Loudon County family fights to keep round-the-clock care for disabled son

 

LOUDON (WATE) – A young Loudon County man blames himself for losing his around-the-clock nursing service from TennCare, although he had nothing to do with affecting his care.

For the last 11 years, Blake Goins has been in a wheelchair, because he has the worst type of muscular dystrophy, Duchenne MD. Physically, he’s lost all movement with his arms and legs. He can hold things in his hands but that’s all. His care was dramatically reduced last month.

“Because I’m 21. I guess they think I can take care of myself, but I can’t,” he said. “It feels like it’s my fault, but it’s not.”

A notice from TennCare announced Goins’s 24/7 nursing care ended January 18. Because of the severity of his disability, his parents never imagined his hours would be cut so drastically.

“His skilled hours of nursing was 112 hours a week and he CNA of 56 hours. He was dropped. The hours now are 27 hours skilled and 8 hours CNA,” said his mother Patricia Goins.

“The care should not change just because a child is getting older. The disease is not going away,” said his father James Goins.

WATE 6 On Your Side asked TennCare why severely disabled young people like Goins, dependent on round-the-clock nursing, lose a big part of their assistance when they turn 21. In an email, TennCare said adults at 21 are subject to benefit limits. These limits were put in place because costs for these types of services were growing at a rate the state could not afford.

TennCare says Goins’s current health plan conforms to the adult benefit limits. But his parents now worry about Goins’s psychological state of mind.

“He’ll get depressed and stuff. Sometimes he gets to the point where he wants to give up, but we’re not going to let him do that,” said James Goins.

Last August, Pat Smith was finally able to smile after she received news from TennCare that her granddaughter Tiffanie would not lose one third of her round the clock specialized nursing care.  Tiffanie, who was about to turn 21, was able to keep her care because she’s on a ventilator. The state changed its mind about cutting her care after Pat Smith appealed the state’s initial decision.

The Goins family has appealed TennCare’s decision that reduced their son’s care. They filed out papers weeks ago and just this week were told their appeal was denied. However, they have one more chance to fight the state by appearing before a judge.

“I want to hear them say that they see a need here and that my son will get the help that he needs,” said Patricia Goins.

TennCare has informed the Goins that Blake is eligible to enroll in Tennessee’s Choices program. It’s set up for people 21 and older with physical disabilities, including those who are 65 and-older. Choices includes either nursing facility services, or home and community-based services, for things such as bathing and dressing.

Blake Goins needs more assistance than that and says he definitely does not want to go to a nursing home.