Friday, January 29, 2016

What is a "Significant" Disability?

MCIL’s response to the Administration for Community Living concerning “significant” disability.

By Christina Clift

Christina Clift
In discussing people with disabilities and the role of centers for independent living, the word “significant” when used to describe the people served or who should be on staff should be taken out of any future rules.  The word “significant” implies that there is a hierarchy or value placed on types of disabilities. 

Does that mean a person who cannot see is less disabled than someone who cannot walk?  Is someone who cannot walk more disabled than someone with an intellectual disability?  The answer should be no.  A person with a disability regardless of its nature faces the same discrimination and barriers.  So why put more of a label on them than their diagnosis already does? 

Even within disability categories the way in which they manifest is different for every person.  Some people with Cerebral Palsy can walk, talk without difficulty, are of average intelligence and have normal vision, while many are not or manifest varying combinations.  Should one person with Cerebral Palsy be more “significant” than another just because in manifests in more ways? 

The language should reflect that we are people with disabilities and we are equally valued and should receive equal service.  Not that some of us are less or more valued just because of our diagnosis’s.  A simple definition of disability is that a person has a body parts that work differently, but that doesn’t mean we wanted to be looked at that way.

CIL’s fight for equality, equal access, and to knock down barriers that society has regarding people with disabilities. We don’t need to add to our struggle the continuing the use of “significant” when talking about our people and their disability.

Wednesday, January 20, 2016

TennCare Redetermination

What is redetermination and how will it affect millions of Tennesseans healthcare coverage?

Allison DonaldBy Allison Donald

Redetermination is the process by which the Tennessee Department of Human Services (DHS) evaluates the ongoing eligibility status of TennCare Medicaid and TennCare Standard enrollees. Starting in December, TennCare entered into the final phase of the redetermination process. 

There have been many challenges during this process that has left many Tennesseans confused and without medical coverage. This year’s redetermination process will look different than in previous years.  DHS workers are said to be helping fill out and fax renewal packets.  Enrollees who do not have a caseworker they can contact, may call the Tennessee HealthCare Campaign (THCC) with basic questions about the Renewal Packet, but there may lengthy wait times.

The state is required to extend coverage for all enrollees who can be determined by review of records already available to the state.  Also, the state is required to send enrollees notices that are pre-populated with any information already available to the state to give enrollees an opportunity to provide any missing information. 

The state must also provide assistance in person or by phone for the redetermination.  The enrollee is required to keep TennCare informed of any changes in contact information.  The enrollee must report any changes in income, household composition and must respond to the redetermination notice within 30 days. Enrollees also must provide supporting documentation, as requested by the state. 
According to TennCare Division of Healthcare Finance and Administration, “All Medicaid agencies like TennCare are required to redetermine the eligibility of members on at least an annual basis. Due to the many complicated changes to Medicaid that took place starting January 1, 2014, the federal government encouraged Medicaid agencies to suspend redetermination efforts in order to focus on other tasks. Most Medicaid agencies – including TennCare suspended redetermination efforts.”

Phase one of the redetermination process began in May and September for approximately 720,000 individuals.  TennCare used SNAP data (food stamps) data gathered by DHS to redetermine eligibility.  No one lost eligibility as part of phase one.

ADAPT Marches for Medicaid equalityOctober through December was the start of phase 2 of the redetermination process TennCare sent notice to 300,000 selected enrollees.  The notice asked individuals to sign and return a form if their circumstances changed since their last eligibility review.   Phase 2 involves a confirmation mailing in which,  enrollees must complete the form and fax or mail it to TennCare to complete the redetermination process. It is especially important that all notices are returned to the address and fax number noted on the notice.  In Phase 2, even if individuals are not able to complete the forms he or she will remain in TennCare.

Phase 3 started in November of 2015 with a pilot group of 10,000.  This step will require enrollees to respond to extensive requests for information (RFI).  It will affect people due for redetermination, whose eligibility was not redetermined in phase 1 or 2.  If the enrollee fails to respond to the notices in Phase 3, TennCare will be terminated.

The initial barrier that has complicated this process is that the state is three years behind with its review of enrollees. The challenges vary; they may include the individuals not having their current address in the state system to ensure the state mails these notices to the correct address.  Notices are very confusing and must be read carefully to understand what steps to take. 

If a person has had a change in either their household income or family size since last applied for TennCare, they will need to sign the notice and return it to the state within 30 days.  For families with multiple members on TennCare, they will need to complete each form and return it to the state. 

Individuals may find it difficulty mailing or faxing information back to the state.  If a person fails to complete Phase 3 they will lose their TennCare.  If this should happen and they are still eligible, they will have to reapply through the Federal Marketplace System. Keep in mind that the Federal Marketplace doesn’t properly screen for every TennCare and Medicaid category.  This will make it very difficult for many who are currently on TennCare to get their coverage back. 

