Ms.Monica Sattler:
50 Beale Street, 22nd Floor
San Francisco, CA 90403

RE:  RFA No. 34386,  Constance A. Webb

Dear Ms. Sattler:

Ms. Virginia Armstrong suggested that we wait some time before pursuing this complaint.  In some instances, even though the DOC chose no action, considerable time had already elapsed.  Currently my complaint includes six independent items:

 a.  the patient's wheelchair
 b.  the patient's bed
 c.  generation of false EOBs
 d.  failure to provide EOBs to the patient's conservator and to the Department of Health         Services
 e.  failure to rescind or provide any report of the patient's condition upon the plan's home
       visitation to DOC and patient's conservator.
 f.   failure of DOC to inform patient's conservator of location of this patient records        within the DOC.

Item a - The patient's wheelchair
 
 Since June of 1997, the patient's wheelchair was promised and measurements taken.  In November of 1998, the wheelchair arrived.  This is after many letters and phone calls.  You may reference enclosed document, letter to Warren Foon (January 8, 1998) as one example.  Though this new wheelchair cost over $5,000, it still has the same problems as the old, temporary wheelchair of eighteen months ago.  It cannot be used.  In the meantime, we use an old issued wheelchair which is potentially harmful to the patient.  Sarah Moon is aware of these problems, and has assured us the they will not remain as oversight by the DOC.

Item b - The patient's bed.

 Since October of 1997 the plan was aware of the inadequacies of their issued bed and has promised a new bed since January 1998, with assurances that it was scheduled to arrive before her wheelchair.  The plan had sent a specialist to our home take the patient's measurements.  There had been verbal promises made that the bed was ordered and due to arrive within two weeks.  That was almost six month ago.   Recently, the plan's PCP inquired as to what was wrong with the present bed and as to why the patient needs another.  Both Foon and Moon are aware of this.
 
 

Item c - Generation of false EOBs.

 After the patient was discharged to her home, her food was purchased directly from the supplier and delivered C.O.D. every time to her home.  After several months, the supplier's accountant called me to inform me that we had fallen in arrears on our account and should find a way to make payment arrangements in order to avoid discontinuance.  After explaining that we had always paid C.O.D., she decided to run through our account with me on the phone.  Starting in October 1997, when Constance came home, she said that I paid $219, then Maxicare paid $219, then I paid $219, and Maxicare $219 for a series of six successions.  Her records showed that I paid this about every three weeks, followed by a Maxicare payment.  On the phone when I protested that something must be wrong with her accounting records, she seemed quite uncertain about everything and promised to mail a hard copy to me.
 Two weeks after that, I called her to inquire if she had mailed me a statement of account.  She had not, but said that they will credit the account with Maxicare's payments, and, that as we spoke, her assistant was actually preparing a request for continuance of coverage, since the patient had not died.  In their view at the time, they felt that the only valid reason to discontinue coverage would be if the patient had died.  This was in the spring of 1998.
 A few weeks ago, without explanation or warning, the supplier sneakily began to charge the patient again;  without explanation as to why a living patient should be denied food.  This action was taken without phone call nor without written explanation from the plan's provider.  I can only presume, while I am paying for her food, the plan is claiming to State investigators that they are paying for it too.

Item d - Failure to provide EOBs to the patient's conservator and to the Department of      Health Services.

 The plan's three underwriters have not responded to any request for EOBs.  This is becoming an urgent matter, affecting the family's ability to survive.  These EOBs have been requested by the California Department of Health Services, HIPP representative, who has reminded me that it is against the law to deny EOBs to the patient or to the patient's representatives.  Without these EOBs, we are unable to receive premium coverage payable to the patient's COBRA plan as administered by the Federal Government for the patient's ongoing care and transition into Federal Medicare and other private plans and in the long-term protection of the patient's estate against false billing.
 

Item e - Failure to rescind or provide any report of the patient's condition upon plan's      home visitation to DOC and patient's conservator.

 One of the initial grievances embraced by RFA #7478 was against the devastatingly invalid prognosis by the MAXPHYSICIAN in February 1997 which effectively brought to a halt any subsequent care essential to this patient's recovery, of which the DOC demonstrated measured concern, to the extent, that the plan's underwriters obliged to make a house call in order to see for themselves the patient's status and to provide in writing their findings.  At the time, they were applauded by both myself and the DOC for their fine efforts, which to wit, nothing ever came from it.  This is a long standing grievance expressed before to all parties, which remains unanswered, overlooked and crucial to the patient's medical care and healing.

Item f - Failure of DOC to inform patient's conservator of location of this patient records     within the DOC.

 In order to actively pursue the best ongoing care, as well as remedial care, long overdue, I have decided to review for myself the extent of documentation utilized by the DOC in the determination of the outcome of this patient's previous RFA.  In this attempt, two letters have been sent to the DOC's Chief Administrative Officer, without response.  I can only imagine that if this administrative officer was encased within their own skin and unable to move, or speak, they might appreciate more urgent action.

   Of course, in reality, and quite sadly, my wife is only a number to so many, despite the potential of moving towards great mental anguish far beyond yours and my own experience and imagination!
 One day my wife was healthy and playing tennis, and then in the next moment her whole world tilted as she crashed upon the ground.  I can't even imagine what that must be like.  Then, upon awakening in strange places with strange people, she found herself unable to move, if only to turn herself over in bed.
   Though that was two years ago, she has still not given up hope that the doctors might come and visit her and that she is more than a UCLA guinea pig of advancing research.  She still has a smile for everyone, and the prayer that they can do better.
 
 

Yours in Trust,

_______________________________
Joel E. Webb - Conservator to Patient

910-B 20th Street,
Santa Monica, CA 90403
(310) 828-2292 (office)  (310) 829-0767 (home and nurse)

Copies to all interested parties and appropriate enforcement agencies.