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Brain Injury Bill

SATURDAY - APRIL 27, 2013 - NAPA, CA -Suzanne and Eric Sandberg and their son, Leif, of Napa, will be in Sacramento Wednesday to support S.B. 320. If approved, the bill would prohibit insurance companies from denying long-term rehabilitation care to patients with brain injuries. Leif Sandberg, 19, suffered a traumatic brain injury in June 2011 in a crash in June 2011. Kerana Todorov/Register

Almost two years ago, Garrison “Leif” Sandberg, a junior at Napa High, was near death from injuries he sustained as a passenger in a DUI-related crash near Napa. Today, at 19, Sandberg walks without a cane. His shaking has subsided and he can speak.

Key to his ongoing recovery, his parents, Eric and Suzanne Sandberg said, was the medical and rehabilitation therapy Leif Sandberg received for nine months at Centre for Neuro Skills in Bakersfield.

However, that long-term inpatient therapy, which ended in April 2012 and cost about $300,000, was not covered under the family’s Blue Shield health policy plan, the Sandbergs said.

The Sandbergs will travel to Sacramento Wednesday to show support for Senate Bill 320 that would prohibit insurance companies from denying long-term therapy for brain injury patients. The Sandbergs will take a stack of signatures in support of the bill, which the California Senate Health Committee is scheduled to discuss.

State Sen. Jim Beall, D-San Jose, introduced the bill in February with the backing of the Brain Injury Association of California, which estimates about 350,000 Californians live with a traumatic brain injury. If approved, S.B. 320 would take effect Jan. 1, 2014.

“The goal is to come home as a whole person so you don’t become a burden to our society,” Suzanne Sandberg said Friday. “Leif is an example of somebody who will be productive in his lifetime.”

Eric Sandberg, whose insurance changed in February, said his son’s in-patient therapy would have been reduced to 20 visits a year after September 2011 once he became able to go from his bed to his wheelchair and the bathroom. Instead, he and his wife took their youngest child to Bakersfield, where Leif continued in-patient therapy for another nine months until he was considered well enough to come home in Napa last April.

A year later, Leif Sandberg continues to improve as he undergoes a full day of counseling along with physical, occupational and speech therapy once every other week at the Centre for Neuro Skills’ campus in Emeryville.

Leif Sandberg, who was 17 at the time of the June 10, 2011 crash on Dry Creek Road north of Orchard Avenue, also receives speech and physical therapy once a week at Queen of the Valley Medical Center, care that’s covered by California Children’s Services, a state program.

Eric Sandberg, who works for an environmental drilling company, estimates his son’s medical bills, including the emergency care he received for about a month at San Francisco General Hospital, has cost more than $2 million.

Because his father’s company changed ownership, Leif Sandberg is now insured under his father’s United Health Care policy. So far, the insurance policies have reimbursed about $75,000 of Leif’s outpatient care in Emeryville — about half of the total bill. The bills continue to arrive. “It’s an ongoing thing,” Suzanne Sandberg said.

“We see the effects of the current laws,” said Eric Sandberg. “It really won’t help us much but it will help others that are in the same position,” he said. “Having been through what we’ve been through, it’s just really important that what’s right is right.”

“And as a parent, with a child whose life is ahead of him, to have somebody arbitrarily cut that future is ... sickening.”

The Sandbergs have collected about 500 signatures in support of the bill at various forums and at community and industry events.

Leif Sandberg, a skateboarder before the crash, gathered signatures from his friends at Napa’s skatepark.

On Saturday, the family was also editing a video for the senators in Sacramento, showing Leif’s progress as he underwent extensive rehabilitation therapy.

The Brain Injury Association of California estimates SB 320 will save California more than $74 billion annually in lifetime savings by reducing disability claims. The bill, if approved, would affect the health insurance policies of an estimated 25.9 million Californians, according to an analysis of the bill by the California Health Benefits Review Program.

In a statement, Sen. Beall said “SB 320 will enable access to treatment of acquired brain injury across a spectrum of specialized licensed facilities that offer appropriate and cost-effective care in California. Enactment of this legislation would ensure coverage on par with other major medical conditions, which have no time limitations on treatment.”

The bill would prohibit insurance companies from denying coverage at specified facilities, including hospitals, acute rehabilitation hospitals, long-term acute care hospitals and medical offices.

A Blue Shield of California spokesman said Friday his company has not taken a position on the bill. However, the California Association of Health Plans, which represents 39 public and private organizations that provide healthcare coverage to more than 21 million Californians, issued a statement Friday in opposition of the bill.

The association voiced concerns over the treatments covered and the facilities affected under SB 320, saying the bill should be amended so that healthcare plans retain the right to exclude “certain types” of facilities, or “certain service categories.”

In the meantime, the Sandbergs continue to speak at forums that raise the awareness of the dangers of drinking and driving. Eric Sandberg also recently appeared at a DUI forum at Vintage High School with Joseph Mackey, who was at the wheel of the pickup that crashed on that fateful night in June 2011.

Mackey, who was celebrating his high school graduation, was inebriated, authorities said. He spent 19 months behind bars in connection with the crash before he was released from the Napa County jail. He is now on probation.

Leif Sandberg, who once was told he would not walk again, has been able to attend classes at Napa Valley College. He wants to attend the University of Hawaii at Manoa.

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