TENNESSEE JUSTICE CENTER INC

TJC PROVIDES LEGAL REPRESENTATION AND ADVOCACY FOR INDIVIDUAL CLIENTS AND ON BEHALF OF LARGE GROUPS OF VULNERABLE, LOW-INCOME TENNESSEANS. DURING 2023, TJC HANDLED 1,753 CASES FOR VULNERABLE CLIENTS IN THE RESOLUTION OF THEIR LEGAL PROBLEMS, SOME OF WHICH INVOLVED ADMINISTRATIVE APPEALS PROCEDURES OUTSIDE THE JUDICIAL SYSTEM. TJC ALSO ADVOCATES FOR IMPROVED ADMINISTRATION OF JUSTICE IN GENERAL SESSIONS COURT BY CREATING RESOURCES AND PUSHING REFORMS THAT MAKE THIS COURT MORE ACCESSIBLE TO UNREPRESENTED INDIVIDUALS. TJC CONDUCTED TRAINING FOR PRIVATE ATTORNEYS TO ENABLE THEM TO HANDLE SUCH APPEALS ON A PRO BONO BASIS. THESE CASES SERVED THE PUBLIC BY PROMOTING THE RULE OF LAW BY HOLDING GOVERNMENT PROGRAMS AND CONTRACTORS ACCOUNTABLE FOR COMPLIANCE WITH THE LAW, AND BY AFFORDING ACCESS TO EQUAL JUSTICE UNDER LAW TO INDIGENT CLIENTS WHO WOULD NOT HAVE OTHERWISE BEEN ABLE TO VINDICATE THEIR LEGAL RIGHTS. TJC ALSO PARTNERED WITH HEALTHCARE PROVIDERS THROUGH TRAINING, TECHNICAL ASSISTANCE, AND MEDICAL-LEGAL PARTNERSHIP TO HELP THEIR PATIENTS ACCESS NECESSARY COVERAGE, AVOID MEDICAL DEBT, AND SUPPORT THE HEALTHCARE INFRASTRUCTURE ON WHICH ALL TENNESSEANS DEPEND. IN ADDITION TO THOSE SERVICES, THE ORGANIZATION LITIGATED THE FOLLOWING CASE IN THE JUDICIAL SYSTEM IN 2023:A.M.C. V. SMITH (TENNCARE DISENROLLMENT): THIS LAWSUIT WAS FILED ON MARCH 19, 2020. IMMEDIATELY AFTER THE CASE WAS FILED, FEDERAL COVID RELIEF LEGISLATION REQUIRED STATES TO SUSPEND ALL TERMINATIONS OF MEDICAID COVERAGE WHILE THE FEDERAL DECLARATION OF A PUBLIC HEALTH EMERGENCY (PHE) REMAINED IN EFFECT. THIS LASTED UNTIL APRIL 2023, WHEN REDETERMINATIONS BEGAN AGAIN. TENNCARE OFFICIALS HAVE SAID THAT THEY EXPECT TO TERMINATE 400,000 CHILDREN AND ADULTS OVER A 12-MONTH PERIOD. THE COURT CERTIFIED A PLAINTIFF CLASS CONSISTING OF "ALL INDIVIDUALS WHO, SINCE MARCH 19, 2019, HAVE BEEN OR WILL BE DISENROLLED FROM TENNCARE, EXCLUDING INDIVIDUALS, AND THE PARENTS AND LEGAL GUARDIANS OF INDIVIDUALS, WHO REQUESTED A WITHDRAWAL FROM TENNCARE." AFTER DENYING THE STATE'S MOTION FOR SUMMARY JUDGMENT ON OCTOBER 18, 2023, THE COURT CONDUCTED A FIVE-DAY TRIAL BETWEEN NOVEMBER 14TH AND 20TH. BRIEFING ON THE CASE CLOSED IN APRIL 2024 WITH THE COURT'S DECISION ANTICIPATED IN THE LATE SUMMER OF 2024.MCCUTCHEN V. BECERRA (BLOCK GRANT): IN JANUARY 2021, WITH THE TRUMP ADMINISTRATION NEARLY OUT OF OFFICE, CMS APPROVED