ACTION ALERT: Help Save TennCare For People on SSI

Working for health care justice Access to health care is a human right

More than 130,000 Tennesseans who have SSI/Daniels TennCare will lose their TennCare despite having serious medical conditions!

Action Needed This Week!

TennCare is sending out 40,000 letters this week asking people for more information. 40,000 additional letters will go out in June, another 40,000 in July, until 150,000 get their letters. When this is all over, less than 20,000 will be able to keep their TennCare.
By definition, these fellow Tennesseans have serious medical conditions, have had a serious disability, are low income, but are not poor enough to stay on TennCare.
Who are these enrollees?

• 14,905 are children under the age of 19
• 90,000 are dual eligible
• 872 are children who are seriously emotionally disturbed
• 15,754 are adults who are seriously persistently mentally ill

Almost all are low income and need specialty care. The 90,000 people who have Medicare and TennCare will lose their TennCare and will not be eligible for any kind of Medicare special assistance.

What services are the 90,000 dual beneficiaries eligible to receive now but can not receive when they lose their TennCare?

• Mental health case management
• Non-emergency transportation
• Inpatient hospital services beyond the Medicare limit (150 days)
• Psychiatric hospital services beyond the Medicare limit (190 days)
• Home health services for individuals who are not homebound
• Home health services that serve a "custodial" purpose (Medicare exempts coverage of custodial care. TennCare says that medically necessary home health care cannot be denied because it is "custodial" in nature).
• Private duty nursing
• EPSDT services (Early Periodic Services Diagnosis and Treatment - This is for children)
• 24 hour residential treatment
• Mental health crisis services
• Psychiatric rehabilitation services
• SNF services beyond the Medicare limit (100 days)

There is not legal way to stop the Governor from making these SSI/Daniels cuts. But there is a political way to help thousands of people because:

• Tennessee is receiving $1.1 billion in additional federal money over 27 months just for its TennCare program to help people keep their coverage;
• TennCare has over $400 million in its own TennCare reserves;
• Tennessee has over $700 million in its rainy day fund; and
• Open the Medically Needy program. This program has been closed since April 2005.

What do You need to do? See below.
Action Step #1: Call your state legislators:

• Everyone has one state senator and one state representative. Go to: http://www.capitol.tn.gov/ and find your state legislators.
• Call toll free: 1-800-449-8366.
• Ask your two state legislators to support putting $20 million dollars in TennCare to OPEN the Medically Needy program. This will not help everyone being cut, but it would help thousands of people who have very serious medical needs.

Action Step #2: Call a local meeting (where 10 or more people can get together):

• Call the Tennessee Health Care Campaign and ask THCC to conduct a training. Call toll-free 1-877-431-7083.
• THCC will help you know the process and your appeal process. This may allow you to stay on TennCare or keep it, at least, until your appeal is completed.
• Find a room in your local library or community center and set the time and date. After you do this, I will tell you how it will happen. THCC will be there.

Action Step #3: Take action NOW. You are not the only one who is hurting.

Action Step #4: Call two legislative leaders who can make this happen.

1. Call Senator Randy McNally, Chair of the Senate Finance Committee - 1-800-449-8366, extension 16806
2. Call Representative Craig Fitzhugh, Chair of the House Finance Committee - 1-800-449-8366, extension 12134

Take care, Tony Garr, tgarr@thcc2.org