APS and new healthcare provider

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:APS teacher of 10 years here - and I am beyond embarrassed by how outraged my colleagues are acting. I am actually happy about the switch to Blue Cross Blue Shield. In previous jobs I've held, insurance carriers have switched, and it hasn't been a big deal. Everyone saying they need days and days off to search for new doctors is beyond ridiculous. I watched the school board comments and I cringed. A small group of APS teachers act so outraged over EVERYTHING and they give the rest of us a bad reputation. Just want people to know we aren't all this crazy. And the people who speak at school board meetings (including one very vocal teacher) - DO NOT represent the majority of teachers in APS.

Thank you! I'm so happy that none of them work in my school.

“The people at the top DO respond to pressure from the bottom, yet the people at the bottom don’t have time or mental energy to fight back or to change how the interact or question why things are done the way they are done. This is how oppressive systems work and the reason they stay functioning. We need people from the bottom to rise up.”

Why do you have a problem with people speaking out about their experience? I didn’t speak out (except for here) and will have to take some leave. I don’t think it ridiculous to state that I am going to need more sub coverage during a sub and staffing shortage. What I am attempting to prevent is kids losing more time learning. We are also pointing out that there are effects from this change, and that classroom teachers shouldn’t constantly be expected to take the brunt of those systemic changes. They should plan in some way for some teachers to need time off. Others don’t need subs and will not have the same consequences.

Because it’s done as a threat to parents “call the school board or your child will miss out on instruction” It makes us all look bad. Misinformation is being spread about why Kaiser didn’t bid. They are in a strike due to overwork- have any of the people screaming conspiracy considered that Kaiser didn’t want us?

I agree that parent’s should be involved as this is within APS, but I also think as employees when we see this coming down the line, if we say nothing to admin, that is a problem too. I wrote to HR (and on here) and kept it to that. I don’t expect parents to care or do anything, but I also think it is my duty to tell admin that I will need some time off and that others probably will too because of the policy change. I don’t want my kid with multiple therapies to not get those.

Sorry- parents shouldn’t be involved with this.

You are not required to do anything.

As a parent who is part of the APS community, I want to be informed of any challenges that a significant group (teachers) are experiencing. I may be able to help in some way.

The only thing you can do to help is to calm people down. Kaiser didn't bid. End of story. This wasn't a big conspiracy. Help explain how PPOs are actually more convenient than Kaiser. Help explain that you don't need to take time off to establish care with a PCP before seeing a specialist. Help explain that this change is not in 1 month (like some people are saying), but 3 months down the road. Help people identify offices that are taking new patients.

Screaming at the board or on AEM doesn't help those teachers. It only makes people more upset and fuels outrage. Help them problem solve. This isn't insurmountable. Lots of people go through this every year. Be a role model on how to handle it.

[Anonymous]

Vote for legislators who advocate for universal healthcare

[Anonymous]

Anonymous wrote:Vote for legislators who advocate for universal healthcare

This. And also that if you rely upon your students' teachers to teach them basic life skills like understanding and navigating health insurance, stop doing that because they clearly have a very sadly narrow understanding of the healthcare system and very little ability to bend and adapt to stressful situations. Arlington teachers are very privileged and they truly are out of touch with a lot of their students and families and the reality of day to day life for many of us.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:APS teacher of 10 years here - and I am beyond embarrassed by how outraged my colleagues are acting. I am actually happy about the switch to Blue Cross Blue Shield. In previous jobs I've held, insurance carriers have switched, and it hasn't been a big deal. Everyone saying they need days and days off to search for new doctors is beyond ridiculous. I watched the school board comments and I cringed. A small group of APS teachers act so outraged over EVERYTHING and they give the rest of us a bad reputation. Just want people to know we aren't all this crazy. And the people who speak at school board meetings (including one very vocal teacher) - DO NOT represent the majority of teachers in APS.

Thank you! I'm so happy that none of them work in my school.

“The people at the top DO respond to pressure from the bottom, yet the people at the bottom don’t have time or mental energy to fight back or to change how the interact or question why things are done the way they are done. This is how oppressive systems work and the reason they stay functioning. We need people from the bottom to rise up.”

