Becky is a 27-year-old single mother, who was working as an office temp while she sought long-term employment to provide for her son. The firm she was temping with told her they had no more work for her, so she applied for unemployment benefits and redoubled her job search. To prove that she was eligible for these benefits, she certified that she was able to work, and every two weeks, she presented a list of the job applications she had filled out. In spite of doing everything needed to get the unemployment, her former temp firm challenged her eligibility four times so they wouldn’t have to pay into the Unemployment Insurance Fund. On her own, Becky went before an administrative judge each time and proved that she was available to work and actively seeking a job, and so deserved the checks she should have been issued. After the fourth challenge, the Illinois Department of Employment Security stopped sending her checks, because they assumed something was going wrong. She needed the checks to care for her young son, but her bullying ex-employer still challenged her again. She came to LAF, feeling harassed and persecuted. She was right, and LAF Staff Attorney Matt Monahan and Harvard Law Student Sabreena El-Amin stepped up to represent Becky at her fifth hearing. When the temp agency saw that Becky now had legal representation, they immediately withdrew their appeal of her receipt of benefits, and the Department mailed her check and made a promise of future checks until she finds a job.
She sent Matt Monahan the following email, to express her gratitude:
“I sincerely do not have the words to express my deepest gratitude to you, Sabreena, and the services of LAF. In a moment, when I was helpless and feeling that all hope is lost, and that I would continue to be bullied by my temp firm, there you and Sabreena were, with LAF. I am beyond thankful to you, that in my case, my file, and personally, I was not treated as a number, I was not treated as if I was ‘just another’ destitute client, but rather, the exact opposite. I was treated graciously, I was heard, the lines of communication were always open, and a weight was lifted off of my shoulders. In closing, I have no more words other than thank you.”
LAF is proud to stand up against bullies who take advantage of people because they think nobody is looking out for them. We are proud of the folks like Matt and Sabreena who are always looking out for our clients and willing to stand up to bullies.
The saga of the Managed Care roll-out in Illinois continues!
After some delays, last week DHS began sending out the first batch of MMAI enrollment letters to individuals in Cook County who are receiving Long Term Services and Supports (LTSS).
MMAI is a managed care program specifically designed for the population known as dual eligible (those who are eligible for both Medicare and Medicaid). Unlike other managed care programs, MMAI is not mandatory, and dual eligibles have the ability to change their plan or opt out of the program at any time, whether during this initial enrollment period, or later.
Dual eligibles who receive LTSS services have the same right to opt out of MMAI at any time as their counterparts who do not receive such services. However, those who do choose to opt out will receive an enrollment package at a later date (possibly this winter) for a managed care plan specifically for their long term care. Medical services will still be covered by their traditional fee-for-service Medicaid and Medicare, but all LTSS services will be covered by the MLTSS managed care plan, and consumers will not have the ability to change MLTSS plans at will, or to opt out of the program.
We remind consumers that if they receive a package or letter titled “Your Health Plan Choices” they will have a 60 day voluntary enrollment period to pick a plan with a Primary Care Provider (PCP). They can go online or call Client Enrollment Services at 1-877-912-8880 from 8 a.m. to 7 p.m., Monday through Friday, and from 9 a.m. to 3 p.m. Saturday in order to enroll. If they don’t choose a plan within 30 days of when the enrollment package is sent, then a second letter will be sent containing the plan and PCP to which they will be auto-assigned if they do not choose in the next 30 days. Once a client is enrolled in a managed care plan, they will have 90 days to switch to a different plan, after which they are “locked in” to the plan for a year.
You can learn more about MMAI and other Managed Care programs here, and you can donate to support our work with public benefits here.
Over the past year, the Public Benefits Practice Group has been busy tracking the terrific new health insurance opportunities for our clients and making sure that they are able to navigate the changes. And it isn’t slowing down yet!
On September 8, Illinois began sending out notices to Medicaid recipients in Cook County to enroll in managed care plan. This is an effort to transition from the Medicaid fee-for-service model to a capitated payment system. With the exception of certain populations, such people eligible for Medicare and Medicaid both, this enrollment is mandatory and consumers will not be able to opt out of the program.
Consumers will receive an enrollment package titled “Your Health Plan Choices,” at which point, they will have a 60 day voluntary enrollment period to pick a health plan with a Primary Care Provider (PCP). They can do so either online at www.enrollHFS.Illinois.gov, or by calling Client Enrollment Services (1-877-912-8880) from 8 a.m. to 7 p.m., Monday through Friday, and from 9 a.m. to 3 p.m. Saturday. If they don’t select their plan within 30 days of when the enrollment package is sent, then a second letter will be sent notifying them to which plan and PCP they will be auto-assigned if they not choose in the next 30 days. Once a client is enrolled in a managed care plan, they have 90 days in which they can switch to a different plan, after which they are required to remain with their plan for 12 months until their next open enrollment period.
Luckily, LAF’s Public Benefits Practice Group, Ombudsman Project and Client Screening Unit are working together to make sure that consumers have guidance when navigating enrollment and to advocate for clients on individual and systemic issues that may arise with such a substantial change to Medicaid.
When the weather heats up and the crops are ready to be planted, LAF’s Illinois Migrant Legal Assistance Project (IMLAP) kicks it into high gear. This year is no exception. Thousands of migrant workers across the state work every day to plant, cultivate, and pick the food we eat; and IMLAP’s attorneys, paralegals, and students work to protect their legal rights.
Equal Justice Works Fellow Karla Altmayer is finishing up a year-long project focused on female farmworkers, who are more isolated than anyone. She is doing outreach and education across the state that focuses on gender discrimination, sexual harassment, and workplace sexual violence. She has worked to train hundreds of community advocates and empowered farmworkers across the state. She has also developed a curriculum that is being used nationally to train advocates.
Staff Attorney Jose Alonso is working hard on connecting with farmworkers who are working in the fields of Illinois pursuant to the H-2A temporary agricultural visa program. These workers labor and are housed in the most remote and inaccessible parts of the state, in conditions described as “as close to slavery as we have in this county.” Jose is currently working with an organization called Ladder Up to help these migrant workers learn about their rights and obligations under the tax code and for those who have to file income tax returns, to receive assistance in filling out the appropriate tax form.
IMLAP is also leading the way on a Statewide Human Trafficking Task Force. One of very few of its kind around the country, they bring together federal and state law enforcement and government agencies; academia; social services agencies; legal assistance attorneys; and faith-based associations, to combat this every growing problem in Illinois.
Here at LAF, we’ve been keeping a close eye on the constant flux of health care in Illinois as the state works to execute the Affordable Care Act (ACA) and put consumers into managed care systems. As always, new issues are popping up, and this week consumers are dealing with complications in their Marketplace applications.
On August 12, the state sent out notices to approximately 10,300 Illinois consumers who are signed up on the Federal Health Insurance Marketplace regarding citizenship and immigration inconsistencies in their applications. Consumers who receive these notices have until September 5th to respond with the appropriate paperwork or they will lose coverage on September 30th. Our enrollment paralegals have begun advising clients on the steps they must take to keep their coverage.
We recommend that clients who receive this notice immediately log into their HealthCare.gov account and upload the requested documents or mail them to the address listed in the notice—even if they submitted the documents previously. Consumers can also call Illinois Department of Central Management Service at 1-800-318-2596 to determine what documents are needed to verify their citizenship status, or to check whether their documents have been received.
Consumers can receive additional information about maintaining their Marketplace coverage here and here.