I am having a dilemma. Really, an ethical dilemma involving my friend who resides in a nursing home in eastern Iowa. It is causing me anger along with great frustration. For many reasons all the persons involved in this writing shall remain nameless.
My friend has lived in a nursing home in Maquoketa for five years beginning in 2020. Last month her savings were depleted. She thought she had adequate Certificates of Deposit and monthly income from Social Security and IPERS to sustain her, but she ran out of funds and was switched to Medicaid. She is grateful that the facility allowed her to remain, as sometimes individuals who are not private pay may be required to move out of the facility.
She is 90, and needs assistance in moving to the restroom, even while using a walker. When she was on private pay the cost was $11,000 per month. Now the State of Iowa is the payor. Her meals are brought to her room. She receives a shower three times a week. She receives $50 for spending money on shampoo, toothpaste, a haircut, and if enough left over a few snack items.
Her current issue is a cavity, and the need to have her teeth cleaned. The last time she saw a dentist was six months ago. She arranged an appointment with her past established dentist and, after traveling there by the available shuttle bus in Jackson County, she was informed he did not accept Medicaid. The round trip was three hours.
She contacted the social worker at the facility to make arrangements to see a dentist that will provide services to Medicaid clients. There is one in Jackson County – the other options were Dubuque, Moline, or Davenport. The social worker was going to check regarding an appointment in Maquoketa, but my friend has heard nothing more about the scheduling in the past three weeks.
I suggested to her that I travel to Maquoketa and take her to the former dentist and reimburse him in cash for the services. She is afraid to do that, as Medicaid will recognize she has another financial source and remove her from services.
I spoke with my personal dental hygienist, and she suggested choosing another dentist, indicating we were strictly cash, and not providing my friend’s Social Security number. She also remarked that the reimbursement for dental services from the State of Iowa has not been raised since 1970. The dentist where she practices provides services to his past clients who have been switched to Medicaid. This is done at a monetary loss for the business as they not only have diminished revenue from a Medicaid visit, but goes into the red paying the hygienist her salary for labor.
I was able to interact in a public meeting with our state senator Jesse Green about general Medicaid services. With a $6 billion surplus, what is Iowa’s plan to help these people? I shared with him how afraid she was the federal government will defund Medicaid and she will be on the street.
He said it was merely a scare tactic. His comment was met with derisive hoots from the those assembled. To share in transparency, he did respond that the legislature was working on a 5-year budget plan should it be necessary to supplement funds for Medicaid clients.
To be fair I attempted to seek input from the Iowa Department of Health and Human Services by calling the 800 number. I was instructed via message to connect to the website. After a thorough search there was not a drop down to learn anything about this issue. I was never able to identify a number that would allow me to speak with a person about this dental issue.
If I can persuade her, we will find a dentist in Dubuque to fill her cavity. We will not use her real name or give her Social Security number. It will be a cash transaction. It will be BOOTLEG DENISTRY!!
I admit I do not feel good about going outside the legal boundaries of Medicaid. If any readers have experienced this type of issue, will you please reach out and provide suggestions or recommendations.
VIEW FROM MY WINDOW is submitted by Mary Weaver, who lives on a farm near Rippey, and is worried about the potential pain her friend will incur from her tooth cavity.
