This week has been extremely mentally exhausting for me. Where do I start? So as you all know last month Brendan was approved for state secondary insurance(ALTEC). We all know what I went through to get that for him. When I take Brendan to see his developmental doctor at the Melmed Center they have given me prescriptions for exactly how many hours of each different therapies they want for him. They give them based on his evaluations with them. So naturally as a mother you do what the doctor wants. Brendan has a team of therapist with a company called Sunrise and they are contracted with the state. Brendan has only been receiving speech therapy 2x a month and occupational therapy 2x a month with them. When I let Brendan's doctor know this information she flipped out because that isn't close to what she has prescribed for him. I explained to her that they wouldn't give me anymore therapy. She told me now that Brendan has state coverage I should try again to see if he can get more hours. Of course anything you do with the state isn't easy so I called my support coordinator with the state and asked for an emergency meeting so I could go over Brendan's goals and to hopefully get more hours. Every 90 days you sit down with your team and you all come up with goals together. We had our goal meeting for his IFSP last month but I just wasn't happy with the goals they set for Brendan. I have been in contact with the legal department for AZEIP(Arizona early intervention program) because I wanted to know what my legal rights were if they kept refusing to give me more hours. So once again I was back to studying more of the law. They had 14 days to give me my emergency meeting. So we had our meeting on Thursday. Normally during the meeting you will have your team there, which is your support coordinator, occupational therapist and the speech therapist. But of course for my meeting they send the support coordinator along with the director of Sunrise and the project manager of Sunrise. This told me they already knew that I was going to fight. I just took my level of momzilla up a notch after they walked in the door. We now begin to go over and rewrite all of Brendan's goals. We all have to agree on this together. This is where we started to disagree. I know that there goal is to give him easy goals so they can say look he has mastered all his goals in 90 days because then they don't have to give him as many hours. I wasn't going to let this happen. We battled with each other over all 7 categories of goals. I of course had a crying breakdown in the middle of fighting because it just makes me so mad how they try and manipulate you. Then after the goals where in place the therapist and director decided how many hours of therapy they will give him. They decided that he would get 1 hour of occupational a week and then still only 2 hours a month of speech. Well I am asking for 3 hours of occupational therapy a week and 2 hours of speech a week. This is what his doctors have written prescriptions for. They are refusing to give me the hours I want. So they inform me that I will be receiving a letter called a NOA which will state that they are refusing my request and then my case will get sent to a judge to decide how many hours he will get with Sunrise. The judge will look at all the documents from the therapist and doctors prescription and make their decision. Whatever the judge decides on then Sunrise will have to give me. However if I don't agree with the judge I will be able to appeal the judge's decision and then we will go to a court hearing. The director of Sunrise tells me she has been there for 12 years and this is their first NOA. My first thought was great I am that mom, but then I said that I just can't believe that another parent has never fought to get more hours. That truly just blew my mind. But you know what I don't care. I am going to fight for what he needs. This meeting lasted 4.5 hours long and it was so mentally draining. So now I will wait for the judge to make his decision!
This blog explains how Brendan was diagnosed with autism at 13 months and it will also follows his day to day experiences. His journey will explain how and why getting early intervention works. He will go from being non verbal to verbal to not needing any more therapy. He will define the odds and prove that getting diagnosed with autism at such a young age helped him live life like a normal kid. As a parent always listen to your gut!
Sunday, November 10, 2013
Novemeber 5th - November 10th Fighting with the State Again
This week has been extremely mentally exhausting for me. Where do I start? So as you all know last month Brendan was approved for state secondary insurance(ALTEC). We all know what I went through to get that for him. When I take Brendan to see his developmental doctor at the Melmed Center they have given me prescriptions for exactly how many hours of each different therapies they want for him. They give them based on his evaluations with them. So naturally as a mother you do what the doctor wants. Brendan has a team of therapist with a company called Sunrise and they are contracted with the state. Brendan has only been receiving speech therapy 2x a month and occupational therapy 2x a month with them. When I let Brendan's doctor know this information she flipped out because that isn't close to what she has prescribed for him. I explained to her that they wouldn't give me anymore therapy. She told me now that Brendan has state coverage I should try again to see if he can get more hours. Of course anything you do with the state isn't easy so I called my support coordinator with the state and asked for an emergency meeting so I could go over Brendan's goals and to hopefully get more hours. Every 90 days you sit down with your team and you all come up with goals together. We had our goal meeting for his IFSP last month but I just wasn't happy with the goals they set for Brendan. I have been in contact with the legal department for AZEIP(Arizona early intervention program) because I wanted to know what my legal rights were if they kept refusing to give me more hours. So once again I was back to studying more of the law. They had 14 days to give me my emergency meeting. So we had our meeting on Thursday. Normally during the meeting you will have your team there, which is your support coordinator, occupational therapist and the speech therapist. But of course for my meeting they send the support coordinator along with the director of Sunrise and the project manager of Sunrise. This told me they already knew that I was going to fight. I just took my level of momzilla up a notch after they walked in the door. We now begin to go over and rewrite all of Brendan's goals. We all have to agree on this together. This is where we started to disagree. I know that there goal is to give him easy goals so they can say look he has mastered all his goals in 90 days because then they don't have to give him as many hours. I wasn't going to let this happen. We battled with each other over all 7 categories of goals. I of course had a crying breakdown in the middle of fighting because it just makes me so mad how they try and manipulate you. Then after the goals where in place the therapist and director decided how many hours of therapy they will give him. They decided that he would get 1 hour of occupational a week and then still only 2 hours a month of speech. Well I am asking for 3 hours of occupational therapy a week and 2 hours of speech a week. This is what his doctors have written prescriptions for. They are refusing to give me the hours I want. So they inform me that I will be receiving a letter called a NOA which will state that they are refusing my request and then my case will get sent to a judge to decide how many hours he will get with Sunrise. The judge will look at all the documents from the therapist and doctors prescription and make their decision. Whatever the judge decides on then Sunrise will have to give me. However if I don't agree with the judge I will be able to appeal the judge's decision and then we will go to a court hearing. The director of Sunrise tells me she has been there for 12 years and this is their first NOA. My first thought was great I am that mom, but then I said that I just can't believe that another parent has never fought to get more hours. That truly just blew my mind. But you know what I don't care. I am going to fight for what he needs. This meeting lasted 4.5 hours long and it was so mentally draining. So now I will wait for the judge to make his decision!
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