I mentioned a while ago about how I had applied to receive a medicaid waiver for Liam and he didn't qualify. We received a letter from the state saying that Liam wasn't disabled enough to qualify and that the medicaid waiver program in NC was for medically fragile kids and kids who would be institutionalized if not for the waiver. According to their criteria, Liam wasn't qualified for their program and that was fine by me. I knew he didn't need to be institutionalized! They have standards and Liam didn't meet those so that was that.
It has been frustrating though to talk to moms in other states who receive medicaid and support through programs that our state doesn't offer. I've felt that Liam has lacked in his needs being met but there was nothing I could do. There are many things I would love to do with him but those services just aren't here in our area.
Anyway, when I mentioned to Liam's therapists that he did not qualify for our medicaid program, they were quite surprised. According to them, Liam has needs greater than some of their other clients who receive the waiver. I was shocked and decided to see about appealing the decision for Liam.
When I contacted the CAP program they reiterated their stance on their judgment but said that if I wanted I could have an evaluation done of Liam. But, if Liam still didn't qualify I would have to pay the $300 for the eval. I said I wanted it, thinking that they would surely qualify him once they actually saw him and the fee wouldn't need to be paid.
Right before we were due to get the eval, I was contacted by the person who would do it. They told me on the phone that I needed to be aware that I had to pay for the eval and that Liam still wouldn't qualify. I asked him what he meant and he said that because the state had already decided no, they would almost assuredly decide no as well. So then, why would I pay for them to tell me no again? I then backed out of the eval thinking that was the end of it.
Fast forward a few months and I was talking to Liam's coordinator for his early intervention services. We were talking again about his denial for medicaid and she said the way I was treated was horrible. She couldn't believe he was denied before getting an evaluation. For the CDSA, it is against the law for them to deny a kid services without even evaluating them. They have to see them and put their hands on them to know whether a child qualifies. She told me that I should probably call the attorney generals office and complain about how we were treated.
I just never got around to doing it. October passed to November and I was gone the whole month for oxygen treatments. Then came Christmas and we were into January before I knew it. I finally decided to get serious and call the attorney general.
I found a number online and called it.
I got transferred to another number. I left a message.
They called back and gave me a different number.
I called this number and again left a message.
Someone from there called me and left a message for me.
I called back and let a message.
Finally, she calls me back and I'm home and she's the person I needed to talk to. I told her what had happened with trying to get Liam evaluated, how we were treated and what we needed. She apologized and said she would get me an evaluation right away. And that was it.
She did exactly what she said she would do and I had someone from the CAP office calling me that very next week. The sweet lady on the phone said she didn't understand how Liam didn't get approved the first time around. I just had to go back down to the department of social services first and apply for CAP again.
After having to reapply for Medicaid, Liam finally got his evaluation.
And yesterday he was finally approved.
