Somebody Else's Problems

1. My pal A, a single mom and visiting nurse, has a kid who needs medical help. He's got psychiatric problems that the average doctor can't handle. A's got the full-time job and insurance for her little family, but she may have to quit the job. Why? Because her work insurance coverage can't cover her kid's needs and if she gets supplemental, the cost will eat up the rest of her income. Naturally the care he needs costs more than she makes. If she quits her job, she'll be able to put him on Medicaid--which will cover the costs--and maybe take care of him at home. Of course she won't be able to get insurance for herself and she'll have to live on food stamps, but at least she won't have to worry as much about her kid.

UPDATE: Amy outted herself in my comments section. IF ANYONE has ANY ANSWERS....SPILL. Secret formulae? Special hotline numbers? Tell Amy.

2. After years of making a long commute to a group practice, my friend L the psychologist recently set up her own office. Many of her patients are insured by the state--they're foster kids and newly adopted former foster kids. Because she had to get a new license number, she can't keep seeing these old patients. Why?

The state isn't taking on new providers.

Never mind that she isn't really a new provider--she was seeing these people already. Forget the fact that because she cares about these kids and families she's willing to put up with the unpaid hours of filling out mind-numbing state paperwork and traveling to the kids' schools and then providing therapy sessions that pay her $20 an hour. Nope. The state only sees that new number and says forget it, never going to happen. And the kids she sees? No provider willing to take state pay has time for new patients. The kids are out of luck too.

Dozens of phone calls later and still no answers for either woman. What the hell are they supposed to do? Maybe they could call FEMA or the Red Cross, models of efficiency. Bugger bureaucrats and red tape that protects no one.

I listen to L talk about the acronyms she's called, the agencies she's contacted and I'm ready to stomp on the automated phone machines and every useless cog of the system. Stomp, stomp, stomp. Screw the people who can't or won't help because they have to follow the rules. Screw the rules that slowly kill people. Fuck the states that mess up kids' health just to save a few bucks. Fuck 'em all. Up against the wall with the acronyms.

Grrrr.

Comments

  1. If she quits her job, she'll be able to put him on Medicaid--which will cover the costs--and maybe take care of him at home.

    Interesting. My son gets SSI because he's autistic, so he also has medical coverage. I was told that when our income reached $3000/month, his SSI would be cut off but he'd STILL get medical. Wonder why she can't get him on the medical stuff without the SSI?

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  2. you are your mother's daughter katie.
    (That's a good thing)

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  3. Wonder why she can't get him on the medical stuff without the SSI?

    Because pparently I'm rich, domynoe. Last time I applied, at the start of this year, they told me that since I made $350/month more than the limit--and I don't make anything near $3K monthly--my son can't get SSI. That happens to be just a bit over what I get per month in child support for my 2 kids, so she suggested I tell the ex to stop paying that--yeah, he'll go to jail, but hey, my son will get a $107/month SSI check. Good trade? I'm thinking not.

    Because my ex covers him on his insurance (required by the AG's office) they won't cover him on Medicaid or Medicare. Same story with MHMR--he has insurance, so they won't help us with treatment, respite care, medications, or anything else. Should the ex decide to drop my kids off his insurance, the Attorney General's office would eat him for lunch. He's not going for this option, and I can't blame him.

    Now, the only way I could keep my job and qualify is if the ex would relinquish his parental rights, drop him off his insurance. He won't do that (but next week I'm going to ask him to, just so I can hear him say no again).

    So. If I quit my job or reduce my income enough to qualify, THEN I can get some state help--but not with MHMR, because the ex STILL carries them because he HAS to. And incidentally, with this plan I'll lose MY health coverage, my life insurance, my retirement plan, and every other benefit of my job, but my son will get what he needs. Even if the ex DOES relinquish his rights, I still might not get the kids on Medicaid, because they have a really fucked up view of how much certain cars are worth and they might deny me because I don't drive a beat-to-shit losermobile. I've been denied in the past because they said my 7 year old Chevy Blazer with 120K miles on it was worth $10,000. I told them, show me the idiot who'll pay that much and I'll sell it in a heartbeat.

    The rules of Texas, oh how they suck.

    The disability people told me 3 seperate times that my autistic and brain-damaged son was not disabled. The 4th time, they said he was disabled, but I made too much money, so sorry, go away.

