Reading across the lines

The book group I’m facilitating at the county jail met again this past week, interrupting an Uno game going on in the common area of the cell block.  I had just played a game of Uno that afternoon, sprawled out across a post-picnic blanket on a grassy patch just above the lake.  Kids splashed below in the warm water, teenage girls lounged allofly in inflatable furniture, and in the distance, people careened back and forth across the wake of motorboats.  This is one of the things that is the most difficult about going into the jail – things that are completely familiar to me, like the Uno game, in a context that is completely different to my everyday reality.  Actually going into the jail has made me realize the boundary between solidarity and being in the same boat.  I think everything that I’ve encountered about jails and prisons firmly establish where you stand.  You are a guard, you are incarcerated, you are incarcerated and in the “therepeutic” block, you are in solitary, you are in the general population, you are a family member or friend here for visiting hours, you are a volunteer.  The roles, the mobility associated with each, and the expectations of each group by the others seem hard and rigid, ruts torn deeper and deeper with all the inertia of the prison industrial complex.  I want to just think that I’m just down, but even going in with the interest of supporting incarcerated folks is mediated by the fact, told bluntly by the corrections officer who did the volunteer training, that my ability to go in is largely based on the realization that programming in the jail tends to placate the incarcerated population there.

The reading group happens in the block and has a variable number of participants.  This is affected by what people have going on at the moment and the fact that people are constantly coming in and out of the jail, coming from a DOC facility for court or returning to a DOC facility after court.  This week, only 4 folks sat down at the table, with only 1 of them having read the book to be discussed.  The book might have been part of the problem.  A few weeks ago we had decided to read A Walk in the Woods by Bill Bryson, a travel account of two middle-aged men who decide to hike part of the Appalachian Trail.  It was funny enough, and met the criteria that was established by those initially interested in the group, of having a subject that seemed to be far, far from the reality of incarceration and didn’t have the self-help twelve-steppy overtones that mark some of the other programming they participate in.  Still, a few folks expressed that they couldn’t get into the book.  My favorite response to the book that I heard was one word – “quitters”, as the protagonists seemed to spend as many nights sleeping in hotels and eating at diners as they did in the woods.  As I read through the book myself, I was a little worried that the book centered on this activity that represented an idleness and mobility; to spend weeks just hiking without worrying about jobs, families, or the things that a lot of the things that people in the jail talk to me about as concerns; that it would seem just insensitive.  Still, it’s unfair and just not true to make assumptions about people’s situations or their reactions in the context of their lives.

So what is my place here in the jail?  Reading, for all the reasons that anyone loves it, with the additional weight of it being an activity that can happen, relatively unhindered, even within the constraints of incarceration, seems to be an important part of people’s lives at the jail.  People talk about the books that they read, and pass them around.  I remember a conversation starting with “Remember that Marilyn Manson biography …”, the book having apparenly made its rounds through the block.  There’s no question that books are important to people in jail.  Having someone come in to facilitate a discussion group about books seems of more questionable value. For the men in the cell block where the programming happens, their days are filled with different groups, many of them focussed around rehabilitation, I think that one more structured activity that involves a group and a discussion just doesn’t seem that appealing.  Volunteering in the jail, there seems to be such an impasse between what corrections officials and non-profits think people who are incacerated need and what people who are incarcerated say they need.  I think that more than anything, people need to not be incarcerated, because dealing with all the other things in life become frustratingly cumbersome to impossible.  Beyond that I think the concerns of incarcerated people are the same as a lot of people that I know, obviously with varying degrees of severity: economic security, a safe, comfortable place to live, help sorting out relationships and family.  Those are such large, ambiguous things, but it’s the way I can most accurately express it.

I like going into the jail because it has made me have to reevaluate how I think about other people and about prison issues as “issues”.  But, even though I feel like I’m getting something out of my volunteer work, the exchange doesn’t exactly seem equal.  One of the men interested in the reading group said he would talk to others in the block to guage the actual interest and to get some input about what format would be best.  We talked about two things that would be an improvement – meeting once a month instead of biweekly and reading shorter works of fiction.  One thing that seems like something that I can really offer is just giving people access to books.  The Monroe County Public Library has a sweet jail library program, but the men I work with said that while they used to get to go to the library once every two weeks, they now can only go once every 4 or 5 weeks.

