September 21, 2006
‘I feel good all over’
In-home patient takes a stand for all
Reprinted from the Charleston Gazette
By Kate Long
Staff writer
GREEN SULPHUR SPRINGS — Jackie Fleshman, 66, expected to be in Kanawha County Circuit Court today for the first round of a class action lawsuit on behalf of hundreds of elderly and disabled people who were dropped from the state’s Medicaid waiver in-home care program.
Fleshman is the lead plaintiff on the suit.
The Rev. Andrew Davis, his friend and medical power of attorney, had planned to pick Fleshman up, drive him up the Turnpike and sit beside him.
Instead, he and Fleshman are celebrating at home. Fleshman — and every other elderly and disabled person who was thrown off the in-home care program by controversial new screening rules — will be reinstated, under the terms of a lawsuit settlement announced Wednesday afternoon.
‘He’s helped hundreds of people’
Davis said he was overjoyed. "Several times recently, Jackie’s told me, ‘I’m worthless here on earth. Why am I here?’" he said. "I don’t think he will say that anymore. He’s helped hundreds of people by being courageous enough to let his name be used in this lawsuit."
When Fleshman heard the news, he said he shouted from happiness in the home he feared he would lose. "They told me I helped hundreds of people," he said. "I feel good all over, because it helps them all, getting them back in. They needed help as bad as I did. That’s how I look at it."
Ironically, Fleshman received a cut-off letter from the state Department of Health and Human Resources on Wednesday, telling him the state planned to cut off his Medicaid card that pays his Medicare premium and drug co-pays. "I didn’t know what to do," he said.
"I told Jackie not to worry about that letter," his attorney, Bren Pomponio, said. "His benefits will be reinstated immediately."
Today, Fleshman’s name is at the forefront of the class action suit, but few people actually know the reclusive Summers County man.
His whole life has been rough
"I wasn’t even born in a hospital," Fleshman told the Gazette Monday. "I was born back on top of the mountain." The whole family worked to survive. "I chased cattle, milked cows, split wood, pulled a cross-cut saw with my brother, all that stuff."
Since he was 6 years old, he has had severe seizures. In part because of a childhood brain injury, he suffers from brain atrophy, retardation and a long list of physical problems, including coronary artery disease and chronic renal insufficiency.
Fleshman’s "whole life has been rough," Davis said. "He was raised in the backwoods. His father died when he was young, and his mother was left with seven children. She didn’t always have enough to feed them in the early years." When Jackie fell from his crib and injured his head, there was no money for doctors.
Though his mother had no money to leave him when she died, "she left him the family home so he’d always have somewhere to live," Davis said.
In 1988, when Fleshman’s mother was dying, she asked Davis to help watch over her son. He promised he would. Since then, the Baptist minister has trekked the 40 miles between his home and Fleshman’s hillside home, making repairs, taking care of paperwork and groceries, later watching over Fleshman during hospitalizations.
Five years ago, he helped Fleshman get into the in-home care program. At the time, Davis said, Fleshman had been hospitalized several times and, "We both knew he couldn’t stay home without daily help. I had already introduced the concept of a nursing home, reluctantly. But then we found the in-home waiver program."
On the in-home program, Fleshman has lived independently in his home for the past five years. A nurse set up his weekly medication tray. A homemaker, Wanda Gwinn, came three hours a day. She made sure he took his medicine at the right times, took him to doctor’s appointments, made meals, went to the grocery store, washed his clothes, and stayed in touch with Davis, now his medical power of attorney.
"She looks like my mother," Fleshman said. "And she can cook like her, too. Green tomatoes."
"Jackie could be a poster person for the success of the in-home program," Davis said. "His quality of life and social skills improved 100 percent."
Fleshman will stay in a rural community of people who understand and care for him, Davis said. "His neighbors help him get to his church and bring mail from the post office."
Somebody has to read him his mail. He never learned to read. He went to first grade, "but the schools weren’t prepared to deal with children with seizure disorders in those days." He was sent home and never allowed back. He did teach himself the ABCs, and he enjoys reeling them off for visitors.
He takes 23 different pills, some three times a day, others twice. He needs several of them to stay alive. His medicine schedule covers almost an entire sheet of notebook paper.
The state said Fleshman could manage all those by himself. On Monday, Davis poured a pile of the pills onto Fleshman’s kitchen table. "I don’t know what they are," Fleshman said, gazing at them. "I used to tell by what color they were."
Those pills would have been on center stage at the court hearing today, attorney Pomponio said.
Last November, the DHHR adopted revised screening rules that knocked Fleshman off the program. Those rules, which were declared null and void Wednesday, were screening out at least three times as many people as the old rules did, according to DHHR statistics.
To stay on the in-home program, a person needed five points. Fleshman got only four points this year. He lost his point for needing help taking his medicine and his point for needing help evacuating the building in an emergency.
By the state’s new rules, if you could pick up a pill and put it in your mouth, you were deemed not to need help taking your medicine. Fleshman can pick up pills and put them in his mouth.
Davis said he was particularly frustrated by Fleshman’s loss of his point for needing help getting out of his home in an emergency. "If Jackie were to wake up to a fire and have trouble breathing, he would likely have a seizure," Davis said. At his cutoff hearing, his in-home care nurse, Linda Lyons, testified that a seizure leaves Fleshman disoriented and unable to remove himself from danger for up to an hour.
By the revised rules, if a person could walk at all and was not disoriented 100 percent of the time, he or she could not get a point for needing help getting out in an emergency.
The lawsuit alleged that "the changes in the medical eligibility standard were made at the request of bureaucrats within the Department and without consultation with physicians or other appropriate medical professionals. Consequently, the changes ... are not consistent with any medically accepted procedure."
Davis said Monday that he now sees ways the state can save money without cutting people off. After Fleshman was dropped from the program, Davis jumped in to help and "neglected my job and family" for about four hours a day. "I saw firsthand that the state was paying 13 doctors, and it was crazy trying to get Jackie to all of them," he said. "It was wearing him out, just trying to get to all those doctors."
Davis got in touch with all of Fleshman’s doctors, and they came up with a plan that would cover all services, but reduce the number of doctors to five. "Think about that," he said.
Davis himself is now fighting cancer, non-Hodgkins lymphoma, while he pastors his church and helps care for his mother-in-law. Why has he spent so much time helping someone who is not a relative? "Because I love him, and I promised his mother I’d watch out for him. And in this case, for all the other people involved.
"I know the state can’t take care of everyone. I understand that problem," he said. "But these new rules were cutting off people who really cannot do without help. We’re boasting about a $300 million excess in the state budget this year while we were cutting aged and disabled poor people off their lifelines."
To contact Kate Long, use e-mail or call 348-1798.
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