Georgia's Trusted Healthcare
& Medical Provider Attorneys

Archives for January 2016

29th Annual FOCUS Education Conference Today

FOCUS If you’re going to FOCUS’ 29th Annual Education Conference today, please stop by and say hello!

We’ll be sharing information about how to appeal Katie Beckett denials and special needs trusts.

Dunwoody United Methodist Church
1548 Mt. Vernon Road, Dunwoody, Georgia

8 a.m. to 3 p.m.

Learn More

Georgians With Developmental Disabilities “Shortchanged”

Developmental DisabilityGaps Remain In Community Support Services

Six years after their 2010 settlement agreement that addressed Georgia’s treatment of people with mental illness and developmental disabilities, the State and the US Department of Justice still cannot agree on what exactly that means.

Under part of the 2010 settlement, Georgia must improve care for individuals with mental illness and developmental disabilities. This includes moving these individuals into community settings when appropriate. There are annual reports filed with the court from an independent reviewer about the progress of the settlement.  According to the most recent report, Georgia still has gaps in services and waiting lists mean community integration has not been fully realized.

U.S. Supreme Court Orders Community Integration

Georgia’s compliance with the 2010 settlement will continue to be a contentious issue. A federal judge overseeing the execution of the settlement said, “The state of Georgia always has shortchanged people with mental illness.” Georgia was the focus of the Supreme Court’s 1999 ruling in Olmstead v L.C. In that case, the Court ruled individuals with mental illness and DD have a right to receive services in the most integrated community setting appropriate for their needs.

Most Applications For Assistance Initially Rejected

Despite the disagreement over what is required under the settlement, the 2010 settlement has helped many people move back or remain in their communities. This is thanks to the increased availability of Medicaid waivers. However, some disabled individuals and their families still get discouraged during the application process, especially if the application is initially rejected.

 We Can Help 

 Jeyaram & Associates has helped dozens of families get and keep support services for individuals with developmental disabilities even after an initial rejection. For more information, contact Jonathan Anderson at  janderson@jeylaw.com.

 

Wills, Trusts, & Estate Planning Client Feedback

Wills, Trusts, Estate PlanningWe love hearing from our clients. We truly believe in spending time with our clients to help them find solutions that best meet their needs.

Here’s a few reviews from some of our clients who we helped set up traditional wills, trusts and estate plans.

“Values Family”

“DJ was extremely helpful in the creation of our will/trust. It was easy to see how much he values family, and he gave us confidence and peace of mind by making a complicated and often difficult process feel manageable.

He was professional yet very personable and made sure that we understood all of the language of the documents. He gave us adequate time and never rushed us throughout the entire process making sure that we had time to think through all important decisions.

He gave us everything we would need to give to all those involved and a very organized presentation of all of our documents to keep.

DJ was wonderful to work with, and I would recommend him to anyone.” – C. Oddi

Originally posted on Google+ 

“Kind and Patient”

“DJ and his team were so wonderful in helping me coordinate my father’s final will, power of attorney and medical directive. The team was kind and patient, explaining all of the steps involved, and assisting with developing the final documents.

As my father was battling a terminal illness, much of our communication was over email. They were very responsive and managed everything with such care.

It was a difficult time in both my Dad’s and my life, but DJ and the team allowed us to check off that box in the process of ‘things to get done,’ so we could focus on the more important things, like spending those last days together.” – L. Efman (sent via email)

“Solid Advice”

“Jeyaram & Associates is outstanding. I can’t say enough good things about DJ Jeyaram. My husband and I needed to create a fairly complicated will. We have multiple properties, 2 children, and 4 grandchildren.

DJ gave us very solid advice. We are so happy he helped us achieve a perfect solution to the distribution of our estate. We’ve already recommended him to several of our friends. Thank you DJ.” – P. Javazon (sent via email)

Contact Us

Need help setting up a will, trust or estate plan? We’re more than to help. Contact DJ at DJ@Jeylaw.com or 678-325-3872.

 

Are You Compliant? HHS Issues Guidance & Likely To Continue HIPAA Compliance Scrutiny

HIPAA AuditThe Department of Health and Human Services (HHS) started the year by publishing new HIPAA guidance with respect to patient access to medical records.

While the recent HHS guidance does not add anything new to the regulations, it serves as a reminder to providers of certain provisions in the law. The guidance is intended as a tool to aid individuals in exercising their rights to access their medical records and to help providers ensure HIPAA compliance.