I’ve also sporadically tutoring math in the jail, and had been working with someone who just passed his GED exams.  Working in this capacity seems like I can offer people something of myself that seems more useful, but it’s still hard.  The person who just passed his GED said that one of the reasons he wanted to get his GED was so he could go into the armed forces when he was released.  I don’t want to see anyone join the armed forces, but I’m afraid that, facing the realities of the current economy, and the additional challenges that someone with a criminal record faces getting a job, the options are limited.  It’s so frustrating that I, and the things I believe in, can’t offer an alternative.  This makes me feel like I’m not in a position to do what people really need.  I can give people books, or some tricks to solving math problems, but I can’t give people jobs or build houses.  It makes me feel like I’m not doing the right thing. Everyone, and I mean everyone everyone and not just incarceration people, need inspiration and tools, to be sure, but it seems really narrow sighted to think that they’re enough.

passing grep results to other unix commands

This is old news to a lot of folks, but new and powerful to me.

Search for text in files and move matching files

$ grep --files-with-matches --null foo * | xargs --null -I xxx mv xxx dir_for_foos/

The above command searches for the string foo in all files in the current subdirectory.  It then moves each file to a specified directory.

Read a list of files from a text file and move those files somewhere

$ xargs -a ok.txt  -I xxx mv xxx /var/lib/accounting/joblogs/parsed

A PMP, finally

Working a lot with computers, acronyms have become second nature – lately it’s been SIP and DID and PBX and a slew of other ones.  Somehow though, I’m surprised when I realize that they don’t just exist in the realm of computer technology.  I’m more surprised when, in these other contexts, they no longer seem like par for the course, this arcane language that one can take pride in navigating, but instead a frustrating impediment, a needlessly oblique interface to tasks that should be simple and painless for everyone.

Getting healthcare for the first time on my own and not through school or family health insurance and getting it through the state subsidized Healthy Indiana Plan has introduced me to an entirely new set of acronyms.  A primary medical provider, that is a family doctor, is a PMP, and your recipient ID number is a RID.  And while cold, technical terms for the participants in a network are fine when we’re talking about computers, when I think about it, it’s a little uncomfortable being reduced to a “recipient”.  Even without the acronyms, the language to describe getting healthcare quickly becomes unintuitive.

After having to change my doctor, or should I say PMP, twice because both my assigned doctor and one I picked from a list of doctors with an “active” status in the MDWise system were not accepting new patients, I ended up just calling most of the doctors on the list provided by MDWise and asking if they were accepting new patients.  It was hard to figure out what to say.  I tried using the PMP term, since that is what was used on the MDWise website, but it just seemed to confuse the seceretaries.  More confusing was when I asked if any doctors in their office were accepting patients.  Most of the doctors that are available through the HIP, with MDWise, in Bloomington are part of a large organization called Internal Medical Associates (IMA) that seems to have around 5 locations and, at least according to their on-hold message, around 60 physicians.

So, it was difficult to figure out which doctors were connected with which location and which phone number corresponded to the office of which doctor.  When I was told that a particular set of doctors wasn’t accepting patients, I was often transferred to another location without really knowing where my call was going.  One location asked me if I had to see a doctor, or if a nurse practitioner (a nurse with at least a master’s degree in nursing) would be okay.  I said either and was able to schedule an appointment with a nurse practitioner  only to then find out from MDWise that only appointments with doctors are covered.

Eventually, I found a doctor who was accepting patients, though not until September, and was able to schedule a physical.  I called MDWise and switched to this doctor and was told I would receive a new insurance card in the mail.  When I told the person on the phone that I had never received my original card, she said that there had been some delays, but that I should expect my new card shortly.  This whole process made me feel happy that I have a job that is flexible enough that I can take the time to make a bunch of phone calls during business hours.  It also made me hope that I will never have to fully master all the acronyms associated with getting healthcare in the U.S., particularly state provided healthcare.  It seems that those who have finally figured out how to navigate the system, to whom the acronyms are second nature, have done so only after a dire struggle to get themselves or their loved ones the care that they need.  I hope that I can stay healthy enough that the frustrations of figuring out how to get health care are an occasional occurence and not a constant reality.  Still, it is important to remember that people already facing the challenges of a state of health that requires more consistent care shouldn’t have to have the additional burden of wading through a bog of acronyms, redirected phone calls, and confusing or unknown information.  I can better understand why some people work jobs just for healthcare.  The idea of being able to get the care you want, when you need it, and to be treated with respect and dignity as you work through the process of that care now seems so amazing, almost luxurious.

