It's Time to Plow Down Medicaid Mountain!

I was standing on this portion of the sidewalk on Kensington Avenue today as I was chatting with a man, a long time resident of Kensington.  I'd never met him prior to this moment.  As we stood there talking about how this area has become an open-air absolutely public no-need-to-hide-it grassroots overdose prevention site, men and women were sticking needles in their necks, tourniqueted arms and legs all in the name of 'taking their much-needed medicine.'  These men and women bear (real or blog names) such as Amy, Ashley, Gina, George, Jose, Jesus, Joseph, David, Manuel, Rashime and so many more. 

Used and uncapped syringes originally meant for insulin injections, piled up on the lighter colored portion of the sidewalk to the right of the step in the picture I've linked you to above.  As this man and I casually chatted in the presence of heroin, fentanyl and all sorts of mystery ingredients entering the veins of men and women I've come to love so very much, I reached in my pocket to be sure that my dose of Narcan was available.  It was and yet, I knew it would not be needed.  Thanks to Prevention Point, there is probably as much Narcan on this street as there is heroin!  

And that's the point of this blog…

These collections of human beings gathered together, whether they be under bridges designed to hold rail lines or on sidewalks of local 'mom and pop' businesses such as are on Kensington Avenue, serve a vital and life-saving purpose.  These men and women who would prefer not to have SubstanceUse Disorder as an officially recognized diagnosis in their lives take their potentially instantly deadly medicine because their bodies DEMAND that they do so, not because they want to nor choose to do so.  It is no longer their choice to take or not take their medicine.  

In a very real way, these collections of human beings gathered on the sidewalks are a grassroots level hospital ward where the patients are also the medical service providers.  Some patients inject themselves.  Others can't and so the medication nurse - another patient - provides the injection.  If someone starts to seriously overdose to the point of needing Narcan, the rapid response team - other patients - steps in to provide the life-saving drug and all standard life-saving procedures.  

For those of us who have never walked down this path of Substance Use Disorder, decide now to intellectually accept this demand of their bodies even if you can't understand it with a firsthand understanding.

Once you accept this fact, even if you can't totally understand it, we can begin to work together to make progress on doing something positive about solving this issue. 

Nearly 100% of the men and women on these streets are reliant on Medicaid for financial coverage of their health care needs.  

The inadequate levels of reimbursement to medical facilities are so insufficient that many places simply cannot afford to take these wonderful human beings in as patients.  Those that do focus on Medicaid patients can't afford to provide decency, dignity, nor respect in their settings.  The end result is a higher death rate among Substance Use Disorder patients on Medicaid compared to those with private insurance. 

This MUST be corrected!

I don't pretend to have the answers…

I do know this…

It's Time to Plow Down Medicaid Mountain!

Pray for Melanie...

For over a year now, I've been sharing stories about "Melanie" in this blog series.  Here they are in reverse date order (for some reason I can't control).

Last summer, as I visited Melanie in jail, she promised me that she would never go back to using heroin.  She has maintained that promise and has told me so each time I've seen her since then.  She has continued to live on the streets for her own reasons that go beyond the point of this blog. 

Melaine has done fairly well until about 10 days ago when, again, for reasons of her own, heroin reentered her pattern of life and her bloodstream.  She has overdosed twice in these ten days and been saved by Narcan twice, once by a resident of the streets and once by a Philadelphia police officer who knows and cares very much for her.

On Wednesday, I found Melanie shortly after this second near death moment.  She asked if she could rest in my car.  She slept for the next couple of hours while I made my rounds visiting people with bananas, water, and song sheets.  I informed each outreach worker who I saw on the streets of Melanie's situation and each one had a different solution based on their experiences and the group they represented.

In the end, Melanie, with the help of the good people of Prevention Point, got out of my car and was considering going in there for help. 

As we hugged each other, I held her extra tight as I was keenly aware that I might never see Melanie alive again.  Her walking path of life is far too thin these days AND it is on the side of a cliff on what I'm calling "Medicaid Mountain."

Pray for Melanie...

Out of My Love for Diane, Guide Me God.

My maternal grandfather was listed as Missing In Action (MIA) for several months during World War I (WWI).  Once home, he refused to ever talk about those months.  To this day, we have no idea what he experienced.  We will never know.

Life as a homeless person dealing with Substance Use Disorder has some parallels to my grandfather's story.  They endure far more than what we hear about from them.  More often than not, these men and women enter their Substance Use Disorder and homelessness through the doors of some form of emotional trauma.

