In 2016, 29 year old Kelsay Mannor, who is diagnosed with cerebral palsy, was denied a stander by the Michigan Department of Health and Human Services (MDHHS). Physicians at the University of Michigan, where Kelsay receives treatment, encouraged her to apply to MDHHS for a standing frame or “stander.” This assistive technology is useful for a person in Kelsay’s condition who relies on a wheelchair for mobility. A stander supports the individual in a standing position and allows for alternative positioning. For Kelsay, this would increase her quality of life and maintain her independence as she ages.
In the spring of 2016, Kelsay and her mother contacted DRM after MDHHS denied their request. The department told Kelsay their services only pay up to age 21 and since she was 29 her request was denied. The law under Medicaid regulations states that MDHHS is required to conduct an individualized medical needs assessment for anyone over 21.
DRM advocates gathered information about Kelsay’s case. MPAS then wrote to MDHHS asking them to address the reason why a particular individual would be denied solely on their age. MDHHS responded and stated it does not deny based on age and the department is in full compliance of Medicaid regulations.
In the fall of 2016, MPAS encouraged Kelsay to re-apply to MDHHS for a second time. MDHHS responded that Kelsay was over 21, she did not medically need the stander, and it was exercise equipment. Based on the second denial letter, MPAS attorneys filed a Medicaid appeal in December of 2016. The trial was set for May 2017 and DRM submitted their pre-hearing brief. One day before the hearing, MDHHS issued a reconsideration, approving the stander for Kelsay.
“Unfortunately, denial notices are sent to individuals all the time”, said Chris Davis, a DRM attorney representing Kelsay. “Most clients do not know the law and these decisions look very black and white. I encourage people to contact organizations such as DRM that know the law and can restore their rights.”
Kelsay Mannor utilizing her standing frame or “stander.”