Sick Girl Hurt by System

You need a medical dictionary just to pronounce the many ailments that afflict Brianna Bird.

Her foster parents, Tim and Lesly Bird of Yorba Linda, took in the friendly little girl with the soft brown eyes three years ago, when she was a 5-month-old, five-pound undernourished baby.

Since then, Brianna has been hospitalized about 30 times, and she requires almost constant nursing care.

Born three months prematurely, she weighed only three pounds and spent her first 90 days on a ventilator before going home with her 18-year-old mother. She was returned to the hospital two weeks later, badly undernourished and with evidence of physical abuse. Brianna became a ward of the county Social Services Agency when she was 5 months old.

Her lungs were badly damaged by the long period she spent on the ventilator, and other illnesses she has developed were caused by her being born prematurely and sick. s

She has been diagnosed as having severe oxygen dependent bronchopulmonary dysplasia and reactive airway disease. She also is a victim of pseudo-obstruction syndrome, which makes it impossible for her to digest food and makes her totally dependent on intravenous feedings.

The little girl requires frequent aerosol medications. She has been connected to an oxygen monitor since birth and has a gastrotomy tube constantly attached to her body to vent gases that build up in her stomach.

None of that deters the Birds. They want to adopt Brianna.

“We love her, and we want to know that she’s really our own,” Lesly Bird said.

But the adoption cannot take place unless the Birds are assured that Brianna’s $25,000-a-month medical bills will be assumed by the state.

The Orange County Board of Supervisors placed her in a “special high risk” category that provides the money necessary for her medical care, but if she is adopted she no longer will be a ward of the county, which no longer would be responsible for her care.

Under the state-federal Adoption Assistance Program, the Birds assumed that they could get the state Department of Social Services to take care of the medical costs after the adoption.

Gene Howard, the county’s deputy director for children’s services, said that when the Adoption Assistance Program was signed into law in 1980, the intent was to help “children who otherwise would be unadoptable.” The law, he said, was an attempt to make it easier for people to adopt children with medical or emotional problems by supplying money for their care.

“There are medically fragile children in the system who must be helped,” he said. “The thing is that there is already a certain amount of money being spent on this child. And all the Birds are saying is that the same amount of tax dollars should continue to be spent on her.”

Decision Overruled

An administrative law judge found last March that the Birds were entitled under the Adoption Assistance Program to continued aid for Brianna’s care after she is adopted, but Linda S. McMahon, director of the Department of Social Services, overruled that decision.

McMahon, who “respectfully declined” to be interviewed, ruled that there was no provision in the law for special aid to cover Brianna’s costly medical needs. She said the Birds were entitled under the Adoption Assistance Program only to the $881 a month they currently receive under the foster care program.

“I just think that the state owes it to Brianna to provide her with a family without penalizing the family for adopting her,” Lesly Bird said.

McMahon’s spokeswoman, Kathleen Norris, said the state’s confidentiality laws prevented anyone in the Department of Social Services from speaking about Brianna’s case. However, a Juvenile Court judge two years ago signed a waiver, allowing public discussion and disclosure of her adoption case.

Howard said the state Department of Social Services may be reluctant to grant the Birds the assistance they seek for fear that it eventually would have to assume medical costs for other “high risk” children if they are adopted.

Prognosis ‘Very Poor’

He said there are 15 chronically ill children in Orange County under foster care, most of whom eventually could lead physically normal lives.

“Brianna’s prognosis is very poor,” Howard said. “She’ll probably never recover.”

The Birds have solicited the help of Supervisor Gaddi H. Vasquez, but his efforts so far have not been successful.

Vasquez said he has spoken to McMahon and was told that she could do nothing for the Birds under her interpretation of the Adoption Assistance Program.

He added, however, that he will try to get a member of the Orange County legislative delegation to introduce a measure to help the Birds and other prospective adoptive parents caught in similar dilemmas. The Birds already have contacted the office of Sen. Edward R. Royce (R-Anaheim) for assistance, and he has promised to find a solution to their problem.

Because of Brianna’s special needs, she would be eligible for Medi-Cal benefits if adopted. But the benefits would not be enough to take care of Brianna’s medical needs 24 hours a day, Lesly Bird said. Under Medi-Cal, the medical services, which include a nurse, would be provided only 16 hours each day.

She also said Medi-Cal would pay only $14 to $16 an hour for a nurse, about half of what private nursing companies normally charge.

Negotiations by Royce

“I wouldn’t be able to find an agency that would work for that,” she said. “Why would anyone want to contract with me?”

Royce said he was negotiating with representatives of Medi-Cal and the Department of Social Services to try to get Brianna’s monthly medical bills paid. He said it might be possible to get Medi-Cal to assume two-thirds of the costs and the state to cover the rest.

If those negotiations are not successful, Royce said, he will introduce emergency legislation “directing the state to help with these extraordinary medical expenses for Brianna.”

“But we’ll work to expedite the situation,” Royce said. “This is very important because, as far as we know, there isn’t anyone who fits into the criteria that Brianna does.”

The emergency legislation, if necessary, will be introduced when the Legislature reconvenes in January, Royce said.

The Birds, in the meantime, are lobbying almost full time in an effort to get the Department of Social Services to acquiesce and provide Brianna the same amount of money the county currently supplies for her medical needs. They are even scheduled to appear on the syndicated television talk show “Hour Magazine” in two weeks.

Foundation Lobbies for Family

The Orangewood Foundation, the organization that raises funds to help the county’s abused and neglected children, also is lobbying on the Birds’ behalf.

Executive Director William G. Steiner said the foundation’s board had directed him to intervene and that, if McMahon cannot be persuaded to reverse her decision, the Orangewood Foundation also will seek emergency legislation to find relief for the Birds.

“The real shame is that the ultimate victim is Brianna,” Steiner said. “This decision is also inconsistent with public policy. It discourages adoption.”

For Tim Bird, the issue is very simple. Brianna cannot be adopted while the situation “is up in the air.”

“She requires very critical care at home,” he said. “The bottom line is that she can’t be adopted and her rights aren’t being protected.”

WHERE THE MONEY GOES

Brianna Bird’s estimated monthly medical costs, according to her fos-ter parents. They are related only to home care and do not include phy-sician’s fees.

Private, one-on-one nursing care $14,200 Rental fees for $3,500 apnea monitor, oxygen machine, pulmo-aid machine, suction machine, humidifier and an oxcinmeter. Pharmaceuticals $4,000 Liquified food $3,000 Speech therapy $300 Total $25,000