Shoreline family featured in Seattle Times story about new limits to Medicaid

Monday, April 18, 2011

A Shoreline family is featured in a front-page story in The Seattle Times. Karen and Bruce Smith are long-time foster parents, who specialize in medically fragile children. They have biological children, adopted children, and foster children, and are leaders in the loose alliance of foster care families in the area.

The story is about the state budget cuts to Medicaid, emergency room visits, and the potential for harm for children currently covered by Medicaid.

The story by reporter Carol Ostrom "Doctors: State plan to limit Medicaid ER trips risks lives" tells how a list created by a researcher who intended to "help officials find out where patients have trouble accessing primary care and help figure out if particular programs work well" will be used to limit conditions that would be covered under Medicaid.

"The state's plan to cut Medicaid would limit visits for potentially serious conditions such as breathing trouble and more.

Medicaid officials say the vast majority of Medicaid patients visit an ER — for any reason — no more than twice a year. Only about 2 percent — mostly adults — visit four or more times.

Some of Karen Smith's children have been in that 2 percent.

She and her husband, Bruce, residents of Shoreline, have had a lot of children — biological, adopted and fostered, including "medically fragile" kids. Medicaid covers foster children and those adopted later.

As her children were growing up, Smith said, she often couldn't tell what was an emergency and what could wait.

And she's a nurse.

"This is scary for me," Smith said. "I can't imagine how it's going to be for parents who have no medical background to decide, 'Is my child sick enough to go to the emergency room?' "

Taiana, her first adopted child, was born with sickle-cell anemia — an excluded condition on the list but one that could qualify as an exception.

For sickle-cell crises, including two strokes, Taiana was treated in the ER 21 times by age 2 — often at night.

"You have nowhere else to go," Smith said. "They need to open up 24-hour walk-in clinics. That's where they have to find a way to fill in the gap, if they're going to cut down on the ER visits.""


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