Thursday, November 19, 2009

Health Care Story of the Week - 11/19/09

Even though it seems that families are far too often fighting losing battles, there is always hope. This week we are proud to bring a success story, achieved because of parents’ relentless dedication to ensuring their children receive the best care possible.

Four-year-old Rebecca Lyons-Winford and her three siblings escaped from a severely abusive home when they were adopted by moms Linda Winford and Kathy Lyons in 2005. Kathy is a retired Army chemical officer who now owns and operates a pet store, grooming and boarding facility. Linda is medically retired from the phone company and now cares for their four children full time. The children came to the Lyons-Winford home with broken bones, shaved heads, and behavioral problems. Each of the children has special needs. But with the love and care of their new family, the children have begun to heal, improving in school and gaining physical and emotional strength.


Last fall, Rebecca suffered an accident, nearly drowning in the family pool. After being rushed to the hospital and stabilized, the family began the long, slow process of recovery. Rebecca is on TennCare, which is required by law to provide the medical care children need. When the family called the Tennessee Justice Center, we began working to ensure TennCare complied with the law. Only three years old at the time of her accident, Rebecca’s life holds so much promise, and getting appropriate treatment is key to realizing her full potential.

One piece of medical equipment essential to Rebecca’s well-being is her Vest airway clearance system. This machine helps clear her lungs and prevent choking and respiratory infections. She has been successfully using the Vest for hundreds of hours, over the course of more than a year. Because of this, Rebecca has not been hospitalized for any type of pulmonary problems. This is a great feat, as many children in Rebecca's condition are continually hospitalized for pneumonia and other bronchial problems. In September 2009, TennCare wrote the family a letter saying it won’t pay for the Vest because it’s not needed to treat her medical problems and it is experimental.

Ms. Lyons and Ms. Winford talked with Rebecca’s doctor and got a letter explaining Rebecca’s needs and recommending the Vest. Then, in a hearing with TennCare attorneys and a judge, Ms. Lyons argued convincingly that it would be cheaper for TennCare and better for Rebecca to continue using the Vest. TennCare’s arguments that the care was experimental did not hold water. The judge ruled favorably, and now Rebecca continues to make improvements, both physically and mentally.

These mothers’ persistence and dedication to their children, even under adverse conditions, is remarkable. Because of their love, four Tennessee children have a real shot at living full, successful lives.

Tuesday, November 17, 2009

2009 Year-End Letter

The following is TJC's 2009 year-end letter, composed by Executive Director Gordon Bonnyman.  If you believe that TJC's work is necessary, please consider making a donation.  As we are constantly reminded through our service to our clients, even the smallest contribution can have a far-reaching impact.


Dear Friend of the Tennessee Justice Center:

Thank you for standing up for the rights of all through your support of the Tennessee Justice Center. As we reach the end of a most challenging year, I urge you to stand with us once again. We value your support and need your help. And so do the many vulnerable Tennesseans who look to TJC to make America’s promise of Equal Justice for All a reality in their lives.

On my desk is a postcard picture of Nelson Mandela, bearing his reminder that achieving justice “always seems impossible until it’s done.” Down the hall are historical images depicting inspiring Tennesseans of past generations, many of whom are nameless today. They worked tirelessly – fighting slavery, standing up for better working conditions and votes for women, marching for Civil Rights – to hold our nation true to its ideals. They remind us daily that nothing ever happens without the effort of lots of people who persevere even when justice seems unattainable. Their stories keep us going.

Most of all, it is our clients’ stories that keep us going. They remind us why TJC’s work for justice matters, even at times when justice seems all too distant.

Their cases involve the brutal necessities of life: subsistence for the states’ poorest families, health care, foster care, mental health services. Typical is the experience of Trina, who just learned that her 10 year old son, Darius, had brain cancer. Days later, she learned that his health coverage had been cancelled. The doctors said it was imperative for Darius to undergo surgery at once, but the hospital refused the surgery until Trina could produce proof of coverage. TennCare insisted Darius was not eligible, and his distraught mother could not get either TennCare or the hospital to budge. She contacted TJC, we got his TennCare reinstated immediately, and Darius underwent a successful operation. Relieved from the terror that her child would go untreated, Trina is now able to devote herself to mothering Darius through chemotherapy, and his doctors are optimistic.

