Services cut in switch to Trillium
BY AMELIA HARPER AND LINDELL JOHN KAY
Sunday, September 24, 2017
For some parents and caretakers of children and adults with intellectual disabilities, the recent transition from Eastpointe to Trillium Health Services has meant dealing with slashed services.
“The transition has been more problematic than we anticipated in a few cases,” Trillium Health Resources CEO Leza Wainwright told the Telegram.
Most of the individuals affected are ones who have Medicaid Innovations Waivers designed to help people with intellectual or developmental disabilities live a more independent lifestyle. Most people wait years to get one of these waivers, which they are told will guarantee them services for their lifetime. But several people in Nash County are now being told that service hours — hours where caretakers assist with their loved ones — are either being cut or dropped completely because of budget concerns.
Nash County Commissioner Lisa Barnes, who sits on Trillium's regional board, said the agency is aware of the complaints and working to resolve the issues.
The Nash County Board of Commissioners voted last year to leave Eastpointe Health Services due to a disparity in county member payments and scandals at Eastpointe in which an executive who later pleaded guilty in federal court was taking kickbacks and embezzling money meant for mental health patients.
Barnes helped guide the county through its transition, which was completed in July. The move came after a protracted legal battle with Eastpointe, which didn't want to let Nash County go.
However, Nash County's transition from Eastpointe to Trillium is going poorly for intellectually disabled residents, said Deborah Jordan, a parent advocate. Jordan, a member of the Tarboro Town Council, has a 22-year-old son with autism. She represents the interests of other parents with disabled children, including residents of Nash County.
“Many cases have had their services cut or stopped, which has caused family crisis and mental scars,” Jordan said. “The families have not been informed in a timely manner about the changes to their services. Some client services were stopped and many administrative errors have occurred.”
Trillium is using a state budget letter as the basis for changing client services, but the budget is supposed to be a guide, not a rule etched in stone, Jordan said.
However, Wainwright said the budget guideline are presumptive guidelines.
“We still have to justify our budgets to the state,” Wainwright said. “Some people’s service levels were so far above their individual budgets, but we allowed those services to continue until about mid-August when we began working with people to find out why the services seem so disconnected from the budgets in some cases. This requires an intensive review process, but we are trying to balance the needs of families with the rules of the statutes.”
Elizabeth Davis said her son Thomas, 21, has severe intellectual disabilities and cannot be left alone. However, earlier this month, she was faced with life-changing news.
Thomas’ assigned Trillium staff member, a person that neither she or her son has ever met, called Davis on Sept. 8 to tell her that Thomas was over budget and the service hours assigned to him would be cut from 40 hours a week to less than 20. This meant that Thomas would either be left on his own for 20 hours a week or Davis would have to somehow cut her work hours to compensate.
“This was rather a shocking revelation to me,” Davis said. “They told me he was over budget, but that doesn’t mean anything to me because I have never been told what level of care my son was assigned. So I asked her to send me that information and asked her what recourse I had. She told me I basically had to repeat everything we did when he came into the Innovations Waiver program — psychological evaluation, physician history and physical and any physical, occupational or speech therapy evaluations — and this all had to be done before Sept. 30, which is impossible.”
Davis said Trillium told her that these efforts were necessary because Trillum did not have some of his previous health records because Eastpointe has been delayed in getting health records to Trillium.
Wainright confims this is true.
“Many of the issues we are having is because Eastpointe did not provide us with the information we needed in a timely fashion. When we took over services on July 1, we did so blind. We did not have any information as to the number of people we were dealing with or their situations. We had no way to know how many people we needed to hire. However, we are dealing with these issues as quickly as possible,” Wainwright said.
Wainwright also said Trillium is willing to work with people to make sure they can get the appointments they need or to extend the time requirement.
Ashley Waters said she has had trouble getting answers from Trillium about her daughter’s situation. Waters has a 15-year-old daughter with intellectual disabilities. Waters said she waited for seven years to get services on the Innovations Waiver and now she is being told that her daughter is in danger of losing all her services within 60 days.
“The invidual we deal with at Trillium has been good when we met with her, however, she will flat out tell me that she cannot help with any appeals or challenging or questioning this at all. I am working on appealing this now. But I have a health care background — not everyone has someone who can take this time to make calls and research the laws and find out who to talk to.”
Waters said she is not happy with the communications process with Trillium so far.
“My Eastpointe worker was fantastic,” Waters said. “I had her cell phone number, she would come out to my house or I could drive up to Eastpointe, which was located right behind Nash General Hospital. With Trillium, I can only call a 1-800 number, and the closest facility is in Greenville.”
Ernest Jeffries is a caretaker for Montel Hawkins, 24. Jeffries not only worries about how the cuts will affect him financially, but also about how they will affect his client. Jeffries said a care coordinator did assess Hawkins and assured them that nothing should change because they were under the budget. However, Jeffries then got a letter from Trillium saying they would only pay for about 78 hours of services between Sept. 8 and Oct. 31.
“They are not concerned about the behaviors of these people with special needs. They are used to certain things, and you can’t change things like that. Routine is everything,” Jeffries said.
Wainwright said she urges people with such concerns to contact Trillium and go through the appeals process.
“The state requires us to offer due process in case of a dispute and we take that seriously,” Wainwright said. “It they are not happy with the results, we have a robust grievance procedure. We welcome feedback and want people to contact us if they feel that something is not right.”
Wainwright said she is certain that the cases could be resolved in a way that is in the best interests of the clients.
“We will do everything we can to make sure that people are getting the level of service they need,” Wainwright said.