Re: Re: Integrated Care Program

[Guest guest]

cmfinato <cmfinato@...> wrote:

>Thanks Thais. Loyola has decided not to enroll. I called Loyola and I was

informed that a PCP can make a referral to a specialist at Loyola. That would

mean I only have to change my daughter's PCP (whom I like, so I'm not too happy

about this). My husband is looking into adding Angel to our health plan at

work. It is a small company, so the premiums are high.

>

>

>>

>> I went to the Arc's presentation on this: if your provider is not enrolled in

either MCO (yet, because they are still in the process of doing this) you can

ask if they are enrolling and in which one, if they are not, ask for a " single

case agreement " . For more info about this contact Fay at Arc of illinois.

>> You have 60 days to do this and in any case 90 days to continue with your

current provider or ask HFS for more time.

>> Thais

>>

>>

[Guest guest]

But if you really like your doctor and he or she is willing they can do a single

case agreement for Angel. It might be worth the try. Apparently doctors who do

this but don't join the network will be paid more quickly than medicaid. BTW I

got my letter today to but I've been too busy with Quentin's last IEP (tomorrow)

to take care of this but I found the Arc presentation very helpful.

Thais

[Guest guest]

Did they say how this would work for doctors who work through Loyola?  I was

under the impression that these doctors get paid from Loyola.  Angel's PCP

works at one of Loyola's Primary Care locations (a few blocks from my house).

Thanks

Check my websites:

www.angelspeaks.com

www.angelspeaksproducts.com

I'm on Twitter: http://twitter.com/angelspeaksprod

We Grow Dreams - www.wegrowdreams.org

From: Francis PALLUAU <fpalluau@...>

Subject: Re: Re: Integrated Care Program

IPADDUnite

Date: Thursday, May 12, 2011, 3:30 PM

 

But if you really like your doctor and he or she is willing they can do a

single case agreement for Angel. It might be worth the try. Apparently doctors

who do this but don't join the network will be paid more quickly than medicaid.

BTW I got my letter today to but I've been too busy with Quentin's last IEP

(tomorrow) to take care of this but I found the Arc presentation very helpful.

Thais

[Guest guest]

I got Bill's packet today, too....went over to his primary for the last 6 years

-- not signing up. So we get to start from scratch again. IlliniCare has only

1, ONE!, physician in all of Naperville; and that office is 20-30 minutes away.

No hospital, on either plan. So our closest medical center in case of

emergency is 30 minutes away: Adventest Bollingbook Hospital. And this is a

GOOD thing? What if the PCP is not allowed to practice in Bollingbook?

It is just so frustrating that this was forced on the least vocal, most

medically compromised individuals in our society not under medicare only to

benefit one man: Govenor Quinn. Is HE on this plan?

Re: Re: Integrated Care Program

Did they say how this would work for doctors who work through Loyola? I was

nder the impression that these doctors get paid from Loyola. Angel's PCP works

t one of Loyola's Primary Care locations (a few blocks from my house).

Thanks

Check my websites:

www.angelspeaks.com

www.angelspeaksproducts.com

I'm on Twitter: http://twitter.com/angelspeaksprod

We Grow Dreams - www.wegrowdreams.org

From: Francis PALLUAU <fpalluau@...>

ubject: Re: Re: Integrated Care Program

o: IPADDUnite

ate: Thursday, May 12, 2011, 3:30 PM

But if you really like your doctor and he or she is willing they can do a

ingle case agreement for Angel. It might be worth the try. Apparently doctors

ho do this but don't join the network will be paid more quickly than medicaid.

TW I got my letter today to but I've been too busy with Quentin's last IEP

tomorrow) to take care of this but I found the Arc presentation very helpful.

Thais

[Guest guest]

They didn't mention any doctors specifically, just that you could ask your

doctor to make a single case agreement with you.

Thais

[Guest guest]

Thanks Ellen,

That's good to know, sounds like (once again) you are ahead of us in this

process.

Arc was also very helpful in giving info that we can give our providers to

incite them to sign on.

Also, I know that this is frustrating but I had the same difficulties dealing

with very expensive private insurance, so I hope that with patience and

perseverance during this conversion process will work well.

Great that we have IPADDUnite to vent and share as we help each other through

another transition.

Thais

[Guest guest]

Sorry, I am way behind in my emails, is this for Medicaid?  I heard they were

forcing everyone to an HMO soon but never heard anything else.  I live in Du

Page County and have not heard anything yet.  Thanks.   Shirley

From: ELLEN BRONFELD <egskb@...>

Subject: Re: Integrated Care Program

IPADDUnite

Date: Friday, May 13, 2011, 12:23 PM

 

We have a similar situation in our area...no nearby hospitals (including the one

that is less than two blocks from Noah's house) and neither his internist nor

his psychiatrist are in the Aetna Network. We also had some problem with the

HIPPA rules...we had to fax guardianship papers to be able to complete the

registration process. Then, I got a call just last week from someone at Aetna,

to talk about case management, but the person on the phone wouldn't talk to me

unless I resent guardianship papers. I probably don't have to tell you what I

told her, since it wasn't very nice...

If you have any concerns you want to discuss with an Aetna representative, the

person I have been sharing my concerns with is:

Caroline () Hall

HallC1@...

Aetna Better Health

Member Services Manager

1-866-212-2851

www.AetnaBetterHealth.com/Illinois

I don't have a similar contact at Illini Care...

We have already received our membership booklet for Noah and it states that a

person in need of immediate emergency care can receive treatment at the nearest

hospital, but it also states that transfer to an in-network hospital should

occur as soon as the member is stabilized.

This concerns me. We need to share our stories...so please post and let's keep a

vigilant watch...thanks Thais for your helpful suggestions/comments.

Ellen

Ellen Garber Bronfeld

egskb@...

