Sunday, May 15, 2016

I maybe don't know how insurance works...

Money started getting tighter this month. Didn't seem like it should be, since we'd been the recipients of significant largess after an ongoing online effort to defray some medical expenses. So, I dove into the bills we've paid, the ones we still have to pay, the online account pages for the insurance carrier, etc... to see what I could find.

The discoveries are confusing. The "benefit year" for my medical insurance plan runs from Oct 1 to Sept 30, so bills incurred in the final quarter of 2015 and those incurred in 2016 thru now are all in the same 'year'... The way I understand it, I have $10,000 cap on out of pocket expenses in that benefit year. Imagine my surprise when I read my annual summary for 2016 (Jan-present, so still a work in progress) and see a Patient Responsibility total of $14,534.86 for care I have received in the calendar year. Add to a PR of $531 for service in late December (the initial vision screening) and $300+ in PR for my son from an accident in late February. By my math, our family out of pocket responsibility seems to have hit nearly $15,400 so far in the benefit year. This would explain why we are short money month to month, despite having paid $7700 worth of bills from my online donation effort, about $250 / month from our own paychecks and another exactly $1500 thus far from our HSA. We will continue to get $250/month from that HSA source through Sept 20, which would basically recoup the $$ spent from our pocket funds up til now OR it can mostly cover the still $1500 outstanding from the ENT surgeon and anesthesiologist (which can't wait to be paid over these next 5 months). The hospital did cut us a break because we paid off the actual hospital (though not surgeons, labs, imaging, or anesthesia) within three days of the check in, and the imaging provider and neurosurgeon gave breaks, as well (and many many thanks to them!!!), so our ACTUAL costs over the year haven't been $15,400they are closer to $12,200but the insurance sees our responsibility as that much, and my question is how is that possible... a $10,000 cap should mean that when $10,000 is hit, then ALL additional charges aren't the patient responsibility... but apparently, we blew right thru $10k and are beyond halfway to the NEXT $10k.

We set the online goal for $12000 with the intent to create a cushion for added child care expenses we thought might possibly happen and thankfully, those pretty much didn't (again, generosity on the part of providers rather than us not having additional needs). I didn't think the cushion would be short by 50% on actual medical billing and be $200 of the actual medical costs for the year (to date). The fact seems to be that if the effort is 100% funded (it's at about 65% now), it will actually be SHORT of the billed 'patient responsibility' medical expenses I've seen since this event started.

So... If anyone knows WHY the numbers add up as they do, we'd love to understand better. If anyone can help in any other way, We'd appreciate that, too

