Monday, May 11, 2015

getting services started

Russell came to our home on Monday, April 6.

I took Russell to the doctor on Wednesday, April 8. The doctor did an exam and sent a referral, that day, to a local therapy company. Russell, due to his special needs, qualifies for physical therapy, occupational therapy, and speech therapy. I explained to the doctor that Russell had been receiving these services while in the shelter in Central Texas.

The rehab company the doctor referred Russell to called me on Thursday, April 9. It wasn't the company I had asked the doctor to use. I decided to not rock the boat though. I explained to the company that I had to have in-home health services for Russell's PT, OT, and ST. (I will not go to the office for the quantity of services that Russell needs. I think it's incredibly important that I be an integral part of all of his therapies! Besides, I would go positively mad sitting in a waiting room that many hours every week!!) They said they would have to contact the doctor to get a new referral but that they'd handle it. I'm pretty sure I told the therapy company that Russell had been receiving these services while in the shelter and I just needed things transferred. Maybe I forgot that though.

On Thursday, April 16, the doctor's office called me and said that Medicaid required a specific kind of exam done on Russell in order to get services approved. Now, I'm quite confident that I told the person on the phone that Russell had already been receiving services. That didn't seem to matter. I was told that a specific developmental screening needed to be done.

Russell went back to the doctor on Friday, April 17, to get this special developmental screening taken care of. When I had to fill out the form for a typical developing 20 month old, I had to mark ZERO for absolutely every single skill. Obviously Russell qualifies for all three disciplines. Now it was officially official. I was told the doctor would be sending the paperwork off for Medicaid to approve.

Sometime the week of April 20, I called Medicaid myself. I was looking to see if Russell was going to have a specific Medicaid case manager. (Every special needs child I've ever had has had a case manager.) The person I got on the phone told me that Russell would and that they'd be calling me soon. (I've never had this much time pass between placement and the assignment of a case manager when it comes to my special needs kids.) The Medicaid lady told me that Russell hadn't been approved for therapies yet. I honestly don't remember what was the specific hold up but she seemed to think that things looked like they were in order and he'd be approved soon.

The rehab company called me on Monday, May 4 to tell me that the doctor's office had neglected to send the paperwork Medicaid was requiring. They told me they had contacted the doctor to get it taken care of.

The rehab company called me today, May 11, to tell me that now Medicaid was holding things up because Russell had already been approved for therapies and that his case was open. However, Medicaid needed to know that it was OK to transfer Russell's therapies from the company in Central Texas (from when he was in the shelter) to this new, local company. The rehab company told me I should call Medicaid myself to tell them to make the transfer. Just in case, they faxed me a form to fill out indicating a transfer of services should be in order.

I called Medicaid. They told me that yes, indeed, Russell did have a case manager. They transferred me to said person. I got the case manager's voice mail.

Finally, Krista called me back.

< sigh >

Krista informed me that Russell's therapies could have been started down here almost immediately. He had already qualified. All Medicaid needed all along was a transfer of services form filled out.

< sigh >

However, *I* couldn't fax this form to Medicaid myself. No no no no. I had to fill out the form, fax it to the rehab company, and they had to fax it to Medicaid on Russell's behalf.

Supposedly services should be able to start for Russell even yet this week.

3 comments:

eileen said...

Fostercare is nothing but a huge ball of red tape. Its so frustrating! Yea that you are making headway, though.

girlfrog2003 said...

To be fair... in this case it's not foster care. It's Medicaid. Us bio parents of special needs kids have been through the same things. And in the meantime, Russell has missed a month of therapies needlessly. Could have been avoided if one of the people involved doctor, rehab coordinator, etc. knew how to navigate the system better.
Hope they get him scheduled ASAP.

Anonymous said...

And, Dear Heavens, if Russell did not have you, or was in a non-English speaking foster home with a ... less experienced family ... would services EVER have happened??? I bet not.
Thank you on Russell's behalf!