A Logical Approach to Healthcare Reform and Models

The Kellogg Foundation (2002) presents a guide that aims to thoroughly assist in the building up of an organization’s need to improve and or expand on to help the consumer. Hence the model presented by Kellogg  includes: (a) Input (b) Activities, (c) Output, (d) Outcomes, and (e) Impact.


Inputs include the consumer (s) who in this instance are patients (for example) who utilize the services provided by the organization. Since patients generally use a facility and or referred to a facility for this discussion let us say that the facility to look at is Kindred Healthcare.  Kindred Healthcare is the nation’s largest health provider, including, nursing, rehabilitation, assisted living, transitional care, home care, and hospice.

Additionally, included in inputs are providers (physicians and nurses), along with payers’ which is inclusive of insurance carriers and state funding, the staff (administrative) and any other technical assistance from external sources. Hence, with the exception of the consumer all other inputs have a hand in meeting the needs of the patient through their system.


The activities for providers is that these have an active participation in the reform process. First, one would need to understand that to reform something there was a problem. For example, the Affordable Reform Act ensures that all people in the US can receive adequate and professional healthcare, and along with that the staff includes community decision making (Kellogg, 2004).


Outputs for providers include more effective distribution of community care resources. For example, Kindred claims to help their patients recover fully in the best setting suitable for their specific care needs so supposedly they have state of the art facilities and equipment to meet the needs of their consumers, or rather patients. Conversely, the administrative process includes data, policy and advocacy, such as the Kindred Code of Conduct which stress that the company acts with integrity.


For outcomes and providers, that is Kindred Health Care should present a comprehensive healthcare delivery system, and the staff the outcomes are community assessment.


If the providers do all they say this should lead to improved health status for their patients, and for staff an increased healthcare system efficiency.

However, Rowan (2000) explained, “A variety of logic models can be used to describe the plans for implementation and expected outcomes of reform (Rowan, 2000). Consequently, concerning the Kellogg Model the outcome and implementation for that would work well if healthcare companies, their providers, their staff, and any external help they require have strict ethical policies in place. Hence, my analysis here is that though this logic model is sound; and, for the most part, healthcare companies might adhere to it—Kindred hospital has not and has breached all aspects of this model.

According to Kellogg (2004), “Outcome approach logic models display the interrelationships between specific program activities and their outcomes”.

I thought that I would mention Kindred Hospital here because from what I see of this model there is no adherence to it, that is,  if the model is used as a standard for healthcare companies (See: United States Army Disabled Veteran, Sergeant Kericia E. Smith Faces Third Heartbreaking Trauma of Her Life).

W.K. Kellogg Foundation Logic Model Development Guide

School Work: Advice Government Agencies -Welfare to Work and JIT

welfare-employment-street-signThe welfare to work program, food stamps and other programs have been criticized. Mainly because of stereotypical thinking of a group and partly (also) because of systematic racism. Hence, for the purpose of this discussion, or rather to keep in line with the prompt of choice  to say the scenario consists of my leading a government agency compromised of one thousand employees who in their job description assists below poverty level families with no father in the home, single parent homes to see how that program is measuring up. In essence, performance measurement of the welfare to work program, and food stamps back to work initiatives.


Ask evaluation questions. According to Harell et al (n.d) a good performance measurement system should begin with clear evaluative questions. Hence, each department should ask those, or ask (a) did the program have the intended impact? -or- (b) did the program have the intended consequences? These two questions along support positive and or negative results (Harrell et al n.d).

Performance Monitoring. An important question to ask here concerning those adults who participate in the program (s) would be is there a significant number increase in adults who are successful. For example, one of the programs that support participants going back to work is the JIT program, or rather Just In Time Training. Hence, is there a significant increase of adults who enter the program to learn a particular skill that leave the welfare system?

