Briefly Noted

A federal audit of opioid treatment programs (OTPs) — methadone clinics — in New York City found that of 115 random sample claims, 35 did not comply with Medicaid requirements, and that of 598 claims in a non‐random sample, 299 were billed in error. Extrapolating these errors, the federal Department of Health and Human Services (HHS) says the state improperly claimed at least $39.3 million in the federal share of Medicaid reimbursement, and owes that money back. Improper claims were mainly due to failure to record patients in the central registry, which exists to make sure patients aren't enrolled in multiple OTPs (18 of the 35 noncompliant claims). This was not an audit alleging fraud. Extrapolation as an accounting method for OTPs, where patients often come in every day, so that each patient has more than 300 claims a year, is questionable, but OTPs are used to this even in state audits. In other words, one OTP patient comes in six days a week, with six claims, and the database balloons. “You're extrapolating over our universe, and our universe becomes large because people come in for medication,” said Allegra Schorr, president of the Coalition of Medication‐Assisted Treatment Providers and Advocates, a New York–based membership organization, and board member of the American Association for the Treatment of Opioid Dependence. “When you're just trying to get money, this counts,” said Schorr. “They hit the lottery when it comes to an audit because of that extrapolation.” However, Schorr, who is also an owner and vice president of West Midtown Medical Group, a Manhattan‐based group that was the first OTP to dispense buprenorphine in New York state, stresses that compliance is always important. “It's critical that there is oversight,” she told ADAW. Meanwhile, the state is reviewing the audit and will respond. “The Office of Addiction Services and Supports (OASAS), in partnership with the NYS Office of Medicaid Inspector General, intends to review the specific findings of this audit cited by OIG [Office of Inspector General] to verify its accuracy and to determine an appropriate course of action,” said Evan Frost, spokesman for OASAS. “As a proactive measure, we will remind our OTP providers of their obligations to comply with state and federal laws and rules for providing and claiming Medicaid reimbursement and ensuring the quality of care for those receiving OTP services.” OA SAS regulates OTPs in the state. For the audit, go to https://oig.hhs.gov/oas/reports/region2/21701021.pdf     

Medicaid Managed Care Programs for High-Risk Older People in Massachusetts

The Commonwealth of Massachusetts has undertaken a major initiative in the development of comprehensive managed health care programs for two sets of high-risk older people: those who are frail and homebound and those who reside in nursing homes. This effort has been coordinated by the state's Department of Public Welfare (DPW; Medical Assistance [Medicaid] Program) and Executive Office of Elder Affairs, and expedited ba a set of Health Care Financy Administration (HCFA) waivers and by the state's revised Nurse Practice Act (MGS Chapter 56). Than act allows nurse-practioners and physician assistants expanded roles as primary providers in home care and nursing home settings. The managed care initiatives have supplemented other efforts (1) to coordinate health and social services for older people, (2) to provide as broad a range as possible of community-based services for older people, and (3) to enroll as many older adults as possible in Health Maintenance Organization (HMO) "Senior Plans" and other similar "Competive Medical Plans."

Though there is still no evidence of the managed care programs' effects, this article summarizes some of the possible risks and benefits of managed care programs for those kinds of populations and presents an agenda of questions that evaluations of managed care programs must address.     

The First Person in Antislavery Literature: John Woolman,his Clothes and his Journal

In his lifetime John Woolman (1720–1772) drew attention to himself with his unusual behavior, his expressive demeanor and his clothes. He sought to become a ‘sign’ directing others toward a way of life without exploitation or slavery. After his death and the publication of his journal, he was celebrated as the most important figure in the campaign to turn the Quakers against slaveholding. Woolman's self-presentation, contemporary responses to him, and the posthumous commemoration of him provide an indication of the power and significance of personal narrative within Quakerism and in antislavery politics in Britain and America.     

İsmail Hakkı İzmirli (1932), Philosophical Currents in Islam: Ibn Khaldun (732-808)

