CALUMET CITY, Ill. - A Calumet City mother says for years she relied on ambulances to take her special needs child to the doctor before those rides suddenly stopped. Now, she’s desperate for help.
13-year-old T.J. Byars needs a ventilator to breath, an IV for nourishment and his mom's constant care to keep him alive.
“Medically, it's just a lot on paper but when you see him he still smiles, he's still happy so as long as he's happy, I’m happy,” said Octavia Byars, the mother of J.T.
Their living room resembles an ICU, and Octavia has counted on ambulances to safely transport T.J. to doctor's appointments until the rides stopped this spring.
“I’m scared because I don't know,” she said. “It's hard being a parent and taking care of a special needs child and then not be able to provide what he needs.”
Byars says she's contacted about a half dozen ambulance companies. She's heard different reasons as to why, but the bottom line is that none will transport her son anymore.
“You know that this person needs these services but you also know you're not going to get paid for those services,” said Christopher Vandenberg, Illinois State Ambulance Association.
Vandenberg says there are several reasons someone like T.J. can't get a home pick up. A shortage of EMTs makes ambulance companies more selective about who they transport. Add in low reimbursement rates from Illinois Medicaid, or no reimbursement at all, because of thick red tape.
“We're doing trips for free or for significantly below costs so we cannot pay our staff at the level they really deserve for the difficult job they're doing,” said Vandenberg.
The Illinois Department of Healthcare and Family Services says they raised ambulance reimbursement rates by 12 percent in the previous year to help prevent these difficulties.
According to the state rate schedule, the reimbursement for a patient like T.J. is $142.63 plus mileage. The ambulance association says that covers just 30 percent of their costs.
In the meantime, families like Byars face tough questions.
“Does this require him to be permanently hospitalized just to get medical care? Do I have to call 911 just to get help?” said Octavia.
Byars says she'll fight for her child to get the care he needs.
“I'm not going to give up, everything I got to do I’m going to do it,” she said. “He deserves to be at home.”