Driscoll Health Plan helps Victoria family find answers

Nov. 09--Catarina Martinez took 26 steps this week.

After years of struggling with an undiagnosed medical condition, the 17-year-old girl who goes by "Catie" is starting to inch toward recovery.

Her story was shared at a 20th anniversary celebration Oct. 25 for Driscoll Health Plan. The insurance plan was able to help Dee Hernandez, 38, through the process, even pushing for her children's treatment to be a covered benefit.

The nonprofit, community-based plan was developed by the Driscoll Foundation affiliated with Driscoll Children's Hospital in Corpus Christi.

In 2000, Driscoll Health Plan started administering the state's Children's Health Insurance Program, or CHIP. Driscoll now provides insurance coverage to more than 175,000 individuals in 24 counties across South Texas, predominantly children and pregnant women, and has almost 500 employees.

Bill Brendel joined the company 12 years ago as medical director. At the time, he was a pediatrician in Victoria, but took the opportunity to help "make Medicaid better."

"The big thing is to get the right care by the right provider at the right time," Brendel said.

Dot Falcon, a resource coordinator for Driscoll Health Plan, said a few months ago she got a call from Hernandez inquiring about medical transportation after her daughter was admitted to a behavioral health facility in Houston.

"This mom just impressed me so much," Falcon said. "She never lost hope."

Falcon was able to connect the family with meal vouchers and offer support while doctors tried to figure out why Catarina was in a catatonic state.

The teen had stopped eating and started having seizures.

A doctor at Texas Children's Hospital ran a full panel and discovered that Catarina had late-onset Cobalamin C Disease. Her body was not getting the B12 it needed, which caused serious neurological problems.

This wasn't the first time Catarina had gotten very sick.

When she was 15, she experimented with synthetic marijuana and was hospitalized.

She lost the ability to use her legs.

Hernandez remembers doctors saying her daughter was depressed and diagnosing Catarina with conversion disorder, which means her symptoms could not be explained by a medical evaluation.

"Everybody was just saying she's going crazy. All these doctors," Hernandez recalled through tears. "All the symptoms she had in 2015. All this time, it was this. Finally, I had an answer."

Hernandez believes the exposure to synthetic marijuana combined with her daughter's underlying condition and prescribed medications caused the symptoms to worsen.

In May, her children, Guadalupe Martinez, 15, and Eduardo Martinez, 14, were screened and she learned they also had inherited the deficiency and were experiencing symptoms.

Hernandez works a full-time job providing for her children, but the initial cost for their daily shots was going to be $1,500 out of pocket.

All three of her children were in the hospital and she worried about how she could afford the treatment they will need while working paycheck to paycheck.

But Falcon and case manager Amber Salazar at Driscoll Health Plan were already working on a solution.

When the family returned home to Victoria after rehabilitation, they found the treatment was approved as a covered benefit by the insurance plan.

Rick Villarreal, vice president of finance for Driscoll Health Plan, said when it comes to the needs of the child, they try to move as fast as humanly possible.

"There's been instances when things come across my desk, and they are not a Medicaid benefit, but we do it because the child needs it," he said.

Hernandez said Driscoll also found a local pharmacy that could compound the medication and helped get a ramp installed at their home.

"I wasn't expecting this kind of treatment. All of the stress was taken off me, and I just have to concentrate on their health issues," Hernandez said.

Every day, all three siblings must inject 0.25 milliliters of medicine into an arm or leg to slow the progression of the disease.

Without the daily shots, Hernandez said they are at risk of weakening of their legs, memory loss, diminished eyesight and anemia. Hernandez is confident that her daughter will recover.

"All the things that they said my daughter wasn't going to be able to do, she's doing," she said. "The treatments are working wonders on them."

Catarina still uses a wheelchair, but undergoes therapy to try to regain her mobility.

Her ultimate goal is to walk the stage at her high school graduation.

"I proved 'em all wrong," she said. "I'll prove them wrong again."

Laura Garcia is the Features Editor for the Victoria Advocate. She may be reached at lgarcia@vicad.com or 361-580-6585.

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