Special needs schools/programs Los Angeles

amother

Amber

Wed, Dec 26 2018, 1:36 am

amother wrote:

This is partially true, but not entirely. Medicaid in NY is an insurance that almost never impacts your quality of care. It is easy to receive and a competent doctor in almost any field accepts it. That is not the case with Medi-cal in California. Also, Medi-cal has out of pocket costs and is strict regarding renewals. Doctors do not really accept Medi-cal, except for in underpriveledged areas and there are waits (not the case in NY and NJ where people with premium insurances often share doctors with those who have Medicaid/Fidelis). Also, there is almost no mental health care in California, which is one reason why there is a huge homeless problem. There are only two large psychiatric hospitals LA county and few smaller ones, but Ronald Reagan closed the majority of them - with that comes a lack of services available for psychiatric patients and also those with disabilities. Things like Food Stamps and Section 8 are also different than in NY (same goes for HEAP) although I've heard Welfare is easier to obtain in LA. Other right-wing policies are zoning incentives which appear left-wing but in reality just improve zoning ordinances for developers.

This is way too long for small post, but the moral of the story is just don't expect to receive the same amount of services, aid, etc. and to even have access to the same amount of services even if you are willing to pay for them. If you plan ahead IYH you'll get what you need, but realize it is not as easy in NY and NJ. That being said, the quality of what you'll get may potentially be better because there aren't many "back door pretending to be qualified to teach x, y and z" in LA and people who work in that field are appropriately certified. I don't have experience to guide you, but did want to warn you and wish you a lot of hatzlacha.

Just a few things...
Full Medi-Cal has no out of pocket costs. But share of cost (for those who technically don't qualify but are right above it) exists in NY too.
There actually is mental health care in CA under Medi-cal. I work in the field and you just have to find it. They cover a lot of meds at 100%. There are lots of clinics where you can see a psychiatrist and therapists all covered by Medi-Cal. You can also get a referral from your PCP for a psychiatrist. There are Medi-Cal doctors all over- including Beverly Hills and right near the frum areas including Pico and La Brea. Take a look at the huge books from the two plans (Health Net and LA Care). I found some for my clients. They aren't all in fancy buildings with doormen but that doesn't mean anything about quality.
Psych hospitals can't all be blamed on Reagan. The big one in LA closed long after he was president... They actually said it closed due to uninsured (I.e. Those that cannot get Medi-cal and cannot or will not pay for private insurance). Again, I work in the field. We have homeless problems for a variety of issues. Firstly, it's warm here. No snow in LA so it is easier to sleep outside than NY or NJ. Plus they stopped forcing people to relocate and basically allow tent cities. Yeah, every once and a while you hear of one getting demolished but so long as they park under a freeway overpass they won't be touched by LAPD as that is the jurisdiction of the CA highway patrol. And they don't bother.
Oh, and we Legalized pot so it has an impact. Many of the homeless have addiction issues.
We also make it easier to get on GR and SNAP (Cal Fresh) if you are homeless. SNAP can be used for hot restaurant food if you say you are homeless... Requirements are more lax.
HEAP is easier to get if you get Medi-Cal. My clients get mail all the time asking if they want to see if they qualify.
We also have closed off the list for section 8, even to those who should qualify. Some of that is due to people staying without having to recertify, people "passing it on" (illegal) and other issues.

There are many reasons for homelessness here so don't put the blame on one governor who was around 30 years ago. There have been democrats (mostly, Schwarteneggar was technically a Repub but not like Reagan) in power since then and they haven't fixed it either. We have lots of issues like anyplace. We also have a lot of great parts too. Weather, certain fields of employment, our frum community is huge (biggest outside NY and NJ), the frum community is quite friendly as a whole, and many other points. But it depends on what you need/want.
I know this is a total tangent but I felt I had to chime in to correct some errors, especially on the programs. Again I work with the mentally ill, homeless etc and am reporting firsthand info and not just talking points placing blame...

amother

Chartreuse

Wed, Dec 26 2018, 8:50 am

amother wrote:

I'm also talking first hand from the perspective of a professor of psychiatry at possibly the best mental health hospital in the world (UCLA) whose second cousin who is a billionaire had to seek inpatient treatment elsewhere out of state because there are no options. Whose other cousin had to have surgery for a broken arm by a surgeon flown in from NY Hospital for Special Surgeries etc. The care for ppl with MediCal is nowhere near that of what it is for ppl with Fidelis in NY nor are the services. There are areas of care in California where even the best insurances will not cover without huge out of pocket expenses (mental health and addiction) and the CA school system is also inferior to states like NY.

amother

Smokey

Wed, Dec 26 2018, 9:37 am

amother wrote:

This is completely off topic but I don't understand this.

