On May 18th, HLA took action to address a barrier to health care that has plagued our system for far too long: inaccurate health plan provider directories. HLA and our fellow members of the Children’s Mental Health Campaign (CMHC) submitted extensive comments urging the state’s Division of Insurance (DOI) to strengthen its proposed regulations requiring accuracy in provider directories.

HLA’s Senior Supervising Attorney Wells Wilkinson leads HLA’s focus on access to health care for consumers with private health insurance and mental health parity. Wells led the drafting of the CMHC’s comments along with Health Care For All’s Behavioral Health Policy Director Suzanne Curry and former Co-Director of Policy Alyssa Vangeli.

Wells also led HLA’s advocacy, again in partnership with HCFA, to support the passage of the 2019 law that requires health insurance carriers’ provider directories to be accurate and frequently updated, and also authorizes the DOI to issue the regulations enforcing the statute that HLA weighed in on last week. In addition, Wells represented the CMHC on a Provider Directory Task Force created by the 2019 law and convened by the DOI to provide recommendations for the regulations. The Task Force included representatives from various health care system stakeholders in addition to consumer advocates, such as health plans, health care providers, and employers.

Subscribers to The Docket have read before about HLA’s Medical-Legal Partnership for Immigrants (MLPI), our collaboration with The Rian Immigrant Center and hospital and health center partners. In the program, our health care provider partners refer immigrants with pressing health care needs to HLA and Rian attorneys for legal representation to help them overcome steep systemic barriers to health insurance coverage and the immigration process. The program significantly improves the health and financial stability of our clients as well as other aspects of their lives.

We are happy to provide our readers with an exciting update on the MLPI. At the beginning of 2022, we launched two new sites of the MLPI – with Dana-Farber Cancer Institute and the Boston Health Care for the Homeless Program. HLA and Rian worked with our wonderful provider partners to adopt systems for identifying and referring patients for legal services. The program’s staff, which includes HLA Staff Attorneys Katherine Purrington and Alexandra Warren, and Paralegals Zachary Meade, Aashna Parikh and Shannon Sullivan, have also conducted numerous training programs for our provider partners and others on immigrants’ rights in the health care and immigration systems and how to address common pitfalls in these areas. We have already achieved very positive results for many of recent our MLPI clients.

From a health care access perspective, the MLPI specializes in representing immigrants facing health challenges who’ve been unjustly denied enrollment in health insurance coverage with comprehensive benefits. This is a very common occurrence for immigrants with low-income because the law and processes that guide MassHealth coverage for immigrants are highly complex, are often misunderstood, and stand in the way of immigrants receiving the coverage they’re actually eligible for.

In fact, partly due to the complexities in our health care system, immigrants in Massachusetts are five times more likely to lack health insurance, and therefore lack access to health care, than U.S. citizens. During the continuing pandemic, when immigrants are also at greater risk of becoming infected with COVID-19, this shocking rate of lacking insurance is especially alarming. Though we have made considerable progress reducing the number of immigrants in our state who are needlessly uninsured, or underinsured, our MLPI program fills a critical need.

By getting our MLPI clients onto comprehensive health coverage, we improve their lives in so many ways. They can access the health care they need. They have better health outcomes. They are protected from devastating medical debt. And with health and financial stability, they can have a better quality of life.

HLA's Immigrant Health Care Access Initiative is supported by the Massachusetts Legal Assistance Corporation, The Klarman Family Foundation, the Blue Cross Blue Shield of Massachusetts Foundation, the Nord Family Foundation, Jill Block and Wade Rubinstein, the Fish Family Foundation, The Clowes Fund, the Massachusetts Bar Foundation, and the MetroWest Health Foundation.

HLA’s Mental Health Advocacy Program for Kids’ (MHAP for Kids) mission is to help children overcome barriers to mental health care. The program’s 12 attorneys, each based in a different city around the state, and three paralegals have provided legal assistance to more than 720 families in the past year. Under the leadership of HLA’s Senior Director Marisol Garcia, MHAP for Kids also improves access to mental health services for kids by conducting dozens of training programs each year to promote this goal.

