McWain-Gray grew hopeless, she said, until a social worker told her about the District’s Elderly and Persons with Physical Disabilities Waiver Program.
The Medicaid program sent an aide to her house for 16 hours a day to help her bathe, dress, cook and clean. She got a motorized wheelchair and learned to ride the bus.
Then one day her freedom ended.
The District would no longer pay for her care during evening hours, she learned in a letter from her home health agency. Then, three days later, the aide left a stack of adult diapers and a cooler of food next to McWain-Gray’s bed and left.
“They helped me with everything, and then all of a sudden it was gone,” said McWain-Gray, who lives on $710 a month in Social Security benefits. “I can’t even go to the bathroom by myself.”
McWain-Gray was illegally dropped from the program, her attorneys say, along with hundreds of other elderly or disabled people in the District — a move that attorneys who work for the city concede might have been improper.
The Washington Post found that the District cut 366 people from all or some of the services they may have been eligible to receive in the nine months ended March 2012, according to records on file at the D.C. Attorney General’s Office. About a third of those people died, the office said. The District doesn’t know how they died because the program doesn’t get copies of death certificates, officials said.
“These are absolutely critical services. The safety net falls and we look at dire consequences,” said Rebekah Mason, a staff attorney for the AARP’s Legal Counsel for the Elderly, which has represented about a dozen people facing termination from the District’s Medicaid waiver program.
Officials with the District’s Department of Health Care Finance, which runs the waiver program, deny wrongfully cutting anyone from home health services. They said many participants lose their spots when contract case managers submit incomplete or late annual paperwork required by federal law. They said people can request an administrative hearing to fight the terminations and get back into the program if they are eligible. In the past two years, the District reinstated about 600 people, said Yvonne Iscandari, program director for the department’s Division of Long Term Care.
“You are not going to have a perfect system,” said Iscandari, who oversees the waiver program. “You are going to have instances where somewhere in the process somebody’s eligibility was not updated.”
But even home health agencies that contract with the District — and take some of the blame — worry that the District’s bureaucracy puts vulnerable people in peril.
“We’re not totally innocent in this, but some of the processes they’ve implemented have put some of the patients at risk and the agencies at risk,” said Linda Davis, owner of Premium Select Home Care, which serves about 100 Medicaid recipients in the District.