03/08/2010 18:01 FAX 14142594011 Boo2/003 Julie A. Griffith, M.D. Northem California Center for Leaming & Behavioral Disorders Pediatric & Adult Neurology 120 Ross Valley Drive San Rafael, Ca 94901 Phono (415) 925-1616 Facsimile (415) 259-4011 Neurology PATIENT: — Hannah Harrison Date: 3 610 This lefter is written on behalf of Hannah Harrison, # 10 year old girl who has life-threatening epilepsy. Please have Hawaii Medicaid authorize payment ‘for nonstop fights, round trip, from Kauai, Hawaii to Denver, Colorado for Hannah (the patient), her mother Summer Harrison, and her nurse, Erlinda Simpliciano, It is necessary for Hannah to have a nurse in fight and during the whole of the Denver trip, since Hannah will need a nurse for both flights and for the days in which Hannah wil be receiving outpatient care (attending specialist appointments). Hannah needs a nurse for observation for, and medication intervention of, seizures. Hannah's nurse also will be rasponsible for providing the ketogenic diet, administering G tube feeds, and administer her complicated medication and supplement regimen. ‘She is scheduled to havo a comprehensive epilepsy consultation along with the ketogenic diet follow up appointment, consultation with the dietician, admission to the hospital for video telemetry, and consultation for muttiple medical specialists, including dermatology, dental, audiology, neurology, ‘ophthalmology, occupational therapy and physical therapy consultations. ‘The nonstop flight from Kauai to Denver is necessary to have the shortest flying time possible, in case Hannah develops status @pileticus, and to limit her ‘exposure to infections. Should Hannah develop an infection, she may develop a fever, which could lower her seizure threshold, There is already a risk of lowering her seizure threshold when flying, since there is a change in time zones, there may be sleep deprivation, there may be sensory overload, and there is an increased risk of infection. Certainly Hannah should not have the Increased risk associated with the extra time and extra exposures by transferring planes. ‘Again, please have Hawaii Medicaid authorize round trip tickets from Kauai to Denver for Hannah, her nurse Erlinda Simpliciano, and her mother, Summer Harrison. Summer Harrison must attend the appointments to make medical decisions for her daughter and is legal guardian of her daughter.03/08/2010 18:01 FAK 14182594011 Boosyo0s CC: Summer Harrison Dr. Terry Carolan MasterGare Hawaii Medicaid