A leading intellectual of the late-Ottoman and early-Turkish Republican period, İsmail Hakkı İzmirli taught philosophy, theology, and law in İstanbul, and was a prolific writer, with more than forty-five published and unpublished books, and many articles. The article reproduced here in translation, which was part of a series of articles on leading Muslim thinkers, is on the life and work of Ibn Khaldun, in which the author both briefly introduces his major books (al-‘Ibar, al-Muqaddima, and al-Ta'rif in particular) and outlines his methodological principles and main arguments in the Muqaddima. İzmirli treats Ibn Khaldun as a philosopher and historian, admiring his philosophical views and methodological perspective as quite original and in many ways trailblazing, though he also criticizes him for unnecessarily “delving into useless issues such as Sufism.” Finally, he frequently compares him with both Muslim and Western intellectuals, e.g. Ibn Rushd, Ibn Miskawayh, al-Farabi, Ibn Bâjja, Niẓām al-Mulk, and Edward Gibbon, Marx, Spencer, and Comte, often finding Ibn Khaldun as a pioneer anticipating the ideas of later thinkers. He devotes a separate section to compare him with Machiavelli, emphasizing differences as well as similarities between the two, and likening the latter to a “disciple” of Ibn Khaldun's, claiming that “Machiavelli followed his mentor's path in his The Prince.”     

Talbott,patient advocate and OTP owner,leaves BayMark

Zac Talbott's last day with BayMark Health Services, which bought his opioid treatment programs (OTPs), Counseling Solutions Treatment Centers, in Chatsworth, Georgia, and Brasstown, North Carolina, last year (see “From starter OTP to acquisition by BayMark: A 3‐year journey,” ADAW, Sept. 8, 2018, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32095 ), was May 24. He had various options and opportunities that could have resulted in him leaving earlier, but he did not want to leave in the midst of so much change. He opened the first Counseling Solutions clinic in 2015 (see “Methadone patient and advocate to open own OTP in Georgia,” ADAW, Aug. 17, 2015, https://onlinelibrary.wiley.com/doi/10.1002/adaw.30292 ).     

Bourdieu,ethics and symbolic power

This article critically discusses Pierre Bourdieu's views on ethics and normative evaluations. Bourdieu acknowledged that people hold ethical stances, yet sought to show that these stances are – unconsciously – conducive to obtaining symbolic power and legitimizing hierarchy. The first part of the article looks at this argument and charts the shifts it went through particularly in the early 1990s. The second part discusses ontological and empirical critiques of the ethics as ideology argument and suggests the latter to be more salient, as Bourdieu proposed his argument as an empirical rather than as an ontological point. The reason why he nevertheless found the ethics as ideology explanation fitting to nearly all the cases he studied, as the third part argues, is not simply that reality ‘obliged’ him to do so, but his circular definition of symbolic capital as qualities that are worthy of esteem. This definition makes his argument of ethics as ideology unfalsifiable and impedes him from distinguishing between cases when legitimate power is the aim of ethics and between those when it is merely their side effect. The article concludes by suggesting ways in which Bourdieu's work can be fruitfully incorporated into the study of ethics once the tautology is resolved.     

Poetry of the Swamp: Blok’s “Folks” Cycle Bubbles of the Earth

Gogol'’s “A Few Words about Pushkin” has traditionally been viewed as evidence that Gogol' idolized Pushkin as a national poet par excellence. This article argues that behind Gogol'’s deference for Russia’s greatest poet lie layers of polemic and subversive iconoclasm. Though he initially proclaims Pushkin Russia’s national poet, Gogol' goes on to use his trademark rhetorical tools to effectively strip the poet of the honour. In doing so, he attempts to influence the reception of his own writings, which at the time predominantly concerned Ukrainian themes, in ways that would encourage his Russian audience to consider him—and not Pushkin—as Russia’s premier national writer. Countering Pushkin’s Russocentric model of national culture, Gogol' champions instead a centrifugal conception of national-imperial identity that places Russia’s imperial periphery at the center of the “Russian” experience.     

‘No Power on Earth can Remove his Liability’: Emperor Haile Selassie and the Foreign Office,a Documentary Essay

Using the newly released unregistered files of the Foreign Office Permanent Under Secretary's Department (PUSD) Macklin's documentary article examines an interesting, if somewhat arcane, ‘missing dimension’ in the history of Abyssinian Emperor Ras Tafari Makonnen, more commonly known as Haile Selassie, and his covert financial relationship with the British government following his exile to Britain in 1936 after the conquest of his country by Mussolini's Fascists, until his return in 1941. By examining how the Foreign Office employed covert politics in order to obviate disruption to its ‘official’ diplomatic strategy Macklin examines how the British government set about ‘neutralising’ the Emperor's diplomatically awkward presence in England in their pursuit of rapprochement with Mussolini through which to drive a wedge between Fascist Italy and Nazi Germany.     

