Most of you know I live in California. How can I afford items is still a mystery.
We live quite Rural at 3,000 ft above Volcano CA pop 101. Beautiful in nature with a small home, and no close neighbors.
I went thru so many state and federal programs before my diagnosis was found.
Years without any income coming in. I was glad to have a house with my partner to stay in, and not be on the streets. I have two moms. My partners Mom, who takes excellent care of me, and my mom, who lives in Alaska, who also is quite supportive. Bruce was my partners dad, quite knowledgeable. Miss him, and our conversations. He had been bedridden for 30+ years. My partner is quite supportive and helpful with me.
I was diagnosed in 2012 with Primary Progressive Multiple Sclerosis.
Many rides were needed to go to Doctors outside our county. This includes The University of California Davis in Sacramento, CA. This can be up to a two hour ride one way.
Our county is smal, and does not attract to many good doctors, I hope you all do your own investigating, and can find expert cae, even if its in the next county with knowledgeable Doctors. My local GP knew something was going on, and knew the only neurologist had not gone far enough. He sent me to a Neurologist outside or County for care.
I am on a dual medi-medi program from the Federal Government, State Government, and Social security.
The State of California made a ruling years ago, that makes sure you get to and from your Dr visits, by providing rides. This applies to anyone on Medicaid, or Medi-Cal or certain other programs. The state maintains a huge fleet contracted out. "All you do is have to call them" ...not so easy.
"The State of California is Required to provide me with transportation to and from all of my doctors. This is something not happening...
John Tan of Legal Services of Northern CA has taken this to court twice.
42 C.F.R. 431.53 requires Medicaid plans to specify that "Medicaid agency will ensure necessary transportation for participants to and from providers" transportation includes rides but also "expenses for transportation and other related expenses...". 42.CFR 440.170(A)(1) Fee For Services... Cal. Welf. And instead code 14132(ad)(2)(B)
A State hearing before Judge Hammond was heard in Sacramento, CA March 26, 2019, and a re hearing was heard July 16, 2019. Both denied.
Legal services of Northern CA has appealed this case March 18, 2020. Due to the world Epidemic, the case is dragging on. Natalie DaSilvia is in charge. the year is 2022. when she left,Ted Mumford took over tmumford@lsnc.net
He is the leader of this ongoing court case in 2022
This state mandate took nine years to find, going thru counties, government, agencies, other organizations, and many counties. to find. organisations who gives rides, but they would not for me.
The year found, 2018 was that in the next small town, Ione, CA, was Hector from foothills medical transportation. Nobody in any State agency knew of him, or that he gave rides. There are five NEMT (Non Emergency Medical Transportation) in the state. Contacting DHCS,(Department of Health Care Services) took them nine years to find Hector for me.
This came from a Sacramento Government Agency, who knew of the problem. They had been contacted many times before, with no response.
To this Date, 40,000 people in Amador County need to be on a ppo plan, as no HMO is in the area, unless you forge that you live in ione, ca. That gets you to a hmo, keiser in the valley, another county away. 2023 you are required to join a HMO.
If on a HMO, there is not a problem with rides, they say. . Many vehicles, and companies can give. the State of California has a huge fleet of vehicle's that they use, pay the drivers, wait time, so to take you home is what is supposed to happen. Our county will not tell you rides are availiable.
Hector can only drive on certain days, as I am the only one in Amador county that needs rides?...
The lawsuit needs to charge each county not being in compliance and letting their clients know of the service, that they can get to And from doctors. Perhaps sue counties also for non compliance
Currently, to try and obtain a ride, I must submit a request to
The Department of Health care services. My Dr, What for, address, ect. I also send this to my county workers, who should know about the program, but fail to let clients know. At one point, the county said travel reimbursement, but I have seen zero. The County personnel also wanted Hippa Privacy items, not entitled to, to be sent.
I keep this list, published here also, so I will not forget who I send requests for rides to.
They usually are ignored, not responded from, or go un-noticed.
tmumford@lsnc.net
Ted Mumford, lsnc.net
Hector Flores
foothillsmedicaltransportation@gmail.com
TMitchell@amadorgov.org
Jrodriguez@amadorgov.org
TDalporto@amadorgov.org
Matthew.Kizzie@dhcs.ca.gov ended employment 5/20/22
Jonathan.Ring@dhcs.ca.gov
Tiffany.Saelee@dhcs.ca.gov
Tere Gonzalez Tere.Gonzalez@dhcs.ca.gov
Jim.Elliott@dhcs.ca.gov
The State of California VS Joe leighkendall was heard by a Judge, earlier this year, as required for transportation. The State has asked for two delays, which were granted. They used this to abuse their powers by auditing Hector, his books, and vehicles he uses.
They did not audit anybody else.
To ensure his fleet was spick and span, records up to date.
I asked DHCS for reimbursement for my partner, Our 29 year old vehicles have taken a beating. Wil can not drive the distance. Records from doctors from 2012 of rides needed were given to all for reimbursement. All current ones are emailed to the above. . I have exhausted all means of transportation.
I asked for transportation to out of town doctors. gas reimbursement, registration fees, insurance fees, repair cost and operating costs. A repair of the system.
I asked them to comply with their rules and supply me with a driver to get me to and from Doctors out of Amador County , as required.
I asked that other people in my situation, have access who qualify, with reimbursement for anything else related.
I asked them to Fix their system, so thousands of others that qualify, or are enrolled and qualify, can get rides, uber, lyft, (we are to small to have that luxery of paid cars to take you places) so need a driver like Hector. He has vehicles, and drives many people on hmo plans. reimbursement, and everything that the DHCS offers. Rides to and from the Dr, medical trips, supplies. He has vehicles ready to hire more drivers, but I am the only one that has researched, taking time being pro active.