[Guest guest]

For people on Medicaid  who are:

- 65 and over

or

- blind

or

- have a disability

 

AND  they live in the community

 

AND they live in:

- suburban cook or

- Kane or

- Kankakee or

- DuPage or

- Lake or

- Will

 

AND DO NOT HAVE MEDICARE OR ANY OTHER COMPREHENSIVE COMMERCIAL INSURANCE:

 

They will need to be enrolled in INTEGRATED CARE.

This is a HMO program and we have two HMOs to pick from:

- AETNA BETTER CARE

or

- ILLINICARE HEALTH PLAN.

 

They each have either own list of hospitals and doctors. They are still

enrolling hospitals and doctors but, currently, most are far away from Lake

County and North Suburban Cook.

 

If you do NOT enroll with one, one will be assigned to you.

 

On a more personal note: I am not very happy (to say the least) about this

change in Medicaid as the current list of providers are not even remotely close

to most recipients. I am actively contacting congress people about this & I

encourage every one to do the same.

From: ELLEN BRONFELD <egskb@...>

Subject: Re: Integrated Care Program

IPADDUnite

Date: Friday, May 13, 2011, 12:23 PM

 

We have a similar situation in our area...no nearby hospitals (including the one

that is less than two blocks from Noah's house) and neither his internist nor

his psychiatrist are in the Aetna Network. We also had some problem with the

HIPPA rules...we had to fax guardianship papers to be able to complete the

registration process. Then, I got a call just last week from someone at Aetna,

to talk about case management, but the person on the phone wouldn't talk to me

unless I resent guardianship papers. I probably don't have to tell you what I

told her, since it wasn't very nice...

If you have any concerns you want to discuss with an Aetna representative, the

person I have been sharing my concerns with is:

Caroline () Hall

HallC1@...

Aetna Better Health

Member Services Manager

1-866-212-2851

www.AetnaBetterHealth.com/Illinois

I don't have a similar contact at Illini Care...

We have already received our membership booklet for Noah and it states that a

person in need of immediate emergency care can receive treatment at the nearest

hospital, but it also states that transfer to an in-network hospital should

occur as soon as the member is stabilized.

This concerns me. We need to share our stories...so please post and let's keep a

vigilant watch...thanks Thais for your helpful suggestions/comments.

Ellen

Ellen Garber Bronfeld

egskb@...

[Guest guest]

Sherri, my son has Medicare A, B and D and my private insurance and HBWD, will

this effect him?  Thank you so much for responding.

Shirley

From: ELLEN BRONFELD <egskb@...>

Subject: Re: Integrated Care Program

IPADDUnite

Date: Friday, May 13, 2011, 12:23 PM

 

We have a similar situation in our area...no nearby hospitals (including the one

that is less than two blocks from Noah's house) and neither his internist nor

his psychiatrist are in the Aetna Network. We also had some problem with the

HIPPA rules...we had to fax guardianship papers to be able to complete the

registration process. Then, I got a call just last week from someone at Aetna,

to talk about case management, but the person on the phone wouldn't talk to me

unless I resent guardianship papers. I probably don't have to tell you what I

told her, since it wasn't very nice...

If you have any concerns you want to discuss with an Aetna representative, the

person I have been sharing my concerns with is:

Caroline () Hall

HallC1@...

Aetna Better Health

Member Services Manager

1-866-212-2851

www.AetnaBetterHealth.com/Illinois

I don't have a similar contact at Illini Care...

We have already received our membership booklet for Noah and it states that a

person in need of immediate emergency care can receive treatment at the nearest

hospital, but it also states that transfer to an in-network hospital should

occur as soon as the member is stabilized.

This concerns me. We need to share our stories...so please post and let's keep a

vigilant watch...thanks Thais for your helpful suggestions/comments.

Ellen

Ellen Garber Bronfeld

egskb@...

[Guest guest]

Yes, Shirley, it is Medicaid.  I live in Dupage, so I believe you should be

hearing from them soon.

Check my websites:

www.angelspeaks.com

www.angelspeaksproducts.com

I'm on Twitter: http://twitter.com/angelspeaksprod

We Grow Dreams - www.wegrowdreams.org

[Guest guest]

If you have private insurance in addition to medicaid you will not be hearing

from them. This is the first phase of a pilot program. I believe we need to be

asking our providers to sign on or do single case agreements, if enough of us do

that they will hopefully eventually sign on. One big advantage for them is that

they will be paid faster than medicaid.

Thais

[Guest guest]

Hi Sherri,

Good info and thanks for sharing with the group.  Activstyle is an approved and

active provider with both Aetna Better Health and IlliniCare of the Integrated

Care Program.

Let me know if I can be of any assistance to any of your clients, anytime!

 

PS, great seeing you at the recent ARC/Autism conference.

 

Mark.

From: Sherri Schneider <benefithelpss@...>

IPADDUnite

Sent: Friday, May 13, 2011 10:49 AM

Subject: Re: Re: Integrated Care Program

 

For people on Medicaid  who are:

- 65 and over

or

- blind

or

- have a disability

 

AND  they live in the community

 

AND they live in:

- suburban cook or

- Kane or

- Kankakee or

- DuPage or

- Lake or

- Will

 

AND DO NOT HAVE MEDICARE OR ANY OTHER COMPREHENSIVE COMMERCIAL INSURANCE:

 

They will need to be enrolled in INTEGRATED CARE.

This is a HMO program and we have two HMOs to pick from:

- AETNA BETTER CARE

or

- ILLINICARE HEALTH PLAN.

 

They each have either own list of hospitals and doctors. They are still

enrolling hospitals and doctors but, currently, most are far away from Lake

County and North Suburban Cook.

 

If you do NOT enroll with one, one will be assigned to you.

