Friday, July 24, 2009

Part II: Duplication of Benefits: Medicaid to the Rescue

Part II: Duplication of Benefits: Medicaid to the Rescue

The Application and Appeal for Disability Benefits

I remember how difficult it was for me to obtain benefits when I first applied several years ago. I am deeply concerned about how the most recent decision to eradicate yet another class of TennCare / Medicaid recipients (the Daniels class made up of SSI recipients by way of a pending federal waiver) will affect the poor and disabled residents in Tennessee. Without my current level of benefits, I simply do not function.

Before my benefits were stabilized, learning to navigate the system consumed every waking moment of my life. I was unable to work or attend school on any substantial level and I am frightened to see at might happen if I were to stray from my established, stabilized, treatment plan. If I lose my benefits, will I still be able to work? To function? To be productive?

Any new public program requires careful planning if it is to be effective. Recent discussions have not focused on the true impact these changes will have on the “street-level.”

Has anyone asked recipients how they feel the new program (safety- net) should be designed, implemented, or evaluated? How will this impact the community and other social service or welfare agencies??? I want access, quality, and outcomes. I want... I want... I want!!!

The massive number of people being disenrolled or limited in their access to medical care and other social services will no doubt create significant anxiety, confusion, and chaos for everyone involved in the social service and health care industries.

I remember when Mr. Brian Lapps was somewhere very high up on the corporate TennCare ladder in 1999 when they adjusted the prescription formulary over Memorial Day in 1999. I see Mr. Lapps quite frequently since he now works at the local gas station down the street from where I live.

To this day, he insists that cell phones and TennCare are somehow contraindicated. Perhaps he knows nothing of the population he claims to know just all-too-well... housing conditions that may or may not have electricity, broken families-some riddled with community violence and domestic disturbances. In the hood, your cell phone is your very best friend. 9-1-1.

These people plagued by domestic violence and community instability makes a cell phone the only logical option. How can you find a job with out a phone? How can you find a home with out a job? Yet even 6 years later, Mr. Lapps uses cellular phones as an example how the TennCare program is being abused by lazy, cheap, and unscrupulous second hand citizens who are just shiftless lazy bums waiting around for their next free hand-out.

Anyone who has EVER applied for or relied upon any kind of government subsidy to have their basic needs met, e.g., food, shelter, medical care, dental treatment, etc... Let me personally assure you that there has never been a single time where I felt I was “pulling one over” on the government. I am not just one of the poor saps who believed what they told me they in school, I bought it hook, line, and sinker for the mere price of $152,718.130 and not a shred of financial security to show for it.

Even after consolidating my student loans, the interest alone is $10 less than my monthly income from social security.

Tennessee is in the process of applying for yet ANOTHER federal waiver to eliminate the “Daniels” class of Medicaid recipients—the poorest and sickest of all. Social Security Recipients. Can you live on $623.00 / month? Can anyone?

So what happens now that the state of Tennessee will begin to cut off social security recipients from TennCare? I honestly do not think I can survive yet another re-certification process—God knows the first one almost killed me. After three years of appeals, my condition had deteriorated so severely that I was forced to drop out of school, lost my home, lost my sanity, and lost hope. In short—I lost my dignity and my belief in the social welfare system.

By the time my benefits were approved, I had already checked myself in to NYU Psych Ward because simply could not cope with the reality of what my life I had become. I weighed 94 pounds and suffered in excruciating pain that has only gotten worse with time. My extremities were ice cold, and my hands were numb since I went without medical treatment for the spinal injury that was first discovered when I was 22.

I am now 36 years old. My spinal cord is now damaged from years of delayed, sub-standard medical treatment. I owe the federal government $152,000 in student loans and when I am able to work, I make $10.46 / hour as a substitute teacher in an urban school district. That job comes with no security and no benefits. It does however offer the flexibility I need to receive the bi-monthly epidural injections and other procedures necessary to manage my pain and alleviate the numbness I feel because of the damage to my nerves. And even though I cannot afford the gas money to get my appointments, pay for all of my medication, or even to get back and forth to work, it does allow me a few weeks of mobility so I can drive, use my mouse or hold a pen.