I don’t think quality health care should be a luxury.  Perhaps I am naive enough about the logistics of providing health care to expect that everyone could have personal attention, respect, and advocacy for working out problems or questions, but I feel strongly that this should at least be the goal, the benchmark by which the heated issue of healthcare is measured.  I don’t think this is the case right now.  A friend recently made the observation, correctly I think, that the Healthy Indiana Plan is, in fact, a rather conservative proposal.  It seems designed, with it’s coverage of preventative medicine, to reduce the costs of the state from uninsured people using the emergency room and not being able to pay for it.  While it’s certainly true that using the emergency room as one’s primary medical care is not in the best interest of the patient either, my experience with the Healthy Indiana Plan suggests an ultimate goal of cost reduction and not of a positive and healthy experience for the patient.

I’ll continue to write here about my experience with healthcare, with the hope that others in Indiana can share their experiences and together we can identify problems and propose solutions to the state’s healthcare approach. Perhaps we can help share ways that we’ve been able to better navigate the system.  Finally, I want to express the way in which the idea of healthcare has become real for me and not just a topic of presidential debates or news stories.

finding a doctor continued

After being told that the physician to which I was assigned by MDWise under the HIP was no longer accepting patients, and that the person I switched to after that (being told by MDWise that their system listed them as ‘active’ or accepting patients) was also no longer accepting patients, I called another practice.  I asked if they were accepting patients and they asked if I needed to see a doctor or if a nurse practitioner would be okay.  I told them that it didn’t really matter because I just wanted to establish care with someone, get a general physical, and have the sebacious cyst on the back of my neck re-examined.  They took my information, and were able to look some of it up based on my MDWise RID, and then scheduled me an appointment for next week with a nurse practitioner.

I called MDWise to tell them this and they said that care with a nurse practitioner wouldn’t be covered, it had to be a doctor. I called the office back, canceled my appointment and tried to see if any of the doctors at that office were accepting new patients.  They weren’t accepting new patients, so I continued down the list of results from the MDWise web site.  Of the people on the list that I have called so far, 10 out of 20 are not accepting new patients.  Right now I am stalled at waiting to get a call back from one of the doctor’s offices who I was told was accepting patients.

One of the biggest confusions that I have encountered is the fact that many of the doctors on the list that MDWise provided are part of very large practices (the on-hold message at one of the practices said they had over 60 physicians) at the same location with diffrent offices and phone numbers.    It’s very hard to figure out who I’ve talked to already, especially since I’ve been transferred to different offices via the phone system.  The thing that has cleared things up the best for me has been to ask the seceretary “Which doctors do you schedule appointments for? Are any of them accepting new patients?”

I have been pretty frustrated by this process so far.  Last month, I went to a forum about the FSSA privatization and how it has affected people receiving food stamp beverages.  WFHB covered the event and its worth a listen just to see how messed up the program is and how many people have been treated unfairly or just had to jump through a bunch of needless hoops just to get their benefits.  At least there was a general consensus, even by the FSSA rep there that things needed to change.  A lot of people who did get their situations resolved did so with support from their state representatives or senators.  I would really recommend that if you’re having problems with the HIP, that you contact your Indiana rep. as many actually have social workers working for their office who might be able to help you navigate the crazy HIP system.  You can look up your representatives at the state’s Who’s Your Legistator page.

Switching Doctors Failed!

I tried calling the doctor I selected last week to schedule an appointment.  The receptionist said they were no longer accepting new patients, even though I selected this doctor from a list that an MDWise rep gave me of doctors that, according to their system, were accepting new patients.   The receptionist at the doctor’s office said that they hadn’t had very much luck with the HIP so far and that I should try calling the doctors on the list to see if they are accepting new patients before switching through MDWise.

Healthy Indiana Plan: Scheduling a Physical

I have gotten my information packet from MDWise but I had to call to get my RID number and assigned physician. Today I got my second POWER account bill from MDWise, but it said I didn’t owe anything. I tried to call my physician to schedule a physical and they said that the doctor was no longer accepting additional patients and that I would need to call MDWise to work that out. So far, my experience with the HIP has been one of a lack of communication, clarity, and knowledge by the people I’ve talked to both on the FSSA side and the MDWise side.

Update:  I called MDWise and was able to speak with someone pretty promptly.  She told me that I would have to pick another doctor and pointed me to the list (actually a search) on the MDWise web site.   She had some trouble pronouncing the doctors names which wasn’t a problem because I had the web page in front of me, but would have been really confusing if I was just on the phone.   She had to list the names because not all of the doctors were accepting patients.  She said that I should pick a doctor and call MDWise back.  She said it would take 3-5 business days to make the switch and notify the doctor’s office and that I couldn’t call the doctor I chose to make an appointment until after that.

diners, corrections, and community

I’ve always loved diners, ever since I was a kid and going to Tucker’s this weekend on a trip to Cincinnati made me think about the role diners and other meeting places play as community anchors.  Then I saw the following article about a Rhode Island program for incarcerated youth that has them learning carpentry and other building skills to restore classic diner cars.  This seems cool, or at least useful, and the response from participants positive, but I always have mixed feelings about programming within the prison system, despite my investment in that.