 

On a more personal note: I am not very happy (to say the least) about this

change in Medicaid as the current list of providers are not even remotely close

to most recipients. I am actively contacting congress people about this & I

encourage every one to do the same.

From: ELLEN BRONFELD <egskb@...>

Subject: Re: Integrated Care Program

IPADDUnite

Date: Friday, May 13, 2011, 12:23 PM

 

We have a similar situation in our area...no nearby hospitals (including the one

that is less than two blocks from Noah's house) and neither his internist nor

his psychiatrist are in the Aetna Network. We also had some problem with the

HIPPA rules...we had to fax guardianship papers to be able to complete the

registration process. Then, I got a call just last week from someone at Aetna,

to talk about case management, but the person on the phone wouldn't talk to me

unless I resent guardianship papers. I probably don't have to tell you what I

told her, since it wasn't very nice...

If you have any concerns you want to discuss with an Aetna representative, the

person I have been sharing my concerns with is:

Caroline () Hall

HallC1@...

Aetna Better Health

Member Services Manager

1-866-212-2851

www.AetnaBetterHealth.com/Illinois

I don't have a similar contact at Illini Care...

We have already received our membership booklet for Noah and it states that a

person in need of immediate emergency care can receive treatment at the nearest

hospital, but it also states that transfer to an in-network hospital should

occur as soon as the member is stabilized.

This concerns me. We need to share our stories...so please post and let's keep a

vigilant watch...thanks Thais for your helpful suggestions/comments.

Ellen

Ellen Garber Bronfeld

egskb@...

[Guest guest]

That's a good point, We should ask our legislator's to set the example by

being on the same plan they ask their constituants to accept.

I got Quentin's too and was about to call to see if they are planning to

sign up and if so which one. Have you already done this? Which doctor in

Naperville?

Quentin has still been seeing pediatric doctors who have been willing to keep

him on even after he went on medicaid at 18 but since this program concerns

elderly and disabled I will take this as an opportunity to change.

Thais

[Guest guest]

this is really wrong.....

I have decided to do something about it.

I have not kept all the stories so far

But if you are willing to give me information about how this is having a

negative impact on your children, I will pull it all together and create a white

paper we can all share with policy makers.

This makes me angry.

I am lucky as my daughter is a " dual eligible " meaning she has Medicaid and

Medicare so she is carved out of the pilot for now.

Send me your stories and I will create a report.

cathyfickerterrill@...

Ficker Terrill

On May 12, 2011, at 4:56 PM, Yoakam <lyoakam@...> wrote:

>

> I got Bill's packet today, too....went over to his primary for the last 6

years -- not signing up. So we get to start from scratch again. IlliniCare has

only 1, ONE!, physician in all of Naperville; and that office is 20-30 minutes

away. No hospital, on either plan. So our closest medical center in case

of emergency is 30 minutes away: Adventest Bollingbook Hospital. And this is a

GOOD thing? What if the PCP is not allowed to practice in Bollingbook?

>

> It is just so frustrating that this was forced on the least vocal, most

medically compromised individuals in our society not under medicare only to

benefit one man: Govenor Quinn. Is HE on this plan?

>

>

>

> Re: Re: Integrated Care Program

>

> Did they say how this would work for doctors who work through Loyola? I was

> nder the impression that these doctors get paid from Loyola. Angel's PCP works

> t one of Loyola's Primary Care locations (a few blocks from my house).

> Thanks

>

>

> Check my websites:

> www.angelspeaks.com

> www.angelspeaksproducts.com

> I'm on Twitter: http://twitter.com/angelspeaksprod

>

> We Grow Dreams - www.wegrowdreams.org

>

> From: Francis PALLUAU <fpalluau@...>

> ubject: Re: Re: Integrated Care Program

> o: IPADDUnite

> ate: Thursday, May 12, 2011, 3:30 PM

>

> But if you really like your doctor and he or she is willing they can do a

> ingle case agreement for Angel. It might be worth the try. Apparently doctors

> ho do this but don't join the network will be paid more quickly than medicaid.

> TW I got my letter today to but I've been too busy with Quentin's last IEP

> tomorrow) to take care of this but I found the Arc presentation very helpful.

> Thais

>

>

[Guest guest]

I think you guys should be coordinating with the Arc of Illinois and Faye

Manaster at Family to Family.

Charlotte

From: IPADDUnite [mailto:IPADDUnite ] On Behalf

Of Terrill

Sent: Thursday, May 19, 2011 12:59 PM

IPADDUnite

Subject: Re: Re: Integrated Care Program

this is really wrong.....

I have decided to do something about it.

I have not kept all the stories so far

But if you are willing to give me information about how this is having a

negative impact on your children, I will pull it all together and create a white

paper we can all share with policy makers.

This makes me angry.

I am lucky as my daughter is a " dual eligible " meaning she has Medicaid and

Medicare so she is carved out of the pilot for now.

Send me your stories and I will create a report.

cathyfickerterrill@... <mailto:cathyfickerterrill%40>

Ficker Terrill

On May 12, 2011, at 4:56 PM, Yoakam <lyoakam@...

<mailto:lyoakam%40aol.com> > wrote:

>

> I got Bill's packet today, too....went over to his primary for the last 6

years -- not signing up. So we get to start from scratch again. IlliniCare has

only 1, ONE!, physician in all of Naperville; and that office is 20-30 minutes

away. No hospital, on either plan. So our closest medical center in case

of emergency is 30 minutes away: Adventest Bollingbook Hospital. And this is a

GOOD thing? What if the PCP is not allowed to practice in Bollingbook?

>

> It is just so frustrating that this was forced on the least vocal, most

medically compromised individuals in our society not under medicare only to

benefit one man: Govenor Quinn. Is HE on this plan?

