Here is the entire response from the WI Department of Human Services: The Department of Health Services’ mission is to protect and promote the health and safety of the people of Wisconsin, especially our state’s most vulnerable residents. We are committed to doing everything that we can to ensure that health care benefits are fairly, quickly and appropriately expedited. It is always our goal to provide the right care for the right person at the right cost at the right time. The Department is required to respond to all requests for equipment, also called prior authorizations, within 20 days, from which the request is received. Please note that not all equipment requires prior authorization or requires prior authorization only after a certain rental period or quantity has been reached. Sometimes when a request for equipment is denied, the paperwork may have not been completely filled out or we need the health care provider to give more information. If a request for equipment, like a wheelchair, is denied the member has the ability to appeal the denial through our fair hearing process. Claire Smith Communications Specialist - Advanced Department of Health Services Office of the Secretary
MONDOVI, Wis. (WEAU) -- Playing with your kids is one of the pure joys of parenthood, but a little patty cake is just about the only piece of cake activity for Kylynn Kummer. She has Dandy Walker Syndrome.
"It's pretty rare," said her mom, Jessica Kummer. "Dandy Walker Syndrome is, she was born missing part of her cerebellum the back part of your brain."
Kylynn is 7, But her mom Jessica Kummer estimates she's just now hitting the milestones of a 9-month-old.
"Mental delays, physical delays, she has seizures," she adds.
She's recently started crawling, but Jessica says they've tried since Kylynn was a toddler to get a wheelchair. Jessica says it was denied. Her occupational therapy assistant told WEAU the state approved a base once, but no seat for the wheels, making it useless. So mom was told she had other options. "You can use a stroller or carry her," she said.
Soon Kylynn outgrew strollers and her parents, who both work and have a busy toddler at home too, had to figure something out.
"We went to Children's Miracle Network and they paid for it," Jessica said.
That's the chair Kylynn has used for 3 years. She outgrew it a year later. Jessica says, "it makes me sad she has to be in things that are too small for her."
Her dad has drilled holes in it, trying to make it last for her growing legs.
"It's pretty frustrating but we make it work," her mom said.
The family says the chair from charity was a one time thing, and with estimates climbing past the $6,000 mark for a new chair that has the required buckles and straps, they are counting on Medicaid to get Kylynn mobile again. "It's a waiting game, always."
"It takes so much time to look over things, approve things, they deny it for a reason then you have to go back and rewrite it until they approve it," said Jessica.
Both Kylynn's physical and occupational therapists say the Kummers are not alone.
Kylynn's therapists told me many families get so frustrated they often give up. To get equipment and therapy approved they say they have to write letters, get a doctors note, and a letter from the company that makes the equipment. If it gets denied, the state has 20 days to reconsider. They say sometimes they have to do that 3 or 4 times before kids can get things like walkers, wheelchairs and seats.
When we asked the state Department of Human Services about the long wait times, the spokesperson says they are committed to doing everything they can to get people benefits fairly and quickly. Claire Smith went on to say, "sometimes when a request for equipment is denied, the paperwork may have not been completely filled out or we need the health care provider to give more information. If a request for equipment, like a wheelchair, is denied the member has the ability to appeal the denial through our fair hearing process. "
Jessica says, "I hope things change."
We went to the Kummer's state representative, Chris Danou to get his thoughts. He said, "I'm not in her shoes and I can't imagine how frustrating that must be. You want to do the right thing by your children, wanna get things done."
Representative Danou says stories like Kylynn's cut across the aisle but the budget battle is always there. "Making those things a priority, adequate staffing, we need to do the things we need to get done that's something we need to look at we're seeing that across state agencies and we're looking to address it."
"I'm not going to give up on her," says Jessica, who has been a constant advocate for Kylynn. It finally paid off.
Just this month, the state approved Kylynn's chair. We were there for the big day as mom beamed. "It feels wonderful a lot more comfortable. It will make life a lot easier," she says.
After seeing her growing first grader get these first rate wheels, Jessica says it's all been worth it and she wants every parent who's going through the same thing to stay positive and stay strong. "Keep going, it's worth it."