A lawyer representing several Idaho caregivers says if the Idaho Department of Health and Welfare gets its way and lowers Medicaid reimbursement rates on Monday, Feb.1, some of the state's most vulnerable citizens will be at risk.
"We're talking about people with severe intellectual developmental disabilities: people on the autism spectrum, with Down Syndrome or possibly brain injury," said Boise-based attorney James Piotrowski. "My clients are telling me that dozens and dozens of people have received notices saying their services are going to be terminated when this rate decrease takes effect."
Piotrowski has filed a legal claim against IDHW, alleging the department didn't undergo the state's rule-making process to determine its lower Medicaid reimbursement, which he said slashes some providers' rates by as much as 50 percent.
"[IDHW] is cutting its own legs out from under itself," said Piotrowski. "Providers simply aren't going to be able to handle difficult cases at $260 a day. We're talking about 24/7, around-the-clock care—dressing, grooming, bathing, preparation of food, eating. It's only with these services that these clients are able to live in their own homes rather than an institution where they would be warehoused with other people with severe disabilities."
For its part, IDHW spokesman Tom Shanahan said the department will keep a close eye on clients once the Medicaid reimbursement rate drops.
"If we see a situation where there aren't enough providers or the quality of care declines, then we'll reevaluate the reimbursement rate," he said.
Piotrowski argues the department's usual response is to "put them in a state hospital and that's what we're trying to avoid. These people belong in their communities."
Piotrowski said the clock is ticking and he's hoping for a January court hearing where he'll push for a judicial delay of the rate change. Otherwise, he said, "this throws a huge wrench into the system of care."