Director’s Message

Jay Sicklick, Esq.

Why Systemic Advocacy for MLP’s? 

Over the past 18 years, the Center's Medical-Legal Partnership (MLP) has been a leader in introducing and advocating for statewide systemic policy reform. We have successfully worked to expand pediatric access to nutritional supplements, reduced the numbers of electricity shutoffs for families with medically at-risk children, and led a coalition of partners to ensure that Medicaid’s requirements for behavioral health screenings are followed. 

In this issue, we focus on our current advocacy agenda, both legislative and policy based – as we continue to work as a multidisciplinary team to change children’s health outcomes.

Our current legislative goals are to expand health care access to adolescents-at-risk … those who are homeless and who are at risk for contracting HIV and AIDS. Our policy goals remain geared toward ensuring that the state fulfill its legal obligation in providing annual behavioral health screenings to every child covered by Medicaid, as well as taking a closer look at why developmentally disabled children may be languishing in acute-care settings because of a lack of appropriate services available to this unique patient population. We continue to work vigorously to ensure that every child insured through Connecticut's Medicaid Program receives legally mandated, safe and timely medical transportation.

As always, we welcome your input and feedback on our systemic work – and urge you to become involved in changing the culture and efficacy of pediatric health care. 

Pediatricians as Advocacy Leaders

By Ada Fenick, MD, MLP Medical Director

While we advocate every day for our patients on the small scale – by teaching them or their parents, by talking to their schools, and by arguing on their behalf with insurance companies – we sometimes need to take a step back to look at the big picture. 

Advocacy on the larger scale can have a great impact for the effort. It isn’t that often that a highly trained medical professional takes the time to talk to a federal, state, or local official, and thus your comments are truly respected and heard.

Advocacy is supported by the American Academy of Pediatrics (AAP), which has phenomenal training modules for those looking to make a big-picture impact. The AAP advocacy guide is another terrific resource – long, but searchable in its online form. As the AAP notes, by engaging in advocacy, you act on behalf of children’s health and well-being in the broader community and public policy arena. And kids are what it’s all about, for us!

Connecticut Switches Medical Transportation Vendor with Little Change in Results

By Bonnie Roswig, Senior Staff Attorney

Transportation to a medical provider is a covered service under the state Medicaid program. While the federal Center for Medicare and Medicaid Services (CMS) provides guidance as to the parameters of the benefit, the individual health care provider determines the patient's transportation needs based on medical condition.

The Connecticut Department of Social Services (DSS) contracts with a vendor to implement the Non-Emergency Medical Transportation program (NEMT). On January 1, 2018, Veyo/Total Transit began its tenure as the state’s NEMT contractor. Under the new arrangement, the essence of the NEMT benefit remains the same: patients who cannot use a bus should be provided with a cab, patients who need to use a medical provider more than 20 miles from their house and those who are immuno-compromised should ride in a cab without other unrelated patients.

Health care professionals have reported ongoing problems since the onset of the contract. Wait times for calls to Veyo have been inordinately long; patients have been denied medically-necessary modes of transportation; and patients not receiving transportation to their appointments have been left stranded after appointments.

The MLP, the Connecticut Hospital Association, and a coaltion of other agencies and health care providers have brought these issues to the attention of DSS and relevant committees of the Connecticut Legislature. On January 26, 2018, DSS issued a letter and a Correction Action Plan to Veyo. Among the directives is the mandate that health care professionals and patients be reimbursed if they had to pay for transportation themselves because Veyo failed to provide the service.

If you or your patients are having problems with Medicaid transportation or would like to learn more about this issue please contact MLP attorney Bonnie Roswig. 

MLP's 2018 Legislative Agenda

By Alice Rosenthal & Jay Sicklick

The MLP is again working with our legislative champions to re-introduce two important healthcare access proposals. The first proposal seeks to broaden adolescents’ right to consent to PrEP (prophylactic medication to prevent the transmission of HIV), and the second seeks to provide homeless youth the right to consent to basic, non-invasive primary care. Here are the details:

PrEP – Prophylactic & Preventative Intervention to Stop the Transmission of HIV

What it PrEP?  PrEP is “Pre-Exposure Prophylaxis, a way for people who do not have HIV but are at substantial risk of getting it to prevent infection. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.” CDC.gov. 

What is the legislative proposal? The MLP is re-introducing a bill to expand present public health law which allows minors to consent to sexually transmitted disease care and treatment.  Conn. Gen. Stat. §19a-216. Under the proposed revision, minors would be entitled to “prophylactic and preventive” interventions, including consent to administration of PrEP. 

How do I follow the progress of this initiative? Go to the Center for Children’s Advocacy’s legislative webpage for updates.  

Adolescent Primary Care – Minor Consent for Homeless and Unaffiliated Youth

Why is this needed? Every year there are over 4,000 children in Connecticut who lack a fixed, regular place to call home. Some of these children are unaccompanied and unaffiliated with an adult caregiver. Although these children are homeless, they deserve access to basic healthcare. Preventive primary care improves health outcomes, helps develop healthy habits and maintenance of good physical, emotional and sexual health. Increased access to primary care for teens allows medical providers the ability to monitor high-risk activities and identify early signs of long-term illnesses that emerge in adolescence.   

What does this proposal do? The MLP is re-introducing legislation that would allow unaccompanied and homeless youth, ages 14-17, to consent to their own primary care. Twenty-three other states have statutes that allow minors to consent to health care services. Connecticut state statutes already allow minors to consent to mental health services, substance abuse treatment and reproductive health. The proposed legislation would expand youth access to health care services.  
 

What can you do? 

We welcome pediatric advocates at all stages of the legislative process. If you are interested in working with the MLP on these proposals, please e-mail us and we will keep you updated on the bills’ progress.   

Would you like more information about Adolescent Health Care and the Legal Rights of Teens? 

Please click here for a link to the publications page of our website.

We Want to Hear From You! 

Are you a pediatrician? Medical provider? Practice or hospital administrator? 

Please send us your feedback.
Send questions or let us know what you would like to see in an upcoming issue. 

Center for Children's Advocacy
65 Elizabeth Street, Hartford, CT 06105
211 State Street, Bridgeport, CT 06604
cca-ct.org/mlpp