I have an advanced master’s degree from an Ivy League Institution. I am eight credits shy of completing PhD in public policy. And despite maintaining a 3.83 grade point average while completing an advanced masters in social and educational policy at an, “Ivy League” institution; a 3.2 GPA during the 3 years I spent working on my doctorate at a not-quite-so-prestigious Graduate School; The Powers That Beat in that damn Ivory Tower don’t will not grant me any leniency by extending the amount or time permitted to complete my degree—a rule that was changed while I was on a formal leave of absence tending to my health (and my Medicaid appeals!). Not only did they decide 8 years was the rule instead of the 10 it had been previously, I was also told that I could not even transfer the credits I had earned toward a different degree towards another program at the same institution. It has been just over ten years since I first enrolled. What a mistake that was!

The “Harvard of the South” no longer officers the degree to which I was admitted—and enrolled so they actually suggested that I pay for a 3rd application to the school (I was admitted into two degrees—the MPP as well as the PhD program in a separate college) requiring two independent applications, fees, official transcripts, graduate test scores, even way back when I was still considered a promising candidate. Now “they” think it is reasonable to ask that I do it all over again??? It goes without saying that I do not have the financial resources available to finish my last semester, take the GREs or GMATs one more time, or even the money to release my transcripts from the Graduate School into any other program at the same University, I guess I am just shit out of luck.

To be clear, WE ARE ALL PAYING for that student debt because I can assure you that their endowment is far greater than any income or earning potential I have given my current financial status and student loan debt! To be clear, YOU ARE ALL PAYING to keep me on Welfare. Yes, all of us are paying some price... I want to work. I want to be productive. I want to be a part of something greater than myself. I want to share what I have learned.

So throughout the years I struggled to stay in school, believing somehow that social justice would prevail, and my heart and dedication towards the greater good would show through to whomever, wherever, or whatever that could make my degree worth while—the Medicaid and disability applications managed to take front seat. So as I filed appeal after appeal after appeal, I managed to acquire well over ¼ million (yes—MILLION) dollars in debt due to uninsured medical expenses and student loans. Despite having three Major Medical insurance policies, I still went bankrupt applying for Medicaid. Morally Bankrupt.

My life will never be the same. My heart will never be the same. I want to pay my bills on time. I want to get off welfare, but no one ever taught me how to be poor.

So after all this—now I face losing my healthcare once again. Where is the safety net? Where is the American Dream that I so diligently chased after for so many years? What was the point spending so much on an education that will never be utilized? I understand the how; I just don’t understand why.

Maybe one of these days Vanderbilt University or and the Department of Education will realize it might just be cheaper to hire me that harass me, because unless I find a real paying job soon, their collections department will no longer be able to reach me on that extravagant lifeline my friend, Brian Lapps, refers to as a luxury.

If anyone on your staff would like to “trade places” with me for one month-I will gladly assume his/her responsibilities for that position if you can find a writer who is willing to endure and write about the reality of social services in our fine state. I do not want a paycheck from your organization; I just want the opportunity to put the myth of freeloading welfare mother s to rest. Live in my shoes for 30 days. Can you find the out? Can you balance my budget and make it work? Can you get the bill collectors of my back? Can you afford Internet service to file state job applications and apply for services online? Can you maintain pride and dignity without feeling the least bit sorry for yourself and the choices you have made?

When I go to the pharmacy, I am humiliated that I do not have the $3.00 necessary for the co-pay on my covered TennCare prescriptions. At least when it was $40 dollars, I was not so damn embarrassed by my lack of funds.

Remind me again why I went to school. Remind me once more, why I bother to speak out. Then remind me right now that that there is somebody listening. I cannot be the only one who actually gives a crap. My contact information is listed below.


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