AARP Foundation Litigation attorneys have joined as co-counsel representing older and disabled Louisianans whose well-being is threatened by the state’s planned cuts to its Medicaid-funded Long Term-Personal Care Services Program (LT-PCS).
Louisiana allows individuals who are eligible for the LT-PCS program to receive up to 42 hours of home and community-based services each week. Program services include assistance with eating, bathing, dressing, walking, toileting and light household chores such as grocery shopping and laundry without which many recipients could not continue to live in their own homes. However, because of a budget shortfall the state legislature voted to cut the state’s Medicaid budget and, in response, the state proposed cutting back on LT-PCS.
The proposed changes include cutting the maximum number of weekly hours to 32. This action will inevitably force many people — up to 11,000 are affected by the changes — who want to remain in their own homes into nursing homes instead.
Louisiana residents, represented by the Advocacy Center for the Elderly and Disabled and a noted disability advocate from Philadelphia, filed a class action lawsuit against the state, arguing that in implementing its Medicaid cuts, the state chose to cut LT-PCS services disproportionately. The Louisiana LT-PCS program originally was established as a result of a settlement agreement in 2003 that disposed of a lawsuit against the state. That agreement established the program with a cap of 56 hours a week; in response to an earlier round of budget cuts a supplemental settlement reduced the hours to 42. Now the state is looking to reduce those hours again.
The Americans with Disabilities Act (ADA) gives individuals a right to receive long-term supportive services in the most integrated setting appropriate to an individual’s needs and not to unnecessarily segregate them and isolate them in nursing homes. The U.S. Supreme Court in 1999 strongly upheld these principals, in a case in which AARP had participated as an amicus: Olmstead v. L.C. ex rel. Zimring.
The plaintiffs in Pitts v. Greenstein are all low-income and are recipients of LT-PCS Medicaid services, but also are all active in their communities and none of them wants to leave their homes, friends and families — yet all are at risk of institutionalization based on program cutbacks.
Take for example, the named plaintiff, Helen Pitts. She is 78 years old, worked as a sales clerk and sitter for people who were ill before she retired at the age of 65 to care for her parents. She has arthritis, fibromyalgia and congestive heart failure, and approximately two years ago had two cancerous tumors removed from her leg. She requires the use of oxygen daily, and at night needs assistance getting in and out of bed, the bathroom, and her motorized scooter, and because of her lack of mobility is unable to prepare meals, do her laundry or attend to household chores. She receives 39 hours of LT-PCS per week and she wants to stay in her home and the community in which she lives, but without the 39 hours of assistance she will not be able to do so.
Another plaintiff is Kenneth Roman, who is 47 years old and suffered several strokes that have left him paralyzed on his left side, as well as several heart attacks. He also has diabetes, congestive heart failure, vascular disease, hypertension, coronary artery disease and renal failure. He needs assistance in bathing, hygiene, and getting in and out of bed. He needs assistance moving from sitting to standing positions, and uses a four-pronged cane for support and mobility. He is unable to shop or do laundry and household chores without assistance. He is active in his church, where his father has been the pastor, and in his community. He receives 39 hours of LT-PCS services per week.
Ms. Pitts, Mr. Roman, and the class of plaintiffs they represent are arguing that without the current level of LC-PTS services, they will be forced into institutions, which they do not want, removing them from their homes, leaving them isolated, and ultimately costing the state and federal government far more than the savings achieved by the LT-PCS cuts. They point out that both federal law and Supreme Court rulings mandate the state Medicaid program to provide them services in the most integrated settings possible, and that the state budget cuts run completely counter to those rights guaranteed by law.
What’s at Stake
State budget cuts are difficult for everyone, but special vigilance is needed to ensure that the burden of the cuts does not fall disproportionately on the most vulnerable members of society.
AARP Foundation Litigation attorneys are serving as co-counsel in similar litigation in California, Florida, and Arizona.
The case is before the United States District Court for the Middle District of Louisiana.