission obsolete (looking at you Brande and Anne), please accept my apologies.

I got word that October was Appalachian Counseling's highest billing month in the history of the agency/practice, so kudos to everyone for heeding the call and kicking their work up a notch. As we push ahead into the liaison system and get accustomed to NueMD, it's great to hear that folks are rolling with the punches. After over five years of constant change and flux in the mental health system and in our jobs, it's great to know that we're on track to hit a delectable period of relative stability and undeniable success.

Rachael Smith said, passed along the info that we'll be "officially" closing our offices between the hours of 12 and 1. "Providers who would like to schedule during that time would be free to do so, they would just need to attend to that client themselves. Unless I hear stong opinions to the contrary, I would like to go ahead with that. We would need to change voice mails and make sure a sign gets put up at each front desk."

She also says, "we are getting more adequate filing help to assist at all sites. Alisha will be coming over to Asheville every Friday again beginning next week. We are also looking at quickly hiring another liason for Brevard, since Kathy will be moving over to Kanuga soon."

The above mentioned Rachael also has a new workphone. So stop what you're doing and put it into your phone now. Otherwise you'll be hunting around for it on some future date. 828-384-1655.

Erica Cook sent me the big list of who got birthed when and who got hired when. Here are October's belated shoutouts and November's current yeehaws.

Workaversaries:

- Byron Allday, Adult CS worker and one of the survivors of this year's Chicago Marathon, celebrated one year with Appalachian Counseling on October 16th.
- Wendy Taylor, Child CS worker and powerhouse superstar, had her anniversary on the same day - 10/16.
- Thalia Brennan, yogic master and Tapestry superstar, started with A.C. last year on November 20th.
- Josh Beran and Jessica Buhrman, Child CS workers and bon vivants, both celebrate one year with A.C. on November 13th.
- Kristin Doyne marked one year with us on September 25th.
- Heidi Houser, who's found a home at Tapestry, has been here a year as of October 30th.
- Pat Menser, substance abuse group leader and all around mensch, had her first A.C. anniversary on Oct. 15th.
- Joell Steininger, Asheville adult therapist and new homebuilder/owner, is a one-year App Counseling contractor since Oct. 24.
- Janet Hall, wise woman and wiseacre, got her four year pin on November 1st.
- Kathy Parris, who's done every job in the agency except Psychiatry (and I'm not really sure about that) has her four-year anniversary on Nov. 18th.
- Polly Penland passed the AppCounseling half-decade mark on October 1.

October Birthdays:
- Michael Smith - 10/2
- Rachael Smith - 10/8
- Kamilah McNeil - 10/16
- Diane Satterfield - 10/23

November Birthdays:
- Tina Nowak and Dr. John Pierson - They both turned 29 on Friday, Nov. 2nd!
- Cindy Willis - She had hers Saturday, Nov. 3!
- Teresa Drevar - It was yesterday! Nov. 4. Happy day, Teresa!
- Pat Menser - 11/12
- Dr. Harry Taub - 11/24

A new award has been created in order to stand up and recognize those who stood out from the crowd as we try to get this patient liaison system up to speed. Jane Ferguson, CEO and sleep-deprived fearless leader, sent me the envelopes:

Patient Liaison of the Week for Oct 29, 2007 was Laura Zabodyn of the Alliance office!

Patient Liaison for the Week of Nov 5, 2007 is Kamilah McNeil of the Hendersonville office!

Laura Donelan had her last day with Appalachian Counseling last Friday. We're all going to miss her expertise and consistent ability to get done what needed to get done. As our number one person at Accounts receivable, she's the one who kept bulldogging the insurance folks to get you what you'd earned. Thanks for everything you did, Laura, in your three-plus years with Appalachian Counseling.

Brent Schlueter says: "I am going to be in a play with Hendersonville Little Theater. It is "Kill Joy", a comedy thriller. It should be quite funny. It will be performed for 3 weekends, starting 11/16 and not including Thanksgiving weekend. It has adult language and situations. It should be a good opportunity to see me make a fool of myself at a non-AC function.

