Dave,
That's AMAZING that you got your trachea removed today! I would celebrate.
Bobbie
Sent from my iPad
On Oct 2, 2012, at 10:46 AM, "Dave Krehbiel" <[email protected]> wrote:
> 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 facility’s 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 isn’t 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. Isn’t 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
> they’re 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
> facility’s 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!
>
