KXAN helps mom reinstate disabled adopted daughter’s Medicaid

Investigations

AUSTIN (KXAN) — On January 20, 2017, Paddy Ramsay stood in front of a Travis County judge and made it official. At the age of 73, her heart was telling her it was time to become a mom.

Despite skepticism from Ramsay’s own family, she adopted Naila Parades, a 16-year-old girl who had been in the custody of Child Protective Services since she was two years old.

“I cannot begin to tell you how much I adore and love this child,” said Ramsay.

Naila Parades
Paddy Ramsay with her daughter, Naila Parades (Courtesy: Paddy Ramsay)

Prior to adoption day, Ramsay had already been fighting for the non-verbal teenager’s best interests. When Parades was 14 years old, Ramsay was assigned to her case as a Court Appointed Special Advocate volunteer. Over the next two years, Ramsay became familiar with the child’s severe autism and brain disorders — factors that turned other potential adoptive families away, but drew Ramsay closer.

Parades’ primary sensor is her tongue.

She touches everything and everyone with it. She is extremely active and self destructive, and lives in a group home with other autistic children where she receives one-on-one care. Ramsay looks forward to weekends when she visits her daughter. Parades is always standing at the window anticipating her mom’s arrival.

“This is where the nightmare begins”

The day after Parades turned 18 on April 2 of this year, Ramsay started receiving letters in the mail stating her daughter’s Social Security benefits and Medicaid were going away.

Ramsay was under the impression the coverage was supposed to last until her daughter turned 21.

Calls started coming from the group home caring for Parades, also telling her she was about to lose Medicaid and that they needed to meet to come up with a plan to figure out how care, medications and psychological evaluations would be covered.

“When you have a child who is completely disabled — and Naila has one-on-one care — that alone is $65,000 a year,” said Ramsay. “It’s pretty scary, I would have to declare bankruptcy if this doesn’t get fixed.”

The next few days entailed Ramsay driving to the local Social Security Administration office, a local Texas Health and Human Services office and local Medicaid offices. In several cases, she would show up, make an appointment, only to be later told she needed to go to a different office and fill out a different form or application.

The initial runaround lasted six more days, and she wasn’t any closer to a resolution.

That’s when Ramsay, fearful of losing her apartment and not being able to pay for her daughter’s medical care, sat down at her computer and typed out a three-page letter of desperation to KXAN.

“The bottom line is the left hand doesn’t know what the right hand is doing” wrote Ramsay. “I no longer wonder why they can’t find enough foster/adoption folks for special needs children. I do not wish this nightmare on anyone. The most frustrating part is I was so sure I could make her life better!”

When the letter arrived, KXAN Investigator Erin Cargile forwarded it to the the media contacts at all three agencies: the Social Security Administration, Medicaid and Texas Health and Human Services, and said “any guidance you could provide on who to turn to for answers on this case would be much appreciated.”

The response was immediate.

A public affairs officer with the Social Security Administration emailed back and said she had already reached out to Ramsay and the agency was looking into the matter. A press officer with HHS called and said she was also trying to get to the bottom of it.

It was the first sign of hope for Ramsay.

Over the next few days, it became clear the Adoption Assistance Medicaid Parades had been receiving, did in fact end when she turned 18. At that point, the Department of Family and Protective Services said it is the parent’s responsibility to switch over to a different type of Medicaid.

DFPS spokesperson Patrick Crimmins said a representative is supposed to sit down with adoptive parents and explain what they need to do when their child turns 18 to avoid a gap in coverage. The parents also sign an Adoption Assistance Agreement stating that they understand.

Ramsay said she signed the form, but a representative never had time to meet with her. And she never read the instructions about the coverage ending at a certain age.

Crimmins looked at the wording on the form himself, and said it blended in with the rest of the document. He told KXAN the agency was reviewing the form and would be considering ways to make it stand out more, and add a phone number telling families who to call when questions arise.

Ramsay said an HHS representative eventually called and got it all sorted out over the phone. Her daughter’s Medicaid benefits were reinstated, and Ramsay received several back payments to make up for the gap in coverage.

“At first I cried of happiness, and then I met a friend and went out for happy hour,” said Ramsay with a laugh. “And when I saw Naila the next day, I know she didn’t understand a word, but I told her anyway.”

The Texas Health and Human Services Commission said anyone with Medicaid questions should call the HHS Office of Ombudsman at 877-787-8999.

Naila Parades
Naila Parades (Courtesy: Paddy Ramsay)

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