by Liz Daube
Staff Writer
Taking on a new area of law is never easy for a busy legal aid attorney but Megan Wall is doing just that. She is expanding Jacksonville Area Legal Aid’s public benefits work to tackle new challenges facing the developmentally disabled.
In the last five years, the state has directed the Agency for Persons with Disabilities to review Medicaid waiver plans and reduce costs. As a result, many developmentally disabled people have had some of their services deemed medically unnecessary and cut.
“We’re really branching into a whole new world of advocacy,” said Wall, who heads the JALA branch in St. Johns County. “This community was untouchable previously. In the past, people thought, ‘We should at least take care of these people if no one else.’ (But) about five years ago, the cuts started everywhere.”
Wall recently received the Ray Watson Brotherhood award from the Association for Retarded Citizens of Florida, a branch of the national nonprofit commonly known as ARC. She received the award in honor of her work with the ARC in St. Johns County, where she has provided legal advice and argued for clients’ medical services.
“She does a lot of advocacy work behind the scenes,” according to David Vincent, residential services director at the St. Johns ARC. He said Wall helps ARC with everything from appeals to everyday questions.
John Hall, executive director of ARC Florida, said Wall’s work is especially important because few attorneys in Florida have experience with Medicaid waiver hearings.
“She shares that information with other attorneys, as well,” said Hall. “They’re able to use some of the arguments that she’s put forth.”
Hall said developmentally disabled people usually don’t have the roughly $10,000 in legal fees that attorneys want, so few lawyers take on the Medicaid waiver issues.
That’s why Wall’s work has been particularly important. She said JALA is the first legal aid organization in Florida to start tackling that area of law.
“We never had this marriage before with this group (ARC) because they were untouched,” said Wall. “It’s a new, huge issue. It’s a whole big flood of new work.”
Wall said she’s devoted nights and weekends to her cases, but she thinks her accomplishments justify the lost leisure time. She explained that her clients have a lot at stake.
Chris Beckner, for example, is one of Wall’s developmentally disabled clients. Wall said Beckner faces a host of physical challenges, as well. He has received a kidney transplant and he takes 17 medications. The drugs keep his body from rejecting the transplanted organ, boost his weakened immune system and control his diabetes.
The state chose to reduce his nursing care because reviews of his paperwork didn’t find his level of care to be medically necessary, according to Vincent. Wall helped defend Beckner’s need for close monitoring and nursing services.
“They were saying he could do his own injections,” she said. “He can’t even read and write.”
Wall devised a mathematical system with Beckner’s nurse to justify the hours she spends with him. Wall said that evidence backed up the nurse’s stories about
Beckner.
The nurse worked with Beckner frequently, so she knew him well, Wall said. If his skin color was off or he acted funny, the nurse could detect a problem when a rotating team of nurses – which costs less – could not.
“A lot of things go hand-in-hand, and that’s one of the things I’ve learned about the community. They don’t complain about pain,” said Wall.
She explained that the one time Beckner mentioned a headache to his nurse, she took him to the emergency room because she knew it was unusual.
“If he’d waited two hours more, he would’ve been dead,” said Wall. “It’s the difference between life and death that they (developmentally disabled people) have the same nurse.”
Beckner ultimately got to keep his nurse. He repaid Wall with what she called “the biggest hug of my life.” Wall said she plans to continue her advocacy work, although she can’t be sure of its effects.
“You act locally and the word spreads,” she said. “You never know how far the ripples will go.”