Over the past year, MHAP for Kids attorneys have conducted 70 trainings on a wide range of topics for groups ranging from about 10 to well over 100 attendees. Our MHAP for Kids trainings are designed to help all kinds of caretakers and child-serving professionals, including clinicians, gain the knowledge and skills needed to help children surmount obstacles to mental health care. Our trainings cover a variety of areas, reflecting the many areas of expertise of our MHAP for Kids staff, including several aspects of special education law, numerous juvenile court topics, health insurance coverage for mental health care, emergency department “boarding,” state agency services, and numerous others.

MHAP for Kids' statewide presence and service area has allowed us to provide frequent training programs in every part of the state for large and smaller local organizations. The program’s attorneys are based in Boston, Brockton, Everett, Fitchburg, Holyoke, Lawrence, Lowell, Lynn, New Bedford, Pittsfield, Quincy, and Worcester. Each works within one of the state’s Family Resource Centers, a network of neighborhood assistance agencies which are a program of the Department of Children and Families.

MHAP for Kids legal services and training programs are as critically needed as they have ever been due to the full-blown children’s mental health crisis in our state and country. More and more youth are experiencing mental illness as obstacles to mental health care grow under the strain of demand.

Pictured above: MHAP for Kids Senior Supervising Attorney Eliza Presson conducts a recent training for more than 100 clinicians from Boston Children’s Hospital on strategies for helping children “boarding” in hospitals, an ongoing aspect of the children’s mental health crisis in our state. Children “boarding” refers to those who come to a hospital in crisis and end up stuck in a bed there because there are not available services at the appropriate level of care. 

In recent months, Health Law Advocates has seen an influx of cases involving reduced or denied personal care attendant (PCA) services for MassHealth members. In addition to representing these clients in appeal hearings and advocating with their health plans, HLA Attorneys Andrew Cohen and Kara Hurvitz are also engaged in advocacy with MassHealth about patterns of issues that relate to systemic problems. A key request from HLA and our advocacy partners is to ensure members’ access to comprehensive and accurate evaluations of their care needs. One recent case exemplifies the need for this effort.

Kara’s advocacy was instrumental in addressing the initially inadequate evaluation for PCA services and demonstrated how this long-standing systems issue harmed the client. Because this problem is widespread within the PCA program, HLA continues to advocate, along with numerous allies, for improvements in the system to make it possible for people with disabilities “to keep their independence, stay in the community, and manage their own personal care” as the program is intended. Presenting individual cases like the one described here with regulators is central to our work representing consumers.

David Belfort, Bennett & Belfort

Nicholas V. Romanos, Foley Hoag

Jared L. Shwartz, Hinckley Allen

We are thrilled to spotlight HLA’s Pro Bono Paralegal, Karen Schwartzman. Karen is no stranger to HLA as she is a longtime generous supporter and has served on HLA’s Board of Directors. Her philanthropy and compassion know no bounds – not only has she served on HLA’s Board, but has also led the Board of Brighton-based DEAF, Inc. and was an active member of the Board of Pine Street Inn for 12 years.

As a Pro Bono Paralegal with HLA since February 2021, Karen has taken on responsibilities that have made her an integral part of our team. For many of our clients, she has been the first point of contact with HLA. She screens callers on our busy intake line, improving our response times, and schedules interviews with our Intake Paralegals. She aids with a variety of key administrative duties, perhaps most importantly, processing release forms that enable us to obtain our clients’ medical and other records. Additionally, Karen assists attorneys in their representation of our clients by calling medical providers and health insurers to gather key information, and drafting correspondence to clients, medical providers, and other parties. By taking on this invaluable work, Karen is helping our paralegals and attorneys work more efficiently and effectively to address our clients’ health access needs. Karen’s volunteer work has truly been a boon to HLA.

Save the Date!!! HLA's 27^th Annual Benefit Breakfast is on Friday, November 4, 2022 at the Sheraton Boston Hotel.

Mikaela Taberner (Chair of Rising Attorneys Events Committee), Beth Israel Lahey Health

Amara Anosike, Boston Children's Hospital

Jessica Beglin, Novartis

Anna Gurevich, Hinckley Allen

Marylana Saadeh Helou, Epstein Becker & Green

Sharon Jaquez, Ropes & Gray

Patrick Ouellette, Mintz Levin

Allie Shalom, Foley & Lardner

Vineesha Sow, Murphy Hesse

Steve Tringale, Husch Blackwell

We are happy to share our latest updates to our Diversity, Equity, and Inclusion (DEI) efforts that our DEI Committee and staff have been working on: