• Get Ready for the Medicare Open Enrollment Period
• Medicare Part D Costs for 2019
• Update on Medicare Summary Notices to Qualified Medicare Beneficiaries
• PHLP Offers Medicare 2019 Webinar
• Federal Funding for Marketplace Navigators Reduced
• Tips for Marketplace Open Enrollment
• State Cancels Procurement for Independent Enrollment Broker for Long-Term Support Services
• State Delays FED Implementation
• CHC Enrollment Underway in Southeast PA
• Update on CHC Implementation in Southwest PA
• General Assistance Is Back: What Advocates and Consumers Need to Know
• The Health Impact Of The Proposed Public Charge Rules For Immigrants

Helping a Mother Secure Vital Care for her Son

Ms. J. reached out to the PHLP to get help for her 16-year-old son Shawn, who has autism, intellectual disabilities, behavioral problems, and complicated physical health issues.  Shawn’s psychiatrist recommended a residential treatment facility, which provides intensive behavioral health treatment and supports in a 24-hour setting.  Shawn’s behavioral health managed care plan approved treatment but could not find a facility able to meet his aggressive behaviors and physical health needs.  The situation was urgent.  Shawn’s mother was struggling to keep him safe at home, without juvenile justice involvement, and had been waiting months for a treatment provider.  On her own, before she contacted PHLP, Ms. J. found a highly reputable out-of-state residential provider that specializes in treating youth with behavioral and physical health conditions.  However, Shawn’s behavioral health managed care plan was unwilling to consider an out-of-network provider, even though numerous in-state residential treatment facilities had already denied Shawn admission because they could not meet his needs.
    
PHLP staff contacted state officials at the Department of Human Services on behalf of Shawn and his mother.  PHLP argued that the health plan’s insistence on exhausting all in-network providers--only to keep getting the same response--was risking Shaw’s safety, and his complicated and nuanced needs required highly specialized treatment.  Our persistent advocacy made a difference.  Shawn’s health plan acquiesced.  He is finally getting the treatment he desperately needs, and his mom is breathing easier.

PHLP Welcomes New Staff Members

Marissa LaWall, a recent graduate of Penn State University’s Dickinson Law School, is joining PHLP’s Harrisburg office.  Her work, which includes representing medically fragile children, is supported, in part, by the Pennsylvania Legal Aid Network’s Martin Luther King Jr Fellowship. 



Kathryn McKee is joining PHLP’s Pittsburgh office as a staff attorney.  Prior to her arrival at PHLP, Katy worked for more than a decade at Neighborhood Legal Services providing provide civil legal assistance to poor and vulnerable residents in Allegheny, Beaver, Butler and Lawrence Counties.



Jessica Osler is a paralegal who will work in PHLP’s Philadelphia Office as the first point of contact for clients seeking legal assistance for access to healthcare.  Prior to her arrival at PHLP, Jessica worked at Community Legal Services in Philadelphia providing legal assistance to residents in Philadelphia.     



Pam Putnam, a recent graduate of Villanova University’s Charles Widger School of Law, is joining PHLP’s Philadelphia office.  Her fellowship—i.e., providing advice and representation to consumers transitioning to Community HealthChoices, is supported by the Independence Foundation.