REPOSTED.. this particular version comes from SEATTLE EDUCATION

REPOSTED.. this particular version comes from SEATTLE EDUCATION, but as you will read below, there is a deeper lineage than that... everything that follows is the work of OTHER AUTHORS, reposted in part because that is the objective and in part because I agree with everything herein.
What’s the big secret about the SBAC and PARCC test questions?
censored-450x392
Back in the day, after I took a test and it was graded, I got my test paper back to see what questions I got wrong. It was part of the learning process.
It seems these days that Pearson doesn’t want the students or teachers to know what the questions are, therefore what questions each student needs to review and focus on to further educate themselves.
It has now gotten to the point where if ANYONE shares one question on the PARCC or SBAC tests, they are to be censored and threatened with legal action.
This is education?
An article was written by a teacher about the Common Core Standards PARCC test (the equivalent of the SBAC used in Washington State) and posted on the blog Outrage on the Page. It described the type of questions given, with examples of specific questions and critiqued each one superbly.
The people at PARCC/Pearson, weren’t happy about this and threatened the publisher of the article with legal action.
Because of the threats, the questions were deleted from the article.
Tweets about the article were taken down and Diane Ravitch’s post on the article disappeared off of her blog overnight. Because of these actions, I and other education journalists are reposting the article that was written by a teacher and revised after threats from PARCC/Pearson, and sharing it broadly on our websites, twitter and Facebook.
Please share widely the following thoughtful article written by an educator about the PARRC test.
The PARCC Test: Exposed
The author of this blog posting is a public school teacher who will remain anonymous.
I will not reveal my district or my role due to the intense legal ramifications for exercising my Constitutional First Amendment rights in a public forum. I was compelled to sign a security form that stated I would not be “Revealing or discussing passages or test items with anyone, including students and school staff, through verbal exchange, email, social media, or any other form of communication” as this would be considered a “Security Breach.” In response to this demand, I can only ask—whom are we protecting?
There are layers of not-so-subtle issues that need to be aired as a result of national and state testing policies that are dominating children’s lives in America. As any well prepared educator knows, curriculum planning and teaching requires knowing how you will assess your students and planning backwards from that knowledge. If teachers are unable to examine and discuss the summative assessment for their students, how can they plan their instruction? Yet, that very question assumes that this test is something worth planning for. The fact is that schools that try to plan their curriculum exclusively to prepare students for this test are ignoring the body of educational research that tells us how children learn, and how to create developmentally appropriate activities to engage students in the act of learning. This article will attempt to provide evidence for these claims as a snapshot of what is happening as a result of current policies.
The PARCC test is developmentally inappropriate
In order to discuss the claim that the PARCC test is “developmentally inappropriate,” examine three of the most recent PARCC 4th grade items.
A book leveling system, designed by Fountas and Pinnell, was made “more rigorous” in order to match the Common Core State Standards. These newly updated benchmarks state that 4th Graders should be reading at a Level S by the end of the year in order to be considered reading “on grade level.” [Celia’s note: I do not endorse leveling books or readers, nor do I think it appropriate that all 9 year olds should be reading a Level S book to be thought of as making good progress.]
The PARCC, which is supposedly a test of the Common Core State Standards, appears to have taken liberties with regard to grade level texts. For example, on the Spring 2016 PARCC for 4th Graders, students were expected to read an excerpt from Shark Life: True Stories about Sharks and the Sea by Peter Benchley and Karen Wojtyla. According to Scholastic, this text is at an interest level for Grades 9-12, and at a 7th Grade reading level. The Lexile measure is 1020L, which is most often found in texts that are written for middle school, and according toScholastic’s own conversion chart would be equivalent to a 6th grade benchmark around W, X, or Y (using the same Fountas and Pinnell scale).
Even by the reform movement’s own standards, according to MetaMetrics’ reference material on Text Complexity Grade Bands and Lexile Bands, the newly CCSS aligned “Stretch” lexile level of 1020 falls in the 6-8 grade range. This begs the question, what is the purpose of standardizing text complexity bands if testing companies do not have to adhere to them? Also, what is the purpose of a standardized test that surpasses agreed-upon lexile levels?
So, right out of the gate, 4th graders are being asked to read and respond to texts that are two grade levels above the recommended benchmark. After they struggle through difficult texts with advanced vocabulary and nuanced sentence structures, they then have to answer multiple choice questions that are, by design, intended to distract students with answers that appear to be correct except for some technicality.
Finally, students must synthesize two or three of these advanced texts and compose an original essay. The ELA portion of the PARCC takes three days, and each day includes a new essay prompt based on multiple texts. These are the prompts from the 2016 Spring PARCC exam for 4th Graders along with my analysis of why these prompts do not reflect the true intention of the Common Core State Standards.
ELA 4th Grade Prompt #1
Refer to the passage from “Emergency on the Mountain” and the poem “Mountains.” Then answer question 7.
  1. Think about how the structural elements in the passage from “Emergency on the Mountain” differ from the structural elements in the poem “Mountains.”
