Addiction Treatment Kaiser Denied

Hello..My name is Marilyn but this is a family story. My family. First of all let me say that my husband and I both have full time jobs. What we also have is bad luck and bad health insurance.

During his second year of college, a well known Christian college in Southern Califrnia, my son developed a drug problem. It’s ironic that he was also admitted to USCB, UC Santa Cruz and Humbolt State among others. As parents, we were so excited to send him off to a christian college for a fantastic education and what we thought would be way less of a party school. They had to attend daily prayer sessions, community charity events and all sorts of non-partying activities. He received a scholarship that would make the expense to us less than a state university. We thought he was in great hands. It turns out, most of these kids had a lot of money. My son was exposed to things we never thought would be a problem at this school. I second guess myself all the time. I was so worried about drinking at Santa Barbara, Pot at Santa Cruz and Humbolt that I never knew the real danger was in the money and maturity level of these kids at the private school. I am not blaming the school, I think for our son it just happened to be a mix of influences that created this perfect storm. As a parent, I feel like it was my job to make decisions for him and I will I would have not push for this school. Either way, its done. I can’t change the past, only look forward to the future.

We were Kaiser Permanente members so we went to Kaiser for help. My son enrolled in the out patient drug rehab program. It did not help, too much freedom for a young man. During his out patient treatment, he overdosed on heroin 2 times. Thank God we were able to intervine both times. He had to be resuscitated by 911 responders, shot in the heart with a stimulant to get his heart beating again. This was the worst time in our lives. No parent should ever have to see their child close to death. He was hospitalized for 2 days and allowed to go home after a two minute conversation with the on duty Psychiatrist.

After his first overdose, my husband went to the addiction/mental health “specialist” with my son at the Kaiser addiction facility he had been attending. My husband explained what happened to the doctor and asked that our son be admitted to an inpatient rehab facility. The doctor actually told my husband and son, “death is nothing, we deal with it everyday”. I’m sure you can imagine what we were thinking. At this point we went along with Kaiser, after all, they were our insurance company and we thought they had our son’s best interest in mind. He continued to attend the out patient rehab at Kaiser. A week later, overdose number two. This time after less than 24 hours in the hospital, he was again released to go home. Before we left, we pleaded with the on duty doctor to admit him in an in patient rehab. The doctor told us “it is not that easy”. We knew now we would have to fight for our son’s life.

We made arrangements for my husband to take our son to see his family in another state for a week while I dealt with Kaiser to find an in patient facility for him to go directly into upon their return. Our son agreed he needed help and was willing to attend the in patient rehab. He did not want to be an addict but did not have the tools needed to break the habit himself. He needed to learn how to live a sober life. From here on out this becomes an unbelievable story.

I begged Kaiser to place him in an inpatient facility. They continuously declined him. The same doctor who said death was nothing was declining him the treatment he so desperately needed and wanted. Now, yes, he was a 19 year old drug addict. He did miss some out patient classes but he attended much more classes than he missed. He drove himself there everyday and participated in the sessions. We did not drag him there, he went voluntarily. The doctor said he denied him because he “lacked motivation and had a bad attitude” Well, again, he was a drug addict. That is why he needed to be in a live in facility. For three days straight I begged every health care professional at Kaiser I could talk to to please get them to admit him. They still refused. I could not believe it. Here they are, our insurance company, refusing to save this young man. It is very hard to express in words how desperate we were. I knew without treatment, the next overdose may be the end. At this point we were on our own. I called and called and called facilities. They are so expensive and I had no idea what to look for in a facility. I had no guidance from my son’s doctors. All I could do was hope we would find a facility tat was reputable and could work with us on payments since we had to pay out of pocket. Unbelievably expensive. We are not rich, just your average working family. I work full time in an office, my husband works full time at a blue collar job.

I found a facility that as it turns out was so fantastic and exactly what our son needed. They had a very intensive in patient treatment plan for 3 months. We were truly blessed to have found them. Just to give them a shout out incase anyone out there needs a facility in Southern California, the name of the facility is South Coast Counseling in Costa Mesa, CA. Jack Motley is the director and I truly believe we owe our sons life to them. A true blessing.

When treating a mental health/addiction problem, there must be a continuous treatment plan for at least up to a year. Especially with young adults because they do not have the life experience adults have to draw on for strength and wisdom. These are things they have to lean thru counseling, therapy and meetings. So comes the sober living. This too is not a cheap treatment. Again, we paid out of pocket.
Here is the mixed blessing. A year before the habit started, my mother had passed away at 92 years old. She left us a small amount of inheritance to use for a down payment on a house. Of course, no hesitation at all was given to use that money to save our son. I thank God we had that money. I don’t think our son would be alive if we had not of had that. We used all our inheritance, all our credit and have gone into deep debt to pay for the treatment. We still work and I am trying to sell on e-bay and do the best I can to dig ourselves out of this hole. But we seem to not make a dent and just keep getting deeper and deeper. Robing Peter to pay Paul. I submitted a claim to Kaiser for reimbursement and they denied our claim because we did not use an approved”Kaiser Facility” What???? They would not send us to a Kaiser facility. It is assured. We pay a high dollar amount monthly to pay for health insurance and they would not treat our family. I have contacted lawyers but all have said no. Kaiser is a huge corporation and I guess our small claim is not worth it.

That is what brigs me to this website. I am hoping to raise enough money to pay the debt we have got ourselves into by paying for treatment and issues relating to our son’s drug habit. If I had it to do all over again, I would still do the same. Our son is the most important thing to us and we cherish every moment we have with him.

My son has been sober for a year. He got himself certified as a personal trainer and he is working. He has new friends now and attends meetings regularly to stay on the sober path of life. He still has struggles and has moments when he fights to stay sober but he is doing great and is looking forward to the future. We are very prod of him.

If you know anyone that has been affected by drugs, let them know there is hope. This is a problem that I thought would never touch my family. I have since learned that this is a big problem in America. It affects all people from all walks of life. It makes me sad that we as a nation have so many problems and this is just another problem that touches many more people then you would think.

Any amount you can donate will help us to pay some of the bills and get back to a place where we are not having to sell jewelry on ebay and worry what bills wont get paid.

You can help by visiting our gofundme website: