Health Care Story of the Week - 9/30/09

Brittany is the mother of two-year-old identical twins Addleigh and Kennedi. She runs a church day care, and gets to work with children throughout the day. However, Brittany’s twins get her extra love and care not only because they are hers, but because they both have medical conditions that cause seizures, muscle weakness, and developmental delays. Neither Brittany nor her husband has health insurance through their jobs, so TennCare has been essential in caring for the twins’ special medical needs. Around the girls’ first birthday, normally a time for celebration, the family was notified that the girls’ TennCare coverage would be discontinued. Brittany was afraid their family might “lose everything that we’d ever worked for.” Brittany appealed the decision and called TJC for help.

TJC client advocates immediately recognized that the twins were still eligible for TennCare in another way. After a phone call from TJC to the Department of Human Services to correct the mistake, the girls’ TennCare was reinstated.

Brittany was overjoyed that her twin girls were safe. As she says, “Addleigh and Kennedi are my greatest blessing.” But she also wanted to ensure that all Tennessee children are protected from similar mistakes and oversights. She worked with TJC to write a letter to TennCare, sharing the twins’ story as well as experiences of other families. In response, TennCare described the new training it has implemented to improve the accuracy of eligibility screens.

In her fight for her twins, Brittany also spoke for many other parents struggling to receive care for their children. She said, “The thought of losing health insurance for my girls was terrifying. TJC helped me solve a problem I had thought was insurmountable, and put my mind at ease.” She continued, “I’m just a mom, and moms do whatever their kids need them to do. I will continue to do what I can to help other families.”

Click here to hear Brittany tell her story in her own voice.

The latest figures show that more than 126,000 Tennessee children age 0-18 are uninsured. For kids whose parents don’t get insurance through their employer (e.g. self-employed, work for a small business, laid off), programs like TennCare and CoverKids can help. But still, many children either do not qualify for or are not enrolled in these programs. Our current health care system, which leaves millions of innocent children without any health insurance, is broken. If children are our greatest resource for the future – we should treat them as such. Let’s invest in America’s success by insuring all children now! Learn more about this issue at the Children’s Defense Fund website.

TJC Director Gordon Bonnyman Wins National Award!

We're proud to announce that Gordon Bonnyman, Executive Director of the Tennessee Justice Center, has just been awarded the prestigious Morris Dees Justice Award by the University of Alabama School of Law. Read the Nashville Post's coverage.

TJC's Susanne Bennett, Shares Her Experiences from Speaking with Foster Parents

Through my outreach, I’ve met many caring foster families who face challenges accessing necessary care for their foster children. They receive children with open arms but are often not provided with the appropriate resources to help foster children on their path to permanency.

Some of the resources foster parents are left without are related to accessing healthcare services for foster children. I’ve talked with foster parents who did not have TennCare cards for their foster children, did not know which providers to take their foster children to, experienced a delay in their foster child’s enrollment in TennCare, or had a foster child who was waiting for dental care or glasses.

I encourage foster parents to insist that TennCare provide the care their foster children need by filling out a TennCare appeal form. Foster parents have a right to file TennCare appeals and doing so can go a long way towards helping a foster child get needed care. Sadly, many foster parents don’t know that they have this right and feel powerless watching their foster child wait for needed care.

That’s where the LEASE project – Legal Education, Advocacy, Services and Empowerment – comes in. The LEASE project helps middle Tennessee foster children enrolled in TennCare obtain needed health and mental health services. LEASE assists middle Tennessee foster families with legal advocacy techniques and individualized legal advice. Through the LEASE project, I’m lucky to have the chance to help folks like Rebecca.*

* See yesterday's (9/16/09) post to read Rebecca's story

Health Care Story of the Week - 9/16/09

Velma’s teenage granddaughter and foster daughter, Rebecca, struggles with scoliosis and ADHD (attention deficit/hyperactivity disorder). Rebecca loves animals and the outdoors. She plans to continue her education and hopes to become a nurse’s assistant. She requires physical therapy for severe back pain and medication for her ADHD. At age 18 she aged out of state custody, but due to a bureaucratic oversight she was dropped from TennCare. At this vulnerable time in Rebecca’s life, as she entered adulthood, the healthcare safety net showed gaping holes.

During the period she went uninsured, Rebecca’s scoliosis and ADHD persisted. While Velma managed to pay for her granddaughter’s prescriptions out of pocket, Rebecca lost valuable physical therapy time. Velma worked with TJC to get Rebecca’s TennCare reinstated, and to file an appeal for her out-of-pocket expenses, which were eventually reimbursed. Velma also worked with TJC to write a letter to the state, asking that other children not encounter the same barriers to getting needed care that Rebecca experienced.

Velma said, “With the Tennessee Justice Center’s help, I was able to get Rebecca’s TennCare back. Now, she will be able to go out into the world with the insurance she needs to stay healthy.” She continued, “I would do anything to help Rebecca and other young people keep their health care.” In her fight to reinstate Rebecca’s care, Velma also spoke for many other parents struggling to obtain care for their children.

There are several ways for Tennessee children to get public health insurance. If your child (under 21 years old) is uninsured or needs more health insurance, call our office to see if she might qualify for TennCare or CoverKids. Call us toll free at 1-877-608-1009. Is your child or foster child having trouble getting services under TennCare? We can help! Call us toll free at 1-877-608-1009. Also visit our website at http://www.tnjustice.org/.