Through your help TJC is the source of such life-giving support to hundreds of individual families yearly who have no place else to turn. And TJC’s class action and policy advocacy extend the impact of our work on behalf of individual clients like Darius to many thousands more. This year, for example, our TennCare advocacy preserved $300 million of medical and mental health services for some 45,000 adults and children with disabilities. And TJC identified unused federal economic recovery funds that enabled the legislature to restore another $25 million in services for foster children and people with severe mental illness.

TJC’s experience serving individual clients has also enabled us to identify structural weaknesses in the existing Medicaid program. Several reforms proposed by TJC have made their way into the pending health reform legislation. These include provisions that would:
• strengthen Medicaid patients’ access to physician services;
• tighten accountability by states and managed care contractors for their expenditure of federal Medicaid funds; and
• enable low income seniors to obtain affordable Medicare Supplement insurance when they lose Medicaid coverage

These technical fixes are “inside baseball,” devoid of the political and ideological overtones that have roiled the debate around health reform. But, if enacted, they have the potential to help hundreds of thousands of vulnerable Americans nationwide.
And yet, for all of TJC’s remarkable record of success, we don’t always succeed. No account of the past year would be accurate without acknowledging our failures. Because so much is at stake, the consequences of failure are often tragic, and cruelly unjust.

This year has been very difficult for hundreds of thousands of Tennessee families. The combined impact of the recession and of misguided state policies has cost Tennesseans hundreds of millions of dollars of much needed medical and mental health care. TJC lost several clients this year whose life-saving care was interrupted when they lost their health coverage. Many other clients had to watch their children suffer needlessly because the family lacked insurance.

As we have done for years, TJC has helped these families tell their stories to the media, at public forums and in legislative hearings. These courageous clients have reminded us that bearing witness against injustice is most essential at those very moments when justice seems most distant. We have been determined to stand with them in educating the public about how the current system betrays our national commitment to justice and equality.

But now, with health reform at the fore, we see glimmers that even work done without hope of tangible return may sometimes touch others in ways that matter. One of several clients who died needlessly in 2005, in the wake of TennCare purges that TJC slowed but could not stop, was a beautiful, vivacious young woman from Bristol named Nikki White. Her life-threatening lupus went untreated after she was cut from TennCare. Her doctor wrote sadly that, “Nikki died of complications of the failing American health care system.” It is too painful to imagine what her parents have suffered. Can injustice ever be crueler than when it costs your child’s life? Can justice ever feel more remote?

After Nikki died, I spoke to a reporter who interviewed Nikki’s parents and wrote a gripping account of Nikki’s death for the Wall Street Journal. Her story made an impression on T.R. Reid, who included it in his influential book, The Healing of America. In recent months, the story has been repeated in columns and editorials, cutting through the acrimony and political posturing to remind us all of what matters.

We don’t know at this point if there will be real health reform or, if there is, how to measure the impact of Nikki’s story. But surely her courageous parents have moved hearts and minds by their selfless desire to save others the pain they have suffered, and by their unflagging faith that America can be more just.

It is a privilege for TJC to serve such clients, and to work for the ideals we all hold dear. Please continue to be an indispensible partner in our work for justice. Thank you.

Sincerely yours,

Gordon Bonnyman
Executive Director

Wednesday, November 11, 2009

Health Care Story of the Week - 11/11/09



Terrell, age 3, has pulmonary hypertension, congestive heart failure, and is ventilator dependent. Though Terrell’s weak immune system confines him mostly to his home, he loves sitting in his backyard. His heart and lung problems prevent him from running around, but he still enjoys the sunshine. He is a bright boy, already learning to write his name and count.


