What greater purpose is being served by denying extremely medically needy children healthcare? It’s safe to assume that the answer is: There is no greater purpose — and there’s no excuse.
Not when the state of Florida was flush with a $635.4 million surplus. Not when parents and grandparents with meager resources are left to fend for themselves. Not when children with severe disabilities and medical conditions are unable to get treatment. And, especially, not when the state of Florida itself is tricking parents into unwittingly undermining their own child’s welfare.
Since May, about 9,000 children with unique medical needs have been purged from the Children’s Medical Services roster. State leaders call it the result of a reorganization. They can call it whatever they want. In reality, it’s Florida’s longstanding attempt to save money by rationing care, and it’s taking it out on the most vulnerable. It’s nothing new, but it remains a disgrace.
In her two-part series, Bitter pill, Miami Herald reporter Carol Marbin Miller reveals the extent to which state healthcare leaders have gone to prevent the “sickest of the sick” from getting care. The state introduced a “screening tool” that asks parents seeking help to answer five questions. Question No. 3, critics say, is a trap: “Is your child limited or prevented in any way in his or her ability to do the things most children of the same age can do?” Answer No, and the child is not eligible, even if he or she previously had been getting care. Parents want their kids to be seen as “normal” — able to attend school, for instance — but it in no way means they are not sick or in desperate need of care. One child profiled in the story is nearly blind — detached retina. The state provided care to protect what little is left of his sight, but he was kicked out of the program, before finally being reinstated. Another young boy with a host of conditions and his grandmother are getting the runaround, and he can’t get necessary medication.
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As always, state administrators stick to the script, even in the face of damning evidence to the contrary: “We are dedicated to the care of children with serious and chronic medical conditions, and their families,” said the state Surgeon General John Armstrong, head of the Department of Health. “We want every child in Florida to achieve his or her full potential. And this program is so important for the medically fragile children in the state.”
Sound familiar? It’s called denial, pretty much the default position of department heads, especially those serving in the Rick Scott administration. In 2013, after several children in the Department of Children & Families died in rapid succession, one DCF staffer explained: “When a child dies, it’s not because DCF dropped the ball. It’s because their families failed to protect them.” Last year, a DCF spokeswoman insisted that: “The safety and well-being of Florida’s vulnerable children is DCF’s top priority. Understanding and assessing child fatalities is one way the department analyzes the issues facing families and develops strategies to meet the needs of struggling families and protect vulnerable children.” That was the department’s response to clear evidence that the state was undercounting the number of deaths of children in its care.
This is absolutely the wrong place in which to pinch pennies. Is the care expensive? Yes, it can be. But rest assured, the state can pay now or will pay — more — later for its shortsighted and inhumane stinginess. And again, what greater purpose is being served?