Feelings of Futility

We are pending approval for placement in a psychiatric facility.

Placement is dependent on the insurance company approving the need.

  1. Certificate of Need is generated by the insurance company.  This allows placement.
  2. Certificate of Need is based in part on the last psychiatric appointment that David had with his doctor.

So, we finally received the notes from his last psych appointment.  Again, the record is inaccurate.  Every time we have to argue with medical records to get copies of the record, the notes have been inaccurate.  I understand that doctors are busy people, but when placement hinges on accurate notes, writing things like this destroys any chance of placement.

The doctor wrote that “patient swung a shovel at his father and broke the sewing machine, after his father washed his mouth out with soap.”

Among other things, David is a known liar.  The shovel incident happened because we were holding David accountable for his behavior.  Because David thinks that he is above the rules of society.

One other thing that may hamper his ability to get placed in residential care?  The number of placements in residential care that he has already had.  Coupled with the number of times he has been in psychiatric acute care this year, we are talking a lot of placements.  Eleven for acute care, and three for residential care.  To me, this is a sign that he needs more care than what he is receiving.  He has had many placements in part because he was discharged against doctors recommendations by insurance.

I hate that insurance companies can dictate the level of care that the mentally ill can receive.  If placement through insurance doesn’t occur then we will need to go the judicial route to get him what he needs.  Damn shame to have to use the courts in such a manner.

You can bet that if we are denied a certificate of need, I will be working to find an attorney.  For the purposes of this post, insurance is North Dakota Medicaid.  The certificate of need comes through a place called Ascend Management Innovations out of Tennessee.  The last time a certificate of need was denied it was because of the doctors notes.  Ascend blamed it on a computer glitch.



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