Pinching Pennies

City Agency Targets Elderly for Payback

What does a mayor do when he has to pinch pennies? He goes after New Yorkers who have pennies.

Gone is the brash dreamer who once drew gasps with a proposed West Side sports complex estimated to cost billions (although two minor league baseball stadiums adding up to $175 million are full steam ahead). Faced with criticisms of his management of the Wall Street-generated $3.2 billion surplus, the now more reserved mayor has indefinitely postponed the personal income tax cut promised during his Senate campaign and put a hiring freeze on most city agencies. No longer aiming to leave the city in a blaze of higher-office glory this year, he'll be damned if Democratic mayoral wannabes will get to say Rudy Giuliani left the city in a fiscal bind.

City Hall machinations mean little to Ada Bloom, a 73-year-old widow from Woodside, Queens. She spends most of her days in a small one-bedroom apartment, despairing of the mice that have started invading and the paint that is flaking off the walls. And she worries about losing her independence should she fall ill.

But an ongoing struggle with the city's Human Resources Administration, which has ordered her to reimburse it $144,000 for the Medicaid dollars spent housing her husband— now deceased—in a nursing home, elicits one political opinion: "I thought Giuliani was a good man, I really did. But now I think he is bad."

Her husband, a navy veteran and former postal worker, developed Parkinson's disease several years ago and required nursing home care. The monthly fee of approximately $7000 would have quickly dried up Bloom's modest savings. So when her attorney, Bernard Krooks, advised her to sign a declaration refusing to pay for the care of her husband and therefore qualifying him for Medicaid, she did. Elder law attorneys say this maneuver is perfectly legal and a last resort among seniors who fall into an awkward income bracket—too low to pay typical nursing home charges of $120,000 per year for a sick spouse, but too high to qualify for Medicaid, which mandates a maximum of about $80,000 in savings and $2000 in monthly income.

Bloom knew she was taking a risk. The city could come after her, Krooks said, and bring her savings down to the Medicaid-mandated level. The same week her husband of 49 years passed away, she received the letter from HRA.

"I couldn't sleep for days," Bloom says. The ongoing dispute with the city, she says, "is hanging over me like a nightmare."

Attorneys say hundreds of seniors across the city share Bloom's troubles, and HRA has stepped up its collection efforts in the past year. But with the city contributing—and, therefore, technically recouping—only 25 cents for every Medicaid dollar spent, senior advocates are confused by the city's zealousness in pursuing cases where it could look the other way. HRA did not respond to a call for comment but several weeks ago told a Channel 4 reporter that the agency "takes all steps to negotiate a reasonable settlement and is sensitive to any hardship issues resulting from these payments."

Presuming the city gives back the state and federal share of the Medicaid reimbursements, the motive may extend beyond saving what, relative to the city's overall costs, amounts to mere pennies. To this administration, it could be just the principle of the thing.

A federal court decision last month found that the city "systematically prevents otherwise eligible individuals from obtaining" public assistance. In doing so, the city has more than halved its welfare expenditure since 1994, reducing it from $894 million to an estimated $405 million this fiscal year. But a recent report by the Urban Justice Center found over half of all food stamp applications were rejected in 1999. Food stamps don't cost the city a dime. They are fully reimbursed by the federal government.

Critics say HRA's stinginess is not surprising given the philosophy of Commissioner Jason Turner, which he encapsulated in a December 1998 statement suggesting that some battered women may be fakers trying to gain special consideration for public benefits.

But New Yorkers were treated to a taste of the Giuliani administration that could have been this June, when the mayor announced an ambitious program to enroll nearly 1 million uninsured New Yorkers in public health care programs. The idea, he said, was inspired by his own struggle with prostate cancer. But State Comptroller H. Carl McCall's office says funding has not yet been specified for the initiative, dubbed Health Stat. And Patrick Markee of Coalition for the Homeless says, "I'll believe it when I see it." Health Stat head Deputy Mayor Anthony Coles's office referred inquiries to the mayor's press office, which did not respond.

Although she is still negotiating with the city, Bloom does not hesitate to spread word of HRA's practice to fellow seniors and the media. But her fearlessness ends when she considers the possibility of losing her savings. "I don't want to be on Medicaid. I don't want to depend on anybody," she frets. She sounds like just the kind of New Yorker Rudy might like.

 
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