Health Care Story of the Week - 9/9/09

“Last Thursday, September 3, was the three year anniversary of Dylan’s wreck. That day, I told Dylan’s story in front of a 400-person crowd in Murfreesboro. It was my way of honoring my son and helping move our country toward a health system that cares for all Americans.” – Dottie Cordle

Dylan Cordle was born and raised in Middle Tennessee, but he was forced to leave his home in order to get medical care. At age 17, a senior in high school, Dylan suffered a traumatic brain injury in a motor vehicle accident. He was in a coma for four months, but eventually came to, and began therapies to help him regain life skills. A little over 2 years post-accident, Dylan completed high school and received his diploma.

During Dylan’s slow recovery, his mother Dottie Cordle was there for him each step of the way. Dottie owns a small embroidery shop called “Eye for Sewing,” and juggling a business and her son’s medical care became more than a full time job.

Dylan had private insurance through his mother’s work, and also qualified for TennCare. Even with two insurance plans, Dylan was unable to get the care he needed in Tennessee. Although children under 21 on TennCare are by law supposed to receive all medically necessary care, Dylan was turned down for acute inpatient rehabilitation which his doctors prescribed. Dottie fought TennCare to cover the service, but she lost.

Likewise, Dylan’s eye doctor said that he clearly needed neuro-rehabilitation, but many insurers, including TennCare routinely deny it, calling it “experimental.” Meanwhile, Medicare recognizes the treatment as safe, and with this treatment, his doctor thinks Dylan would have been better able to perform basic daily activities.

Without the medical care he needed, Dylan’s progress slowed. He remained unable to care for himself, and was socially isolated from his peers. His family and his doctors knew it was not a physical limitation that was holding Dylan back, but an insurance one.

Then, Dottie heard that Kentucky has a traumatic brain injury program for kids like Dylan. Since Dylan’s grandmother lives in Kentucky, the family made the difficult but clear decision to move Dylan out of state for treatment.

The care Dylan had fought so hard for in Tennessee but was unable to get was readily available across state lines. Dylan has already been in the program for about one month and is making progress. In addition to getting the therapies and doctor visits he needs, he participates in community outings with other individuals with brain injuries.


In Tennessee with TennCare, Dylan could not get the care that doctors ordered for him. A few hours away, getting the care he needs is easy. Ms. Cordle thinks there is something wrong with this picture. Her family has been in Tennessee for since 1984, and Dylan was born and raised here, yet he had to leave to get care. “Tennessee ought to provide its children with the best chance to reach their potential,” she said, “or else we risk pushing our kids out of state and draining Tennessee of its most valuable natural resource.”

Video Conference for Advocates and Consumers 9/17/09 (rescheduled date)

Were you, a loved one, or a patient/client in the Daniels class and now being cut off TennCare?

September 17 (rescheduled date) you're invited to join an expert panel on at 9:30 Central/ 10:30 Eastern Time for a 1.5 hour video conference. The conference, which will include time for questions, will tell you what you can do to keep TennCare if you are eligible. If you are not eligible, it will cover other options.

Please visit the TJC website again for instructions on how to sign in to the video conference and links to presentation materials.

Health Care Story of the Week - 9/2/09

Ann B., though sick, is full of life. Ann wants to live for her son, to see him go to college. She lives in Memphis with her husband and 18 year-old. Her husband is a military veteran and receives his health care through the VA, and her son, who will graduate high school this year, is on TennCare. These programs help her husband, who is 67 years old, nearly blind, on oxygen, and barely able to walk and her healthy son get the medical care they need. Ann, however, was recently cut from TennCare due to a change in the program’s eligibility categories. TennCare sent a list of private companies from which Ann could purchase insurance. She called them all, and the lowest monthly premium was $600, almost 30% of the family’s monthly income, and much more than they can afford.

Ann relies on about 15 medications daily, as well as regular lab visits and doctor’s appointments to stay healthy enough to care for her son, husband, and herself. She suffers from rheumatoid arthritis, and without a chemotherapy medicine and regular lab checks, she would not be able to bathe, brush her teeth, cook, write, or drive. With the medication, she can do all of these things. Ann also has thyroid disease, congestive heart failure, blood clots, anemia, and other serious conditions, all of which require medicines and ongoing medical treatment.

She’s 62 years old – too young for Medicare – and she cannot get onto the Medicare program through a disability determination because she stopped working due to illness one quarter too early to qualify. Ann is calling prescription assistance programs, calling her elected officials, and telling her story to the media in hopes that someone will help her get her medicines and afford the doctor’s visits. But, Ann feels hopeless, as if there is no help to be found. She says that losing her TennCare is like a “sentence to die.”

Right now, Ann is completely out of her chemo pills and is already foregoing care. The household relies entirely on the fixed retirement income of less than $25,000 per year. After paying their house note, utilities, and gas, there’s virtually nothing left. They applied for Food Stamps, but were a few dollars over the limit. Ann knows from previous experience what it feels like to choose between food and medicines. She said that “when your stomach is grumbling, you’ll always choose the peanut butter sandwich over a pill.”

Ann is one of the thousands of Tennesseans who have fallen into the cracks in the health care system. She warns others, “don’t get sick like me,” for there may be little help to be found. For now, Ann looks for help wherever she can, and wonders why the richest country on earth continues to leave behind its own citizens.