>

>

>

> Re: Re: Integrated Care Program

>

> Did they say how this would work for doctors who work through Loyola? I was

> nder the impression that these doctors get paid from Loyola. Angel's PCP works

> t one of Loyola's Primary Care locations (a few blocks from my house).

> Thanks

>

>

> Check my websites:

> www.angelspeaks.com

> www.angelspeaksproducts.com

> I'm on Twitter: http://twitter.com/angelspeaksprod

>

> We Grow Dreams - www.wegrowdreams.org

>

> From: Francis PALLUAU <fpalluau@... <mailto:fpalluau%40wowway.com> >

> ubject: Re: Re: Integrated Care Program

> o: IPADDUnite <mailto:IPADDUnite%40>

> ate: Thursday, May 12, 2011, 3:30 PM

>

> But if you really like your doctor and he or she is willing they can do a

> ingle case agreement for Angel. It might be worth the try. Apparently doctors

> ho do this but don't join the network will be paid more quickly than medicaid.

> TW I got my letter today to but I've been too busy with Quentin's last IEP

> tomorrow) to take care of this but I found the Arc presentation very helpful.

> Thais

>

>

[Guest guest]

Charlotte,

Once I get it all written up, I plan to partner with The Institute on Public

Policy, the Arc, Family to Family, the Family Support Network and any one else

who would support us.

Ficker Terrill

On May 19, 2011, at 2:48 PM, " Charlotte Cronin " <fsn@...>

wrote:

> I think you guys should be coordinating with the Arc of Illinois and Faye

Manaster at Family to Family.

>

> Charlotte

>

> From: IPADDUnite [mailto:IPADDUnite ] On Behalf

Of Terrill

> Sent: Thursday, May 19, 2011 12:59 PM

> IPADDUnite

> Subject: Re: Re: Integrated Care Program

>

> this is really wrong.....

> I have decided to do something about it.

> I have not kept all the stories so far

> But if you are willing to give me information about how this is having a

negative impact on your children, I will pull it all together and create a white

paper we can all share with policy makers.

> This makes me angry.

>

> I am lucky as my daughter is a " dual eligible " meaning she has Medicaid and

Medicare so she is carved out of the pilot for now.

>

> Send me your stories and I will create a report.

>

> cathyfickerterrill@... <mailto:cathyfickerterrill%40>

>

> Ficker Terrill

>

> On May 12, 2011, at 4:56 PM, Yoakam <lyoakam@...

<mailto:lyoakam%40aol.com> > wrote:

>

> >

> > I got Bill's packet today, too....went over to his primary for the last 6

years -- not signing up. So we get to start from scratch again. IlliniCare has

only 1, ONE!, physician in all of Naperville; and that office is 20-30 minutes

away. No hospital, on either plan. So our closest medical center in case

of emergency is 30 minutes away: Adventest Bollingbook Hospital. And this is a

GOOD thing? What if the PCP is not allowed to practice in Bollingbook?

> >

> > It is just so frustrating that this was forced on the least vocal, most

medically compromised individuals in our society not under medicare only to

benefit one man: Govenor Quinn. Is HE on this plan?

> >

> >

> >

> > Re: Re: Integrated Care Program

> >

> > Did they say how this would work for doctors who work through Loyola? I was

> > nder the impression that these doctors get paid from Loyola. Angel's PCP

works

> > t one of Loyola's Primary Care locations (a few blocks from my house).

> > Thanks

> >

> >

> > Check my websites:

> > www.angelspeaks.com

> > www.angelspeaksproducts.com

> > I'm on Twitter: http://twitter.com/angelspeaksprod

> >

> > We Grow Dreams - www.wegrowdreams.org

> >

> > From: Francis PALLUAU <fpalluau@... <mailto:fpalluau%40wowway.com> >

> > ubject: Re: Re: Integrated Care Program

> > o: IPADDUnite <mailto:IPADDUnite%40>

> > ate: Thursday, May 12, 2011, 3:30 PM

> >

> > But if you really like your doctor and he or she is willing they can do a

> > ingle case agreement for Angel. It might be worth the try. Apparently

doctors

> > ho do this but don't join the network will be paid more quickly than

medicaid.

> > TW I got my letter today to but I've been too busy with Quentin's last IEP

> > tomorrow) to take care of this but I found the Arc presentation very

helpful.

> > Thais

> >

> >

[Guest guest]

Great... I just know that Faye is a pit bull on this and could probably be a

big help.

Sent via DROID on Verizon Wireless

Re: Re: Integrated Care Program

> >

> > Did they say how this would work for doctors who work through Loyola? I

was

> > nder the impression that these doctors get paid from Loyola. Angel's PCP

works

> > t one of Loyola's Primary Care locations (a few blocks from my house).

> > Thanks

> >

> >

> > Check my websites:

> > www.angelspeaks.com

> > www.angelspeaksproducts.com

> > I'm on Twitter: http://twitter.com/angelspeaksprod

> >

> > We Grow Dreams - www.wegrowdreams.org

> >

> > From: Francis PALLUAU <fpalluau@...

<mailto:fpalluau%40wowway.com> >

> > ubject: Re: Re: Integrated Care Program

> > o: IPADDUnite <mailto:IPADDUnite%40>

> > ate: Thursday, May 12, 2011, 3:30 PM

> >

> > But if you really like your doctor and he or she is willing they can do

a

> > ingle case agreement for Angel. It might be worth the try. Apparently

doctors

> > ho do this but don't join the network will be paid more quickly than

medicaid.

> > TW I got my letter today to but I've been too busy with Quentin's last

IEP

> > tomorrow) to take care of this but I found the Arc presentation very

helpful.

> > Thais

> >

> >

[Guest guest]

Great

I will get you the new contact at Illini care. He has a child with a disability.

