Tennessee Justice Center

Tjc provides legal representation and advocacy for individual clients and on behalf of large groups of vulnerable, low-income tennesseans. During 2022, tjc handled 1,216 cases for vulnerable clients in the resolution of their legal problems, some of which involved administrative appeals procedures outside the judicial system. Tjc also advocates for improved administration of Justice in general sessions court by creating resources and pushing reforms that make this court more accessible to unrepresented individuals. Tjc conducted training for private attorneys to enable them to handle such appeals on a pro bono basis. These cases served the public by promoting the rule of law by holding government programs and contractors accountable for compliance with the law, and by affording access to equal Justice under law to indigent clients who would not have otherwise been able to vindicate their legal rights. Tjc also partnered with healthcare providers through training, technical assistance, and medical-legal partnership to help their patients access necessary coverage, avoid medical debt, and support the healthcare infrastructure on which all tennesseans depend. In addition to those services, the organization litigated the following case in the judicial system in 2022:a.m.c. V. smith (tenncare disenrollment): this lawsuit was filed on march 19, 2020. Tjc and co-counsel have engaged in the discovery process with the state following a subsequent june briefing on the preliminary injunction and class certification motions, as well as a motion by the state to dismiss. Discovery in the amc case in the summer 2021 disclosed the fact that tenncare had unwittingly terminated the coverage of 3,000 children and adults who remained eligible, prompting the state to reinstate their coverage. Tjc anticipates this case will go to trial sometime in the fall of 2023. Immediately after the case was filed, federal covid relief legislation required states to suspend all terminations of medicaid coverage while the federal declaration of a public health emergency (phe) remains in effect. Tenncare officials have recently said that, when the phe ends (probably by april 2023) and the moratorium on terminations ends, the state will begin a process of terminating 350,000 children and adults over a 12-month period. This looming threat makes this case all the more important, because we allege that tenncare's notices, appeals and accommodation of people with disabilities are all defective and fail to protect eligible people from wrongful termination of their coverage.mccutchen v. becerra (block grant): in january 2021, with the trump administration nearly out of office, cms approved Tennessee's amendment converting tenncare to a block grant for ten years. This is a case of national importance. The tenncare block grant, if allowed to stand, poses the most serious national threat to the medicaid program since congress narrowly defeated the 2017 bill to repeal the affordable care act and block grant medicaid by statutory amendment. On june 30, 2022, cms sent a letter to tenncare asking it to amend its block grant proposal to remove its draconian prescription drug coverage limits and to essentially remove the block grant funding mechanism portion. In august, tenncare withdrew the pharmacy provision and modified the funding provision, which was a major victory benefiting all tenncare enrollees and eliminating precedents that endangered the future of the medicaid program. The amended tenncare iii proposal was subject to another comment period from september 6, 2022 to october 6, 2022. Analysis of the results from the comment period are expected in early 2023.m.a.c. V. smith (didd home care): on july 2, 2021, tjc's litigation team filed a lawsuit challenging the inequities associated with tenncare enrollees' home care as part of the didd waiver. The first case management conference with the magistrate judge occurred on september 29, 2021 and subsequently the state filed a motion to dismiss and a motion to stay discovery during the pendency of the dispositive motions. In december, judge crenshaw denied the state's motion to dismiss and the case is proceeding to discovery in the coming weeks. In 2022, tjc settled the case and successfully added additional intervenors who will benefit from the settlement terms obtained in the lawsuit. The tjc anticipates filing a motion to be awarded attorney fees in this case in 2023.glover v. smith / staggs v. smith (institutional medicaid effective date): on august 9, 2022 and november 28, 2022, tjc appealed two administrative rulings concerning the effective date of our client's institutional medicaid coverage. Institutional medicaid is a special category that covers people who require more than 30 days of care in a medical institution. Federal law has a specific provision on institutional medicaid that requires that the start date of coverage begin on the first day of the 30-day confinement period in an institution. The purpose is to cover what would otherwise be catastrophic medical expenses incurred over the course of confinement. Tjc client, mr. glover, was in the hospital from december 2021 to april 2022 as a result of cardiovascular, respiratory, and endocrine issues. He accumulated nearly $1,000,000 worth of medical bills in the process. Tjc's other client, keith staggs, has medical bills of over $100,000 from his stay. The effective date of his coverage determines whether both men have overwhelming medical debt or not. Reversal of the state rule would benefit more than a thousand families each year.

Tjc's nutrition advocacy program supports greater access to affordable nutrition, including defending and improving safety net programs like snap (formerly food stamps) and school-based meal programs. Tjc protects these programs against cuts at the state and federal level. Tjc educates and convenes other agencies and stakeholders who intersect with low income tennesseans. Our team works with low-income clients across the state that have been wrongfully denied or lost their snap benefits. We address child hunger and poverty through wic expansion efforts and advocating for stronger child nutrition programs. We educate our community about how nutrition programs like snap and wic put food on the table for tennesseans who struggle with hunger and pull families out of poverty. Over 1,000 stakeholders receive our monthly updates and dozens of partners statewide join us at trainings and regional anti-hunger meetings to work together for a state where no Tennessean goes hungry.in 2021, tjc continued to play a pivotal and crucial role in ensuring that tennesssee families were able to take advantage of pandemic-ebt, a benefit created in the response to the covid-19 pandemic to support families whose children participate in free and reduced-price school meals as a part of the national school lunch program (nslp). Tjc also worked with refugee resettlement partners and public officials to help afghan refugees receive much-needed nutrition benefits following their desperate evacuation from kabul and subsequent arrival in Tennessee.

Tjc's medicaid, independence and children's health advocacy programs focus on improving the well-being of tennesseans, particularly those who are vulenerable and have low income, by ensuring access to affordable healthcare coverage. Tjc is currently leading a statewide campaign to get the tn legislature to expand tenncare. Tjc engages organizational partners and grassroots volunteers to contact tn lawmakers to ask them to draw down $1.4 billion/year in federal healthcare funding in order to provide health insurance to 300,000 tennesseans (including 24,000 veterans), generate 15,000 jobs, protect the state's rural hospitals, and provide much-needed funding to address the opioid epidemic.tjc's independence program aims to ensure seniors and adults with disabilities receive the support they need. Tjc helps individual clients, provides training sessions to health care and social service providers, and advocated for systemic change to programs that allow seniors and adults with diasbilities to live with safety, dignity, and independence.also among tjc's goals is to ensure that every child in Tennessee is enrolled in health insurance and that public health insurance programs work effectively to meet children's needs. The team educates the public, policymakers, and community leaders about the importance of vital children's healthcare programs, such as medicaid and the children's health insurance program (chip), and the need to protect and improve these programs to better meet the needs of children and families in Tennessee. It also educates community partners and advocates through in-person and virtual trainings, education materials, and a monthly newsletter.