Archives

Written by Jennifer Mezey

Oct 12

2012

Legal Aid and Whitman-Walker Health Train About 70 Volunteer Attorneys to Help Low-Income Medicare Beneficiaries During the 2012 Medicare Part D Open Season

Jennifer Mezey, Supervising AttorneyFor the past six years, the Legal Aid Society of the District of Columbia and Whitman-Walker Health have collaborated to work with pro bono attorneys to counsel hundreds of Medicare beneficiaries about their options during the Medicare Part D (Prescription Drug Plan) Open Season which runs from October 15 through December 7.  Last year the two organizations helped over 500 Medicare beneficiaries navigate both the Medicare drug program and the associated benefits that help low-income beneficiaries afford to participate in Part D.  These beneficiaries are elderly and/or struggle with physical and mental disabilities, which makes it challenging for them to choose a drug plan and enroll in low-income benefits without assistance. 

We are facing several challenges this year that make our work even more important. 

  1. During this period, most Part D plans change their coverage for the upcoming year so even if clients’ plans are currently working for them; that could change next year. 
     
  2. Several plans that many low-income Medicare beneficiaries are enrolling in are changing their names (Medco to Express Scripts) or combining into another plan (Health Net Orange Option 1, CVS Caremark and Community CCRx Basic are combining into Silver Script Basic). 
     
  3. We know that many low-income Medicare beneficiaries are having problems with their associated benefits of Medicaid, Qualified Medicare Beneficiary (QMB) (which helps with drug costs and Part B premiums) and the Low-Income Subsidy (LIS) (which helps with drug costs). 

Without the work that we do, many beneficiaries would, at best, be confused by all of the above, and, at worst, face major health and economic crises because of unaffordable drug costs.  Over the past six years, Legal Aid and Whitman-Walker, along with our pro bono volunteers, have saved countless clients from ending up in these crises. 

This year has gotten off to a great start with two trainings hosted by Hogan Lovells and Arnold & Porter.  In these two trainings, Legal Aid supervising attorney Jennifer Mezey and Whitman-Walker Health Senior Managing Attorney Erin Loubier trained about 70 volunteers from Arnold & Porter; Hogan Lovells; Steptoe & Johnson; Morgan, Lewis & Bockius; Wilmer Hale; Covington & Burling; Alston & Bird; Crowell & Moring; Ropes & Gray; Akin Gump; Foley & Lardner; Patton Boggs; and Davis Wright Tremaine.  These attorneys will work with Legal Aid and Whitman-Walker staff at 12 walk-in clinics held in their NW and SE offices as well as the NW and SE offices of Bread for the City.  (See flyers posted below for clinic dates and times).

Please feel free to distribute these flyers among your clients and any other organizations you work with that serve low-income Medicare beneficiaries.  Hopefully, we can help even more beneficiaries this year ensure that they will be able to fill all their prescriptions at affordable prices, thus leading to better health outcomes. 

Legal Aid-led Part D Clinics (English/Spanish)
English Flyer for Open Enrollment Clinics Legal Aid 2012
Spanish Flyer for Open Enrollment Clinics Legal Aid 2012

Whitman-Walker-led Part D Clinics (English)
English Flyer for Open Enrollment Clinics WWH 2012

Jun 28

2012

Affordable Care Act Decision Good News for Legal Aid’s Client Community

Jennifer Mezey, Supervising Attorney

All across the country, experts are going to be analyzing and commenting on today’s Supreme Court decision on the Affordable Care Act (ACA).  For now, though, it seems clear that the vast majority of the law remains in place which is certainly something to celebrate for persons living in poverty in the District of Columbia.  We are concerned about the Court’s limitation on the ACA’s Medicaid expansion and the implications of that part of the decision for many vulnerable families and individuals.  However, we are pleased that coverage for Medicaid beneficiaries in the District does not appear to be jeopardized by today’s decision.

Let’s start with the good news.  Lost in the discussion of mandates, taxes, and federal expenditures are the many great things contained in this law for our client community and all District residents, including:

  • Protections against discrimination on the basis of pre-existing conditions for adults and children (which, in some states, could include being a survivor of domestic violence);
  • Requirements that new insurance plans cover preventive health care services (including mammograms, HIV testing and contraceptive methods and counseling) at no cost to the consumer;
  • Requirement that maternity care be covered under new individual, small business and Health Insurance Exchange plans;
  • Closing of the Medicare Part D “doughnut hole;” and
  • Requirement that insurance companies allow people under the age of 26 to stay on their parents’ insurance policies.

These are only a few of the improvements in the insurance market which will improve access to health insurance and health care for millions of families and individuals.