Once out on the streets, they endure more trauma by way of harsh treatment from Non-Substance Use Disorder persons, the medical community, and the legal system.  For men standing on street corners, harsh words and items thrown at them by passersby are common.  For women doing 'dates', degradation and violence are far more common than we ever hear.

That's what makes "Diane" such an awesome witness to her Christian Faith.  She endured far more as a person imprisoned on the streets by a situation she did not want and from which she sought healing than we will ever know.

Diane never told me any of the incidents that she would have most likely experienced.  Just like my grandfather's stories, we will never know. 

But I do know this:

Before the living water of Diane's life evaporated from the fine crystal and porcelain vessel that we recognized and hugged, she declared her Faith in her LORD and Savior one more time and in a way for all of us to know.  She wrote this in a letter to me that I received three days after she died:

Those of us who had the privilege of knowing Diane are grieving our loss from our unique perspectives of parent, sibling, children and extended family or friend.  For some of us, this Christian Faith thing is not understood.  We grieve our loss of Diane in the absence of her Savior. 

Diane endured so much in her life and yet her Faith burned bright.  Maybe, just maybe, those of us who are struggling with our loss in the absence of Diane's Savior could consider taking a closer look at the One she claimed as her own.

In our loss of Diane, we are enduring so much pain.  If you are enduring this pain in the absence of the One Diane called Savior and LORD, I'd like to invite you to take a closer look at the Faith of Diane.

Perhaps this could be your conversation with God:

God, I'm hurting… I don't get it…  How could Diane experience so much pain in her years of suffering and yet maintain and declare Faith in You?  She knew of Your Love as an absolute Fact of Life.  I don't.  In honor of Diane, I'm willing to learn more about you.  I don't know that I'll ever really believe as did she but I'm willing to take a peek at who You are.  I'll read some of Your Bible.  I'll visit a church.  I'll ask others who share Diane's Faith.  My heart hurts so badly right now.  I don't get it God but out of my love for Diane, I'm willing to learn more.  Guide me, God.

**********

Blog Analysis Addendum: Out of My Love for Diane

Original Blog Title: Out of My Love for Diane, Guide Me God.

I. The Human Narrative: The Letter from the Grave

The "visceral grab" of this story is the timing: a letter arriving three days after the writer has passed. You compare the silence of your WWI grandfather to the unspoken traumas of the street—the "harsh treatment," the "items thrown," and the "degradation" of the dates. Diane, the "fine crystal and porcelain vessel," endured these in silence, yet used her final days to declare her faith. Her letter is a bridge for those who grieve her, inviting them to look at the Savior she claimed, even if they only "take a peek" out of love for her.

"She declared her Faith in her LORD and Savior one more time... in a letter to me that I received three days after she died."

II. The "Lynne’s Laws" Article and Section Review

Diane’s final letter provides the ultimate evidence for Article 11, focusing on "Spiritual and Emotional Continuity."

Article 1, Section 1: The Medical Necessity and Parity Mandate. Diane’s trauma-informed entry into addiction ("through the doors of some form of emotional trauma") is the clinical root of her case. This mandate ensures that the "Why" of the addiction is treated with the same intensity as the physical "What," preventing the systemic neglect that Diane endured in silence.

Article 11, Section 1: The Spiritual Continuity and Chaplaincy Act (New).

• The Law: Recognizes that for many patients, faith is a "Clinical Vital Sign." It mandates that state-funded recovery systems must allow and facilitate access to a patient’s chosen faith community (Mass, worship, or spiritual counseling) as a core component of the treatment plan.

• The Application: If Diane had been in a facility that prioritized her "Walking with Jesus" as much as her detox, her transition would have been supported by her church family, potentially closing the "Interval Gap" that led to her death.

Article 11, Section 2: The Post-Mortem Family Advocacy Act (New).

• The Law: Mandates that in the event of a patient's death due to systemic failure (like an unsafe discharge or lack of transition), the state must provide immediate, high-level grief counseling and "Truth and Reconciliation" services for the family.

• The Application: This would support the "broken-hearted family" and two little girls Diane left behind, ensuring their "MIA" mother's story is told with truth and that their own trauma is addressed by the state that failed to protect her.

III. The Professional Tension and Consensus

• The Supportive View: Trauma-informed therapists and chaplains argue that spiritual resilience is the strongest predictor of long-term recovery. They support Article 11 because it treats the "Whole Person," not just the "Chemical Organism."

• The Skeptical View: Secular policy-makers worry about "Separation of Church and State" and argue that tax dollars shouldn't fund "Spiritual Continuity."

• The Lynne’s Law Resolution: This is a Patient Choice issue. If Diane’s recovery is rooted in her Catholic faith, the state has a medical obligation to support that "Internal Light" because it is her primary defense against the "Demon."

