Ready, Willing for the Disabled
Linda Smith was feeding 5-year-old Michael breakfast through his stomach tube.
Eight-year-old Joshua was standing as still as he could while Dick Smith combed the boy’s hair, and big sister Rosanna, 12, was finishing up her cereal when the doorbell rang and two neighborhood kids bounded in, ready to carpool to summer school Wednesday.
“Welcome to the Smith household,” Dick Smith said amid the cheerful chaos, as his wife dished out final instructions to their kids, all former foster children who have been either adopted by or placed under the Smiths’ legal guardianship.
“Joshua, you won’t have a helper during summer school, so you’ll have to tell your teacher yourself about your medicine,” she said to the boy, who has attention problems and other disorders associated with fetal alcohol syndrome. (Dick Smith assured his wife he would tell the teacher as well.)
As she finished feeding Michael, she admonished Rosanna not to buy junk food at school. Then she turned her attention back to Michael, who has cerebral palsy, and tried to comb his hair.
“Anything sensory is really difficult for him,” she explained as Michael wiggled.
The Smiths have taken in 29 foster children, most of them with medical or physical problems, during the past 13 years.
Linda Smith is equally well-versed in dealing with the governmental agencies that help pay for the children’s complicated care. She will impart some of that experience Friday when physicians, other health-care workers, the disabled and advocates gather for a conference on how well the county’s Medi-Cal managed care program serves the disabled.
CalOPTIMA, which has administered the Medi-Cal program for nearly two years, is co-sponsoring the conference to promote an exchange between medical professionals and disabled patients, who make up 14% of the agency’s 240,000 clients.
CalOPTIMA has been criticized for its treatment of the disabled, who require more frequent and specialized care than most Medi-Cal patients. A class-action lawsuit filed in February charged that the disabled are treated improperly and denied rights under the program.
Settlement negotiations are in progress, said Susan Eastman, attorney for the Public Law Center in Santa Ana, one of the law groups suing on behalf of the disabled. CalOPTIMA officials say the agency is trying to work out the problems.
“This is a more complex patient population to care for,” said Dr. Margaret Beed, CalOPTIMA’s chief medical officer. “We know they need special attention and special care.”
For Smith, a representative for the disabled on CalOPTIMA’s advisory board, the health-care needs of her two boys are many.
Abandoned at birth, Michael came to the Smiths as a newborn foster child. They had no intention of keeping him permanently, she said.
“We thought we were over the hill,” said Smith, 49, who had already adopted Rosanna and obtained guardianship of Joshua. But when another family abandoned plans to adopt Michael, they became his guardians.
Michael takes medication to diminish his seizures and had surgery in January to treat chronic gastrointestinal problems. He has daily physical therapy and feeding therapy twice a week.
Although he can eat only puree, “they tell me someday he will eat a hamburger,” Linda Smith said happily.
Joshua, whose biological mother died about five years ago, was born prematurely and has had several surgeries for intestinal problems.
The Smiths, who between them have five grown children of their own, originally became foster parents “to get a little girl,” said Linda Smith, and began caring for Rosanna when she was 6 weeks old.