Thursday, September 10, 2009

Changing an Address with a Government Agency

Robert is 44 years old, has had a lifetime of uncontrolled seizures caused by debilitating epilepsy and receives government assistance. He’s also my brother. Robert receives Social Security benefits, SSI (state disability), Medi-Cal and Medicare. We live in California. I am very grateful for the financial assistance Robert receives but am extremely concerned for those needing government assistance and not having an advocate to assist them in getting the necessary benefits.

Robert has become mentally as well as physically disabled due to years and years of seizure activity in his brain, the brain surgeries (yes, that’s plural) as well as the plethora of medications he takes to somewhat stabilize his condition. I say “somewhat” quite generously because he can drop like a rock without warning and has spent many nights in the emergency room after doing so. He now wears a hard shell helmet which has diminished the need for stitches on a regular basis but he can still get pretty banged up.

Robert was, amazingly, able to live with a companion for many years. She also has epilepsy and they were able to help care for one another. However, Robert’s condition deteriorated enough that it was no longer even remotely safe for him to live on his own. He now lives in a residential care facility near me.

Because he lived in a different city than the care facility he was moving to, we had to change his address with both the state and federal government social agencies. Medi-Cal was our first change so that he could qualify for a pilot program in the city to which he was moving. The program would provide benefits for a Residential Care Facility with Robert paying with most of his Social Security and SSI money and Medi-Cal paying the difference.

I carefully researched the facilities participating in the program and chose one that was charming, which provides activities as well as the day-to-day assistance Robert needs. It sounded perfect. The only task left was to change his address to the new county.

How naïve I was to think this would be a simple task. As a full-time Legal Administrator I am quite capable of getting things done in an efficient and organized manner (I manage an office full of lawyers, for goodness sakes!). However, after dealing with government agencies, I am beginning to think one needs a Ph.D. in the Science of How Government Agencies Work to accomplish even the simplest of tasks.

I began by calling the Medi-Cal office in the county that he used to live in (Stanislaus). After numerous attempts to get through to a real person on the phone, I finally succeeded. Don’t think this took a few tries one afternoon. This took days. Days. Finally, I was able to talk to a real, live person and not just hit a bunch of buttons that eventually told me all lines were busy and to call back. Argh! Okay, live person. Focus. This is your one chance, I told myself. “My brother has Medi-Cal in Stanislaus County and he is moving to a Residential Care Facility in Sacramento so I need to change his address.”

“Have you notified Social Security?”

“Um, no, I thought that’s what I was doing by calling you.”

“No. You first have to notify Social Security to change his address and then Medi-Cal can change his address.”

Okay, I get it. Sorry, I’m new at this. Notify the Federal government first and then the State government can be notified. Fine. One more step but it’s a step in the right direction. Or so I thought.

I called the Social Security office at the 800 number and, after numerous attempts to actually talk to a person (again with the recording and the buttons!), I spoke to a very nice woman. I explained what I wanted to do.

“Are you the representative payee?”

“I don’t think so. I’m Robert’s sister. I don’t know what a ‘representative payee’ is. Rob receives the benefits, he’s disabled and cannot handle things on his own now so I’m calling. I have durable power of attorney, though, and can fax that to you.”

“We don’t recognize the durable power of attorney. You have to be the representative payee for us to talk to you.”

“You don’t recognize power of attorney? Are you kidding me? I don’t understand; I specifically set that up so I could handle Robert’s affairs. I am his sister. I have power of attorney. Rob is lying in a bed in a nursing home right now hooked up to an I/V. I am trying to change his address so he can be transferred to a Residential Care Facility.”

“I’m sorry, ma’am, you have to be the representative payee for me to talk to you. You can take your brother to a social security office to have him make you the representative payee.”

I just want to change Rob’s address and I don’t want it to involve me dragging Robert to the Social Security office with his hospital gown flapping in the wind and him dragging along an I/V pole. I’m wondering what the heck happens if the person is in a coma. How does a person become the representative payee then? Drag along a hospital bed??

And, don’t call me ma’am!

Obviously, the phone calls are not working. After reviewing the Social Security website, I realized I could not make any changes without being Rob or his representative payee. I can’t become his representative payee right now because he is not well and he is stuck in a nursing facility. This was an endless loop of getting nowhere. I knew I had to visit the office in person because, surely, they would be able to help. A person sitting in front of me would understand the ridiculous situation I was in and the simple request I was making. I expected a long wait so I tried to make an appointment but appointments were being set several weeks out. I needed to get Rob’s address changed as soon as possible since he would be discharged soon and needed to be set up in the new facility.