California has world class doctors and hospitals like UCLA and Cedars Sinai as well as in other major urban areas. People fly here for surgery - e.g. my friend's father came to Cedars for cardiac surgery.

Having seen therapists in LA and California, I would say that it is equivalent as private insurance doesn't generally cover good therapists because they are not in the restricted network so at best you will receive limited reimbursement - when I used, it was 50% of "customary rates in area" which was generally less than therapist charged.

My personal experience with a relative who was hospitalized for severe depression was that the facility was excellent - it was attached to one of the major UC teaching hospitals. What is true is that like most psychiatric inpatient units, it was geared for short term in-patient care with the goal to get the patient stabilized on medication and back into the community. There are also excellent programs available for adults doing out patient therapy - I.e. all day with group sessions but this is if a patient is motivated to attend and probably also dependent on insurance - the person I know was on Medicare with excellent Medigap protection.

The issue of the homeless is generally because they are dual diagnosed - I.e. they have mental issues as well as some form of chemical dependency. Those people who are homeless solely because of difficult economic circumstances are often able to cycle out of homelessness because they are willing and able to navigate the system. Of course the development of areas that traditionally had lower cost housing exacerbates the problem just as the demolition of SRO residences in Manhattan exacerbated the issue of housing for low income people there.

amother

Amber

Wed, Dec 26 2018, 9:46 am

amother wrote:

So don't live here? No one is forcing you to to. Every place has positive and negative aspects.
You know one person who needed to fly in a surgeon. I know too many to count who fly in to CA for our medical care. People who fly from NY, NJ and elsewhere. For all sorts of procedures- surgery, cancer care, children's... Between Stanford, UCSF, CHLA, UCLA, Shriners...
People flying is no proof that an entire system is better or worse- just that they couldn't get what they needed where they lived. Like I said, not every place is for every person. But don't bash an entire state!
Addiction treatment?- medi-cal pays for free. Again no out of pocket and they pay for 60 day inpatient for free. Or outpatient programs. Or detox...

Mental health? Yeah it could be better but some of that is due to laws we have to prevent abusive committing policies. There are more patient protections here than elsewhere. So while it means it is harder to get 5150d it also means feuding family members can't commit someone for the financial gain as easily.

Funny you should mention education. Look at our public universities... 3 of top 5 are all in CA and none in NY!
(Again public elementary schools are different. Ours is awful but we also have a huge percentage of kids who are illegally here and/or don't speak the language.)

https://www.usnews.com/best-co.....ublic

https://www.timeshighereducati.....tates

amother

Chartreuse

Wed, Dec 26 2018, 11:00 am

amother wrote:

Addiction treatment?- medi-cal pays for free. Again no out of pocket and they pay for 60 day inpatient for free. Or outpatient programs. Or detox...

I assume you don't have first hand experience with addiction and treatments in LA, where I have a lot of experience. There is barely help in NY and many people fly to CA but a decent addiction rehab is a minimum of $15,000-$30,000 per month. Detox facilities are more expensive but on a shorter basis. Try calling decent places - Call Beit Teshuva. Call even cheap Clare. Call Brothman's detox. Tarzana detox does not have a high success rate and has no beds. Try calling. It's even worse than the mental health care. My family personally funds several with large donations annually so people who cannot afford it can get help. We've helped many ppl from NY. Again, I love CA but people need to realize it is not the same as NY and NJ in terms have services. Have you ever lived in NY and NJ amongst frum people and seen the amount of services etc.?

amother

Chartreuse

Wed, Dec 26 2018, 12:50 pm

amother wrote:

CA has excellent medical care, but not necessarily for those who are underprivledged (although UCLA which is possibly one of the best health facilities in the world does serve Medi-Cal patient) which is not the case in NY and NJ especially in the frum areas. Ppl from the east coast are not used to that. Someone paying $2,300 for health insurance in NY will have coverage that covers just as much as a neighbor who has fidelis in NY and sometimes it's even better to use no insurance and pay a flat fee than bill through an insurance because of what NY/NJ medicaid and the frum community have accomplished.

Amarante

Wed, Dec 26 2018, 1:03 pm

amother wrote:

I don’t disagree but I was responding to what seemed to be a post about a person with wealth who couldn’t get good medical care and had to have it flown in.

Medi-cal doctors are limited here although hospitals all take Medi-cal. The problem is with chronic or basic medical care and not the kind one gets in a hospital. I was surprised that people had no experience problems finding Medicaid doctors in NY. Without opening a can of worms, I have wondered if that is true outside frum neighborhoods since there seems to be a disproportionate number of frum families with relatively high incomes onMedicaid.

