Mrs. Edna Street is an elderly lady and a double amputee; last May when she was in the hospital her doctor sent a form to the Department of Health and Human Services asking that she be provided – under Medicaid – in-home care when she went home to convalesce.
The doctor never heard back.
So Mrs. Street’s daughter called CCME (the former client of lobbyist-turned-Cabinet-Secretary Lanier Cansler) who Cansler picked (and gave a no bid contract) to handle the medical needs of home care patients.
Mrs. Street’s daughter called again and again. And got no reply.
Finally she learned the problem. The doctor had left a ‘code’ off the form.
So the doctor added the code and sent the updated form in – and more weeks passed. Still, Mrs. Street heard nothing.
Next her home care provider, trying to help, called the Department of Medical Assistance – which is over CCME and Medicaid.
No one returned the call.
So the provider contacted Secretary Cansler.
Again no one called back.
More calls and more emails to CCME – and, still, no reply.
Finally, after two months, CCME turned up with bad news. It said since Mrs. Street had not seen a physician in the last ninety days it would not review her application for home care. Of course, Mrs. Street had seen her doctor in the last ninety days – when she was in the hospital.
Nonetheless, an ambulance carried Mrs. Street to her doctor, who conducted another examination and sent another updated form to CCME.
Again, no reply.
In September, Mrs. Street’s home care provider tried again, contacting the Department of Medical Assistance again. This time the department said it was forwarding her inquiry to CCME.
No reply from CCME.
In October, Mrs. Street’s provider contacted the state again and, this time, the Division of Medical Assistance told her that on Mrs. Street’s form – filled out back in May – the doctor had (in error) checked a block that said she was not medically stable. That information made its way back to the doctor who said, ‘Of course she wasn’t stable when I filled out the form – she was in the hospital.’
The doctor corrected the form, sent it back and another week passed.
Then Mrs. Street’s provider emailed the Department of Medical Assistance and told them WRAL-TV was about to interview Mrs. Street.
The next day CCME showed up, did an examination of Mrs. Street and determined she did need the care her doctor prescribed.
Then WRAL aired its report and Secretary Cansler’s Department went into crisis mode: It had a mess on its hands with reporters calling and legislators asking for explanations. It was a public relations nightmare. And the department needed an answer. And it found one. Overnight. It announced that Mrs. Street was what is called a ‘Special Low Income Medicaid Beneficiary’ – which means she was not eligible for any Medicaid home-care at all.
So, Secretary Cansler’s former client (CCME) had ruled she needed care, his division of Division of Aging had said she was eligible for care, but the Division of Medical Assistance – trumping everyone else – said she was not.
Then six weeks after the WRAL report Mrs. Street died.
Which is all a pretty fair example of how government works.
The doctor leaves off a code, no one returns calls, nothing happens until the press reports the bureaucratic train wreck, the poor patient is told twice she’s eligible and once she’s not and before it can all be straightened out, dies.