HHS highlighted certain provisions in the HIPAA regulations including provider obligations to respond to a request from a patient within 30 days and provide PHI in an electronic format if requested (assuming the electronic format requested can be readily produced by the provider).

The guidance also reminds providers that covered entities are not required to provide every single record about an individual even if the individual asks. Certain exceptions to a patient’s right to access include:

  • Patients do not have the right to access to information that is not used to make decisions about that individual. For example, certain quality assessment or improvement records, patient safety activity records, or business planning, development and management records that are used for business decisions do not have to be provided to an individual.
  • Individuals do not have a right to access psychotherapy notes that a mental health professional maintains separately from the individual’s medical record and that document or analyze the contents of a counseling session with the individual.
  • Providers can deny access to certain records if a licensed health care professional determines in the exercise of professional judgment that the access requested is reasonably likely to endanger the life or physical safety of the individual or another person.
  • Patients do not have a right to access certain records compiled in reasonable anticipation of, or for use in, a legal proceeding.

Additionally, providers do not have to create new information, such as explanatory materials or analyses, that does not already exist in the record.

The government’s emphasis on HIPAA is expected to continue with pending audits of covered entities and business associates likely to take place this quarter. Now is the time for healthcare providers to review their policies to ensure that they are complying with the HIPAA regulations.

If you would like to review the HHS guidance it is available at http://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html.

If you need help ensuring HIPAA compliance, please contact Danielle Hildebrand at dhildebrand@jeylaw.com or 678.325.3872.

 

 

Champion Change for Special Needs Children: Sign the Katie Beckett Petition

Katie Beckett PeitionIn the early 1980’s a little girl named Katie Beckett was only 3 years old and suffering from a viral brain infection she caught a 5 months old that left her fighting for her life and permanently disabled. Her parents insurance was capped at one million dollars and they quickly surpassed that. Medicaid began covering her hospital stay. She was in the hospital for 3 years before her condition improved to where going home was even a possibility. BUT they faced a huge obstacle. While in the hospital Medicaid covered Katie’s needs. At home, her parents would not qualify. Her parents could not afford her care.

The dire situation of Katie Beckett got the attention of President Ronald Reagan. He too saw the absurdity. Her hospital stay was costing taxpayers more than providing Medicaid to her parents so they could provide her treatment at home. In 1981 Katie Beckett’s family was the first to receive the soon called Katie Beckett waiver and a week before Christmas Katie finally left the hospital with her new doll from the Reagan family in tow. In 1982 it was expanded to be a state plan option provision under Medicaid.

More than 30 years later, it is children in GA that now need help. Children who, like Katie, are severely affected by cognitive, developmental and physical disabilities. These children are in danger of losing the help they NEED and becoming wards of the state and institutionalized if they cannot receive the help their parents need to care for them at home. It is highly likely that Katie Beckett herself would not qualify for the waiver named after her if she were a child today living in the state of Georgia. Currently GA families are facing an unreasonable tightening and reevaluation of the requirements for those children receiving the Katie Beckett Medicaid Deeming Waiver.

The requirements are now stating that therapy/ nursing must be received 5 DAYS a week. While this requirement might not seem extreme, if enforced to this exact interpretation, thousands of children needing help would be denied and thousands of families would be forced with the agonizing decision of ripping apart their families and having their beloved children institutionalized in hospitals at great expense to the taxpayers of the state of Georgia. There is a provision in the guidelines that states that children with disabilities qualify regardless of ability to participate in therapy if they meet certain psychological testing guidelines.  This provision is being overlooked and children are routinely being denied. What are some of the problems?

NURSING:

  • It is very hard for families of medically fragile children to qualify and/or afford in-home nursing care for their children. In fact, the Department of Community Health is removing access to nursing care of these medically fragile, vulnerable children.
  • The majority of private insurance companies do not cover in home, private duty nursing care. In many instances, there are not enough nurses to staff the hours and days, particularly for highly specialized care.
  • A parent may choose to become their child’s unpaid 24/7 nurse for their child after being trained and given oversight by qualified personnel. Because they do not have “skilled nursing hours” they can be denied Katie Beckett with these stricter requirements.