Last edited by Amarante on Wed, Dec 26 2018, 1:18 pm; edited 1 time in total

mha3484

Wed, Dec 26 2018, 1:18 pm

I am in Chicago which has many many hospitals that have affiliated medical practices and they all take a medicaid plan if not more then one choice. They can afford to absorb the cost of poor reimbursement better then a small practice of only a few doctors. When I had medicaid I was able to get specialty care with no issues. Primary care doctors were harder to find but once I was able to get employer insurance I heard that it became easier to find internal medicine doctors.

OP, I have a child with a variety of attention and behavior needs and no one here relies on the Board of Ed even in the best public school districts. You can get basic services but everyone I know gets extra services through their health insurance companies or paying out of pocket. Its a unique thing to the NY area that you can get so much assistance for so little cost. At the other end there is a lot less bureaucracy. You get your OT, Speech, PT etc from Blue Cross etc and you just deal with them and the clinic. You dont have a government agency arguing about what services you can get and from whom. On the off chance your interested in the midwest your free to PM me.

imorethanamother

Wed, Dec 26 2018, 6:37 pm

amother wrote:

It kinda upsets me that you're anonymous. All this passion, no way to actually talk to you and all this "experience" that might be useful for actual people. Feel free to PM me to disseminate all this amazing knowledge that might help the thousands of people in LA who are NOT GETTING HELP. I'm not scared of putting my screen name on here.

If you live in California, and you feel some kind of weird allegiance to it, I'd like to know why. I've lived there, and I moved because it literally was AWFUL for anyone with any kind of need. Young, old, if you needed something, you didn't get it unless you were rich. Don't grow old here. Don't bring special needs kids here. Stay in New York or New Jersey.

And unless you've tried to navigate the Medi-Cal system yourself, don't put up this fantasy story online for everyone to see that it's just amazing as long as you're in the know. Nobody decent takes Medi-Cal. Nobody. I'm sorry to say, but that's true. Maybe there are some incredible pious people out there willing to submit to all the shenanigans Medi-Cal puts them through, and then get reimbursed about $10 after expenses, but no one I know.

imorethanamother

Wed, Dec 26 2018, 6:42 pm

amother wrote:

Thank you for the dose of reality. And kudos to you and your family. California is just so lacking in basic services, even though they seem to be the epicenter of the nation with regard to addiction rehab - it doesn't come cheap, or for free. The only places that take Medi-Cal are basically institutions, and there are no beds. It's because of all the hoops they have to jump through in their applications.

Oh, and Chabad Rehab Center is pretty good as well.

amother

Amber

Wed, Dec 26 2018, 10:11 pm

amother wrote:

So funny...Beit Teshuva is a private institution. They don't accept insurance of any kind as far as I have heard. Private pay only. And their success rates aren't that great either. I have worked with people who relapsed soon after.
A coworker just got someone into Brottman detox on Medi-Cal.
Detox will be naturally shorter as it is only there to safely remove the drugs/alcohol from their system. After there is no risk from their PAWS (technical term for detox symptoms) especially with alcohol and benzos - there is no reason to be in a hospital level of care. That's why it is so short. Then they go to a treatment center (residential, IOP etc). Detox will not solve most addictions. They are for medical stabilization only. Addicts need a lot more help than that but that discussion could take a while,

There are a number of treatment centers who do accept Medi-cal. But don't dismiss them based off of rates. Success rates vary depending on how you calculate sober time and there has not been one conclusive way to determine it. Is it 30 days? 6 months? A year? What if it is their 3rd time? So private places will use the numbers that make them look the best even if they are no different in terms of results. Plus private places automatically get clients with better support systems, less untreated medical needs, less homeless... Because they can pay. Also about 90+% of heroin addicts relapse even with treatment. So that puts the statistics into perspective.

amother

Amber

Wed, Dec 26 2018, 10:30 pm

imorethanamother wrote:

I can't post under my SN. It will out who I am. How many frum ladies from LA have worked with addictions, medi-cal, homeless... Lol I probably have said too much and people will point to this and say "yikes that's my sister in law/niece/neighbor! I must be careful complaining about her on here!"
And yes, I help people navigate the Medi-Cal system everyday at my work. So it is no fantasy. It might not be perfect, NY may be easier, but it isn't as bad as the other anon poster said. People take it because they have a guaranteed clientele. So even if they get less per client they get way more clients without paying for advertising.
Go through the medi-cal book and I looked it up based on location. I found PCP doctors for them that aren't too far, they went and asked for the doc to put in the referrals they needed, and have appointments. And no they don't live in south central. My clients also are not always the most educated and stable population but somehow they get their surgeries, treatments etc. it is no PPO but it is free and decent. Just don't get assigned to the county clinics and if you are, ask to switch. It's your right to switch. Those are awful about getting appointments but no one is forced there...