Hart v. Berryhill Settlement Means Social Security Relief for Many Bay Area Clients

Hart v. Berryhill Blog Graphic

By, Rebecca Levin

A recent class action settlement could mean relief for many Bay Area residents whose Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) were denied or terminated between 2007 and 2013.

The case of Hart v. Berryhill, challenged consultative examinations conducted by Dr. Frank Chen, who was disqualified from performing medical exams after numerous complaints. The complaints were related to quality of his reports, the thoroughness of his examinations, and his manner toward claimants. Dr. Chen’s examinations were used as the basis for Social Security Administration (SSA) to deny or terminate SSI and/or SSDI benefits.

One such case was that of plaintiff Kevin Hart, who saw Dr. Chen in 2013 after applying for disability benefits due to injuries sustained after being hit by a car. The injury completely shattered his leg and resulted in permanent disability. “He didn’t even know me, he didn’t even look at me,” said Hart of the interaction he had with Dr. Chen. The report that Dr. Chen provided to SSA did not even note that Hart required a cane in order to walk.

Justice in Aging represented Hart and a class of approximately 4,000 other California residents whose benefits were denied or terminated based on Dr. Chen’s reports. The case resulted in a settlement that went into effect on June 26, 2017. SSA is currently undergoing an evaluation of effected cases and will send out settlement notices in July to eligible individuals.

Clients whose benefits were denied or terminated between 2007 and 2013 should contact SSA as soon as possible to verify their current mailing address to make sure they receive any relevant information regarding this case. To do so, please call 1-800-772-1213. 

The first set of settlement notices:

  • will be mailed out no later than July 17th;
  • will be sent to class members whose claims are still pending; and
  • these group members must decide whether to elect relief within 30 days after receiving their notice

The second set of settlement notices:

  • will be mailed out no later than September 25th;
  • will include class members who have closed claims that resulted in a fully unfavorable for partially favorable decision; and
  • this group must decide whether to elect relief within 90 days (for fully unfavorable decisions) or 180 days (for partially favorable decisions)

For more information, contact Trinh Phan at Justice in Aging, 510-931-4203.


Just in Time for Pride: PRC’s Ads Live on Grindr, Out, Advocate, and Muni

Just in Time for Pride- PRC's Ads in the Community (1)

What do walking around in downtown San Francisco, checking your favorite LGBT online media, and looking for the next love of your life all have in common? You can see Positive Resource Center’s ads by doing all three. That’s right—just in time for San Francisco Pride 2017, PRC has published ads on Muni busses and light rail vehicles, Out Magazine, The Adovcate, and Grindr’s mobile app.

With the support of Getting to Zero SF, PRC’s ads promote awareness about the high cost of obtaining antiretroviral therapy (ART). According to the Centers for Disease Control and Prevention, the average annual cost of ART was an estimate $23,000 in 2010 dollars. PRC’s ads ask the formidable question: what could that money be spent on instead of medication?

The resulting ad campaign brings attention to the fact that HIV treatment doesn’t have to have such a hefty price tag. Thanks to the Office of AIDS Health Insurance Premium Payment (OA-HIPP) and AIDS Emergency Fund’s Health Insurance Premium Payment (AEF-HIPP) programs, San Francisco residents living with HIV can get the help they need at a price they can afford.  These programs pay for medical copays and insurance premiums for qualifying individuals, making getting medication and seeing a doctor affordable for low-income San Franciscans.

For many San Francisco residents with HIV, the financial assistance these programs provide could mean life or death. Those who cannot afford this medication and are not connected to organizations like PRC too often go without the medication they need to survive. PRC’s benefits counseling program focuses on getting these SF residents the assistance they need to survive.

For more information on OA-HIPP, AEF-HIPP, or PRC’s ad campaigns, please call PRC at 415-777-0333.

Frontline Worker Spotlight: Recipients of the 2017 US Conference on AIDS Scholarship

Frontline Worker Spotlight (10)

By, Rebecca Levin

Positive Resource Center’s work in the community extends beyond interactions with clients with its work in the Frontline Organizing Group (FOG), a group that provides training and networking opportunities to San Francisco’s HIV frontline workers. As a founding member, PRC’s work with FOG has opened new opportunities for the growth of many San Francisco frontline workers.

This year, FOG extended scholarships to six exceptional individuals working directly with people living with HIV in San Francisco to attend the 2017 United States Conference on AIDS (USCA) in September. Recipients will present their findings at a FOG training.

After careful deliberation, FOG selected the following individuals:

Dianne Georgetti is a Registered Nurse Case Manager at Westside Community Services. Dedicated to improving the psychological, spiritual, and physical health of community residents, Westside Community Services provides a wide range of mental health, case management, and substance use services to community members, regardless of HIV status. Dianne’s clients “have been discriminated against for years and some live lives made extremely difficult by the nature of the social and government structures in place here in the US.”

In her own words: “I have had a personal connection to the AIDS epidemic since I was 12 years old and I am committed to advocating for this community for the rest of my career.”

