Fall 2017
The Docket
Quarterly Newsletter

Like us on Facebook

Follow us on Twitter

What's Inside...
  • A Message from the Executive Director
  • Client Profile: Eva
  • Staff Spotlight: Meet our New Class of Fellows and New Co-Op
  • Project Update: Immigrant Access to Health Care
  • MHAP for Kids - Major Development!
  • HLA Seeks Legal Director
  • Pro Bono Legal Network members earn major victories
  • Fellowship Opportunities at HLA
  • HLA Launches New Website
Staff Spotlights 
Welcome to our fantastic new class of fellows and new co-op!
Niya Mack
Niya is serving at HLA as the Boston University School of Law's N. Neal Pike Disability Rights Fellow. She received her JD from BU in May 2017. Previously, she graduated with honors and a Bachelor of Science in Public Health from Temple University. 

Before coming to HLA, Niya served legal internships with the Massachusetts Attorney General's Health Care Division, the U.S. Dept. of Health and Human Services General Counsel's Office in D.C. and in HHS's Region 1 General Counsel's Office in Boston. 

Also during her years at Boston University, Niya was Co-President of the Black Law Students Association and was a Litigation Summer Associate at Flaster Greenberg, P.C. in Cherry Hills N.J.

Sara Maldonado
Sara is an AmeriCorps Legal Fellow serving at HLA through the Massachusetts Legal Assistance for Self Sufficiency Program (MLASSP).
Prior to joining HLA, Sara served as a Health Law Fellow at the Center for Health Law, Bioethics, and Human Rights and as a legal intern with Greater Boston Legal Services and the City of Boston's Office of Fair Housing and Equity. 

Sara has a JD and Master's in Public Health from Boston University and graduated with dual bachelors degrees in Community Health and Latin American Studies from Tufts University. She serves clients at HLA in both English and Spanish. In law school, Sara was an editor for the American Journal of Law and Medicine 

William Rainsford

William is HLA's 2017-2018 Parmet Fellow. He comes to HLA with experience as a legal intern with Segal Roitman LLP, Justice at Work, Unite Here Local 26 and Greater Boston Legal Services.

At Northeastern University Law School, he was an editor of the Law Review and was a Lawyering Fellow in the Social Justice Program. Prior to law school. William was a Grassroots Marketing Representative for the New England Revolution soccer club.
William received his JD from Northeastern in May 2017 and has a Bachelors of Arts in English and Political Science from UMass-Amherst.

Kimberly Romero

Kimberly serves as HLA's Paralegal/Intake Coordinator through Northeastern University's co-op program. 

At Northeastern, Kimberly is a fourth year political science major. She also volunteers as a grant writer for the East Boston Community Soup Kitchen and Dance Complex, a non-profit dance studio.

Before joining HLA, Kimberly served a co-op placement in the office of Boston City Councilor Andrea J. Campbell where she resolved constituent matters and managed social media. 

As a fluent Spanish-speaker Kimberly performs bilingual intake and outreach duties for HLA.  
HLA Seeks 
Legal Director

Be a Leader in the Fight for Health Care Justice
HLA is conducting a search for a Legal Director. The Legal Director will lead the legal advocacy work of our team of committed and talented lawyers. This is an exciting opportunity for an attorney with an interest in developing and executing creative legal strategies to protect the rights of vulnerable Massachusetts residents. The strongest candidates will share our passion for public interest law, have the skills to thrive as a leader in a collaborative non-profit law firm, desire to be at the center of the action, and have a good sense of humor. See the full position description. Inquiries to HLA's Executive Director Matt Selig at selig@hla-inc.org are welcome.
 Public Interest Fellowship Opportunities!

HLA seeks recently admitted attorneys to serve as fellows. Recent or soon-to-be Northeastern University Law School graduates are eligible for HLA's Parmet Fellowship. We also host new lawyers participating in public interest fellowships sponsored by their law school, with the AmeriCorps Legal Advocates of Mass. programEqual Justice Works and other fellowship programs. Fellows serving at HLA gain invaluable legal experience while serving some of the most vulnerable members of our society and receiving mentoring from experienced attorneys. Please contact HLA's Executive Director Matt Selig if you wish to serve a fellowship at HLA.   
A Message from the Executive Director
Dear Friends, 

At HLA, we are as busy as I can remember. The team here is working incredibly hard to protect health care access during these tumultuous times. We are making progress. Maybe that's why those who have a different set of values, especially in Washington, are trying so hard to push back right now. 

I'm very happy to provide you with this update on HLA's work. It gives us a chance to tell you about some of the day-to-day legal work we do on behalf of our clients and the projects we undertake to tackle those health care barriers that stubbornly inhabit our system and block many of the most vulnerable among us from receiving the health care they need. 

All of us, on the staff and board of HLA, are grateful to you for your support of our work and the collaborations we have with many of you. 