Why do you have a problem with people speaking out about their experience? I didn’t speak out (except for here) and will have to take some leave. I don’t think it ridiculous to state that I am going to need more sub coverage during a sub and staffing shortage. What I am attempting to prevent is kids losing more time learning. We are also pointing out that there are effects from this change, and that classroom teachers shouldn’t constantly be expected to take the brunt of those systemic changes. They should plan in some way for some teachers to need time off. Others don’t need subs and will not have the same consequences.

Because it’s done as a threat to parents “call the school board or your child will miss out on instruction” It makes us all look bad. Misinformation is being spread about why Kaiser didn’t bid. They are in a strike due to overwork- have any of the people screaming conspiracy considered that Kaiser didn’t want us?

I agree that parent’s should be involved as this is within APS, but I also think as employees when we see this coming down the line, if we say nothing to admin, that is a problem too. I wrote to HR (and on here) and kept it to that. I don’t expect parents to care or do anything, but I also think it is my duty to tell admin that I will need some time off and that others probably will too because of the policy change. I don’t want my kid with multiple therapies to not get those.

Do you have to take time off now for those therapies? If so how is it any different?

You’ve never switched providers? There is usually some lead time to get in as a new patient to establish care. Potentially delays in medications as well. It’s not trivial.

Yes I have. We have 90 days, and an additional 90 if covered under continuity of care. The vast majority of us who aren’t Jewish have today to call

Ok, well I have already explained about this earlier in the thread and yes, it will be necessary for me to be there for the initial intake appointments because that is what the therapists (OT, PT, BCBA) do. Then we can establish weekly appointments after school, but you have to have the initial appointment and the screening is a longer appointment and usually done during the day.
Look, fight me all you want, question my ability to make appointments for special needs kids if you need to, but I am truly only trying to explain the situation and give a realistic view of my leave. Of course I will do my best, but again, I also think it is my job to give a heads up during a sub shortage that I will need more coverage because of the switch.

I hear your stress. I hope this is helpful to you and not annoying. I have taken multiple children to PT and OT and had to switch providers. Typically, the new provider does not do a whole new intake. I have BCBS- plans vary a little so play a lot of attention to the brochure- I have not needed a referral for OT. The PT referral is just a prescription from a doctor. If your child already has a PT referral, just get a copy of it from Kaiser- BCBS isn't a closed system like Kaiser so they will take the Kaiser referral. At least among PT's I know, they view BCBS as the 'gold standard' for coverage- the easiest to work with. When we have switched, the new therapist picks up the plan and notes from the old therapist- they might do a 'mini-intake' but its not as involved as the first one and generally done at a regular appointment. For child OTs and PT's Good Beginnings in Falls Church is a solid practice with a lot of providers. I have made an 'advance' appointment with them when I was waiting for new insurance to kick in.
In terms of ABA therapy- I honestly don't know what BCBS covers- I would check the brochure really carefully. That being said- I thought Kaiser contracted with ABA therapists rather than having them in house- so you don't necessarily need to switch ABA therapists.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:APS teacher of 10 years here - and I am beyond embarrassed by how outraged my colleagues are acting. I am actually happy about the switch to Blue Cross Blue Shield. In previous jobs I've held, insurance carriers have switched, and it hasn't been a big deal. Everyone saying they need days and days off to search for new doctors is beyond ridiculous. I watched the school board comments and I cringed. A small group of APS teachers act so outraged over EVERYTHING and they give the rest of us a bad reputation. Just want people to know we aren't all this crazy. And the people who speak at school board meetings (including one very vocal teacher) - DO NOT represent the majority of teachers in APS.

Thank you! I'm so happy that none of them work in my school.

“The people at the top DO respond to pressure from the bottom, yet the people at the bottom don’t have time or mental energy to fight back or to change how the interact or question why things are done the way they are done. This is how oppressive systems work and the reason they stay functioning. We need people from the bottom to rise up.”

Why do you have a problem with people speaking out about their experience? I didn’t speak out (except for here) and will have to take some leave. I don’t think it ridiculous to state that I am going to need more sub coverage during a sub and staffing shortage. What I am attempting to prevent is kids losing more time learning. We are also pointing out that there are effects from this change, and that classroom teachers shouldn’t constantly be expected to take the brunt of those systemic changes. They should plan in some way for some teachers to need time off. Others don’t need subs and will not have the same consequences.