A second note of interest, at least to me. In August, my wife (Pam) and I finally got our cerificate of occupation for our house. We have been building it ourselves, for the most part. It has been a 4 1/2 year project with us living in a camper trailer for 3 1/2 years and squatting in the house for a year. It's nice to be there legally with all the amenities that come with that: flushing toilets, electricity, heat. My world is good. "

Tina Nowak's selling: "I have a 2007 Seadoo GTI, 155 Horsepower, only 10 hours on it. Need to sell due to having to pay storage since I sold my house. Paid $9500 in July, Sell for $7200. 551-2717."

Crystal Lance reminds us that "Teresa is on vacation from 11/2 until 11/12. I am going to be covering for her during this time."

That's about all for this edition, but I wanted to leave you with an interesting article for the sleep-deprived or those who love them. Click here to read the whole thing, or just read the excerpt below:

Without sleep, the emotional centers of our brains dramatically overreact to bad experiences, research now reveals.

"When we're sleep deprived, it's really as if the brain is reverting to more primitive behavior, regressing in terms of the control humans normally have over their emotions," researcher Matthew Walker, a neuroscientist at the University of California, Berkeley, told LiveScience.

Anyone who has ever gone without a good night's sleep is aware that doing so can make a person emotionally irrational. While past studies have revealed that sleep loss can impair the immune system and brain processes such as learning and memory, there has been surprisingly little research into why sleep deprivation affects emotions, Walker said.

Walker and his colleagues had 26 healthy volunteers either get normal sleep or get sleep deprived, making them stay awake for roughly 35 hours. On the following day, the researchers scanned brain activity in volunteers using functional magnetic resonance imaging (fMRI) while they viewed 100 images. These started off as emotionally neutral, such as photos of spoons or baskets, but they became increasingly negative in tone over time—for instance, pictures of attacking sharks or vipers.

"While we predicted that the emotional centers of the brain would overreact after sleep deprivation, we didn't predict they'd overreact as much as they did," Walker said. "They became more than 60 percent more reactive to negative emotional stimuli. That's a whopping increase—the emotional parts of the brain just seem to run amok."

Send your suggestions, questions, submissions, complaints, and juicy peaches to me at gsmith@appcounseling.com

See you next time!

Newsletter 10-1-07

It's here.

NueMD. The fantabulous system that will streamline our billing and do away with those "Get Off The Server!" emails we've come to know and loathe. I don't know what the actual statistics will be, but I'm guessing we've got about three weeks of minor confusion ahead of us as we accustom ourselves to the newness. Jane says:

"Our dedicated staff--Kody, Crystal, Vicky, Laura Z, Erica, Carol Messina, Kamilah, plus two non-staff members Mary Kay and Jay Trussell--came and hand entered appointments this weekend thru the end of the year. You will be happy to know that we have about 750 appointments per week being seen in our offices.

Our staff is also handing out new client information, a new health history questionnaire, a new HIPAA privacy act and consent to treat out to every person coming in. They discovered that there is much corruption of data in the old system and want to be sure that NueMD is started off right with accurate information, addresses, phone numbers and the like. We were also concerned that with so much data corruption we were not getting accurate reporting.

Because of the switch our staff will be under much stress for the next few weeks. Please find ways to go out of your way and thank them for their dedication. Crystal was up working on the switchover for about 36 hours straight (while moving). Kody has been here all night--almost--3 nights in a row. Other staff--like Vicky and Laura, among others, were here for countless hours. Thank you all--from me--for all the great work that you did. I know this change is not easy.

I hope that you all are planning to attend the coding and billing training this week and next. They will go over NueMD in that training also to do an update with you. I think it has been awhile since you even saw it. Please try and be very patient with the changes--change to new systems always cause disruption"

750 appointments a week? That's a lot. Jane asks us to be patient with the staff and system, and I ask that the staff be patient with we contractors as we figure the thing out ourselves. To minimize confusion, please, please, please attend one of the three training events...

