Many step up with help for infant, family | AspenTimes.com

Many step up with help for infant, family

Allyn Harvey

As Christmas approaches, good news for Saige Blotske has been piling up like presents beneath a tree.

Donations from locals over the last 10 days have rescued the 13-month-old Carbondale girl with a life-threatening genetic condition from having to go into the hospital on Christmas Day. The money – several thousand dollars in two separate accounts – will be used to pay for Saige’s nursing care from Dec. 25 though Dec. 31, a weeklong period that neither of the family’s insurers plan to cover.

Early yesterday morning, a nonprofit organization in Denver e-mailed the Blotskes about its promise to cover costs for 36 hours of nursing care a week for the first two months of next year. Combined with Saige’s insurance coverage, which resumes on New Year’s Day, it’s just the right amount of help to ensure she stays home.

Then, just a few hours later yesterday, Saige’s parents, April and Trevor, received a call from a representative at American Family Insurance, who told them that billing errors by American Family and Aetna, the family’s other insurer, could mean tens or hundreds of thousands of dollars will soon be available for Saige’s home health care.

“I’m shaking, I’m so excited,” said April. “The woman from American Family said there could be as much as $200,000 available for Saige now, and more in the future. She said after reading your article, she thought something was wrong.”

A spokeswoman for American Family said it appears some of the Blotske’s coverage options with their two insurers were overlooked, but she was unable to say whether that would help solve Saige’s home nursing dilemma. The spokeswoman said the family needed to work out the details with Aetna.

Saige’s health problems and insurance woes were made public last week in a series of articles published in The Aspen Times; the story was also picked up by The Denver Post.

Saige was born in November 1998 with Apert syndrome, a genetic disorder that afflicts approximately one in 160,000 children, according to the National Center for Biotechnology Information. The condition causes the plates in the skull to fuse at a very young age, and without extensive surgery, it can inhibit growth of the brain, resulting in retardation or death. Severe respiratory problems are also typical with Apert babies, as are fused fingers and toes.

Saige breathes through a tracheal tube in her throat. She has gone though a dozen surgeries in her short life – for her skull, respiratory system, fingers, toes and eyes – and she is scheduled for a second round of cranial surgery in February.

Currently, nurses take care of Saige all night, every night, monitoring her heart and breathing, and performing special breathing treatments every three hours. Nurses also take care of Saige three days a week during the daytime; April and Trevor have her alone during the day the other four days.

Saige’s doctors have decided that without 24-hour home nursing care, she must be institutionalized.

Her story came to light after Home Health of the Rockies notified the Blotskes it was cutting the family’s home nursing service beginning Christmas Day. The Grand Junction-based home health services firm has provided the Blotskes with nurses since January. But company owner Ted McWhorter announced last month that Medicaid and the two insurance companies weren’t reimbursing him for Saige’s care, so he was dropping their case.

Neither Aetna nor American Family have any record of Home Health billing for Saige’s nursing. McWhorter was at a loss to explain the situation, and said he was “resubmitting” the invoices.

The amount of privately donated money is estimated at between $5,000 and $10,000, but an exact figure was difficult to pinpoint because donations have been sent both to the family and to their church, Christ Community Church in Basalt, which has set up an account to help with Saige’s health-care costs.

The couple said they plan to use the cash to pay for Saige’s nursing between Dec. 26 and Dec. 31. Aspen Home Health, the only other home health provider that offers around-the-clock nursing to Roaring Fork Valley residents, offered to pay for nursing on Christmas Day. Aspen Home Health is not qualified to bill Medicaid, which is helping the Blotskes cover Saige’s bills, so its ability to pick up where Home Health of the Rockies is dropping off is limited.

But now FACE the Challenge, a nonprofit organization that sends doctors around the world to perform critical facial surgery (of the sort that Saige needs to breathe and see), has agreed to cover two months of daytime nursing with a $5,000 donation. Aspen Home Health can bill the private insurers and pay the nurses for their nighttime shifts until the end of March, when the coverage through Aetna is scheduled to lapse again.

“On behalf of our nonprofit medical relief organization, FACE the Challenge, Inc., we are pleased to be able to send you a check by Federal Express, due to arrive at Christ Community Church tomorrow. It will be in the amount of $7,500 ($5,000 for Saige’s medical expenses and $2,500 for family-related needs),” reads yesterday’s e-mail from the group’s board of directors.

April, however, is just grateful for the extra time. “Now we have two months – we don’t have to do all the work necessary to keep Saige home in just a few days. The support we’re getting is remarkable,” she said.


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