Re: Money Follows the Person, PCS, etc.

[Guest guest]

Haven:

Did you have any problems getting through the disability review? MDCP called me today. Even though they'd told me previously been "approved," now they're saying we're not. We passed the "medical necessity" review and are stuck in "disability determination." They told us we had enough documentation for the first but not the second. I'm having to get our doctor to write a really in depth letter - we're hoping she'll do it but she's already written two for us. Its so frustrating! We'd counted on starting services in August at the latest and now we don't even know if we'll get services for .

Preston was completely denied. Even after a review. They said he doesn't demonstrate "medical necessity." I think its because he's got an Asperger's diagnosis instead of Autism.

I'm just ready to sit down and cry.

Any advice?

Thanks,

Byrne

Read our kids'stories online at Caring Bridge - http://www.caringbridge.org/visit/prestonbyrne and http://www.caringbridge.org/visit/toribyrne

To: Texas-Autism-Advocacy Sent: Sun, June 6, 2010 9:49:13 PMSubject: Re: Money Follows the Person, PCS, etc.

,It sounds like your situation and ours are similar, but you have TWO special needs kids! Like you, I care for my mother. She is pretty independent for 86. she has her own house on our farm (a nice double-wide) and we put it across the driveway, and I gave her a bullhorn to keep by the bed that has a siren on it that sounds like a civil defense siren. If she needed me in the middle of the night, all she has to do is push a button, and I imagine the siren will wake the neighborhood!But our house was too small to move her into, and we just had a new septic installed and are still having trouble! 5600 dollars and we are still having trouble! Now they say the problem is in the pipes under the house! Good grief!Anyway, my dad died about four years ago suddenly. My mom had a stoke years ago and then a pretty good heart attack, but she has been doing well. She is still

driving. However, DPS has ordered her to take a driving test this Thursday, and I am praying she passes as if she doesn't, I will have to drive her everywhere, and she likes to go, go, go. I am a homebody. Beginning next week, though, my son will start his summer program over sixty miles away. My husband will take him in the mornings and I will pick him up in the afternoons --so that will be 130 miles round trip. i wish there were an appropriate program closer, but there just isn't. So we do what we have to do. I hope your paperwork goes through quickly and you get on the program soon. It will be a big help to you. My respite worker helps me with watching my son, helping with his laundry (geez, he can go through clothes!) and since i cook all his meals from scatch, she helps with clean up and with his room and with tutoring, and she helps with getting his educational notebooks and

medical notebooks in order. I also like the extra help if we go shopping. It is just good to have an extra set of eyes on him.For us, I am just so glad that we were able to get him into therapies again.

[Guest guest]

No.  We didn't have any trouble.  But I had over a thousand pages of medical records, including 300 pages of emergency room visits, and reports from a lot of doctors and therapists.  However, we are up for review again, so who knows.  Here we go again......  You have to redo the paperwork and get reviewed every year.

My son has some serious lung issues : asthma, chronic bronchitis, chronic pneumonia.  Did you ask them what their specific criteria is?