Now for the less than great news.  Although we are awaiting the complete analysis by Medicaid experts, it appears that states may not have to expand their Medicaid programs (as required by the ACA) if they choose not to do so.  There are, however, strong financial incentives for these states to provide coverage to these vulnerable populations, and we hope these incentives will be sufficient to ensure that these individuals are not left behind.

That said, our concerns about Medicaid should not extend to the District, which was one of the few jurisdictions who expanded its Medicaid program even before the requirement to do so kicked in.  Again, much will be written on this in the upcoming days and weeks, but it would appear that the District can continue its expanded Medicaid program, which has contributed to the District having one of the lowest rates of uninsured individuals (6 percent) in the country.  (The percentage of uninsured children is even lower at about 3.5 percent).

We applaud the District’s long term, sustained commitment to providing access to health insurance for so many low and moderate income families and individuals.  Legal Aid and many other organizations have long worked with the District government to ensure that our Medicaid program delivers promised benefits to our client community.  These efforts have continued through our collaboration with the many District agencies’ implementing the ACA.  We look forward to continuing to work with the District government and our coalition partners to improve access to health insurance and quality health care services as we move towards full implementation of the ACA in Fiscal Year 2014.

Mar 22

2011

New Video on the Importance of the District’s Interim Disability Assistance Program

Jennifer Mezey, Supervising Attorney

Interim Disability Assistance (“IDA”) provides essential temporary cash assistance to the City’s most vulnerable disabled residents while they wait – often months or even years – to be approved for Supplemental Security Income (SSI).  $270 per month from IDA (less than 30% of the federal poverty level) is often the only income individuals with disabilities can rely on to scrape by while waiting for the federal government to rule on their disability claim.

Over the last four years, the District’s budget for IDA has been slashed to the bone. The program has been cut by over 70% from FY 2008 to FY 2011. As a result of these cuts, there are currently over 600 people on a four-month waiting list for the program who are struggling to get by on virtually no income whatsoever.

So Others Might Eat (SOME) and the DC Fiscal Policy Institute (DCFPI) have released a two-minute video featuring three District residents who have benefited from the IDA program.  With the help of IDA, two of the featured former IDA recipients are now receiving SSI, and another was able to receive treatment that helped him overcome his disability.  Their stories put a human face on IDA and demonstrate the necessity of maintaining the program.  As Mayor Gray prepares to present his budget on April 1, it is critically important that the voices of those who stand to lose the most from an unbalanced approach to the budget be heard and heeded.

Watch the SOME/DCFPI video here, and make sure to share it with others.

Learn more about – and get involved with – the efforts of Legal Aid and other members of the “Invest in DC” Coalition, which advocates a balanced approach to the FY 2012 budget.

Mar 08

2011

TANF benefits to be cut for some families as of April 1, 2011.

Jennifer Mezey, Supervising Attorney

As of April 1, 2011, thousands of TANF recipients who have received benefits for 60 months or more will experience a 20 percent cut in their benefits as a result of DC Council actions taken earlier this year.  If you work with this client community, we are writing to ask you to spread the word to TANF recipients that if their benefits are cut or they think their benefits have been cut, legal advice and assistance is available.

TANF recipients can contact any of the organizations listed on the attached flyer or call the Legal Aid TANF hotline at (202) 887-4170.  They can speak to a lawyer who can determine if (and why) their benefits have been cut and whether they might qualify for an exemption.  Service providers can also call to learn more about the benefit cuts and how they will affect their clients.

The attached flyer provides more details about how to get help.  We would really appreciate it if you could circulate to your networks and post in your offices.  (Spanish translation to be available soon.)

Background on the cuts

In December, the DC Council adopted a $4.5 million cut to the District’s TANF program.  On April 1, 2011, the District will implement this reduction through a 20 percent benefit cut for TANF households who have received benefits for 60 months or more counting from March 1997.

Any month in which the TANF household met any one of the following criteria will NOT count towards the 60 month limit;

  1. A TANF household was headed by a grandparent or other relative whose needs were not included in the grant – a “child only” household;
  2. A TANF household that was headed by a parent(s) receiving SSI while the children received TANF;
  3. A TANF household that was receiving benefit through the POWER program (for individuals whose physical or mental disabilities make them unable to work or participate in work activities).

The impact of these cuts

TANF advocates are very concerned about the impact that these cuts will have on these vulnerable families.  Even a full TANF grant puts a family at less than 30 percent of the federal poverty level.  As we all know, TANF families have difficulty meeting their most basic needs even with Food Stamps and Medicaid as well.