I just do not want to lose these first hand stories.

This is not good public policy.

Ficker Terrill

On May 20, 2011, at 7:33 AM, " ELLEN BRONFELD " <egskb@...> wrote:

> Thanks for offering to compile the information, .

> I am sending bits and pieces, as I get comments, back to the representative at

Aetna (I don't have a contact at Illini Care) and I cc everything to Hamo

....They need to be hearing the stories...

> Ellen

> Ellen Garber Bronfeld

> egskb@...

>

>

[Guest guest]

Hi ,

I've been gone for 3 weeks and see there are many emails on the integrated care

program to catch up on.  Thank for your willingness to compile stories about

issues with this pilot. 

My state representative is highly skeptical of managed care organizations,

having had years of experience with them through an advocacy group.  She asked

for feedback on this pilot, so I'll be very glad to pass it on.  And I hope

others on IPADD will also share the information with their state representatives

and, of course, to Hamos.

Medicaid and public employee pensions are the two biggest parts of Illinois'

budget.  Given the continuing bad budget situation, it seems inevitable that

legislators will work for Medicaid " reform. "   I think we must let them know how

it impacts our families.

Thanks again.

Bonnie Dohogne

________________________________

From: Terrill <fickerterrill@...>

" IPADDUnite " <IPADDUnite >

Sent: Thu, May 19, 2011 2:51:46 PM

Subject: Re: Re: Integrated Care Program

 

Charlotte,

Once I get it all written up, I plan to partner with The Institute on Public

Policy, the Arc, Family to Family, the Family Support Network and any one else

who would support us.

Ficker Terrill

On May 19, 2011, at 2:48 PM, " Charlotte Cronin " <fsn@...>

wrote:

> I think you guys should be coordinating with the Arc of Illinois and Faye

>Manaster at Family to Family.

>

> Charlotte

>

> From: IPADDUnite [mailto:IPADDUnite ] On Behalf

>Of Terrill

> Sent: Thursday, May 19, 2011 12:59 PM

> IPADDUnite

> Subject: Re: Re: Integrated Care Program

>

> this is really wrong.....

> I have decided to do something about it.

> I have not kept all the stories so far

> But if you are willing to give me information about how this is having a

>negative impact on your children, I will pull it all together and create a

white

>paper we can all share with policy makers.

> This makes me angry.

>

> I am lucky as my daughter is a " dual eligible " meaning she has Medicaid and

>Medicare so she is carved out of the pilot for now.

>

>

> Send me your stories and I will create a report.

>

> cathyfickerterrill@... <mailto:cathyfickerterrill%40>

>

> Ficker Terrill

>

> On May 12, 2011, at 4:56 PM, Yoakam <lyoakam@...

><mailto:lyoakam%40aol.com> > wrote:

>

> >

> > I got Bill's packet today, too....went over to his primary for the last 6

>years -- not signing up. So we get to start from scratch again. IlliniCare has

>only 1, ONE!, physician in all of Naperville; and that office is 20-30 minutes

>away. No hospital, on either plan. So our closest medical center in

case

>of emergency is 30 minutes away: Adventest Bollingbook Hospital. And this is a

>GOOD thing? What if the PCP is not allowed to practice in Bollingbook?

> >

> > It is just so frustrating that this was forced on the least vocal, most

>medically compromised individuals in our society not under medicare only to

>benefit one man: Govenor Quinn. Is HE on this plan?

> >

> >

> >

> > Re: Re: Integrated Care Program

> >

> > Did they say how this would work for doctors who work through Loyola? I was

> > nder the impression that these doctors get paid from Loyola. Angel's PCP

>works

>

> > t one of Loyola's Primary Care locations (a few blocks from my house).

> > Thanks

> >

> >

> > Check my websites:

> > www.angelspeaks.com

> > www.angelspeaksproducts.com

> > I'm on Twitter: http://twitter.com/angelspeaksprod

> >

> > We Grow Dreams - www.wegrowdreams.org

> >

> > From: Francis PALLUAU <fpalluau@... <mailto:fpalluau%40wowway.com> >

> > ubject: Re: Re: Integrated Care Program

> > o: IPADDUnite <mailto:IPADDUnite%40>

> > ate: Thursday, May 12, 2011, 3:30 PM

> >

> > But if you really like your doctor and he or she is willing they can do a

> > ingle case agreement for Angel. It might be worth the try. Apparently

doctors

>

> > ho do this but don't join the network will be paid more quickly than

>medicaid.

>

> > TW I got my letter today to but I've been too busy with Quentin's last IEP

> > tomorrow) to take care of this but I found the Arc presentation very

helpful.

> > Thais

> >

> >

[Guest guest]

Bonnie,

Here is what I have so far.

Illinois Integrated Care Pilot

The first few weeks….. June 6, 2011

… Thoughts from parents who are trying to coordinate their child’s medical

care….

Story #1

I got Bill's packet today, too....went over to his primary for the last 6 years

-- not signing up. So we get to start from scratch again. IlliniCare has only 1,

ONE!, physician in all of Naperville; and that office is 20-30 minutes away. No

hospital, on either plan. So our closest medical center in case of

emergency is 30 minutes away: Adventest Bollingbook Hospital. And this is a GOOD

thing? What if the PCP is not allowed to practice in Bollingbook?

It is just so frustrating that this was forced on the least vocal, most

medically compromised individuals in our society not under Medicare only to

benefit one man: Governor Quinn. Is HE on this plan?

Story #2

We are now in the throws of trying to figure out what to do with the changes in

Medicaid that are being forced upon our daughter, as a handicapped adult, by the

State of Illinois.