Hendersonville: Tuesday October 2nd at 8 am
Brevard: Wednesday, October 3rd at 6:30 pm
Asheville: Tuesday, October 9th at 8:30 am

As we're struggling with growing into our new system, Raleigh is promising not to rock the boat for a little while. Carmen Hooker Odom, the uber-destabilizer whose greatest hits include Slashing CS, 10% Off Medicaid Outpatient, and Unadulterated Nonsense is gone. Her replacement, Dempsey Benton (bio here), says things are going to calm down:

"I want to collaborate with people across the state," Benton said in a telephone interview last week. "I'm going to listen to ideas."
[...]
""One of the things we've been hearing is that we need stability in the system," Benton said. "We don't want to have any more surprises than are absolutely necessary. We've had too many already."
[...]
""We have to standardize some of the functions and procedures so people don't have to fill out 25 forms with the same information," he said.
[...]
"One of the realities we're in is that it's private providers utilizing public funds," Benton said. "There has to be oversight, but we have to maximize the efficiency."

O.K., O.K., so we've got our fancy new NueMD, and we've got a sensible human being in Raleigh. Appalachian Counseling is prepared to stabilize and strenghten our foundations. We've got to provide excellence in services while remembering the bottom line. We're a for-profit company that can't exist unless folks are making money. To this end, A.C. has created a new position that will serve to enhance our operations. Rachael Smith was asked to enter this new position, and she starts today. She writes:

"Hi everyone. I'm sure you've heard that I am to leave my work as a counselor and take a position as clinical manager. I wanted to take this opportunity to share with you what my responsibilities will be, so here it goes:

- I will be coordinating with Jane and Crystal to communicate issues both up and down the organization
- I will be meeting with program directors regularly to go over a progress report, assist in troubleshooting and problem solving.
- I will be available to clinical staff to answer questions, provide training on paperwork, and protocols. I will work at streamlining systems.
- Develop/maintain system for client complaints, comments, and satisfactions surveys. I would also like to do the same for staff complaints
- spot chart audits
- assist with supervision plans
- Stay informed of changes that affect the agency (DMH) and share critical info.
- Consider implementation of care authorization team (CAT) in Brevard to address hospital discharges, incidents
- Follow up on incident reports
- Promote more awareness of people's jobs/responsibilities throughout the agency
- Assist in fostering better communication/consistency across programs and providers (ie. CS and therapist work together on client goals, Psychiatrists and clinicians share diagnosis or discuss and document if disagreement)

This is brand new for me and I want everyone to know that I am very open to feedback, suggestions, questions, and of course - support! I'm excited and feel ready to take this on. Thanks for giving me the chance.

Ch-ch-ch-ch-changes!

In other A.C. News, Jay Joslin is offering a lot:

"In 2 weeks a parent coach with InJoy Parenting will be doing a free coaching session (she normally charges $$$$$$). And starting next Wednesday [Oct. 3], I will be teaching MAPP classes in Asheville for the next several weeks... if you know anyone who is interested in respite/foster/adoptive parenting, let me know so I can get them booked. You may also choose to attend any of the 10 classes yourself [for free] for more information on how kids can learn to cope with separation and loss, effective behavioral interventions for kids in foster care, and how to help parents create effective natural support networks. I do provide certificates for contact hours! "

Meanwhile, on the national level, mental health has been getting a lot of attention. Mental Health Parity in the form of the Paul Wellstone Act has passed the Senate and is working its way through the House. Parity would mean that health insurers have to provide mental health coverage at least as good as their base physical health coverage. The House version has been through two committees, will be heard by a third and final committee later this month, and then we'll have to see when the Speaker chooses to put it on the House Calendar. If this thing passes, a lot of people are going to able to afford to access the mental health care they need.

That's it for now. As usual, please send me your newsletter items. Also, you can leave comments below this post by clicking "comments".

Journalist, Blogger, Advocate - Leslie Boyd

Hey y'all,

I came across this blog post by Leslie Boyd at the Asheville Citizen-Times and wanted to share it with you. Leslie has been a tireless advocate for mental health services. Her journalistic work has kept the public informed about what can be very complicated legislative and social issues surrounding mental health services.