Unfortunately, this benefit cut will have the largest impact on the District’s most vulnerable TANF recipients.  Studies of states that have implemented these kinds of cuts show that families who have been on TANF for five years or more likely face multiple work barriers including disability and domestic violence.  Losing a portion of their grant will only make these families more vulnerable.

Help spread the word

Please help us reach as many TANF recipients as possible to let them know that help is available.

  • We want to make sure that families whose benefits are cut really received TANF for 60 months or more.
  • We want to make sure that all TANF recipients who qualify (or should qualify) for exemptions receive them.  This is particularly important for individuals with disabilities.  We know that there are significant numbers of TANF recipients who struggle with mental and physical disabilities.  However, there are only a few hundred families enrolled in the POWER program, due, in large part, to the District’s failure to adequately assess and refer individuals with disabilities to services.   We want to make sure that individuals with disabilities that qualify them for POWER get the services they need and are protected from any future benefit cuts.

If you have any questions, please feel free to contact:

Jennifer Mezey or Andrew Patterson at Legal Aid (jmezey@legalaiddc.<orgmailto:jmezey@legalaiddc.org> or apatterson@legalaiddc.<orgmailto:apatterson@legalaiddc.org>)

Marta Beresin or Becky O’Brien at the Washington Legal Clinic for the Homeless (marta@legalclinic.<orgmailto:marta@legalclinic.org> or becky@legalclinic.<orgmailto:becky@legalclinic.org>) or

Stacy Braverman or Allison Miles-Lee at Bread for the City (sbraverman@BreadFortheCity.<orgmailto:sbraverman@BreadFortheCity.org> or amiles-lee@BreadFortheCity.org )

__________________

TANF Hotline Flyer Final

Nov 23

2010

Legal Aid’s Thanksgiving Message

Jennifer Mezey, Supervising Attorney

Legal Aid is one of more than a dozen blogs participating in this year’s Thanksgiving Blog Blitz. Since we often criticize the way the government serves our client community, it is imperative to remember the things we are thankful for about the way the DC government has systems in place to help the most vulnerable among us.

I, for one, am thankful that the District has a TANF program so that there is a safety net for the District’s most vulnerable families with children. When parents lose their jobs and can’t qualify for unemployment insurance, when a woman is fleeing her abuser and when a father is waiting for his SSI application to be approved, there is a program that will make sure that their family is not utterly destitute. The program should be improved so that it can better help parents who can work become employable and provide better linkages to supports for parents who cannot work. We have clients at Legal Aid who are pursuing education and training opportunities and need the TANF program to better support them as they work to improve their skills. And we have clients who are struggling with disabilities that have not been acknowledged and accommodated by the TANF program. But the District is working to improve these aspects of the program, and we will hopefully see better outcomes for children and families as these changes are implemented. The bottom line is that TANF is an important part of the safety net for the District’s families and it must remain intact for the families who need it.

The DC Council will decide in the coming weeks how to fix a $175 million budget shortfall. Rather than relying solely on more cuts, it is time for a balanced approach that includes progressive revenue streams. Right now DC’s top tax rate (8.5%) starts at $40,000 a year. City leaders should create a new top tax bracket (of 1% more than the current rate) for income over $200,000. The revenue raised can help preserve the programs we are thankful for.

Please look at the Save our Safety Net website for more information . 

Other Blog Blitz Participants:
Beyond Bread

Sep 03

2010

ANNOUNCEMENT OF PUBLIC BENEFITS TRAINING SERIES

Jennifer Mezey, Supervising Attorney

In partnership, Legal Aid Society of DC, Washington Legal Clinic for the Homeless, and Whitman-Walker Clinic are pleased to announce our Public Benefits Trainings series again this Fall.  We encourage case managers, legal services lawyers, pro bono lawyers, or anyone who works with low-income clients to attend these sessions.  The trainings are free and an opportunity to learn about eligibility, benefits, application procedures, and practical tips on how to help your clients navigate the system. 

We are requesting that anyone interested in attending RSVP to Jeremy Strauss at jstrauss@legalaiddc.org   since we have some space limitations and need counts on materials.  We greatly appreciate the DC Bar Pro Bono Program for partnering with us and hosting this training series.

 1st Training:  Disability Benefits:  SSI/SSDI/IDA on Tuesday, September 14 from noon – 2 pm.

Please help us get the word out.  Please distribute this e-mail (and attached flyer) widely.  We look forward to a strong turnout! 

Thank you in advance for your help.

Erin Loubier, Whitman-Walker Clinic
Scott McNeilly, Washington Legal Clinic for the Homeless
Jennifer Mezey, Legal Aid Society of DC

Jul 30

2010

Proposal to Sanction TANF Parents Will Harm Children and Families and Is Unlikely to Improve Children’s School Attendance or Get Unmet Mental Health Needs Addressed

Supervising Attorney

Councilmember David Catania and his staff are developing proposals that would address several important issues, including unmet children’s mental health needs, truancy and disconnection from supportive services.  One of many proposals that Councilmember Catania will consider, as reported in The Washington Post, is sanctioning (or reducing) benefits for District Temporary Assistance for Needy Families (TANF) recipients if their children have repeated unexcused absences from school.

Although we share the Councilmember’s underlying concerns and strongly support his efforts to improve the delivery of mental health services to children through schools and other public and private entities, we believe that the TANF sanction proposal will not improve school attendance and will harm some of the very families he is trying to help:

*   Sanctioning TANF families with truant kids does not lead to increased school attendance among TANF recipients’ kids.

*   Sanctioning TANF families with truant kids will merely punish families who are already struggling with significant challenges.

*   The proposed policies will increase the material hardship for sanctioned families which could make it harder for them to support their children’s education.

*   Children suffer when their parents are sanctioned.

*   The District could better engage families and improve school attendance outcomes by improving services for vulnerable families.

Please see the  fact sheet prepared by the DC Fiscal Policy Institute, Legal Aid and the Washington Legal Clinic for the Homeless describing in more detail why we urge Councilmember Catania not to include this proposal in any package of legislative and other proposals to address the important issues of truancy and children’s mental health.

Jun 23

2010

Health Care Reform: Making Sure DC Makes the Right Choices.

In March 2010, President Obama signed into law federal health care legislation that will change dramatically the way health care services are delivered in this country.  The Patient Protection and Affordable Care Act (PPACA) will provide the District of Columbia and all states with the opportunity to make health care accessible and affordable for all of their residents.

On Monday, the Legal Aid Society of DC, a member of the District of Columbia Coalition on Health Care Reform, a coalition of organizations who represent consumers and providers participating in public and private health insurance programs in the District of Columbia, sent the attached letter to the Mayor, City Council and executive officials.  The letter presented our combined views regarding the opportunities presented with health care reform and the implementation of the new federal health care reform law. 

The District should be commended for making access to health care a major priority long before federal health care reform was enacted.  Instead of cutting back on Medicaid, as other states are doing, the District is expanding Medicaid income eligibility four years before it is required to do so, proposing higher income eligibility limits than are required under the PPACA and providing full Medicaid benefits to those who are newly eligible.  These efforts are laudable and have positioned the District as a national leader in ensuring that District residents have access to affordable health care.  This leadership is even more commendable given the tough budget pressures the District is facing. 

As the Mayor and Council have acknowledged, in implementing the PPACA, coordination, collaboration, and partnership across government agencies, and between agencies and the provider and consumer communities will be critical.  Health care reform need not increase the complexity of the health care system – though it could without careful planning.  Rather, it provides an unprecedented opportunity for development of a unified system encompassing all of the public payor options, i.e. Medicaid, safety net programs, expansions, and the soon to be created Health Exchange. 

The undersigned organizations urge the District to create a health care system that ensures that: (1) consumers can easily access benefits through a single point of entry system, and (2) providers can deliver high quality care assured of prompt and reasonable payments. 

To that end, we propose that the following principles guide the District as it moves forward in its implementation of the PPACA:

  •  Principle 1:The District should have a coordinated policy development and implementation plan allowing for all affected District agencies and critical stakeholders to provide input.
     
  •  Principle 2:The District should ensure that no one loses coverage as a result of health care reform implementation and that all individuals can access quality, affordable health care safely. 
     
  •  Principle 3:The District should streamline its eligibility rules and processes for public insurance and the Exchange. 
     
  • Principle 4:Any money saved through the implementation of the PPACA should be reinvested into the health care system.

We discuss each of these principles in greater detail in the attachment to this letter and offer initial recommendations designed to work toward that achievement.

May 06

2010

Action Alert – Emails Needed to Save IDA!

The DC Interim Disability Assistance (IDA) program provides essential cash support to people with disabilities who can’t work and are waiting for a decision from the Social Security Administration on their application for federal disability benefits.  The program also brings badly needed federal revenue into the Distric.  When an application for benefits is successful, the District can recoup the IDA funds from the federal benefits.

IDA is an critical for many Legal Aid clients.  Social Security determinations can take months and are delayed by staffing shortages in the agency.   Without IDA, many people living with a disability will become homeless or go hungry.  

Currently, IDA is facing severe budget cuts of up to $7 million that will leave over a thousand DC residents with disabilities on a waiting list to receive this emergency financial aid.  Please email the DC Council to express your concern and to ask them to restore funding to IDA.

