James Doyle had already fallen far by the time he fully understood the March 18 discharge document from the Cheshire Regional Rehab Center, his home for the last eight months.
This, he could not, would not, will not abide — certainly not during a global pandemic that has everyone locked down.
The document said he must leave the rehab center, though he had no place to go. It showed an address in Meriden where he was to move, forcibly if necessary, by April 17. Doyle, a former toolmaker who has suffered three strokes, didn’t know what was at that location.
A lawyer confirmed it was Shelter Now, a homeless shelter in Meriden, though the street name was listed incorrectly.
“I said ‘No, I will not go to a shelter,’” Doyle told me Friday, a couple of hours before Gov. Ned Lamont announced another 1,090 COVID-19 cases and warned of the impending surge. “I have too many medical needs. I can’t walk, I can’t take care of myself.”
How did we arrive at a point where a 65-year-old disabled man in a nursing home faces eviction to a homeless shelter — at any time, let alone in the middle of the coronavirus crisis?
That’s what James Doyle wants to know and he’s scared. “I’ve been a good person all my life and I hear about the things that go on in a shelter,” he said.
That’s also what Kevin Brophy wants to know. As managing attorney in the elder law unit of Connecticut Legal Services, he sees a few of these discharges to homeless shelters a year — which is a few a year too many — and there may be more he’s not seeing.
“During this pandemic we don’t think nursing home involuntary discharges should be issued,” he said.
At any time, there must be a better way. Even beyond the obvious moral concern, how long would James Doyle last in a shelter before they rushed him to a hospital?
Until last spring, Doyle, a longtime Naugatuck resident, lived independently with his wife, Kathleen. Each cared for the other. She had cancer, he lived with a raft of health problems stemming from the strokes, a long-ago broken back, obesity, mild diabetes and asthma. Then she died in May.
He sustained another stroke, cracked a hip, cycled in and out of a Waterbury hospital and rehab facility and landed, last summer, in Cheshire. The trouble started when he turned 65 in December — aging out of the Medicaid program known as HUSKY D for low-income adults.
He might qualify for Medicaid coverage for people over 65, but lacks the wherewithal to apply. “They sent me the paper work but I can’t understand it and the social worker here says ‘That’s not my job,’” he lamented.
Doyle’s inability frustrates him. As a young man, he told me, “I was research and development, I built machines for people…I made the first machine that made airbag canisters for cars.”
Then around age 30, he crashed in a snowmobile. He broke his back, had multiple surgeries and never fully recovered. He worked in manufacturing as long as he could, then migrated to computer work at Bozzuto’s Inc., the food wholesaler, and drove a pilot car for oversize highway loads until he couldn’t work anymore.
“It’s not like I wasn’t a useful person,” Doyle says. “I had a good mind, and now my mind is crap.”
Through the phone, over the din of his roommate’s TV, I hear the physical therapist arrive. “I actually managed to walk 24 steps the other day,” Doyle says.
“I’m happy here but I owe this place, I think they said $48,000. And it’s getting higher every month.”
And so, without a source of payment for Doyle, after three months Cheshire Regional Rehab Center moved to throw him out. He appealed, and that automatically brought in the state’s long-term care ombudsman’s office, which, in turn, contacted Brophy’s office.
The state Department of Social Services rejected that first involuntary discharge letter, saying it didn’t meet the requirements of state statute, Brophy said. That was in early March. Then, as the nation started to shut down, Cheshire Regional Rehab issued Doyle the March 18 discharge letter.
The timing of that is notable for two reasons. First, tenant eviction hearings aren’t happening right now and mortgage foreclosures are on hold, yet there’s no ban on involuntary nursing home discharges. “These folks are a lot more vulnerable basically than most tenants,” said Sara Parker McKernan, policy advocate at New Haven Legal Assistance. “If anybody should be sheltered in place, it should them.”
That day, March 18, happened to be the same day Lamont issued Executive Order No. 7F, which appears to say hearings at nursing homes need not take place in person. That could hamstring lawyers and violate due process rights, Parker McKernan argues.
Brophy and other Legal Aid lawyers sought clarification from Lamont’s office on whether that order applies to discharge hearings. And they formally requested a temporary ban on all involuntary discharge orders, hearings and actual discharges.
Max Reiss, a spokesman for Lamont, said Friday the governor is looking closely at many ways to keep residents safe and healthy through new or modified orders.
Here’s what happened in Naugatuck when a different nursing home won a discharge case in March against another client of Brophy’s. The home called the cops when the man refused to leave. Police from that town showed up, shook their heads and said no, sorry, we’re not forcibly removing this resident in the coronavirus crisis.
Doyle may not face a hearing because the Department of Social Services ruled that the March 18 order against him was defective, like the earlier one. A spokesman for the department did not respond late Friday so I couldn’t ask whether the DSS would go through with such a hearing even if it could, and whether the department supports a hold on discharges.
Two administrators at the Cheshire Regional Rehab Center didn’t respond to phone messages Friday. As an optimist, I’ll assume they’re hunkering down in the crisis with Doyle in place and won’t try a third discharge order.
There’s also a decent chance Brophy will find an outside lawyer to help Doyle qualify for Medicaid again.
Doyle, lacking the luxury of optimism, must prepare for the worst. He’s looking for a place to live, which clearly isn’t going well in a pandemic, with his low Social Security income and need for a lot of help. He has no children and, having grown up in foster care, isn’t close to his brothers and his mother.
He left his car with his cousin. That could be a last resort if he’s ordered to a shelter. “I will find a way to get out of here and I will go somewhere else. I just don’t know.”
I don’t know either. But this can’t be the best way to run a system for poor and disabled people nearing the end of a hard life.