Hector can only drive me on certain days. My Doctors do not allow me to choose dates. As they only see patients on certain days. He takes many patients to dialysis, thus he has a filled schedule.
The year, 2018, not looking for another diagnosis, my Endocrinologist sent me to the Cancer Doctor at UC Davis, as blood readings kept being off. The cancer Dr. did some gene testing, ruling some out, before he found the HFE Gene, a Rare H63d Gene causing Iron Overload in me. Quite Rare, and I have only found a few other persons in a ten year span that have iron overloaded.
This caused 17 phlebotomy to uc davis weekly, along with trips to my other Doctors. The only treatment is barberic, known as blood letting or a Phlebotomy weekly, to drain blood from me, trying to get the iron down. My blood comes out as thick as pancake batter.
No rides given, even though the State DHCS knew about the real need, as exhausted all other means.
2019
John Tan of Legal Services of Northern CA has taken this to court twice.
The State of California VS Joe leighkendall was heard by a Judge, earlier this year, as required for transportation. The State has asked for two delays, which were granted. They used this to abuse their powers by auditing Hector, his books, and vehicles he uses.
I asked for reimbursement for Wil, who had driven,
A hearing by a different Judge was asked for On terms CA was not following their own rules. The first judge took fifteen pages to state denial. The second judge did not override any items.
CA IS NOT FOLLOWING ITS OWN RULES, as I am Not on a Managed care plan, and Can not be. Must be on a PPO plan, because of all the specialist, and No HMO plan covers our county.
On Sunday August 11 On page 6a of the Sacramento Bee, Cathhie Anderson wrote a excellent article that blast medi-cal for failing 18 counties, and she doesn't know people on Nemt, have been forgotten, and No rides given, or re reimbursed for. .This Took DHCS Nine years, and then another three months to find me a driver 15 miles from home, taking the largest toll on trying to keep a vehicle running for multiple specialists weekly, and a Toll on Wil trying to maneuver Sacramento.
The State says they do not have a reimbursement plan in place, but they do, just a code Needs added to their existing transportation for those of us forgotten patients. That would pay Nemt (non emergency medical transportation) drivers , the same premiums that the state's drivers are paid ( they pay a lower rate currently) , and wait time, to go hundreds of miles, reimbursement for mileage Wil drove, plus maintenance, and, would love new vehicle that is safe for local Doctors.
UPDATE OCTOBER 2020
this case is being heard by the California Attorney General. They just want this to go away...
This is being handled by legal services of northern California for me.
I would need a Second Class Action Attorney to represent thousand not receiving this benefit.
I did Not accept their offer, as Rides to appointments are still needed to Sacramento. Rides Wil can not drive.
Local rides, I asked for the excess repair needing done, including a timing belt, tires,and engine repair on old vehicles. A Driver the state has, like Hector, and wages paid in accordance.
I would like this to be not just me, but open the door for others that can not receive rides to their Drs, as I am not on a HMO plan, that guarantees rides, reimbursement for lyft, uber, taxis, and any form of ride, regardless. This is Stated in CA Law.
Know I am remote, but many people are in same predicament, in the entire state of California in small rural areas, or small counties forgotten.
For all hose that do not know, DHCS sub contracts out to a huge driver van service used to move people to Drs and back home. If not, the people can hire lyft, taxis, for reimbursement. That is not a option for us in our small county, thus requested out of town rides provided by state.
Transportation Services
https://www.dhcs.ca.gov/services/medi-cal/Pages/Transportation.aspx
Hector from foothillsmedicaltransportation.com was contracted to drive us, but missed many rides. He has my medical Dr list for next six months, along with everyone on the email list above.
so I hope he can still help on some rides..
Their is expensive rides in hundreds of dollars, people would charge, just to be denied they are not on DHCS registry, and I would not be reimbursed that I was asked to take.
We live at 3,000 ft elevation that gets Snow in Amador County.
The State of California is Required to provide me with transportation to all of my doctors. This is something not happening.
. I asked for reimbursement for Wil.
I asked for transportation to out of town doctors.
I asked for the wait time, and to be able for second appointment the same day paid for, as the state caps the wait time for Hector at a minimum wage when he can drive.
Some appointments are more than the hour allotted, being a few hours, or waits between two Drs on the same day
In the meantime, Hector has stepped in to help out of town driving, per agreement with the State. But not many fit his schedule.
I have exhausted all possibilities of other rides.
Hopefully this will find its hands into the proper State, County, Federal people to see that their program failed me, along with thousands of others, that do not know, or are not told about this.
Even Hector could hire another Driver if others in Amador County knew of the Rides to and From Drs even outside of our small county to obtain expert Doctors needed.
Contact me everchangingms@gmail.com, or my legal team, tmumford@lsnc.net for answers.
Thanks for reading my rant
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Joe
This Last year, 2022, Hector has been unable to make any rides., except two on a friday/Saturday.
DHCS Requires in 2023 Everyone be on a HMO plan. Drs in our county do not accept this plan. You can call the list provided, and will not get a Dr, or Hospital.
DHCS required me to ask to a Exemption from UC davis. One filed, but forms kept coming to join a HMO. A second Exemption of 75 pages was filed by my Dr. Then DHCS accepted this, and then stated I did not need, as was Exempt from joining a HMO.
The latest hearing, DHCS is being required to turn over a list of everyone driven in CA, and how they pay drivers, reimbursement. Still dragging on.
On a note Kiser was given the HMO contract in 2024 for Amador County. ( no bidding?) Or Drivers to take care of need Now?