Of course, I would be remiss if I didn't tell you how much we hope to see you at our 22nd Annual Benefit Breakfast coming right up on Tuesday, November 7th. The renowned political comedy troupe The Capitol Steps will provide the entertainment and you will see a lot of your favorite friends and colleagues there. Tickets are available here.
We hope to see you soon!

With appreciation, 
Matt Selig
Executive Director   
The Only Way to Her Doctors Was by Ambulance -  Coverage was Denied
A denial of non-emergent transportation leaves family facing a $36,000 ambulance bill

Five years ago, Eva was in a horrific car accident during her senior year of high school. The crash left Eva quadriplegic, blind, and prone to seizures. Since then, Eva's parents have advocated for their daughter to get the care she needs to survive.

Since 2012, Eva began traveling to Boston for medical appointments from her home on Cape Cod since there are no providers near where we lives that can give her the specialty care she needs. However, the trip to and from her doctors can be challenging. Problems occur when Eva is in her wheelchair in a van for an extended period of time because it increases the likelihood of her having a seizure when she is exposed to certain physical stimuli, such as movement, light, and changes in temperature. This makes conventional modes of transportation dangerous for Eva. Fortunately, her father's insurance was covering her ambulance rides so that if she were to have a seizure en route, she was already in a space equipped to keep her safe and treat her.

Recently, Ivan, Eva's father, received notice from his employer that his insurance coverage had changing. He was told that the ambulance service his daughter uses to travel safely to her medical appointments in Boston was no longer being covered. Ivan's private insurer denied six claims for non-emergent ambulance transport, and he received $36,000 in bills.

Ivan sent an appeal of the most recent denial to his health insurer. When he received an adverse decision, he contacted HLA. The case was assigned to Staff Attorney and Boston University Law School N. Neal Pike Disability Rights Fellow Lauren Bentlage.

Lauren reviewed the case and found that Ivan's insurance deemed the ambulance ride not medically necessary because Eva was physically able to sit in a wheelchair, but it ignored the medical and safety risks. However, several of Eva's doctors wrote letters confirming her need for non-emergent ambulance transportation, stating that van transportation exceeding 30 minutes could be fatal due to an increased risk of seizures and aspiration. Traveling from Cape Cod to Boston and back was a 120 mile trip and could take hours depending on traffic. Forcing Eva to sit in a van, without the proper equipment to address problems that could very well arise, was not only an irresponsible claim by the insurance company, but against policy, argued Lauren.

Lauren marshaled written testimony from Eva's health care providers, group home, and family describing Eva's condition and stating that without ambulance transportation, Eva's risk of fatality during travel notably increased. Armed with significant evidence and the language in the family's evidence of coverage, Lauren submitted an appeal to the state's Office of Patient Protection (OPP) which conducts independent review of health insurers' coverage decisions. 

The OPP agreed with Lauren's argument and found that her health insurer had improperly denied coverage for transportation to her specialty medical providers. All six claim denials were overturned, saving Eva's family $35,880 that they would have had to pay out-of-pocket.
Project Update: Protecting Immigrants' Health Care Rights
HLA steps up its efforts to protect immigrants amid increased oppression 

President Trump's anti-immigrant policies and rhetoric are preventing immigrants from receiving the health care they have a right to. HLA is leading efforts to fight back.

HLA has been a champion for health care access for immigrants for many years. Immigrants' rights are often targeted or overlooked, so it is essential that we remain vigilant. 
One critical area of focus for HLA right now is confronting the Trump Administration's oppressive tactics that are instilling fear among many immigrants in our community. Fear of detention and deportation, including among many immigrants lawfully present in the U.S., is preventing immigrants from visiting health care providers and enrolling in health insurance. 

A key part of our strategy is making sure immigrants and health care providers have the information they need about their legal rights, from trusted sources, so they know it's safe to access health care. HLA, Health Care for All and the Massachusetts Immigrant and Refugee Advocacy Coalition are collaborating to produce a Tool Kit that we will work with community leaders to promote. Partners HealthCare is providing targeted financial support for the Tool Kit.   The Fish Family Foundation, The Eastern Bank Charitable Foundation, Cambridge Health Alliance, the Blue Cross Blue Shield of Massachusetts Foundation, the Cummings Foundation, The Clowes Fund and many other individual and corporate donors have also provided HLA with generous support for HLA's advocacy on behalf of immigrants. 

HLA's Supervising Attorney Andrew Cohen heads up our Immigrant Health Care Access Initiative.  In the past few years, HLA attorneys have overturned more than 100 wrongful denials of health insurance enrollment in individual cases. We have also delivered more than 50 consumer education programs that have trained hundreds of advocates, medical providers and consumers on immigrants' legal rights to health care. HLA has also worked alongside more than sixty partner organizations in the Immigrant Health Care Access Coalition we founded to advance policy reforms and defeat bad policies to improve health care access for immigrants. Recently, we have worked with the state's Office of Medicaid to improve processes for enrolling low-income immigrants and submitted testimony to state and federal agencies strongly opposing a proposed state policy change that runs the risk of causing thousands of low-income legal immigrants to lose coverage.