Because it’s done as a threat to parents “call the school board or your child will miss out on instruction” It makes us all look bad. Misinformation is being spread about why Kaiser didn’t bid. They are in a strike due to overwork- have any of the people screaming conspiracy considered that Kaiser didn’t want us?

I agree that parent’s should be involved as this is within APS, but I also think as employees when we see this coming down the line, if we say nothing to admin, that is a problem too. I wrote to HR (and on here) and kept it to that. I don’t expect parents to care or do anything, but I also think it is my duty to tell admin that I will need some time off and that others probably will too because of the policy change. I don’t want my kid with multiple therapies to not get those.

Do you have to take time off now for those therapies? If so how is it any different?

You’ve never switched providers? There is usually some lead time to get in as a new patient to establish care. Potentially delays in medications as well. It’s not trivial.

Yes I have. We have 90 days, and an additional 90 if covered under continuity of care. The vast majority of us who aren’t Jewish have today to call

Ok, well I have already explained about this earlier in the thread and yes, it will be necessary for me to be there for the initial intake appointments because that is what the therapists (OT, PT, BCBA) do. Then we can establish weekly appointments after school, but you have to have the initial appointment and the screening is a longer appointment and usually done during the day.
Look, fight me all you want, question my ability to make appointments for special needs kids if you need to, but I am truly only trying to explain the situation and give a realistic view of my leave. Of course I will do my best, but again, I also think it is my job to give a heads up during a sub shortage that I will need more coverage because of the switch.

I hear your stress. I hope this is helpful to you and not annoying. I have taken multiple children to PT and OT and had to switch providers. Typically, the new provider does not do a whole new intake. I have BCBS- plans vary a little so play a lot of attention to the brochure- I have not needed a referral for OT. The PT referral is just a prescription from a doctor. If your child already has a PT referral, just get a copy of it from Kaiser- BCBS isn't a closed system like Kaiser so they will take the Kaiser referral. At least among PT's I know, they view BCBS as the 'gold standard' for coverage- the easiest to work with. When we have switched, the new therapist picks up the plan and notes from the old therapist- they might do a 'mini-intake' but its not as involved as the first one and generally done at a regular appointment. For child OTs and PT's Good Beginnings in Falls Church is a solid practice with a lot of providers. I have made an 'advance' appointment with them when I was waiting for new insurance to kick in.
In terms of ABA therapy- I honestly don't know what BCBS covers- I would check the brochure really carefully. That being said- I thought Kaiser contracted with ABA therapists rather than having them in house- so you don't necessarily need to switch ABA therapists.

NP That’s helpful information. I think people who have been with Kaiser a long time don’t realize how restrictive it can be. Plus as you mentioned they contract out a lot of therapies including some mental health.

[Anonymous]

If you’re already complaining about long waits to see a provider, you do NOT want universal healthcare. Look at how the NHS has gone to sh!t in the UK.

[Anonymous]

Anonymous wrote:If you’re already complaining about long waits to see a provider, you do NOT want universal healthcare. Look at how the NHS has gone to sh!t in the UK.

Then do it like a country that manages it well.

Oh right . 'Merica

[Anonymous]

Anonymous wrote:

Anonymous wrote:Vote for legislators who advocate for universal healthcare

This. And also that if you rely upon your students' teachers to teach them basic life skills like understanding and navigating health insurance, stop doing that because they clearly have a very sadly narrow understanding of the healthcare system and very little ability to bend and adapt to stressful situations. Arlington teachers are very privileged and they truly are out of touch with a lot of their students and families and the reality of day to day life for many of us.

Sit down. You have nothing to add to this discussion.

[Anonymous]

Anonymous wrote:

Anonymous wrote:If you’re already complaining about long waits to see a provider, you do NOT want universal healthcare. Look at how the NHS has gone to sh!t in the UK.

Then do it like a country that manages it well.

Oh right . 'Merica

Anyway still need UHC when 67% of personal bankruptcies are discharging medical debt.

[Anonymous]

APS teachers - do you need help finding new providers? Happy to provide recs.

[Anonymous]

Anonymous wrote:APS teacher of 10 years here - and I am beyond embarrassed by how outraged my colleagues are acting. I am actually happy about the switch to Blue Cross Blue Shield. In previous jobs I've held, insurance carriers have switched, and it hasn't been a big deal. Everyone saying they need days and days off to search for new doctors is beyond ridiculous. I watched the school board comments and I cringed. A small group of APS teachers act so outraged over EVERYTHING and they give the rest of us a bad reputation. Just want people to know we aren't all this crazy. And the people who speak at school board meetings (including one very vocal teacher) - DO NOT represent the majority of teachers in APS.

