CHESAPEAKE, Va. (WAVY) — Fighting for his son’s healthcare is an obstacle Ty Swartz never imagined he would have to face. 18-year-old Tristian Swartz was shot in the head in Camden County back on September 20.
“They sat us down and said it was very grim,” said Ty Swartz. “When we got to see him, he’s in the ICU, everything’s connected so that was really hard.”
Tristian was in a coma for almost a week before they saw signs that he was improving.
“They said this type of injury less than 5% make it, and for him to move as quickly as he did, to where he is at now, is nothing short of a miracle,” said Ty.
He began to slowly speak and move and was eventually transferred to a traumatic brain injury rehabilitation center, the Shepherd Center in Atlanta.
“It’s focused just on his age group and they have set criteria and goals for him,” he said.
The battle to get Tristian into the center is what led Ty to reach out to 10 On Your Side.
Ty is a U.S. Navy veteran and his family has TRICARE insurance. The Shepherd Center is in-network, but TRICARE initially denied sending Tristian there for treatment. Instead, TRICARE wanted to send him to another rehabilitation center in Richmond.
“So there’s a child who is a victim of a violent crime, now being a victim of health care insurance, because they want to save money,” said Ty.
WAVY TV 10’s investigators helped Ty reach out to local and state leaders for help. Ty also wrote a letter to Senator Warner’s office asking him to get involved. He received this reply:
“When I heard from Ty, and he told me the story about his son Tristian being shot and then getting turned down from TRICARE it kind of made me crazy. I said this is not right, this young man deserves the best healthcare possible.”
Sen. Mark Warner
Sen. Warner opened a Congressional inquiry and then TRICARE approved the appeal for Tristian to go to the Shepherd Center. Tristian is getting treatment there now with his family . His dad says he’s doing well. But his father’s fight raised another question.
“Could we not improve some of the care? If we had a traumatic care place in Hampton Roads, even people who aren’t military would benefit,” said Ty.
Anne McDonnell is the executive director of the Brain Injury Association of Virginia. She called Virginia’s brain injury care system “fragmented.”
“We have roughly 285,000 Virginians who are disabled as a result of brain injury, and we have eight programs across the state,” said McDonnell. “Right now, those eight funded programs are serving about 3,000 people.”
Sen. Warner says he’s going to use Tristian’s case as an opportunity to see if there is a need for a traumatic brain injury rehabilitation center in Hampton Roads, and he may include that in a future authorization request.
“Out of each of these cases you can see this isn’t just a one-off problem. This is a systemic problem that needs to be solved,” said Sen. Warner.
As Tristian heals, Ty is hoping for change, a change that will protect other families who find themselves in the same spot his family was in just weeks ago.
“How many other people have had this same exact fight, same exact problem, and nobody’s done anything?” asked Ty.
Ty says that Tristian should be getting medically cleared in a few days and from there he’ll go to four weeks of outpatient therapy treatments.
10 On Your Side reached out to TRICARE about the reasons why a family would be denied a move to a specific center. TRICARE replied with general information about what TRICARE would look for in the case of a beneficiary that requested a move to a specialty facility.
TRICARE would assess:
- Services proposed to be provided, and if they are a covered benefit.
- If there is a military treatment facility that can provide the service (assuming the family is in TRICARE Prime).
- If the facility is in-network or a TRICARE authorized provider.
- If there are other facilities that can provide the same service that are closer to the patient’s home.
