The Arkansas Supreme Court
today upheld a lower court order that stopped the state Human Services Departmen
t from curtailing home health services to disabled
and aging Medicaid recipients.
Jacob Rosenberg explained this problem,
challenged in both state and federal court lawsuits.
About 4,000 people receive Medicaid support for in-home services, which keeps them out of more expensive institutional care. But the Human Services Department made an unannounced change in that program that significantly reduced services for some. The assessment for services was changed from a nurse assessment, with room for discretion, to a computer algorithm based on survey answers.
Circuit Judge Wendell Griffen
issued a temporary restraining order in a suit filed by Legal Aid of Arkansas for seven plaintiffs pending a full trial. The state appealed that order and said plaintiffs hadn't demonstrated a chance of success in the lawsuit. The Supreme Court rejected that appeal in affirming Griffen.
A key finding was the Supreme Court's agreement with plaintiffs' argument that the state had adopted a general rule without adequate notice and a time for public comment. Said the court, in an opinion written by Chief Justice Dan Kemp, "... appellees 'have presented evidence that shows that there is a substantial likelihood that they will be able to
succeed on the merits of the underlying action.'
But, as Rosenberg's article indicated, the state might be able to get approval
of the computer-driven assessment after sufficient notice. That won't solve the problem of people with great needs who've had services reduce.
Rosenberg wrote, for example, about the needs of Shannon Brumley, left with brain and lung injuries and paralyzed in a wreck. His mother described the round-the-clock care he needs and how Medicaid home care met only a part of the need — now even less.
The new rules are unfair, his mother, Lana Brumley, says. "Somebody like Shannon requires around-the-clock care, but if eight [hours per day] is the most you can get — for somebody in that bad of shape — give it to them," Lana Brumley said, referencing the eight hours per day her son receives vs. the approximately five hours per day the ARChoices algorithm says he should receive. "Why wouldn't you give it to them? Our government can do so much more, our state can do so much more by providing for the family members to take care at home, or allow them to hire somebody to come in."
Here's the decision in the case.