My wife and I have spent a great number of hours on the phone these past few

days with Integrated Care, IlliniCare, Aetna Better Health, various hospitals,

and various doctors' offices trying to find out if anyone is joining these new

networks that are being thrust upon us. To our dismay and tremendous

frustration we have been told by ALL of 's doctors, specialists, and

hospital (Northwest Community Hospital) that none of them have joined, nor are

they planning to join, either of these programs.

has some very specific health needs and this now puts her in a very

precarious and dangerous predicament.

I am writing to ask if you know about these changes and if anything is going on

from a legal standpoint to try to fight this.

It seems clearly discriminatory that the State of Illinois has singled out

" older adults " and " adults with disabilities " as the two groups who are affected

by these changes. Is there anything we can do to keep with her

present physicians and hospital? Or is there some avenue we may pursue to fight

this?

Any help you can offer will be greatly appreciated.

Story #3

So, how does this stupid program affect my family?

Well, the closest hospital, a level 1 trauma center, is Good Samaritan. It is

not listed. Less than a mile away, Good Samaritan has an emergency outpatient

facility, which I have used for my daughter (also used it for hubby). It's much

easier than going to the ER at Good Samaritan.

All of Angel's doctors are now out of Loyola. I did that on purpose - because

Loyola accepted Medicaid, they have a great reputation, and a Loyola Primary

Care facility is walking distance from me. Angel's new PCP is there, plus her

new podiatrist is there once a week, making Angel's medical care easier. Angel

goes to Loyola University in Maywood for her psychiatric care. She's been doing

this for, I believe seven years now. Again, at the time, Loyola was selected

because it's a university medical center and getting her psychiatric help when

she was 15 was easier and quicker (though I did check out some of the hospitals

listed).

My brother in law is a doctor and he does not take Aetna. My sister did not

have favorable things to say about Aetna when it comes to the payment

department.

Plus since Medicaid made my daughter her 'head of case' (even though I included

the guardianship papers with the Medicaid application), I now have to go through

the hassle of having that changed before I can make changes with the Integrated

Care Program.

Story #4

I received this packet of information in the mail. Today I called to find out

what it is all about. I have three children with intellectual disabilities and

my oldest is Rick. He is 20 and has Down syndrome. He is moderately involved.

At 18 we had to switch from his pediatrician to a general practitioner for

adults. Well, let me tell you, that did not go over well.

I made my call today to find out more about this program. The nice young lady

did my intake and then asked about his doctor. I informed her who my son's

doctor is and that he is with Loyola Hospital. Of course, that is not on either

program. I explained our situation; that my son will not see any other doctor

and that it is important he stay with Loyola since all of his specialist are

practicing out of Loyola Hospital. She will send a note to the doctor to see if

he is willing to accept either of the programs.

They seemed nice enough, but what are families who have VERY involved loved ones

going to do? I'm upset about my own son, but I immediately thought about the

families with more involved children; all the medical records, comfort levels

etc.

Something is not right about this whole program.

Story #5

Hi all:

We just had our first experience with Integrated Care...I was told that Noah

needed vision testing annually as part of his ISP. There is a group called March

Vision Care that signed on to Aetna Better Health. When I called, I was given

the closest providers, one of which was about 10 minutes away...Rosin EyeCare

Glenview (there are a number of Rosin Eyecare offices, and, I think, all are

part of this.) The O.D., Bechtold was very nice to Noah and the exam was

quite thorough. Office staff were also very nice. This particular office is

located at 1346 Patriot Blvd, Glenview, 847-729-5050...

I am now waiting to see if Aetna pays...I asked the office staff to be sure to

let me know if there is any problem.

STORY #6

Yes I would love the name of any of the good docs you have found. Like I said, I

contacted Aetna and did the HFS on line search and NOTHING came up in the

suburban area -even if I didn't specify a particular specialty of service. This

is so much worse than Bad Medicaid. It will force us to abuse the system and

go to the hospital for care just like smart insured people are not supposed to

do. I think I will be very happy if the Walgreen Take Care Clinic or CVS will

take this Insurance to tell you the truth- it's convenient when you are sick and

they care so much about you when there are Nurse Practitioners - unlike our

state -

Story #7

This is just more and more frustrating. Today, I found out that some

secondary/backup physicians who Bill has seen that ARE listed with Aetna on

their website are listed because they take the Aetna INSURANCE. NOT this new ICP

stuff. So a physician's name listed on the companies websites is NOT a guarantee

they are in the program, as discussed in the letters I've been receiving. So

company websites are no good.

So I called the help number -- of course she won't talk to me without my faxing

the guardianship papers (SO GLAD I filed for those) and waiting for a call back

from the office sometime tomorrow or the next day before anyone will talk to me

about anything. Instead, she directed me to <http://www.illinoiscebICP.com>

www.illinoiscebICP.com So the help phone number is no good.

So I went to www.illinoiscebICP.com NOTHING. First they wanted all Bill's

numbers (SSN and Medicaid) on a NONSECURED site (WHAT????) before I could even

search. So I crossed my fingers, listed the numbers, misspelled our family name

as the state has done for 6 years, and was then allowed to search. again NOTHING

in our zip code, NOTHING in our county. I tried multiple searches, multiple

combinations, added, deleted criteria. Always NOTHING!!!! So the ICP web site is

no good.

When I asked Bill's doctor what his advice was since I'm not finding any PCPs in

this town, or the next towns, I was advised " take him to the ER, they'll treat

him there " . So we have to use the ER for routine medical care?? This is supposed

to be cost-savings????????

And now I find I have no card for June -- his card expires today. Is the state

not sending out the old cards for June?

PLEASE HELP!!!!!!!

One very frustrated Mother / guardian / POA

Story # 8

The choices for PCPs are pathetic. I can't even pronounce the names of the

doctors, nor can I determine their gender by looking at their names. My daughter

(autistic) does not like to be examined by a male doctor. There are no female

doctors listed.

