Because of his cerebral palsy, the 40-year-old, who works at an environmental engineering firm and loves attending sports games of nearly any type, depends on his home care support person for assistance with things most people take for granted, like meals and bathing.
Every morning, Seiler’s support worker lifts him out of bed, positions him in his wheelchair and helps him get dressed for the coming workday. The worker checks back in at lunch time to help with lunch and toileting, then returns again in the evening.
But when Seiler’s home state of Idaho created an automated system – an algorithm – to apportion home care assistance for people with disabilities in 2008, it cut his home care budget in half. He faced being unable to even use the bathroom at reasonable intervals.
“It was awful,” said Seiler, who feared he would be forced into an institution. “I can’t even get up in the morning if I don’t have help. This would take all my freedom and independence.”
Like Seiler, thousands of disabled and elderly people in more than a dozen states have had to fight against decisions made by an algorithm to get the support services they need to remain in their homes instead of being institutionalized.
The cuts have hit low income seniors and people with disabilities in Pennsylvania, Iowa, New York, Maryland, New Jersey, Arkansas and other states, after algorithms became the arbiters of how their home health care was allocated – replacing judgments that used to be primarily made by nurses and social workers.
“Since the pandemic, individuals are coping with so many different forms of stress that might be activating a compassionate part of them that they...