Excerpted, but it really doesn't do the piece justice to break it up - click here to go read the whole thing:

"Depression doesn't run in my family; it gallops. My sisters and I usually laugh when we say this, but some members of my family have been on meds for years. I think one of us was on Prozac the day after it was approved and I was just a week or so behind her."
[...]
"Sometimes, people say things about people with depression that really piss me off -- like when a state official referred to us as "the worried well," when she explained that people with "simple" depression wouldn't be part of the "targeted population" that would be cared for in the state's new mental health system."
[...]
"So, it's time to change the language -- and the perception. Not everyone with a brain-chemistry imbalance is "mental" or "crazy." People just need help dealing with a chronic illness. It should be treated the same as any other chronic illness -- dealt with before it becomes an emergency and managed so that it doesn't lead to a disaster."

Jay's Latest Hootenanny

This Sunday from 5pm til ? I'm very pleased to invite you to my housewarming/dedication in the lovely burbs of West Asheville. I'll have the grill going and allegedly a game of volleyball will be played following the dedication by Howard from Jubilee. If we rain out I'll try again next weekend. Feel free to bring finger food and beverages, lawnchairs/blankets for sittin', but no housewarming presents, please. If anything, please bring a stone for a circle I'm building out back. Please RSVP no later than Friday so I can grok how much grillin' will be going on.
Thanks to everyone for being so awesome,
jay

PS: Oh, you want directions? Here you go. Just enter your starting point and Google will handle the rest.
PPS: Feel free to bring along anyone you like, but no canines, por favor. My cats will love you for it.
PPPS: Carpool if ya can... there's a lot down by the Latino grocery a block away if we max out.
PPPPS: Know anyone who likes to mow lawns for cheap?

Newsletter 9-6-07

Hello again Appalachian Counseling. Thanks to those of you who gave me great feedback about this blogging format for our newsletter and other A.C. updates.

I've got a lot to pack into this edition, so away we go:

Kambra has a couple of things to pass along, and this first one is muy importante -

"I am taking on the new intake role for the western highlands contract. Which means I need information from all clinicians in the Hendersonville and Brevard offices. Please repsond to let me know the who, what, when, where, why, and how much regarding your current status. I am looking to place people easily and with the right fit for all, so that this can hopefully be a smooth process for everyone involved.

Please email me a quick blurb about where you are, who you see, what panels you are on, special areas of expertise, how full or open your caseload is currently, populations you serve, etc."

This next one is also important - to be filed under Fun Times:

LAAFF festival this Sunday Sept. 9th from 11am to 10pm. It's the annual Lexington Avenue Arts and Fun Festival, featuring all local and original artists and performers. IT'S FREE!! It's all along Lexington Avenue in dowtown Asheville, and there are multiple stages of fun performers and lots of fun activities. It is family-friendly! Rumor has it you will be able to soil a zombie (come see what that means. . . ) You can stop by Kambra and former App Counseling therapist Peyton Kinnaird's shared booth, where they will be selling some of their hand-crafted wares. It will be FUN. . . it's part of the name of the festival, for pete's sake. Check out arts2people.org for more details. See you there!

Wendy Taylor is working to create some fun and incentives:

I was perusing our employee handbook when I found something that was said to exist, but didn't. So, Jane asked me to make it exist. We need to start an incentive box committee. These folks will be in charge of finding incentives to put in a secure box at each site of Appalachian Counseling- for employee perks. Perks may include anything and everything (okay maybe not everything) from chocolate bars to movie passes to massage certificates, whatever we can drum up. If anyone is interested in being apart of the committee, please reply. OR if you have stuff to donate to the incentives box- please let me know. I will be emailing Gordon with our committee members' names

Hey... When am I getting that email?

Some training opportunities are coming up, and here's the skinny:

Jen Worthen invites you all to The Bonny Method of Guided Imagery AND Music, Level I Training…To be held this February, 2008 in the Triangle area, NC…Specific dates and location TBA…CEU credits available!! Email her for lots more information at jenwo@charter.net .

