DHS bills the estate of a man who died while in state care
Will the injustices visited upon Richard Meredith never end?
As a youth growing up in central Iowa during the 1930s and 1940s, Meredith showed signs of a mild disability, engaging in repetitive behaviors now associated with autism.
As a young adult, he was sent to live at a state institution where, at the age of 24, he was subjected to a lobotomy that left him profoundly disabled. According to his family, the procedure made Meredith “like a zombie,” and he would require institutional care the rest of his life.
It was a life that ended unexpectedly on Sept. 1, 2013, after workers at the state-run Mental Health Institute in Clarinda mistakenly gave him a peanut butter sandwich rather than the doctor-ordered pureed food he was able to swallow.
Meredith was found by the staff slumped over at a dining table, with peanut butter clogging his airway. He was declared dead a short time later. His family sued the state and the Iowa Department of Human Services, which ran the institute.
One of their complaints was that DHS administrators had tried to cover up the manner in which Meredith had died. State officials had mentioned a choking incident, they alleged, but said nothing about the sandwich or the subsequent state and federal fines for substandard care. On Meredith’s death certificate, a state psychiatrist had cited “cardiac arrest” as the sole cause of death and listed no contributing factors. The family learned the truth only after reading The Des Moines Register’s published report of DHS being cited for contributing to the death of a resident.
Richard Meredith was given a lobotomy and lived in state institutions the rest of his life
In defending the lawsuit, the state went to court and asked a judge to dismiss that part of the Meredith family’s case that dealt with the alleged cover-up. The state’s lawyers pointed out that under Iowa law “claims arising out of misrepresentation and deceit are barred from recovery.”
With the trial scheduled to begin in June, the two sides agreed recently to settle the case for $150,000. But as part of the deal, the Iowa Department of Human Services insisted on clawing back $25,000 of that from Richard Meredith’s estate as reimbursement for some of the Medicaid dollars spent on Meredith’s care at the MHI.
Mind you, the only money in Meredith’s estate is the $150,000 the state paid to settle the wrongful-death claim. In that context, the Medicaid “reimbursement” amounts to little more than grave robbing, perpetrated by the very agency that brought about Meredith’s death.
The family’s lawyer, J. Campbell Helton, says state officials originally wanted to claim even more of the settlement but he was able to negotiate the amount down to $25,000.
DHS spokeswoman Amy McCoy says federal law requires Iowa Medicaid officials to seek estate-recovery payments to recoup the costs of patient care financed by the public health insurance program.
That law is in place to ensure Medicaid isn’t billed for care that individuals — through their estates — might otherwise finance. It’s a good law that protects taxpayers. But Medicaid is not supposed to pay for substandard care, even when that substandard care is delivered by the very agency that administers the Medicaid program.
REGISTER EDITORIAL: There are good reasons for ‘estate recovery’
What’s more, DHS shouldn’t be seeking reimbursement for care that was so deficient as to have actually caused the death that led to the estate recovery.
By considering the state’s own payout on a wrongful-death claim to be part of the deceased’s estate — and thus fair game for recovery — the state created a twisted form of victim restitution in which the perpetrator is entitled to seize the assets of the victim.
Regardless of the state’s intent, this case serves as warning to other Iowa families whose loved ones die as the result of Medicaid-funded negligence while in the state’s care: If you sue us and negotiate a settlement, we’ll lay claim to those proceeds as “compensation” for our Medicaid program.
That’s not only unjust, it’s deplorable.