Lenice told me she had a Medicaid appointment to go to with a consumer, and asked if I wanted to go with her. So I asked Amanda if she needed me, or if I could go with Lenice to complete one of my learning plan activities. Amanda said she thought it would be a good experience for me, and that I should go. The Medicaid appointment itself was not what I what curious to experience; I was more interested in just seeing how Lenice acted and handled things when she went to appointments with consumers.
When Lenice and I left for the appointment she started explaining the process to me of how applying for Medicaid. She explained that one has to first go to the office and fill out an application, and then a caseworker would set up an appointment. When one comes to the first appointment they have to bring certain documents that the caseworker uses to determine the applicant’s eligibility. She asked if I was familiar with this process at all and I told her I have been on and off Medicaid for years.
Lenice laughed and stopped there saying that I already know all about it, so she didn’t need to explain. Even though I did already know all about it, I had let her explain to me what she thought I needed to know anyway because there could always be something she says that I did not know and would have missed otherwise. I remember on my midterm evaluation Amanda said something towards the effect that I need to stop always telling people what I know, and instead be more receptive to learning what others are offering or trying to teach. If I am always showing what I know then I am not in a position to learn something new.
I have learned there is a big difference between many of the same services offered in Hendricks and Marion County. The Office of Family and Children, now called the Office of Child Services, toted a greatly different atmosphere in Hendricks County than anything I was used to in Marion County. Marion County always seems run down, dirty, and uninviting. When I walked into the Hendricks office I felt comfortable and welcome.
As soon as Lenice and I walked in we immediately went to the caseworker’s office where Lenice’s consumer was. I will call the consumer Sara to make this easier to understand. While in the office I just sat in the back out of the way since I was only there to observe. Lenice sat next to Sara and aided her by answering questions at times when she did not know the answers. Most of the questions Lenice helped with were regarding finances, medications, or medical diagnosis. When asked Sara said she was not sure what she was applying for, and was not sure about all her meds or bills.
The case worker was nicer than others I have had dealt with in Marion County, but then again she may have acted different than normal since it was not only a client in the office this time. Just as workers act different when supervisors are around, she could have been acting different since there was a case manager there, and a student to observe. This caseworker had a nice demeanor, yet did not engage with the client. She seemed to just do her job, input the information, and nothing further.
Sara had been on SSI, SS, and Medicare Part D. She was at this appointment because her benefits had been cut off and she did not know why. Lenice has different levels of involvement with each client. With Sara, I learned that she had helped her fill out the reapplication papers and had turned them in herself.
After the caseworker asked several routine questions about Sara’s finances, living situation, employment, history, etc, she asked about her medical history. Sara was not sure about her diagnosis, so they had to look at the papers from her doctors. She had depressive diagnosis disorder/bereavement, PTSD, and borderline or histrionic personality disorder. She also has been legally blind since 1966, but can see with her glasses.
Next the caseworker said she wanted to get a ‘social summary’. She asked about other medical things, such as Sara’s medications and if her diagnosis limits her. She also asked if she drives, has a degree or GED, if she is working, her last job title, if she has had vocational rehab, how she got to the appointment, and her relationship to the person who gave her a ride. Next she asked things I would expect more of a doctor to ask: if she uses recreational drugs, if she hears/sees things that are not there, if she understands all the questions she was asked today or if she needed assistance, if she has been having suicidal thoughts, what a good day is like for her, if she often leaves the house on her own, etc.
Overall, I was surprised by some of the questions that were asked. I have been to several Medicaid appointments, but have never been asked some of the things this caseworker asked. I was left wondering if it was because of the client’s medical history and diagnosis, or if it was something the caseworker asked all her clients. I also wondered if this was something just this caseworker did, or if this is part of the difference between Marion and Hendricks County offices.
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