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Zephyrhills family fights for nursing care

6:14 PM, Aug 23, 2013   |    comments
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Selah Clanton nearly drowned in the Erie Canal last year and now her parents must battle their insurance company and the state.
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Zephyrhills, Florida -- The purple walls lined with stuffed animals make for a cheery atmosphere, but the medical equipment lets you know not all is right.

"This is the suction machine," says Jon Clanton, pointing to a bedside contraption.

Jon and Yvonne Clanton adopted their daughter Selah from the Ukraine. She had developmental problems, but now the situation is much more serious.

A year ago, Selah suffered severe brain damage after nearly drowning in the Erie Canal. It was a tragic accident when Dad lost control of a stroller. 

"There's times I think we rescued a girl from a mental institution only to lose her in the Erie Canal," says Jon, standing near Selah's hospital bed.

The 9-year-old girl now breathes with the help of a tracheostomy tube, another tube feeds her, and they're not sure if she can see. Selah is not the girl she used to be, but a parent's love doesn't change.

"What is love, do you just love people on sun shiny days? Care for your family when it's convenient?" questions Clanton, who works as a prison chaplain and who is also a pastor at Grace Church.

Since they brought her home from the hospital, nurses have helped care for Selah, like suctioning out the mucous from her airway. And sometimes that care can get complicated and urgent.

"She can go from completely normal to having to call the ambulance in just a few minutes," says Yvonne.

However, now the Clanton's insurance, Blue Cross Blue Shield or Florida Blue, doesn't want to pay for nurses, saying the family can handle those duties. Jon works for the state, so he appealed to the Florida Department of Management Services, which agreed with the insurance company.

Florida Blue had this statement for 10 News:

STATEMENT FROM FLORIDA BLUE:

While we cannot comment directly on this particular member's issue due to privacy laws, it is our understanding that applicable rules do allow for an appeal either to an administrative law judge or via an informal hearing.

To clarify, the relationship between the State of Florida and Florida Blue, the State of Florida is an Administrative Services Only (ASO) employer group with Florida Blue, which means Florida Blue administers their benefit plan, and handles other administrative tasks such as billing and claim processing.

Selah's doctors have written letters, saying that nursing care is necessary for her health and the Clanton's intend to continue with the appeals process.

The Clanton household includes three other disabled children, both adopted and biological. Shadrach, 9, is blind in one eye. Sam, 9, was born blind, but a corneal implant gives him some sight. Sarah, 6, is blind and developmentally delayed. And the Clanton's fear that without nursing help for Selah, everyone's care could suffer.

"I can't imagine being totally responsible for her nursing care, with my other ones," says Yvonne.

This is a unique family, with unique problems, but they stick together and a nursing home for Selah is not an option. 

Yvonne says, "She's better at home. She's content."

The Clanton's have also reached out to former state lawmaker and current Pasco Tax Collector Mike Fasano. On Friday, Fasano sent letters to the Pasco legislative delegation asking them to help with the family's cause before state officials.

"I strongly encourage you and the other members of the Pasco County Legislative Delegation to come to the support of Selah Clanton and ask the Division to reconsider its ruling and allow the in-home care to continue," writes Fasano. "I think we can agree that being home with a loving family is the ideal setting for anyone who is seriously ill, especially a child..."