+1, thank you. Between this and the FCPS phishing test debacle at the end of last year, it appears many of your colleagues are just completely out of touch with and tone deaf to things that have been a reality in the corporate and nonprofit worlds for some time.

I sympathize with the struggle and that things may seem overwhelming right now, but it is what it is. If people want to burn their PTO days on appointments, then they can do that. I realize we are in a sub shortage but people are entitled to their PTO. Everyone else that doesn’t want to burn PTO can schedule before or after hours, or on the multitude of days off APS has and that doctors all work. This includes just about every weekday that is not New Years Day, Thanksgiving, Christmas, Labor Day, or Memorial Day, and many practices offer Saturday hours now too.

[Anonymous]

I'm very supportive of teachers and have written emails to the school board in support of teachers on topics such as the calendar options, the bloated and inefficient bureaucracy of Syphax, giving the Syphax staff 3 weeks of extra vacation while ignoring the teachers, etc. But the teacher who posted on AEM Facebook page saying teachers should get an extra 2 days of sick leave to find new providers was way over the top. I get it's a pain to find new providers, but you don't need 2 additional sick leave days!

BCBS has the largest network in the area. Talk to friends and neighbors about who they see. As long as it's not a Kaiser provider, they will most likely take BCBS. Use the plan website and search. Other people deal with this all the time.

[Anonymous]

Anonymous wrote:I'm very supportive of teachers and have written emails to the school board in support of teachers on topics such as the calendar options, the bloated and inefficient bureaucracy of Syphax, giving the Syphax staff 3 weeks of extra vacation while ignoring the teachers, etc. But the teacher who posted on AEM Facebook page saying teachers should get an extra 2 days of sick leave to find new providers was way over the top. I get it's a pain to find new providers, but you don't need 2 additional sick leave days!

BCBS has the largest network in the area. Talk to friends and neighbors about who they see. As long as it's not a Kaiser provider, they will most likely take BCBS. Use the plan website and search. Other people deal with this all the time.

Many providers allow you to schedule an appointment with a new provider the exact same way Kaiser does, via online scheduler at any time of day

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm very supportive of teachers and have written emails to the school board in support of teachers on topics such as the calendar options, the bloated and inefficient bureaucracy of Syphax, giving the Syphax staff 3 weeks of extra vacation while ignoring the teachers, etc. But the teacher who posted on AEM Facebook page saying teachers should get an extra 2 days of sick leave to find new providers was way over the top. I get it's a pain to find new providers, but you don't need 2 additional sick leave days!

BCBS has the largest network in the area. Talk to friends and neighbors about who they see. As long as it's not a Kaiser provider, they will most likely take BCBS. Use the plan website and search. Other people deal with this all the time.

Many providers allow you to schedule an appointment with a new provider the exact same way Kaiser does, via online scheduler at any time of day

But anyone who had Kaiser will now need to schedule new patient appts for family members, losing sick days.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm very supportive of teachers and have written emails to the school board in support of teachers on topics such as the calendar options, the bloated and inefficient bureaucracy of Syphax, giving the Syphax staff 3 weeks of extra vacation while ignoring the teachers, etc. But the teacher who posted on AEM Facebook page saying teachers should get an extra 2 days of sick leave to find new providers was way over the top. I get it's a pain to find new providers, but you don't need 2 additional sick leave days!

BCBS has the largest network in the area. Talk to friends and neighbors about who they see. As long as it's not a Kaiser provider, they will most likely take BCBS. Use the plan website and search. Other people deal with this all the time.

Many providers allow you to schedule an appointment with a new provider the exact same way Kaiser does, via online scheduler at any time of day

But anyone who had Kaiser will now need to schedule new patient appts for family members, losing sick days.

But new patient appts aren't a thing outside of Kaiser. You don't have to see your primary care doctor in person to establish care. Yes you may want to interview a few therapists, but even those are usually very brief. I just switched Peds for my son and literally didn't take him in for months until he needed his physical. A lot of this sucks but it's also not moving a mountain. You can do it.