24-Hour Split-Shift Medicaid Personal Care Service Cases

On Sept. 4, the U.S. District Court for the Southern District of New York issued a preliminary injunction on 24-hour split-shift Medicaid personal care services cases as a result of cuts by the NYC Medicaid program. This injunction bars the NYC Medicaid program from reducing the hours of the 24-hour split-shift cases unless there has been an improvement in someone's medical condition. This was in response to NYC starting in April or May of 2011 to review all split-shift cases as part of an effort to reduce or transfer split-shift cases.

The decision also clarifies several crucial distinctions in home care:

- Some versus total assistance;

- Care at times that cannot be predicted;

- Turning and positioning; and

- Changes in a patient's condition.

On Oct. 5, the case was reviewed and it was determined “Elderly disabled Medicaid recipients whose 24-hour continuous split-shift home care was terminated were granted class certification.” This opens the door for all NYC Medicaid recipients of continuous split-shift home care since Jan. 1, 2011, who have been threatened with unlawful reduction or discontinuance to have their cases reviewed and possibly overturned.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871