At age 18 months, as Terrell was becoming more independent, his doctor ordered a special wheelchair for him. However, Irene, his grandmother, had to fight for seven months to obtain the wheelchair, although by federal law, children on TennCare like Terrell should receive all the medical care they need. In her fight to obtain the medical services that Terrell needed, Irene also spoke for many other parents struggling to receive care for their children.

Seven months after the doctor’s prescription for a wheelchair was submitted, Terrell still had not received his new chair. Terrell’s mobility was limited without the medical device the doctor ordered. It was impossible for Irene to lift Terrell, along with his oxygen tank and ventilator, suction machine, battery, and medicines – the equipment alone weighed more than 100 pounds – without the special wheelchair. Lacking the wheelchair, Terrell had been late to doctor’s appointments, and the family was increasingly desperate.

At this point, Irene called the Tennessee Justice Center. The TJC worked with her to write a letter of appeal to the state’s attorney. A few days later, Terrell was measured for his wheelchair, and soon it arrived. Irene said, “When all this started, I didn’t know where to go or who to turn to. With TJC on my side, I was able to stand up for Terrell and get him the care that his future depends upon. Having TJC helping me get things done really relieved a lot of stress.”

Thursday, November 5, 2009

Health Care Story of the Week - 11/5/09


Bradley is dependent on a ventilator and a feeding tube. He cannot talk or move; he sits in a wheelchair during the day. Bradley relies on eye gazes to communicate.

Suzette, his mother, explains: "Bradley has not spoken any verbal words in his thirteen years, but his life has spoken volumes of his zeal to live. Despite his physical disabilities, Bradley loves to play basketball, attends school with his friends, and enjoys walking the dog and watching cop videos with his Dad. His perseverance, strength and courage, gives us the motivation to provide him with the best care that we can."

Bradley's father, Barry, works full time and his company provides health insurance for the family. However, in June 2006, the insurance company told the family that Bradley had exhausted his lifetime limits.

With Bradley’s continuing intensive medical needs, and no private insurance, the family was fortunate to have TennCare to rely on as a safety net for Bradley. However, after becoming exclusively reliant on TennCare, bills began to arrive. Children receiving TennCare benefits are not supposed to receive bills from providers. More and more of the illegal bills continued to arrive. The family talked with the hospital and with doctors, trying to assert their rights, however, they were tangled in billing bureaucracy. Worried about the mounting bills and the impact they might have on her son’s medical care and her family’s future, Suzette contacted the Tennessee Justice Center for help. After receiving letters from the Tennessee Justice Center, TennCare acted and notified the family that they were not liable for the bills.

However, Bradley and his family, as well as thousands of other Tennessee families face new hurdles. Pending changes to TennCare mean that Bradley could lose his TennCare coverage. Without TennCare, his family could be in very serious trouble, facing tremendous medical care challenges for Bradley and overwhelming financial problems.

Suzette said, "The work that the Justice Center does on behalf of the medically fragile children of Tennessee is greatly appreciated by our family and other families across the State...they have stepped in and become our advocate in the billing process for Bradley. This has removed the worry of billing and given us the time to focus on what is important - Bradley’s care."

Monday, November 2, 2009

TennCare stories in the media

Rebekah Hearn’s October 31st article, “TennCut: Why the state Medicaid program is slashing services to thousands of disabled people” tells the stories of 3 severely disabled Tennesseans whose lives depend on a program that is doing everything it can to exclude them.  The article includes several beautifully shot, intimate photos by Lance Murphey.  According to Ms. Hearn, about 84,000 Tennesseans have lost their TennCare coverage since cuts began earlier this year.  Below is a brief summary of the article.  The full article can be found at by clicking this link, and it truly is well worth the read.