I took the next morning off from work to visit our local Social Security office, knowing full well I would be waiting for quite a while. Imagine my surprise when I was called up to a window almost immediately after checking in. I was so excited. I thought they realized this would be a simple matter that could be cleared up quickly and all the other people waiting had much more complicated matters to handle.

Is it possible for me to be any more naïve?? This first window was yet another check-in process although the nice lady did politely listen to my entire story only to smile at the end and ask me to take a seat “over there.”

After three hours, I had figured out where people were being called to (one of two securely locked back doors) and which people had arrived after me. There were restrooms which I was badly in need of but I was too worried that if I didn’t jump up as soon as my number was called, I would be pushed to the back of the queue again. Surely, people give up after a few hours. I was hoping I could outlast the elderly couple across from me and the mother and daughter next to me so I could move up in line. I knew everyone needed help but at this point of waiting and needing to use the restroom and not hydrating (because of the bathroom issue), my empathy had left the building. This was not a time to be nice. This was an endurance test. This was the government’s version of Survivor and I was not about to be voted off the island because I had a small bladder. I was starting to realize why there was a guard stationed in the waiting room. Patience could get a little thin around here.

Finally, my number was called with instructions to proceed to Window 3. I was let into the now unlocked door on the left and couldn’t help but wonder what was behind the door on the right. Was the door on the right better? Faster? Sheesh, three hours in the waiting room has fried my brain. Get a grip, Trish. Who cares what is behind the other door? Let it go.

I sat down and waited for my agent to arrive at my Window 3. She must have been finishing up paperwork from the last visitor. Or maybe she was using the bathroom. Alright, stop being bitter.

Finally, I am face to face with a person and I explain my predicament. “I need to change my brother’s address from Stanislaus County to Sacramento County so he can move from a Skilled Nursing Facility in Sacramento to a Residential Care Facility in Sacramento and I need to do it soon so he can be approved and be eligible for the Medi-Cal Waiver program and this is his social number and this is his old home address in Modesto and this is where he is staying now and this is where we want him to be moved to and this is one of my numerous copies of the Durable Power of Attorney which you can keep for your files and . . .”

She interrupted me to tell me I need to change the address with the Stanislaus office of Medi-Cal first and then she could change it in the Social Security system. And that I needed to have Rob with me.

No. No. No, that is not the right answer. I was on the phone with that very office and they told me I had to change his address in the Social Security system first and then I could change it with Medi-Cal. No, ma’am, that is not the right answer. I. Need. To. Change. Robert’s. Address. Here.

At this point, another agent came over to discuss a different case with my agent. I waited for them to finish and when they walked away – yes, they walked away without saying a word to me – I wrote a note and stuck it through the window. “Went to use the restroom. Be right back.”

When I returned, my agent was finishing up with the other agent. Apparently, I had time to run out for coffee, too.

Eventually, my agent turned her attention to me again. I just looked at her and said, “We have to get this changed. Please help me.” She proceeded to look things up on her computer, and she called the nursing home where Rob currently resided. After much review of the documents I insisted she review and several minutes of typing on her computer, she handed me a piece of paper with a box checked and said to take it to the Medi-Cal office down the road. She said she normally faxes the document to the county where the resident lived but said I could physically take it to the local Medi-Cal office. I confirmed that she changed the address in the Social Security system. She said she did but that I would need to bring Robert with me next time in order to change the address to his new facility once he moved there. I made a mental note to figure that one out later. I thanked her, left the building and walked to my car. The only box checked on the form said “replacement card needed.” That can’t be good. My only hope was she had actually changed the address to Sacramento.

I took my form and what little optimism I had left with me to the Medi-Cal office. Amazingly, the line was not long. I went to the window and explained that I had just changed my brother’s address with the Social Security office and I needed to have it changed in the Medi-Cal system. The young woman told me I would have to have Rob contact his caseworker in the County of origin to do that. I asked if there wasn’t some way we could change it up here since I was in Sacramento and Stanislaus County was an hour and a half away and my brother was in a nursing home hooked up to an I/V. I also explained that the Social Security office had told me to come to this office. I again explained that I only wanted to change my brother’s address. She said there wasn’t anything she could do.

I asked to speak to a supervisor. I was tired of waiting, tired of being bounced around like a ping pong ball, tired of being told conflicting information and really starting to worry that I was not going to be able to get my poor brother admitted to a Residential Care Facility. I was told to take a seat. I saw that coming.

Finally, a supervisor came out and I, again, explained what I was trying to do. She asked a few questions and then told me I needed to go to a different Medi-Cal office in Sacramento. I must have looked pitiful because she immediately gave me the name of a specific person to see at that office and told me to tell them I wanted to make an “inter-county transfer.” Not an address change, not a change due to a move but she said to use the words “Inter-County Transfer.” Magic Words. Hey, whatever works. If Magic Words get me the keys to the kingdom, I’ll be shouting them from the rooftop.