Or rather, look at the fact that state agencies and or programs are being asked to reduce their caseloads. Hence, is Just in Time Training [sufficient] in helping people get back to work

In the graph we see that from the years 1994 to 2010 Families with Children in poverty has increased to 7 million families, however, the estimate of 7 million now includes jobless families with children with AFDC/TANF families at five million over previous years. These indicators reflect that now not only are there generational TANF recipients but also an added measure of people applying for benefits because of loss of employment. Subsequently, the premise here of those who are on welfare is significantly changed. Just in Time Training should give people new skills to return to workforce, or enter the workforce. Also, there is indication that in 2010 the participants in the TANF program dropped significantly to 2 million from 5 million in 1994. Is this because of the welfare to work program or something else?
Recent changes to the federal Temporary Assistance for Needy Families (TANF) block grant place new pressures on states to reduce their welfare caseloads and increase the number of families participating in work activities or face financial penalties. At the same time, the new rules make it harder for states to design effective welfare-to-work programs, particularly for those recipients who face the greatest barriers to employment. This policy brief analyzes these challenges in the context of Texas’ welfare program and proposes a set of policy changes designed to help Texas meet the federal requirements while improving outcomes for welfare recipients (Center of public Policy Priorities, 2007).

Process Evaluation. These questions should ask how the program operates and documents procedures and activities. For example, are there workshops, mandatory participation even for those receiving unemployment benefits

And finally,

Cost Evaluation

How much does the program cost?

Related Articles

Evaluation Strategies for Human Services Programs| A Guide for Policymakers and Providers

 TANF Emerging from the Downturn a Weaker Safety Net


United States Army Disabled Veteran, Sergeant Kericia E. Smith Faces Third Heartbreaking Trauma of Her Life

img_1132Many people, born and raised in the United States from an early age adhere to and are taught to pledge our allegiance to the flag, and ultimately our allegiance to America –the red, white and blue, that is, the bloodshed, or the honor and purity of white and of an unstained message; and, a color that results in the blue as like streaming tears that come, however, despite that scripture tell us to love our neighbors.

Our neighbors as those who reside here with us under God. One Nation undivided, in liberty and justice for all. Hence, it is a must that we all consider to look at this message with the question of how does it happen that bad things are a reality in a country so great as this?

How, is it the case, that my country does not have my back, or that, those who live here do not have my best interest and the interest of my family; or the interests of my neighbor at heart? How–can one still love their neighbor, or more specifically, how can my neighbor love me after this, that is, the trauma of the American Dream; and, we ask how does this massacre of U.S. citizenry happen?

Embracing Me as Her Journalist

Sergeant Kericia E. Smith said, “I think you should tell them why you decided to write this story,” and after thinking about it, or rather, after her prompting I have agreed to tell you her story sprinkled with my voice (together we will speak) so that those still asleep abiding in the American Dream can wake up to the travesties of life happening while you are sleeping? I accepted this story without too many reservations, because firstly as Americans we forget that to give does not come in the form of money only, especially when someone faces hardship reaching deep into their heart and soul. I have a heart and to believers, the scriptures tell us “Do not worry…”. Scriptures also tell us that we are to ‘bear one another’s burdens’.

Secondly, I have been trained well to understand that as a journalist I am called to be the proverbial ‘watchdog’ of the government and not only the government but those who connect with it to utilize law, and along with this understanding I see that the more professional journalists (some seemingly) care more about their bosses than a common cause among the people; however, I have no boss except the Most Highest God of this universe. Hence, the excuse is taken away of what will I eat or what I will wear.

Also, in this stance I as a writer, a mother, wife, grandmother and citizen take the pledge to uplift my neighbor in whichever way I can in honesty and fair dealing and I know that this is the Way, and, I believe scripture is true that He will provide. As a reward, I have been trained to help Sergeant Kericia E. Smith through this circumstance. In any case, I am more grateful in this instance that the Most High chose me to serve her. As a result, Sergeant Smith has created a new phrase calling me her ‘freestyle journalist’. It’s catchy would you agree?

We need you to look at this, and notably, this story is for anyone facing the trauma of inadequate care of yourself or a loved one in a hospital and or health care environment, and this message is also helpful for workers who see such horrendous events take place.

