Apparently my message never made it to the quad list. Is that because I had included an attachment? Anyway, here is my post without the attachment. If anybody wants a PDF file containing Morse code (as described below) please e-mail me directly.
Thanks, and take care, Dave Krehbiel -----Original Message----- From: Dave Krehbiel [mailto:[email protected]] Sent: Tuesday, October 02, 2012 9:35 AM To: 'Trish Conway' Cc: '<[email protected]>' Subject: RE: [QUAD-L] Getting Medicare/Medi-Cal Benefits Thank you for looking out for your friend. I am sorry, I can't offer any good advice about your transportation situation. But maybe I can offer some advice about communications. I am personally a C4/C5 quad, and initially in the hospital I was similarly unable to communicate. As a child, I was a Boy Scout, and knew a little bit of Morse code. I tried to blink a message to family members standing nearby, but none of them knew Morse code. And I did matter member all of Morse code myself. I kept hoping that somebody would get a simple cheat sheet so that I could read the codes and blink and they would understand it, letter by letter. Unfortunately, nobody got the message. Today, I've had my trach removed, and I'm happy that I'm able to communicate more normally. You might consider printing out a one-page piece of paper containing Morse code. This might help your friend communicate. For example, if he is having trouble breathing, he could blink SOS (three short dots, read longer dashes, three short dots). I have attached a file containing Morse code in PDF format. Good luck. Dave Krehbiel -----Original Message----- From: Trish Conway [mailto:[email protected]] Sent: Tuesday, October 02, 2012 1:55 AM To: [email protected] Subject: [QUAD-L] Getting Medicare/Medi-Cal Benefits My friend, a resident of a subacute facility, is a spastic quad with a trach. He cannot speak. He has no means to signal if he is undergoing respiratory distress. Finally, he has gotten appointments for occupational and speech therapy at a rehab center which is in the top 20 nationally. So we have hope. The problem is his facility is 45 miles away from the rehab center and his facilitys social services director is saying neither Medi-Cal nor Medicare will pay for transportation. We could take public transportation for the disabled but. . . --- He could require suctioning enroute. While his mother could administer shallow suctioning (with a Yankauer), the set up of the public disabled transport isnt conducive to this since 1) the wheelchair is positioned next to the driver where she would have no access to her son. And 2) we may be accompanied by other riders. --- He has no good anterior head support if he must be seated vertically, in his wheelchair --- The trip one-way can take 2 ½ hours instead of the 1 hour it would take by a non-emergency ambulance. Since he has a G-tube, that 5 hour round trip and 2 hours of appointments means he has no food or water or meds at least 7 hours. Are any of you familiar with Medi-Cal or Medicare regulations? --- Medicare - As I understand it, all Medicare non-emergency medical transportation (NEMT) requires that there be a medical necessity. Isnt it a medical necessity that my friend be able to signal he needs help if his trach becomes plugged? --- Medi-Cal I think has the same requirement. They will pay for NEMT if there is a medical necessity so I would apply my Medicare argument here too. But also I read that there was a legal case (Valdivia v. Coye) which required Medi-Cal to expand eligibility to include therapy services when theyre deemed necessary for a nursing facility resident to attain or maintain the highest practicable physical, mental or psychosocial functioning. For my friend, OT & ST could do so much to help him toward this goal. Since he has basically been treated as a custodial case so far, does the fact that the rehab center recognizes his potential mean that Medi Cal should provide him means to get to those appointments? Do you know of any precedent for such a case or maybe you have an example of a successful Medi-Cal Task Authorization Request that I could show his facilitys Social Services Director. Do you have know of a medical transport company in the Metro Los Angeles area that might take on such a case pro bono or at a significant discount? Thank you for your help. Trish P.S. If not, perhaps you know of a forum where folks might have answers for us? Thanks!
