Thursday, September 10, 2009

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Dealing from the Bottom Up

For many years now I’ve taken the Low Road in my political endeavors. Since moving here to New Mexico, this philosophy has become more deliberate.

Some might say moving to New Mexico was a courageous venture on my part. I moved here alone, without friends or kin, while recovering from a quadruple bypass. If you’ve ever been “taken off-line” by the docs, you might relate to my impression that recovering from this surgery was like coming back from being soul dead. It was a slow and difficult time, a time when I felt strangely void of preference and will. My solar plexus sent very few messages, I floated and napped much of the time, and that was the best of my experience.

I had already started my move when I had my heart attack. Most of my belongings were already sitting here in Albuquerque. My old home in Maryland was so empty of possessions that I had to rent a hospital bed just to have somewhere to rest my bones. By the time I came “home” from the hospital I found it hard to remember why or how I had “fallen in love” with the idea of relocating to New Mexico. Nonetheless I continued to put one foot after another, doggedly hoping that I was not going to fall off the edge of the universe with the next step. Among other resolutions I used to move forward was the notion that, since I could recall that my decision to relocate was in some profound way a “spiritual” choice—a “calling” if you will, a feeling of having found “home” after a long walkabout on other, less comforting ground—that I would try not to prejudge what I would undertake once I arrived. I resolved to make myself aware and open.

After I settled in and began to feel stronger I ventured out. Hearing of an Anniversary Rally to End the War in Iraq, I encountered the Grannies for the first time and enlisted. My gut reaction, beyond admiring their pluck and their songs, was that I would learn from these women and be in good company.

When I mentioned that I had a chador from Afghanistan as we were preparing for another anti-war rally at the gate to Kirtland Air Force Base, one of the Grannies encouraged me to wear it to the demonstration. So, being open to suggestions and just having researched the number of dead and injured women and children in Iraq, I decided to attend the demonstration as their representative. I wasn’t there for more than 3 minutes when the police descended upon me, asking me to remove my garment. And the rest is history (see my Facebook for a video of my poetic response at the Albuquerque City Council). Having nothing to hide under my chador, this encounter actually served me and my Grannies well. I got a letter of apology from the Chief of Police. The resolution we went to the City Council to support, a resolution urging the US to leave Iraq, passed the City Council! From my personal perspective, while I was shocked and frightened by the police response that day, this was just one more episode of making the personal political, working from the BOTTOM UP.

As I wonder through life, I just tend to bump into walls! When I do, because of my education and upbringing and history, I have this odd, some might say devious, tendency to regard the issue as more than just a personal challenge. When I respond, I respond on behalf of those who cannot or will not or do not know how to stand up for themselves. I make waves! I encourage my readers to follow suit: nothing was ever accomplished by lying down and letting yourself be run over by those who would deny your rights or the rights of others.

RECENT JOUSTS!

My grandmother used to be amused by pushing younger relatives into the swimming pool with her cane. Now that I use a cane to get around myself, I consider it my sword as I sally forth on behalf of disabled individuals. My grandmother, who was the first so-called white woman to settle in Bemidji, Minnesota (she actually bore the blood of two indigenous Americans women in her veins), would heartily approve.

During this last year I was approved for Medicaid (for the working disabled) as well as the Medicare I receive as a disabled person. Once again, this private journey has led me to learn things I never knew and, in the course of reaching out to solve my own problems, find some of the challenges that impact a much larger group of people like myself.

Make no mistake; I am grateful for the benefits Medicaid offers me! Because the Republicans were on a mission for Big Pharma when they supported Part D, my numerous medications were deeply unaffordable before I went on Medicaid. Medicare refuses to acknowledge that senior have teeth. Years of expensive dental work has gone south because no one told me that the dry mouth caused by the medications I take daily to keep my heart ticking would ruin my teeth. When they discharged me from the hospital they should have given me the tablets I take now that protect my teeth and gums from dry mouth and the bacterial infections that ensue! There is also a documented relationship between gum infections and coronary plaque, just one more compelling reason for Medicare to provide dental care! I find myself with only one chewing surface because our medical system doesn’t treat people holistically. My back is also much worse since my cardiac surgery because the medical system we have only seems capable of looking at patients from a narrow and specialized perspective. So I am grateful for the help Medcaid offers, and it’s the best I’ve been able to find as a citizen in our big ole wealthy nation, this government run single payer system!

But, I am also struck by the incompetence I have encountered trying to gain access to my benefits as a disabled person. Initially, my application for Medicaid was denied. The Social Worker who read my application failed to note my boldly marked information that I was applying for MEDICAID FOR THE WORKING DISABLED, and put me in the wrong program for which I was denied. When I reached her by phone to correct this, she let it be known that the Social Welfare office didn’t truly understand this program. This is part of the problem of being a “client” in our welfare system—one must go prepared to become fully informed and be prepared to bring those who are gatekeepers up to snuff! The social services system is not for the feeble!

We need more people sitting in the desks that service the system and we need them to understand what it’s like to be or have been a client! We need more people who help from the BOTTOM UP.

I finally DID get my Medicaid Card! Then I went on a journey to get my teeth fixed. I found a good dental provider, though this took several calls to state offices. I made an appointment and sure enough, my dentist felt I needed partials. I also needed PRE-AUTHORIZATION. The woman who handles the pre-auth desk at my provider was less than encouraging. She said that it might take months and I might not qualify because I needed to have two front teeth missing to get partials. “Maybe I should go out and get in a bar fight!” was my response. Sheesh!

While I waited for pre-auth I tried to find the regulatory information on the Web. I also searched for a Grassroots organization for the Working Disabled. The paucity of information was alarming! I also explored what was happening in New Mexico.

Just last week, after much poking and prodding and calls to Santa Fe, I managed to get myself invited to participate on the New Mexico Focusing on Abilities Leadership Board. Well, they said they wanted disabled folks to participate (smile). And I registered for the Southwest Conference on Disabilities later this month. Never underestimate the power of one semi-employed Raging Granny and her cane! You will hear more about this pilgrim’s progress in this blog in months to come.

MEANWHILE, ABOUT THOSE PARTIALS… Now here’s a funny story. Following up with the clinic, I discovered that while I was under the state’s standard Medicaid coverage, my partials were approved. This only took 30 days. But, meanwhile the state of it’s own accord decided I need to be part of an insurance system to supervise my care and had reassigned my case to Evercare. Goddess only knows why, as I don’t. So my preauth needed to be resubmitted.

A month later, when I called United Healthcare (yet another layer of Insurance that monitors dental care under my “Long Term Care” (COLTS NM) Provider), to check on the progress of my preauth, I was told they had never received it! I went back to my dental provider.

“This happens,” said the woman at the desk. “Sometimes we have to resubmit requests for months.”

I was in pain as I stood there, with a huge wad of bloody cotton in my mouth having just had a tooth extracted. I removed it so I could speak. “Can I get a copy of the preauth request? If the place where it needs to go is in New Mexico I will drive it there myself!”

“Because of HIPAA regulations I can’t give you your paperwork,” she replied. Removing the bloody wad from my mouth one more time, I responded, “That is totally crazy.” Then I left the clinic, but not because I was about to back down.

The next day I called and asked to speak with her supervisor. This woman, who in her job capacity would be required to take HIPAA training, was obviously misinformed if not covering her own lack of due diligence.

When she returned to the phone she informed me I would be able to pick up the paperwork the next day. I did so and promptly sent it off to United Healthcare with a certified Return postcard. My approval was granted a week and a half later! I know it will take time…but I am glad to report this Granny will have teeth in the future. Somehow it strikes me as appropriate!

Bottoms Up!

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