Believe me, folks, you do not want to be poor and sick in America. I read the comments of the people who think we get “free” health care and how lucky we are and how grateful we should be and how ripped off they are.
Not true. First, let’s lay down a foundation: I worked full-time as long as I was physically able. I was a secretary for twenty-seven years. Then I was poisoned by a physician who prescribed medication but didn’t monitor it. Okay? That’s why I’m sick, and I’m poor because I’m too sick to work. Keep that in mind.
In the past month my health has failed so badly that I no longer can manage to live independently. According to the evaluation by the NYS Dept. of Health “Patient Review Instrument,” I should be in a skilled nursing facility with assistance available twenty-four hours a day. This isn’t me saying so; this is the government saying so. If you are poor and receiving services then nobody believes you. Everything has to be assessed by some government bureaucrat.
You know why? Because you demand it. You all out there think I’m a lazy, lying thief just because I’m poor. (See also: I am poor because I am sick and I am sick because a doctor screwed up.) You want absolute guarantees that I won’t be stealing money, i.e., Medicaid, from you. Because you demand it, across the country there are millions of paper-pushers whose main function is to deny necessary services to people like me.
I am one of the most moral people you will ever meet. My aide says that one of my problems is that I expect other people to be as moral as I am. If you trusted me, then we could cut out loads of paperwork and, instead of paying bureaucrats and their clerks, the money you’re paying could actually be spent on direct care for me.
This stiff little lecture is being brought to you courtesy of Bobbi Dallas, who is a case manager in the Onondaga County Office of Aging, Dept. of Long Term Care, and her boss, Kathy Dutton.
Two days ago, I had an accident. I couldn’t get to the bathroom in time to use the toilet. If you’ve ever changed baby diapers on a regular basis, then you know that in a matter of seconds feces can be smeared far and wide. I was alone, unstable on my feet, and my aide wasn’t scheduled to arrive for six hours. If I had been in a nursing home, help would have been one bell-pull away. At home—no help.
So I called and left a message for Bobbi Dallas. She is the petty bureaucrat who authorizes my home health aide hours. We have issues. She showed up at my door the day I was moving two years ago. As a matter of fact, she blocked the door while movers, electricians, etc., were trying to get their jobs done. She was utterly insensitive to the fact that she was in the way; I had to tell her to leave.
Here’s the fact: I have the constitutional right to not have government people invade my home. In a prior phone conversation, I had asked Dallas if she needed to make a home visit and she said no. Then she showed up unannounced, stood in my doorway for three minutes, asked if moving was stressful, and left. When I filed a complaint about her, I learned that on her official work record she had reported that as a home visit. How much time do you think she claimed for that “home visit?” An hour? Half an hour? Where do you think she actually was when she claimed to be with me? And how much did you, the taxpayer, pay for her nonexistent “home visit?”
So now every time I talk to Dallas, there’s a third party present. Not because she did a bad thing and needs to be kept under surveillance, but because I am “difficult”: I effectively filed a complaint and held her accountable. It’s about county employees protecting each other, not about them efficiently and effectively providing services to the citizens.
So when Dallas returned my call, her supervisor, Kathy Dutton was present and they had me on speaker phone. I explained about the PRI, the need to be in a nursing home, and the morning accident, and then I requested increased home health aide hours while we work to get me into a nursing home.
Dutton’s reply was, “We don’t know that you need increased services.”
“So what’s the process?” I ask.
Dutton tells me that first the doctor has to order a nursing evaluation, and then they have to schedule a nurse, and then . . .
Fine, I say, how long does it take? Dutton says they will fax the necessary form to the doctor and then “It all depends on the doctor.”
Well, approximately how long, I ask. Dutton says, “It all depends on the doctor.”
Are we talking about one day or one month, I ask? What’s the ballpark figure? Dutton says, “It all depends on the doctor.”
Fact: any competent employee can say something like, “Typically, doctors return the forms in about three days. Sometimes it’s one day, occasionally a week or more.” That would be a competent employee who knows what she’s doing. Kathy Dutton works for the county. The county has a long history of hiring and retaining employees based on their contributions to the Republican Party, not their competence.
I tell Dutton that my doctor and I communicate by email and his response time is usually less than three hours. That shuts her up.
After the conversation ends, I email my doctor to be on the lookout for the faxed form. Near the end of the day, he tells me he hasn’t received it. That was two days ago. A woman who needs to be in a nursing home is lying in bed in independent living and only getting two hours of aide care a day, and the county has not yet faxed the form so the doctor can order a reevaluation.
Yesterday afternoon, the doctor again emails me that he hasn’t received the fax. He tries to call Dallas but is dead-ended on her voice mail.
At 7:15 a.m. today, I query him and he says he still hasn’t received it. I call and leave messages for Bobbie Dallas, her supervisor Kathy Dutton, and Kathy Dutton’s supervisor. They start work at 8:00 a.m. It is now 9:00 a.m. and there have been no call-backs.
Two days ago, Kathy Dutton repeatedly told me that my evaluation for adequate care “depends on the doctor.” The doctor cannot fill out the form because the county employees still have not sent it to him. This is the “free” health care provided to citizens who are poor and sick.