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Kenyan immigrant in MN who received a bone marrow transplant could have coverage for her treatment discontinued due to health cuts

Posted by Administrator on March 10, 2012

Mellen Mingate recently received a bone marrow transplant to treat multiple myeloma, but cuts to Emergency Medical Assistance mean her treatment coverage could be discontinued. (MPR Photo/Jennifer Simonson)

Mellen Mingate recently received a bone marrow transplant to treat multiple myeloma, but cuts to Emergency Medical Assistance mean her treatment coverage could be discontinued. (MPR Photo/Jennifer Simonson)

BROOKLYN PARK, Minn. — Dorothy Mingate is worried about her mother.

Her mom, 57-year-old Mellen Mingate, has multiple myloma, a cancer of the blood. Mellen Mingate lives in Brooklyn Park with her daughter and son-in-law and their three young sons.

“[Mellen] says her back hurts a lot of the times. And she has bone fractures everywhere in her body. And her blood count sometimes goes down and makes her weak,” Dorothy Mingate said, translating for her mother.

Mellen Mingate is an immigrant from Kenya who came to the country legally two years ago. Her daughter Dorothy, who’s now a U.S. citizen, sponsored her. Dorothy also happens to be a nurse who keeps track of the paperwork for her mom’s health odyssey in big three-ring binders. In December, Mellen Mingate received a bone marrow transplant.

Mellen Mingate doesn’t qualify for Medicaid or Minnesota Care because she’s not yet a citizen. She’s only been in the country two years, and she needs to be here five years to apply for citizenship.

Hundreds of Minnesotans, including Mellen Mingate, with severe illnesses are wondering if they’ll continue to receive outpatient medical treatment and prescriptions via the Emergency Medical Assistance program.

The state notified 2,300 non-citizens late last year that come January, it would only cover things like emergency room visits. While those cases are on appeal, key legislators and advocates say they’re making progress toward a solution.

EMA is a program of last resort for people like Mellen Mingate. The state budget agreement reached last summer cut state spending on the program by about a third, or almost $15 million.

Hundreds of EMA patients appealed the cuts, among them, the Mingates. Care continues while case are on appeal.

The Mingates were supposed to have a hearing by phone last month with an administrative law judge with the Department of Human Services, but it was postponed. Dorothy Mingate said she was told  the judge was too busy with other cases. Mingate said she won’t call to ask — she’s afraid of the outcome.

In the meantime, her mom is supposed to start back up on chemotherapy in two weeks. Holding her baby on the couch, Dorothy Mingate explains how daunting that will be if they have to cover it on their own.

“21 capsules that she takes for 3 weeks is about $7,400,” Dorothy Mingate said. “It’s not going to happen.”

Dorothy Mingate works as a nurse, and her husband owns a small tax preparation business.

Dorothy Mingate said if DHS rules against covering her mom’s chemotherapy, the family will have to make some tough choices about her care.

“I’ll be asking the doctor a lot, ‘What if she doesn’t get the bone marrow biopsy this time? What’s going to happen?’ Based on that, we’ll decide what to do,” she said.  Dorothy Mingate figures they can only cut corners so long before her mom weakens, and needs to go to the ER or the hospital, where the EMA coverage will kick back in.

SYSTEMATIC CHANGES

But driving people to the most expensive kind of care — ER visits and hospitalizations — isn’t what lawmakers like Jim Abeler, the Republican chair of the House Health and Human Services Finance Committee, want to see. In a voicemail to MPR News, Abeler said he’s working on a bill to make systemic changes to Emergency Medical Assistance.     “I don’t believe I have any new money to spend on it,” Abeler said. “But I’m convinced if we can spend it more prudently, that we can still accomplish the goals of the people, the needs of the people we serve.”

Legislators, care providers and the Dayton administration have been negotiating for months to come up with a solution for families like the Mingates.  Those involved in the negotiations say they could have a solution as early as next week.

Source: http://minnesota.publicradio.org/display/web/2012/03/09/emergency-medical-assistance-cuts/

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