Emails needed by Mon. May 10th, to:

Vincent Gray, vgray@dccouncil.us
David Catania, dcatania@dccouncil.us
Michael Brown, mbrown@dccouncil.us
Phil Mendelson, pmendelson@dccouncil.us
Kwame Brown, kbrown@dccouncil.us;
Jim Graham, jgraham@dccouncil.us
Jack Evans, jackevans@dccouncil.us
Mary Cheh, mcheh@dccouncil.us
Muriel Bowser, mbowser@dccouncil.us
Harry Thomas, Jr., hthomas@dccouncil.us
Tommy Wells, twells@dccouncil.us
Yvette Alexander, yalexander@dccouncil.us
Marion Barry, mbarry@dccouncil.us

 Sample message (feel free to modify this to reflect your concerns or experiences):

DC residents with disabilities need your help. Please restore the $7 million cut to Interim Disability Assistance in the Mayor’s proposed FY2011 budget.  If the cut is not reversed, between 900 and 1,400 residents with disabilities will have no income while they wait the months or years it can take to get a decision on their Supplemental Security Income (SSI) claims.  The District will also lose the federal reimbursements which help pay for IDA.  More importantly, residents forced onto the waiting list will face homelessness and hardship. They will be left with no money for rent or household expenses, no money for bus fare to doctor’s appointments or for any other basic needs. 

 

Anything you can do to restore full funding for IDA will help District residents with disabilities avoid severe hardships. Thank you.

****************************************

For more information or to get involved in advocacy to support IDA, contact Scott McNeilly at the Washington Legal Clinic for the Homeless, scott@legalclinic.org/ (202) 328-5508.

 

Jan 12

2010

Big Thanks to Medicare Part D Clinic Volunteers!

Supervising Attorney

Supervising Attorney

The last month and a half of 2009 was Medicare “open season,” when Medicare enrollees attempted to navigate the maze of prescription drug plans to find the one that will best meets their needs in 2010 . Legal Aid and Whitman-Walker staff, together with a host of incredible volunteer attorneys, spent this time running a series of Medicare Part D Clinics to assist clients through this complicated and tedious process. Through the efforts of our volunteers efforts and those of Legal Aid and Whitman-Walker staff, we were able to serve 348 clients — 133 through Legal Aid and 215 through Whitman-Walker. Behind these figures seniors persons or living with a disability who would not have been able to get their drugs without help. These are just a few examples of the lives that we touched: 

  • A Legal Aid client was taking several prescription drugs that were not covered under any low-income subsidy plan. A volunteer did her drug analysis and then phoned her doctors to discuss whether there were medically equivalent alternatives that would be covered under one of these plans. He got through to her doctor, spoke with him and the client is now going to be able to get the prescriptions she needs through a plan that will not charge her a premium. With income of less than $700 per month, payment of any premium would have been a hardship.
  • Another Legal Aid client was very concerned about switching plans even though the plan she was in would have charged a premium. This client faces challenges with literacy and memory as well as very low income so the premium payment would have been a problem. A volunteer did her drug analysis and identified a plan that would have covered all of her drugs without restrictions or a premium. Despite the client’s reluctance and the fact that she was hard to get a hold of, the volunteer spoke with the client repeatedly and patiently explained her options to her. Through her patience and perseverance, she was able to convince the client to change to the better plan.
  • A Whitman-Walker hearing impaired client with HIV and severe mental health issues was taking a mental health medication that none of the low income subsidy plans covered and planned to move back to Florida to be closer to his family after the new year. A volunteer analyzed plan options for both DC and Florida to find a plan covering all his medications with very low out of pocket cost that was accepted in DC as well as Florida. The volunteer also coordinated new applications for the Florida Medicaid and QMB programs.
  • A Whitman-Walker client living with HIV was unable to attend a clinic as she was out of state caring for her mother during open enrollment. In researching her plan options, it was clear that her 2009 plan would no longer cover one of her medications, Ribavirin. If she stayed in the plan, her annual out of pocket cost for medications would exceed $10,000, while her annual income is just under $12,000. Even when Ribavirin was covered, most low-income plans required prior authorization before they would pay for it. After some research, we secured a $0 premium plan that covered all of her medications, including Ribavirin, without burdensome restrictions and an annual pocket costs of only $113.

These stories are only a few of the many people who were helped through these clinics. Many times during these clinics clients expressed their thanks and their incredible sense of relief to have an advocate knowledgeable about this complicated process to guide them through this important choice. We are very grateful to all of our volunteer attorneys for their time and dedication. Thank you!