Write an essay that explains the differences in the structural elements between the passage and the poem. Be sure to include specific examples from both texts to support your response.
The above prompt probably attempts to assess the Common Core standard RL.4.5: “Explain major differences between poems, drama, and prose, and refer to the structural elements of poems (e.g., verse, rhythm, meter) and drama (e.g., casts of characters, settings, descriptions, dialogue, stage directions) when writing or speaking about a text.”
However, the Common Core State Standards for writing do not require students to write essays comparing the text structures of different genres. The Grade 4 CCSS for writing about reading demand that students write about characters, settings, and events in literature, or that they write about how authors support their points in informational texts. Nowhere in the standards are students asked to write comparative essays on the structures of writing. The reading standards ask students to “explain” structural elements, but not in writing. There is a huge developmental leap between explaining something and writing an analytical essay about it. [Celia’s note: The entire enterprise of analyzing text structures in elementary school – a 1940’s and 50’s college English approach called “New Criticism” — is ridiculous for 9 year olds anyway.]
The PARCC does not assess what it attempts to assess
ELA 4th Grade Prompt #2
Refer to the passages from “Great White Shark” and Face the Sharks. Then answer question 20.
 Using details and images in the passages from “Great White Sharks” and Face to Face with Sharks, write an essay that describes the characteristics of white sharks.
It would be a stretch to say that this question assesses CCSS W.4.9.B: “Explain how an author uses reasons and evidence to support particular points in a text.”
In fact, this prompt assesses a student’s ability to research a topic across sources and write a research-based essay that synthesizes facts from both articles. EvenCCSS W.4.7, “Conduct research projects that build knowledge through investigation of different aspects of a topic,” does not demand that students compile information from different sources to create an essay. The closest the standards come to demanding this sort of work is in the reading standards; CCSS RI.4.9 says:“Integrate information from two texts on the same topic in order to write or speak about the subject knowledgeably.”Fine. One could argue that this PARCC prompt assesses CCSS RI.4.9.
However, the fact that the texts presented for students to “use” for the essay are at a middle school reading level automatically disqualifies this essay prompt from being able to assess what it attempts to assess. (It is like trying to assess children’s math computational skills by embedding them in a word problem with words that the child cannot read.)
ELA 4th Grade Prompt #3
  1. In “Sadako’s Secret,” the narrator reveals Sadako’s thoughts and feelings while telling the story. The narrator also includes dialogue and actions between Sadako and her family. Using these details, write a story about what happens next year when Sadako tries out for the junior high track team. Include not only Sadako’s actions and feelings but also her family’s reaction and feelings in your story.
Nowhere, and I mean nowhere in the Common Core State Standards is there a demand for students to read a narrative and then use the details from that text to write a new story based on a prompt. That is a new pseudo-genre called “Prose Constructed Response” by the PARCC creators, and it is 100% not aligned to the CCSS. Not to mention, why are 4th Graders being asked to write about trying out for the junior high track team? This demand defies their experiences and asks them to imagine a scenario that is well beyond their scope.
Clearly, these questions are poorly designed assessments of 4th graders CCSS learning. (We are setting aside the disagreements we have with those standards in the first place, and simply assessing the PARCC on its utility for measuring what it was intended to measure.)
Rather than debate the CCSS we instead want to expose the tragic reality of the countless public schools organizing their entire instruction around trying to raise students’ PARCC scores.
Without naming any names, I can tell you that schools are disregarding research-proven methods of literacy learning. The “wisdom” coming “down the pipeline” is that children need to be exposed to more complex texts because that is what PARCC demands of them. So children are being denied independent and guided reading time with texts of high interest and potential access and instead are handed texts that are much too hard (frustration level) all year long without ever being given the chance to grow as readers in their Zone of Proximal Development (pardon my reference to those pesky educational researchers like Vygotsky.)
So not only are students who are reading “on grade level” going to be frustrated by these so-called “complex texts,” but newcomers to the U.S. and English Language Learners and any student reading below the proficiency line will never learn the foundational skills they need, will never know the enjoyment of reading and writing from intrinsic motivation, and will, sadly, be denied the opportunity to become a critical reader and writer of media. Critical literacies are foundational for active participation in a democracy.
censored moneyWe can look carefully at one sample to examine the health of the entire system– such as testing a drop of water to assess the ocean. So too, we can use these three PARCC prompts to glimpse how the high stakes accountability system has deformed teaching and warped learning in many public schools across the United States.
In this sample, the system is pathetically failing a generation of children who deserve better, and when they are adults, they may not have the skills needed to engage as citizens and problem-solvers. So it is up to us, those of us who remember a better way and can imagine a way out, to make the case for stopping standardized tests like PARCC from corrupting the educational opportunities of so many of our children.
ParccPost script by the editor:
I just came across this cartoon on Facebook and wanted to share it.


