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Home health aides quitting because lack of payment from the state

CINCINNATI (Jeff Hirsh) -- Ohio's system to help those who depend on health care at home was failing for some; specifically the aides who weren't paid for almost two months and their patients.
 
In a baby picture, Robin Egnor looked like any other healthy little kid.  51-years-later, it was a lot different.  She cannot walk or talk.  Robin's family described her just like a little newborn baby.  Brain damaged at birth, Robin was not expected to live a year.  But she did, needing constant help to do anything.  Her parents, Roger and Margaret Egnor, provided that care by themselves for Robin's first 31 years.

Roger said, "The only reason she's here today is we love her.  We care for her and we insist on nothing but the best for her."

That "nothing but the best" included home health care nurses like Tammy Taulbee.  Tammy and two other nurses work in shifts, morning thru night, 7 days a week, giving Robin food, medicine, baths and a human touch.  The state of Ohio picked up the cost.  But now, Robin's three nurses have given notice of quitting.

"May 31st was the last time I got a check and it was for one day," said Tammy.

Tammy and other independent home health care providers have fallen between the cracks as the state of Ohio changed the way the health care aides were paid.  The nurses caring for Robin and other providers Local 12 spoke with were not getting paid at all.  Tammy was owed more than $5,000.  She has children of her own and needs a paycheck.

"I can't keep working here for free and that's what I'm doing," Tammy told Local 12.  "It really hurts me to have to leave her. We're leaving her in a vulnerable situation.  We're leaving the parents with no one. It's just a mess and it's not fair."

The problem broke down like this: on June 1, the state of Ohio changed from paying the aides directly to having insurance companies handle the program.  For Tammy, it was Aetna.  Tammy said she called Aetna repeatedly, got the run around, but still no money.  So in a couple of weeks, when her notice will be up, Tammy will say goodbye to Robin and her parents.

"It was the hardest thing I had to do, to give them my notice.  I know they know I don't want to go but we have to.  We can't keep staying and not getting paid," she said.

This was all devastating for Robin's parents.  The Egnors lost their only son, Jody, in a military helicopter accident in 2002.  They rely on religious faith to make it through the day.

Margaret said, "Robin is all we have left.  I could throw her in a nursing home, cost the state more, but the state chose this program so we can keep our children at home and now look what's going on. It's not right."

A website which handled Tammy's billing said Aetna was experiencing a technical issue processing electronic claims, although some claims seemed to be going through.  But Tammy had not seen a dime since May 31.  Tammy said if the money started coming, she would stay.  But no one was optimistic.  The Egnors, age 70, must prepare to take care of Robin by themselves.

"I will care for her if I have to crawl on the floor because that's how much I love her.  But with what she's eligible for I should not have to be doing that," said Margaret.

A spokesman for the state Medicaid department told Local 12 he believed the problem like Tammy's were few and far between, with the more than 100,000 patients involved in the insurance change.  But besides Tammy, Local 12 has heard from other independent providers in Westwood and Harrison.  Local 12 heard from a quadriplegic who said he was going to lose the aide who has cared for him for 10 years because she had not been paid.  And Local 12 also received a Facebook post from someone up in Lorain, near Cleveland, that said it was a problem there too.
   
One local independent provider said her car had been repossessed because she was unable to pay her bills.  And Tammy Taulbee said she was so fed up she contacted a lawyer to see if that could help.

As you might imagine, Local 12 wanted to hear from Aetna on this.  Phone and email messages were sent to the official identified as the media spokesman.  Stay with Local 12 for updates on this situation if and when Aetna responds.




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