Disgruntled mental health patients, health activists and supporters are scheduled on Nov. 5 to rally in front of the John A.Wilson Building to demand that District officials provide specialized home health care services for people who suffer from both mental health and physical illnesses.
Organizers said the protest was called to send a message to city officials that failing to provide adequate services for the patients has created a health crisis in the community which in some cases places D.C.’s most vulnerable residents at risk.
“State, national, and international health care agencies and experts agree that integrated home-based care addressing mental and physical disorders at the same time should be an essential part of health care for seniors, HIV patients and disabled individuals,” said Charles J. Moreland, who chairs the D.C. Health Priorities ad-hoc committee. “The D.C. government’s insistence that there is no need for these specialized services effectively denies D.C. residents Medicaid-funded care which could mean the difference between life and death.”
One company, M.J. Home Health Services, has been seeking the city’s approval to provide the services since May 2010. D.C.’s State Health Planning Development Agency (SHPDA) denied the company’s application twice. M.J. appealed and in January 2012, Judge Jesse P. Goode, an administrative law judge at the D.C. Office of Administrative Hearings, ordered the agency to issue a certificate of need to the company to provide health care services to “patients whose psychiatric illness complicates treatment for their physical illness.”
Goode found that more than 1,300 such patients had been identified by M.J. Home Health. The judge reversed SHPDA’s finding that there was no need and ordered the agency to issue a “certificate of need” to M.J. Home Health. The agency appealed and requested a stay of the order.
Ferris D. R. Foote said his 89-year old mother suffers from high blood pressure, thyroid disease, foot and leg disorders and that due to Alzheimer’s disease “she is unable to comprehend that her nephew defrauded her out of her home more than five years ago.”
Foote moved in with his mother in 2006 after a physician’s report added mental illness to her physical problems. “My mother is physically and mentally ill at the same time. She needs specialized home care. That’s what they mean by dually diagnosed,” said Foote. “She has three shifts of nurses who bathe and feed her, but they can’t address her mental needs.”
Foote has contacted more than 14 care givers trying to find help. “Medicare pays, but there is no provider in the District that provides this type of care,” he said.
Mental health care advocates said federally-funded Medicaid provides a "safety net" for low-income elderly and others needing specialized home care.
Several home health service providers have attempted to obtain city approval but have been delayed by bureaucracy. The State Health Planning and Development Agency (SHPDA) has the responsibility to approve proposals to address the problem.
After a decision on July 30 denying all appeals, SHPDA finally issued a certificate of need to M.J. Home Health, now called M.J. General on Aug. 10, under Goode’s final order.
M.J. designed services for 75 of the patients who had been identified. Officials said D.C. is only providing services to a fraction of the patients who need specialized care. SHPDA continues to deny applications from prospective providers, stating that there is no demonstrated “need” for the services.
“No one can understand how this government can be so cold hearted,” said John Kamya, president of M.B.I. Health Services, a Ward 7-based certified mental health provider. “The SHPDA knows that mental health patients need specialized home care. The solution would not cost the D. C. Government one penny.”
When M.B.I. applied for a certificate of need to provide services for the same population in April, it was denied by SHPDA, which again claimed there was “no need.”
“In spite of the compelling evidence on the record proving the dire and urgent need for the home care services that we proposed to provide in our application, including information by Judge Goode, the SHPDA continues its shocking assertion that no need exists,” said Kamya. “This leaves us with no choice but to believe the SHPDA is implementing a ‘Don’t Act, Don’t Help’ policy with respect to the gap in home health services to the dually diagnosed population.”
According to appeal pleadings filed by M.B.I.’s lawyer, Paul Taulouse, the D.C. Department of Health’s denial of its application “exhibited a reckless disregard for the health, safety, and well being of these citizens.”
SHPDA denied it was deliberately keeping the patients from receiving the care needed. “SHPDA continues to review certificate of need applications for home health care services. After reviewing specific proposals from applicants…SHPDA determines whether there is a need for the proposed project,” said Najma Roberts, a spokeswoman for the D.C. Department of Health.