>Angel's next session with her psychiatrist is June 8th. She's been with Loyola

for behavioral health for six years now. As long as she is on these dangerous

meds, I have no intention of experimenting with a 'new' doctor from that

pathetic list. I will ask her doctor for instructions on weaning her off the

meds. For regular medical care, I'll take her to the ER. Screw this freakin

state. The most vulnerable of its citizens, older adults and adults with

disabilities have been banished to this horrible program. The parasites still

get the free ride.

>I just hope that my husband gets this new job and we can put Angel on the

insurance.

>Does anyone know the bill number where this horrible program was passed? I want

to get a list of the representatives and state senators who voted for it,

because I intend to use the internet to convince their constituents to vote for

someone else. A dog could do a better job in Springfield.

Story #9

I feel the same way. I too would like to know who's behind this

thoughtless piece of legislation. My daughters long time medication has now

been changed and I found this out when I went to pick up her meds at the

pharmacy and our new doctor is a half hour away and is located in a

Walmart.

I will be the voice for my daughter; this is not right.

From: IPADDUnite [mailto:IPADDUnite ] On Behalf

Of Bonnie Dohogne

Sent: Wednesday, June 08, 2011 3:28 PM

IPADDUnite

Subject: Re: Re: Integrated Care Program

Hi ,

I've been gone for 3 weeks and see there are many emails on the integrated care

program to catch up on. Thank for your willingness to compile stories about

issues with this pilot.

My state representative is highly skeptical of managed care organizations,

having had years of experience with them through an advocacy group. She asked

for feedback on this pilot, so I'll be very glad to pass it on. And I hope

others on IPADD will also share the information with their state representatives

and, of course, to Hamos.

Medicaid and public employee pensions are the two biggest parts of Illinois'

budget. Given the continuing bad budget situation, it seems inevitable that

legislators will work for Medicaid " reform. " I think we must let them know how

it impacts our families.

Thanks again.

Bonnie Dohogne

________________________________

[Guest guest]

I was advised by Faye at Arc of Illinois to ask for a single case agreement. She

sent me the sample letter and I compiled a list of all doctors, providers and

hospitals that Quentin has been seeing as well as a list of meds (the generic

brand caused him to have increased seizures), our guardianship papers and sent

all of this to the Bureau of Contract Management with copys to Arc, our senator

and rep.

I will post as soon as I hear back from them.

Thais

[Guest guest]

Thanks, . I'll forward these to my state rep. and senator.

Bonnie

________________________________

From: Terrill <fickerterrill@...>

IPADDUnite

Sent: Fri, June 10, 2011 10:29:38 AM

Subject: RE: Re: Integrated Care Program

Bonnie,

Here is what I have so far.

Illinois Integrated Care Pilot

The first few weeks….. June 6, 2011

… Thoughts from parents who are trying to coordinate their child’s medical

care….

Story #1

I got Bill's packet today, too....went over to his primary for the last 6 years

-- not signing up. So we get to start from scratch again. IlliniCare has only 1,

ONE!, physician in all of Naperville; and that office is 20-30 minutes away. No

hospital, on either plan. So our closest medical center in case of

emergency is 30 minutes away: Adventest Bollingbook Hospital. And this is a GOOD

thing? What if the PCP is not allowed to practice in Bollingbook?

It is just so frustrating that this was forced on the least vocal, most

medically compromised individuals in our society not under Medicare only to

benefit one man: Governor Quinn. Is HE on this plan?

Story #2

We are now in the throws of trying to figure out what to do with the changes in

Medicaid that are being forced upon our daughter, as a handicapped adult, by the

State of Illinois.

My wife and I have spent a great number of hours on the phone these past few

days with Integrated Care, IlliniCare, Aetna Better Health, various hospitals,

and various doctors' offices trying to find out if anyone is joining these new

networks that are being thrust upon us. To our dismay and tremendous

frustration we have been told by ALL of 's doctors, specialists, and

hospital (Northwest Community Hospital) that none of them have joined, nor are

they planning to join, either of these programs.

has some very specific health needs and this now puts her in a very

precarious and dangerous predicament.

I am writing to ask if you know about these changes and if anything is going on

from a legal standpoint to try to fight this.

It seems clearly discriminatory that the State of Illinois has singled out

" older adults " and " adults with disabilities " as the two groups who are affected

by these changes. Is there anything we can do to keep with her

present physicians and hospital? Or is there some avenue we may pursue to fight

this?

Any help you can offer will be greatly appreciated.

Story #3

So, how does this stupid program affect my family?

Well, the closest hospital, a level 1 trauma center, is Good Samaritan. It is

not listed. Less than a mile away, Good Samaritan has an emergency outpatient

facility, which I have used for my daughter (also used it for hubby). It's much

easier than going to the ER at Good Samaritan.

All of Angel's doctors are now out of Loyola. I did that on purpose - because

Loyola accepted Medicaid, they have a great reputation, and a Loyola Primary

Care facility is walking distance from me. Angel's new PCP is there, plus her

new podiatrist is there once a week, making Angel's medical care easier. Angel

goes to Loyola University in Maywood for her psychiatric care. She's been doing

this for, I believe seven years now. Again, at the time, Loyola was selected

because it's a university medical center and getting her psychiatric help when

she was 15 was easier and quicker (though I did check out some of the hospitals

listed).

My brother in law is a doctor and he does not take Aetna. My sister did not

have favorable things to say about Aetna when it comes to the payment

department.

Plus since Medicaid made my daughter her 'head of case' (even though I included

the guardianship papers with the Medicaid application), I now have to go through

the hassle of having that changed before I can make changes with the Integrated

Care Program.

