Mandated Home Healthcare Transition, this should be interesting!
Entry posted by 1967stingray
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Monday morning, bright and early, the nurse from our newly chosen agency came by to "evaluate" Ray for Long Term Managed Care aka LTMC (formerly known as the Lombardi Program to us, or Money Follows the Person to most of you). Turns out she was really just here to sign us up immediately, no qualifications required. But she was so helpful, she stayed for two hours, and I have high hopes for the future now, at least as far as homecare. She told me of things I should have been informed of long ago: Best of all, that all Ray's everyday supplies like adult underwear, inserts, gloves, sanitizer, wipes and so on are totally covered by Medicaid. All you need is a prescription from his PCP, which she is taking care of. Then I call her place once a month and order as much as I need, and it will arrive via UPS a day or two later. Just think of all the money I've been wasting!
She initially tried to talk us into adult daycare, even mentioned the same facility as the Dominicans suggested last week. But it's as far away as the two I interviewed back in April, while meanwhile being in a somewhat seedy area. Probably the cheapest option. Nope, I told her part time in-home care is what we need and she said fine. She gave me way more aide hours than I really want, but I won't squabble about that right now, after all the trouble I've had. It will be a bit of an adjustment after having no help at all for the past year, but we'll sort it out. However this time I'm getting a spy cam for the bedrooms, I learned my lesson about that the hard way.
She also told me that hearing, vision and dental is totally covered through them, not just the visits but eyeglasses, hearing aides, dentures and anything else needed. Just the dental is great, it is something Ray has been avoiding forever (way before the stroke), but I didn't push because of the cost. The biggest change of all will be that whatever nurse we are assigned will be in charge of all our appointments, so we have to do absolutely everything through her. But it will be by phone, they don't go out in the field, so they are always available when we need them. Hallelujah! So tired of the weekly visit routine: We see enough doctors that the nurse visits were seldom useful, just us sitting around waiting for her to show up two hours late as usual, just to take his blood pressure.
They say in their brochure you can use any doctors you wish, but that remains to be seen. Our primary, definitely, we already have to go tomorrow to meet with him about the switch, an appointment which they set up for us. But I mentioned his ENT office, and our eye doctor, and the podiatrist, and she said they're not in their network. I know this is the latest thing that got Obama into hot water, guess it extends outside of Affordable Care. Maybe I can make a special request? She kept mentioning their network doctors in our nearby town, but none that I would pick on my own. Nothing I can do I guess, beggars can't be choosers (my new mantra!) Looks like Ray can keep his neurologist and his psychiatrist at least.
Then the strangest turn of events. It started with Pat our ex aide stopping by last week. I knew that she had quit the agency that supplies aides to the Dominicans; not enough clients they said, while they told us not enough aides, something's very fishy. So she is now looking for a job, and although she is a CNA she has applied to Home Depot and 7Eleven and the like. She visited for a good long time for a change and Ray was so happy to see her, he was all smiles. Then she told me something that I couldn't remember, it was called CD something, she told me to ask the new nurse about it. I forgot since I had no idea what it was. But the nurse brought it up herself, and I don't know if this is something new but it is called CD-PAS, stands for Consumer Driven Patient Aide something or other. Love those government acronyns. What it is, you can hire ANYONE to watch the patient, as long as they don't live with you. They don't even have to be certified, just someone you trust. And this agency will pay them directly for home care. So that's what Pat wanted me to find out about. And despite that one incident where I'm not sure I trust her 100% anymore, I think I might be able to trust her more than a total stranger. And she is more like a friend to Ray; I am so not looking forward to someone(s) starting from scratch and having to break them in.
But, to complicate things a little....as Pat had told me, her phone is "out of order" as it occasionally is. I guess she does the prepaid cell phone, and she may be a little broke right now, but how is she expecting to get a job without a phone? She is coming by next week though, to drop something off for Thanksgiving, she told me 10 times, so I will tell her then and see what happens. Our new agency starts Dec 1, so we have time to set it up. The nurse made a note and said she'd wait to hear from Pat for now.
Dec 1 is the official date of our transition, but the Dominicans are supposed to be in charge til then and overlap for 90 days after too, to help with the changeover. The new nurse called their office and told them we are switching as of Dec 1, which shouldn't be shocking since they are no longer an agency for aides anyway. Strangely, the Dominicans had called Friday to set up an aide for us, as a last ditch effort obviously, to come every Tues and Thurs for two hours. So I figure, three visits from him until the end of the month, at the very least. I went ahead and scheduled a way overdue haircut for myself, and was getting ready to call some girlfriends for lunch dates. But the day after the nurse's sign up call, I wait for the aide visit at the appointed hour although not with bated breath, and of course no call, no show. Same with the nurse, who usually comes the same day. Excuse me, you are still my agency at the moment, what a bunch of deadbeats. I will be writing up our whole history with them in the next few days and sending it to the proper authorities, just to get it off my chest. My experiences with them have been like the Three Stooges. I'm pretty sure they are getting paid for a lot more visits than they ever made. The nurse didn't show up for a month and a half last Dec and Jan, just for starters. They had a change in supervisors then so bet she figured she could get away with it, still burns me up. You call the office, get a machine, leave a message and never get a return call. I didn't complain at the time, they were going though a lot of changes so I figured they wouldn't care about me and my petty problems anyway.
So we see how it goes.......can't be much worse than what we've had to deal with so far! All the agency people who ever visit us are amazed at how much I know about their business, but how can you not? I feel sorry for anyone that doesn't have someone watching out for them, and researching all the options out there.
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