ICAN helped Debra keep her home care hours from being cut.

home care hours story photo

Debra has been living with multiple sclerosis for over a decade. In spite of the paralysis and seizures, she has been able to continue living in her own home in the Bronx because of the daily homecare services she receives through her Medicaid managed long term care (MLTC) plan.

After a recent assessment by her plan, Debra was told that her aide’s hours would be cut from 60 to 36. Debra was aghast. “By cutting my hours, the plan was actually threatening my life. I was so worried, I couldn’t take it. I need my aide by my side or I cannot live. This decision was making my health worse; I felt like I was at the end of my rope.” She tried to appeal but her care manager would not return her calls and nobody she contacted could provide information about fair hearings.

Debra contacted ICAN and was connected with, Jake, an advocate at the Medicare Rights Center, an ICAN agency. Jake investigated and discovered that the reduction notice did not provide an appropriate reason for the change in hours, as required by law. When the plan denied Debra’s appeal, Jake filed a complaint with the state detailing how the notice was defective and Debra’s condition had not improved. Eventually, the plan reversed its decision and restored the 60 hours. In addition, the plan assigned a new care manager.

Debra was greatly relieved that the aide’s hours would remain the same. “I can’t thank Jake and ICAN enough! Jake is an angel. He’s my angel.”