The Call for Help

I received a voicemail from Sergeant Kericia E. Smith, founder and CEO of the Association of Veteran Women, Incorporated [AOVW, Inc.] who (in short) explained that she needed a storyteller. Telling me, she was having some troubles, or rather, that she is having a few heartbreaking moments she wanted me to take a look at.

So I do not need to tell you how excited I was and unprepared for even this one. Subsequently, I learned she is named after her best friend pronounced [Ker (ee) sha], and they also share a birth month.

Sergeant Smith is an advocate for all women, but mainly for those women who have risked their life serving their country in the Armed Forces. Ultimately, a voice that until now has gone unheard, and, she is a miracle because I believe she is a groundbreaker and a trend setter for many who have lost hope. Hence, she fits the profile of a fighter, and she does not look like what she has been through. Thus, as divine connections happen she and I have worked diligently and have crafted a story that is beneficial for the public to know. However, before I move on, it is important that you know that Kericia initially called several journalists’, major newspapers and magazines to tell her story, but decidedly they were uninterested because there was no response. Kericia says, that someone told her to search out freelance journalists and she found my website The Dailey Grind where my motto is ‘Reporting what the news won’t.’  She told me, that she prayed and left a message, and I am the only one to respond to help her.

Therefore, I tell you Kericia this is it—the time is now and that God has prepared you for such a time as this! In the words of Ms. Shirley Chisolm, Kericia has decided that she is “Unbought and Unbossed!”  Essentially, she says “My misery has become my ministry!” I agree.

My Best Friend Died

I am Sergeant Kericia E. Smith. I am a disabled veteran diagnosed with Post Traumatic Stress Disorder [PTSD], a trauma I acquired while on active duty. I was also my best friend’s primary caregiver, and is the reason why I want to tell you the story about my best friend who was admitted into Arlington Memorial Hospital for dehydration and a urinary tract infection, and who was later admitted to Kindred Rehabilitation Hospital for a bedsore. Moreover, in the process of admitting my best friend I was given admission papers to sign, but now in retrospect suspect there may have been a  Mandatory Binding Arbitration Clause. Nevertheless, I was never given a copy of any document I signed. However, in that case, what I do know is that my best friend was un-necessarily medicated to the point of a medically induced coma. As a result, they did not feed him, but without authorization inserted a feeding tube, gave him steroids and two blood thinners; along with, another drug that also causes bleeding.

In short, on May 16, 2016 at about 10:30 a.m., I walked into my best friend’s room and found him


Custom Casket Spray

bleeding out severely, and all day long I begged the doctors and medical staff at Kindred Rehabilitation Hospital to transfer him to Arlington Memorial Hospital Emergency Room which is right across the street—they refused. Consequently, around 8:30 p.m., my best friend who was my father was unresponsive and to my dismay there was no defibrillator available for them to attempt life-saving measures. Hence, my beloved father, a Medicare/Medicaid patient bleed-out and died.

To date, I have not been able to obtain my father’s death certificate because Kindred Rehabilitation Hospital has not filed or recorded it with the City of Arlington, or, Texas Department of Vital Statistics. I would also like to mention that Kloe my service dog has done an outstanding job and has been a tremendous help throughout this ordeal—she saved me.

Please note, that if I had given my father two blood thinners and allowed him to bleed to death I would be in jail.  Needless to say, I am re-traumatized all over again, because (as mentioned) I was my father’s primary caregiver.  I witnessed my father’s death and it was nothing I could do to help him. Consequently, it is a sad day in America that I served my country since I was 18 years old, and yet, my father had no medical staff including doctors to care enough to let me save my father’s life by answering my pleas to transfer him to the emergency room across the street. I ask how can they continue to receive federal and state funds? These doctors and medical staff took an oath to save lives so how could they just stand by and let my precious beloved father die for no good reason?  

This is not an attack on all medical professionals or providers, and, it is in my personal opinion that there are excellent hospitals, doctors, nurses and other medical staff who give quality care to all their patients. However, at Kindred Rehabilitation Hospital my father did not receive the quality lifesaving treatment that he deserved. [Sergeant Kericia E. Smith, United States Army, and Army Reserve; Disabled Veteran; Face to Face Interview, Thursday, September 15, 2016; 4:30 p.m.].

