445AM JRC called me to inform me that when they were preparing Talia to come to NY for her dental work, at 352 AM she had a seizure. Sleep deprivation and stress can precipitate seizures, and Talia had to get up early for her 9am dental work in NY, I am sure anxious as her routine was suddenly disrupted. Instead she ended up in the local ER. My older daughter literally spent 90 minutes on the phone with Massachusetts General trying to schedule a follow up appointment for her. Any individual private doctor’s office that did that would be out of business immediately. I lied in bed awake wondering how Talia is ever going to get her dental work done. I wondered if I have to keep her at my house the night before despite her dangerous behaviors with my husband’s heart condition who was hospitalized last week. Would she have to quarantine after that? I didn’t have the dental work done in Massachusetts because at Boston Children’s Hospital, there were two options. Either they would use restraints to take XRAYs which could traumatize her or she could be put under general anesthesia twice, once for XRAYS and once to have any cavities or other issues resolved. They will not do both at once because they will not lose money keeping an operating room open any more time than necessary to make as much money as possible. I have a private dental office in NY, which I pay for, that will do it all at once. The office in NY agreed to do a 1pm procedure next time although Talia will have to fast all morning. Furthermore, when NY students are placed out of state because there are no appropriate placements in NY to care for them, their Medicaid will only cover emergencies outside of NY. Talia fortunately has private health insurance but many students are on Medicaid having to return to NY for all non-emergency appointments, a waste of resources, and even polluting the environment. Worse, it is bad for continuity of care, but unfortunately, in our society individuals with disabilities come last.