Rachel Holtzman

The Project

Rachel (she/her/hers) will represent medically fragile children (MFC) in New York City in appeals of adverse Medicaid determinations and wrongful denials of medically necessary care. Her work at the New York Legal Assistance Group will ensure that medically fragile children can remain at home, and undertake systemic advocacy on related issues.

Many medically fragile children risk being placed into settings where infectious diseases, like COVID-19, are more easily spread—places like emergency rooms, nursing homes, rehab facilities, and group residences. The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) provision of the federal Medicaid Act guarantees medically necessary health care for children under age 21. EPSDT protections, however, are poorly enforced. This leads to unlawful denials of care and places medically fragile children at risk of institutionalization. Despite the significant legal needs of medically fragile children, few legal services providers exist for MFC in New York City to avoid institutional placement. This project will address this access to justice gap, and in doing so will help keep medically fragile children safely at home with their families.

Fellowship Plans

During her Fellowship, Rachel will provide direct representation to medically fragile, low-income children through all stages of their appeals process to maintain Medicaid eligibility and access medically necessary care. She will also engage in policy advocacy and impact litigation by working with coalitions of other advocates and attorneys who are advancing the rights of people with Medicaid coverage. She will also facilitate community education for families of medically fragile children and lead educational trainings for pediatric clinicians through partnerships with local and national organizations. Finally, she will design legal trainings and toolkits to foster more sources of legal advocacy for these children and their families.

Rachel’s own chronic health condition, a voice disorder called spasmodic dysphonia, as well as her background as a Returned Peace Corps Volunteer fuel her commitment to ensuring all people have access to the health care, services, and supports they need.