After five years of legal proceedings, a settlement has been reached in a class action lawsuit against the state Department of Health and Human Services over its handling of the Choices for Independence program.
Funded by Medicaid and overseen by DHHS, the program provides an at-home means of care as a nursing home alternative for adults with disabilities. The participants, of whom there are approximately 4,000 across the state, hire and compensate caregivers while living in their residences.
In 2021, the Disability Rights Center, NH Legal Assistance, the law firm of Nixon Peabody and AARP Foundation initiated a class action lawsuit against the department for failing to provide program participants with the at-home services to which they’re entitled.
The suit, which was slated for trial in November, argued that the state administration of the program imperiled the lives of those reliant upon home care to maintain their health and independence.
People relying upon CFI services to go to the bathroom, get out of bed, eat meals, get dressed and take medication reported that a shortage of caregivers resulted in “unmet needs,” according to the initial complaint. Program recipients faced “grave risk of suffering deteriorating health and related complications…”
With a settlement reached on Monday, DHHS will be required to “undertake programmatic reforms” over the course of four years through a number of measures:
The department will conduct yearly analyses of the provider network serving CFI, work to raise reimbursement rates, and create and maintain an online portal of provider services, according to court documents.
In addition, DHHS will identify and work to “remediate service gaps” for recipients, broaden its system for grievances to help better identify people who aren’t receiving approved services, enlarge its “oversight of contingency plans,” and report biannually to ensure it’s remaining in compliance with the settlement terms.
For Joyce Thomas, who has multiple sclerosis and osteoporosis and requires assistance in many facets of her daily life, CFI allows her to remain at home. She has struggled to find caregivers and has been left “stranded” numerous times. Her husband needed to quit his job in order to stay home with her. He receives compensation through CFI but took a large pay cut in order to fill the caregiver role.
The couple is still searching for additional help to fill Thomas’s remaining authorized care hours.
“Finally,” she said when she heard news of the settlement. “I’m so pleased.”
It’s been “exhausting,” she said, constantly having to advocate for herself in order to get her needs met. She sees the settlement improving the lives of everyone on CFI.
“I think that it’s going to make a huge impact on my quality of life for the better for sure,” said Thomas, who lives in Hillsborough.
Attorney General John Formella said in a statement on Monday that the state Department of Justice will work with DHHS and other state partners to “support implementation” of all the settlement criteria.
“Older adults and people with disabilities deserve access to the services they need to live safely and independently in their homes and communities,” he said. “This settlement strengthens accountability and oversight of the Choices for Independence program and provides a framework to address service gaps.”
