Posted on November 17, 2011 · Posted in TBI Voices
This entry is part 7 of 17 in the series Rita

Severe Brain Injury Under Medicaid: Rita Part Seven

Severe brain injury under Medicaid is limited to how much therapy they will cover and in Rita’s case it was very little considering how severe her brain injury was. At some point, every family realizes that they have to do more than they are going to get from the system.  Sadly, for those like our previous interviewee, Steven, if there is no family to help, “necessary but uncovered things” such as in severe brain injury under Medicaid don’t get done.  Rita’s Mom explains what they did because severe brain injury under Medicaid is limited:

There’s two things that we did (to help with her therapy because severe brain injury under Medicaid). We hired a musical therapist to come. The first time she came was the 15th of February, and it was amazing.

Of which year?  2010?

Yeah.  When she was still on the fifth floor and not getting anything (any therapy because of severe brain injury under Medicaid).  She came maybe two times a week, and it really, it really made a difference.  You could tell.

What did the music therapist do?

She had an instrument called a key chord where you play music, and what she basically started out doing was all the music that’s embedded in our brain like, Christmas music was the main thing; just songs like, you know, Happy Birthday, things that you just know.

And it, it was amazing how she recognized it.  When she did Silent Night, Janelle would always close her eyes when that part came.  We were like amazed.  But, you could tell she was listening and  understood the song.  She had told me that the music part of your brain is located right next to your speech center.  That’s why music therapy helps so much.

Tell me more about music therapy which severe brain injury under Medicaid would not be covered. 

Well look about what happened with Gaby Giffords.  That rehabilitation place I saw it on the news.  She had music therapy, like right away from the get go.  Music is just something that is, brings back a lot of information and memories, and so.

Is it safe to say that your daughter didn’t get quite the resources towards her rehabilitation because of the limitations of severe brain injury under Medicaidas Gaby Gifford did?

Oh, no question.  Absolutely no question.  She was in some great place for five or six months.

As a Florida real estate broker two years ago you were probably more of a Republican than a Democrat?

I’m an independent.

You got to more of an independent and less of a Republican.

Yeah.  That’s for sure.  That’s for sure.

Talk about Medicaid.

Oh, don’t get me started.

They talk about Medicaid as if it’s some sort of – they call it an entitlement program.  It’s like somehow or other, we’re wasting our money on the undeserving of poor or the severe brain injury under Medicaid.

Medicaid.  Well, this is, you just brought up the subject that you have to be, you cannot get Medicare, which I’m hoping might be better than Medicaid.  I don’t know.  Um, you can’t get that until, uh, for two years.

29 months?

Yeah.  After your, after you start collecting your Social Security disability.  So it’s not even two years after your accident.  It’s –

So when does she become eligible for Medicare in addition to severe brain injury under Medicaid?

It would be a year from now.  It’ll be a year because I didn’t get her, she didn’t get her Social Security disability until July of 2010.  So it’s a year after you start getting your Social Security disability.  So it has nothing to do when, when you had your accident.

You were saying about severe brain injury under Medicaid.

Medicaid, they’re just very stingy in the State of Florida.  First of all, you can’t talk to anybody.  There’s nobody to talk to.  They do have an 800 number.  But you wait forever, and then you probably don’t get your answer.  Okay? I don’t want to sound like I’m ungrateful because they did pay for all the bills.  I mean, I didn’t even see any of the bills.  I don’t know what the bills were.

One of the lawyers told me, keep a notebook of all the bills, which I did.  I never added them up. I assume that was all taken care of.  It’s just after you’re medically safe and you want to get the person, you know, some kind of life, that they need rehabilitation, that’s when it all starts.  So when she went to the nursing home, she, she paid her, her portion.  She basically gave her Social Security disability.

It all went to pay for her, the nursing home stay.

One of the oft repeated campaign promises of the 2008 Presidential campaign was that all Americans should get the kind of medical coverage that members of Congress get.  Well, that didn’t happen.

Could there be any greater contrast than between the care received by a member of Congress got for her brain injury versus what a Medicaid patient in Florida received?  Gabby Giffords versus Rita.  Who has the better chance of recovery?

Five months on a general hospital ward floor with no treatment, waiting for a trach to be removed.  Then more time in a nursing home before she was deemed eligible for rehab and then six weeks, only three hours a day – and then out.

If we must ration care in our society, the rationing system should favor someone who is only 30 years old.  The choice is: a lifetime of recovery or a lifetime of profound disability.  We must choose recovery.  There is a public movement to occupy Wall Street.  Perhaps we in the brain injury community must start to occupy the Hospitals, until someone starts to get it.

Next in Part Eight – Troubled Return Home for Catastrophic Brain Injury Survivor

By Attorney Gordon Johnson


About the Author

Attorney Gordon S. Johnson, Jr.
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice :: 800-992-9447