What a Christmas Present!!!

I haven't posted much about our funding problems with Annie because it has just been too life sucking.  Suffice it to say that we have been doing the Medicaid denial of funds and subsequent appeal dance for the last few months.  We have called in favors from our network of social service folk, and we have talked with our State Senator and Representative (or at least their minions).  But we were really scared.  We cannot let Annie come back home because she is too dangerous to the other people in the home, particularly Kendra as she has intense jealousy towards her and has physically attacked her many times in the past.  But there didn't seem to be anywhere for her to go, I am not sure even homeless shelters would take her.

Well today the official sounding knock came at the front door and I was required to sign a certified letter for Annie.  We opened it and to our surprise discovered that Annie has qualified for the Acquired Brain Injury Waiver.  This is a new funding program and there were only 50 spots funded for this year and Annie got one!!  Some one is looking out for her, her guardian angel pulled some major strings.

With this funding stream we can now seek a residential/group home style facility for her much closer to home and one that will meet her needs for brain injury rehabilitation.  This funding stream was created to fill the hole between children's services which end at 18 and adult services which don't start until 21.  It is totally amazing that Annie got funded.  I mean, I am not saying that she isn't in desperate need but so are so many others.

The weight that has been lifted from our shoulders is immense.  I feel like we can be happy at Christmas now.

There is still a lot to do, we have to find a case management agency and then start investigating programs.  There is one we have in mind but we don't know if they have an opening or if they would consider Annie given her issues.  But it so much more hopeful to know that now we can start looking for a home for Annie rather than worrying about her being homeless.

Our prayers have been answered and now there are just the ton of details to deal with, but I am not  complaining.

Brooke's home visit

Brooke (in her prom dress and hairstyle) was home for several days this week. We had a good visit, we went grocery shopping, to the zoo and then picked up a few outfits for her. She learned how to use the Wii to bowl and got a huge kick out of me playing Guitar Hero. We had a good time all in all.

During the two days she also had several anxiety attacks, followed me around the house, even stood outside the door to my bathroom while I was using it, asked the same questions over and over and persevarated over food. That is life with Brooke.

Suffering from prenatal alcohol exposure, mental retardation, and a host of mental health issues ranging from anxiety to psychosis, Brooke has had a rough time of it. But with the support of many fine professionals and our constant presence in her life she really seems to be coming out the other side. She is calmer, more accepting of her life and far more willing to accept direction, love and care from those around her. There were many times that we thought her best result would be a locked psych facility if it wasn't jail. She was so violent in a crazy, crazed way, violent to herself and to others, indiscriminate in her violence and really quite scary that we were not sure she would survive. But she has and she is now blossoming.

Brooke is in a group home for young adults with mental handicaps, she is still in public school until next year when she turns 21 (hence the prom). And she is doing great. She has the structure she needs, the expectations she can live with and the wonderful care of some truly loving staff. Do I wish she could live with us? Yes. Is it possible right now? NO. Despite her major improvements she is still very volatile and we still have younger, smaller ones who need to be protected from her potential violence. Do I see a time when she might be able to live with us? Yes, but I also see a time when she will want to live independently in the community with minimal helps, and that is such a positive, wonderful goal that it makes me cry each time I think if how far we have come as a family with her.

Shaken Baby, Aquired Brain Injury,

Annie is the middle child of my adopted sibling group. She struggles with Acquired Brain Injury, the result of her being shaken and beaten as an infant. Unlike some of the most severe cases of shaken baby much of her damage is invisible. She does have some vision loss and some quivering of her eyeballs but in the scheme of things she got off lightly, if you can say that about brain damage.



What Annie lives with is some frontal lobe impairment which impedes her judgement, her planning and some of the higher order thinking skills such as abstract reasoning. As she has gotten older these deficits have become more apparent and more of an impediment to living a full life. Her lack of judgement right now makes her quite a danger to herself, as she seeks stimulus and pleasure she is not making good decisions about keeping herself safe and is winding up placing herself in very dangerous situations.



To add to the mix Annie also struggles with severe Depression, ODD, ADD and RAD. For the last 17 months she has been in a rehabilitation center for folks with A(cquired) B(rain) I(njury). I blogged about some of my frustrations with her response to treatment. Since then she seems to have settled down a little, or we are just in a lull of negative behaviors. She is facing discharge soon from this program. We have to decide how we want to handle this. On the one hand she is turning 19 this month we could announce she is an adult and let her make her own way. Or we could seek guardianship and try to steer her to more treatment programs etc. The one thing we know for sure is that she is not welcome to come home right now. She is unwilling or unable to abide by the rules of the household and we are unwilling to have her with us unless she will. It is a standoff.


Today we went to a ABI treatment program to meet the Executive director and get some insights into what services they could provide. We were very pleasantly impressed. They have a relatively new program of long term residential services in group homes of 3 clients and 1 staff. Eventually Annie could be helped to move into an assisted living apartment. She would also be as integrated into the community as possible. The buildings were nice and open and airy. The staff all seemed friendly and very confident and outgoing. It has been the first bit of hope I have had on Annie's behalf in awhile.


Issues still to deal with, we would have to get guardianship of Annie, and we would have to figure out payer sources. She is still on the adoption subsidy which provides a medical card, but technically that expires on her 19th birthday. We would have to fight with Medicaid and the adoption subsidy people to see if we could get it extended until she turns 21 at which time she would eligible for the ABI waiver and that would cover her needs. I love this little hole in services that young adults fall into, where their child medical coverage ends at 18 and they are ineligible for the Medicare waiver programs until they are21. Exactly what they are supposed to do for 2-3 years is unclear.


So now we have to make a decision, how involved in Annie's life do we want to remain, because I have news for you any continued involvement on our part is not going to greeted with enthusiasm by Annie. Do we want to keep struggling with the black hole of Annie's needs or do we want to let her go and face the guilt of knowing she is incapable of taking care of herself. Either way we lose to some degree (at least our emotional health takes a hit), I guess the real question is which decision benefits Annie more? And from whose perspective?