State officials have advised 17,000 Medicaid patients that it dropped from its rolls recently to reapply. But they're not making it easy.
Callers told The Atlanta Journal-Constitution they reach recordings, not people. They follow phone prompts to get in queues to wait to be served, but queues may be full and they get cut off. Or they’re told to record their names so they can be called back; often, no one calls back.
“It’s not easy to get anything done over the phone; it’s not much easier to do anything in person,” said Hilary Leland, an attorney with the nonprofit group Atlanta Legal Aid.
“I’ve been working here for 10 years,” Leland said. “I’ve never had a client say, ‘I was able to resolve something on the phone.’ ”
> RELATED: What to do if you were benefits were cut off from Georgia Medicaid in error
Still other clients said they sometimes have problems using the computer system.
Vicky Kimbrell, a lawyer for another nonprofit law firm, Georgia Legal Services, said helping people get Medicaid coverage has become less a fight between attorneys over what the law allows and more about working through state bureaucracy to fix mistakes.
“That is most of the work we do,” Kimbrell said.
A spokesman for the state Division of Family and Children Services, which determines Medicaid eligibility under contract to the state Department of Community Health, said in a statement that customer service is important to the agency, to “strengthen families by ensuring Georgians in need of economic assistance receive access to the services that enhance their wellbeing and their ability to provide for their families.”
“We have worked diligently to improve customer service though our DFCS Customer Contact Center over the past several years,” said the spokesman, Walter Jones. “The current average wait time has been improved to less than eight minutes.”
Unlike the general public, the lawyers have relationships and contacts within the bureacracy and know who fixes what.
The AJC first reported last week that the state terminated the Medicaid accounts of 17,000 poor elderly or disabled Georgians. The DCH says all those people didn’t respond to renewal notices.
Lawyers say the computer accounts of their clients show they never received renewal notices.
In the cases of the people being cut off, Medicaid is an extra benefit. They are typically already on Medicare but are so poor that Medicaid steps in to pay costs Medicare doesn’t, such as the Medicare monthly premium of more than $100, plus co-pays.
If the people cut off believe they are eligible, they have 10 days to appeal, the state says.
Or they can start from the beginning again and reapply. If they do that within 90 days and the state cut them off in error, they will be reinstated and get back their accumulated missed benefits, a DCH spokeswoman said.
Lawyers who represent some of them say this population is one that can least afford to miss even one month’s benefits. As a worst-case scenario, one cut could lead to shorting a rent bill and then being evicted. Or not receiving health care.
The very poor are some of the least equipped people to fight a bureaucracy. They may not have experience navigating offices or possess access to a computer or own a phone. If the main office phone message says to call the local office, and the local office message says to call the main office, they may not have the ability to hop in a car and drive to different offices to figure out what’s wrong.
And yet, as those people try to resolve the problem, they say they’re running up against a bureaucracy that is remarkable in itself.
The AJC listened to a phone call to DFCS’ main office where a recorded message told a patient to call a local county office. The number it gave the caller turned out to be disconnected.
After the AJC asked DFCS about that, the agency’s spokesman, Jones, said a work order was immediately put in to fix it and other recorded numbers were being checked for accuracy as well.
Kimbrell said that things were never easy. But in her opinion they really got bad when the state installed a new computer system and the number of caseworkers declined.
Jones said there was no decision to reduce caseworkers based on the new computer system. In fact, he said, DFCS now has approval for 200 more employees than it had two years ago — if it can hire them.
The actual number of people doing the work has declined by more than 200, though, as market competition has heated up for competent workers willing to make $27,000 per year. (For a household of two parents with three kids, that would be under the federal poverty level.) DFCS is trying to fill 500 positions.
Even when employees are there, they don’t always help.
Louis Askew, 70, whose Medicaid was terminated, finally gave up calling and went in search of the DFCS office in Fulton County that handles his case. He said he never received a renewal notice, and the termination notice he got came out of the blue. The staff at the office didn’t help him, and it wouldn’t let him meet with a superior.
But they told him that to work on his problem he should leave them the termination notice he came with, he said. He did. Now he doesn’t have that, either.
WHAT TO DO
Whatever you do, act quickly.
State offices
If you believe you have been cut off from Medicaid in error, the state Department of Community Health says you have 10 days to appeal the decision. After that, the DCH says you can apply within 90 days for renewal at the local office that serves your county — that will be a Department of Family and Children Services office, not a DCH office.
The main customer service number for Medicaid is 1-877-423-4746. County offices have their own phone numbers, listed at https://dfcs.georgia.gov/locations.
Outside lawyers say it can matter a lot, though, whether a person reapplies or instead appeals for renewal. An application can take much longer and requires the person to gather all his or her documents again.
Outside legal help
To get help with that, even the DCH and DFCS tell people in notices that if they believe they are wronged, they can call specific legal offices. The offices don’t take every case. But they do take cases where it looks like the state has done something wrong and the lawyers can help fix it and make a difference.
One group of lawyers helps people in parts of metro Atlanta, and the other group helps people in the rest of the state.
Atlanta Legal Aid
Atlanta Legal Aid helps people in these counties:
Cobb County: 770-528-2565
DeKalb County: 404-377-0701
Fulton County: 404-524-5811
Gwinnett County: 678-407-6469
South Fulton and Clayton counties: 404-669-0233
Georgia Legal Services Program
Georgia Legal Services helps people in all the other counties.
1-800-498-9469
The lawyers’ quick tips
To appeal termination:
1. Take a copy of the termination notice to your local DFCS office, along with the paper that talks about fair hearings and appeals.
2. Tell DFCS you want to file an appeal.
3. Fill out the appeal section on the notice or ask for a form to write a fair hearing request, and turn it in to the DFCS office.
4. You can ask to speak to a DFCS worker directly to file your appeal. If you leave any documents with them, make a note of the name of the person you gave the documents to, the time and the date. Keep that note for your records.
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