No TCM Units left for the rest of the year!

Sanchez | | 3163046368
Advocate says …

I received a disturbing letter in reference to a very vulnerable individual who has minimal supporters to advocate for his needs. {He is a ] Tier 1. 

Just an FYI… Sunflower is sending out a blanket denial of Targeted Case Management requests for more units, and I am 58 units (14.6 hours) over the allotted 240 units per year for individual. Therefore, anything I do for this individual would end up being done for free for the rest of the year. At this point it doesn’t look good for TCM’s across the state who have Sunflower as an MCO,  have high need clients and have run out of units. So far we have not had this problem with United or Amerigroup.

At this point I will keep fulfilling my TCM duties for this individual, but Sunflower has basically denied me the ability to get compensated for any services I would need to provide for individual for the rest of the year.

2 thoughts on “No TCM Units left for the rest of the year!

  1. Advocate says

    I would be very careful with this and definitely be documenting the time even if I were not compensated. We don’t want Sunflower saying “Well, we limited the hours and everything worked out fine.” and don’t think it would not happen that way. No one should be donating time so that Sunflower can make a profit!

    I just can’t believe this is happening but it was all predicted but “they” would not listen. Be sure to call the governor’s office and tell them because of this, he shouldn’t expect your vote! Perhaps those that felt this would work would like to take up a collection to reimburse those that are donating time/services to this highly vulnerable population and it is like they knew you would just for that reason so why not indulge themselves at the expense of those that care for people with disabilities. So wrong!

  2. e. remington

    A word to the wise: You only have power over people so long as you don’t take everything away from them. But if you’ve robbed a man of everything, he’s no longer in your power. Aleksandr Solzhenitsy


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