AARP Maryland and Legal Aid Bureau: Elderly file lawsuit against state for denial of long-term health care

BALTIMORE, Jan. 18 /PRNewswire/ -- Seven disabled, sick and low-income elderly Marylanders denied Medicaid long-term care services -- including help with eating, medication management, toileting, bathing and mobility -- filed a lawsuit this morning against the state.

The lawsuit, filed in Baltimore City Circuit Court against the Department of Health and Mental Hygiene, claims Maryland uses a stricter criteria than what federal law allows, thus improperly denying the plaintiffs the critical health care services they need.

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"Our clients are simply asking the state to follow the law and provide the much needed assistance they are eligible to receive," said AARP attorney Sarah Lock. "Just because their conditions don't require around-the-clock care from a doctor or nurse does not mean they don't need help with other vital and essential functions of daily living necessary to protect their health."
 

The plaintiffs, who range in age from 75 to 88, hail from Baltimore City, Anne Arundel, Baltimore, Carroll, Montgomery, Queen Anne's, and Worcester counties. Each has requested -- and been denied -- long-term health care services. All the plaintiffs suffer from some combination of dementia, chronic heart failure, diabetes, incontinence, take multiple medications, or have difficulty performing the normal activities of daily living.

"The law provides that low-income older adults who suffer from mental and physical conditions can receive health-related services above the level of room and board," said Legal Aid attorney Regan Bailey. "Imposing criteria that restricts that care until a person is in need of extremely intensive health care is not only illegal, it robs our family and friends of their safety and dignity.

"If the state's criteria are not changed, our clients will continue to deteriorate," she continued. "Many may end up in the hospital because they did not get the care they needed to maintain their health."

Plaintiff Evelyn Burrell, 86, suffers from congestive heart failure, hypertension, atrial fibrillation, peripheral vascular disease, and has a history of recurrent stasis leg ulcers, degenerative joint disease and osteoarthritis. While Mrs. Burrell is able to live alone, she is unable to walk, bathe, perform household tasks or buy and prepare food.

"Mrs. Burrell spends her entire day in her wheelchair," Bailey said. "She can't safely get out to use the bathroom. She has serious circulation problems and, as a result of sitting in her chair all day, she suffers from skin breakdowns.

"But after Mrs. Burrell applied for Maryland Medical Assistance, she was denied services because the department determined she didn't demonstrate she needed the level of care provided in a nursing facility," Bailey continued. "However, she does meet this level under the federally required standard."

Maryland's Medicaid program provides health care services for those who cannot afford health insurance and who need long-term care. It is administered by DHMH and is subject to Federal and state laws. Federal law requires Medicaid to cover nursing facility services, above the level of room and board for low-income older adults who need help because of a mental or physical impairment. Maryland law restricts the coverage to only those people who, on a daily basis, need assistance from a licensed nurse or physician.

The Legal Aid Bureau, founded in 1911, is Maryland's largest provider of free civil legal help to low-income Marylanders.

AARP is a nonprofit, nonpartisan membership organization that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. We produce AARP The Magazine, published bimonthly; AARP Bulletin, our monthly newspaper; AARP Segunda Juventud, our bimonthly magazine in Spanish and English; NRTA Live & Learn, our quarterly newsletter for 50+ educators; and our website, http://www.aarp.org/. AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.