This is a heartbreaking and touching story. Conversely, as I was writing and recounting her pain it is easy to visualize this scene taking place in the hospital, because for those of us who have lost a parent or both parents we understand grief– but not this way. Moreover, perhaps there is someone who can attest to this type trauma, or, those people who have experienced the trauma firsthand and know the full picture. Hence, here I will recount to highlight some of the facts Sergeant Smith mentioned so that we all will understand better the plight Sergeant Smith and her dad suffered at the hand of medical professionals who take an oath to save the lives of the people they treat.

A Brief Background Check of Kindred Rehabilitation Hospitals

Renamed Kindred Healthcare in 2001–Vencor (1998), was one of the nation’s most prominent healthcare companies, however, the company has a shady and elusive past and is due for a background check if you are considering this source for your loved ones.

Here is a breakdown of events:

Frederick D. Smith (October 11, 1937 - May 16, 2016)

Frederick D. Smith (October 11, 1937 – May 16, 2016)

   A Last Word from Sergeant Kericia E. Smith

Vencor/Kindred’s long history of wrongdoing seems to always survive and thrive due to Medicare fraud which only adds insult to injury with the loss of my father.  If these Medicare fraud cases were known to the public then our loved ones would be less likely to be put at risk.  Kindred seems to look at ‘profits over patients,’ and our lives are worthless because Kindred medical staff is reckless with our medical care. Additionally, any other business as unethical and abusive would have gone out of business decades ago, yet, Kindred continues to thrive on recklessly committing Medicare fraud. 

Why has the Department of Justice not been more aggressive at informing the public about Kindred’s record of bad behavior? It is the case, that Kindred decayed decades ago from the inside out, and this should send a stench up our noses because the carcasses of our loved ones are not collateral damage and the loss of life should cry out for justice. Nevertheless, we are told ‘If you see something to say something!’ Consequently, I did see something, and I said something, but they did absolutely nothing! It is absolutely appalling! Kindred Rehabilitation Hospital had NO Defibrillator!

I am Sergeant Kericia E. Smith and I approve this message—over and out!
[Sergeant Kericia E. Smith, Electronic Communication, September 21, 2016; 5:31p.m.].

Related Articles and Additional Resources

Also see:

For more information on Association Of Veteran Women, Incorporated call:

Sergeant Kericia E. Smith, (817)461-5116. Or send an email to: aovwinc@aol.com


kayla-dailey__picKayla Dailey, is a prolific writer whose aspirations include hope of encouraging those who face trials and difficulties in life through the written word. As a student of the word she writes, Kayla has earned a Bachelor of Arts Degree in Journalism and Mass Communication from Ashford University, and holds, a Master of Arts Degree in Organizational Management with specialty in Public Administration. Mrs. Dailey is an advocate for civic and community building issues, African American liberties, equal employment, and now veterans and their families; as well as, advocacy against domestic violence for women, children, abortion and other issues people face.  

© Copyright 2016. The Dailey Grind. All Rights Reserved.

Your Sunday Bread: Keeper of the Flock? Or Feeding on the Sheep?

