Sunday, October 28, 2012

Down the MED Rabbit Hole We Go

I exaggerate only slightly when I say that no bureau instills fear in the heart of Foreign Service families quite like MED. I don't mean this as a reflection of the individuals who work in Washington and around the world; in fact I've had generally pleasant experiences with the doctors and nurse practitioners who have the sometimes daunting task of making sure we not only survive even our most exotic postings, but that we maintain a modicum of sanity while we do it.

For the past seven years, I've enjoyed the much-coveted Class 1 medical clearance. All of us must have one to be hired--all new hires must be worldwide available. I was hired as a single person, so it never occurred to me to worry about anybody else's clearance until a few year's later. Husband is similarly healthy and, for our first tour, Boy secured a Class 1 without any problem. Girl followed suit.

Why does your clearance matter after being hired? Simple: it determines where you can serve (or, in the case of dependents, where your family can join you). Not all Class 2 clearances are created equal, so those depend mostly on what services are available at each post for your specific medical or educational needs. A class 2 is scary because it makes what is normally a high stress bidding process go off the charts with hand-wringing. You do your normal lobbying, but then you have to submit a list of bids to MED so they can yay or nay each post for the health concerns of the family member(s) or employee in question. You may have your hearts set on Nowhereistan, but unless Nowhereistan has epi-pens widely available at hospitals, your child with a deathly peanut allergy just can't go, and so on. A class 2 is scary because it happens as soon as it's warranted, whether it's in the middle of your tour or when your on R&R in the States or...


So, like most FS families would do, when Boy received OT and other services through Fairfax County while we were in language training, we didn't make a big deal out of it with MED. We mentioned it briefly on his clearance update paperwork, and hoped they won't take notice. At the time, it seemed like losing our assignment after language training, etc., would be the worst thing that could ever happen. We were confident he would continue to improve.

Here we are, almost 2 years after his initial IFSP through the county, starting the process all over again.

After our meeting at his school, we had a talk about his needs, our priorities, and what we need to do as parents. Sorry, Taxpayer, though it feels the opposite on some days, I have to remain a parent first, a public servant second. We took a gulp and reached out to the regional psychiatrist, who referred us to the doctor and social worker in charge of the developmental assessments. We have a referral from Boy's school in hand, and I need to submit that together with his initial IFSP from Fairfax County to start the process to evaluate him all over again. And of course I have that IFSP, because what type of parent wouldn't have such an important document? Who wouldn't keep the assessment and services plan for your small child?

Um. Erf. Um.

SO. I have the binder with the county's services. I have the assessment from the counselor. I do not, for the life of me, have a copy of his IFSP, or at least not that I've found. I know we had it. It discussed where he scored on his speech, PT, OT, and social/emotional assessments. It's important.

I'm going to spend the rest of today digging through absolutely everything and, if that is to no avail, I'll email Infant-Toddler Connection and request a copy. No guarantees I won't tell them the dog ate the first one. I fear judgment.

(BTW, if you FS families out there in Fairfax are wondering about their services--they're great! They respond right away once your pediatrician refers you, and I loved our occupational therapist.)

I don't know what this will mean. We've advertised for a new full-time nanny, thinking that worst case scenario he can be taught at home while he matures and those impulse control synapses start firing. Perhaps we'll keep him in preschool part time with a nanny on the other days and some more OT or other services. Perhaps they won't let him come back. I don't know. We'll jump of that bridge once we get there, I suppose.

Until then, here we go...

No comments: