A ride to the doctor can mean life or death

Lois Henry: A ride to the doctor can mean life or death
BY LOIS HENRY, Californian staff writer
lhenry@bakersfield.com | Tuesday, Nov 18 2008 6:22 PM

Last Updated: Wednesday, Nov 19 2008 7:19 AM

All Martin Zapata needs is a ride.

But Zapata, 28, who lost the use of his arms and legs a little more than two years ago to a virulent strain of valley fever, is stuck in a kind of no-man’s land when it comes to getting bed-ridden patients to and from doctor visits in Bakersfield.

There is virtually no nonemergency gurney transportation here, particularly for Medi-Cal patients.

Zapata must see his doctor twice a month to have liquid drawn from his spine to check the progress of the disease and to make sure his catheter is properly cleaned to prevent a life-threatening infection.

No doctor visits also mean no medication. And that could mean his life.

His last visit was in August and his medication supply is getting low.

But Hall Ambulance Service, which had been taking him for the previous two years stopped in August, saying they’d been doing it in error and couldn’t continue.

Since then, Zapata’s mom, Sally Zapata, who cares for him at her home, has been on the phone daily trying to find a new service for him. There just isn’t any.

That’s when she called me, out of pure frustration and desperate for any help.

“This boy is going to die” if he can’t get to the doctor, she told me.

If he could sit in a wheelchair, he would have at least some options, though in metro Bakersfield even those are scarce compared to other cities and counties.

Wheelchair patients can get curb-to-curb service through GET-A-Lift or door-to-door service through Consolidated Transportaiton Service Agency (CTSA), both funded through the Kern Council of Governments.

Or they can call Tri County Medical Transport Services or Valley Medical Transport, which also both accept Medi-Cal.

But Martin Zapata can’t be in a wheelchair, his bones are too brittle and his muscles too atrophied to support himself in a chair, even a geri-chair (more like a recliner).

He must be on a gurney. Tri County is the only service for gurney transport and they’re maxed out right now, they told me.

I figured there must be some mistake so I kept digging and calling.

But no. Hospital case management workers, nursing home directors, dialysis center managers all told me the same thing — we have a terrible lack of services.

Sally Zapata is absolutely right to worry that her son’s condition will worsen before anyone will respond.

A Hall Ambulance supervisor recently told his bosses about a 911 call for a dialysis patient whose body was shutting down because he hadn’t been able to make appointments for lack of a ride.

“We know there’s a problem, but we don’t have an answer,” John Surface, Hall’s ambulance division manager, told me.

The problem, of course, is money.

Unless you have the cash to fork over, and I understand it can be between $100 and $200 for a round trip ride to see a doctor, most private insurance doesn’t cover gurney transport and Medi-Cal’s reimbursement rates are shamefully low.

Medi-Cal pays $26.29 for a response to a call, plus $5.65 per 15 minutes (up to 90 minutes total) for waiting time while the patient is at his or her appointment and $1.30 per mile. And with budget cuts now, any claim that’s submitted gets an automatic 10 percent cut.

Yeah, we all know the state doesn’t have any money and anyone whose services are cut is going to scream bloody murder.

But those abysmal gurney transport rates have been so low for so long they’ve chased companies out of the business and created a classic cutting-off-our-nose-to-spite-our-face situation.

Medi-Cal won’t pay the full cost of gurney transport, so people like the dialysis patient (and maybe Martin Zapata if he can’t get help soon) are going into crisis and taxpayers are instead footing the bill for full-blown ambulance and emergency room care.

Which seems like the smarter way to go?

I asked Kern County Supervisors Michael Rubio and Mike Maggard about this situation and they both wanted to know how many people are in Zapata’s situation. I have no idea, probably not a lot. Even if it’s just a few, however, a simple ride can mean absolutely everything to them.

The whole mess, including why Kern seems to have so few providers even for wheelchair service, is now in the hands of County Emergency Medical Services Director Ross Elliott and Aging and Adult Services Director Kris Grasty after the Board of Supervisors asked them on Tuesday to look into it and report back.

Hopefully they’ll find an answer before it’s too late for Martin Zapata.

Opinions expressed in this column are those of Lois Henry, not The Bakersfield Californian. Her column appears Wednesdays and Sundays. Call her at 395-7373 or e-mail lhenry@bakersfield.com.

http://www.bakersfield.com/102/story/613788.html