There are still 5 spaces available for the DBT introductory training next Wednesday, September 12 - email Nancy Mercer if you're interested: njmercer55@yanoo.com or call me at 713-6697.

All of the contractors are having meetings at their locations with Jane this week. The first was held last night in Hendo, and here's the schedule for the rest: The second will be in Brevard at Country Club on 9.6.07: Thursday night 6:30 PM; the third will be in Hendersonville on 9.7.07 Friday morning at 8. The fourth will be in Asheville 9.7.07 Friday afternoon at 12:30. All contractors are strongly urged to attend. It's about you and the future of our practice together.

The state has completed another evaluation of its mental health reform. While I could have saved them a lot of time and money by simply explaining the rampant suck factor in everything the state has done, they wanted someone else to break it down. Click here to read the August report. It's really interesting and important as we move toward the next phase of our broken system's evolution. Here's a little excerpt:

- In the rush to complete structural changes, the public partners have lost sight of the effect on consumers; There has been insufficient joint effort at resolving consumer access problems.

- The pace and number of changes have been too fast and numerous, especially during the last two years, resulting in instability and insecurity about the future.

Well, duh!

Broughton Hospital got docked $1,000,000 as "administrators failed to make adequate safety improvements after a patient’s death while being restrained."

The New York Times reports that Bipolar diagnoses for children have increased 40-fold from 1994 to 2003.

"Many experts theorize that the jump reflects that doctors are more aggressively applying the diagnosis to children, and not that the incidence of the disorder has increased.

But the magnitude of the increase surprises many psychiatrists. They say it is likely to intensify the debate over the validity of the diagnosis, which has shaken child psychiatry."
[...]
"Some experts say greater awareness, reflected in the increasing diagnoses, is letting youngsters with the disorder obtain the treatment they need.

Other experts say bipolar disorder is overdiagnosed. The term, the critics say, has become a catchall applied to almost any explosive, aggressive child."

That's it for another edition of the App Counseling Newsletter. As always, send your announcements, news, links, and whatnot to me via email, or just leave it in the comments here. Thanks for reading and let me know if there's anything I can do to improve this format.

Ciao!

Medicare Outpatient MH Services at Transylvania Community Hospital

This popped up in the Asheville Citizen-Times today, and it's great news for those of us who have been looking for a referral for Medicare folks:

"A new program at Transylvania Community Hospital is trying to address the lack of mental health services in Western North Carolina.

The AgeWell Fresh Start program provides outpatient mental health services to adults. The program, which started in June, is designed to help Medicare recipients suffering from a wide range of mental health problems."
[...]
"The Fresh Start program uses intensive group therapy to help patients who suffer from dementia, anxiety, depression, psychosis, bipolar disorder, post-traumatic stress disorder and other mental health issues.

A check-in group helps patients talk about why they need help, and a coping skills group helps patients recognize symptoms and change their behavior. Dodds said the program is designed to help patients graduate from its services in two to six months.

CLICK HERE TO READ THE REST OF THE ARTICLE

Newsletter August 27, 2007

{don't click on the pictures, they won't take you anywhere}

Hi everybody. Welcome to the temporary home of our App Counseling newsletter. I've put it here, so it's easy to find. I know how quickly things drop down the inbox list in our gmail, so you can check this site whenever you'd like to remind yourself of items or to check for updates. I'll send you an announcement each time something comes out along with a link to the A.C. News Blog.

I'll also post what's known as "open threads" for people to leave comments. In order to leave a comment you'll need to register with the blog's hosting service, Blogger. It's easy. In these comment threads you can keep folks updates about any changes or exciting news. You can also comment under any other post. Simply click on the word 'comments' at the bottom of any post.

Please note that this blog should not ever contain any client information. Ever.

If you'd like to see your news posted here and you don't want to leave a comment, please email it to me anytime. If you'd like to see particular links posted here (favorite news sites, band sites, business sites, MH focused sites), let me know that, too. And now - on with the newsletter.

