Rebecca Friedman

The Project

Rebecca provided legal representation, advocacy, and education to protect low-income Medicaid beneficiaries experiencing changes, confusion, and barriers to accessing healthcare as North Carolina transitioned to a managed care Medicaid system.

In July 2021, North Carolina implemented an overhaul of its Medicaid system, launching the transition to managed care from a mostly fee-for-service system. As a result, almost 1.6 million Medicaid beneficiaries in the state entered a service delivery model very different from what many had known for their entire lives. There was widespread concern about the confusion and uncertainty that would result, and fear that individuals would be unable to receive essential care and services or see the providers with whom they had built relationships. An urgent need existed for direct support for Medicaid beneficiaries experiencing these changes and for advocacy to ensure Medicaid beneficiaries’ rights were prioritized and protected.

Fellowship Highlights

During her two-year Fellowship, Rebecca:

  • Collaborated with partner organizations and government officials to anticipate problems arising in the state’s transition to Medicaid Managed Care, successfully advocated for beneficiary protections, and educated beneficiaries and stakeholders about the major changes affecting the state’s Medicaid program
  • Conducted 18 presentations to educate allies, partners, and other service providers, and to provide substantive training to NC Medicaid Ombudsman staff about the transition to managed care
  • Participated in approximately 200 external meetings, including many recurring coalition meetings, to advance the impact and reach of her work
  • Advocated to government officials for flexibilities and enhanced support to promote access to health care and other public benefits for marginalized populations as the devastation of COVID-19 lingered
  • Represented clients denied access to Medicaid, food stamps, or other essential public benefits and helped beneficiaries understand their rights under new public benefits programs and policy flexibilities that were implemented in response to COVID-19, providing advice and/or legal assistance to over 60 individuals
  • Advocated for better care for individuals with serious behavioral and intellectual disabilities in Mecklenburg and surrounding counties

Next Steps

Rebecca will continue in the Charlotte Center for Legal Advocacy’s Family Support and Health Care Program as a Staff Attorney, where she will persist in advocating for Medicaid beneficiaries’ rights as North Carolina’s managed care system’s implementation continues. She will provide direct representation to low-income recipients of Medicaid, food stamps, and other public benefit programs in Mecklenburg County and advocate for statewide policy improvements.

Media

NC Medicaid Beneficiaries Urged to Find Plans Under New Managed Care

Confused About Medicaid Transformation? Here's Some Help

Big Change To NC Medicaid System Takes Effect Thursday

The Project

Jessie expanded legal advocacy to create access to quality mental health services for Alameda County’s foster youth through direct representation, community collaboration, and policy implementation.

More than half of foster youth have a need for mental health services; however, many are over-institutionalized and receive minimal mental health services. Children with troublesome behavior are placed into alternative schools or restrictive group homes and about 25 percent of foster youth are prescribed psychotropic medications with little oversight. An attorney is needed to confront the legal barriers that prevent foster youth, especially youth of color, from receiving adequate mental health treatment.

Fellowship Highlights

In the past two years, Jessie has:

  • Provided direct representation to 53 foster youth with high mental health needs, participating in two trials and numerous settlements on behalf of her clients;
  • Consulted with 38 individual foster youth hospitalized for a psychiatric emergency to ensure protection of their legal rights in placement and medication;
  • Reviewed more than 270 psychotropic medication requests and conducted follow-up with providers and youth on many of these;
  • Interviewed around 15 youth held in juvenile hall and represented them in delinquency hearings by providing information regarding mental health and trauma history;
  • Conducted over 30 trainings on legal mental health topics, including local psychotropic medication approval procedure; foster youth mental health privacy protection; trauma-informed systems; guardian ad items for transition-aged youth; and the basics of dependency practice;
  • Obtained a $23,000 grant to support ongoing review of psychotropic medication requests for foster youth.

What’s Next

Now that the Fellowship is complete, Jessie plans to:

  • Continue her mental health advocacy for foster youth at East Bay Children’s Law Offices;
  • Incorporate trauma-informed representation and mental health awareness into advocacy for foster youth who are charged with crimes or detained at juvenile hall, and youth who are at risk of being commercially sexually exploited;
  • Train additional providers, courts, and attorneys;
  • Maintain thorough self-care to enable her continued open heart for her clients.