Story #4

I received this packet of information in the mail. Today I called to find out

what it is all about. I have three children with intellectual disabilities and

my oldest is Rick. He is 20 and has Down syndrome. He is moderately involved.

At 18 we had to switch from his pediatrician to a general practitioner for

adults. Well, let me tell you, that did not go over well.

I made my call today to find out more about this program. The nice young lady

did my intake and then asked about his doctor. I informed her who my son's

doctor is and that he is with Loyola Hospital. Of course, that is not on either

program. I explained our situation; that my son will not see any other doctor

and that it is important he stay with Loyola since all of his specialist are

practicing out of Loyola Hospital. She will send a note to the doctor to see if

he is willing to accept either of the programs.

They seemed nice enough, but what are families who have VERY involved loved ones

going to do? I'm upset about my own son, but I immediately thought about the

families with more involved children; all the medical records, comfort levels

etc.

Something is not right about this whole program.

Story #5

Hi all:

We just had our first experience with Integrated Care...I was told that Noah

needed vision testing annually as part of his ISP. There is a group called March

Vision Care that signed on to Aetna Better Health. When I called, I was given

the closest providers, one of which was about 10 minutes away...Rosin EyeCare

Glenview (there are a number of Rosin Eyecare offices, and, I think, all are

part of this.) The O.D., Bechtold was very nice to Noah and the exam was

quite thorough. Office staff were also very nice. This particular office is

located at 1346 Patriot Blvd, Glenview, 847-729-5050...

I am now waiting to see if Aetna pays...I asked the office staff to be sure to

let me know if there is any problem.

STORY #6

Yes I would love the name of any of the good docs you have found. Like I said, I

contacted Aetna and did the HFS on line search and NOTHING came up in the

suburban area -even if I didn't specify a particular specialty of service. This

is so much worse than Bad Medicaid. It will force us to abuse the system and

go to the hospital for care just like smart insured people are not supposed to

do. I think I will be very happy if the Walgreen Take Care Clinic or CVS will

take this Insurance to tell you the truth- it's convenient when you are sick and

they care so much about you when there are Nurse Practitioners - unlike our

state -

Story #7

This is just more and more frustrating. Today, I found out that some

secondary/backup physicians who Bill has seen that ARE listed with Aetna on

their website are listed because they take the Aetna INSURANCE. NOT this new ICP

stuff. So a physician's name listed on the companies websites is NOT a guarantee

they are in the program, as discussed in the letters I've been receiving. So

company websites are no good.

So I called the help number -- of course she won't talk to me without my faxing

the guardianship papers (SO GLAD I filed for those) and waiting for a call back

from the office sometime tomorrow or the next day before anyone will talk to me

about anything. Instead, she directed me to <http://www.illinoiscebICP.com>

www.illinoiscebICP.com So the help phone number is no good.

So I went to www.illinoiscebICP.com NOTHING. First they wanted all Bill's

numbers (SSN and Medicaid) on a NONSECURED site (WHAT????) before I could even

search. So I crossed my fingers, listed the numbers, misspelled our family name

as the state has done for 6 years, and was then allowed to search. again NOTHING

in our zip code, NOTHING in our county. I tried multiple searches, multiple

combinations, added, deleted criteria. Always NOTHING!!!! So the ICP web site is

no good.

When I asked Bill's doctor what his advice was since I'm not finding any PCPs in

this town, or the next towns, I was advised " take him to the ER, they'll treat

him there " . So we have to use the ER for routine medical care?? This is supposed

to be cost-savings????????

And now I find I have no card for June -- his card expires today. Is the state

not sending out the old cards for June?

PLEASE HELP!!!!!!!

One very frustrated Mother / guardian / POA

Story # 8

The choices for PCPs are pathetic. I can't even pronounce the names of the

doctors, nor can I determine their gender by looking at their names. My daughter

(autistic) does not like to be examined by a male doctor. There are no female

doctors listed.

>Angel's next session with her psychiatrist is June 8th. She's been with Loyola

>for behavioral health for six years now. As long as she is on these dangerous

>meds, I have no intention of experimenting with a 'new' doctor from that

>pathetic list. I will ask her doctor for instructions on weaning her off the

>meds. For regular medical care, I'll take her to the ER. Screw this freakin

>state. The most vulnerable of its citizens, older adults and adults with

>disabilities have been banished to this horrible program. The parasites still

>get the free ride.

>I just hope that my husband gets this new job and we can put Angel on the

>insurance.

>Does anyone know the bill number where this horrible program was passed? I want

>to get a list of the representatives and state senators who voted for it,

>because I intend to use the internet to convince their constituents to vote for

>someone else. A dog could do a better job in Springfield.

Story #9

I feel the same way. I too would like to know who's behind this

thoughtless piece of legislation. My daughters long time medication has now

been changed and I found this out when I went to pick up her meds at the

pharmacy and our new doctor is a half hour away and is located in a

Walmart.

I will be the voice for my daughter; this is not right.

From: IPADDUnite [mailto:IPADDUnite ] On Behalf

Of Bonnie Dohogne

Sent: Wednesday, June 08, 2011 3:28 PM

IPADDUnite

Subject: Re: Re: Integrated Care Program

Hi ,

I've been gone for 3 weeks and see there are many emails on the integrated care

program to catch up on. Thank for your willingness to compile stories about

issues with this pilot.

My state representative is highly skeptical of managed care organizations,

having had years of experience with them through an advocacy group. She asked

for feedback on this pilot, so I'll be very glad to pass it on. And I hope

others on IPADD will also share the information with their state representatives

and, of course, to Hamos.

Medicaid and public employee pensions are the two biggest parts of Illinois'

budget. Given the continuing bad budget situation, it seems inevitable that

legislators will work for Medicaid " reform. " I think we must let them know how

it impacts our families.

Thanks again.

Bonnie Dohogne

________________________________