Kambra Meyer, who's coined the term "A-Team" for our Asheville office, sent this via email:

"Just wanted to inform you all that I will be changing my role here at App. . . I have been offered a position that helps me move toward art therapy and counseling and end my role as a community support worker. (thanks to the LPC) It is with sadness that I say that you will not see me in the Asheville office much, as the new role is primarily in Hendo and Brevard. No official word on transition date, but I anticipate that it will be in the next couple of weeks. It is my intention to start an art therapy group in Asheville, though, so look for more info to come about that once I hammer out the details. However, once I get on insurance panels, I plan to come back to the Asheville office to serve clients full time, and hopefully that will happen in 6 mos to a year. So, you haven't seen the last of me. . .

I will be speaking to some of you individually about discharge plans for clients we share and attempting to graduate some of my clients to med mgt and therapy only.

It has been my pleasure to be a part of the A TEAM! I hope to be back soon!!"

Congratulations Kambra on getting your license and growing in your professional life!

A-Team member Byron Allday lets everyone know about this cool spot:

"Hey y'all. just wanted to let you know of some bed space at a family care home where i have a clt. there are 3 beds available. 2 are for private rooms, male or female. the semi-private is for a male. great home and great people who run it. they even give the residents an extra $20 each month more than they are required to do. very reliable transportation also. let them (or me if that would be easier) know if you might have anyone interested, ask for joanne or newland.

joanne's family care home
245 anchor rd.
alexander, nc
683.0898"

Darlene asked me to remind everyone that NC Health Choice will pay for only one service per day. You might make a list of your Health Choice clients, so you can keep it straight for yourself. Why bill and write a note when no one's paying?

I want to let everyone know that I found my cellphone. You may commence speed dialing.

Tina Nowak asked y'all to think about hopping into this sporty little number:

2002 MercedesBenz ML320
75K miles, White w/tan leather interior,
Moonroof,Dual power seats,power doors/windows,
drivers side memory seats,security system, much more.
Loaded. Great Condition. $16,000.00
Call Tina @ 551-2717.

In ironic and absurd news, Smoky Mountain LME is shocked. SHOCKED! Evidently the state's precipitous and capricious cuts to CS services have caused a lot of providers to stop providing CS or to provide it only in limited ways with selected recipients. This notice went out from Smoky Mountain LME to providers in these counties: Cherokee, Clay, Graham, Haywood, Jackson, Macon, and Swain counties -

We have an urgent need that necessitates a meeting with Community Support providers from the Southern Region. In recent weeks a number of providers have decided to cease provision of Community Support Services or have limited capacity to receive further referrals, while others wish to select the type of consumer they will serve. This puts consumers in our community at risk. It is our responsibility to ensure consistent availability of services within established standards. We plan to meet that obligation. However, before we take steps to resolve these concerns, we want to meet with you and listen to not only what barriers you are finding, but hear your creative ideas and recommendations as to how such barriers might be resolved. This must be done quickly as the need is urgent and has significant impact on consumers. We plan to host this important problem-solving meeting next Thursday, August 30thth at 4:30 p.m. at the Area Office (following the DVIP training for those providers involved with this). This is your opportunity to have input and be a part of the solution. We appreciate your constructive and resourceful thinking as we move forward with a plan.

Got to laugh to keep from crying, eh?



Lastly, know that Jane will be rolling out some pretty big restructuring over the next couple of months. It's time for every area of Appalachian Counseling to stand on its own. We're a for-profit business that has labored under mental health crises, system changes, New Vistas' implosion, and immense community needs. So we've still looked a lot like one of the old non-profit community agencies.

The next year will see App Counseling become a stable, for-profit entity providing the best services in our three counties. If you've got any of that old non-profit thinking rolling around between your ears, it's time to push the eject button. We're going to be amazingly successful as we continue to move towards a sustainable model of practice, which includes excellence in service and keeping our eyes on the bottom line.

I hope you like the new newsletter format. Let me know what you think, and send me your news and information for the next one.

Y'all rock,

Gordon

The Appalachian Counseling News Blog

Since I'm not so great at templates and such, our Appalachian Counseling news will be here. I'll email people links to new posts, and you can check it any time. Email me news and information through our agency gmail.

Welcome.