If you are experiencing any difficulty during the process please feel free to contact the Tennessee Justice Center (TJC) at

Monday, January 11, 2016

STAC Committee Meeting Report January 2016

By Allison Donald, Christina Clift and Bobbie Fields

Chart showing MATAplus ridership growing from 2,900 in 2012 down to 2,800 in 2013; up to 3,000 in 2014, and up to 3,300 last year.The Specialized Transportation Advisory Committee (STAC) held its first official meeting of the New Year.   Russell Jones (chair), June Mangum (vice-chair) Bobbie Fields (secretary) William Bass (member) Christina Clift (member), and Allison Donald (member) were in attendance to discuss the previous year’s progress as well as outline an agenda for the upcoming year.  An invitation was extended to a Mata plus representative to attend as per usual, but they chose not to. 

Even though there has been some improvements made in terms of the rider experience with MATAplus there are still some issues that have yet to be adequately addressed by the administration that runs MATAplus.  Christina Clift and other members of the STAC committee expressed concerns about the status of Ms. Stanko and her level of involvement in the day to day operations of MATAplus.  Mr. Garrison has yet to inform anyone on the STAC committee of what her responsibilities are.

Bobbie Fields informed the members that she had been late four times and cancelled out for an entire day just this week alone.  In addition to that we would like to work with the individuals responsible for the automated messages that riders here when calling MATAplus to improve its functionality and streamline the prompts that we have to wade through as riders. 
Allison Donald

STAC is also in the process of revising the MATAplus application and rider’s guide.  Both documents are a blatant violation of the effective communication portion under the ADA.  In concert with that we want simplified explanations of the assistive equipment and medical explanations that are listed on the application (i.e. it would be very easy for someone to confuse receiving oxygen through an inhaler versus receiving oxygen via an oxygen tank, because a clear distinction isn’t made on the application).  We would like the input of MATAplus so we could get this issue resolved as quickly and painlessly as possible. 

As a committee we would also like to begin shadowing MATAplus, but we have yet to receive any concrete dates and times from Ms. Wade to when we are going to do so.  We have decided as a committee to table the Rider’s survey until we can narrow down the questions that will comprise the survey.

STAC also would like to recognize a MATAplus employee during the quarter recognition mark.  As a committee we are hoping the awards will be given out during the MATAplus board meeting which is scheduled on January 25th.  STAC would like to nominate drivers by using the compliment and complaint line 901-522-9175. This event is extremely important to STAC, because we want to keep the lines of communication open which serves to benefit all parties involved.  If you have any questions about the event or would like to make a donation please contact Bobbie Fields (901)726-6404.

Friday, January 8, 2016

Open enrollment for Affordable Care Act Insurance ends this month

More than a Quarter-Million Tennesseans choose Obamacare

Activists march for equality
The deadline for choosing a plan through the Affordable Care Act is at the end of this month and already more than 236,000 Tennesseans have signed up for Obamacare coverage. To find out if you are eligible for coverage, renew coverage or to sign-up for coverage you may visit

The U.S. Department of Health and Human Services reports that over eleven million US citizens have signed-up through for health insurance. The Affordable Care Act made health insurance coverage more available to people with disabilities because of the elimination of the “pre-existing condition” restrictions.

Although our state has not expanded Medicaid to provide coverage to working Tennesseans that do not qualify for the Affordable Care Act subsidies, Tennessee still ranked eleventh of the 38 US states that use the marketplace. Tennessee Health Care Campaign estimates that 280,000 Tennessee residents remain in the “coverage gap,” because our state has failed to adopt Medicaid expansion or pass Governor Haslam’s Insure Tennessee legislation. The total tax money lost by not expanding Medicaid is approaching $2 billion, thousands of lost jobs, closing hospitals and higher taxes in our state.

Activists demand Tennessee close the Medicaid gap
The U.S. Department of Health and Human Services reports Marketplace Signups and Tax Credits in Tennessee:

* 82 percent of Tennessee consumers who were signed up qualified for an average tax credit of $213 per month through the Marketplace.

* 60 percent of Tennessee Marketplace enrollees obtained coverage for $100 or less after any applicable tax credits in 2015, and 92 percent had the option of doing so.

* In Tennessee, consumers could choose from 5 issuers in the Marketplace in 2015 – up from 4 in 2014.

* Tennessee consumers could choose from an average of 71 health plans in their county for 2015 coverage – up from 48 in 2014.

* 78,571 consumers in Tennessee under the age of 35 are signed up for Marketplace coverage (34 percent of plan selections in the state).  And 64,705 consumers 18 to 34 years of age (28 percent of all plan selections) are signed up for Marketplace coverage.

1. Florida-1,569,551
2. Texas-1,108,935
3. North Carolina-558,892
4. Georgia-517,715
5. Pennsylvania-412,914
6. Virginia-387,470
7. Illinois-348,346
8. Michigan-324,359
9. New Jersey-260,323
10. Missouri-258,696
11. Tennessee-236,000