Edwin Geovani Espinoza is a Youth Advocate / Health Educator at Instituto Familiar de la Raza. Since 1978, Instituto Familiar de la Raza has been providing culturally competent therapy, case management, social support and classes to the Chicano/Indigenous/Latino community. Edwin hopes “to gain knowledge on how to improve prevention strategies for transitional age youth and how to keep those living with the virus on a treatment plan.”

In his own words: “I hope this conference helps me become a better role model to Latino LGBTQ youth who lack resources that cater to their various cultural backgrounds and might have a difficult time facing the stigma of living with HIV, being LGBTQ, and being Latino all at once.”

Jorge Vieto is a Health Systems Navigator at GLIDE Memorial. GLIDE’s mission is to promote inclusivity, justice, and love in order to alleviate suffering and break cycles of poverty and marginalization. GLIDE provides food, health services, a crisis walk-in center, and a legal clinic to assist its mission. As a phlebotomist and linkage to care representative at GLIDE, Jorge is interested in learning about, “how biomedical HIV prevention is being expanded to people of color and trans folks,” expand his scope of work, and how to affect public policy initiatives.

In his own words: “Attending USCA  would expose me to new perspectives and ideas to help reach folks that are disenfranchised, homeless, and undocumented to find the care they deserve and STAY in care regardless of the barriers they may face.”

Patrick Kinley is a Rapid Linkage Specialist at San Francisco City Clinic. SFDPH’s mission is to protect and promote the health of all San Franciscans, regardless of immigration, insurance, or HIV status. At USCA, Patrick hopes to learn about new innovations for retention in care, information on the most successful interventions for Pre-Exposure Prophylaxis (PrEP), and different methods for reducing stigma in the San Francisco community.

In their own words: “I [will] use the knowledge I acquire [at USCA] to better implement and coordinate RAPID and early retention efforts here in San Francisco.”

Pau Lagarde is a HIV & Mental Health Case Manager at A Woman’s Place. This 24-hour supportive residential service organization offers emergency shelter and long-term treatment to women and trans women with special needs, such as mental disabilities, sexual or domestic violence, drug and alcohol use, and HIV/AIDS. At USCA, Pau hopes to learn more about bringing down the barriers to care for many transgender people of color, such as, “language barriers, discrimination, racism, anti-LGBT policies, stigma, lack of health coverage, immigration status, [and] awareness & education.”

In his own words: “I care deeply about my clients and my goal for them is to know that they don’t have to be alone in this fight, they don’t have to feel hopeless.”

Zachary Davenport is a Behavioral Health Clinician at South Van Ness Adult Behavioral Health Services, San Francisco City Clinic, and San Francisco Department of Public Health. South Van Ness Adult Behavioral Health Services provides intensive case management, medication monitoring, individual and family therapy, group therapy, socialization, and peer support to a variety of individuals in the community. Zachary’s primary focus for the conference is cis and trans women. More specifically, they “want to better learn how to advocate for changes within the systems of public health that will promote greater outreach that is cultural relevant to trans and cis women.”

In their own words: “One of my best friends was an HIV positive trans woman who was murdered over 10 years ago in the Tenderloin, so I am very passionate about increasing access to services for trans women, gender non-conforming individuals, and women.”

Scholarship recipients will give presentations on the information they received at FOG trainings and other meetings. To find out more about FOG trainings and events, email sfhivfog@gmail.com.

American Health Care Act Knowledge Roundup

American Health Care Act knowledge roundup (1)

By, Rebecca Levin

On Monday, house Republicans revealed their alternative to the Affordable Care Act (ACA). The American Health Care Act (AHCA) involves multiple reversals to ACA policies and will affect many Americans. Here are some useful resources we’ve identified to help digest what exactly these changes are and how they will affect people living with HIV:

  • This New York Times article lays out, point by point, the changes from the ACA to the AHCA.
  • POZ Magazine’s analysis looks at the present and future effects of the AHCA on people with HIV.
  • Vox’s article is easy to understand and covers how the plan will affect patients with chronic illnesses, like HIV.
  • The Kaiser Family Foundation’s Interactive Map compares the tax credits under the Affordable Care Act to the tax credits under the American Health Care Act.
  • The Center on Budget and Policy Priorities’ article takes an in-depth look at how the Medicaid per capita cap would affect coverage.
  • The Western Center on Law and Poverty’s two pager discusses how the AHCA will cause changes to Medi-Cal coverage and shift major financial burden to California.

The Termination of A.J. Boggs and What It Means for You


By, Rebecca Levin

The California Department of Public Heath (CDPH) has terminated its contract with A.J. Boggs for AIDS Drugs Assistance Program (ADAP) administration.

Effective March 6, 2017, CDPH will directly provide all ADAP eligibility and enrollment services. CDPH is in the process of developing a new enrollment portal, call center, and data processing center for program administration.

The termination of the A.J. Boggs’ contract does not require any action from ADAP clients, but it will cause important changes to enrollment workers’ processes in the following weeks. Clients and providers should keep in mind the following information:

If You Are a Client:

  • The benefits you are receiving, the enrollment worker you work with, and the pharmacy you use will not be impacted by this change.

