Joe contacted OCRA when he received an overpayment notice that said he owes Social Security more than $45,000. Although Joe has been a regional center consumer for most of his life, Social Security determined that his disability had ended because he earned too much money in certain months. Because Social Security had already paid him for all of those months, he was overpaid $45,000 in SSDI benefits. OCRA assisted Joe in completing forms to show that he had subsidies in his past employment that should have been considered when determining the total amount of his earnings.
For several months, Dustin experienced resistance from his Section 8 voucher landlord in making reasonable modifications to his apartment so he could continue to live safely and independently. OCRA sent Dustin’s landlord a demand letter explaining his disability and new health issues. The letter clarified how Dustin’s health concerns require railings to be installed at his apartment’s front steps and grab bars added to the inside of his shower.
Carl repeatedly received bills for a medical service which he believed his medical insurance should have paid. Carl has both Medicare and Medi-Cal. OCRA contacted the medical provider to make sure they had Carl’s correct insurance information and had properly billed. OCRA also told the provider that state and federal law prevents them from “balance billing” because it accepted Carl as a Medi-Cal beneficiary when it provided the medical treatment to him. OCRA discovered that the medical provider simply had the wrong address for Medicare and Medi-Cal.
After being discharged from the hospital, Julie could not attend school because her immune system was compromised and she had extensive medical needs. Once her health stabilized, her parents notified Julie’s school that she was ready for educational services in her home. The school district demanded that Julie return to the public school setting, threatening truancy action against Julie’s parents if she didn’t return. OCRA attended an IEP meeting to obtain educational supports and services in the home.
Ana’s IHSS social worker told her they were terminating her IHSS benefits completely, but did not send her a written notice of action. Ana’s IHSS provider continued to serve her, but had not been paid from July 2015 to December 2015, despite numerous calls and attempts to contact the county about the issue. OCRA agreed to assist Ana by using the advocate inquiry complaint process. OCRA sent the inquiry, noting the verbal IHSS termination with no written notice of action and no payments to the provider, and requested review of Ana’s case.
Owen is a young adult who attends junior college. He is a very talented computer artist and hopes to eventually get a job in computer graphics and be self-supporting. He was receiving SSI and signed up for the SSI Ticket to Work program with the Department of Rehabilitation. The Ticket to Work program allows recipients to postpone the SSI eligibility redetermination process during the time they are training for the work which will make them self-supporting. There was a typographical error in Owen’s Social Security number on the original DOR application.
After frequently arriving late to his day program, George and his parents wanted to change his transportation vendor. OCRA informed George’s parents of the regional center’s responsibility to provide transportation as written in his IPP. OCRA also informed George’s parents of the right to request a new transportation vendor and to review the referral packets that the regional center was sending to the proposed transportation agencies. George’s parents requested to change the transportation agency and to review the referral packets.
Satoshi is a young child who comes from a monolingual Japanese-speaking family. His parents applied for Medi-Cal on his behalf. The application was denied multiple times due to errors and incorrect information. OCRA appealed all of the notices and contacted the Medi-Cal eligibility worker to correct the errors and misinformation that had triggered the denials of eligibility. Within a week, Satoshi received his notice of eligibility and Medi-Cal card. Satoshi is now able to access the Medi-Cal therapy services he needs.
Hector has Medi-Cal through a managed care plan (MCP). Hector’s doctor requested a speech-generating device for him, which the MCP denied. OCRA researched Hector’s right to have Medi-Cal fund the speech device and advised his mother to file an appeal. OCRA negotiated with the MCP to determine which speech device would be appropriate to meet Hector’s needs. After many conversations with Hector’s educational speech and language pathologist and the MCP hearing representative, the MCP agreed to fund an iPad with the appropriate software to meet Hector’s needs.
Tomas is 61 years old and has profound intellectual disability. He does not speak, but communicates through his behavior. Tomas does not have any family or friends involved in his life and does not have a conservator appointed by the court. Tomas had lived in a developmental center for more than 55 years, since he was five years old. His transfer to a less restrictive community group home setting was well-planned with considerable cross-training between the developmental center staff and the group home to ensure staff understood Tomas’s behavior and could provide appropriate services.