Kinnick Kay and Carver Lee: September 11th, 2009

Friday, September 11, 2009

September 11th, 2009

Rainbow's United provides early intervention to children ages 0-3. This is critical to developmentally delayed children's success. Kinnick and Carver both receive these services. Our services include SLP (Feeding and Speech), PT (gross motor), OT (fine motor), VT (Vision), AVT (Audiology), and an Early Childhood teacher. I never feel like we get enough services (I'm just that kind of mother). However, I do feel very fortunate that we receive the services that we do receive and they are at no cost to my family. Until the last couple of months, we had the best AVT through Rainbows. She wasn't a certified AVT until just recently, but had the experience -just needed to complete the certification. She is the ONLY AVT certified individual in the area. Rainbows let her go as part of their "Reorganization" effort. I guess they couldn't afford her. This has left us without any kind of Teacher for the Deaf. This is a huge blow for us. Carver needs these services to give him the full benefit of his CI's. There isn't even anyone else in the area that can offer these services. This highly needed individual is now jobless and not accessible to the many people that desperately need the services that she offers. Many of us are pleading with Rainbows to reconsider. I've even begged my ENT to consider hiring her in their office. So, I'm kinda bummed right now. Carver's second CI is scheduled for September 30th, and I don't even know who's going to provide the services that he needs to make the difference.

4 comments:

Anonymous said...: Oh my goodness! I can't believe that! I teach with someone who's daughter works with Rainbows and it sounds like there is some major stuff going on there. I saw that in the news too. It just seems so sad that the kids are the ones who are going to end up suffering the most when somebody at the top didn't do their job right! I hope they can get her back!! Do you have any info for us to help call? Maybe if we bombard them, they won't be able to ignore us!
Neva; September 12, 2009 at 4:06 PM
Kristina said...: Is there any way to have your private insurance pay for her as an AVT? Our insurance covers Emma's AVT for a certain number of session/year as part of the approval for her cochlear implant. Maybe you can go that route? Or, maybe she can cut you a great price if you hire her out of pocket and have a fund raiser of some sort to help raise the money? I'm so sorry you have to go through this - this really sucks!; September 12, 2009 at 8:14 PM
Tara Bennett said...: I just love early intervention, but there are some serious flaws. I hope there is a resolution - and soon!; September 16, 2009 at 12:20 AM
Jodi said...: What can I do to help? Can I call Rainbows and who do I need to speak with? I can sure ask Olivia's therapists as well.; September 16, 2009 at 5:15 PM

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Disability Determination when you don't qualify Financially

In order to extend Cobra medical coverage 11 months due to a Disabled member of the family, a Disability Determination Award letter is required. How do you secure a Disability Determination if you are not intitled to an Award? You ask for a Special Determination (SSA-553) of Disability. How did we get this? Here are my contacts:

We live in Wichita, KS. My contact at the Social Security Administration in Wichita was Nick Janzen. His phone number is 866-931-4486.

The Kansas/Nebraska/Iowa/Missouri Regional SSA office is located in Kansas City. My contact in the Kansas City Office is Mike Stiles. His phone number is 816-936-5740. Mike is able to communicate with all of the Disability Experts including those at the national headquarters in Baltimore, MD. Mike was able to guide my Wichita, KS contact, Nick in order to complete the necessary paperwork to obtain a Disability Determination even though we didn't qualify under Title II or Title XV1.

Here's is how it worked:

Nick completed a paper SSA-3820 (for a child), and obtained as much medical evidence as possible from me. He also prepared an SSA-5002 with the date of my qualiffying event (date I went on Cobra initially). This material was then sent to the following Address:

Office of Medical and Vocational Expertise

P.O. Box 17786

Baltimore, MD 21235-7786

A Manual Development Worksheet (MDW) was used to document my case.

The OMVE will prepare and release the appropriate notice for this type of case and will return the completed case to the field office along with a special determination (SSA-553) of disability and a copy of the notice.

Overnight address:

SSA, Office of Medical and Vocational Expertise

1st Floor Oak Meadows Building

6401 Security Blvd

Baltimore, MD 21235

Sedgwick County Developmental Disability Organization - MRDD Waiver information

Kinnick and Carver are on the MRDD Waiver. This is a needs based program based on being mentally retarded or developmentally delayed - not income. So, regardless of income, you may qualify. What benefit are we getting from the MRDD waiver? If you are on this program at age 5, you will receive a medicaid card. Prior to turning age 5 (while on the waiting list), you qualify for case management and family support funds. Case management is very helpful in helping you find funding sources if needed. The family support funds have provided all of K&C's expensive equipment needs. Due to budget cuts, the family support funds are not available this year, but could return at any time. You shouldn't wait to sign up for this program. There is a waiting list to receive the medicaid card at age 5. The waiting list is 2 years or longer. Therefore the sooner you get on the waiting list the better. You do not have to be 5 to be on the waiting list.

How do you apply for the MRDD Waiver program?

Rachel Ryan

Intake and Referral Coordinator (SCDDO)

615 N. Main

Wichita, KS 67203

(316)-660-7640

http://www.sedgwickcounty.org/cddo

Kansas Medicaid - Travel Expenses

I'm posting this to help others. It has been a struggle to get Medicaid to pay for our travel expenses. I have been able to get them to commit to paying $81.00/day hotel expense, $27.00/day for food, and .20/mile for mileage to/from.

The KEY is to call the number(s) below before you leave on the trip (unless it is an emergency).

1-800-285-4978 Option 2 (Out of State Prior Auth)
The doctor from the referring hospital/office and the doctor that you will be seeing will need to send paperwork for your approval. You can call this number to confirm this is getting done.

1-888-561-8747 x5002 (Meals and Lodging)
Let them know where you are going and how long you think you will be there. You will have to call every 2 wks to extend the time. They only approve 2 wks at a time.

1-888-240-6497 (Transportation)
Let them know where you are going and how long you think you will be there. You will have to call every 2 wks to extend the time. They only approve 2 wks at a time.

Medical Transportation Approval Process

In order to obtain approval for Medical Transport, the following steps were followed:

1.) Kinnick and Carver's primary physician (Pediatrician) wrote a "Letter of Medical Necessity". Below is a small sampling of the letter:

LETTER OF MEDICAL NECESSITY

Date:
Insurance Company:
RE: Kinnick and Carver
DOB:
Diagnosis: ROP, 23 wk gestation twins, severe chronic lung disease.

Attention Medical Director:

The letter requested approval for an air ambulance round trip flight for the specific eye surgery. It then listed medical reasons why Kinnick and Carver's medical needs meet criteria for air ambulance transport for their eye surgery. Their medical needs consisted of the following:

Continuous oxygen per nasal cannula
Continuous cardiac and respiratory monitoring
Feeding intolerance that requires gastrostomy feeds
Deep suctioning using a suction machine and catheter

Signed by the Primary Physician

2.) My Primary Physician faxed the Letter to Kinnick and Carver's Case Manager at my Insurance Company.

3.) Kinnick and Carver's Case Manager forwarded the Letter to the Medical Director for approval. This process only took a couple of days.

4.) Kinnick and Carver's Case Manager faxed the Approval to Air Ambulance and my Primary Physician.

Kinnick Kay and Carver Lee

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