7 June 2001
We’re moving a week from today. Until this week, I was packing boxes every morning while Dan drove Damian to Santa Monica, or sometimes vice versa. But we got the keys to the new house on Tuesday. As of yesterday Dan started spending those school mornings perched precariously on a ladder scraping horrid glittery acoustic gook off our new ceilings. Theoretically we should be ninety percent packed right now, since our packing time dwindled so dramatically. Ha, I say. Ha. And again: ha. We’re swimming in boxes but our lives are far too intact. There’s too much to do in too short a time, and I don’t know if we can get it all done.
But that’s small potatoes -- I’m talking the tiny fingerling eat-in-one-bite type of spud -- compared to the headache that’s becoming Damian’s treatment program.
First there’s the insurance company. They pay for thirty two speech therapy sessions per calendar year after you jump through the hoop of proving your true and honest need. They also pay for eighteen sessions of occupational therapy. Both of which run out in, oh, a week. Now we have to ask for an extension. It’s a no-brainer, right? If an insurance company agrees that a child like Damian needs these services, they can’t expect that he’ll be all better in just four months.
Then why did the woman in Medical Review tell me she’s never seen a request for more speech therapy come back with that big stamp of approval? Which, by the way, contradicts what a man told me back on the phone back in January, and contradicts what yet another woman told Laura the Speech Therapist when she called to confirm my bad news. Someone’s either lying or badly misinformed, and we don’t know who.
The only way to find out, of course, is to go through the process, submit the myriad letters and clinical notes they want. Then what? The best case scenario is that the woman from Medical Records who scared the daylights out of me is dead wrong and the insurance company sends back two lovely letters saying "get all the therapy you need for your precious boy." Bureaucracy being what it is, said letters will probably take a minimum of two months to arrive. We then submit the accumulated invoices and wait another month or two for reimbursement.
In the meantime we’ll be paying out of pocket for Damian’s therapy, to the tune of $1880 per month. Gah. We’re already tightening our finances, scouring our budgets for stray ill-spent pennies, eliminating newspaper and bottled water deliveries and meals out, and sure, that makes up much of the difference between rent and mortgage, but two thousand dollars? We didn’t live high enough on the hog to scrounge that kind of money out of our pockets.
So the insurance company is making me nervous. Very very nervous. If, god forbid, they do reject the speech therapy extension, we’ll appeal. If we get rejected, we’ll go to court, where we stand a very good chance of winning. But then, of course, we’re spending the eight hundred per month speech portion for even longer before seeing the 85% refund from insurance.
Did I mention that Dan is out of work right now? Did I mention that we would have just enough money to get us through hiatus without that extra two grand per month hit, except that we just found out he’s going back at the end of August instead of the end of July? Did I mention that I have a knot in my stomach the size of a grapefruit and all my muscles are permanently clenched?
We could, of course, switch to publicly funded therapy. Except that Damian is now three years old and therefore is in the process of transferring services to the school district. Our local district is notorious for not wanting to give a kid an ounce of treatment more than they absolutely must by law. The law is a slippery thing, subject to interpretation. They like group speech therapy, for example. I know Damian. In a group, he’d clam up. It would be all about how he responds to being around those other children rather than about how he learns to talk. And I don’t want to switch. Laura is doing amazing things with him. I’ve talked to a developmental pediatrician and the head of a major autism advocacy organization, and both of them basically said speech therapy is a waste of time because the therapists aren’t willing to push the kids. Laura’s a shining exception. Switching therapists could be detrimental to Damian’s progress and therefore his quality of life.
I don’t expect to have this insurance fight about occupational therapy, which is good because a kid in Damian’s class was just denied occupational therapy by the school district even though she clearly needs it. They didn’t choose to see the benefit. But even if the school district says yes to occupational therapy and the insurance company says no, I’d be worried about switching. Heidi has a magic touch, even more so than Laura. Laura works hard and gets results over time. Heidi is intuitive and smart and fun and gets results almost instantly. Damian is in the right hands with both of them. I pray we can afford to keep him there.
So you can start to see why my stomach hurts and I get headaches practically every night. But there’s more. Because we’re scheduled to meet with this selfsame tightwad school district next month to determine what services they think Damian needs. Right now he’s in a private school. Early Intervention stops paying for it when we switch to the school district. The school district thinks their public programs are plenty good, thankyewverymuch, and that’s where they try to funnel all children coming into the system. Never mind that this private school is actually a "non-public agency", which means they’re vendored by the school district, and it’s completely acceptable to send public money their way. My liaison with the school district gets very vague and slithery with me when I bring this up, and I consider that a Very Bad Sign.
There are myriad reasons Damian should probably stay put rather than switch. I need to visit the public program to be sure, of course. I’ll go, I’ll ask pertinent (and perhaps impertinent) questions, write up a list of pros and cons, and present the school district folks with my findings on the auspicious date of Friday July 13th. If they give us grief, we can get mediation and due process, and if none of that works, we can drag their butts into court. Which I’d be willing if not happy to do, if it ensures the best possible education for my child. My child who is doing so wonderfully, miraculously well, thanks in large part to Laura and Heidi and the school. I don’t want to do anything that might jeopardize his further progress. He’s made great strides, but he still has a long way to go. And I’m going to be a tiger -- a polite but insistently growling mama tiger -- to make sure he gets there.
So. Let’s review. Moving. Packing. Stress. Mortgage larger than rent. More stress. Insurance running out, applying for an extension which we may or may not get. Stress multiplied. Dan’s job starting later. Stress through the roof. School district placement meeting on the horizon. Stress and determination.
And now we’re being audited. Yup, we got that love letter from your pals and mine. I’m not particularly worried. It’s not the first time -- we made a short film in ’94, which we amortized over five years. ’99 is the last year it’s on there and should be the last time it triggers an audit. They’ve accepted it before, so it shouldn’t be a problem this time. It’s just a nuisance. Paperwork, organizing files, typing up spreadsheets. And paying our accountant (ouch) and maybe owing some little amount if they want to quibble over mileage or meals. Not fun. Stressful. More money going out with none coming in.
I’d get a job right now, a full time job, but remember what I said about Damian and how I wouldn’t do anything to jeopardize his progress? If I got a full time job and Dan went back to work, working his usual ten hour days, where’s Damian? With a nanny. Where on earth are we going to find a nanny willing and able to do the kind of constant interactive playful pushing we do? Not to mention how traumatic that could be, not seeing either of his parents all day when he’s used to having me at least as a kind of home base, the ever reliable center of his turning-faster-than-ever world. No, now is not the time for me to get a full time job.
Dan has started looking for a job to cover him until September, but that’s easier said than done. He’s known in the TV episodic world, but producers hire in the summer and expect their editors to stay with them through the TV season; i.e.: until April. He’s going to look for documentaries, trailers, commercials... but he has to start from scratch, make cold calls, do the looking-for-work dance in a world that’s built on connections and relationships, a world where he has neither. I don’t know the odds of his finding something, but I’m holding my breath because it would help. It would help so very much.
I know the problem is temporary. Once Dan gets back to work, once we get the insurance company to say yea or nay and either continue with Laura and Heidi (yes yes yes!) or switch to school-vendored therapists (assuming we can get them to agree he needs it!), once we get things worked out with the school district and the IR-You-Know-Who, once we get next year’s tax refund and see the big chunk that comes from homeownership, then we’ll be just fine, or at least better. We’ll have breathing room.
I just don’t know how to get from here to there. All I can think is that money is dribbling -- no, pouring -- out of our bank account and we can’t stop the flood without potentially harming our amazing child’s incredible growth.
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copyright 2001 Tamar