If You Are an Enrollment Worker:

  • Through 5pm March 3, 2017, continue submitting documentation to A.J. Boggs and calling the A.J. Boggs support team (Ph: 844-550-3944, Fax: 844-666-1411)
  • Beginning Monday, March 6th
    • Call 844-421-7050 for questions regarding eligibility or ADAP enrollment.
    • Fax documents related to Medical Out-of-Pocket Claims to Pool Administrators Inc. at 860-560-8225.
    • For questions regarding medication access at the pharmacy, call Magellan 24 hours a day, 7 days a week at 800-424-5906.
  • If you previously sent information to A.J. Boggs and have not heard back, please fax the information to CDPH at 844-421-8008.
  • Beginning the week of March 13th, the Office of AIDS will start providing enrollment workers training and access to the new enrollment portal.
  • OA-HIPP documentation should be submitted directly to the appropriate OA-HIPP Analyst or faxed to OA-HIPP at (916) 440-5490.

Open Enrollment Ends Today—Don’t Wait!


By, Rebecca Levin

The first month of 2017 is almost gone, and with it, the open enrollment window for health insurance. The time to enroll is now. Be sure to enroll in a health insurance plan through Medi-Cal benefits by January 31 to access benefits in 2017.

If you attempt to enroll by January 31st and do not complete your application, you have until February 4th to complete your Open Enrollment application to receive benefits.

Keep in mind that Covered California might not be your only option. Medi-Cal offers year round enrollment and can pay for treatment and medication. You might qualify for Medi-Cal benefits if you:

  • Have an annual income that is below 138% the poverty level ($16,395 for a single adult)
  • Are 65 or older
  • Are blind or disabled
  • Are under 21 (or are a parent, caretaker relative, of a child under 21) or
  • Are pregnant

PRC’s Equal Access to Healthcare Program is here to help HIV+ San Francisco residents who have problems accessing healthcare. Give us a call at 415-777-0333 for help and more information.


By Chuan Teng, Esq.

Managing Legal Director

CA Office of AIDS’s Health Insurance Premium Payment program (OA-HIPP) now pays the first month’s premium (“binder payment”) for eligible health insurance plans (Management Memo 2016-18). Individuals must enroll in OA-HIPP within 48 hours of enrolling in a health insurance plan to access the binder payment benefit via OA-HIPP.

Individuals who miss the 48 hour deadline for binder payment may be eligible for limited special funding through AIDS Emergency Fund. See below.


The following health insurance plans sold through Covered CA are eligible for OA-HIPP binder payment.

  • Blue Shield
  • Kaiser
  • Anthem Blue Cross (non-Covered CA plans also eligible)
  • Health Net


New clients must enroll in OA-HIPP with a certified ADAP/OA-HIPP enrollment worker within 48 hours of enrolling in an eligible health insurance plan to access binder payment.

NEW CLIENTS: Immediately after health insurance plan enrollment, submit to an enrollment worker a Covered California Enrollment History or Current Enrollment summary page which includes the following information:

      • Premium amount
      • Health plan name and medal tier
      • Advanced Premium Tax Credit taken
      • Health plan billing address (if available)

(*A screenshot or screen-print(s) from the Covered California account is permissible.)

ENROLLMENT WORKERS: Submit enrollment documentation through the A.J. Boggs portal by creating an Update Form using the People Picker tool and inform your ADAP Advisor of a new pending OA-HIPP application within 48 hours of the client’s health insurance enrollment.

[1] Existing OA-HIPP clients must update their health insurance information in the A.J. Boggs portal as soon as possible to ensure ongoing premium payments.

    • STEP 1: Create an Update Form by using the People Picker tool to upload the enrollment documentation in the “most recent Covered California medical plan billing statement[2] field under the “Insurance Assistance” tab in the A.J. Boggs portal.
    • STEP 2: Enter the Covered California enrollment confirmation number located in the top left corner of all summaries into the “Member or Subscriber ID” field.
    • STEP 3: Promptly notify ADAP Advisor that a new OA-HIPP application has been submitted and requires initial payment so the application is prioritized for review/approval.
    • STEP 4 (Follow-Up Steps Required AFTER Enrollment): Upload client’s billing statement with the client’s health plan member ID/policy number to the A.J. Boggs portal by creating an Update Form. The client will receive a health plan billing statement from his/her health plan once initial payment is made by OA-HIPP.

If the client misses the 48-hour deadline to enroll in OA-HIPP for binder payment, the client will need to make the initial premium payment out-of-pocket to secure health insurance. See below for special funding.


Limited special funding through AIDS Emergency Fund is available for individuals who miss the 48-hour deadline to enroll in OA-HIPP to access a binder payment. HIV-positive San Francisco residents may be eligible for special funding. For more information, contact AIDS Emergency Fund (415-558-6999 x 228).

[1] Existing OA-HIPP clients must update their health insurance information in the A.J. Boggs portal as soon as possible to ensure ongoing premium payments.

[2] A billing statement is not required at the initial OA-HIPP enrollment. However, a billing statement must be uploaded in the A.J. Boggs portal after the binder payment is made and the health plan issues a billing statement to the client. See Step 4.