Thursday, May 6, 2010

Hawaii Medicaid: Denials of Access to Services?

Denial of access to medical services through Medicaid can take many forms.

Cutting out transportation to medical appointments can be a denial of services for an elderly or disabled person with no other way to get to their appointments.  If those appointments are for, say, dialysis, what is the eventual fate of an individual denied access to life-giving dialysis treatments?

Refusing to authorize prescription medications can be a denial of services, especially when those medications are necessary to continue life.  My daughter has had her prescriptions denied twice by Evercare (owned by UnitedHealth), and each time the company played doctor and demanded she first try another medication of their choice. 

The question I'm raising is if failing to provide a ten year old child with medically necessary catheters is a denial of access to services as well.

My little girl had a trip to the Emergency Room last week during to severe urine retention problems.  She was cath'ed and the pediatrician the next day ordered her to be cathed if she holds her urine more than twelve hours.

That was last Friday afternoon.  I immediately alerted Hannah's case coordinator at Evercare of this issue, and that we needed supplies.

There are no spare urinary catheters on Kauai.  And as of right now (Thursday at 11 a.m.) we still don't have any catheters for Hannah.

If Hawaii Medicaid cannot be concerned with getting catheters to a disabled child, no wonder there is no concern about other potentially life-threatening actions taken under its authority.

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About Me

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I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.