Disabled college student's future depends on ruling

The Associated Press
February 08. 2003 11:42AM


Nick Dupree is a quadriplegic who depends on a ventilator for life and Medicaid regulations for his future care. He's approaching a medical crisis.

His work on a degree at Spring Hill College and hopes of becoming a writer could vanish Feb. 23. That's when Dupree turns 21. By then, if the state doesn't modify its Medicaid regulations that now permit in-home nursing care benefits, Dupree could be forced into a nursing facility, possibly in another state.

Dupree said he feels "nervous, worried, upset" about the approaching deadline.

He has a rare form of muscular dystrophy and requires full-time care.

A court hearing on Dupree's plight is set for 1 p.m. Tuesday in Montgomery before U.S. District Judge Mark Fuller. At issue is a motion that seeks to prevent the Alabama Medicaid Agency from cutting off his 16-hours-a-day home nursing care, pending the outcome of a lawsuit filed for him.

Dr. Lawrence Sindel, Dupree's physician, said Dupree would be at serious risk of injury or death if placed in a nursing facility, the suit says. And if the ventilator malfunctions or is unattended, he will die.

Dupree's 18-year-old brother, Jamie, also requires in-home care. Also a student at Spring Hill, he has the same form of muscular dystrophy as Nick and is a quadriplegic on a ventilator.

Alabama's Medicaid program also pays for a nurse to accompany each of them to classes. But Medicaid discontinues this aid when they become 21.

After Nick's next birthday, Medicaid will pay for his care only in a nursing home. He also faces the loss of critical prescribed medical equipment.

Dupree is a junior at Spring Hill,a part-time student who has a 3.54 grade point average. His brother is a full-time student and regularly makes the Dean's List at the college. He is a sophomore.

The two live with their single mother, Ruth Belasco, who is a professor of fine arts at the private Roman Catholic college.

Belasco said she pays $364 a week for additional nursing help beyond the care paid for by Medicaid. She also spends many hours helping to care for the boys and maintaining their ventilators.

Last winter, then-state Sen. George Callahan, R-Mobile, introduced legislation to make Medicaid continue in-home nursing services to people who qualified for such care before turning 21.

Callahan, who loss his re-election bid in November, said the bill died because of pressure brought by representatives of the Alabama Medicaid Agency.

A spokeswoman for the agency said the bill would have discriminated against people who didn't need such care until after age 21.

Medicaid policy adviser Mary Finch said last year that Alabama could face costs of $27 million to $78 million if the state created an in-home nursing benefit for adults.

The motion for a preliminary in junction, filed with a lawsuit recently by Montgomery lawyer Larry Menefee, names as defendants Gov. Bob Riley and state Medicaid Commissioner Mike Lewis.

They are being sued in their official state capacities. Repeated attempts by the Mobile Register to reach Lewis about the case were unsuccessful.

"This is the nearest thing to the death penalty I've encountered in civil litigation," Menefee told the newspaper. "It's a tragic situation."

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