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Screwed

Posted Jun 24 2010 12:00am
I got the call this morning from our service coordinator, the one I've been waiting for regarding the speech eval Finn underwent last week. I was informed that, yes, Finn now qualifies for speech therapy, but Regional Center has now decided to "enforce the law that went into effect last year" which, boiled down, means that we now have to go through our medical insurance to get services for Finn. Regional Center will continue to pay for Emily, Finn's OT, until her contract is up which is in two months I believe. All new contracts and new services, apparently, have to be submitted to private insurance first, and Regional Center will only cover services that are not covered by insurance.

What does this mean for us and for Finn? It means that we have to obtain referrals to therapists from our pediatrician, and we have to obtain authorization from our insurance carrier. We have an HMO, so we can only use providers in our network, and neither Emily nor Rebecca, the SLP who did Finn's speech eval and whom we were crossing our fingers to get as his speech therapist, are in our network. So it means no more Emily in a couple months, and no Rebecca. It also likely means that even if our insurance will cover therapy, it will only be a limited number of sessions per year (which may be fewer than he would have otherwise received). Regional Center would then cover any therapy beyond what our insurance will cover, but it would mean switching therapists yet again at some point in the future. Going through our insurance also means that it is highly unlikely that we will be able to get in-home therapy, and I will be required to drive across town to obtain therapy for Finn. Which I am not able or willing to do due to all the other commitments I have with my other kids. Oh, and it also means paying $20 co-pays for every therapy session.

Our SC did inform me that Regional Center is still willing to pay for Finn's therapy provided we give up in-home therapy and switch to center-based group therapy. She said there are two locations they contract with - the one she most highly recommends is about a 30-minute drive in clear traffic. Can't/won't make a commute like that. The other center is apparently local to me. I guess I will have to check it out before I reject it outright, but I have to say that center-based therapy is not what I want for Finn, for various reasons.

I knew this whole insurance thing was a possibility, and yet, it still took me by surprise. I started crying on the phone to our SC, to my chagrin, and then ranting at her. I told her that I feel that Finn has already been screwed because he was, by law, supposed to be automatically eligible for services from birth just based on his diagnosis of Down syndrome, and yet we've had to fight to even get him a speech evaluation, and here he is, about to turn two years old. I asked her, "What about the fact that he's entitled to services in the most natural environment? That's our HOME! Not some center 20 miles away." I really went off on her. And then I apologized, telling her, "Look, I know you're just the messenger, I know you're just doing your job. But you have to try to understand where I'm coming from. My kid is being screwed. And some day, when he's all grown up, society is going to look at him and say, 'Look at the retard who can't take care of himself!' And all because he's not being taken care of NOW the way he should be."

Ugh.

I don't even know if I believe that. I still find myself completely torn down the middle about services, about the value and the toll of therapy. I guess what upsets me so much is just the feeling that Finn and kids like him are so fucking dispensable. They're not valued members of society, they're not viewed as human beings with the potential to grow and contribute. They seem to just be very easily discarded. I feel a very palpable sense of marginalization right now, and I'm outraged.

And this whole thing, I swear to God, just makes me want to take Finn and the rest of my kids and go live off the grid. You know, some farm or commune or something, where it doesn't matter what Finn can achieve. Where he can just be.

I don't know what's going to happen now with therapy. I was too upset to give Amber an on-the-spot answer about switching to center-based group therapy. I guess she's going to go ahead and submit whatever necessary paperwork to our pediatrician to get the ball rolling on the insurance front.

Meanwhile, Finn is oblivious to all this bureaucratic bullshit. Either that, or he's decided to find solace in a bottle of vodka.




Okay, the bottle's empty, but I thought finding him with this was fitting.

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