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I've spent my entire legal career as a Legal Aid lawyer. After I graduated from law school in 1979 I worked at Legal Aid of Western Michigan for four years, and I've been working at Vermont Legal Aid since 1983. I've loved not necessarily every day of it, but definitely every year, and it's mainly because the work and the Legal Aid movement makes it possible to bring about positive change both for individual clients and for large segments of the population touched by poverty, neglect, and injustice.

Working in Legal Services for so long I know that we don't make our achievements alone, and I'm proud not only of what I can accomplish but when my colleagues are able to accomplish great things.

This is one of those stories.

At Vermont Legal Aid we have a project that provides legal representation to Medicare beneficiaries, and recently we had an individual case in which a client had been denied reimbursement for rehab services because they weren't helping her get better. No surprise because lots of people have chronic conditions that will never get better, but rehab services will help them live independent lives in their own homes, giving them the maximum level of self-direction possible, and saving society a lot of money that would otherwise be spent on nursing home care into the bargain. By good lawyering my colleagues were able to keep the independent living services coming and one Medicare beneficiary was able to preserve her independent living situation.

But it didn't stop there. You may have read about this in The Times. Vermont Legal Aid cooperated with the Center for Medicare Advocacy and filed a class action seeking to change the policy not just for our individual client, but for Medicare beneficiaries across the country who were in danger of losing the home-based that were enabling them to live outside of nursing homes. Last week it was announced that the government had agreed to settle the case, and to continue providing these vital services.

As The Times reports:

Federal officials agreed to rewrite the Medicare manual to make clear that Medicare coverage of nursing and therapy services “does not turn on the presence or absence of an individual’s potential for improvement,” but is based on the beneficiary’s need for skilled care.

The case also attracted an editorial from The Times, which said of the settlement, "It is clearly the humane thing to do for desperately sick people with little hope of recovery." and "The solution to Medicare’s cost problem is not to deny needed services but to make the delivery of care more efficient and less expensive, and to ensure better management of care for the chronically ill."

I didn't work on the case, but I'm proud to be part of an organization that was able to see the need for this change and was willing to support the excellent work needed to carry it through to success.

As I said, the work is hard, the days can be challenging, but the rewards are great.

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