14088660_1264868840192410_5560811262134131050_nOh, I get it why people are offended. I get it that we do not understand the true definition of what it means to be a keeper of the flock, because if we did we would understand that a keeper of the flock does more than stand around, but actually does see the sheep they watch over. In other words, a guide and a teacher. For example, Bereshith [Genesis 4v.2] depicts Abel as being a keeper of the sheep, that is, one who cared for his flock and one who looked fondly at his flock.
So out of that the people we get are Shepard and or shepherdess, pastors, herdsmen, companions and those who entreat. When someone entreats it means that we are earnestly begging those within hearing range (for example) to retreat and turn back from a danger point.
If that makes sense, then see that the place or danger point in under disguise of the sheep keeper, can devour and eat those who they are supposed to be keeping. It is a strange thought that Strongs H7462 brings out that our beloved pastors could actually to be your friend, and someone called to keep the sheep.
Further, the word springs forth that is more specific for these positions as scripture points prophetically and tells us “Woe unto the shepherds that destroy and scatter the sheep of my pasture! saith Yahuah” (Yirmeyahu [Jeremiah] 23:1).
So then we understand why people are speaking out against this blatant attack on the flock and ask people opposed to sound reasoning of scripture to prove what you say with not quotes, but through actual teaching what that scripture means if you can. This is not an occasion of offense when someone explains a scripture more in depth research than we have had ears to hear, or rather explained to us. Consequently, people are more attracted to titles than in set apart teachings. Pastors go to seminary schools and are trained on hand movements, body language and all those displays of outer appearance to engage their audience. and in class are taught languages such as Hebrew.
In that one should ask why are they learning Hebrew for their flock only to follow an English text, and this begs the question of how if your pastor has studied Hebrew does he not know that Yahuah, not god has a name. This is why people are offended when someone other than those title pushers disturbs the nest. The broad gate is the church and those who follow it are headed for destruction. Take heed.

Job Seekers: Beware of Supicious Solicitation

download.pngDear Job Seekers,
There should be a word of caution when applying for jobs, as well as, responses to emails to alert seekers of potential positions.
Here is one I received in my messages telling me about such a position:
Merry-Digital LLC.
linda.t <linda.t@merrydigital.com>
Hello Kayla Dailey.
MerryDigital is looking for new team members for our Customer Service
Department. We are proud of our specialists from Customer Support and
and due to further expansion to the USA we feel great need in more
personnel and introduce home-based position. If you are
highly-motivated, responsible and self-exacting, you have opportunity
to become our employee and get your stable income! To proceed with
employment, fill out Application Form, attached to this e-mail and
send it back to us. Once we get Application Form from you, you will be
contacted for further interview and employment process by our HR
specialists. Note: Please be careful when fill out the application
form in order to avoid possible mistakes. All information must be
correct and up-to-date. Please, fill full Application Form and sign in
handwriting (put your full name and date on the Application Form and
signature in the end using blue pen). All information will be checked
by our security team. The Customer Service Agent position includes
free distant training. Every day you will receive all the necessary
instructions and information from your official Supervisor. If any
questions arise, do not hesitate to contact us ASAP. If interested,
reply to this message within next 48 hours and we will proceed with
Best regards,
Senior Manager
First, any professional would understand the need for format when writing their emails, and or other documents of importance. Then it is fair to say that is done by an unprofessional and mostly likely in a hurried and rushed manner, and probably through copy and paste without understanding that sometimes the paste will yield other than the original format and will need to be adjusted. Consequently, that did not happen here not even a name to reply to later, however, the name Linda as a supervisor can be found on the application.
Secondly, when a call came in response to my reply to the original email sent by James I asked if there is a website so that I can research their company. I was given this: www.merrydigital.com. I accessed that site and found vague information on one page with no links to click elsewhere. For example, links providing one with other detail of the business. Hence, there was little to decide if I wanted to send them the application. Consequently, the application is suspicious.
In addition, during my research of the company I did see that the site was created in April 2016, but again–no other information to go by.
See Also: Merrydigital Status Report

“Trans Woman student Abused and Shoved out of toilets at Leeds University”



So the headline reads.

These sorts of stories always catch my eye, because in my years of reporting on gender trends I have learned that the facts behind the story are often more complex than the headline would imply. The first thing I assume in reading a headline like this, is that whatever bathroom incident occurred, it did NOT occur in a mensroom. I make this assumption because I’ve never seen a “bathroom incident” reported where a male transgender was “abused” or ejected from a men’s bathroom.

One would think with the transgender movement’s primary, number one issue being male access to women’s lavatories and locker rooms (and other public spaces segregated by sex for female protection against male predation) that the evidence of NEED to access such spaces- for example evidence of attacks on those males who wear female clothes into men’s lavatories- would be widespread. Or at least…

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