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Woman sues HHS for suspending Medicaid

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By CLARENCE MABIN / Lincoln Journal Star

Wednesday, May 21, 2008 - 12:11:19 am CDT

A Lincoln woman whose Medicaid assistance was suspended by Nebraska Health and Human Services for failing to meet a welfare-to-work agreement is suing the agency over the sanction.

Jennifer Davio, a mother of two young children, said in a lawsuit Tuesday the Legislature authorized sanctions on cash assistance  — but not on Medicaid — for parents who fail to meet their obligations under the state Employment First program.

In August, the department temporarily suspended Davio’s cash assistance under the Aid to Dependent Children program and her Medicaid coverage after it determined she failed to participate in Employment First, said her attorney, Erin Ching of the Nebraska Appleseed Center for Law in the Public Interest.

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Employment First was designed to move families from public assistance to economic self-sufficiency. Nebraska requires adults who are on ADC and able to work to participate in the program.

Under it, families meet with caseworkers and develop self-sufficiency contracts. Adults can choose from a variety of activities to meet the contract obligations, including education, job skills training, job searching or employment.

Ching said Tuesday the Legislature authorized suspension of ADC cash payments for adults who failed to meet the contract terms. But, she said, lawmakers never approved Medicaid sanctions, and HHS overstepped its authority in doing so.

“She’s no longer challenging the ADC (cash payment) sanction,” Ching said. “The main thrust in her case is that this (Medicaid sanction) won’t happen again.”

An HHS spokeswoman declined comment Tuesday, saying the department had not been served with papers in the case.

Ching said transportation and child-care needs interfered with Davio’s efforts to meet the terms of of her Employment First contract last year. Davio was supposed to attend job search classes for about 20 hours a week, Ching said.

The department imposed sanctions on her beginning Aug. 1.

Ching said Davio, whose children are about 5 and 6, was without Medicaid coverage for about seven months. The benefits were restored after she became pregnant, Ching said.

The lawsuit seeks a judge’s declaration that the Medicaid sanction regulation violates the separation of powers clause of the Nebraska constitution.

Davio, who, according to the lawsuit, has a serious heart condition, is also seeking reimbursement for medical expenses she incurred during the sanction.

In a separate filing Tuesday, Ching asked the court to give the lawsuit class-action status. Such a class would include all ADC parents in Nebraska whose Medicaid was sanctioned for failure to participate in the Employment First program.

Ching said 465 Nebraska families were sanctioned in the first three months of 2008.

Reach Clarence Mabin at 473-7234 or cmabin@journalstar.com.


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BOB wrote on May 21, 2008 12:43 am:
" It is about time some put HHS in it's plsce. "

 york county resident wrote on May 21, 2008 3:03 am:
" File a lawsuit, don't ya need money for that. I would say get a job lady!!!!!!!!!!!!! "

 the answer to her problem wrote on May 21, 2008 6:17 am:
" I love that she can just go and get pregnant as a solution to her problem. They also have free birth control as a state benefit, why isn't she taking advantage of that like she is the rest of the system? You gotta love that ASSISTANCE program that never goes away no matter how long you are on it.
"

 Sarah wrote on May 21, 2008 6:37 am:
" How "serious" can this womans heart condition be if she keeps having children? She can't afford medical care but yet she must think she can afford kids. Unreal...... "

 no no no wrote on May 21, 2008 6:56 am:
" I have to make arrangements for my kids when I have appointments. I have to show up in order to get a paycheck. Why does this woman feel that she is deserving for not TRYING. I am all for helping people who try to help themselves, but come on, ya gotta try!

How does another baby help her? Bad choice for someone with a heart condition and not fulfilling other obligations. (throws hands up in the air) "

 kan wrote on May 21, 2008 7:01 am:
" The benefits were restored after she became pregnant, Ching said.>>>This is pretty darned funny if you ask me.But only in a morbid sense.You gotta laugh to prevent outrage.Where are the dads in this scenerio?
"

 No wrote on May 21, 2008 7:31 am:
" If she already has 2 children without medicaid benefits, why did she become pregnant with a 3rd. "

 concerned wrote on May 21, 2008 8:02 am:
" ADC policy is publicly available, through the DHHS website, in a section regarding sanctions this is what I found.


468 NAC 2-020.09B1
6. If the parent(s) fails to participate in Employment First, the result is the loss of ADC cash assistance for the entire family as well as medical assistance for the adult(s). In a two-parent family, failure to participate by one parent will result in the loss of ADC cash assistance for the entire family and medical assistance for both adults (see 468 NAC 2-020.09B2f).

