Louisiana slashes aid to the neediest, most disabled of its citizens

BATON ROUGE - Carol Forsloff - Like
other states across the country, Louisiana is facing severe budget
cuts; but it's the choices it makes that hurts the most needy according
to lawyers fighting for the rights of the disabled.

  The

State of Louisiana is poised to cut home-care Medicaid services for
approximately 11,000 severely disabled poor people and institutionalize
them.  A class action suit filed in federal court makes the claim, as Louisiana makes hard choices in its $1.6 billion budget deficit.

Louisiana
has also had to slash the education budget, leaving many towns where
universities have thrived with significant problems as people move away,
leaving homes empty, students without classes and businesses struggling
to survive in the downturn.

The
voices of the disabled are represented by legal claims, but real people
are suffering in the recession, those who are at the bottom in terms of
poverty and medical concerns.

Similar
class actions in other states have pointed out that institutionalizing
disabled people will cost the states more in the long run.

More
than 80 percent of Louisiana's Medicaid money comes from the federal
government, and if the state accepts the money, it must comply with
federal rules, the class claims.  But there has to be enough support for
the people to understand the crisis people now face.

Disabled care will fall to nursing facilities and other state-run institutions if Medicaid funding is cut.

Those
specific four plaintiffs named in the class action suit range in age
from 30 to 78.  They have severe chronic conditions that include
paralysis, stroke, chronic heart failure and multiple sclerosis.  

"None
of them wants to leave their homes, friends, and families and to go
into a nursing home in order to receive the same Medicaid-funded
services that they presently receive in the community," according to the
complaint. "They are all at risk of institutionalization if their Long
Term-Personal Care Services are reduced and capped, as the defendants
propose."

Medicaid
funding care has included assistance with bathing, dressing, eating
bowel and bladder care, meal preparation and clean-up, shopping and
laundry.  It has allowed the disabled people to remain in their homes
and communities. 

The
story of one of these disabled individuals provides an example of the
concerns addressed in the lawsuit.   Rickii Ainey, 30, has been disabled
her whole life with congenital arthritis that has paralyzed her from
the waist up. She lives alone in New Orleans and needs assistance with
all activities of daily living because she is unable to prepare meals or
shop without assistance.

 Ainey's
"mother lives nearby but refuses to assist her daughter. Ms. Ainey has a
sister who lives in Arkansas and four brothers who live in New Orleans.
Her brothers cannot provide the intimate personal care she needs, and
Ms. Ainey does not believe they are responsible enough to help her on a
regular basis.

     "Ms.
Ainey attempted suicide in December of 2006. The primary reason for the
suicide attempt was the fact that she had no personal care assistance."

     Under
the Americans with Disabilities Act, "institutionalization and
segregation are prohibited forms of discrimination against individuals
with disabilities," the complaint states.

"The
ADA therefore requires that a public entity administer its services,
programs and activities in the 'most integrated setting appropriate' to
the needs of qualified individuals with disabilities."

 Because
of the projected $1.6 billion budget    Due to its projected $1.6
billion budget deficit, every department of state government has been
asked to trim its budget by 35 percent.

 The
state Medicaid program receives federal dollars and must comply with
federal regulation. "Federal Medicaid funds make up 81.48 percent of
Louisiana Medicaid payments," according to the complaint.

"States
are not required to participate in the Medicaid program, but if they do
so, they must operate their programs within federal statutory and
regulatory provisions. They must adopt a state plan that delineates the
standards for determining eligibility and identifies the extent of
Medicaid benefits. ..."

"Nationally,
the mean number of hours of personal assistance services that persons
who require assistance for four ADLs receive per week is 85.9 hours."
(ADLS are Activities of Daily Living: eating, using the toilet, moving,
and moving around in bed.)

What
the lawsuit points out is that until this past March, the maximum
amount of care a disabled person in Louisiana could receive was 56 hours
per week and after March dropped to 42 hours.  They are poised to
reduce the maximum number of hours of assistance to 32 hours per week.

The Louisiana Department of Health and Hospitals reports 10,878 people statewide receiving Medicaid LT-PCS services.

This comes at a time when there is a shortage of physicians
in the State, especially in rural areas or small towns like
Natchitoches, Louisiana because of low reimbursements from Medicaid
provided by the state.  These new cuts continue the crisis in Louisiana
in medical care, already near the bottom in relationship to the other
states.

In March it was announced that Louisiana will pay $122 million
back to the federal government, as part of a settlement to repay
Medicaid money.  This was because it was found the money had been
misspent years ago.  Lawmakers agreed to a repayment schedule.

The U.S. Centers for Medicare and Medicaid Services  maintained
the state had violated federal rules in its payments under Medicaid to
certain government-run nursing homes, a problem that is said to have
gone on for years.  When this was reported in March, it was said the
repayment would impact Medicaid recipients in the future.  That, along
with state budget cuts, leaves the helpless even more in critical need

without hope.