“Thyroid disease, congestive heart failure, blood clots, anemia, and rheumatoid arthritis are just some of the health problems Memphian Ann B. wakes up to every day,” writes Ms. Hearn.  Since Ms. B. lost her TennCare coverage, TJC and her primary care physician have helped her apply for assistance.  Even with help from the Partnership for Prescription Assistance, Ms. B. is unable to pay for all the medicines she needs.  Losing TennCare coverage was, “like a sentence to die,” said Ms. B.  “I mean, if I don’t take my medicine, I’m dead.”

Brandon Byrd also faces the possibility of losing coverage.  At age 24, Mr. Byrd became a tracheotomy-dependent quadriplegic when he fell off a trampoline while playing with his children, ages 5 and 11.  Mr. Byrd requires constant care to keep his tracheotomy from clogging, which could be fatal.  If Mr. Byrd loses coverage, he will be forced into a nursing home, where his “quality of care will go down,” said one healthcare worker.  “They can’t make me go,” said Mr. Byrd. “I would stay at home as long as I could. I probably wouldn’t make it any longer than a week and a half. But I don’t want to go live in a place that could be even worse than prison, where I can’t even see my kids.”

Jacqueatha Philips was born with spina bifida, and needs catheterizations and help taking her medications.  Her mother, Linda Fann, became a certified Personal Assistant (PA) so that she could care for her daughter.  When TennCare tried to cut Ms. Philips’s in-home care, she appealed.  At the hearing, Ms. Fann argued that she was actually saving TennCare money by becoming a PA.  The judge agreed, and said Ms. Philips could keep her in-home care.  But TennCare overruled the judge’s decision and reduced her care anyway.

Ms. Hearn indicated that the healthcare situation for low-income Tennesseans will probably get worse before it gets better:  CoverKids, a program that covers low income children and pregnant women, will stop accepting new enrollees Nov. 30 despite increased federal matching funds. TennCare is also putting American Recovery and Reinvestment Act money into the reserves even though federal law requires that it be spent right away.

Jane Beasley Receives Award from Mayor’s Advisory Committee for People with Disabilities


TJC's latest press release, regarding senior paralegal Jane Beasley's recent award!



Jane Beasley, senior client advocate and paralegal at the Tennessee Justice Center (TJC), has received the Professional Award from the Mayor’s Advisory Committee for People with Disabilities in recognition of her work in improving and enhancing the lives of people with disabilities. The award was presented to Beasley during an awards ceremony and reception held at the Frist Center in Nashville.


“I am truly honored to receive this award. It is a privilege to be an advocate for our disabled clients, who often cannot speak on their own behalf,” said Beasley. “Their courage and persistence is inspiring to me and everyone at the Tennessee Justice Center.”

Beasley joined TJC in 1998. She is an expert in the complex rules of eligibility for public programs, and assists disabled and sick clients who need help with TennCare and Families First. She also advocates on behalf of clients who have lost their benefits. Prior to joining TJC, Beasley was the coordinator of the Insurance Counseling and Assistance Program at the Legal Aid Society of Middle Tennessee, assisting clients on issues surrounding Medicare, TennCare, long-term health insurance, and Medicare supplement policies.

“Jane has improved life for thousands of Tennesseans with disabilities,” said Gordon Bonnyman, executive director of Tennessee Justice Center. “In some cases, she has enabled people to obtain medical care that they credited with saving their lives. Her advocacy for individuals and her contributions to systemic reforms have helped countless Tennesseans with disabilities maintain or enhance their independence.”

Since 1981, the Mayor’s Advisory Committee for People with Disabilities has presented awards of recognition to outstanding individuals whose efforts have enhanced the lives of those in the disability community in Nashville. Awards were presented in 13 categories this year.

The Tennessee Justice Center (TJC) is a non-profit public interest law and advocacy firm serving Tennessee’s families. It gives priority to policy issues and civil cases in which the most basic necessities of life are at stake and where advocacy can benefit needy families statewide. TJC works to empower its clients by holding government accountable for its policies and actions. TJC was established in 1996 and is located at 301 Charlotte Avenue, Nashville, TN. For additional information about the Tennessee Justice Center and its services, visit www.tnjustice.org or call 615-255-0331.