Youth in RI juvenile detention centers work on restoring diners and preparing food.

Youthful Offenders Restoring Luster to Diners of Old – NYTimes.com:

“It keeps my mind off the negative,” said Rob (state officials withheld last names because juvenile offenders’ records are not public). “I can say, ‘Yeah I helped make that.’ ”

Rob, who said he had “been in detention a million times,” said he preferred the diner work over some other training programs, like the poetry and rapping workshop, which he said censored some language.

“You can’t express what you want — nothing about drugs, violence, sex,” said Rob, who plans to record a rap album and call it “In Harm’s Way, Volume 1: Talk Is Cheap.” “They just want us to rap positive. But I can’t just be talking about sunshine and flowers and how colorful they are. That’s not my life experience.”

Devin, 18, with a 10-year history of armed robbery and lesser crimes, said he also values the diner program, especially taking apart the stove and refrigerator because, “I always want to break things.”

…

“Building birdhouses like a traditional high school program is not what these kids need,” Mr. Scott said. “We’re actually preparing them for all kinds of skills: there’s ceramic tile in these diners, sheet metal work, plumbing, electrical. You always meet people who want these kids to be locked away, and I respect their ill-informed opinion. But I look at the training school as kind of like Home Depot of the correctional system. We give them the tools, and when they’re ready to use it, they’ll use it.”

…

To keep the cash-strapped state from paying $25,000 to $200,000 to restore each diner, Mr. Scott and Mr. Zilka found partners in Rhode Island. New Harvest Coffee Roasters in Pawtucket concocted New Hope coffee (organic, fair trade, shade grown), and about $4 of each $11 bag supports the project.

Students at Bryant University in Smithfield are creating business plans for each diner. Angelo’s, an 84-year-old landmark restaurant in Providence, will operate the diners, employing offenders once they are released.

“Hopefully, one of them will be able to own one,” said Robert Antignano, the president of Angelo’s.

Jail Book Group

I’m trying to be better about posting what I’ve been doing lately.  Last night, the book group I’m facilitating through Pages and New Leaf New Life in the “therapeutic” block of the local jail met for the second time and we picked the book that we’re going to read, A Walk in the Woods by Bill Bryson.  We did a rough vote and there wasn’t an overwhelming consensus so I’m going to bring in a few copies of the other books that I brought up as options including Me Talk Pretty One Day by David Sedaris, Oryx and Crake by Margaret Atwood, and The Golden Compass by Phillip Pullman.

Doing the group is challenging.  Some people are extroverted and seem to love to talk about themselves and their experiences.  Some are the exact opposite.  I feel like we’re also fighting the difficult dynamic of being a “group” amidst a lot of other mandatory groups that the men have to go through all day.  I think, at the end of the day, some just aren’t feeling another group.  People in the block are respectful and quiet, but the whole jail is noisy.  There are lots of interruptions like meds and the church group that comes in to provide worship services without notices.  I’m still getting my balance as a facilitator and trying to make it more clear why I’m there and what I’m doing and try to get past the reasonable distrust that some of the guys have for people like me.

In spite of all the challenges, we had a short discussion about a piece of writing titled The Best Time in My Life and many shared a memory or description of places and eras that they had seen pass.  For some it was rock quarries in southern Indiana, for another being towed around on an old car hood in his tiny hometown, and for another it was the closure of a vital youth center in his Chicago neighborhood.

Healthy Indiana Plan Update

I still haven’t gotten my introductory literature from my health provider (MDWise) or my second month’s bill for my POWER account.  I called MDWise and they said they were behind on sending them but that I should receive them “soon”.  The rep also said that I shouldn’t worry about being late on my POWER account payment because of the delay in sending out the bills.  Finally, I was able to get the name and # of my assigned doctor and my Recipient ID (RID) number so I can go and receive healthcare.  So, if anyone else has the HIP and hasn’t heard from them, call MDWise or Anthem and see if you can get your info.  You can call Anthem at 1-800-553-2019 and MDWise at  1-877-822-7196 or 317-822-7196 if you are in the Indianapolis area.