A mother’s call for Medicaid expansion in Iowa

Moving personal testimony given before a packed Iowa Senate subcommittee, by CCI Action member Lou Ann Burkle

February 11, 2013

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My name is Lou Ann Burkle. I live …  in Des Moines.

[SHOW PICTURE] This is my beautiful, talented and precious daughter.

My husband and I adopted our daughter when she was 6 weeks old.

Our goal was to give her the best home possible, love her unconditionally, and give her every opportunity to be a whole, loving and productive person, and to be a little sister to our 4 year old daughter at that time.

It soon became evident to us that her relational skills were slow in developing. Going to school became a huge anxiety for her. She did not talk in pre-school, kindergarten and first grade. We took videotapes to school to show teachers that she could talk. We sought help and received counseling.

At age 6 our daughter was diagnosed with a mental illness known as “Selective Mutism,” an anxiety disorder on the spectrum of autism, in which a person, when anxious, cannot speak. Overall, communication is difficult and every new experience is anxiety ridden.

Because I had great family insurance as a teacher employed by the Des Moines Public Schools, we were able to get her counseling as needed from age 6 to 19.

With mental illness, there are physical illnesses as well. At times our daughter would pass out from anxiety attacks and had frequent heart palpitations. We were able to go to Mercy Hospital as needed and receive monitoring from heart specialists.

As she grew older, things became more complicated and along with mental illness, there comes a host of other issues, like – depression, suicide attempts, skipping school, running away from home, drug addiction, trouble with the law. Life becomes a roller coaster of crises. Our life became consumed with how to find the next best treatment and how to navigate all the necessary systems.

Having good insurance provides some security and a safety net.

This insurance came to an end when our daughter was 19 and I needed to retire.

My husband and I worked as long as we could, not only because we loved our jobs, but also because we needed insurance for our daughters. We retired two and a half years ago, my husband at age 70 and myself at 67. We went on Medicare and Social Security.

Therefore, insurance for our daughters stopped and the new rule that they could be on the parent’s insurance until age 26 did not apply in our case.

With help from social workers, psychiatrists and counselors we got our daughter on Medicaid.

While on Medicaid and with provider approval she was able to get residential treatment, go to the same doctor and hospital, get dental care and receive counseling.

Last year when she turned 21 she could no longer be on Medicaid. Everything stopped, but her need for treatment continued. The only option for her was to enroll in Iowa Cares.

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Now she can only be served at Broadlawns or Iowa City. She is not living at home and has no car or transportation; and Broadlawns is the only option for mental health counseling, drug treatment and hospitalization. But right now Broadlawns outpatient and inpatient drug treatment center is full.

She can maybe get out-patient treatment if she can get to Broadlawns on certain days of the week by 8:30 in the morning and wait for an opening, in case someone doesn’t show up for their appointment. With no transportation, she would need to navigate the bus system from the South side of Des Moines to get to Broadlawns on the north side by 8:30. So treatment isn’t happening.

Other services she needs must come from Broadlawns as well – that means a new doctor, new psychiatrist, new counselor, new hospital, and wait for an opening for recommended, inpatient treatment.

Mentally ill persons find changes difficult, much less try to comprehend a new system.

Bottom line is – my daughter is overwhelmed, confused and mute.

Today is her birthday. She is 22 years old and lost in the system.

Our daughter needs help. She needs the safety net of Medicaid.

She needs the same, continuous system she had before she turned 21.

My daughter and thousands of Iowans need Medicaid. We need Medicaid:

1. To preserve my daughter’s dignity and the dignity of every person who is sick, homeless, mentally ill, or out of work.

2. To give people options for health care so they can go to counselors, doctors or hospitals that are accessible to them and with whom they are familiar and have a history.

3. For continuous treatment, especially for the mentally ill for whom therapy is a matter of building trust and support over time with the same therapist.

Expanding Medicaid for Iowans is desperately needed. We know with our heart that it is the right thing to do, and we know with our head that it makes sense.

To deny Medicaid for our loved ones and the most vulnerable citizens of Iowa is

  • heartless,
  • unjust, and
  • immoral.

Who among us does not have a heart enough to feel, or eyes wide enough to see that there are people in our state who are hurting, who are ill, and who are falling through the cracks, my daughter being one of thousands.

Iowa needs to save and expand Medicaid. It is the right and just thing to do.



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