If I'm reading this right it says DHHS is in the right. "

 Heather wrote on May 21, 2008 8:19 am:
" I hope she wins! Who are any of you to judge why she needs Medicaid. Im sure you say that as you sit back and look at your purse/wallet with your private issue insurance card. Many people work and cannot even afford the health insurance their company's offer. All children should be covered by medical insurance, regardless if their parents are poor. "

 Lincoln mom wrote on May 21, 2008 8:36 am:
" Obviously none of you have ever been in "need". HHS is supposed to be there to "help" get back on your feet. If you are attending Employment First's classes for 30 hours a week you tell me how you're supposed to get out and look for work. I am working 3 jobs and am being told my "transitional" food stamps are being sanctioned for not attending their classes. I have 2 children and would rather not have to accept any help. However, my children are worth my loss of pride. Lay off people who are doing their best. "

 bio wrote on May 21, 2008 8:40 am:
" Hey "no", have you ever heard of anyone getting pregnant while on birth control? Well I have 2 children to prove it happens. Why don't you people look at the real problem? Employment First.......... "

 bigger picture wrote on May 21, 2008 8:41 am:
" Everyone wants to place blame on the Big Bad HHS system, but look at this woman.....no job, two kids she can't afford (as evidenced by her receipt of "assistance") pregnant with a third (which I'm pretty sure she still can't afford) and she can't even follow through with 20 hours a week of classes to continue to receive her free paycheck from the State. And of course, the penalty for her lack of follow through is the fault of HHS, not her. Now, multiply that entitlement attitude by a couple of thousand people who all want their free money RIGHT NOW and you might have a slight idea of what is it like to work at HHS. It sucks, but someone has to do it for the kids who need the help. Yes, the system has flaws, yes there is always room for improvement, but it really isn't as bad as our "deserving clients" make it out. Without HHS and its' money, where would this woman be? "

 mmhmm wrote on May 21, 2008 8:51 am:
" This is unfortunate...People are upset now that they are not able to sit on their behinds and collect benefits, and they have to job search for a measley 20 hours!!! it is outrageous that they are complaining, when there are plenty of people working their butts off to make ends meet. ~Dont even get me started on the birth control issue!! UNBELIEVABLE "

 silence dogood wrote on May 21, 2008 8:57 am:
" not much to say but "quality just real quality" "

 Mary wrote on May 21, 2008 9:00 am:
" She needs her medicaid back so she can get birth control. People who can't afford the kids they have, shouldn't be getting pregnant and having more for you and I to support. "

 unbelievable wrote on May 21, 2008 9:04 am:
" I can't believe the people in this world that keep having children when they can't afford to take care of themselves & the children they already have. Where is the father? They all expect us to keep paying for them to live. It's the kids that suffer. "

 toomanybennies wrote on May 21, 2008 9:11 am:
" i'm sick and tired of paying for babies of people on medicaid. its time THEY become responsible for their actions. sure sometimes people get into situations by no fault of their own, but having more children is insane. once a family is on medicaid their benefits should be lock. if they decide to have more kids then they need to figure out how they will handle it. "

 Sounds wrote on May 21, 2008 9:20 am:
" like she is trying to get some free money! there are people out there who need the help and will work with agencys to get it. I don't think the whole story is being told. Mistakes are made by HHS but some people try to use the system for more benefits. By the way with two kids what is she doing PREGEANT again? "

 Kristin wrote on May 21, 2008 9:25 am:
" I have an idea. Get a job and pay your own bills and quit expecting the state to take care of you and the kids you brought into this world that you couldn't afford. "

 been there wrote on May 21, 2008 9:49 am:
" Good for her!! DHHS is can be so evil, and I believe to be a caseworker, they should have to have been a client and on assistance at one time in their lives to really feel what this lady has been through....believe it or not it isnt about "lazy" its about a crappy system that holds us back, so if you've never been there, dont comment because you really dont know! Please!! "

 Full time work with children can happen wrote on May 21, 2008 9:49 am:
" What makes me SO angry...The people who cannot make ends meet in the first place, or become ineligible for benefits always manage to become pregnant again to get the benefits reinstated.
I agree with York County - utilize birth control & get a job.
There is never an incentive to do better. The more baby daddies, the more benefits. "

