A Hawaii mother has written the following letter, and sent it to Governor Abercrombie and Hawaii state legislators, regarding SB 1274.
My family and I are strongly opposed to Senate Bill 1274, which will unjustifiably and irreversibly damage health care consumer protection in Hawaii. Our external review law, H.R.S. § 432E-6, has served health care consumers well for over a decade. It gives health care consumers a more level playing field against powerful insurance companies. Consumers have access to experienced advocates to assist them with preparing and presenting their cases in a manner consistent with Hawaii’s medical necessity law. Decisions are made by a local expert panel, and consumers are able to present expert testimony and other evidence in a fair, but efficient, hearing process.
If this law passes, it will have a profound impact on my entire family. In addition to endangering my daughter, it could cost my family tens of thousands in unrecoverable attorney fees. When we exercised our right to appeal with the IC, we were not informed that the law could change in the process of appeals and that we could lose all of our rights retroactively. Basically the entire playing field changed with no warning. We--our daughter included--are being stripped of our current rights--this from insurance division and a Legislature that is supposed to be responsible for overseeing the safety of the Hawaii citizens they are sworn to protect. Furthermore, it appears that the retroactive application of the law, which was added by the Senate Committee on Ways and Means, punishes struggling families and benefits one, and only one, entity – rich and powerful UnitedHealthcare Insurance Company, known as “Evercare,” which would otherwise be required to pay those costs and expenses.
Please allow me to explain. We have a four-year old daughter who has a life-threatening seizure disorder known as Lennox Gastaut Syndrome. There are some days that she had had over 1,000 seizures per day. Despite these inhuman challenges, she struggles with all her might every day to learn to walk on her own and to communicate, and she is unfailingly appreciative of the help she receives. Our daughter has numerous physicians that provided her health care plan with prescriptions and letters of explanations for why she needs 24/7 skilled nursing care. It was reviewed by a physician on the health plans staff and denied. The part of this that is so concerning is the health care plans physician that provided the denial is not even a neurologist; nor has never seen our daughter as a patient; nor is this physician familiar with her care plan.
The health plans told us that, if our daughter needed 24/7 care, then the most “cost effective” place for her would be placement in an institutional setting. We feel strongly that such a move would be the most inhumane choice for
a four-year old child; it would amount to banning her to an institution away from her family forever, and depriving her once and for all of the hope of a meaningful and fulfilling life. We worry that such a move would send a horrible message to her brother—a message that family does not matter and that children can be thrown out like used Dixie cups.
Does institutionalizing a little girl who tries so hard to get better sound like something that constituents would support? The impossible part about this scenario is there is no facility in Hawaii to accomplish this “institutionalization.” Where did they want to send my medically fragile daughter? Were they thinking about taking our daughter from us and placing her on another island or, worse yet, sending her to another state? By doing this, they are putting Hannah in jail. If my daughter is placed in an institution, she won’t have her family or her right to a Free Appropriate Public Education. They will put her in a crib bed that is caged and not allow her to live her life. In essence, they would be putting her in a jail because of her disabilities. We treat our criminals better. What crime has my four year-old child committed that she deserves this fate?
I invite you to visit my child. While she has severe disabilities, she is a lovely and loving child. She works hard every day to master new skills. She is learning against great odds, and her quality of life is very high. So is the joy that she gives to us, her caretakers, and our friends.
We exercised our right to appeal what we think is a medically and morally bad decision, and so far, our daughter has the care she needs to remain with her family, school, and community. If you allow Senate Bill 1274 to take effect, it will be devastating to Hawaii families with disabled persons. I am begging you, please, don’t take away the only rights we have to help our disabled children and community. I ask you to look into your hearts—not just at budgets-- for the implications of these proposed bills. Please take the wise and humane course of action.
Very truly yours,
S.M.
Kilauea, HI 96754
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