A Life-Saving Victory for a Legal Aid Client
February 16, 2012
PITTSBORO, N.C. –A young woman will receive
insurance coverage for a life-saving kidney transplant thanks to
Legal Aid of North Carolina, the statewide, nonprofit law firm for
North Carolinians in need.
Ashley Quiñones, 31, of Sanford, learned last November that the
state’s Division of Medical Assistance had reversed its decision to
deny her Medicaid coverage for a kidney transplant and will now pay
for the procedure, which is scheduled for Feb. 21.
Quiñones, an English-as-a-second-language teacher who also works
with disabled children at a nonprofit, was diagnosed at age 2 with
cystic fibrosis, a life-threatening, chronic lung disorder that
forced her to undergo a double-lung transplant in 2001. The
medication she took for years afterward damaged her kidneys to the
point where by 2010 she was suffering from kidney failure and was
placed on a waiting list for a transplant.
Already a Medicaid recipient, Quiñones sought coverage for the
procedure from the Division of Medical Assistance, which manages the
federal insurance program under the N.C. Department of Health and
Human Services. Last August, Quiñones received notice that her
request had been denied. The problem was her lungs. Her body had
begun rejecting the transplants and she was diagnosed with a severe
lung disease. The Division of Medical Assistance labeled the disease
an “irreversible end-stage illness,” which disqualified her for
The denial letter Quiñones received included instructions
about the appeal process, informed her of the possibility of
receiving free legal aid and listed contact information for Legal
Aid of North Carolina. Quiñones did some research and eventually
walked into Legal Aid’s Pittsboro office looking for help.* The
Pittsboro office is one of the organization’s 20 locations where
low-income residents can go for free legal help in civil cases.
Staff attorney Tashama Williams spoke with Quiñones, advised her to
appeal the division’s decision and took on her case with the help of
Jennifer Simmons, co-chair of Legal Aid’s benefits task force and a
staff attorney in the Raleigh office.
Williams and Simmons represented Quiñones at a mediation session
with the division’s representatives and when it failed to produce a
satisfactory outcome, they began preparing for a hearing before an
administrative law judge scheduled for early December.
The attorneys began gathering evidence and securing the agreement of
Quiñones’s doctors to testify on her behalf. Their goal was to prove
that though her condition was certainly severe, she could live with
it for years and her doctors considered her lung function to be
stable. Williams and Simmons received invaluable pro bono support at
this stage from E. Spencer Parris of Martin & Jones PLLC in Raleigh,
who is a member of Legal Aid’s board of directors, and Sandra
Johnson, a retired attorney formerly with Johnson & Johnson PA in
As the lawyers prepared for the hearing, Quiñones’s kidney function
deteriorated to the point where she needed dialysis, which her
doctors felt was risky given her condition. On Nov. 30, just days
before the hearing and with preparations for dialysis underway,
Simmons received a surprising call: The Division of Medical
Assistance had reversed its decision and would cover the transplant.
Few details were offered for the about-face but the path was now
clear for Quiñones to receive her new kidney.
“There was blood rushing in my ears I was so excited,” said Simmons.
“I could barely absorb the words. Everyone here knew about the case
and when I spread the good news there was dancing in the hallways.”
“When Jennifer called me,” said Williams, “I could not process it
either. I think I made her repeat it several times to make sure I
wasn’t misunderstanding. Ashley is a tremendous woman and I’m
overjoyed at the outcome. Not only does she have an impressive
presence but she has managed to transcend all the obstacles she’s
faced and do incredible things like backpack around Europe and
volunteer in her community.”
“She really is inspirational,” said Simmons. “Sometimes I get chills
thinking about her life and the choices she has made. Instead of
getting an easy desk job, she helps disabled children and teaches
English as a second language. She really does inspire.”
A fundraising campaign at
www.cotaforashleyq.com is underway to help Quiñones raise
$50,000 to cover additional expenses and has collected more than
$40,000 so far.
*Correction: This release originally
stated that Quiñones contacted Legal Aid of North Carolina
on the advice of her doctors.
Sean Driscoll, Media Relations Consultant, 571-435-2643,
The materials contained on this website are for information and
educational purposes only and do not constitute legal advice.
Also please note that Legal Aid of North Carolina does not provide
legal assistance by E-mail. Contact your Legal Aid of North Carolina
office or a private attorney if you need to speak to an attorney
regarding your particular situation.
See our complete
Legal Aid of North Carolina is a statewide, nonprofit law firm
that provides free legal services in civil matters to low-income
people in order to ensure equal access to justice and to remove
legal barriers to economic opportunity.