Fw: Integrated Care Program

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From: Finato <cmfinato@...>

Subject: Integrated Care Program

" Bellock " <rep@...>

Date: Friday, June 10, 2011, 4:48 PM

Dear Representative Bellock:

I am the parent of a 22 year old daughter with autism.  She has been on

Medicaid since she turned 19.

I, and many other parents of adult children with disabilities, recently received

a packet from the Illinois Department of Healthcare and Family Services about

how 'Medicaid is changing to better serve you'.  The program - Integrated Care

Program.

After reading this packet and spending days online trying to find providers for

my daughter, my question is,

" how is this going to better serve me? " .

It took me several weeks to find doctors who accept Medicaid to treat her.  All

of her doctors are from Loyola University, where my daughter has been under the

care of a psychiatrist at their Behavioral Health department for the last seven

years (this happened after she had to be hospitalized because of a bad reaction

to medication prescribed by her pediatric neurologist.  Since being under

Loyola's care, Angel has made tremendous improvement.  It took us six months to

get into Loyola's program.

Now that is going to change.  Loyola is not part of (nor do they intend to be

part of) this stupid plan.  In fact, I don't see any level 1 hospitals on the

list that is part of the Aetna Better Health or IlliniCare Health Plans.  The

closest hospital to my house is a level 1, Good Samaritan.   They have an

emergency outpatient facility about one mile from

me.

Individuals with autism do not react well to change.  My daughter will not let

a male doctor physically examine her.  The provider listing provided on the

website does not give the ability to search for a female doctor.  I've also

noticed that the majority of the doctors are in Chicago, even though Chicago

residents aren't being banished to this program.  No wonder this state is in

such a dismal mess.

I am attaching the stories of other families who are going through the same

hardship that I am.

I am asking for your help in getting this program terminated until it can be set

up to actually better serve us.  HFS has given me until August 5th to choose a

PCP.  Their letter listed a PCP and plan that they have already picked for me

if I miss that deadline.  There's no way I can tell by reading the doctor's

name (I can't even pronounce it) if the doctor is a male or female.

Please,

Representative Bellock, help us keep our adult children SAFE and healthy.  My

daughter is taking dangerous drugs.  I don't want her to end up hospitalized

again.

Sincerely,

Finato

Stories from other families, the link to read emails from families impacted by

this, go to:

IPADDUnite/.

… 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.