TJC 2010 Mother of the Year - Evelyn Human

When TennCare decided to sharply limit home health care for all adults on the program in the fall of 2008, Evelyn Human decided that she was not going to let her son’s care be cut without a fight.  Her son, John, is mentally retarded.  At 25 years old, he has the mental capacity of a small child.  He requires constant care, almost continuous suctioning to keep his airways clear, and assistance with all aspects of his life.  He had been receiving enough in-home nursing care from TennCare for his mother to work and provide for the family.  TennCare’s new rules, however, said that his in-home nursing hours would be capped at 35 hours per week.  With only 35 hours, John would be left unattended for long stretches, and could aspirate from lack of suctioning.

Instead of providing the care John’s needs to stay safe, the MR Waiver, a supplementary program John is enrolled in along with TennCare, only agreed to provide just 4 hours of care per day.  Waiver representatives told Ms. Human that this care would be delivered in 15 minute intervals throughout the day – for a total of 16 separate visits each day!  Not surprisingly, no nursing agencies agreed to provide care on this schedule.  On the day John’s care was set to be reduced, he received no care at all through the Waiver.  Ms. Human was unable to work due to the constant care she had to provide. 

Ms. Human immediately contacted TJC, and we contacted Waiver personnel to discuss the problem.  When that did not fix the problem, TJC contacted attorneys for the State to alert them to the violation of John’s rights.  The attorneys agreed, and John began receiving his supplementary care.  But there were still long gaps throughout the day when John would be alone.  Ms. Human appealed and asked for more nursing hours.  TJC located a pro bono attorney, Leslie Muse, to represent the family.  TJC helped train Ms. Muse in techniques for winning TennCare appeals.  After a hearing lasting several hours, the judge agreed with Ms. Human and John’s doctors that his needs make constant care medically necessary. 

Because of Ms. Human’s advocacy, John is now receiving the skilled care he needs to safely live at home.  We honor her persistence and dedication as a 2010 Mother of the Year.