Our Community Integration/Healthcare (CI/HC) Team champions health care access for all individuals with disabilities in Texas, and works hard so that clients with disabilities continue to have access to health care coverage and services that meet their unique needs, and that all healthcare services for Texans living with disabilities remain readily available, affordable, accessible and accountable.  This advocacy includes: preparing for and attending Medicaid Fair Hearings, advocating for fair medical transportation, advocating for clients to be provided with wheelchairs, power scooters, and other necessary medical devices and equipment related to their particular disability, and navigating the complex world of benefits, conditions, services, and discharge from home health care, group homes, and nursing homes. Much of this work involves preparing for and representing clients in administrative hearings.

The CI/Healthcare team also advocates for the full inclusion of people with disabilities by promoting comprehensive, quality, and community-based services as an alternative to institutionalization. The CI/Healthcare Team helps individuals when their rights to live in the community have been violated. This work includes both individual and systemic and class action litigation.

Pro Bono Opportunities with the CI/HC Team

Volunteer opportunities include administrative hearings, State court practice, and Federal court practice.  The vast majority of CI/Healthcare cases resolve at the administrative level.  The most common advocacy opportunities in Community Integration and Healthcare include:

Medicaid Fair Hearings

If an individual with a disability is denied a medical service that is normally covered under Medicaid such as nursing care, attendant care, or durable medical equipment like a wheelchair or power lift, then the person has the right to appeal the denial by requesting a fair hearing. Fair hearings are informal telephonic hearings before a non-attorney hearing officer.  The Medicaid agency bears the burden of proof, and typically presents its evidence first.  Opposing counsel is unlikely with most Medicaid fair hearings.  Medicaid Fair Hearings are conducted under the Texas Medicaid Fair Hearing Rules, and the traditional rules of evidence do not apply.

Preparation for a Medicaid fair hearing involves the pro bono attorney contacting the client and requesting a copy of the client’s complete file from the agency.  Pro bono attorneys typically obtain copies of any relevant medical records that support the client’s request for services or devices, including an affidavit from the client’s treating physician if necessary.  The pro bono lawyer will then review the medical records, and draft a short memo detailing the client’s medical condition, disability, and any relevant change in the client’s circumstances since the denial.  The pro bono attorney will usually prepare an exhibit packet to send to the hearings officer in advance of the hearing along with the memo, and prepare the client to testify at the telephonic hearing.  The hearing officers typically make their decisions based upon a review of the exhibits, the client’s medical records, and the testimony presented at the telephonic hearing.  A decision is usually issued within 90 days from the date that the appeal request is received.  DRTx and our pro bono partners have a high rate of success at these hearings.

Advice and Counsel on Healthcare Related Matter

Often individuals with disabilities have challenges navigating the healthcare system. Whether it is the need to get questions answered about what medical services are available, or just getting legal advice on the available services that would best meet their needs.  Pro Bono counsel can serve a key role helping these individuals by conducting legal research on legal questions, and providing short-term assistance, advice, and counsel on disability related healthcare matters.

Training

Disability Rights Texas would be happy to provide training on handling CI/Healthcare cases to any attorneys interested in pro bono representation. Additionally, we can provide ongoing support and assistance on cases ranging from technical support to co-counseling depending on the need and desire of the pro bono attorney handling the case.  If you are interested in becoming a DRTx Pro Bono Volunteer Attorney, or scheduling a CLE for your office, firm, or corporate law department, please contact:

If you are interested in becoming a DRTx Pro Bono Volunteer Attorney for the CI/HC team in or scheduling a CLE for your office, firm, or corporate law department, please contact Cicely Reid, Pro Bono Coordinator, in one of the following ways:

• call 832-681-8216
• email creid@DRTx.org
• submit a Pro Bono Volunteer Attorney form