WYNNE — A finding that a Parkin man no longer qualifies for help with daily living tasks was “essentially arbitrary” and should be overturned, an attorney told a Department of Human Services hearing officer on Friday.
During a hearing at the department’s Cross County office in Wynne, Legal Aid of Arkansas attorney Kevin De Liban argued that Bennie King’s health needs hadn’t diminished between March 2015, when he was found eligible for Medicaid, and January 2016, when he was found ineligible.
If anything, King, who is 79 and suffers from end-stage renal disease and heart disease, had simply grown a year older and deteriorated in health, De Liban said.
“These are conditions that don’t get better,” he said.
King echoed that point.
“I can’t do what I done last year,” he said.
Human Services Department attorney Angela Foster said King had improved.
An assessment using the department’s ArPath tool found in March 2015 that King needed “extensive assistance” moving from his bed to a wheelchair while a January 2016 assessment using the same tool found he needed only “limited assistance.”
The hearing officer, Otis Hogan, said he would take the matter under advisement and issue an opinion in about two weeks.
Since early 2013, the Human Services Department has used the ArPath tool to annually determine Medicaid eligibility for Arkansans with severe disabilities who need help with daily living tasks, such as dressing, bathing and eating.
About 10,000 Arkansans receive the services under the ARChoices program, department spokesman Amy Webb said.
In a federal lawsuit filed last week on behalf of two other Medicaid recipients, De Liban said the ArPath tool has resulted in “the widespread denial and termination” of services for Arkansans who were later found eligible for Medicaid-funded nursing-home care.
The tool uses a person’s responses to about 200 questions to assign the person a score, which determines the person’s eligibility for services, according to the lawsuit.
Previously, Human Services Department nurses had assessed applicants using a different form and their own “professional judgment,” the suit says.
Webb said in an email Friday that the ArPath tool is “rooted in research and data” and is similar to tools used in “many states” and other countries.
“It’s important to use an independent assessment to ensure that all populations served have a fair and equitable assessment that allows us to match their needs with the right services and resources,” Webb said.
According to testimony at Friday’s hearing, low-income Arkansans can qualify for ARChoices based on their need for help with three types of tasks: using the toilet, eating, and moving from one surface to another, such as from a bed to a wheelchair.
An applicant is eligible if he requires “extensive assistance,” meaning he requires help throughout the task, with one of those activities; or limited assistance, meaning help is only required on some occasions, with two activities.
An assessment in January 2015 by Human Services Department nurse Joeanne Hendrix found King was not eligible because he didn’t require help in any of those three areas. But three months later, she reported that King needed extensive assistance getting out of the bed and the bathtub.
In January 2016, she found he needed only “limited assistance” with such tasks a few times each week.
Hendrix said Friday that she may have gotten more information during the March 2015 assessment than in January 2016 because a relative was with King during the earlier assessment to help him answer the questions.
The ArPath tool asks questions about an applicant’s needs over a period of time, such as during the past several days or weeks, she said, but the score could vary based on a person’s condition on a particular day. For instance, she said it’s possible that King would receive a lower score on a day when he had been weakened by a dialysis treatment.
King, a former farmworker who is illiterate and hard of hearing, said he can walk with a cane or walker or by holding on to walls or pieces of furniture. He said he wants to stay out of a nursing home and tries to move around by himself as much as he can.
De Liban noted that ambulance workers were called to King’s house at least five times from June to November of 2015, including on two occasions when King had fallen.
Metro on 05/14/2016