TENNESSEE'S AMENDMENT CONVERTING TENNCARE TO A BLOCK GRANT FOR TEN YEARS. IN MARCH 2021, TJC AND THE NATIONAL HEALTH LAW PROGRAM (NHELP) FILED SUIT ON BEHALF OF SEVERAL TJC CLIENTS, A CROSSVILLE PEDIATRICIAN AND ON TJC'S OWN BEHALF AS A PLAINTIFF. WE SUED CMS FOR IMPROPERLY APPROVING THE WAIVER, AND TENNESSEE HAS INTERVENED AS A DEFENDANT. ON JUNE 30, 2022, CMS SENT A LETTER TO TENNCARE ASKING IT TO AMEND ITS BLOCK GRANT PROPOSAL TO REMOVE ITS DRACONIAN PRESCRIPTION DRUG COVERAGE LIMITS AND TO REMOVE THE BLOCK GRANT FUNDING MECHANISM PORTION ESSENTIALLY. AS AMENDED, THE WAIVER STILL ALLOWS THE STATE TO WITHHOLD RETROACTIVE COVERAGE FROM MOST ELIGIBLE TENNCARE ADULTS. UNFORTUNATELY, CMS APPROVED THE TENNCARE III WAIVER AS AMENDED BY THE STATE. THE CASE IS NO LONGER STAYED AFTER FEDERAL APPROVAL OF THE AMENDED TENNCARE III WAIVER. WE, ALONG WITH OUR CO-COUNSEL, THE NATIONAL HEALTH LAW PROGRAM, WILL FILE AN AMENDED COMPLAINT THAT WILL FOCUS ON PLAINTIFFS WHO STAND TO BE AFFECTED BY THE REMAINING COMPONENTS OF THE WAIVER, NAMELY THE LACK OF RETROACTIVE COVERAGE AND THE 10-YEAR DEMONSTRATION PERIOD.M.A.C. V. SMITH (DIDD HOME CARE): ON JULY 2, 2021, TJC'S LITIGATION TEAM FILED A LAWSUIT CHALLENGING THE INEQUITIES ASSOCIATED WITH TENNCARE ENROLLEES' HOME CARE AS PART OF THE DIDD WAIVER, FOR PEOPLE WITH INTELLECTUAL DISABILITIES. AFTER DISCOVERY BEGAN, THE PARTIES REACHED A SETTLEMENT, WHICH THE COURT APPROVED. WE SETTLED THE CASE AND SUCCESSFULLY ADDED ADDITIONAL INTERVENORS WHO WILL BENEFIT FROM THE SETTLEMENT TERMS OBTAINED IN THE LAWSUIT. THE COURT FOUND THAT WE WERE A PREVAILING PARTY AND AWARDED US ATTORNEY FEES OF $348,140 PLUS $2,434.30 IN MEDIATION COSTS.GLOVER V. SMITH / STAGGS V. SMITH / BLAKE V. SMITH (INSTITUTIONAL MEDICAID EFFECTIVE DATE): ON AUGUST 9, 2022, AND NOVEMBER 28, 2022, WE APPEALED TWO ADMINISTRATIVE RULINGS CONCERNING THE EFFECTIVE DATE OF OUR CLIENT'S INSTITUTIONAL MEDICAID COVERAGE. INSTITUTIONAL MEDICAID IS A SPECIAL CATEGORY THAT COVERS PEOPLE WHO REQUIRE MORE THAN 30 DAYS OF CARE IN A MEDICAL INSTITUTION. FEDERAL LAW HAS A SPECIFIC PROVISION ON INSTITUTIONAL MEDICAID THAT REQUIRES THAT THE START DATE OF COVERAGE BEGIN ON THE FIRST DAY OF THE 30-DAY CONFINEMENT PERIOD IN AN INSTITUTION. TENNCARE RULES CONFLICT AND HOLD COVERAGE DOES NOT START UNTIL THE 30TH DAY OR DATE OF APPLICATION, WHICHEVER IS LATER, WHICH LARGELY DEFEATS THE PURPOSE OF THE FEDERAL PROTECTIONS, WHICH