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While taxpayers have plenty of reasons to be outraged, Legal Aid is focused on patients who suffer. Bourassa says that the majority of indigents get sufficient care from NBHD but that too many slip through the net; one of these is Joan Cuomo, a 46-year-old divorcée suffering from a host of physical and psychological ailments.
Cuomo, who lives with a charitable friend in a little rented Tamarac villa, has no credit, no bank accounts, no money (she had $1.06 to her name last week) and can't work. At just five-foot-one, she weighs more than 300 pounds and suffers from spinal degeneration. She says the pain is so great that she can barely get out of bed. A victim of sexual abuse as a child, she also has severe depression, anxiety attacks, and asthma.
Until she was divorced in 1998, she had health insurance through her husband. After three years working as a cashier at Publix and Walgreens, her health deteriorated. When she applied for disability benefits, physicians backed up her claim that she couldn't work, but the State of Florida denied her. Other than $141 a month in food stamps, Cuomo is on her own.
She did qualify for free medical care from NBHD. For the past three years, she says, she's been treated almost exclusively by a clinical nurse rather than a doctor, despite the alleged $44 million in doctors' contracts. And district officials have never let her see an orthopedist for her back, though the district contracts with an orthopedic group.
Basically, the district has done little more than treat her back pain with a prescription for a weak narcotic called Darvocet that gives her little relief. "If I had something better, I could dress myself and leave the house," she says, tears streaming down her face.
She pleads for psychological help, but the district won't provide her a psychiatrist or a counselor. "I had a terrible childhood, and now my adulthood is terrible and there is nobody to talk to," she says, sobbing. "I can't believe this is happening to me. I can't believe I can't get help."
And then there's the bureaucratic nightmare -- and not just the inevitable hours-long wait for care. In May, NBHD mistakenly failed to recertify Cuomo as an indigent -- and refused to give her care. So she went to Legal Aid attorney Louise Caro, who set out to prove to the district that Cuomo had no money.
Proving a negative is never easy, and in the middle of that process, Cuomo came down with an abscessed tooth and a raging infection. When she tried to get care at NBHD's Pompano Adult Primary Care Clinic, she was turned away. Caro then drove Cuomo to the district's Seventh Avenue Family Health Center in downtown Fort Lauderdale. "They said not only do they not take walk-ins but we're booked for three months and there was only one dentist for the whole district," Caro recalls.
So they had hit a brick wall. Finally, Bourassa's private dentist, Howard Ackerman, offered to pull the tooth free of charge. "I'm not alone -- there are lots of stories like mine," Cuomo says. "If you sit down in a clinic for nine hours waiting to be treated, you hear terrible stories. But the people are afraid to talk because they think they'll lose the care they do get."