Medicaid Home Care Cuts Are Unjust, Lawsuit Says

The lawsuit, filed in United States District Court for the Southern District of New York, names three plaintiffs: an impaired 84-year-old woman living alone in Manhattan, a frail 18-year-old Brooklyn man with severe congenital disabilities, and a 65-year-old Manhattan man with diabetes and a schizoaffective disorder. But it was brought by the New York Legal Assistance Group on behalf of tens of thousands of disabled Medicaid beneficiaries who need home health care or help with daily tasks like bathing and eating.

It represents a challenge to an ambitious Medicaid overhaul by Gov. Andrew M. Cuomo that shifted $6 billion in public spending on long-term services, including home care, to private managed care companies that are paid a fixed sum for each enrollee. The goal of the overhaul, which was set in motion in 2011, was saving money and improving the coordination of care. But advocates for aged and disabled people have complained that in the scramble for the most lucrative enrollees, companies are shunning frail people with the greatest needs and signing up those who could be given minimal services….

Janie Taylor, the lead plaintiff on the case, was required last year, as part of the Medicaid overhaul, to enroll in one of two dozen plans provided by private managed care companies under contract to the state. Before the changes, Ms. Taylor, an octogenarian with diabetes, high blood pressure and a dangerously unsteady gait, had the help of an aide for 10 hours a day, seven days a week. That care was continued at first by her managed care plan, VNSNY Choice. But on July 1, the lawsuit says, without notice or explanation, VNSNY cut her services to five hours a day, though her condition had not changed.


Read the Complaint here

Imagine what we could buy if we did not have to spend billions on police brutality cases

It’s true that most cases result in far smaller payouts, but they can add up to nearly a billion dollars a year for just one city. That’s eye-popping when you consider that state governments collectively spend roughly $10 billion on public assistance programs for the poor. When more money is spent consoling victims of brutality than providing assistance for low-income people, that’s both a fiscal and humanitarian crisis. And while police brutality cases are paid by cities, not states, these numbers place a dollar value on the tremendous breadth and depth of systemic police brutality. 

Consider New York City. In 2012, taxpayers paid $152 million in claims involving the NYPD. That same year, Mayor Bloomberg voted to cut $175 million from childcare and afterschool programs, affecting 47,000 kids. Child programs not only provide relief to working families with maxed-out schedules, they are the best tools the city has to foster an equal society in the long term. Instead the city is spending money settling cases like the one last month involving Officer Eugene Donnelly, who drunkenly barged into a woman’s home one night and “beat the hell out of her.”…

Prosecutors have an extreme reluctance to pick up cases of police abuse. Federal prosecutors decline around 95 percent of such cases for two main reasons: juries are mostly conditioned to side with the police, and various impediments are in place to make prosecution more difficult (federal attorneys cannot argue that an officer acted recklessly or criminal negligence). On the state level, legal quirks like “transactional immunity” in New York make it enormously difficult for prosecutors to use incriminating testimony against officers.  

Some say plaintiffs ask for too much money. Yet as crude a mechanism it is, the threat of litigation is one of the few shields citizens have against police abuse. The problem isn’t high settlement and the solution isn’t tort reform. The problem is police brutality and the solution is less of it. It’s an ugly cost that means so much more when states are spending less than ever on good, generative public services.