A mentally challenged Alpena woman died earlier this month from a dental infection after she was denied Medicaid coverage for a surgery that could have saved her, according to those who were close to her.
Now health care professionals, legislators and activists are asking the Michigan Senate to restore cuts to the Adult Dental Medicaid Benefit eliminated by Gov. Jennifer Granholm's executive order to balance the 2009 state budget.
Blanche D. LaVire, 76, of Alpena was described as a happy woman who loved to dance, swim, picnic and eat by her older sister and guardian Alice Neumann, also of Alpena. It was when she stopped eating and starting hitting herself, which was the way LaVire told people she was hurting, that Neumann knew something was wrong.
Doctors initially suspected leukemia because dental infections can mimic the disease but abscesses were later discovered through x-rays. Because of the severity of her mental impairment, the procedure couldn't be performed in a dentist's office, it needed to be done in a hospital setting, according to Gerald Chase, health officer for the Health Department of Northwest Michigan.
LaVire was scheduled to have the procedure late in June, before the executive order was in effect, but she contracted pneumonia which precluded her from having the treatment. After LaVire's pneumonia was treated, the procedure was in the process of being rescheduled when it was discovered she no longer qualified because of the elimination of the benefits.
"After July1, the governor's executive order eliminated all oral health services except emergency health services," Chase said.
After the first denial came from Medicaid, the process was started to provide documentation that it was an emergency.
"Frankly, by the time the documentation was put together, she died," he said.
Neumann said the last time her sister was taken to the hospital, she knew she wasn't going to make it. LaVire died Oct. 7 at Alpena Regional Medical Center.
"I always felt that if her teeth were fixed, especially the bad ones - and maybe they were all bad - she might have lived longer; might have given her better health than she had and it really took her downhill," Neumann said.
Dentists at Dental Clinics North planned to donate their services for surgery but Medicaid denied coverage of her $5,000 hospital stay. LaVire is the first known death in the state resulting from cuts to the Adult Dental Medicaid Benefits. Chase said the circumstances of LaVire's death are "ridiculous."
"This woman had a chronic dental infection that ultimately killed her. If the infection had been but a dental infection, Medicaid would have paid for treatment, including hospitalization," Thomas Veryser, executive director of Dental Clinics North said in a press release issued by the Health Department of Northwest Michigan. "We predicted cuts to the Adult Dental Medicaid Benefit would cost lives and now it has."
Legislators, activists and the Michigan Dental Association also have taken a stance on the issue.
Among those who were saddened to learn about LaVire's death is Rep. Andy Neumann, D-Alpena, who said her death was completely preventable.
"We cannot stand by and watch as our most vulnerable residents are fighting for their health and well-being without medical coverage," he stated in a press release. "It is unacceptable that anyone has to lose their life because the state chose to cut Medicaid adult health care services."
Neumann recently voted against cuts to Medicaid and for the Quality Assessment Assurance Program that would help bring back $400 million in federal funding to help restore Medicaid coverage and ensure funding for vital health care services. He has urged the Senate to move quickly to pass the plan to prevent any more of these tragedies.
Progress Michigan, which describes itself as a "first-of-its-kind organization whose mission is to provide a strong credible voice that holds public officials and government accountable, assists in the promotion of progressive ideas and uses state-of-the-art Web based new media to creatively build grassroots support for progressive ideas," is among the citizen groups that have demanded the Senate to restore Medicaid funding by taking up the House-passed tax on doctors' services.
On Tuesday, the MDA condemned her death as "needless" and urges lawmakers to restore funding to the 2010 budget. The MDA claims the elimination of adult dental benefits has caused the state's fragile system of care to unravel.
MDA President William Wright said the MDA joins Michigan's citizens in expressing condolences to LaVire's family, in a press release the organization.
Alice Neumann said it feels really good to know people are moving forward with efforts to encourage the legislation to pass because she doesn't want this to happen to somebody else. She said it was when her sister was going through the really hard times was when she would think of how the state had let her down.
"I believe something should have been done," she said. "It never was."
Crystal Nelson can be reached via e-mail at firstname.lastname@example.org or by phone at 358-5693.