In today’s Post, I wrote about a recent jury verdict awarding $2.9 million to the family of a mentally disabled man who died in the District’s care from a spinal condition that could have be easily treated.
A federal judge found that the city’s oversight of Curtis Suggs’s case was negligent, failing to ensure that he received the medical care he needed.
The District is fighting the verdict, and there is a troubling postscript. Despite the finding of negligence in its oversight, the District seeking to recover some of the cost of the care it provided Suggs by filing a nearly $600,000 lien against his estate.
The city did so after the Suggs family settled a suit against the operator of the group home where Suggs lived for $900,000, according to Harvey S. Williams, the family’s lawyer.
In other words, the District is seeking payment for care that a judge has said it showed “deliberate indifference” in monitoring.
Williams is calling on Mayor Vincent C. Gray (D) to withdraw the lien, deeming it “further evidence of the city’s unwillingness to admit wrongdoing.”
Laura L. Nuss, director of the D.C. Department on Disability Services, said the District has an “affirmative obligation to assert a Medicaid/Medicare lien under federal law.” The D.C. attorney general’s office declined further comment.
It might be an affirmative obligation, but it is not an absolute obligation. The city has previously withdrawn such liens or otherwise not pursued them.
In 2002, stories and editorials in the Washington Post described how the city used liens against the estates of indigent mentally disabled residents as leverage in settlement negotiations.
Under pressure, Mayor Anthony A. Williams (D) withdrew liens previously filed and adopted a policy where repayment would only be sought if an estate recovered funds from a group home in an undisclosed settlement.
Then-City Administrator John A. Koskinen explained the policy: “What we’re not willing to do is let [the estates] get paid by the insurance companies and then get paid by us while we’re negotiating in the dark,” Koskinen said. “We think people should be fairly compensated ... but you can’t get two and three bites of the apple.”
In the Suggs case, however, the settlement with the group home operator, the Symbral Foundation, is not confidential, and the District is, of course, no longer negotiating with the estate.
Joseph Cammarata, a lawyer who has been involved with several cases where liens were filed, said he was alarmed to hear the city had resumed the practice. ”I thought this was already decided, that the D.C. government would not bill for their own negligence,” he said.
The D.C. Council, in fact, banned the practice of cost-recovery liens in some cases in 2007, after the city sought $2.2 million from a man, represented by Cammarata, who gouged his eyes out while a patient in St. Elizabeths Hospital.
This is how the council’s judiciary committee put it in a report on the bill: “It is not right that the government should bill for negligent care.”
But the bill — named after the St. Elizabeths patient, Frank Harris Jr. — only banned the city from billing for the care of persons “in a hospital for the mentally ill” and if the funds sought are from a settlement or judgment against the District.
Cammarata said he was particularly shocked that the Gray administration was pursuing a lien given Gray’s history as an advocate for the mentally disabled and his support for the Harris legislation.
“I can’t imagine that anyone has informed Mayor Gray that his administration is trying to do this,” he said.
D.C. Council member Phil Mendelson (D-At Large), who introduced the bill, said this about the Suggs lien: “It’s tacky; it’s just tacky,” he said “You provide lousy care and then you file a lien to get paid for it. ... How callous do you want to be?”
Mendelson said he would consider broadening the application of the Harris bill to people who, like Suggs, receive care in facilities for the developmentally disabled. But he said legislation shouldn’t be necessary.
”The mayor could, on his own, say, ‘No, no, no, this doesn’t work.’” Mendelson said. “And that’s what should happen.”