For a woman who is allegedly ruthless with area home health care providers, Yvonne Garcia sure has a lot of supportive family and friends. The group packed one side of Bexar County Children's Court today, as lawyerless Garcia defended herself against the allegations of Child Protective Service representatives that she is somehow a threat to her terminally ill son, Rafael Garcia.
Child Protective Services isn't after Rafael yet, but they asked the state, in the person of Judge Richard Garcia, to require Yvonne Garcia to have home health care services for her son and to receive a psychiatric evaluation. Yvonne has sought this medical assistance for more than a year (and through her month-plus stay at Methodist Childrens' Hospital with her son during his recent repeated bouts with pneumonia).
Strangely, that medical care CPS is demanding, and Yvonne has sought for so long, has been in place since Rafael was released from the hospital earlier this month.
Methodist Children's CPS liaison, Talia Marquez, says she personally knew of “more than three” home health agencies that would not work with the Garcia family â?? thereby suggesting that Yvonne has been jeopardizing Rafael's life by being overly demanding on nurses.
Rafael, you may remember from You Kill Me, suffers from the degenerative disorder known as spinal muscular atrophy and requires a lot of specialized care. It's care that his mother and sister had bee providing for more than a year until he was hospitalized with pneumonia at Methodist in November.
“I've never been more nervous in my life, basically,” Ralphie tells me before heading into the chambers. He's requested a personal audience with Judge Garcia (no relation to Yvonne, Ralphie, and family). He's optimistic. And the sign on the wall urging passer-bys to “Look Up” inspires him to keep faith.
“I looked at that sign and I felt my heart melt,” he said.
In the courtroom, Ralphie replaces his protective mask to guard against the inevitable fits of coughs that cedar season has unleashed in San Antonio.
Marquez agrees with Ralphie's court-appointed attorney that Yvonne is acting as a protective mother, that her depression would be the logical outcome for any parent facing the challenges that she has, but somewhere Yvonne's behavior “crossed the line,” Marquez says.
Marquez admits she has no direct knowledge of the ways Yvonne “goes overboard,” but a good indicator is “when home health care can't come for a year.”
Taking the stand herself, Yvonne doesn't consider this may be a good time to introduce a few key items that would assist the judge render a verdict â??that two of the “more than three” cases in which Yvonne had problems with home health groups were due to her sons complaint of being sexually molested by a home health nurse and a case of possibly fraudulent billing.
She insists she only demands nurses provide and chronicle “what is written in the plan of care.”
Who prepares the plan of care? Judge Garcia asks.
“The home health agency,” she replies.
Ralphie's attorney tells the judge that she is “concerned over the course this investigation has taken.”
“I believe the family is willing to do all of these things that are asked of them outside of a court order,” she says.
After meeting with Rafael privately for a few minutes, the judge concurred. Returning to the courtroom with only two words: “Case dismissed.”
What did he say to the judge? I ask Rafael later. He says he told Judge Garcia about his stay at Methodist, about becoming a captive of the hospital and the threats made by the variety of agencies involved.
The takeaway? Standing up for your rights and the rights of your family doesn't always end with prolonged victimization by bullying mid-level regulatory goons. Or medical "professionals."
So while the Garcias have skated retributive justice for speaking out about a broken system, the nursing shortage, shortchanging of health care in our state, and failures of enforcement at the Texas Department of Aging and Disability Services all leave plenty of room for the continued mistreatment of other special-needs families.
Rafael has a dream to write a book about his experiences and become a prominent advocate for others in the system.
Ultimately, he wants to get to Washington and speak to President Barack Obama. I hope he gets there.
But for his sake, I hope he also will take the judges advice offered in closed quarters, and allow himself to enjoy being 13 for a while first.