Getting Missourians Access to Healthcare

by Gregg Lombardi - Executive Director

I’m excited to report, albeit belatedly, about the work that Stacy Schaub and others have been doing on the Legal Aid Family Support Division Work Group in regard to problems the State of Missouri has been having in processing Medicaid applications. Other members of the Work Group include: Billie Orr, Alicia Johnson, Lisa Gentleman, Jeffiner Thompson, Emily DeStefano and Abbie Rothermich.

In the last year, the State has made major funding cuts and office reorganization in the Family Support Division (known as the FSD), which processes applications for public benefits, including Medicaid, Food Stamps, and Temporary Assistance. 

Medicaid provides health insurance for low-income Missourians who are permanently and totally disabled and, because of their disability, are not capable of gainful employment. It also pays for or subsidizes health insurance for children in low to moderate income families. For thousands of low-income Missourians, Medicaid is their only viable means of accessing long-term, pro-active medical care and the prescription medications they need to bring the pain and other aspects of their maladies under control.

The FSD funding cuts and reorganization have meant that for many Medicaid applicants there is no one to talk to from the State about questions they have on their applications and no one even to give them a receipt when they submit required documentation supporting their applications. We have had many situations in which we have actually faxed in information, like an income verification to the FSD for a client only to have the FSD send the client a letter several weeks later, saying that their application has been denied because they did not provide the FSD with the birth certificate.

The FSD also has gotten much slower in processing applications for Medicaid. So, now it can take several months to get a decision back from FSD, which is a long time to wait when you have a serious medical issue. 

Because of these obstacles and others, from September 2013 through March 2014, Medicaid enrollment in Missouri dropped 3.9% (approximately 33,800 people, one of the largest drops in Medicaid enrollment in the country. While this saves the State and the federal government money in the short-term, it greatly damages the health of the people who need Medicaid and leads to major costs for the hospitals that treat people who are wrongly denied Medicaid when they have catastrophic health crises as a result of not receiving the care they need.

Stacy Schaub, who is the Supervisor of Legal Aid’s Public Benefits Team in our central office, is part of a team of Legal Aid attorneys and other staff who are strategizing on how to respond to problems in the FSD’s processing of Medicaid applications and the processing of other public benefits. 

In early August, the Missouri HealthNet Oversight Committee held a meeting in Jefferson City on the status of Missouri’s Medicaid system. At the meeting, FSD leadership testified that, although there were problems that needed to be addressed, FSD had adequate funding and staffing to handle them. Stacy provided powerful testimony at the meeting bringing to light the numerous problems that the FSD is having.

I’m very proud of the work that Stacy and the other members of Legal Aid’s FSD Task Force have done on this issue. It’s a major step towards getting lots of Missourians in need the healthcare they need and that, under the law, they deserve.

TMC Medicaid Appeals Project Follow-Up

Gregg Lombardi - Executive Director

There was a great article in the Kansas City Star this morning about the Medicaid Appeals partnership that Legal Aid of Western Missouri has with Truman Medical Center.

http://www.kansascity.com/2012/10/04/3848419/alan-bavley-hed-like-to-lose-this.html
 

As the article pointed out, the project has gotten more than 1,000 Truman patients who are permanently and totally disabled access to long-term, proactive medical care. It has also generated more than $11 million in sorely needed revenues for Truman.

 

The article, however, failed to mention the tremendous team that does this work. Effie Day as Project Director and Stacy Schaub as Supervising Attorney of the Public Benefits teams have done excellent work in making sure that when Truman’s patients are wrongly turned down for Medicaid, they have the best possible representation they can have to make sure that they get the benefits they deserve. And the same holds true when the patients come from our other referral partners, including K.C. Free Health, KU Medical Center and St. Luke’s Hospital, as well as when the wrongfully denied client just calls us on the phone.

 

The fact that Legal Aid wins more than 85% of all of the Medicaid Appeals cases is the result of the excellent work of everyone on Legal Aid’s Public Benefits team, including the case handlers: Effie Day; Stacy Schaub; Karen Karnes; Katie Wood; Maura Weber; and, Megan Simpson and our talented paralegals: Tracie Griddine and Kim Morris, along with the team’s legal secretary—Sandy Kincaid.

 

We also could not get the results we get at Truman without the excellent work of the Financial Counseling Center staff, the assistance of the social workers and medical staff at Truman and the support of Lydia Jones and Bill Colby who oversee the project at Truman.

 

It’s a wonderful project and the true credit should go to the front line staff who get the job done.