IV. Legislative "Teeth": The "Trauma-Informed Witness" Standard

• The Objective Standard: A patient's history of "MIA Trauma" (unspoken street violence) must be documented as a high-risk factor.

• The Mandate: If a patient identifies as a "Person of Faith," their discharge plan must include a handoff to a spiritual support system. A "Curb Discharge" (as happened to Lynne and effectively to Diane) that severs a patient from their faith community is a legal breach of the Duty of Care.

V. The Prevention Savings

By implementing the Spiritual Continuity Act, Pennsylvania saves on:

• Generational Trauma Costs: Protecting the faith and legacy of mothers like Diane helps break the cycle of addiction for their children.

• Relapse Rates: Patients who are re-connected to a church or community "Sanctuary" have significantly higher success rates than those left in a row home on Kensington Avenue.

VI. The Corrected Path

Under Lynne’s Laws, the letter Diane wrote to you wouldn't have been a "goodbye from the grave." It would have been an invitation to her first "Post-Recovery Mass." The system would have seen her "porcelain vessel" was cracking and provided a "Sanctuary Transfer" that included her priest and her Christian books. She would be walking with Jesus on this earth, not just in heaven—and those two little girls would be holding her hand in the pew.

#LynnesLaws

TODAY's Touch of the Master's Hand!

Touch of The Master's Hand

Myra Brooks Welch

Twas battered and scarred,

and the auctioneer
Thought it scarcely worth his while
To waste much time on the old violin,
But held it up with a smile.
'What am I bidden,

good folks,' he cried,
'Who'll start the bidding for me?'
'A dollar, a dollar. Then two! Only two?
Two dollars, and who'll make it three?'

'Three dollars, once; three dollars, twice; Going for three…'

But no,

From the room, far back,

a grey-haired man
Came forward and picked up the bow;
Then wiping the dust

from the old violin,
And tightening the loosened strings,
He played a melody pure and sweet,
As a caroling angel sings.

The music ceased, and the auctioneer,
With a voice that was quiet and low,
Said: 'What am I bid for the old violin?'
And he held it up with the bow.
'A thousand dollars,

and who'll make it two?
Two thousand!

And who'll make it three?
Three thousand, once;

three thousand, twice,
And going and gone,' said he.

The people cheered,

but some of them cried,
'We do not quite understand.
What changed its worth?'

Swift came the reply:

'The touch of the Master's hand.'

And many a person

with life out of tune,
And battered and scarred with sin,
Is auctioned cheap

to the thoughtless crowd
Much like the old violin.

A 'mess of pottage,' a glass of wine,
A game — and he travels on.
He is 'going' once, and 'going' twice,
He's 'going' and almost 'gone.'

But the Master comes,

and the foolish crowd
Never can quite understand
The worth of a soul

and the change that is wrought
By the touch of the Master's hand. 

I wish you could have seen TODAY's Touch of the Master's Hand!:

On this rainy Sunday, I walked up to "Cricket"[1] with an oddly shaped conglomeration of cloth.  "Hi Cricket. Come with me." I said as we entered Martin's Deli.  "I'm not allowed in there." She said.  "For this, you will be." I told her.  We walked in and I opened the cloth (my raincoat on this bad weather day) and she saw the case containing a 3/4 size violin.  She started shaking as she covered her mouth.  I opened the case as it sat on the top of the popsicle cooler.[2]

As I handed Cricket this 3/4 size violin, she took it in hand and, with hardly skipping a beat, lit up that deli with the fastest fingering and string usage I could have ever expected!  People pulled out their cameras.  Cricket danced with joy to her self made music and had an instant audience!

Cricket stopped.

In the doorway of Martin's Deli, Cricket cried.

Cricket spoke: "It's been over a year since I've played a violin."

I hugged her and she bawled the cry of one who unexpectedly reawakened her passion.  

As I held her, I simply said:  "Please know how much Jesus loves you." 

She cried some more.

She played some more.

As we were packing up this violin to keep it safe from the weather, the manager came within range and told Cricket to get out.

I wish you could have seen TODAY's Touch of the Master's Hand! 

PS: Please know you are a magnificent human being made in the image of GOD and you are Worthy of the Highest Dignity, Honor, Respect and Love.

Please Allow Yourself to be touched by the Master's Hand!

---

[1] A woman who is a classically trained violinist and who, until Substance Use Disorder rerouted her life, was a teacher of violin in the Suzuki Method in the area of West Chester Pa.

[2] in this deli near the intersection of Somerset Street and Kensington Avenue.