 You wrote on May 21, 2008 9:50 am:
" have to sign a contract agreeing to participate in Employment First and that also means you agree to the sanctions for non-participation. Read what you sign! "

 okayyyy wrote on May 21, 2008 11:52 am:
" she is fighting to have MEDICAID HEALTH benefits people...read the article again...Thats what she is challenging, not the "free" money.Don't pass judgment on those who need assistance, not all or lazy or feel entitled. And you do not know her or what situation she may be in. Also, many states offer Medicaid to working adults and their families, so that those who cannot afford insurance from their employers can receive it for less. I once had to go to DHHS for emergency assistance because of a bad situation I was in temporarily, it is hard enough sometimes to have to ask for assistance. Some comments posted on here are part of the reason, people look down on you and judge you automatically. "

 No sympathy wrote on May 21, 2008 12:04 pm:
" I am sorry but as a non-dead beat dad who makes each and every child support payment and every medical insurance payment and gives away a third of my hard earned money to child support I have very little sympathy for someone like this. I can't tell the state I can't afford my child support even though it is enough that the kids mother doesn't have to work, does not sound like "support" to me, or that I can't afford the medical insurance or I end up in jail. You just grin, bear it and do what you have to do to make it work; a fair life was never promised anyone. "

 No wrote on May 21, 2008 12:32 pm:
" To Okayy-people do not look down on you because you need help when you are down on your luck. People start to look down on people like this who become pregnant THREE TIMES knowing full well they cannot afford it. It is infuriating to know my husband works full time and I have to work full time and send my kids to daycare while some (and I said SOME) mothers sit on their behinds at home, all the while using my hard earned tax money to do it. THAT is what is making me look down on people. "

 Smith wrote on May 21, 2008 12:50 pm:
" OMG! Since when is being pregnant a reason not to work? Or to look for work? Every mother who worked right up to delivery day raise your hands please. Believe me there are thousands of hands in the air right now.
Having children is a resposiblity not a right. If you don't live up to that resposiblity maybe you shouldn't have those children. There are lots of people looking for children to adopt. People who do know the difference. "

 Idiots wrote on May 21, 2008 12:59 pm:
" Ok, somehow i'm missing something here.... You are all saying that she is in the wrong, did you not hear that she has HEART PROBLEMS? Ok, so that means that she can't walk too far without having more problems.. And with the gas prices anymore, who can afford to get a car and pay for the gas to go to some CLASSES for 20 hours a week... The job market around here is crap, and even if you get a 20 hour a week job, you can't get help, and you end up homeless... BUT NONE OF YOU KNOW THIS BECAUSE YOU'VE NEVER BEEN THERE! I was pregnant when I left my abusive husband, so I needed the medicaid since I couldn't work--BECAUSE OF MY HEALTH!

Why don't you all walk a mile in a homeless person's shoes and see how you like it? That means no car, no stereo, not knowing when you are going to eat next, no stable roof over your head.. Try living in poverty and trying to better yourself, but circumstances holding you back. "

 HHS-Heinamen wrote on May 21, 2008 1:40 pm:
" you guys, HHS has been seeing revolutionary changes as Heineman has put his hand into this system, and since then we have seen:
1.Banishment of acknowledgement of homosexuals (as they say "Because we don't have to by federal law")
2.Even more mental care facility declination
3.A strong religeous tone in HHS
4.A rather strong opinionated influence in medicare and medicaid coverage
5.They lost 80% of their board since Heinamen, only to replace them with this strong religeous idealism type of boardmembers

I think Heinamen should write a letter to the city of Omaha (particularly mayor Fahey) for making the statement "I plan on making Omaha a safe haven for homosexuals" "

 donthavetobethere wrote on May 21, 2008 2:05 pm:
" surprise!! just because i 'havent walked in your shoes' doesnt mean i'm incapable of understanding the situation. but tell me why we the tax payers should be willing to accept welfare recipients having babies and expecting us to continue to foot the bill. dont give me this crud about taking care of the children. if these people were concerned about the welfare of the children they wouldnt have more kids until they could support them financially. its time welfare people understand they are free loading and its time to step up. take a look in the want ads. there's always job available. sure they might not pay 100k per year but hey warren buffet once had a paper route. "

