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Seven Individuals With Disabilities Continue the Legal Fight Against Secretive Medicaid Home Care Cuts

LITTLE ROCK, Ark., January 27, 2017– Seven Arkansans represented by Legal Aid of Arkansas filed suit today in Pulaski County Circuit Court to stop the Department of Human Services from using a secret computer algorithm to cut Medicaid in-home services for people with disabilities such as cerebral palsy and quadriplegia. The suit alleges that DHS hid the algorithm from public input and oversight in an act of bureaucratic lawmaking that violates the Administrative Procedures Act.

The services at issue are provided through the Medicaid ARChoices program. The program exists so that low-income individuals with disabilities can receive care in their communities instead of in a nursing home that would cost the state up to six times more. Serving around 8,000 people, the program provides an in-home caregiver to help with tasks of daily living that individuals with disabilities may not be able to do independently, such as using the toilet, bathing, eating, getting dressed, preparing food, keeping the house clean, and laundry. The number of caregiving hours a recipient gets is supposed to depend on the severity of their condition. The seven plaintiffs received between 40 and 56 hours per week, the maximum.

However, once DHS replaced the discretion of a trained nurse who visited the individuals in their homes with a computer algorithm known as RUGs, clients whose medical conditions had not improved started facing big cuts. The seven plaintiffs lost an average of 43% of their services, a drop of up to 4 care hours per day. With such large cuts, the plaintiffs have had to sit in their own waste, go without meals, risk falls, and stay shut in. If the cuts are upheld, nursing homes will be in their futures.

Despite losing a federal court case for failing to give ARChoices clients proper notice about cuts, DHS continues to defend the secret RUGs system. Legal Aid of Arkansas attorneys offered three times in writing to meet with DHS officials before filing this lawsuit, but their requests were refused.

“The RUGs computer algorithm was decided on in secret by unelected DHS leaders who don’t understand the system well enough to explain how it works. It’s not responsible to trust a computer you don’t understand when someone’s life is at stake, and it’s against the law to do it without going through the right public process,” says Kevin De Liban, lead attorney on the lawsuit for Legal Aid of Arkansas.

If the suit is successful, the RUGs system will be invalid, and DHS will have to submit it for public vetting and possible rejection. As plaintiff Louella Jones says, “I did not know DHS was ever considering a new method for determining the number of hours I would get. Now that the computer algorithm has been used to reduce my hours, I want the chance to explain what the impact of the algorithm has been on me.”

All media inquiries should be directed to Kevin De Liban at (901) 834-0436.

 

Disclaimer
This Blog/Webpage is made available by Legal Aid of Arkansas for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. Using this webpage does not create an attorney-client relationship between you and Legal Aid of Arkansas. The Blog/Webpage should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.

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