When Jake and Natalie Koprowski decided to adopt two young girls from the Democratic Republic of Congo, they did so with the desire to give the girls better lives than they had in orphanages.
And when the Washougal couple brought 1½-year-old Lucie and 3½-year-old Myradie home three weeks ago, they made getting the girls healthy their No. 1 priority. The girls are dealing with an array of medical issues — the result of poor diet and minimal health care — and neither has received immunizations.
But the Koprowskis had no idea getting their adopted children the health care they need would be so difficult. Despite having insurance, the Koprowskis can’t find a pediatric office that will see their children.
“After all these kids have been through, that they would run into trouble like this after they made it home is infuriating,” Jake said.
While Jake and Natalie have a commercial insurance plan, their children are insured through the state Medicaid program and have a plan from Columbia United Providers. The single-income family — Jake works as a graphic designer, and Natalie stays home with the kids — qualifies for Medicaid, but they pay a monthly premium for the plan.
But when they tried to schedule medical appointments for Lucie and Myradie at The Vancouver Clinic — where Jake, Natalie and their four other children are patients — they learned of a new policy that means their adopted children will not be accepted as patients.
The Vancouver Clinic is accepting only Columbia United Providers-insured newborns (defined as younger than 4 weeks old) of established siblings. The new policy is the result of The Vancouver Clinic’s May decision to reduce the number of Medicaid services it provides, said Tom Sanchez, The Vancouver Clinic’s chief operating officer.
So while Lucie and Myradie are siblings of established patients, they don’t qualify to be patients at the clinic.
“If I was pregnant, we would be fine,” Natalie said.
“It seems really targeted at adopted kids,” Jake added.
But the access issue doesn’t end there. In the last three weeks, the Koprowskis said, they have been turned away from more than a dozen local medical offices that aren’t accepting new Medicaid clients unless they have siblings who are already patients at the clinic.
“The problem is, there’s no doctors,” Jake said. “Insurance is nice, but we really want the doctors.”
Columbia United Providers said local physicians are working hard to provide access for Medicaid clients, even as the state reduces Medicaid reimbursement rates.
“Patient access to providers is something CUP takes very seriously,” said DJ Wilson, spokesman for Columbia United Providers. “It’s why CUP has worked to recruit new physicians to the community, and why we’ve worked with our providers to be as supportive of them as possible.”
Rule change
The Koprowskis adopted their two oldest children — Chloe and Taylor, both 8 — from Vietnam when they were 5 months old. Once they were in the U.S., Natalie called their insurance company, had the girls added to their policy and took them in for doctor appointments — all without trouble.
The Koprowskis assumed things would be just as smooth this time around. Instead, Natalie said, they’re trying to help sick children adjust to a new environment while also dealing with the health care system.
Lucie nearly died from malnutrition a year ago. Natalie flew to the Democratic Republic of Congo with a suitcase full of infant formula in an attempt to save Lucie’s life. After that, the Koprowskis got Lucie moved from an orphanage to a foster home, for which they paid a monthly fee.
Lucie’s belly is still distended from malnutrition, and she’s had diarrhea for several months. Desperate for help, Natalie took Lucie to a hospital emergency department when the toddler became lethargic. Without a primary care physician, the hospital was reluctant to run blood and stool tests.
But a sympathetic physician did run blood tests and diagnosed Lucie with giardia, an intestinal infection caused by a parasite. She was prescribed medication, but the $200 prescription can’t be filled until the state approves the paperwork — a process that can take about a week.
At a standstill
Myradie’s physical health appears to be better than Lucie’s, but she needs a routine checkup and immunizations. The Koprowskis were able to get Myradie in to see a dentist for the first time. The dentist wants to put Myradie under general anesthesia in order to get X-rays, pull some of her rotted teeth and put crowns on some of her teeth. But since Myradie hasn’t had seen a doctor for a physical checkup, they can’t move forward.
“So our lack of a primary care physician now means Myradie has to continue to live with a mouth full of rotten teeth,” Jake said.
For now, the Koprowskis are at a standstill.
They’re hoping to find a clinic in Clark County that will accept Lucie and Myradie. If they can’t, they may have to consider taking out a private insurance policy for the girls in order to get them into a medical office and get their health issues addressed.
“We’re trying to get them up to American standards,” Jake said.