Wednesday, April 6, 2016

Money: Who has it and where it goes

A short reflection today on two events from the past 24 hours...

#1 was a unforeseen consequences of something really good that went sideways, but then straightened out.  Last month, the MRI bill was just north of $2k. I figured I'd do half at the time and then half again. So I sent $1000 via my bank's bill pay system.

But THEN I got an EOB from my insurance carrier detailing a recoding and indicating the new MRI balance would be just over $340. (Thanks, MB, for the work on that end, btw!!!)

THEN I got this month's MRI bill showing that $340 amount and no recent payments.

Turns out that the account I had with the same provider was NOT the account number for the current visit. So my $1000 had gone into the ether to whence, we knew not. But phone calls were made and payment details passed on and today, I have been credited with the payment; MRI is paid in full and refund is en route via EFT and can be applied to something else.

#2 was a note from our friends at the IRS, wishing to confirm the return filed in my name and with my SS# was in fact filed by me. I am not due a refund this year (I underwithheld), but someone else submitted some other numbers that apparently supported them getting a nice comfy refund. And while they have been waiting, the IRS decided it was fishy. Good IRS. Let's make sure they remain adequately funded, shall we? The only real consequence for me is that I may NOT file electronically this year or possibly in the next several years. BuhBye TaxSlayer :P

Tuesday, April 5, 2016

Spring! Good & Less Good things make for interesting days

I'm back to work as of yesterday. Have had a good couple of days catching up with all my students and the cast of my show. I am so very pleased with the accomplishments of the music director and choreographer, who've been running rehearsals while I've been gone. I had an amazing substitute (who is also one of my theater parents) who did a great job keeping my groups going up to spring break and then she teamed the final week with my student teacher, who has already started on his lesson for my Intro class. There are some challenges at work, though, so we'll see how that all shakes out.

I spent the weekend and part of the previous week, doing productive, but relatively undemanding work at my house. Some gardening and landscape work, but no heavy lifting (20# restriction was the thing for the last part of my time away from work). The home front has challenges lurking, too... spring break was supposed to be 8 days of being on top of my sloth-like remodeling effort, but that is largely on hold, as the reserves that were paying for it have been exhausted paying instead for this other thing. Thus the projects with no price tag except time and (eventually, now that I am cleared to do some more actual work) sweat.

Also spent some of the weekend sorting through various tupperware / rubbermaid containers, figuring out which connected to which MealTrain providers (that was an amazing several days of very good, no hassle food... so much thanks to Kirie for organizing it and making several deliveries). Going to return those this week.

Some of the bills are still just arriving. Saw first bills today from pre-op labs and anesthesia ($272.38 and $462.00). Also got the updated balance from the pre-op MRI ($340.80). On the bright side, two providers are paid in full: the hospital & the eye doc, and I have balances partially paid, though with very close to $1200 remaining, collectively: neuro & ENT surgeons, who haven't sent updated bills.

The most troubling thing to come in the mail today was the note from the IRS indicating someone has already filed a return this year using my name and social security number. So yeah. That's fun.

Looking forward to having a regular month that only sees correspondence from the water district, Rogue Disposal, Pacific Power, and the internet provider :)

Tuesday, March 15, 2016

One Week Ago

It was this time last week that I was emerging from anesthesia and getting my bearings in the ICU at Asante Rogue Regional Medical Center. An update on what's happened since then:

I am largely OK. Using pain meds at a far lower rate than Rx allows, eating normally, taking my antibiotics. Vision didn't come back as quickly as last time (when it was noticeably better upon awakening), but it has crept back over recent days and I no longer have the cloudy sense when things are happening wide right of me. It may not recover fully, but it will again be functional for at least another seven years. Speaking of another seven years, I will plan my insurance package purchases more in tune with what might loom, so the deductible and out of pocket hits are far less extreme. I also don't want this to become a routine, so here's hoping science and technology gains some ground on my condition in the next half decade.

The effort to raise money to help me online is keeping pace with the bills. I haven't received the 'next wave' yet, and have gotten the 30 days or older notice on the MRI. That is my next payment, just over $2k. I expect I have about $1k per surgeon still to go. I'll post some specifics when I get the next round. The fundraising and what I've actually sent out are within a few hundred dollars of each other, so that's been a real help, but the woods are not behind me, yet. The remaining effort is about $5.5k from met and the remaining bills are about $4.5k known and a still some unknowns. My hope is I won't /need/ to raise it all, but it will sure be a relief if I do.

