When “Sic” Meets Sick


My letter to Kathy Hart, Medicaid director, ended with “Ms Hart, do you realize how horrible this system is?  Patients can’t get rides and providers can’t get paid because Medicaid Transport is so poorly managed.  Elderly sick women in wheelchairs are fighting with tired, sweat-soaked transport drivers because of mistakes Medicaid Transport is making.  Medicaid Transport is the cork in the bottle, and it is causing all of us an enormous amount of distress.

“We are sick citizens who have paid our taxes and voted every year, and now we are reduced to this abuse!  All we want is to be able to go to the doctor to try to ease our pain, or get some measure of healing.  When you go to the doctor, Ms Hart, you stick your keys in the ignition and go wherever you want to.  The only way we can get to the doctor is locked through a single telephone number.  We have no options, no choices.  This causes frustration, anger, depression and despair.  Why bother to try to take care of ourselves, we wonder?  Why not just give up and die?

 “That’s what Medicaid Transport is doing to a lot of fine people who are old and sick.

“Please tell me what you’re going to do to fix the problems.”

The contract for dispatching Medicaid transportation had been moved from the agency in Onondaga County to an agency on Long Island.  Kathy Hart was trying to violate their contract and had asked for my help in doing so.  I submitted information documenting some of the problems, including dialing sixty times before I broke through the busy signal, and being on hold for 41 minutes.  The operator in Long Island told me that (a) she was the only person working Medicaid calls; (b) she was having to put numbers into “the Medicaid box” about three times before they’d work; (c) they were taking calls for 5000 accounts, and (d) doctor’s calls get priority.

This really rankled:  doctors get priority.  We live in a society where doctors matter and patients don’t.  I’m getting up in the morning and reading the Holy Bible, which says that Jesus came for the poor and the sick, and that they—hey, me!—matter to God.  Nowhere in my bible does it say that physicians come first.  Jesus and his apostles healed the sick.  In 2002, in Upstate New York, the sick come last; doctors come first.  That riled me.  And besides—those 5000 accounts that the telephone answering service is serving—aren’t they all paying the same amount to buy service?  How come the money that Medicaid pays to the answering service doesn’t buy the same level of service as the money that a doctor pays to the answering service?

So Kathy Hart violated the Long Island contract and it was let to Rural Metro.  According to their website, “Rural/Metro is a national leader in private ambulance and fire protection services in 21 states and nearly 700 communities from coast to coast.  Rural/Metro is a national leader in private ambulance and fire protection services in 21 states and nearly 700 communities from coast to coast. . . Rural/Metro’s EMS professionals provide more than 1.3 million 911 emergency and interfacility [sic] ambulance transports annually. Our firefighters respond to more than 60,000 calls for assistance each year. Our experienced and proven management team is supported by 21 zone executives and local operations managers with an average of 24 years of industry experience.”  So you would figure they would know what they’re doing, right?

Wrong.

The way the Medicaid transportation system works is this.  First, you have to apply for Medicaid transportation; it does not come automatically with Medicaid.  Then you have to call the Medicaid transportation dispatch office.  They verify that you are covered by Medicaid, take your ride order—in which you specify the company with which you want to ride—and then send the order to that company.  Brain surgery might be a little tricky, but dispatching Medicaid transportation orders is not, nevertheless, Rural Metro couldn’t get it right and every time I reached out to the general manager at Rural Metro he told me that he didn’t have anything to do with Medicaid transportation.

Excuse me?  He runs Rural Metro and Rural Metro’s got the contract, so what is going on here?  How can he disavow responsibility for the failure of his employees to perform their jobs correctly?  Well, there was a little kink that I didn’t understand.

Rural Metro (“50 Years of Service Others” [sic]) sent out a letter.  Before reading any further, you need to know that “sic” is Latin for “thus” and the shortened form of sic erat scriptum, which means “thus it was written.”  In other words, when you are quoting someone who has written something that is wrong and you know it, then you stick sic in there to alert your readers to the fact that you know this is wrong but it’s actually what the original author wrote.  So here’s part of the letter: 

Postmarked 06-20-03

Rural/Metro                    

Medical Services

50 Years of Service Others [sic]

IMPORTANT NOTICE REGARDING

ONONDAGA COUNTY MEDICAID TRANSPORTATION

Medicaid transportation is not an entitlement.  You do not automatically get Medicaid transportation because you are receiving Medicaid assistance.

To receive Medicaid transportation you must . . .

If you believe you have a special medical condition, you, or a representative, must complete the front page of the enclosed form.  You must then forward the form to your PRIMARY CARE PHYSICIAN who will complete the reverse side of the application.  Your primary care physician is the ONLY person authorized to confirm the accuracy of your transportation abilities.  Forms completed by any one [sic] other than your primary care physician will NOT BE REVIEWED and all transportation will be DENIED.  The physicians’ staff, at the direction of the physician, may enter patient information but the psychic in [sic] must sign the verification statement.

All forms will be evaluated in accordance with the standards set in the Americans With [sic] Disabilities Act.  (ADA). [Sic]

The mailing of t he [sic] forms have been [sic] electronic recorded in our computer system and is expected to be returned [sic] . . .

Please mail the completed form to:

Rural Metro Medical Services

C/O:  MAS Transportation

488 W. Onondaga St.

P.O. Box 671

Syracuse, NY 13201

If you have a question about these forms, call Medicaid transportation at 315-701-7500.

If you disagree . . .

Revised 7/08/2003 [sic]

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
This entry was posted in American medical industry, disability, Fraud, God, Government Services, Medicaid, Onondaga County, political corruption, Poverty, Power, Powerlessness, Values and tagged , , , , , , , , , , . Bookmark the permalink.

2 Responses to When “Sic” Meets Sick

  1. Idebenone says:

    We report here a multimethod assessment of Medicaid reform within a rural state. The study addressed research questions at three levels of analysis. (a) Sequential surveys answered questions about the impacts of Medicaid managed care (MMC) for individuals. (b) Ethnographic methods assessed what effects occurred for safety net institutions and local communities. (c) Analysis of publicly available secondary databases determined how sentinel events changed as population-level indicators.

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