Ilyenkov on Aesthetics: Realism,Imagination, and the End of Art

It is sometimes claimed that Evald Ilyenkov's writings, particularly those on the problem of the ideal, best express the philosophical framework of Russian cultural-historical psychology and activity theory. In this article I consider a neglected part of Ilyenkov's legacy: his work on aesthetics. Ilyenkov's writings on art cast significant light on his views of culture and mind and on the humanistic vision at the center of his philosophy. In 1964, on a rare trip to the West, Ilyenkov visited an exhibition of pop art in Vienna. He was disgusted by what he saw and wrote a scathing critique entitled "Chto tam, v Zazerkal'e?" ("What's there, through the looking glass?"). Does Ilyenkov's antipathy to pop-and, indeed, to so-called modern art in general-show him to be enamored of a narrow, reactionary form of socialist realism? If so, how can this be squared with his reputation as a creative, critical voice within Soviet Marxism? I examine Ilyenkov's other writings on aesthetics in search of a nuanced interpretation of his reaction to pop. I consider his idea that art should serve to cultivate higher forms of perception and his attendant concepts of aesthetic sensibility and imagination, and I explore how these notions contribute to his view of the unity of the cognitive virtues, his hostility to the division of labor, and his ideal of genuine human activity, guided by reason. Such themes are vital constituents of Ilyenkov's humanism, which celebrates free, creative activity as a life principle that must assert itself against the mortifying forces of mechanization and standardization. Although these ideas may not entirely redeem Ilyenkov's hostility to modern art, they reveal his stance to be far more sophisticated than appears at first sight.     

Peter Kireevskii and the Development of Moscow Slavophilism

Abstract

Although the name of the folklorist Peter Kireevskii is well known to historians of nineteenth-century Russia, comparatively little has been written about his place within the Slavophile circle. Some scholars have treated him as the 'first' Slavophile. Others have questioned whether his views were in any sense really Slavophile at all. This article argues that Peter Kireevskii's life-long interest in Russian folklore was rooted both in his understanding of the Russian countryside and his exposure to the influence of a Russian Romantic tradition that viewed the narod as the authentic representative of national identity. It suggests that Kireevskii was from his youth convinced that Russia possessed a culture and history that was equal in value to any country in the West, but that it was only in the late 1830s that he stressed the role played by Orthodoxy in shaping Russia's development. Although his mature views brought him closer to the Slavophile 'mainstream', there were always some elements that set him apart, perhaps reflecting the fact that Slavophilism was a more eclectic and diverse phenomenon than sometimes realized.     

Starting a new OTP and leading clinical services for an OBOT: Talbott

Zachary Talbott, who founded Counseling Solutions Treatment Centers in 2015 and operated opioid treatment programs (OTPs) in Chatsworth, Georgia, and Murphy, North Carolina (see ADAW, August 17, 2015), which were then acquired by BayMark Health Services in August 2018 (see ADAW, Sept. 10, 2018), and who ultimately set his sights on returning home to Maryville, Tennessee, had a plan. Anyone who knows him knew he would. He recently joined ReVIDA Recovery Centers as their director of clinical services to develop, implement and oversee a comprehensive behavioral health program within the company's continuum of care.     

TMZ shifts blame from police to drugs in Floyd death coverage

Last week, the Hennepin County Medical Examiner released the cause of death report of George Floyd, and when celebrity website TMZ got hold of it, it started what seemed like blaming the victim. Floyd's murder by the police was followed by days of protests around the country. The Minneapolis police officers involved — one choked him to death with a knee on his throat while the others watched — were fired. But TMZ's headline said “M.E. says he died from heart attack, had fentanyl…,” and the article went on to interpret the death certificate as follows: “In other words … he suffered a heart attack while they were arresting him, and that complicated their efforts to subdue him. The report says George had fentanyl in his system, and they also found signs of recent methamphetamine use. It also says his manner of death is homicide.”     

Boris Eikhenbaum's Response to the Crisis of the Novel in the 1920s

Abstract

Focusing on the Russian literary scholar Boris Eikhenbaum (1886–1959), the present article considers the interrelationship of autobiographical, scholarly and fictional modes of writing. In 1925 Eikhenbaum wrote in a letter of his 'longing for acts, longing for biography'. This article views the scholar's acute sense of diminished agency in the context of the crisis of the novel in the 1920s and discusses how Eikhenbaum's own generic experimentation becomes a means of finding an answer to the question he posed to himself and his age of 'how to be a writer'. The discussion is primarily based on Eikhenbaum's autobiographical sketches in Moi vremennik (My Periodical, 1929) and his scholarly monograph, Lev Tolstoi. Piatidesiatye gody (Lev Tolstoi: The Fifties, 1928), and attention is drawn to the generic, rhetorical and narrative strategies used across these hybrid scholarly texts, which in turn become invested with a certain emotional and ethical charge. In the end, the article shows how, above all, Eikhenbaum's empathetic engagement with Tolstoi marks for him the restoration of 'biography' and the solution to the entwined epochal and personal crises of genre and authorship.     

