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Legal Aid to host meeting on cuts to residential care

The Jonesboro Sun - 6/3/2017

JONESBORO - As Legal Aid of Arkansas prepares for a meeting on the issue next week here, Cash resident Bradley Ledgerwood says he continues to struggle not knowing the fate of services through the Medicaid ARChoices program.

ARChoices is a community-based program for seniors and those with a physical disability. It allows people like Ledgerwood, who has cerebral palsy, to receive attendant care, in-home meals and other services - keeping him and others from residential care and in the communities they call home.

"This has worked very well for me because I am able to feel secure in my home while attending lots of community events," Ledgerwood said. "I currently am able to serve as alderman for the City of Cash, and I am a member of, and attend, most all of the Republican Party meetings in Craighead County."

While eligibility for services was previously determined on field interviews by qualified nurses - which Ledgerwood said worked well - in 2016, the program administrator for the Department of Human Services started using a computer algorithm to determine the amount of assistance hours clients receive.

"I feel like the program worked until they incorporated the computer system, which takes the human element out of the determination of the hours," Ledgerwood said. "To get established on the program, you should be evaluated as to your needs. This should be an independent board with input from your doctor, since he has all of your medical records and knows in-depth your limitations."

Ledgerwood was one of 4,000 out of 8,000 clients in the ARChoices program who has seen a reduction in benefits since DHS started using the algorithm dubbed RUGs (Resource Utilization Groups).

"My services have been cut the last three years, but through appeals they have been restored each year," Ledgerwood said. "This causes great distress for me because I don't know what will happen each year. If the services were cut, I would feel as if my life had been destroyed."

Without the services her receives, Ledgerwood would be forced to enter a residential care facility.

"I would have to go to a day service or nursing facility," he said. "I am actually a total-care patient and require assistance with basically every aspect of daily living. Therefore, I would not have the opportunities that I have while receiving this service."

The thought of that, for Ledgerwood, who is an active and contributing member of his community, is almost too much to bear.

"I am very active with the assistance of my caregiver, which gives me a meaningful life," he said. "The thought of a nursing home or day facility causes me extreme anxiety, because I visit nursing homes regularly and see that the care they receive does not come near to the care I receive."

He hopes DHS will stop using the program, return to a human-based assessment and that input from people overcoming illness like himself will be taken into consideration.

"If you only understand the business side of it, then you are only seeing one side of the issue, and if hours are cut, then it should be proved that your condition has improved," Ledgerwood added. "I think most people would agree that a total care patient would need maximum number of hours as they can not do anything independently."

Ledgerwood was one of two plaintiffs represented by Legal Aid in 2016 when a lawsuit was brought against DHS. In that case, a federal judge ruled in favor of Legal Aid, that DHS did not adequately explain the cuts.

Legal Aid attorney Kevin De Liban said since then the nonprofit has continued to fight in appeals court the secrecy surrounding the process and the use of the program.

"Starting in 2016, the nurses would still go out and ask the same questions, but the decision about how many hours you would get was made strictly according to a secret computer algorithm. They are extraordinarily complex," De Liban said. "No one at DHS can explain the algorithm. The director and and assistant director have testified they couldn't understand the algorithm and couldn't explain them."

De Liban said the meeting - at 1 p.m. Wednesday at the East Arkansas Area Agency on Aging, 2005 E. Highland Drive in Jonesboro - will feature presentations on the ARChoices program, the algorithms used and offer anyone affected resources to fight cuts in their own service.

"We will talk about the background and give a general introduction on the program, why it's there and some of the history on it," De Liban said. "We will be talking about the computer algorithm, what it does and doesn't do, and how it works, as much as we can break it down in easily digestible terms."

For more information, contact De Liban at (870) 732-6370, ext. 2206, by email kdeliban@arlegalaid.org or follow Arkansas Legal Aid on social media. Ledgerwood and local advocates have also created a social media page, Restore Services for Disabled Arkansans.