Ivan, are you talking about Medicare - home care?

Larry

----- Original Message -----
From: "Ivan M Suzman" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Saturday, July 06, 2002 8:34 PM
Subject: Fw: Re: PCA hours


> --------- Forwarded message ----------
> From: [log in to unmask]
> To: [log in to unmask],[log in to unmask]
> Cc: [log in to unmask],[log in to unmask]
> Date: Sat, 6 Jul 2002 00:13:45 -0400
> Subject: Re: PCA hours
> Message-ID: <[log in to unmask]>
>
>
>
> Dear Sue,
>
> I do not agree, Sue.  I still contest the 74 hour assessment
> by Tammy.  It is a 19% cut in PCA hours. My income is too
> low to pay privately for the removed hours.
>
>  She also forgot to assign, in the actual evaluation of me,
> weekly hours to at  least two categories of ADL's. It is an]
> assesssment with errors, done under duress, inconsistent
> with my established pattern of of need.
>
> My attorneys and I never agreed to the 74 hours.
>
> The  so-called "90% rule" cut  me from 91 to
> 63  "daytime"hours. My need ,adding in  14
> hours per week, was assessed at 105 hours
> for three years in a row, starting in 1998, by Kathy Adams.  It
> was confirmed at 105 by Kevin Concannon, following a year
> of hearings  and arguments, as recommended by Ronald
> Stoodley, on September 10, 2001.
>
> The cut to 63,  or 63.5 hours, ignores my medical needs,
> as well as the need, in similar cases, of other Alpha One consumers.
>
> The so-called "90% rule" violated my  estabilshed level of
> need. For me, it was a slash and burn, 28 hours per week,
> 4 hours a day gouging of my hours used in 1998, 1999,
> 2000,200l, and 2002. It  is a 31% cut in PCA "daytime"  hours.
>
> Who will pay for my lost hours? I have to believe  that
> Alpha One is more compassionate to lower income
> consumers.
>
> Sue, you have NEVER assessed me.  I have no reason to accept
> you as knowlegeable enough about my  personal medical
> condition .  Tammy's "compromise" assessment came just 3 days after
>  you intended to cut me, under instructions from Mollie Baldwin,
> to 63 hours, but  you left when you informed me that it did not
> matter how you assessed me, you would be cutting me anyway
> to 63 hours!!
>
>
> Ivan
>
> 2 Jul 2002 09:22:07 -0400 "Sue Grant" <[log in to unmask]> writes:
> > Ivan, as a follow up to the mailing that we recently sent out to PCA
> > consumers, as of 7/1/02 you are eligible to bill for up 74 daytime
> > hours per week and 14 hours at night.   This increase represents the
> > hours that were documented as your existing personal care needs
> > during your last reassessment in December of 2001 and also
> > represents a removal of the 90% rule.   As mentioned in my last
> > email, you are only eligible to bill up to 63.5 daytime hours prior
> > to 7/1/02.
> >
> > Please contact me by email if you have any questions.
> >
> > Sue Grant, OTR/L
> > Independent Living Specialist
>
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