The MealTrain effort has been wonderful and tasty. Good food so far from families of a couple of my students, both of whom I have broader connections to that predate the current kid in the classroom. It's made life much easier to simply heat up some chicken or soup rather than wonder what there might be to eat.

My classroom is well in hand and my sub is a wonderful facilitator for my lesson content, as well as for communicating directly and for helping students to stay in contact via the appropriate school mechanisms. Makes this a lot easier than it might otherwise be.

I am enjoying spending time with Robert and look forward to being able to supervise (though not really pitch in) on some work being done here at the house. 

Thursday, March 3, 2016

My morning at RRMC

This AM has been spent at the hospital. The good news is that the overall billing has hit my cap and I will not be seeing a bill for the CT I just had. The other (not bad, per se) news is the surgery itself is what's hitting my cap and it IS being billed and will be the next thing I need to take care of. The estimated charges are just north of $70k, with allowable charges a tad over $58k, and when the dust settles, the amount left on my cap that the hospital actually expects is $4376. IF I can get that paid by the 13th, I can save nearly $600 (a hospital discount) and still have the full amount count toward my cap... So that is the next amount we need to hit and we are partway to it (with the movement on the YouCaring effort on my behalf, we've raised just over $4700 and that has all been applied to existing billing aimed at the $10k cap). Some of my own money also went there in January ($1200 down for the MRI), before the YouCaring effort launched. Some of that $10k is still 'pending' form the vision field test and the initial MRI ($2036 still owed there -- got that bill today), which haven't been paid in full, as yet.

My child care situation is stable, so far, but post-op could make it more complicated, so our next push needs to be to get to the $10k number, so I can get the hospital taken care of, then the final $2k may be far less urgent and may even be un-needed. Fingers Crossed!!

Monday, February 29, 2016

Social Media does things I didn't even know about

First, a big thanks to the care team for my son, who are keeping his life as normal as possible while his mom and I ramp up for me going in for surgery in a week. We have his day care split among three different providers (due to limits in their schedules): my mom (who will also be looking after him over night twice next week), the North Medford CDC, and a local in-home provider named Michelle (who we found on Craigslist). With my wife and I working the crazy schedules we do (me with a HS theater, her with an overnight 40 hours a week at the hospital), these folks see Robert for portions of 6 days each week.  I am actually really looking forward to getting some days with him in the coming weeks. The CDC can't do anything extra to help, schedule-wise, but they are a rock when it comes to being stable and supportive. Michelle is able to accommodate a lot more weirdness and I hope to be able to make that flexibility not be a hardship for her. And obviously, my mother will go from 8 hours a day two days a week to 21 hours each for the day of and day immediately following the surgery. And then she'll get to care for me, too, a couple of evenings after that.

Then the other thing that happened to today that I need to express some amazement and gratitude about is a thing called mealtrain.com where one of my former students is coordinating meal prep for me and my family on some of the high stress days coming in the next two weeks.

I've had some amazing response and comments from people I'd lost touch with for years, including SCA friends I last saw in 2001, Wesleyan classmates I've only occasionally sparred with in facebook threads over the last 25 years, and SCA folks I've never even met in the context of an event. At least two former students brought me to tears with reflections of my role in their life that I had no awareness of...

A week from tonight, I'll be finished getting everything ready. I'll be in the hospital by 6am the following morning. If things go like last time around, I'll be under by 7:30am, and awake again around 4pm. Last time, I then watched the season premier of Battlestar Galactica on the tiny TV across the room form me in my recovery room and spent one night in that room before moving upstairs and having and additional night in a 'regular' room while they made sure everything was working right with me. Not sure what I'll do this time, but I am three weeks behind on Agent Carter :). Last time, Jenny Warren dumped all the Harry Potter books on me and I read the lot during my recovery. I started the series again just after Alan Rickman's death and am (slowly) repeating that effort. Feels like I should just call the Potterverse my recover reading for all things.

I do have one more pre-op appointment later this week... a Sinus CT and meetings with the anesthesiologist and the admit team. Not sure how and when the next wave of billing will hit, but as of today, all the things that are already due have been paid for by this online effort ($3200 of it has made it through to me, so far.. more should be in my account tomorrow AM). There is still a fair amount to go before the out of pocket cap is met, but my level of stress has plummeted over the past few days and that can only be a good thing!