Medicaid Transportation: Second Verse, No Chorus (Part II)


Annie Goes to the Legislature  

“Here’s one way this plays out,” I say.  “All the hospitals are reporting that a couple times a week each one has to keep a patient overnight because they can’t get Medicaid transportation to discharge them.  For want of a $27.50 ride, the patients are occupying $1000-beds.

“The drivers,” I explain, “start work at 5:30 in the morning to get their first patients to dialysis by six o’clock.  Drivers get no coffee breaks and no lunch breaks.  They work till the last patients are home, which may be 9:30 p.m.  They work as many as ninety hours a week.  They get no health care and no paid holidays.  Some of their kids are on Medicaid.  They often start at minimum wage and none get paid more than $12 an hour.”

As I speak, I repeatedly scan the legislators.  Legislator Kathy Rapp, the Republican floor leader, has a dark look.  Another Republican looks down at his desktop every time our eyes meet.

“There is a second problem,” I say.  “For about six years, Medical Answering Services has had a no-bid contract for Medicaid dispatching services.  It started at a quarter of a million dollars and now is about $300- or $350,000.  Their compliance with the contract has been so poor that they are now under investigation by the New York State Office of the Medicaid Inspector General.

“There are legislators here today,” I say, looking directly at Kathy Rapp, “who have known for years that there is a problem.  The Dept. of Social Services knows.  The County Executive’s Office knows.  And nobody has done anything about it.

“Now the state has to come in and clean up the mess.

“You should be ashamed.”

I sit down and wheel across the floor to the side aisle.  Lovie gives me a small smile and gesture of approval.  The gallery is about half full.  Many people—people I don’t know and have never seen before—give me more smiles and nods of approval, and mouth single words of appreciation or support.

Legislator Tom Buckel rises and comes back to me.  He leans down and tells me I did a good job, and now he will make a motion for the Social Services Committee to investigate.  I just blew the lid off this thing and now we will watch the fallout.

I sit in the back and can’t see or hear a thing, just the buzzing in my brain.  What is it with adrenalin?  Does it divert the blood away from the brain and to the muscles?  It’s about twenty minutes of reactive stress, during which time I am not sure if I will faint, before I tune back into the session.

Today’s agenda is long and has about forty items on it.  We are on number five, which has to do with the Homebound Transportation program.  The legislators spend forty minutes arguing about it.  The Democrats are trying to get it funded; the Republicans are blocking it.  They bring in item thirty-three, which is also about Homebound.  Apparently number five requests that County Executive Joannie Mahoney put it back in the budget, from whence she cut it several months ago.  Number thirty-three directs that information be gathered about the specific usage of the Homebound program.

Buckel speaks to the fact that the county executive cut Homebound without coming to the Legislative committee to explain why.  A Republican says to the Democrats that they should have asked for that information during the budget hearings.  A Democrat gets mad and says that he’s working full-time to support his family and, although he goes to every meeting he’s supposed to, he can’t get all the information.  The county executive has a full-time staff of employees and she should have gotten the information.

Rapp says that the county executive has a hard job before her—to reinstate or not to reinstate.  The Democrats, one after another, rise in anger.  The county executive has a hard job???  What about the poor, sick people for whom Homebound is their only escape from home?  What about them?

Mark Stancyzk, the Democratic floor leader, speaks clearly and vigorously, repeatedly referring to the “poor, sick people.”  I wish I could tell him that Homebound does not serve the poor people.  It costs $20 a ride.  Nobody on Medicaid can afford it.  If they are fighting like this about Homebound, I wonder, what are they going to do about Medicaid transportation?

Finally the vote is taken.  Ten to eight against funding transportation for disabled people, right down party lines.  The Republicans have a lock on the Legislature.  The Republican chairman slips and says it has been approved, then has to correct himself.  What would Freud have made of that?

At 3:30, too tired to listen anymore, I wheel out and stop in the hall to gather myself.

A complete stranger comes hurrying after me, introduces himself, gives me his business card.  He is Bob Antonacci, the county comptroller.  He says, “When I hear the words ‘no bid,’ I want to ask questions.”

We agree that I will call him.

I wheel outside, where it is snowing, and am glad of the sharp, cold air.

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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