Trisha- Call Rancho Los Amigos in Downey and ask for Jesus Garcia's contact 
information. I was injured in CA and spent 3 weeks at Rancho. Jesus is a peer 
mentor there and also does classes  on resources in CA for people in chairs and 
has information and contacts you may be able to use. He's also one of the 
sweetest, most encouraging wheelers I've ever met.

Dave- I know someone is in the hospital with a trach right now that this might 
work for. I would like the PDF if you don't mind. Great idea, there! 

My family went through the alphabet one letter at a time, and I would blink 
when they got to the letter I needed. They then wrote the letter down until we 
got to what I wanted to say. I had the patience for it, but they didn't. We 
would get two words into a sentence and my parents wanted to guess the rest of 
it, or they would speed up when they got to the letter I needed and think I 
blinked at the one on either side. That's where my new gray hairs came from, 
not the injury! LOL

Lord, that was so miserable, not being able to talk the 2 months I was in the 
trauma center. I'm sure we all have stories. I have a bad and a good story. The 
bad was when two oblivious techs came in for a chest X-ray and ended up pulling 
my NG tube out, millimeter by slow millimeter, until it fell on the floor. I 
was very weak with pneumonia and couldn't get their attention by signaling. The 
good story was when the head respiratory therapist came in and blocked the 
trach with his finger so I could speak for the first time. Nurses, techs, and 
family stood around the bed for this moment, giving me ideas for what to say 
first. I looked up at my parents and said, "get me out of here!" I think that 
was the most laughter I ever heard in that room. ;)

All the best,
Mandy, c6-7

On Oct 2, 2012, at 8:46 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!
> 

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