City of Portland / ODS - Lap Band surgery coverage

After going thru the appeals process with the assistance of ObesityLaw, appealing the denial from ODS for my Lap Band surgery and then to the City of Portland to override their denial I finally received their decision.

DENIED. OL (Obesity Law) had a teleconference with the City Attorney who was handling my case and basically OL said that it was his job on making the recommendation to the City on whether to approve/deny my surgery. OL told me that they were still quite surprised when talking with the City Attorney as although it was ultimately denied, he totally "got it" (the reasons why i needed the surgery, the fact that the surgery cures something like 80% of type 2 diabetes, also GERD, Sleep Apnea) and that it would be more cost effective for the City of Portland to pay for the surgery than all these co-morbidities that obese folk like myself ( :o( - hate that word) which only get worse and more expensive over time. Fyi - I have joint issues, had major hip surgery, have Apnea, pre-diabetes, Acid Reflux, hital hernia.

The City Attorney apparently said where he was stuck was that the language regarding exclusions in our contract was black and white: No bariatric surgery and regardless of the reasons for having it, ultimately it was still bariatric surgery and he didn't feel they could get around it.

HOWEVER, the contract is up for revision in June and he is going to be making a recommendation that they consider including covering the surgery in the new contract. So I will be hounding my Chapter Chair (who also fortunately happens to sit next to me at work) into going after this in the next labor agreement negotiations.

I know several people who are interested in this procedure who work in the City (in my bureau and outside of it) and who may not have the ability (or family member who can do it) to pay for it. I recognize how incredibly lucky and blessed I am that my father is doing this for me. I will never ever forget his kindness and generosity for doing this for me. He's basically saving my life. It's coming from his retirement but he doesn't care. He said he couldn't live with himself if something happened to me and the money was just sitting there. I plan to pay every cent back, although he told me he doesn't care if I do. But I will. And be so glad and proud to. :o)

I feel it's imperative that this surgery be available to others and will really hound the union to push for this to be put back into our contract as many members will benefit from the coverage. I won't be able to recoup my surgery expense but it will mean that if I need to have adjustments (fills in my band which are very basic, quick clinic appointments every few months for the first year or so at most usually) I won't have to drive all the way to Coos Bay (they are included for the first year in my surgery price if I go to my Dr. in Coos Bay so I'd rather do them there than pay the local Dr. $ to do it), plus - Heaven forbid I have any complications but if that were to happen at least I could have it done in Portland (at OHSU hopefully - my preferred hospital always) and it would be covered by insurance. I also am fortunate to have double coverage so I wouldn't have to pay a cent out of pocket which would be SWEET. So yes, I'm going to petition my big fat bootie off to get this approved.

But I urge any folks out there who also work for the CoP to talk to your union folks and let them know you want this surgery COVERED and put back in our agreement (they covered gastric bypass several years ago and some AFSCME officials weren't even aware this coverage was removed!)

Anyway, I hope, hope, hope that this surgery ends up being covered.