ARE THERE TO PROTECT PATIENTS FROM CATASTROPHIC EXPENSES. ON MAY 8, 2023, CHANCELLOR RUSSELL PERKINS RULED IN OUR FAVOR IN STAGGS V. SMITH. AS PART OF THE DECISION, THE COURT FOUND THAT WE WERE A PREVAILING PARTY AND AWARDED $18,000 IN FEES IN STAGGS. CHANCELLOR MYLES, WHO PRESIDED OVER THE GLOVER CASE, ASKED US TO SUBMIT A FEE PETITION, WHICH WE ARE IN THE PROCESS OF PREPARING. STATUS: WE RECEIVED FAVORABLE RESULTS FROM THE DAVIDSON COUNTY CHANCERY COURT ON BOTH STAGGS AND GLOVER ON THE SAME ISSUE. WE RECEIVED AN ADVERSE RULING FROM TENNCARE'S ADMINISTRATIVE JUDGE ON THE SAME ISSUE IN BLAKE V. SMITH AND MAY FILE A THIRD APPEAL ON THIS ISSUE. REVERSAL OF THE STATE RULE WOULD BENEFIT MORE THAN A THOUSAND FAMILIES EACH YEAR.

TJC'S MEDICAID, INDEPENDENCE AND CHILDREN'S HEALTH ADVOCACY PROGRAMS FOCUS ON IMPROVING THE WELL-BEING OF TENNESSEANS, PARTICULARLY THOSE WHO ARE VULENERABLE AND HAVE LOW INCOME, BY ENSURING ACCESS TO AFFORDABLE HEALTHCARE COVERAGE. TJC IS CURRENTLY LEADING A STATEWIDE CAMPAIGN TO GET THE TN LEGISLATURE TO EXPAND TENNCARE. TJC ENGAGES ORGANIZATIONAL PARTNERS AND GRASSROOTS VOLUNTEERS TO CONTACT TN LAWMAKERS TO ASK THEM TO DRAW DOWN $1.4 BILLION/YEAR IN FEDERAL HEALTHCARE FUNDING IN ORDER TO PROVIDE HEALTH INSURANCE TO 300,000 TENNESSEANS (INCLUDING 24,000 VETERANS), GENERATE 15,000 JOBS, PROTECT THE STATE'S RURAL HOSPITALS, AND PROVIDE MUCH-NEEDED FUNDING TO ADDRESS THE OPIOID EPIDEMIC.TJC'S INDEPENDENCE PROGRAM AIMS TO ENSURE SENIORS AND ADULTS WITH DISABILITIES RECEIVE THE SUPPORT THEY NEED. TJC HELPS INDIVIDUAL CLIENTS, PROVIDES TRAINING SESSIONS TO HEALTH CARE AND SOCIAL SERVICE PROVIDERS, AND ADVOCATED FOR SYSTEMIC CHANGE TO PROGRAMS THAT ALLOW SENIORS AND ADULTS WITH DIASBILITIES TO LIVE WITH SAFETY, DIGNITY, AND INDEPENDENCE.ALSO AMONG TJC'S GOALS IS TO ENSURE THAT EVERY CHILD IN TENNESSEE IS ENROLLED IN HEALTH INSURANCE AND THAT PUBLIC HEALTH INSURANCE PROGRAMS WORK EFFECTIVELY TO MEET CHILDREN'S NEEDS. THE TEAM EDUCATES THE PUBLIC, POLICYMAKERS, AND COMMUNITY LEADERS ABOUT THE IMPORTANCE OF VITAL CHILDREN'S HEALTHCARE PROGRAMS, SUCH AS MEDICAID AND THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP), AND THE NEED TO PROTECT AND IMPROVE THESE PROGRAMS TO BETTER MEET THE NEEDS OF CHILDREN AND FAMILIES IN TENNESSEE. IT ALSO EDUCATES COMMUNITY PARTNERS AND ADVOCATES THROUGH IN-PERSON AND VIRTUAL TRAININGS, EDUCATION MATERIALS, AND A MONTHLY NEWSLETTER.