She then gently broke the news that I needed my brother to sign an Appointment of Representative form in order for me to do anything on his behalf at the other office.

I could not believe what I was hearing but I had figured out by now that the game had to be played and there was no turning back. The alternative was to send Rob back to independent living where he would most likely come down with another infection or he would be seriously injured (or worse) from his seizures. I thanked the woman, took the form and walked out of the office in tears. I hoped Rob was awake.

After a visit to Rob which, of course, was not quick (but, at least he was awake), I made my way to the next government office. The wait was a little longer than the last Medi-Cal office but less than that at the Social Security office. While waiting in line at the check-in window, I overheard people complaining about waiting for more than 3 hours after being told to “take a seat.” Whole families with little children, hungry little children, were waiting and looking about as drained as I felt.

At the window, I asked for the person the last office referred me to. “He’s on vacation.”

I looked down and took a very deep breath. When I looked up, the woman asked why I needed that specific person. I explained that I needed an Inter-County Transfer from Stanislaus County to Sacramento County. She said Rob needed to do this in Stanislaus County. I shoved the Appointment of Representative towards her and before I could speak, she said they could fill out a form and they would mail it to the Stanislaus office. I told her that was not sufficient. That my brother needed this done today and that I had been bounced from office to office to try to get this done and I needed to have help today or he would not have a place to live when he was discharged from the nursing facility. I realized my voice was getting louder when the people in line behind me began to move back a little and the woman at the window next to mine protectively grabbed her child and moved away from me. “I need to talk to someone that knows how to get this done. Please. Please give me to someone who knows how to fix this. I only want to change an address.” After huddling with two other agents with occasional glances my way, I was told to take a seat and someone would be with me soon.

I was called to a back room by a supervisor. People who had waited much longer than me stared at me walking into the secured back rooms. I felt bad but knew I could not help them. At this point, I could only do my best to help Rob.

I sat across the table from this new supervisor. I explained my situation. I showed her every document I had that I thought would be relevant to pleading my case. I really only wanted to change his address. The supervisor told me it could be done. I wilted into the seat with relief.

Her next sentence was they couldn’t do it at this particular office because of some computer/procedure upgrade that they hadn’t been trained on yet and that actually the first Social Security office I had been at could have done it so could I please drive to the office downtown to have them do it? I think I started shaking at this point. I may have had steam coming out of my ears. I’m sure I turned red and my blood pressure was probably 300/150. I was so close to having this done. So close! Rob would have a shot at being eligible for the Medi-Cal Waiver program. He would have a shot at assisted living so that he would be healthier and be able to live longer than if he was taking his chances on his own. I could not abandon my baby brother. I needed to get this done for him.

The woman must have seen something in my face (daggers, perhaps?) because she gently asked me if I wanted her to call the downtown office to get this done. What? Did I just hear you right? You can call the downtown office to make this happen but you’re asking me if I want to drive down there, wait in line while the clock ticks closer to closing time and explain what I need – yet again?? Gee, why would I want you to do that?? No, thanks, I’ll just drive downtown to my FOURTH GOVERNMENT OFFICE OF THE DAY WHEN YOU CAN JUST PICK UP THE DANG PHONE TO MAKE AN ADDRESS CHANGE. OF COURSE, I WANT YOU TO CALL THE DOWNTOWN OFFICE TO DO THIS!!

I finally left the Medi-Cal office, making note of all of the people in the waiting room and silently wishing them luck in getting done whatever they needed done.

Having made it back to my office near the end of the day, I received a call from the last Medi-Cal worker I spoke with confirming the address had been changed. She said it wouldn’t show up in the system for a few days but it was changed. I thanked her and hung up and just hoped that what she said was true and that in a few days we would be able to get Rob approved for the waiver program.

Later that evening, I phoned the waiver program representative to tell her I was able to get Rob’s address changed with Social Security. She was shocked and said it took six months for most people to get it changed. It was my turn to be shocked but I knew Rob couldn’t wait six months and I am sure most people shouldn’t have to wait that long. However, after having spent the entire day not taking “no” for an answer, I completely understood how someone sick or disabled or elderly would not be able to have the stamina or the time or the energy to find the “magic words” to slog through the government bureaucracy in anything less than six months.

The good news is Rob was approved for the waiver program and is now infection-free and happily living in the Residential Care Facility.

I am truly grateful for the government assistance. I just hope he is able to stay there for a very long time so I don’t have to change his address again.

1 comment:

Jessica said...

Wow. I'm seriously exhausted just reading that. Rob is so lucky to have you, and I know he appreciates it. Just think if you, Joelle and I went together - they probably would have called the damn cops!