I want to tell you a story that happened many years ago, as recently as today and will happen again tomorrow. It is a story about a deceptively familiar place where securing the basic necessities of life, health care, housing, transportation and communication, requires persistence to overcome one obstacle after another. I call this place “The Parallel Universe.”
After years of medical care consisting of trips to Urgent Care and the ER, Trila totally gets the importance of coordinated personal health care, but the reality is she is dependent on public transportation, which does not exist in her mid-sized town. Job and Family Services (JFS) offers free transportation to and from medical appointments for Trila as a qualified Medicaid recipient IF she calls them every month and leaves her name, social security number, address and birthdate; IF she requests transportation at least 48 hours before a specific appointment; IF there are sufficient drivers and IF enough places are still available in the van. When the van does not show up, Trila is stuck.
“Call a cab,” suggests her attempting-to-be-helpful next-door neighbor. “It’s seven dollars each way, but I think JFS has vouchers you can use.”
“Yes, we have reimbursement vouchers. Just pay your cab fare, bring the driver’s signed voucher and a voucher signed by your health care provider to our office, and we will reimburse you by check once a month.”
“I don’t have $14 for cab fare.”
“That’s okay. JFS can reimburse the taxi driver directly. Just come by our office and pick up some vouchers for the driver to sign.”
“I live five miles away. How am I going to get to your office?” Close to tears, Trila listens into the silence coming from the other end and hangs up.
Forty-five minutes later my phone rings. “Trila did not show up for her doctor’s appointment today,” the recorded voice informs me. “Please call to make another appointment. Also, please note that our appointment policy allows only four missed appointments in a 12-month period.”
In fairness to the overworked folks at Job and Family Services, their office is so understaffed they no longer answer the phone. Using a Triage system, staff work their way through the messages one by one returning the most urgent ones first, a creative response to a difficult situation.
This is one of the many places I enter the scene. IF Trila has been able to schedule a new appointment, IF I am willing to drive the 43–90-mile round trip (depending on which doctor she is seeing), and IF I have enough time to give that day (anywhere from 2-5 hours) then it’s a go.
But the bottom line remains: if I cannot make the round trip, then neither can Trila.
* To protect their identity, Trila is a composite of these women. All the stories are true and describe my experience as companion in each case.
