Mentally Ill Targeted for Medicaid Cuts

COLUMBUS, Ohio (CN) – A federal class action challenges Gov. John Kasich’s elimination of Medicaid mental-health funding for thousands of disabled nursing home residents. The class claims the $40 million in cuts are unconstitutional, and target the most vulnerable people most in need of help.

     “Defendants have stated that they plan to completely eliminate mental health services funded by CMH [Community Mental Health] Medicaid for long-term residents of long-term care facilities, while continuing to provide such services for Medicaid recipients who are short-term residents of longterm care facilities or do not reside in such facilities. This action will unlawfully discriminate against the most vulnerable and needy population of Ohioans (who are by definition disabled) in violation of the Medicaid Act, the Americans with Disabilities Act, the Rehabilitation Act and the Supremacy Clause of the United States Constitution,” according to the complaint.
     About 85,000 Ohioans live in long-term care facilities, the complaint states. Most are elderly, and “all meet the criteria of being disabled by virtue of their need for the level of care required for a nursing home stay. A substantial number of them have been or are diagnosed with mental illness and require mental health treatment.”
     The complaint continues: “The State of Ohio, through ODMH [defendant Office of the Department of Mental Health] and/or ODJFS [defendant Office of the Department of Job and Family Services], is preparing to enact a rule (initially on an emergency basis) that will eliminate CMH Medicaid coverage of mental health services for long-term residents of long-term care facilities, including individual plaintiffs and class members.
     “Currently, Ohioans living in long-term care facilities can be transported to a local mental health agency or seen on-site by a mental health therapist, and those services are funded by CMH Medicaid and are billable through the community mental health system, just as they are for any other Medicaid recipient.
     “Under the new rule, ‘long-term’ residents of long-term care facilities will no longer be eligible for CMH Medicaid funding for any service delivered by a community mental health agency provider. As a consequence, many of them will no longer receive mental health services at all.”
     Class representatives include Joanne McKenzie, 60, who suffers from “traumatic brain injury, syncope, hypokalemia, encephalopathy, anemia, fibromyalgia, seizure disorder, hypothyroidism, hyperlipidemia, chronic obstructive pulmonary disease, hypertension and hyperparathyroidism,” and is bipolar.
     Plaintiff Dean Buehler, 64, suffers from “cancer, severe vision impairment, glaucoma, grand mal seizures, gastroesophageal reflux disease, osteomy and conjunctiva bleeding. He also has been diagnosed with schizophrenia.”
     The plaintiffs say the state’s plan violates the Constitution because deprives of medical services only those “categorically needy” people who live in long-term care residences.
     It violates the ADA by imposing “eligibility criteria that screen out or tend to screen out individual plaintiffs and class members … from fully and equally enjoying the CMH Medicaid services,” the complaint states.
     The class seeks an injunction preventing implementation of any law that “eliminates or disproportionately reduces payments for CMH Medicaid services provided to long-term residents of long-term care facilities who are Medicaid recipients.”
     They are represented by Caroline Gentry with Porter, Wright, Moss & Arthur, of Dayton.

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