Re: Paralyzed teen...
James Lubin (jlubin(AT)eskimo.com)
Thu, 09 Apr 1998 12:39:38 -0700
Well, I hope Sara will be able to go home. I'm also a vent dependent
quad. I live at home with my mom and brother. Medicaid (Washington state)
will pay for 16 hours of skilled nuring per day and my family takes care
of the rest of the time. It's my understanding that the nuring agency get
$25/hr ($400 per day), the nurses (RNs) are paid $16/hr. So part of the
problem is the home-health agencies (such as the one mentioned in the
article). I'm just fortunate we found a good home-health agency that
cares more about caring for people rather than making a big profit.
Several refussed us to when I first went on medicaid after my insurance
ran out.
I need someone around 24 hours in case there's a problem with the
ventilator, but it's not like I require constant care. Once I'm out of
bed and in my wheelchair I'm fine by myself
At 11:28 AM 4/3/98 -0500, Maxim Bily wrote:
Paralyzed teen longs for home: Insurance won't
cover care that would allow her to leave hospital
By Dorsey Griffith Bee Staff Writer (Published April 2, 1998)
At Sutter Memorial Hospital, Room 476 has been transformed in the past
three months. A stuffed lion, bear and pig hang from an IV stand. Giant
metallic balloons hover near the ceiling. Snapshots adorn the cabinets. A
Pearl Jam tune plays on a boom box on the window sill.
But hard as Sara Granda tries to feel comfortable in this intensive care
unit room, it's a far cry from home for the 18-year-old.
The most agonizing thing is that doctors and hospital officials agree she
is ready to return to the Davis home she shares with her mother and
sister.
The problem for Sara, who was paralyzed from the neck down in a car
accident last July and breathes with the help of a ventilator, is that
her insurance will not pay for the round-the-clock nursing care she will
need once she gets home and there is no guarantee that public assistance
can fill the gap.
So, while everyone argues over who is responsible for the costs of her
care, the girl who was supposed to be studying international business on
a scholarship at Cal Poly waits alone in a hospital room typically
reserved for the critically ill.
"Everybody here is old," she says, her soft-spoken words
separated by gasps of breath, tears streaming from her clear brown eyes.
"They can't talk. My neighbors are dying. It's depressing because I
think I may die, too. I want to go home."
Sara's ordeal began July 24 while running errands in Woodland with her
older brother. The two had been shopping for clothes and then went to fix
the tires on her 1989 Ford Escort.
"The car ran off the road. I wasn't speeding. Then I tried to brake,
and the car flipped over three times and spun around."
Her brother walked away from the accident, but when Sara woke up at the
UC Davis Medical Center, she found she wasn't so lucky. "I couldn't
move. I couldn't talk."
Sara had broken her neck and suffered the same spinal cord injury as
actor Christopher Reeve. Like Reeve, Sara has no feeling below her
shoulders and breathes through a tube in her throat.
After five weeks at UC Davis Medical Center, Sara was transferred to
Children's Hospital in Seattle, where she spent three months in a
rehabilitation program. She then went to University of Washington
Hospital, where she remained for a month.
On Dec. 29, she was flown to Sutter Memorial. What was meant to be a
weeklong stay, however, has turned into a three-month hospitalization
where she is cheered only by family visits, television sitcoms and time
with her nurse, who applies makeup and paints the nails on Sara's
unmoving fingers.
Her doctor, pulmonary specialist Bradley Chipps, said there is a very
slim chance that she will recover any movement or that she will ever
breathe on her own again. He has recommended she get 24-hour licensed
nursing care.
He said that as long as she's cared for appropriately she should be able
to live a long and productive life. For Sara, that begins with a trip
home.
The chief obstacle is the health insurance policy her father has as a
professor at California State University, Sacramento.
Jos Granda pays about $375 per month for the coverage he bought through
the California Public Employees Retirement System. He also pays for the
PERS long-term care plan.
"Professor Granda was responsible enough to take out what was
represented to him to be the very best insurance available for his
family," said Roger Dreyer, the family's attorney.
In fact, the policy covers only 100 home nursing visits per year at four
hours per visit, or 161/2 days of 24-hour care. The long-term care plan
does not cover dependent children.
"No one offers 24-hour nursing care for a person's lifetime,"
said Pat Macht, Cal-PERS' public affairs chief. "Our job is to make
sure everyone gets the benefits they are entitled to. It's also our job
to make sure . . . we're not providing things that aren't under the
policy that would ultimately cause rates and premiums to go up and out of
control."
Macht added that the plan will pay for only 180 days of skilled nursing
care at $500 per day. Sara has used up 90 days already.
Sara's mother, Beverly Granda, has applied for Medi-Cal, which would most
likely cover up to 16 hours per day of home care. But even if that were
enough to meet the need, few home health-care operators accept Medi-Cal
patients because the reimbursement rate for 24-hour care -- at $532 per
day -- is too low.
"You just can't make any money at it," said Richard Helms,
administrator at Customcare of Sacramento, which specializes in
ventilator-dependent patients.
Hospital officials have tried to urge Sara to consent to moving to a
skilled nursing facility, but they acknowledge that none exists in the
Sacramento area that are appropriate for her. And they know she fears
being put in an institution more than anything else.
So, she remains in the intensive care unit at Sutter Memorial because
it's the only place in the hospital where nurses trained to take care of
patients on ventilators and respiratory therapists are available around
the clock.
"I have told the family I can't turn Sutter into a rehab
facility," said assistant administrator Mark Rieger. "But I do
think we have gone out of our way to accommodate many of the things they
need."
The hospital has paid many of the bills Beverly Granda has been unable to
pay since quitting her nursing job to care for her daughter. Craftsmen
for Christ, a charitable group, has begun readying the Granda home for
Sara's return. And members of St. James Catholic Church in Davis have
sent meals to the Granda home and have made a quilt that will be raffled
off for her care. They have also set up a trust fund to help cover the
cost of moving her home.
Sara still clings to her dream of going to college with the help of a
nurse and looks forward to attending weddings and baby showers for her
friends.
In the meantime, she has asked her nurse to take the clock off the wall
in her room. "Otherwise all I'd do is watch the clock," she
said.
-- Maksim (Max) Bily
mail to: imax(AT)odyssee.net
----
Jim
Lubin
jlubin(AT)eskimo.com