Mental Health Advocacy Program for Kids 
To Receive Investment from the state's 
Dept. of Children and Families
HLA MHAP for Kids Senior Attorney Lisa Morrow and Director/Managing Attorney Marisol Garcia along with Essex County Juvenile Court Justices Garrett McManus and Kathryn M. Phelan-Brown (l to r) at the MHAP for Kids Back to School event at the Lynn Family Resource Center on Sept. 17.
HLA's Mental Health Advocacy Program for Kids (MHAP for Kids) is slated to receive an investment of $50,000 from the state's Department of Children and Families (DCF). The funding, approved by the state Senate on October 19, will create a public-private collaboration in support of the program which helps children with mental illness receive treatment and diverts them from juvenile court. 

MHAP for Kids embeds specially-trained attorneys in DCF's Family Resource Centers in Lowell and Lynn. These lawyers remove barriers to treatment for at-risk youth through advocacy with schools, state agencies, insurers and juvenile courts. 

A recent two-year 
i ndependent study
of the program by the Boston University School of Public Health found it is extremely effective. MHAP for Kids significantly: improves the mental health of children and parents, reduces truancy, improves family functioning and reduces children's need for emergency and inpatient treatment, thereby saving significant state resources, the study found.  

HLA is working to expand MHAP for Kids to additional Family Resource Centers throughout the state so many more children in need of treatment who are also at risk of court involvement can receive our valuable and cost-effective services.  

MHAP for Kids has been developed with the generous support of numerous funders. The Peter and Elizabeth C. Tower Foundation has been the program's lead funder. Additional generous funders have included The Klarman Family Foundation, the C.F. Adams Trust, the Blue Cross Blue Shield of Massachusetts Foundation, the Gardiner Howland Shaw Foundation, the Theodore Edson Parker Foundation, Boston Children's Hospital, Hagens Berman Sobol Shapiro, the John W. Alden Trust, the Ludcke Foundation, the Eastern Bank Charitable Foundation and the Bennett Family Foundation.

HLA's Pro Bono Legal Network in Action

Volunteer attorneys secure access to life-saving 
but prohibitively expensive medication for 3 children

Spinal muscular atrophy (SMA) is a rare, debilitating and sometimes deadly genetic disorder in children. Certain types of this condition affect very young children by weakening muscles used for standing and walking, and sometimes even sitting, swallowing and breathing. Recently a medication called Spinraza was approved by the Food and Drug Administration to treat SMA. However, the treatment costs hundreds of thousands of dollars per year, making it unaffordable and inaccessible for just about every family with a child that needs it, unless they have health insurance to cover the expense.

HLA Pro Bono Legal Network members Mala Rafik and Sarah Burns of Rosenfeld & Rafik, P.C., recently provided pro bono representation for three families with children suffering from SMA when their health insurers denied coverage for Spinraza. Mala also serves as President of HLA's Board of Directors.

Attorneys Rafik and Burns represented one family before the MassHealth Board of Hearings when their MassHealth managed care insurer declined to cover Spinraza for their young child. Due to their advocacy on this case, led by Attorney Burns, the Board of Hearings overturned the coverage denial. In another similar pro bono matter involving a family with a commercial insurance plan that denied coverage for Spinraza, Mala and Sarah provided consultation services during a successful appeal to the state's Office of Patient Protection. For a third family, Mala and Sarah successful negotiated a settlement with their health plan under which the insurer agreed to cover the Spinraza treatment and change its policy to allow for coverage of Sprinraza for children with SMA types II and III.

HLA is also working to make prescription drugs more affordable through policy advocacy. On July 11, Senior Staff Attorney Wells Wilkinson testified before the state legislature's Joint Committee on Health Care Financing in strong support of the Act to Promote Transparency and Prevent Gouging of Pharmaceutical Drug Prices, a leading priority of HLA's partner organization Health Care For All. This bill permits the state's Health Policy Commission to obtain actual manufacturing, research and advertising costs for excessively priced drugs.

HLA Launches New Website
We're very excited to unveil our new website! The new design allows visitors to easily navigate our different initiatives, connect with HLA in a modern, streamlined way, and find resources that HLA produces to better educate consumers and advocates.  
As our health care system changes, so do the barriers to care that consumers encounter. At HLA, we have long worked to identify and overcome these new obstacles. Our old website did not exactly represent the cutting-edge work we do, day in and day out. We're pleased to now have a web-presence that conveys HLA's pioneering work, both in form and function. 
The new site was made possible by generous grants from the Boston Foundation and the Blue Cross Blue Shield of Massachusetts Foundation.  
We encourage you to take a look, click around, and please let us know how we can improve!