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Insurance Fails, State Takes Over

Wed Sep 29th, 2010 on     Long-Term Disability,    

A Palm Beach County judge was faced with a terrible choice this week. A man who, according to police, had broken his father’s legs, wanted to go home. He didn’t want to miss Halloween, which was just a few days away, he said. He was clearly confused, and his actions showed he couldn’t control his emotions — but everyone there knew he wasn’t mentally ill. This man has a brain injury, and the judge knew that insurance companies and the state of Florida have failed people with a disability like his.

The injuries are the result of a 2004 incident that resulted in this man, R.C., being severely beaten and run over by a car. His behavior is typical of people with serious brain injuries: confusion, mood swings, depression, inability to concentrate and emotional outbursts.

The judge has seen R.C. in her courtroom before, and she has been working on treatment options for the 25-year-old for more than a year. She knows she cannot send him home this time, though, because of the alleged assault of his father.

She has instead invoked Florida’s Baker Act. It’s only a temporary solution, but the Act allows her to commit R.C. to a mental health facility for 72 hours. Such an involuntary commitment is only possible if a person is deemed to be a threat to himself or others.

At the same time, a representative from the Florida Department of Children & Families is looking for a longer-term solution. This man’s hope is that two state agencies, the Department of Health and the Agency for Health Care and Administration, will foot the bill for a three-month neurological rehabilitation program for R.C.

All involved agree that R.C. would greatly benefit from the intensive residential care offered through the program. The program costs about $27,000 a month, though, and neither state programs nor R.C.’s mother’s insurance will cover it. (It’s unclear whether R.C. received any treatment or insurance settlement from the 2004 incident that caused his brain damage.)

R.C.’s defense attorney reported that the mother’s insurance company may reconsider their decision not to cover treatment. The company has agreed to cover costs associated with R.C.’s father’s injuries — injuries that may have been avoided if the insurer had paid for rehabilitation for R.C.

Neither father nor son is clear on the details of the alleged assault. According to his mother, R.C. doesn’t even understand what has happened.

Resource: SunSentinel.com “Authorities Wrestle to Devise Plan to Handle Brain-Damaged Man” 9/28/10

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