Health Services System Changes Policy, Thanks to A Local 21 Member’s Activism

Robin Hansen, an Engineering Associate 2 (5366) and Local 21 member, isn’t someone who backs down easily. “I’m going to pursue something if I feel like there’s an injustice,” she said.

She has children who have learning disabilities. She’s used to pushing back against regressive institutional policies to ensure her children have the resources that they need.

So, when she realized that existing HSS (Health Services System) policies regarding health coverage for adult children with disabilities seemed to unfairly penalize the parent and child, she set about to change it. 

HSS policy allows a member’s children to stay enrolled on their insurance until they turn 26. However, adult disabled children need to stay on their parents’ insurance past 26. Until recently, HSS’s policy on adult disabled children was that the adult child must be continually enrolled in an HSS medical plan from age 18 to 26 to qualify for coverage past the age of 26. This means the child needed to be on the same insurance for 8 years straight with no breaks, or they wouldn’t qualify.

That’s what happened to Robin Hansen and her son. Right before her son turned 25, Robin talked to personnel at a health fair about her situation. She had a special needs adult child, and the need for her son to stay on her health insurance after he turned 26. They directed her to fill out some paperwork. Robin sent in the paperwork, only to be told that her son was getting taken off her insurance because when he wasn’t enrolled continuously on her plan.

“It is a really difficult life being the parent of a child with disabilities and my son is not my only disabled child. This life is also extremely expensive so my husband (also a public PERS employee) and I would switch the children back and forth to whichever employer would offer the same insurance for a lower price.  Due to high special education and therapy costs we have qualified for the IRS medical deduction since our son was 10 years old,” said Robin.

When she was informed of the health insurance application rejection, Robin looked over the eligibility criteria on adult disabled children, and it “sounded so ridiculous, it didn’t compute.” Her son was on her health insurance for 5 years straight, but the HSS required 8. For comparison, her husband’s system only required adult disabled children to have been enrolled for one year prior. She did her research, and couldn’t find any other policy as punitive as the HSS’s regarding disabled adult children.

Robin wrote several letters to the HSS Board on the rule. “Our family has incurred staggering costs trying to make our children as highly educated and as high functioning as possible.  Unfortunately, despite our best efforts, it is unlikely that our children will live independently. Since our children are borderline, there was always the possibility that they could gain independence. It is all but impossible to predict their outcome until they are adults and attempt college and real life experiences. My children will likely not be able to be financially independent and pay for health insurance,” she wrote. “I wish that there was some sort of a signed release to let parents know that this rule exists. It also seems extremely unfair that if I quit my job and came back to the city, then this rule would not apply!”

“It was nerve wracking and stressful,” said Robin of the experience. But her efforts paid off.

The HSS Board called her personally and said they agreed; they couldn’t find a rule like that anywhere else. Because of Robin’s advocacy, the restrictive policy that governed the continuation on disabled children 26 and over has been revised. The policy going forward will change for everyone.

“For people with kids who have disabilities, it’s hard. Invisible disabilities are much harder to prove, because they look ok. I’ve been in continuous litigation for my three kids to make sure they got the education they need,” said Robin. “I’m used to fighting battles. I don’t take no for an answer easily, unless they give me a reasonable response.”

She shared her fears about the ongoing effort to take 32 million Americans’ health insurance away. “I was afraid that with the ongoing national healthcare battle, he would be left with nothing; even Medical would be taken away if they repeal the Affordable Care Act. Then there would be a break in coverage, and he’d be uninsured.”

When asked about her reaction to the decision, Robin said “I’m really happy they’re changing the whole system. When you’re dealing with schools, you must sign a gag order—it’s a ‘were giving you this, but you can’t tell anyone, because then we must accommodate them, too.’ I have coworkers who also have kids with disabilities, but they might not be aware. The silly little rule was buried in a quarter of an inch-thick booklet. It didn’t seem right.”

During Robin’s free time, she volunteers with Support for Families of Children with Disabilities, where she mentors other parents who have children with disabilities. Thank you, Robin, for standing up for what’s right, and changing the HSS rule for all City and County of San Francisco employees!