    Yeah, Kate. Fuck 'em all. I gave notice at work today and will be banging my head against this particular wall next week. I've got 20 more days to get it worked out before B's insurance runs out. I'm open to any suggestions.

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  4. eb--sweet of you to say so, but my mother would have DONE something. She would have flown down to Texas to do it, too.

    Amy--I'm sorry. It's screwed up. Anyone we can write to? Rant at?

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  5. I dunno, Kate. But if there's ever a point where a shitload of letters would make a difference, you can bet I'll put out the call.

    To end the day on a positive note--I got a piece of pie to go after dinner tonight (I am SO not in the mood to cook so I ate out) and when I walked to my car, I dropped the to-go box. It didn't pop open! I'm eating it now and thinking, homemade cherry pie makes everything better. (At least for a while.)

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  6. Maybe if they claimed to be religious, they could get faith-based initiative money.
    --Rob

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  7. Do you know of any faith-based organizations, Rob? I'll be whatever they want me to be. No one has to know I'm a godless heathen. (Oops. Shouldn't have said that.) Seriously, though, if you have any ideas about an organization to contact, I'm on it in a heartbeat.

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  8. Amy - How strongly do you feel about not leaving Texas (although I guess you'd still have to quit the job).

    Would changing schools help?

    My (half)sister (in PA) gets everything through school. By law she can stay in high school until she's 21 and they basically do everything for her (they reccomend specialists, she's had verious aides for different things throughout the years, etc). Granted, her parents don't listen, but that's another story all together.

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  9. Amy, is your son autistic? My late friend Marcia had an autistic son. She went through one frustration after another with trying to get him help as well.

    Maybe try networking with autism non-profits to get ideas of what resources are out there. Even if the autism is only part of his problem, it's worth a try. Drop them an email. They might be able to direct you through the ucky mess of frustrating red tape entangling you know, or know some shortcuts or have some resources or ideas.

    I looked up some non-profits for you. Here are the links. I hope this helps. Good luck. Maybe something you also might want to consider (you didn't hear this from me, lol) is working under the table as a visiting nurse to elderly people who just want someone to talk to.

    Dallas/Fort Worth Center for Autism

    http://www.dfwcenterforautism.com/


    National Alliance for Autism Research

    http://www.naar.org/

    Autism Speaks *this web site might prove more handy as it seems more personal, started by grandparents of an autistic child

    http://www.autismspeaks.org/founders.php

    Lots of links on autism, scroll down to the website links

    http://www.tourette-syndrome.com/autism.htm

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  10. Thank you, thank you for all the ideas. I'm writing them down, and will definitely be contacting the autism societies to see if I can lay hands on an advocate. Heaven knows I need help figuring this crap out.

    Emma, I'd rather stay closer to my family than move farther away, but I do have some family in Oklahoma. I'm not very close with them, just because of the distance, but maybe it's time to rectify that. Still, my living situation here is very low-cost, so I'd be very hesitant to move to a place that would cost me more money--although if that's what it takes, that's what'll happen.

    Hell, I've always wanted to live in Alaska. Wonder what their Medicaid program is like.

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  11. Georgia has one hell of an autism program in the schools. We were in Cali where my son was in a mixed disabilities class and not doing well at all. Half the time the staff couldn't manage him. And there were so many issues he had in school that he didn't have at home that I just knew is was the school. Out here he's in a moderate autism only class, they have a higher number of teachers (3 adults, 5-6 kids - which is what it's supposed to be, but Cali had 3 adults and 9-10 kids with a mix of disabilities), and he's just doing fantastic! In Cali, I don't know what the cut off was for income, out here is the $3k and he still gets SSI coverage. We've had other issues because of the move we made, and we do miss family and friends, but the improvements for my son have made it all worth it. If you ever decide moving is feasible, you may want to consider Georgia - particularly into Gwinnett county or the Atlanta area.

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  12. AMy all i can do is say good luck. I'm in Texas (and my brother is mentally retarded) so I know how crapped up the system can be. I wish I had some ideas or advice for you =(

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  13. Monica's comment above reminded me that texas does have an income based insurance program--a friend of mine qualified with three kids and she was married. http://www.texcarepartnership.com/

    I have no idea waht the qualifications are but good luck again doll!

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