 SJL wrote on May 21, 2008 2:21 pm:
" Hey, I'm all for helping someone who needs it. My family was on welfare for a short time when I was a child and my mother was going through a divorce. Once she got back on her feet, she took care of us on her own. It's called getting off your butt and making something of yourself. This reminds me of my pregnan stepdaughter, who was perfectly capable of working, complaining to me one day that she had to stand in line for over an hour to get her free cheese, flour, etc. What a joke! She had nothing better to do since she didnt work. And then went and had another baby with another daddy after that one. The system is set up to help those that will help themselves. "

 be greatful wrote on May 21, 2008 2:31 pm:
" i work full time and i have two children and get no child support my kids are very well taken care of and i always have enought to pay bills and make ends meet so it is very possible !! i am sick and tired of the excuses people make why its everyone elces fault that they cant do anything!! its not the states fault that people keep having babies and cant afford it ! at least we have something in this country thats offers help for those who cant seem to help them self!! they should be greatful !! "

 To York wrote on May 21, 2008 2:33 pm:
" You don't need money to file a suit if 1. the attorney works pro bono, 2. the attorney works on a contingency (getting a percentage if they win the case) or 3. if the suit asks for attorney's fees to be paid by the defendant.
"

 FYI wrote on May 21, 2008 3:32 pm:
" If she truely has a medical problem that prevents her from working or looking for a job then she could give a note from the doctor which would have been included with her contract that she signed with her case worker. It's called state AID for a reason, it's sole purpose is to AID people to make ends meet or provide insurance when it's too expensive or not offered another way it's NOT to replace all support of yourself and your family. If I stopped going to work I would no longer recieve a pay check or my health insurance. This is why people who are recieving assistance SHOULD NOT BE ALLOWED to have any more children until they can support the ones they already have. "

 HHS is right wrote on May 21, 2008 4:01 pm:
" I prayed to jesus, and he told me that Heinamen and HHS are right on that narrow path to heaven! "

 ABF wrote on May 21, 2008 4:38 pm:
" For all of you complaining about people who have babies who can't afford them...what do you propose, more abortions????? And stop judging people before you know their entire story...
Birth control does fail...I know. I became pregnant at 19, during my sophomore year of college. So I could've had an abortion or I could go on public assistance until I finished school and got on my feet. I chose the latter. So yes, some of you did pay for me and my daughter. Mothers on welfare do work hard for their children. The "lazy, sit on their behind" myth of women with children who are on welfare is just that. Again, I know...my thesis (which I'm currently working on) explores some of the issues surrounding women with children on welfare. Try doing some actual, academic research before you comment on how lazy we are. I was taking a final on my due date and I was back in summer classes 4 days after my daughter was born. Now I'm off welfare and working on my Master's degree. I am insulted by most of your comments...you should be ashamed. "

 To concerned wrote on May 21, 2008 5:15 pm:
" Read what the lawsuit is about. It says the LEGISLATURE never allowed for sanctions against the health benefits. Just because HHS policy allows it, doesnt mean the legislature did. Kinda what you come to expect from HHS. Herman Goering would have been proud of em. "

 Sarah wrote on May 21, 2008 5:56 pm:
" ABF, you sound like you don't know what causes pregnancy. Yes we all know birth control fails. If a person disregards that fact and still chooses to have a sexual relationship I can't feel too sorry for them when they cry about having a child and not being able to afford one. They made their bed......so to speak. Why should I pay for other people's lack of responsibility? "

 Asisstance needed but abuse happens wrote on May 21, 2008 8:31 pm:
" I've watch employees (of mine) maniupate and actually ask to NOT get their raise so the do NOT lose assistance. I've also watch those folks spend money on artificial finger nails and tattoos...and enrolling their children in expensive dance classes....all the while the focus in their life was the bar scene and invititably another pregancy.

There are definately situations where responsible people need assistance...then there is a growing number of those manipulating the system (because that's all they know) to survive in the life style they've become used to...

ABF --Regarding birth control that failed and you got pregnant at 19 --guess what abstenance works everytime!!!! "

 AWP wrote on May 21, 2008 9:39 pm:
" Perhaps if this woman is not physically or financially able to provide for these children, the children's father or fathers should have custody of them. "

 abuse never stops wrote on May 22, 2008 8:19 am:
" I'm in my 40s and grew up on food stamps and medicaid, without them, we would not have been able to eat and certainly would not have received medical care. My Mother always worked a full time job but with 4 children, she really needed the assistance. Even back then, we watched other families abuse the system. It's nothing new and as far as I can see, Employment First is the first real step that has been taken in a long while to fix the abuse. I agree with many others; if you can't afford the children you already have...stop having more!! Medical issues or not....
Thank God I have been able to provide for my child without help from the State or Federal government but it's good to know it's available for honest people who need the help. "

