Advocates want face-time with feds to protest state’s health care cuts for the poor

Diane Olsen wants to tell federal officials face-to-face why she visits state Department of Social Services’ offices six times a year with the same paperwork.

The 69-year-old Willington woman said that making the half-hour drive to Windham to show paperwork she previously hand-delivered — but that the agency never entered into its computer system — is the only way to preserve Medicaid benefits for her disabled son.

And Olsen isn’t the only one hoping to persuade federal officials to take the unusual step of visiting Connecticut to discuss a state plan to tighten eligibility for a Medicaid program that serves 78,000 poor adults.

Several of Connecticut’s leading health care advocates also are pushing for a hearing. Some argue that the proposed changes to the Medicaid for Low Income Adults program, known as LIA, will end benefits for up to 13,000 people — most of whom will not be able to afford private coverage.

Others join Olsen in arguing that the daunting task of trying to periodically re-examine 78,000 LIA recipients to test their eligibility will swamp an understaffed state agency that already is wrongfully terminating benefits for other Medicaid recipients because of bureaucratic mistakes.

“They have never been able to handle (the caseload) they have now, Olsen said. “And this problem didn’t happen in just the last five years. But it’s gotten considerably worse.”

New Haven Legal Assistance Association, a nonprofit social service advocacy group, already is suing the state on behalf of DSS clients, charging that the agency has failed to process applications for Medicaid and food stamp assistance in a timely fashion.

The suit alleges that requests to renew assistance have been improperly terminated by DSS — even though clients submitted the correct paperwork on time — because the agency lacks staff to record this paperwork in its data processing system.

And Olsen, whose 50-year-old son who suffered brain trauma since being diagnosed with a tumor 31 years ago, said preserving his Medicaid benefits has become a biannual saga.

Every six months, Damon’s eligibility must be reauthorized. For Olsen that means hand-delivering — not mailing — her son’s financial information to the DSS branch office in Windham.

Why take the 30-minute drive rather than use the mail? It’s the only way to ensure that Olsen leaves with a photo-copied receipt, proving her son’s paperwork was submitted on time, she said.

What follows — almost without fail over the past five years — is an automated notice from DSS informing her shortly thereafter that her family missed the deadline, and that Damon’s benefits have been terminated.

From there, it’s back to the DSS office to show them her photo-copied receipt. The branch office’s explanation is always the same: While it received Olsen’s paperwork, its staff failed to enter the information into the department’s database.

And while each visit usually ends with a pledge that — this time — the information will be entered, Olsen added it can take as many as three follow-up trips to resolve the issue.

And this entire exercise happens twice a year.

“I don’t care when the public hearing is,” Olsen said. “If they (federal officials) come to Connecticut, I’ll make it my duty to be there.

“My son lives in fear of when I’m not going to be here,” Olsen added. “He says, ‘Mom, who else will go through what you go through for me.'”

Social Services Commissioner Roderick L. Bremby has told officials at the federal centers — who will decide the fate of the proposed LIA changes — that the department has taken several steps to ensure the new eligibility rules are administered promptly and correctly.

• The department added about 120 new staffers in March and recently got permission to add another 100.
• The department also will work with a private contractor to notify all LIA recipients and gather income and assets information to help reassess their eligibility.
• And certain staff in each agency branch office have been told that processing the new eligibility information is a priority.

But Olsen isn’t the only one who remains skeptical.

“One of the biggest concerns we have is how hard it is for DSS right now to provide the services they have to,” said Jane McNichol, executive director of the Legal Assistance Resource Center of Connecticut, a Hartford-based health care advocacy group.

Marcia DuFore, executive director of the North Central (Connecticut) Regional Mental Health Board, also appealed for a local hearing in her testimony to the U.S. centers, arguing the added caseload will cause chaos through the Medicaid program here.

“We hear the stories of numerous recipients of Medicaid and benefits who are suffering,” DuFore wrote, adding that some have had to resubmit paperwork as many as five times after “being notified that their benefits have been cut off due to their failure to cooperate with the redetermination process.”

“This creates more than just confusion, disruption, and frustration. It causes harm,” DuFore added. “These individuals have gone without food, medical care, and medicine that keeps them well. And because they face the additional daily challenges of living with a mental illness, this confusion, disruption, frustration, and harm can actually aggravate their symptoms, actually make them sick. This waiver, if approved, stands to exasperate this problem.”

New rules

Sheldon Toubman, an attorney and health care advocate with New Haven Legal Assistance Association, who prepared the lawsuit against DSS, noted that the state improperly notified LIA recipients in early June that program rules were changing before they had been approved.

LIA serves single adults who have no minor children and whose incomes are below 56 percent of the federal poverty level.

The administration has proposed two eligibility restrictions:

1) Setting an assets limit of $10,000;

2) And, if a LIA applicant is between ages 19 and 26 and lives with a parent or can be declared a dependent for income tax purposes, then the parent’s income and assets can be factored in when determining if the applicant is eligible.

The changes are supposed to save $50 million in this fiscal year’s state budget. And health care advocates argue Gov. Dannel P. Malloy’s administration is pursuing the changes to cut costs, not because of any significant abuses of the LIA program.

But while legislative panels held hearings on these proposals in June and July, the DSS notification letter made no mention of those gatherings.

“That needs to be corrected,” said Toubman, who, like McNichol and DuFore, appealed to federal officials to visit Connecticut. “There were hardly any LIA enrollees between 19 and 26 who testified at those hearings,” he said.

Toubman and others have said they fear many of the younger LIA clients come from households that will be unable to afford private health insurance for their adult children.

“Sometimes these types of problems are much more impactful when they are explained in person,” said Debra Polun, director of government affairs for the Community Health Center Association of Connecticut. “There’s a big difference between that and just sending in your written testimony.”

But while health care advocates were hopeful federal officials would visit Connecticut after the deadline for filing written testimony expires on Saturday, they acknowledged it doesn’t happen often.

A spokeswoman for the federal centers declined to comment on the likelihood of a hearing.

But according to the center’s rules, it will publish all written comments it receives after the filing deadline.