Physicians,hospital face $9 million lawsuit following fatal OD

Two years ago, Victor Williams, a 56‐year‐old Black man, died from a fatal overdose of fentanyl and fentanyl analogs. He was at home, but his family didn't have any naloxone, because he had not been given any by his treatment provider, despite multiple previous ODs. He had an opioid use disorder (OUD) and instead of being prescribed methadone or buprenorphine, he was prescribed Schedule II analgesics in the hospital. Just hours before his fatal OD, the hospital discharged him after an accidental heroin poisoning.     

RIVERINE CROSSINGS: GENDER,IDENTITY AND THE RECONSTRUCTION OF NATIONAL MYTHIC NARRATIVE IN THE CRYING GAME

The Crying Game's central, tragic theme of warrior/lovers caught between their love for one another and loyalty to their respective factions has significant roots in early Celtic mythology. The elegaic theme of potential lovers forced into ill-fated combat that frames the film's events also, significantly, bears the weight of the film's most unambiguous political commentary, when Fergus speaks directly to the picture of Jody in Dil's apartment, telling him: ‘You should have stayed at home.’ This sad remonstration, which clearly lays responsibility for the chain of causality that has led to so much suffering not with Jody, but with the British state, is similar in quality to Cu Chulainn's lament as he contemplates his meeting with Ferdia. When we listen carefully for ways in which Celtic mythical themes underlie and nuance the film's events, different rhythms emerge, accenting different beats.     

Falling into the existential abyss: Ivan Franko’s realist prose in experiments with Gothic and crime fiction modes

This article examines three novels by Ukrainian realist Ivan Franko (1856–1916): Dlia domashn'oho ohnyshcha (For the Home Hearth, 1892), Osnovy suspil'nosti (Pillars of Society, 1894), and Perekhresni stezhky (Fateful Crossroads, 1900). Previous scholars saw elements of crime fiction in these works, but the actual relationship between the two genres of crime fiction and realism has not been fully developed. By studying the conventions of crime fiction, along with its antecedent, the Gothic, and their influence on Franko, the author shows the make-up of the early Ukrainian crime fiction genre and points to its importance in understanding Franko’s vacillation between realist and modernist tendencies. As she argues, the scales of his vacillation are tipped toward modernism in its decadent form, an existential void that characterized fin de siècle Europe. Hence, Franko’s “ideal” or programmatic realism (defined by Franko as a literary style with a didactic tendency aimed at educating society), which he introduced under the appealing cover of crime and Gothic motifs, ultimately failed him. The author proposes that it is the creative modes (Gothic and crime fiction) that Franko chose for voicing his ideas about social reforms that led him, unsuspectingly, away from his programmatic goal and toward the decadent aspects of modernism.     

Expectations and realisations: the employment story of a young man with cerebral palsy

Britain has laws and a range of policies which promote the employment of disabled people. The lack of progress to get disabled people into paid work has resulted in huge dissatisfaction for some. Evidence of disability and employment problems is often expressed as hard data, but what of the personal experiences of trying to find employment? This article is based on interviews with ‘Nick’, a young man with cerebral palsy who wanted to recount his preparation for work, including work experience, through school, the Connexions service and the local Employment Office. He explained how he felt his voluntary work and work experiences were not fully planned and ultimately unsatisfactory. Nick found paid employment, but soon discovered that there were too many problems for him to continue. He reflected on his experiences, including his own initial confidence, his despair at the ending of his paid employment and the realities of what employment means for him.     

BIASED INFORMATION AND EFFORT

We study the impact of information manipulation by a principal on the agent's effort. In a context of asymmetric information at the principal's advantage, we test experimentally the principal's willingness to bias (overestimate or underestimate) the information she/he gives to her/his agent on her/his ability in order to motivate her/him to exert more effort. We find that (1) principals do bias information, and (2) agents trust the cheap‐talk messages they receive and adjust their effort accordingly. Therefore, biased messages improve both the agent's performance and thus the principal's profit. This, however, does not increase efficiency. We also find that overestimation occurs much more often than underestimation. Making the signal costly in an additional treatment reduces this effect. (JEL D83, C92, M12)