 Hmmmm wrote on May 22, 2008 12:10 pm:
" To the person who wrote that HHS workers should be on welfare first to understand.... there are hhs workers who are single parents with children...who are working to support themselves and their children doing a thankless job! But they tote their children to daycare, work all day, go pick their kids back up and go home..... the State is there to help out not to foot everyone's bill, there are those who abuse and those who really want the help and get off of it... most don't realize that hard working people who work everyday and the taxes taken out of their paycheck go to people who choose to not work and take advantage of the system..... this case will drag on and on and whose paying for that? The citizens of NE! "

 interesting.... wrote on May 22, 2008 12:14 pm:
" After reading all of the entries thus far, I have realized most of us are on the same page. Welfare is needed and there are a lot of very deserving individuals and families! My heart goes out especially to those that are working so very hard to make ends meet! I know a lot of people that make too much to qualify for welfare but are still struggling to make ends meet, without living out of their means. The problem is that there are so many that will not comply with these, simple Employement First Requirements. I think this was brillant, to develop these requirements to weed out the welfare abusers that are not employed or trying to find work at all. We talked about having all welfare applicants submit to random UA's...that would ELIMINATE HUGE numbers of welfare recipients! but for things like ADC when they can cash a check and buy whatever their hearts desire, it may be wise. Medicaid however, I believe to be a different story...
As for the mothers that wrote about having a child, being on medicaid and then working through it and standing on their own 2 feet, I applaud you! That is exactly how welfare should be used! When times are tough you are able to have that assistance to stand on your on again...not to live life without any responsibilities or efforts towards a better life, bc you can, thanks to us and state dollars "

 Whatever wrote on May 22, 2008 4:15 pm:
" Birth control would be better for people in this situation and not just keep handing out money to people who may not really need it. "

 concerned wrote on May 22, 2008 4:25 pm:
" Guess who approves DHHS policy? The Legislature. It is written into the Nebraska Constitution. "

 Birth Control Fails wrote on May 22, 2008 6:54 pm:
" when you don't take them the way you are supposed to and when you are on antibiotics and some other meds. And to the woman who had 2 kids on birth control; once it failed the first time why didn't you do something different? That said; we have to remember that life is messy, circumstances change, and we need a temporary safety net for people. If the woman in the story were truely disabled and couldn't work she would be on SSI not welfare. "

 Amanda wrote on May 28, 2008 1:42 pm:
" Everyone wants to jump to their conclusions about this one woman and her situation but the truth is that this has happened to many more families with their own unique circumstances. I am very happy to see that "Concerned" did their research but I must add that I read, in the court documents that are provided on neappleseed.org, that the State legislature does not allow the Department to sanction adult Medicaid coverage for a failure to comply with Employment First.
My Medicaid coverage was also sanctioned because of Employment First. I chose to go back to school but was notified that I was being sanctioned for failure to comply since my projected graduation date was two months beyond their allowed time frame. My family, that is my husband, his two sons, myself and our daughter, had to make due on my husband's job as a garbage man and my financial aid consisting mostly of student loans. Not having health insurance proved to be costly to us and I hope that she wins her case so that this doesn't happen to anyone else again. "

 Mary wrote on May 29, 2008 1:53 pm:
" I am a single parent of one child and I feel that this whole world needs to open their eyes. I used to be on welfare until I went a little over income and they took my son's medical assistance away. People talk about not being able to afford the health insurance that their work provides and they are probably right. I am one of those people that can't afford to pay for health insurance, but I do because my son needs medical insurance. I raise my son totally on my own and receive no child support. I work a fullt time job and there are many times I work 50-60 hours a week. It can be done and people just need to get off their butts and work. It said that she has a heart condition. There are many jobs that you can find that are not strenous jobs and alot of jobs that are sit down jobs that she could do.I get tired of hearing of all of these people that get assistance that don't deserve it. What I mean by that is those that sit on their butts and do nothing. I also think that a lot of people need to open their eyes and realize that there are people on welfare that do work and that work very hard to support their children. As for this woman I definitely feel that she needs to get out and get a job and that she deserved to lose her benefits. AS for having another baby, "What was she thinking." She obviously can't support the two that she has so why in the world would you have another one. Being on welfare is definitely something that I was not proud of but when it comes to your children you do what you have to support them. "

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