Gregory E. Knoll, CEO/Executive Director, Consumer Center for Health Education and Advocacy

The Legal Aid Society of San Diego, Inc. is a nonprofit law firm that provides free legal services to lower income San Diego residents. The mission of the Legal Aid Society of San Diego Inc. is to improve lives by advancing justice through effective, efficient, and vigorous legal advocacy, outreach, and education. Here are just two examples of how their services impact individual’s lives.

Housing Crisis

The Consumer Center for Health Education and Advocacy, a project of the Legal Aid Society of San Diego, received a call from a 61-year-old consumer who suffered from both mental health and physical health disabilities and was struggling with his Section 8 housing recertification. It was a complex process, and he had no experience with it. With the help of Legal Aid’s Housing Administrative Hearing Advocate, the short-term case managers helped the consumer obtain and submit the necessary documents for the recertification to keep the client in stable housing. Working, Legal Aid staff were also able to connect the client with their community partner’s, the Disability Rights Center of California, Client Assistance Program. These efforts preserved the client's Section 8 voucher and Low-Income Housing Tax Credit.

The team also helped the client use emergency flex funds from the County of San Diego to vaccinate the client's service dog, which allowed the client to comply with his newly signed 14-month lease. At the time, the client was also working to fulfill his lifelong dream of going to law school with the assistance of the California Department of Rehabilitation. These efforts helped ensure that the client could receive the assistance needed to begin his individualized education plan to attend law school. He is now preparing to take the LSAT.

Securing Surgery

A local resident was denied gender-affirming surgery (metoidioplasty or “bottom surgery”) because the requested surgeon was out-of-network for the resident’s medical insurance plan.  The plan alleged to have qualified in-network surgeons.  The consumer and Legal Aid Society of San Diego staff called the insurance company’s Member Services to request an appeal and a list of in-network providers that had the appropriate specialty and clinical expertise to complete the needed procedure.  The insurance company’s Member Services representative refused the requests, indicating that it was the consumer’s responsibility to identify a provider and to confirm if a provider was “in-network.” 

After both the prior authorization and a request to see an out-of-network provider were denied, the consumer appealed and was again denied by the plan.  Legal Aid Society of San Diego staff helped the consumer draft and file a Department of Managed Health Care (DMHC) complaint highlighting several deficiencies in the plan’s network, their non-compliance with the appeal process, and timely access to care.  After extensive advocacy on behalf of the consumer and submission of medical evidence supporting the patient’s requests, Department of Managed Health Care overturned the plan’s prior denial.  The plan then authorized the patient to see the out-of-network provider, including out-of-town travel support.  

Unfortunately, days before the patient’s surgery, the medical director of the plan reversed the authorization to cover the travel support needed to obtain the services.  This delay then led the surgical center to cancel the procedure.  Legal Aid Society of San Diego quickly filed a new Department of Managed Health Care complaint and after weeks of additional delay and extensive advocacy by Legal Aid Society of San Diego, the surgery, travel, and lodging were authorized and rescheduled.  The Legal Aid Society of San Diego’s persistent advocacy for this consumer helped the customer obtain the needed services.

Learn more about Legal Aid Society of San Diego and their services at: https://www.lassd.org/