Health Care Story of the Week - 12/30/09

This fall began like any other for ten year-old Darius Richardson. In September, he started practicing with his football team for the season’s opening game. But then, Darius found out that he had brain cancer and would have to have an operation. Darius has been serious about sports since age five. Football, basketball, and baseball are among his favorites.

Darius lives with his single Mom, Trina Parker, who worked full-time until Darius got sick. The cancer began forcing Darius to miss football practice and school due to chronic headaches and severe weight loss. She had to cut her work hours in half so that she could care for him, leaving both her and her son ineligible for her employer’s health insurance.

Darius and Ms. Parker didn’t think things could get much worse. Then, TennCare told him he was going to lose coverage the day before he was to have the tumor removed. Without insurance, Vanderbilt would not do the operation. Ms. Parker asked the Department of Human Services (DHS) for help, but nothing happened. “I didn’t know who else to turn to,” she said. Then, a social worker told her about the Tennessee Justice Center.

When Ms. Parker called TJC, we realized immediately that TennCare had made a mistake in calculating Darius’s family’s income, and that he should stay on TennCare. We helped Ms. Parker file an appeal, allowing Darius to keep TennCare during the appeal. The surgery went smoothly, and Darius went home with his Mom about a week later.

Despite everything, “Darius is in good spirits. The doctor explained everything and he understands that the treatment is to get rid of the tumor,” said Ms. Parker. “He has a really good family-based support and church.”

But her fight wasn’t over yet. Darius’s cancer was worse than doctors had thought. A few days before Darius was scheduled to return to the hospital for chemotherapy, DHS told Ms. Parker they were going to close Darius’s TennCare case. Ms. Parker called TJC again. We wrote the Case Manager a letter reminding him that DHS rules required him to keep Darius’s case open.

DHS kept the case open, and later approved Darius’s TennCare application. He is currently at the hospital, receiving his first round of chemotherapy treatment.

Without a law firm's help, Darius would not have been able to get the surgery he needed to live, even though he still had a right to TennCare coverage. “I don’t know what else I would have done,” said Ms. Parker.

When Darius and Ms. Parker needed it most, our healthcare system was not there for them. “It’s clear to me that the system is broken,” said Ms. Parker. “I pray that we can work together to fix our country’s healthcare, so other families don’t have to go through the same struggle we did just to get basic care.”