THERAPY:

  • A parent may receive a prescription for therapy 5 or more sessions a week from their doctor which is the amount of therapy that is medically necessary for the child. Many times it is impossible for children to be able to receive it. Lack of availability of therapists and therapy centers.
  • There are not enough therapy centers or therapists to accommodate the growing list of children who now need 5 sessions of therapy a week in order to keep the Katie Beckett Deeming Waiver.
  • If a parent is lucky enough to find such a center, there is then usually a wait list for afternoon hours. Many children attend school during the day and many parents try to have therapy later in the day so the child misses the least amount of school.
  • Most primary insurance plans have limitations on amount of therapy or what type is covered. Many families cannot afford it and may not be enrolled in therapy when they apply for Katie Beckett. Medicaid rarely covers five days per week of therapy for any child, even the most severe.
  • Lack of therapy services and providers in the school setting. Across the state, the majority of children receiving therapeutic services at school through their IEPs are enrolled in group therapy. Many schools only offer this due to limited funding, time, and staffing. While there is NOTHING in the Medicaid guidelines stating that this type of therapy cannot be provided or counted, they are now not being allowed to count this as a session of therapy by the state of Georgia. Furthermore, the majority of these children are not able to continue their therapies at school over the summer and are getting penalized as not having enough therapies because of this.
  • Only physical, occupational, and speech therapies are being counted as counted therapies. This excludes other medically researched, peer reviewed proven therapies like Applied Behavioral Analysis (ABA) and music therapy that have greatly improved the quality of life and health of these children.
  • Stamina and health issues of medically fragile children: Some children are too immune compromised to attend a therapy center and/or miss therapy frequently due to hospitalizations, illnesses, medical procedures/appointments.
  • Many parents do not have the means to safely transport their medically complicated or child with severe physical disabilities 5 sessions a week, and parents have had an extremely difficult time finding therapists to come to their homes. They will be DENIED Katie Beckett for this reason.

Please help us to send a clear message to our lawmakers in GA, that we must help these children who cannot help themselves. Without this waiver, more children will be placed in the care of the state of Georgia and be placed in institutions at a cost that can be six times the cost of caring for the child at home which Georgia taxpayers will be paying!

The state of Georgia will be forced to place many of these children in pediatric facilities like Children’s Healthcare of Atlanta for long-term care creating a bed shortage, and ANY sick child across the state of Georgia will suffer due to a lack of treatment space. This policy will cost the state of Georgia more in the long run than any savings it may gain in the short term!

Please sign this petition and let us remind our Governor, Representatives, and those who oversee the Katie Beckett Medicaid Deeming Waiver that this vulnerable population of children matter. We must be the voice of these children who are unable to speak for themselves.

LETTER TO
Governor of Georgia Governor Nathan Deal (Governor of Georgia)
Chair Health & Human Services – Georgia House of Representatives Representative Sharon Cooper
Georgia House of Representatives Speaker Representative David Ralston
and 15 others
Leutenant Governor of Georgia Leutenant Governor Casey Cagle
Chair Senate Health and Human Services Committee Senator Renee Unterman
Department of Community Health – Office of Communications & Legislative Affairs Janice Abrams
Department of Community Health – Office of Communications & Legislative Affairs Jeremy Arieh
Department of Community Health – Director, Office of Communications and Legislative Affairs Lisa Marie Shekell
Department of Community Health – Constituent Services Constituent Services
CBS 46
WSBTV
Atlanta Business News – Atlanta Business Chronicle
AJC
Fox 5 News
11 Alive News
Newnan Times Herald
Georgia Advocacy Office
Children’s Healthcare of Atlanta CHOA Social Media

Please help Georgia’s children with disabilities and preserve the Katie Beckett Deeming Medicaid Waiver created by President Ronald Reagan! These children are in danger of losing the help they NEED and becoming wards of the state and institutionalized if they cannot receive the help their parents need to care for them at home. It is highly likely that Katie Beckett herself would not qualify for the waiver named after her if she were a child living in Georgia today. Currently GA families are facing an unreasonable tightening and reevaluation of the requirements for those children receiving the Katie Beckett Medicaid Deeming Waiver. Without this waiver, more children will be placed in the care of the state of Georgia and be placed in institutions at a cost that can be six times the cost of caring for the child at home which Georgia taxpayers will be paying! The state of Georgia will be forced to place many of these children in pediatric facilities like Children’s Healthcare of Atlanta for long-term care creating a bed shortage, and ANY sick child across the state of Georgia will suffer due to a lack of treatment space. This policy will cost the state of Georgia more in the long run than any savings it may gain in the short term! Please fix this problem started by President Reagan for the sake of these children and the taxpayers of Georgia.