thanks for joining us at ten, i'm bob clausen. ((ashley)) and i'm ashley ketz. a state program helps about eight thousand people across arkansas get nursing care at home -- instead of in an institution. in the past -- nurses decided how many hours to care for these patients based on their individual needs. two years ago -- they switched to a computer algorithm, based on a digital questionairre. ((bob)) working for you's marci manley sitting down with people who say this formula for care cut their hours -- and those of thousands of others across arkansas. [shannon brumley, archoices client]"i never would have imagined myself like this. over the past 16 years...shannon brumley...has had to come to terms...with his life looking a lot different than he planned.[shannon brumley, archoices client]"a spare tire came out of the back o t truck...and hit me...
"the young man who was buildling a career as an electrician...had a new baby at home...and lived to be outdoors...had his life shattered by a car crash.[lana brumley, shannon's mother]"he should have never come off the ventitlator but he did...
" shannon survived...but is now paralyzed from the neck down...[lana brumley, shannon's mother]"we're going to put your arm down - i'll get it.
"in the past few years... a brain hemorrage, seps and multlesurgeries have set him back...requiring iv antibiotics every six hours and constant care. through the archoices program -- shannon receives care at home...his mom is paid as a caregiver...so he can have those supports...while retaining some independence...and a plan for the future.[lana brumley, shannon's mother] "we're getting older. there's going to come a time when e be able to do it.
"8 thousand other elderly arkansans and those with physical disabilities - rely on this state program...to keep them out of nursing homes. [craig cloud - department of human services]"it was important to make sure benficiaires were assessed fairly and objectively.
"in january 2016 - dhs started a new system...to award hours.... [craig cloud - department of human services]"i know there are some who may not have agreed with the outcome or the output, but i believe we are doing hte best job possible.
" that new system uses computer-based assessments...to place people into resource utilization groups -- or rugs. [craig cloud - department of human services]"we place the le to t their . before --- n asse clients and assign hours...wi oo to adjust based on perceived need. now - answers to 280 questions are plugged into an algorithim - or mathematical formula -- to produce a score...you may have heard of algorithims before..it's essentially the same technology that creates rules that produce outcomes. it's what generates your google search results...and what's used to decide what shows up in your facebook newsfeed...only in this system...instead of deciding what videos show up on your screen...the formula determines the hours of life-sustaning care someone receives.[craig cloud - department of human services]"the answers they input...we are assigning those hours based on the rug level they are placed into.
"according to the department of human services... this system prevents patients with similar needs from receiving vastly different care hours because of nurse discretion...although there had never been a documented complaint about the process...dhs says its being proactive...[julie howe, center for arkansas legal services]"we really haven't seen much good come from the algorithim.
" others argue the outcomes have only functioned to punish patients...[julie howe, center for arkansas legal services]"about 4,000 people acros t at o arkansas have been affected by reduio t the archoices program.
"the center for arkansas legal services -- has received calls from hundreds of people...saying their hours had been drastically reduced...or even eliminated. [julie howe, center for arkansas legal services]"we had one gentleman come to us -- he's 103ar. he had been on the program for 13 years...and received 156 hours a month...but was deemed ineligible under the new system...shannon - had been receiving 56 hours a week - or 8 hours a day under the old system[shannon brumley, archoices client]"for a quadrapelegic who can do nothing for himself..that's minimal.
"under the algorithim...that dropped... [shannon brumley, archoices client]"cut 37 hours...to 37 hours a week...or five hours a day...[shannon brumley, archoices client] that's just sorry.
"a cut of 35 percent.[shannon brumley, archoices client]"i wish they had to be in my position. one week. go live my life for one week.
" [lana brumley, shannon's mother]"i worry alot about shannon.
"shannon's limited income from disability...wouldn't support hiring someone outside the home...to make up the hours[lana brumley, shannon's mother]"i think i worry more about what w hpe when we're not here to care for him anymore.
"over the years...shannon has found ways [shannon brumley, archoices client]"i push forward - and it splits it.
"to overcome...and find his own version of a quality life.marci: this is the place that you heal.. shannon:yes - . this is home.everyday challenges --like chopping wood --and mowing the lawn... make him stronger..but if the cuts in hours keep coming...[shannon brumley, archoices client]"i i'll more than likely have to go into a nursing home.
" shannon's afraid he...and others...may end up having to leave home behind. working 4 you, i'm marci manley. ((ashley)) d-h-s says a significant number of people actually received an ?increase? under the system -- but they have not provided us data on that. nurses still go out to the homes, observe patients and assess their needs...to provide the answers the algorithim analyzes. tomorrow, in part two of our series -- we walk you through that process from nurse observations to hour allocations. plus we look at why finding out the reason a person's hours are increased or reduced -- isn't just simple math.