For those who qualify for our services, Community Legal Aid SoCal’s Health Consumer Action Center (HCAC) is a resource for free assistance with problems related to healthcare coverage and other consumer health service issues.
Our HCAC team of health advocates work directly with clients to solve their health-related matters. Additionally, the HCAC team also engages in effecting broader changes by spotting trends through their casework that will inform the direction of advocacy and policy work towards effecting systemic changes.
Recently, through her casework, HCAC attorney Joan Chang found that low-income disabled adult children were erroneously being required to make monthly payments for Medi-Cal before accessing healthcare because the County of Orange (County) failed to evaluate them as eligible for the Disabled Adult Child (DAC) program under the DAC Medi-Cal aid code. She found that rather than evaluating them under the DAC aid code, the County incorrectly assessed them with an expensive monthly share of cost (SOC).
This was the predicament of the brother and sister disabled adults who came to Joan seeking assistance. The aunt of the siblings, who held the power of attorney, reached out to us and the HCAC because the siblings were not able to access medical care due to their high SOC. Both are extremely vulnerable individuals —one has Down Syndrome and the other has a congenital brain disorder. Neither one of them had the financial resources to pay the SOC.
On behalf of her clients, Joan was able to get the County/Medi-Cal to fix the Medi-Cal aid codes to the DAC Medi-Cal program. This change then allowed the siblings to receive the health services they need and avoid the exorbitant SOC payment of $734/month.
Since the nature of the DAC eligibility requires the consumer to be disabled prior to age 22, disabled adult children are particularly vulnerable and at risk. In most instances, they are incapable of advocating for themselves when something arises. Recognizing the issue and the failure by the County, Joan and the HCAC team saw this as an important opportunity and focus for systemic change. How many others out there were also wrongly assessed and therefore not receiving the healthcare they need?
Joan raised and pressed the issue with the County and California’s Department of Health Care Services (DHCS). As a result of her persistence, DHCS worked with the Orange County Medi-Cal office to correct the issue. They also agreed to provide updated training support for their staff.
The County also confirmed that individuals were not screened into the DAC program during the application process. They then stated that they would review their DAC training for any necessary enhancements, and that they will also be staffing a reminder regarding the importance and methodology of DAC screening during their next monthly Program Summary meeting.
In essence, because of the issues brought forward by Joan and the HCAC team, DHCS will do a statewide training, starting with Orange County, and will issue a Medi-Cal Eligibility Division Information Letter (MEDIL) that will go out to all 58 county welfare directors statewide. These are significant developments and changes that will have an impact on disabled adult children and their families, not only in Orange County, but throughout the state.
